Covid-19 News

It is very very unfortunate that COVID response has become a political issue in the US.

There is no good solution to this. What is being done will change the economy forever and scar the country.

Letting the disease run without control would overwhelm health services and (most people) would find the high death toll impossible.

With enough preparation, and will, a sweet spot could be found where ALL at high risk people (rich and poor, citizens and illegal immigrants) are very completely shielded, where all nursing homes etc are very completely shielded (lots of testing and PPE), where hospitals are made properly free of charge for everything COVID-related, where then for everyone not at high risk life continues as normal.

No country had enough time to organise that, and frankly few countries would have the political will to do it - there is still quite a high death toll. But arguably less than the total deaths as result of COVID + lockdown.

Otherwise I understand it is worse overall (long term) to lock countries down. But it would be the action of a monster not to lock countries down.

I don't see this is a political issue in any country except the US - and it is that there because of polarization of politics. That is everyone's fault - but I have to say current POTUS is a more polarising even than is usual in the US and the wrong person for this crisis for that reason, whatever your politics.

I have one (idealistic) hope. The terrible suffering from COVID lock down could be used to speed up transformation to lower carbon economy. That process would be painful anyway. If we make sure that the necessary reconstruction is pushed towards what we know will be needed long term then some of the societal harm (long term) is minimised. It does nothing for those who lose now. Cushioning that is the job of governments (if you think they should) or how the cookie crumbles if you think governments should stay out.

I'd also like to think that this will cause everyone to think countries should be run so that everyone in the country has an adequate place to live, adequate food, with adequate basic health care.

Another interesting story on what the actual number of infections may be:

1. Obviously could be a positive in terms of the actual mortality rate

2. But if it’s true, it’s mind boggling how quickly the virus has run through the population.

https://www.cnbc.com/2020/04/2…-than-reported-cases.html

Sure put an end to the concept of the American Dream, of endless pursuit of economic growth and international global competition rather than cooperation. All laid out in capitalist socialism of the UK Labour Party and US Democrats. The will to do it is there, but the fundamental weakness of democratic systems is to elect charismatic psychopaths or 'buffoons' who gain political power by spinning dreams which their electorate are so easily fooled, by wishful thinking, into believing almost like a religion or cult. Hence the present ridiculously unstable political situations in the US and UK.

Quote from Wyttenbach

But such figures tell nothing as we don't know the real number of affected, the number of immune people not even showing antibodies, hidden mortality e.g. in care homes etc..

In Canada we report fatalities from nursing homes. Like Sweden almost half of Covid19 related deaths are from nursing homes.

About immune people without antibodies : this is hardly appreciated! The innate immune system reacts first and quickly to infection. If it doesn't end the infection, then the adaptive immune system - involving antibodies - starts kicking in, I think from about four days or so. Also, the innate immune system has a memory, although not as specific or long lasting as the adaptive system.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5917086/

Many people have robust innate immune systems, particularly younger people. Who knows what percentage of people have dealt with a Covid19 infection without even the need to call on an antibody response. It could be half of our population for all we know, mostly younger people. Again, this exposure and immunity wouldn't show up in a blood antibody test.

This might be in part why - even with highly transmissible disease like flu - only something like 15 percent of the population shows infection, and yet the disease rather mysteriously disappears. At first there is a fast exponential increase to large numbers as the virus shows its ugly face by burning through the populations which have vulnerable immune systems.

Quote from Dr Richard

Sure put an end to the concept of the American Dream, of endless pursuit of economic growth and international global competition rather than cooperation. All laid out in capitalist socialism of the UK Labour Party and US Democrats. The will to do it is there, but the fundamental weakness of democratic systems is to elect charismatic psychopaths or 'buffoons' who gain political power by spinning dreams which their electorate are so easily fooled, by wishful thinking, into believing almost like a religion or cult. Hence the present ridiculously unstable political situations in the US and UK.

Yup. Its not great. But then the fundamental weakness of dictatorships is they are controlled by people whose only motivation is to keep power, irrespective of the good of their people.

Quote from Mark U

About immune people without antibodies : this is hardly appreciated! The innate immune system reacts first and quickly to infection.

We do not yet know all factors that protect some of us from covid-19. There are genetic variations that protect some from AIDS. This protective GEN strongly varies (2-10% later a rare case) among different populations. We also do not know whether a classic corona infection does help to protect you. We almost know nothing about low level virus spreading, that may cause soft immune reactions, but with a very low amount of antibodies remaining that cannot be found by a standard test.

But the results of the first antibody test look very promising and fully confirm the first logic derivation, that this new virus act like a predator only mostly affecting weak people. Lets hope we do not smile at the tip of an iceberg!

Here is a really useful blog-style but competent peer review of the Santa Clara seroprevalence prepint.

It bears out (in great detail, and convincingly) my previous comment that this study (indicating much lower than expected mortality and higher than expected asymptomatic infection rate) was fatally flawed.

We can still hope for a higher number of people to be infected: but not on the basis of this study.

THH

From above link (conclusions after much detail):

To summarize, there are three broad reasons why I am skeptical of this study’s claims.

1. First, the false positive rate may be high enough to generate many of the reported 50 positives out of 3330 samples. Or put another way, we don’t have high confidence in a very low false positive rate, as the 95% confidence interval for the false positive rate is roughly [0%, >1.2%] and the reported positive rate is ~1.5%.
2. Second, the study may have enriched for COVID-19 cases by (a) serving as a test-of-last-resort for symptomatic or exposed people who couldn’t get tests elsewhere in the Bay Area and/or (b) allowing said people to recruit other COVID-19 cases to the study in private groups. These mechanisms could also account for a significant chunk of the 50 positives in 3330 samples.
3. Third, in order to produce the visible excess mortality numbers that COVID-19 is already piling up in Europe and NYC, the study would imply that COVID-19 is spreading significantly faster than past pandemics like H1N1, many of which had multiple waves and took more than a year to run their course.

These points may be mistaken. If so, I welcome corrections. And it would be wonderful news as it would imply we were much closer to herd immunity at a lower cost than people thought.

Alternatively, if these points are correct, we should try to do a second round of serosurveys that (a) aggressively reduces the false positive rate with many controls and possibly multiple independent tests and (b) that uses some form of unbiased recruitment for the serosurvey, potentially similar to jury duty.

While I disagree with the conclusion of the paper, I want to thank the authors for their hard work and hope that these comments prove useful in future serosurveys.

They are certainly cracking out the HCQ Z-pak Anti Bat Combo: The question arises does this enthusiastic use without scientific verification show up positively in the statistics of cases and deaths from COVID-19. Any suggestions?

Sermo Reports Week 3 Results: Globally 17% Point Increase in COVID Treaters Who Have Used Hydroxychloroquine (33%-50%) and Azithromycin (41%-58%)

April 15, 2020

Percentage of New York Physicians Who Have Used Hydroxychloroquine Nearly Doubled, Italian and French Physicians Jumped 30% Points + Over 2 Weeks

Plasma Still Perceived as Most Effective but Not Widely Used

Perception of Hydroxychloroquine’s Efficacy is Significantly Higher Among Physicians in Europe and China vs US Physicians (50% vs 29%)

New York, New York – April 15, 2020 – Week three data of the Barometer study from 4016 physicians in 30 countries conducted by Sermo reveals the emergence of treatment patterns and efficacy perceptions. Sermo, the largest global healthcare polling company and social platform for physicians, has published unrestricted access to the results of its Real Time Barometer study on sermo.com.

Key findings:

In Wave 3 we explored perceptions of physicians who were high vs moderate vs low treaters of COVID patients. The total number of physician respondents for Wave 3 was 4016. Of those, 33% treated COVID patients (n=1337).

The COVID treaters (1337) breakdown was:

• 42% of COVID treaters have treated between 1-5 patients
• 20% of COVID treaters have treated between 6 -10 patients
• 38% of COVID treaters have treated between 11 and more patients

We did not find significant differences between highly active and low active COVID treaters in the below findings.

Usage patterns among COVID treaters (N= 1337)

• The top three treatments that doctors reported having prescribed were Azithromycin (58%), Hydroxychloroquine (50%), and Bronchodilators (48%); traditional Chinese medicine has been used by 67% of physicians in China.

Week over week increases in usage

• Percentage of physicians in New York who have used Hydroxychloroquine nearly doubled since Wave 1 week of March 25 (23% to 40% to 43% wave over wave).
• Italy and France had the highest increase in COVID treaters having prescribed Hydroxychloroquine wave over wave; an increase from 50% to 83% for Italy and an increase from 20% to 50% for France.
• The number of COVID treaters that report having used Hydroxychloroquine and Azithromycin both increased 17% points since Wave 1 the week of March 25.
  • Hydroxychloroquine Wave 1: 33%, Wave 2: 44%, Wave 3: 50%
  • Azithromycin Wave 1: 41%, Wave 2: 50%, Wave 3: 58%
• The number of COVID treaters that report having used Bronchodilators increased 12% points (from 36% to 48%) week over week.
• Usage of anti-HIV drugs (e.g. Lopinavir plus Ritonavir), drugs to treat the flu (e.g. Oseltamivir), and plasma from recovered patients remains steady week over week, while use of non-approved drugs (e.g. Remdesivir) decreased slightly.

Perceived treatment efficacy

• Physicians who treat COVID patients in Italy, Spain, France, and China have higher perceptions of Hydroxychloroquine’s efficacy vs the US (~50% vs 29%).
• The top treatments that have been used/seen used and reported as very or extremely effective among COVID treaters (N= 1337) include:
  • 46% plasma from recovered patients (n=363); 40% Hydroxychloroquine (n=875); 38% high dose steroids during a cytokine storm (n=556)
  • No significant differences of perceived efficacy were observed between highly active COVID treaters and users of these drugs (physicians treating 11+ patients) and lower active COVID treaters (1-10 patients)
  • 55% of physicians in China who have used traditional Chinese medicine rated traditional Chinese medicine as effective or extremely effective

Most popular Hydroxychloroquine dosage regimen

• 75% report using 400mg BID on day one (800mg total), then 400 mg daily for 4-5 days
• 10% report using 600mg BID on day one (1,200mg total), then 400 mg daily for 4 days

Methodology

Most results are reported for individual countries with a minimum sample size of 250. A sample size of 250 point estimates have a precision of a +/- 6% precision at a 94% confidence level. Where sample sizes are smaller, N sizes are noted. Thirty countries included in the study are the United States, Canada, Argentina, Brazil, Mexico, Germany, Italy, the United Kingdom, France, Spain, Belgium, the Netherlands, Sweden, Turkey, Poland, Russia, Finland, Ireland, Switzerland, Austria, Denmark, Norway, Greece, Taiwan, Japan, South Korea, Australia, China, India, and Hong Kong. No incentive was offered to respondents. Full methodology.

About Sermo

Sermo is the largest healthcare data collection company and social platform for physicians, reaching 1,3MM HCPs across 150 countries. The platform enables doctors to anonymously talk real-world medicine, review treatment options via our proprietary Drug Ratings platform, collectively solve patient cases, and participate in medical market research. For more information, visit sermo.com.

Media Contact:

Niki Franklin

Racepoint Global on behalf of Sermo

+1 617 624 3264

[email protected]

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Quote from Wyttenbach

Japan crossed the line of a controllable infection weeks ago, because they allowed free partying karaoke etc.

They almost crossed the line, but they are now back. See:

https://covid19japan.com/

As shown here, everywhere but Tokyo and Osaka, the daily new cases barely increased. Granted, Tokyo alone is 10% of the population, but still, much of the country is safe. Today's national totals are 330, down from the peak of 700, 9 days ago. There have been 8 days of decline. As before, the prefectural databases list every patient in detail (anonymously), so anyone can trace a contact. For example, it will say the patient is female, age 30, who works in such-and-such place, lives in such-and-such district, and took a Shinkansen train at 4:13 from Tokyo to Hakata on March 20, probably after contracting the disease. That is how closely they are monitoring and tracing. Every city and town office clerk is now doing that.

Also, it turns out that most of the cases in Tokyo were not from karaoke ect. but from hospital infections. There were several clusters ranging from 20 to 50 in hospitals and nursing homes.

Does this strike anyone as a good idea? What do they think it will do to the curve? Do they even know what a curve is?

Quote

Way more people may have gotten coronavirus than we thought, small antibody study suggests

By Tia Ghose - Assistant Managing Editor 2 days ago

Between 50 and 85 times as many people in Santa Clara County have coronavirus antibodies as have tested positive for the virus.

https://www.livescience.com/co…pread-in-santa-clara.html

The above is a widely cited study (also known as the "Stanford Study") because if valid, it suggest that the mortality rate of COVID-19 is way lower than first thought-- maybe 50x lower. Unfortunately, the antibody test currently has significant false positives. Why is this a problem? Because if you take a large sample, few of whom are really positive, even a small percentage of false positives will be a large number. And it will be an error. The paper below suggests that even as small an error rate as 1-2% false positives would invalidate the study. This would also applies to the Los Angeles area study which similarly concludes that way more people than was known have had asymptomatic infections.

Dr. Birx, on the President's panel (USA) knows this but when she tried to explain it today on TV, it appeared that nobody in the room understood it and I did not see it reported. I saw another study which found 22 antibody positive people in a population of around 1000 IIRC. When they interviewed these people every one of them recalled having had symptoms. So is there a large incidence of people with COVID-19 antibodies who have had no symptoms. Nobody knows but I am guessing possibly not.

"Peer Review of “COVID-19 Antibody Seroprevalence in Santa Clara County, California”

The high reported positive rate in this serosurvey may be explained by the false positive rate of the test and/or by sample recruitment issues."

https://medium.com/@balajis/pe…y-california-1f6382258c25

ETA: sorry THHuxleynew , I just saw you had already posted the medium.com article. Well, it's worth repeating!

Quote from seven_of_twenty

Georgia re-opening . . .

Does this strike anyone as a good idea? What do they think it will do to the curve? Do they even know what a curve is?

My sister does not think this is a good idea. She just told me: "no bowling for you!"

I say, Hey! Everything is under control. We had only 1,242 new cases and 94 deaths today. Only who knows how many, because the state Health Dept. records showed no deaths in a nursing home that actually 14 deaths. But who's counting? No one!

There is nothing to worry about. All over town signs popping up saying: EVERYTHING WILL BE OK.

https://www.ajc.com/news/local…s/1OrY3nikCcQsaX3RmthpjP/

Apparently, Georgia hospital doctors & nurses do not think everything is hunky-dory. They just asked us to sew 100 more mask covers. Apparently this is happening all over the U.S. because vendors everywhere are out of elastic, bias tape, and ribbons (to tie on the mask covers). Or their websites say they will only ship to people who are making hospital mask covers.

Quote from Shane D.

No, it is not good idea if you look at it from only one perspective...yours. A Governor can not be so myopic though, as they have to look at the big picture, and not just focus on a small part of it. They have to take into consideration not just those lives they are trying to save, but also those they will lose in trying to save them. It is a balancing act, and either way, there will be lives lost. Much like what any General is faced with on the battlefield.

This is like a general who orders the troops to surrender without firing a shot. Sort of like the French army in 1940.

Quote from Shane D.

As to the curve, and what the Georgia Governors decision "will do to it"...we will find out soon enough, as many states, both blue and red, many countries, are about to start, or in the process of, reopening. Worse case scenario, we have the capacity, and medical infrastructure to handle it.

We do not have the medical infrastructure to handle it today. Or the doctors and nurses. Georgia hospitals are still putting people in tents and an emergency facility in a conference center. Doctors and nurses are run ragged, and they are getting sick in large numbers. There are still not enough masks, so people are sewing cloth covers. They are cleaning and recycling masks. Nurses in some places are still wearing garbage bags instead of protective clothing.

Worst case scenario, best case, and only case scenario: the rate of increase will back to what it was in mid-March, doubling every 3 days. So, if the governor does not re-impose the lock-down, NINE DAYS later, instead of having 1,242 cases per day, we will have 10,000 cases. Nine days after that we will have 80,000 per day.

That is what must happen if we go back to the pre-lock-down situation. The situation has not changed. Human biology has not changed since mid-March. There is no monitoring or follow up of cases. Georgia is #45 in testing. The health department cannot even keep track of deaths, never mind cases.

Shane D. wrote

Quote

As to the curve, and what the Georgia Governors decision "will do to it"...we will find out soon enough, as many states, both blue and red, and many countries, are about to start, or in the process of, reopening. Worse case scenario, we have the capacity, and medical infrastructure to handle it. Best case scenario, the world can start investigating how we were frightened into such a draconian measure, as shutting down a large part of our economy

In a worst case scenario, things get so bad that everyone has to go back to even stricter restriction and thousands of people die needlessly. And the economy of Georgia is struck again only this time, harder. I suspect that this will happen although of course, I hope it will not.