COVID-19 | science, damage limitation, NO POLITICS

[Manoli]

Manoli, armand, many thanks for your contributions regarding Greece, they were much appreciated.

Keith, thank you.
Thought you may also appreciate an NYT article on the 'Fauci's' this side of the Atlantic.
https://www.nytimes.com/2020/04/05/world/europe/scientists-coronavirus-heroes.html?referringSource=articleShare

Manoli

[KLaban]

Keith, thank you.
Thought you may also appreciate an NYT article on the 'Fauci's' this side of the Atlantic.
https://www.nytimes.com/2020/04/05/world/europe/scientists-coronavirus-heroes.html?referringSource=articleShare

Manoli

Thanks for that.

There's no doubt that respect for the scientific and medical sectors has blossomed whilst that for politicians - career and those wannabes  as witnessed on LuLa - has shrivelled.

Keith

[Alan Klein]

Not 34 pages, but post #644.

**/off-topic**

I wish them a lot of luck.  The tourist industry and travel, cruise ships, hotels, air travel,Disney, etc are going to be hard hit for a long time.  I like traveling but I'm really nervous especially due to my age. 

[LesPalenik]

After a few days of less than 2,000 deaths in USA, the daily death total jumped again to 2,400.

[Robert Roaldi]

Is it my imagination or is weekend data often a little wonky?

There is a footnote on Worldometer about 3000 deaths in New York whose classification is confused.

The footnote reads, 'New York City today has reported 3,778 additional deaths that have occurred since March 11 and have been classified as "probable," defined as follows: “decedent [...] had no known positive laboratory test for SARS-CoV-2 (COVID-19) but the death certificate lists as a cause of death “COVID-19” or an equivalent" [source]. We will add these to the New York State total as soon as it is determined whether the historical distribution can be obtained'

[LesPalenik]

The daily totals are fluctuating up and down, but the overall trend for Canada, USA, worldwide is still going up. OTOH, West European countries seem to be on an downward slope.

[Paulo Bizarro]

The daily totals are fluctuating up and down, but the overall trend for Canada, USA, worldwide is still going up. OTOH, West European countries seem to be on an downward slope.

In Portugal, as of late Ifind it more representative to look at:

1. 7 days moving daily average, to smooth out any "noise" introduced by the lagtime between testing and getting results. Also results seem to accumulate during weekends, which results in early week spikes of daily cases.

2. Numbers of patients addmited into hospitals.

3. Number of patients in ICU.

For the last 7 days, #1 is hovering at around 700, and #2 and #3 are slowly coming down.

Number of deaths today stands at 599, mostly older people, and about 1/3 in caring homes for older people. The latter I criticise a lot, because there was ample time in Portugal for government and institutions to prepare. By the time visits were prohibited, about 1 month ago, the virus was already there.

There is now talk of slowly opening up in May, but with many restrictions: limited number of people in restaurants, shops, etc, general use of non-cirurgical maks for people, etc. Every 30 working days, Portugal's GDP goes down 6%, so clearly a strict quarantine is not sustainable for long.

[Alan Goldhammer]

I am breaking my no posting about SARS-CoV-2 only to inform those who are interested that the weekly aggregations of my email newsletter are now up at:  https://agoldhammer.com/covid_19  If there are any LuLa readers who wish to subscribe to the "free" newsletter, send me a private message. 

Returning to radio silence.

[Robert Roaldi]

I am breaking my no posting about SARS-CoV-2 only to inform those who are interested that the weekly aggregations of my email newsletter are now up at:  https://agoldhammer.com/covid_19  If there are any LuLa readers who wish to subscribe to the "free" newsletter, send me a private message. 

Returning to radio silence.

Thank you.

[Alan Klein]

I am breaking my no posting about SARS-CoV-2 only to inform those who are interested that the weekly aggregations of my email newsletter are now up at:  https://agoldhammer.com/covid_19  If there are any LuLa readers who wish to subscribe to the "free" newsletter, send me a private message. 

Returning to radio silence.

Nice job Alan.  Two questions.  What are the odds for a cure remedy for those who have caught it?  What about a vaccine? Will the disease die out on its own or continue through the summer and fall? Will their be a new strain next year?  I'll send you these questions through direct email but would appreciate if you answer here so everyone an gain your insights. Thanks.  Alan K.

[Alan Klein]

This is what the governors are looking at and why they'll act sooner than later.  For one, NY Governor Cuomo is looking at a 78% decline in the NY manufacturing index.  The other economic news is just as dire. 

The economic data is even worse than Wall Street feared: ‘The economy is clearly in ruins here’

"Consumer and manufacturing reports for March showed the hit to the economy from the coronavirus was even swifter and deeper in the early weeks of the shutdown than expected.

March retail sales fell 8.7%, the most ever in government data, and New York regional manufacturing activity hit an all-time low, declining a shocking 78.2%. Industrial production slipped 5.4% and manufacturing was down 6.3%, a record reflecting in part the 28% decline in auto production as plants shut down."
https://www.cnbc.com/2020/04/15/the-economic-data-is-even-worse-than-wall-street-feared-the-economy-is-clearly-in-ruins-here.html

[Paulo Bizarro]

I am breaking my no posting about SARS-CoV-2 only to inform those who are interested that the weekly aggregations of my email newsletter are now up at:  https://agoldhammer.com/covid_19  If there are any LuLa readers who wish to subscribe to the "free" newsletter, send me a private message. 

Returning to radio silence.

Alan, thanks, impressive work.

[Alan Goldhammer]

Nice job Alan.  Two questions.  What are the odds for a cure remedy for those who have caught it?  What about a vaccine? Will the disease die out on its own or continue through the summer and fall? Will their be a new strain next year?  I'll send you these questions through direct email but would appreciate if you answer here so everyone an gain your insights. Thanks.  Alan K.

It is highly likely that one of the vaccine trials will succeed.  Several of the vaccines being tested are entirely new delivery platforms and this is their first testing in humans.  We have no idea whether they will even work.  Some companies are using more traditional ways of making vaccines and I think stand a better chance of success. The bigger question is how much safety data will be required.  Most late stage vaccine trials enroll 50,000 patients so they can reliably detect a 1 in 10,000 rare adverse event.  Whether the public will tolerate a less tested vaccine that 'might' have some bad effects at a rate such as that will be a question for policy makers.  Personally, I would not accept a vaccine that does not pass that threshold.   

What we need is a good oral antiviral drug that can be given to those who are first diagnosed.  Unfortunately, none of the trial data that I have seen gives me any optimism.  We also need a drug that is 'relatively' safe as opposed to hydroxychloroquine which has some nasty side effects (it's half life in the body is measured in days not hours!!).  Remdesivir, an antiviral developed for Ebola, has shown a bit of promise but it has to be administered IV so it's use is limited.  It's also not clear at what stage in the illness it will be effective.  There are some monoclonal antibodies that slow down the immune response which may help those who are in the worst shape (patients whose immune system over react tend to have very poor clinical outcomes).  There is also work looking at using purified antibodies from those who have recovered.  While this on paper looks like it would work, sera from just one person can only treat 2 or maybe 3 people.  We will need to develop monoclonal antibodies that can be produced at large scale to substitute for this.  there is a lot of work going on in that area and we should have some clinical material in 1-2 months.

THIS IS ONLY MY OPINION:  The reason for shutting things down was to alleviate a total meltdown of the healthcare system.  there was a statistic in the paper today that maybe as many as 9000 healthcare workers contracted SARS-CoV-2.  Had we not engaged in severe social distancing things would have gotten even worse.  there would have been rolling shutdowns of many stores and manufacturing facilities had the pandemic continued without social distancing.  that would have had an adverse impact on the economy (look at what happened in Sioux Falls, SD where they had to shutter a meat processing plant because 400 people caught the virus).  I am optimistic that with a lot more testing we can understand the base rate of infection and make an intelligent decision on how to open things and what kind of controls are to be put in place.  Only with a well thought out testing regime can we then confidently identify hot spots quickly and take action.  Harvard economist Larry summers pointed out that each week we are shut down costs about $80 billion a week.  If we took a portion of that and invested it right now in testing scale up we could recoup the investment by opening things weeks ahead of the plodding schedule we are presently on.

Back to Radio Silence

[Alan Klein]

Alan  What about gene therapy.  The fact that an Amur Tiger at the Bx. Zoo but not other cats was infected by a human handler shows the virus effects particular species.  The Amur tiger comes from China among other areas in Asia.  Maybe the virus started with one and was transferred to humans there.  In any case, is anyone looking into gene therapy and trying to find markers in the DNA?

[John Camp]

Not exactly science, but definitely not politics:

Here in New Mexico, and I believe also in Arizona, the Navajo Indian Nation is really being hit hard. In a county dominated by the reservation, there have been 192 confirmed cases, and 10 deaths. Just out of curiosity, and because I'm an Iowa native, I clicked on the county that has Iowa's biggest reservation (which is not very big, the entire county has a population of only 16,000) has 108 confirmed cases and two deaths. This makes me wonder if Indian reservations are being hit harder than the general population, and if so, whether the cause might be genetic (lack of some kind of immunity, as with the early plagues that wiped out so many Indians during the European settlement here) or cultural. In the case of the Navajos, the talk I've heard is that the cause is likely cultural, with many multi-generational families living together, rather than the single-family homes typical of the rest of the U.S.

In Alan's post, he talks about being worried about 1 in 10,000 adverse event (which I assume means death or some other catastrophic illness as happened with the polio virus accident back in the 50s) but I'm of the opinion that a 1-in-10,000 as a theoretical possibility would be acceptable, given that the death rate among confirmed cases of the virus seem to be about 1% (one in a hundred.) It might be that such a vaccine could be targeted at the elderly, who seem to have much greater than a 1% death rate. We do that currently, with a flu vaccine designed specifically for the elderly, although I'm not sure whether that is a slightly different vaccine, or just a larger dose of the standard vaccine. If we do get a vaccine that doesn't have the full safety protocol, but is "believed" to be safe, I think the government should indemnify the manufacturer against claims.

I've been following the Sweden situation. Now 1,203 deaths with 11,927 confirmed cases of Covid-19. That's a death rate of 10% among confirmed cases.

[Robert Roaldi]

Not exactly science, but definitely not politics:

Here in New Mexico, and I believe also in Arizona, the Navajo Indian Nation is really being hit hard. In a county dominated by the reservation, there have been 192 confirmed cases, and 10 deaths. Just out of curiosity, and because I'm an Iowa native, I clicked on the county that has Iowa's biggest reservation (which is not very big, the entire county has a population of only 16,000) has 108 confirmed cases and two deaths. This makes me wonder if Indian reservations are being hit harder than the general population, and if so, whether the cause might be genetic (lack of some kind of immunity, as with the early plagues that wiped out so many Indians during the European settlement here) or cultural. In the case of the Navajos, the talk I've heard is that the cause is likely cultural, with many multi-generational families living together, rather than the single-family homes typical of the rest of the U.S.

In Alan's post, he talks about being worried about 1 in 10,000 adverse event (which I assume means death or some other catastrophic illness as happened with the polio virus accident back in the 50s) but I'm of the opinion that a 1-in-10,000 as a theoretical possibility would be acceptable, given that the death rate among confirmed cases of the virus seem to be about 1% (one in a hundred.) It might be that such a vaccine could be targeted at the elderly, who seem to have much greater than a 1% death rate. We do that currently, with a flu vaccine designed specifically for the elderly, although I'm not sure whether that is a slightly different vaccine, or just a larger dose of the standard vaccine. If we do get a vaccine that doesn't have the full safety protocol, but is "believed" to be safe, I think the government should indemnify the manufacturer against claims.

I've been following the Sweden situation. Now 1,203 deaths with 11,927 confirmed cases of Covid-19. That's a death rate of 10% among confirmed cases.

There has increasing worry about the state of things in Canada's northern reserves. Aside from whatever distancing issues there may be, e.g., larger numbers of people under one roof, hospital facilities in those locations would be inadequate to the task of coping with a Covid-19 outbreak. The folks woudl have to be flown elsewhere, not a simple thing.

That 10% number for Sweden seems like an outlier, comparable to the early numbers out of China. As Alan G. has said many times, until we get widespread testing of large numbers of people, we don't really know the actual rate of infection, although it was mentioned in another post that mortality seems to heading for the 0.3% to 1% range, which is plenty high enough.

It appears as though the US number of deaths has recently settled at 2000 per day, or at least it shows no obvious signs of increasing. But if it's true that the New York numbers are flattening, this means that they are increasing in other states. The new cases per day has been hovering at around 30,000 per day. As someone else suggested, a moving 7-day average plot would be nice to see.

[Manoli]

The Robert Koch Institute estimates that in Germany the R0 is now between 0.8-1.2.  The value represents how many people one positive patient will infect.  If it's below 1, it means the virus will run out of healthy hosts to infect. 

That’s good progress. 
Social distancing works.

[Paulo Bizarro]

Not exactly science, but definitely not politics:

Here in New Mexico, and I believe also in Arizona, the Navajo Indian Nation is really being hit hard. In a county dominated by the reservation, there have been 192 confirmed cases, and 10 deaths. Just out of curiosity, and because I'm an Iowa native, I clicked on the county that has Iowa's biggest reservation (which is not very big, the entire county has a population of only 16,000) has 108 confirmed cases and two deaths. This makes me wonder if Indian reservations are being hit harder than the general population, and if so, whether the cause might be genetic (lack of some kind of immunity, as with the early plagues that wiped out so many Indians during the European settlement here) or cultural. In the case of the Navajos, the talk I've heard is that the cause is likely cultural, with many multi-generational families living together, rather than the single-family homes typical of the rest of the U.S.

In Alan's post, he talks about being worried about 1 in 10,000 adverse event (which I assume means death or some other catastrophic illness as happened with the polio virus accident back in the 50s) but I'm of the opinion that a 1-in-10,000 as a theoretical possibility would be acceptable, given that the death rate among confirmed cases of the virus seem to be about 1% (one in a hundred.) It might be that such a vaccine could be targeted at the elderly, who seem to have much greater than a 1% death rate. We do that currently, with a flu vaccine designed specifically for the elderly, although I'm not sure whether that is a slightly different vaccine, or just a larger dose of the standard vaccine. If we do get a vaccine that doesn't have the full safety protocol, but is "believed" to be safe, I think the government should indemnify the manufacturer against claims.

I've been following the Sweden situation. Now 1,203 deaths with 11,927 confirmed cases of Covid-19. That's a death rate of 10% among confirmed cases.

I think the regional variability in social and economical conditions is one of the drivers of how the infection spreads. In Portugal, 60% of the cases are in the north, and some possible explanantions have been proposed:

1. Industries are mostly there, fashion, shoes, cars, etc. Strong ties to Italy and Spain. First cases were people returining from fashion fairs in Milan, or from Carnival break vacations in the snow in northern Italy.

2. When the state of emergency was declared, those factories kept on working at reduced levels, because that work can not be done at home, and wewanted to mitigate the impact on the economy.

3. Finally, families in the north are more traditional, in many homes 3 generations live together - with the increasing risk of children, who are mostly asymptomatic, infecting older people. This was similar to Italy, where schools were closed and children infected their grandparents.

4. One third of deaths in Portugal are in nursing homes for old people so clearly preparation was neglected. Similar to Italy and Spain.

[Paulo Bizarro]

The Robert Koch Institute estimates that in Germany the R0 is now between 0.8-1.2.  The value represents how many people one positive patient will infect.  If it's below 1, it means the virus will run out of healthy hosts to infect. 

That’s good progress. 
Social distancing works.

In Portugal the estimation now for R0 is 0.8. Scientists say that once it goes down to 0.7 it would be "safe" to reopen, with the necessary cautionary measures. The EU recently has proposed a set of reopening recommendations for EU countries to follow. But of course once countries start to reopen the R0 will go up again. The challenge will be to balance this "game".

Several factories have reopened yesterday (e.g. Continental Mabor), but only with half of the workers. The idea is to work in 14 days shifts, the workers being replaced on rotation. Of course with desinfection, masks, etc. We will get there, but we need to prepare for a second wave and for another winter without a vaccine.

[Ray]

I tend to refrain from commenting on these Covid-19 threads because I'm retired, have no debts, have no health issues, have no children, and have an acreage property where I can grow more of my own food if the economy becomes catastrophically bad.

People who live in apartments in congested cities are in a completely different situation to mine, and I do sympathize with their fears and concerns.

However, the reason I'm making this post is the hope that some of you 'experts'    can clarify a very puzzling issue, regarding the number of Covid-19 deaths, per million of population, in certain countries.

I'm Australian, and am pleased at the relatively low total number of deaths from Covid-19, currently at 63, nation-wide, in a population of 25.5 million. The USA has approximately 13 times the population of Australia. Multiply 63 by 13 and one gets 819, a lot less than the current Covid-19 death rate in the USA, which is currently close to 30,000.

An explanation for the relatively low Covid-19 death rate in Australia is because we already have natural social distancing because we are such a large country with a small population. However, the majority of the population still live in congested cities such as Sydney, Melbourne, Perth and Brisbane.

An example of a country that has an even lower Covid-19 mortality rate than Australia, is Thailand. This is the most puzzling.

The current mortality rate in Thailand is just 46, yet Bangkok is one of the most visited cities in the world, rivaling Paris and London. The percentage of Chinese tourists in Thailand is greater than any other nationality. Considering that Thailand is not a fully developed nation, has lots of poverty and a very low minimum wage, and has very high air pollution from natural burn-off for agricultural purposes, and vehicles with inadequate emission controls, one would expect that Thailand's death rate from Covid-19 would be relatively high. Yet it isn't. It's amazingly low.

The population of Thailand is close to 70 million, yet its Covid-19 total deaths are significantly less than Australia's which has a much smaller population, and even more significantly less than so many European countries and the USA.

Any explanation, anyone?