Coronavirus Disease Weekly News 24October 2020

Written by rjs, MarketWatch 666

The news posted last week for the coronavirus 2019-nCoV (aka SARS-CoV-2), which produces COVID-19 disease, has been surveyed and some important articles are summarized here. The articles are more or less organized with general virus news and anecdotes first, then stories from around the US, followed by an increased number of items from other countries around the globe. New US cases turned up by 15% in the last week. US deaths ended a gradual decline and increased by 12%. Elsewhere, new cases are still rising again in Europe, but India, the new global hotspot, may have peaked for new cases. Economic news related to COVID-19 is found here.

Please share this article – Go to very top of page, right hand side, for social media buttons.

Summary:

New records across the board – anything I could say in summary would be eclipsed by the reality on the ground. You must know that new US cases were just short of an all time high on Thursday, easily beat the all time high on Friday, and then posted what would have been an all time high on Saturday were it not for Friday’s record. We’re easily up more than 15% week over week. US deaths spiked to 1224, the highest since August on Wednesday, and although below 1k per day the rest of the week were up nearly 12% WoW.

The same is true in Europe as well; on Thursday, 9 separate European countries hit all time highs (as 8 US states were doing the same). With Europe and the US leading, global records were set on Monday, Wed, Thurs, and Friday. Theynow top a half million new cases a day. For perspective on that, new cases first topped 400,000 only eight days earlier.

Calculated Risk is tracking the daily testing rate and results. The 24 October graphic:

The increase in new cases is coming from a slight increase in testing and a pronounced upturn in percent positive.

Another source of regularly updated data is the Johns Hopkins’ web site. Below is a graphic for Johns Hopkins for the daily global new cases since the start of the pandemic.

Also, the map from Reuters has been updated for data through 21 October. Last week the data was as of 10 October and there have been very significant changes in just 11 days. The map is interactive to show data if you click on it:

Of course, Steven Hansen summarizes and links the latest news related to the pandemic every day, 7 days a week, plus displays over a dozen important graphics updated at least daily. The most recent article at the time this is published: 24 October 2020 Coronavirus Charts and News: Early Signs Suggest The COVID-19 Pandemic May Be Propelling Drug Resistant Superbug Candida Auris.

This article leads the daily newsletter from Global Economic Intersection every day. Newsletter subscription is free.

Here are the rest of the articles for the past week reviewed and summarized:

Long-term problems in younger low-risk COVID-19 patients; flu shot may offer some protection (Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

• Long-term health problems seen in low-risk COVID-19 patients. Young, healthy adults with COVID-19 who do not require hospitalization are still at risk for long-term health problems, Oxford University researchers found. They studied 201 recovering UK patients with an average age of 44, more than 90% of whom did not have risk factors such as diabetes, high blood pressure, or heart disease. Only 18% had been sick enough to be hospitalized. At an average of 140 days after their symptoms began, 98% were still fatigued, 92% had heart and lung symptoms, 88% had muscle aches, 87% had breathlessness, 83% headaches, and 73% gastrointestinal symptoms. Organ damage was more common among those who had been hospitalized. But it was not limited to that group as 66% of the patients had impairment of at least one organ. Magnetic resonance imaging (MRI) scans showed mild damage to lungs in 33%, heart in 32%, pancreas in 17%, kidneys in 12%, liver in 10% and spleen in 6%. The researchers say their study, posted on Friday on medRxiv ahead of peer review, cannot prove the virus caused these later issues. But it does suggest long-term monitoring of organ function will be necessary even in relatively low-risk patients. (https://bit.ly/2IAR83N)
• Flu shot may help protect against COVID-19. Flu vaccines may help the body defend itself against COVID-19, according to a Dutch study that found hospital workers who got a flu shot last winter were less likely to become infected with the new coronavirus. In test tube experiments, the researchers saw that last winter’s flu vaccine could prime healthy cells to respond more effectively not just to the flu, but also to the new coronavirus. When they analyzed COVID-19 rates among staff at their hospital, they found the number of infections was 39% lower among those who had gotten a flu vaccine. “These data, combined with similar recent independent reports, argue for a possible beneficial effect of influenza vaccination against both influenza and COVID-19,” the researchers say. “This could mean that the flu vaccine could offer partial protection against both infections this winter.” They posted their report on medRxiv on Friday ahead of peer review. “We thought it was important to publish these results already because the flu shot is made available to a large group of people,” study leader Mihai Netea of Radboud University Medical Center said in a news release. (https://bit.ly/35bqEgV)

Hydroxychloroquine as pre-exposure prophylaxis for COVID-19 in healthcare workers: a randomized trial | Clinical Infectious Diseases – We investigated whether hydroxychloroquine could prevent SARS-CoV-2 in healthcare workers at high risk of exposure. We conducted a randomized, double-blind, placebo-controlled clinical trial of healthcare workers with ongoing exposure to persons with SARS-CoV-2, including those working in emergency departments, intensive care units, Covid-19 hospital wards, and first responders. Participants across the United States and in the Canadian province of Manitoba were randomized to hydroxychloroquine 400mg once weekly or twice weekly for 12 weeks. The primary endpoint was confirmed or probable Covid-19-compatible illness. We measured hydroxychloroquine whole blood concentrations. We enrolled 1483 healthcare workers, of which 79% reported performing aerosol-generating procedures. The incidence of Covid-19 (laboratory-confirmed or symptomatic compatible illness) was 0.27 events per person-year with once-weekly and 0.28 events per person-year with twice-weekly hydroxychloroquine compared with 0.38 events per person-year with placebo. For once weekly hydroxychloroquine prophylaxis, the hazard ratio was 0.72 (95%CI 0.44 to 1.16; P=0.18), and for twice-weekly was 0.74 (95%CI 0.46 to 1.19; P=0.22) as compared with placebo. Median hydroxychloroquine concentrations in whole blood were 98 ng/mL (IQR, 82-120) with once-weekly and 200 ng/mL (IQR, 159-258) with twice-weekly dosing. Hydroxychloroquine concentrations did not differ between participants who developed Covid-19-compatible illness (154 ng/mL) versus participants without Covid-19 (133 ng/mL; P=0.08). Pre-exposure prophylaxis with hydroxychloroquine once or twice weekly did not significantly reduce laboratory-confirmed Covid-19 or Covid-19-compatible illness among healthcare workers.

Tocilizumab doesn’t ease symptoms or prevent death in moderately ill COVID-19 inpatients – The drug tocilizumab (Actemra) does not reduce the need for breathing assistance with mechanical ventilation or prevent death in moderately ill hospitalized patients with COVID-19, according to a new study led by researchers at Massachusetts General Hospital (MGH). The study, published in the New England Journal of Medicine (NEJM), casts doubt on earlier research suggesting that tocilizumab, which is commonly prescribed for rheumatoid arthritis (RA) and other conditions, might be an effective treatment for patients with worsening cases of COVID-19.About 15 percent of patients with COVID-19 develop severe cases. These patients typically develop pneumonia, which reduces oxygen levels in the blood and requires hospitalization. Evidence has suggested that this life-threatening condition may be caused by a so-called “cytokine storm,” in which the immune system unleashes an abnormally high volume of inflammatory cells–which are normally protective–that damages the lungs and requires treatment with supplemental oxygen.”Inflammatory markers in the peripheral blood are elevated at sky-high levels,” . COVID-19 patients with elevated levels of a cytokine called interleukin-6 (IL-6) have a greater need for supplemental oxygen delivered with mechanical ventilation and greater risk of dying. The drug tocilizumab blocks IL-6. Stone previously conducted clinical trials that led to the approval of tocilizumab for treating another inflammatory condition: giant cell arteritis. Several previous studies suggested that tocilizumab may benefit COVID-19 patients, though none were randomized, double-blind, placebo-controlled (“gold standard”) trials needed to confirm that hypothesis.

Remdesivir has ‘no meaningful impact’ on COVID-19 survival, huge study finds | Live Science The antiviral drug remdesivir does not reduce deaths among COVID-19 patients, as compared with standard care, according to the results of a large, international trial.The Food and Drug Administration, in May, authorized remdesivir to be used in an emergency to treat COVID-19, after a large clinical trial suggested that the drug reduces the time it takes for COVID-19 patients to be discharged from the hospital, as compared with a placebo treatment, Live Science previously reported. As of August, the drug has been authorized for use in all patients hospitalized with COVID-19, not only those on supplemental oxygen, The New York Times reported. Thousands of U.S. patients have received the treatment, including the president.But now, an enormous trial sponsored by the World Health Organization suggests that remdesivir doesn’t reduce the risk of patients dying from COVID-19 in the month following treatment. The study was posted Oct. 15 to the preprint database medRxiv and has not yet been peer-reviewed; it included more than 11,200 people from 30 countries, The Times reported. About 4,100 of those patients served as a comparison group and received no drug treatments, while the rest received one of four drugs, or a combination of several medications. These drugs included remdesivir, hydroxychloroquine, an antiviral called lopinavir and an immune-stimulating molecule called Interferon-β1a. About 650 patients received the interferon and lopinavir, together. Ultimately, the study results suggest that no single drug or drug combination significantly reduced deaths among patients, as compared with the no-drug group. In addition, the drugs did not reduce the chances that treated patients would be placed on a ventilator, nor did the drugs reduce patients’ time in the hospital. “The unpromising overall findings from the regimens tested suffice to refute early hopes” that the medications would reduce mortality among COVID-19 patients, the study authors wrote. Earlier trials already indicated that hydroxychloroquine and lopinavir don’t reduce mortality, but the data on remdesivir offers new insight on whether the drug really works, according to The Associated Press.

FDA Approves Gilead’s Remdesivir To Treat COVID-19 Despite Data Showing Drug Doesn’t Work – Despite reams of data from an international WHO study raising serious questions about its efficacy, the FDA has finally approved the use of Gilead Science’s remdesivir – a powerful antiviral originally developed to treat ebola – for the treatment of COVID-19, making it the first such drug approved to treat the virus in the US. The FDA first granted the drug emergency authorization in May, allowing hospitals and doctors to use the drug even though by all accounts it wasn’t that widely used. President Trump received one course of remdesivir along with several other COVID-19 therapies after contracting the virus. Doctors also gave the president dexamethasone, a steroid that has a much better track record for treating the virus, according to the available data. Trump also received an experimental drug from Regeneron, which, along with Eli Lilly, has filed for emergency use approval for its COVID-19 antibody treatment. Gilead has been waging a PR campaign against the WHO, which recently publicized the results of its global trial of remdesivir, producing data that was widely hailed as definitive by other scientists. But Gilead had a lock on approval seemingly from the very beginning, as US officials, including Dr. Anthony Fauci, praised the drug. Dr. Fauci once said the drug would “set a new standard of care” for COVID-19. Back in August, Gilead said the company planned to produce more than 2 million courses of the drug by the end of the year, with “several million more coming in 2021.” Initially, Gilead says it will initially focus on meeting “real-time demand” in the US. Oddly, none of the initial coverage of the FDA’s decision included much discussion of the WHO’s trial data, which pretty clearly branded the drug a flop. Even the evidence that Gilead has managed to marshal in remdesivir’s defense has been pretty unconvincing.

Patients who had more severe covid-19 may be the best donors for convalescent plasma therapy Sex, age, and severity of disease may be useful in identifying COVID-19 survivors who are likely to have high levels of antibodies that can protect against the disease, according to a new study co-led by researchers at Johns Hopkins Bloomberg School of Public Health. The findings suggest that older males who have recovered from COVID-19 after having been hospitalized are strong candidates for donating plasma for treating COVID-19 patients. Doctors have been using infusions of plasma–the part of blood that contains antibodies–from recovered COVID-19 patients to treat COVID-19 patients and also as a possible prophylaxis to prevent COVID-19. Doctors have used convalescent plasma to treat patients or immunize persons at high risk of virus exposure during outbreaks of measles, mumps, polio, Ebola, and even the 1918 pandemic flu. Clinical trials of convalescent plasma treatment against COVID-19 are ongoing, and doctors until now haven’t had guidance for selecting COVID-19 survivors who are likeliest to have strong antibody responses. “We propose that sex, age, and severity of disease should be used to guide the selection of donors for convalescent plasma transfer studies because we found that these were significant patient characteristics that not only predicted the amount of antibody but the quality of that antibody,” says study lead author Sabra Klein, PhD, professor in the Bloomberg School’s Department of Molecular Microbiology and Immunology.

Down Syndrome associated with a 10-fold increased risk for COVID-19-related death – At the start of the COVID-19 pandemic, many national health organizations emphasized quarantining or physical distancing, especially for those deemed to be extremely vulnerable on the basis of certain medical conditions. Although Down syndrome was not specifically mentioned on official lists of conditions that put people at increased risk, the condition is associated with immune dysfunction, congenital heart disease, and pulmonary pathology. Therefore, it may be an unconfirmed risk factor for severe COVID-19. Researchers from the University of Oxford, the University of Nottingham, the London School of Hygiene & Tropical Medicine, and the University College London studied a cohort of 8.26 million adults through a QResearch database to evaluate if Down syndrome is a risk factor for death from COVID-19. The authors found an estimated a 4-fold increased risk for COVID-19-related hospitalization and a 10-fold increased risk for COVID-19-related death in persons with Down syndrome. They stress this novel evidence should be used by public health organizations, policymakers, and health care workers to strategically protect vulnerable individuals. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-4986.

Most psoriasis patients taking immunosuppressants survive COVID-19 – Patients with psoriasis who are taking drugs that affect their immune system have high rates of survival from COVID-19. According to the first findings from a global registry of psoriasis and COVID-19 patients, led by Guy’s and St Thomas’ clinicians, over 90% survive. The researchers found that the risk factors of severe COVID-19 outcomes in patients reported to the registry were similar to the general population. The findings come from the first analysis of the web-based PsoProtect registry, established to understand how psoriasis and the medications that are used to treat it might influence the severity of COVID-19. Collaboration has been crucial to the registry, founded by dermatologists and researchers at the St John’s Institute of Dermatology at Guy’s and St Thomas’, King’s College London and University of Manchester, and supported by psoriasis patient organisations throughout the world, including the Psoriasis Association in the UK. Psoriasis is a skin condition that causes red, flaky, crusty plaques of skin covered with silvery scales and affects around 2% of people in the UK. It is thought to be related to a problem in the immune system, so dermatologists have been working to understand how COVID-19 and the condition may interact. Patients with moderate to severe disease are treated with drugs that affect the immune system including biologics that target specific immune proteins, or traditional tablet immunosuppressants, and many of these patients were asked to shield during the pandemic.

Dogs Detect Coronavirus Fast and Reliably – Why Not Use Them Everywhere? – Europe is in a panic over the second wave of COVID-19, with infection rates sky-rocketing and GDP plummeting. Belgium has just announced it will no longer test asymptomatic people, even if they’ve been in contact with someone who has the disease, because the backlog in processing is overwhelming. Other European countries are also struggling to keep up testing and tracing. Meanwhile in a small cabin in Helsinki airport, for his preferred payment of a morsel of cat food, rescue dog Kossi needs just a few seconds to tell whether someone has coronavirus. If it were left to Kossi and his pals, crowds of potential virus carriers could be cleared in a fraction of the time for a fraction of the cost with none of the physical discomfort that accompanies the current nasal swab test based on the polymerase chain reaction (PCR) method. A dog can sniff a cloth wiped on a wrist or neck and immediately identify if it comes from someone who has contracted the virus as much as five days before any symptoms appear which would lead a person to go into isolation. “A dog could easily save so so, so many lives,” University of Helsinki veterinary researcher Anna Hielm-Bjorkman told DW, who says their testing has shown an accuracy level of nearly 100%. It was originally her idea to see whether Kossi, a talented disease-detection dog, could redirect his skills in sniffing out mold, bedbugs and cancer to detecting the new virus just as it started to spread in Europe. “It took him seven minutes to figure out ‘okay, this is what you want me to look out for,” Hielm-Bjorkman said. “So that totally blew our minds.” Susanna Paavilainen, the executive director of the Wise Nose scent-detection foundation and the woman who saved Kossi from euthanasia in a Spanish shelter eight years ago, immediately started retraining her dogs to find the coronavirus.

Ending Covid With Herd Immunity Dangerous Fallacy – The concept of ending the Covid pandemic through herd immunity is “a dangerous fallacy unsupported by scientific evidence”, say 80 researchers in a warning letter published by a leading medical journal.The international signatories of the open letter in the Lancet say the interest in herd immunity comes from “widespread demoralisation and diminishing trust” as a result of restrictions being reimposed in many countries because of surging infections in a second wave. The suggestion that the way out is by protecting the vulnerable and allowing the virus to transmit among those less at risk is flawed, they say. “Uncontrolled transmission in younger people risks significant morbidity and mortality across the whole population. In addition to the human cost, this would impact the workforce as a whole and overwhelm the ability of healthcare systems to provide acute and routine care.”The signatories have expertise spanning public health, epidemiology, medicine, paediatrics, sociology, virology, infectious disease, health systems, psychology, psychiatry, health policy, and mathematical modelling. They include a number of scientists who sit on the breakaway Independent Sage group in the UK, such as former chief scientist Sir David King, former WHO director Anthony Costello, virologist Prof Deenan Pillay, behavioural scientist Prof Susan Michie and professor of European public health Martin McKee. There is no evidence that immunity after recovering from Covid-19 lasts, they say, adding that people who are vulnerable would be at risk for the indefinite future and cannot be kept safe.“Prolonged isolation of large swathes of the population is practically impossible and highly unethical,” they say, calling for action to suppress the levels of virus in the population.

Wearing masks could save more than 100,000 US lives through February, new study suggests If 95% of Americans wore masks in public, more than 100,000 lives could be saved from Covid-19 through February, a new modeling study suggests. The study — from the Covid-19 forecasting team at the University of Washington’s Institute for Health Metrics and Evaluation — notes that, in September, only about 49% of US residents reported that they “always” wear a mask in public.If mask-wearing is 49% through February and states continue with removing social distancing mandates, the Covid-19 death toll across the United States could reach about 1 million deaths by February 28, according to the study, published in the journal Nature Medicine on Friday.Yet under the assumption that states shut down when their daily death rate exceeds 8 deaths per 1 million people in the population but mask-wearing doesn’t change, the study’s model projections forecast the death toll could reach 511,373 deaths by February 28. The scenario that 95% of people in each state wear masks — in addition to states reinstating social distancing mandates if their daily death rates exceed 8 deaths per 1 million people — resulted in the lowest death toll projection, with 381,798 deaths by February 28, according to the study.

Patient In AstraZeneca COVID-19 Vaccine Trial Dies – In what appears to be the worst news yet concerning any of the leading COVID-19 vaccine candidates, a patient enrolled in the trial for AstraZeneca’s COVID-19 vaccine candidate (which it’s working on with Oxford) has died. Brazilian health authority Anvisa announced Wednesday that one of the volunteers who was participating in the study had died. The news sent the company’s ADRs to their lowest level since April, per Reuters. AstraZeneca’s massive globe-spanning trial was put on mandatory hiatus back in September after two participants were sickened in the company’s trial in the UK, prompting authorities to close it down briefly. However, the FDA refused to restart the trial in the US, citing vague safety-related criteria. We now await more information from AZ. Update (1340ET): AZ has just revealed that the patient who died received a placebo, not the actual vaccine. AZN rebounded sharply on the claim. The Federal University of Sao Paulo, which is helping coordinate late-stage trials in Brazil, separately said that the volunteer was Brazilian, according to Reuters. Participants in the US AZ clinical trials still haven’t taken their second dose since the proceedings have been _

FDA should ‘under no circumstances’ fast-track a COVID-19 vaccine, says patient safety group – Earlier this month, the FDA issued safety guidelines that say vaccine makers should follow clinical trial participants for two months before seeking emergency authorization.But in comments to the FDA, the Emergency Care Research Institute says approving a vaccine with such limited data could pose “significant safety risks.”Visit Business Insider’s homepage for more stories.There could be “very severe” consequences from rushing out a COVID-19 vaccine before clinical trials are completed, according to the Emergency Care Research Institute, a nonprofit that advises public and private health care providers on safeguarding patient safety. “Vaccines are some of the safest and most effective ways to protect the American public from disease, but rushed deadlines and incomplete data pose significant safety risks,” Dr. Marcus Schabacker, president and CEO of ECRI, said in a statement on Wednesday. The comments come as the US Food and Drug Administration is holding a teleconference on Thursday to discuss the development and authorization of a vaccine for the novel coronavirus. President Donald Trump has claimed a vaccine could be authorized before the November election. But earlier this month the FDA issued safety standards, opposed by the White House, that instruct pharmaceutical companies to monitor clinical trial participants for at least two months before seeking emergency approval. But ECRI, in a policy paper submitted to the FDA, maintains that no vaccine should receive emergency approval with such limited data. Indeed, “under no circumstances” should US authorities authorize a vaccine without a full six months of follow-up information, it says. “Complete clinical trial information and careful consideration of the limitations of available data are essential to ensuring the safety and effectiveness of a COVID-19 vaccine,” Schabacker said. “The risks and consequences of a rushed vaccine could be very severe if the review is anything shy of thorough.”

Top infectious-disease expert says ‘the next 6 to 12 weeks are going to be the darkest of the entire pandemic’ – A leading US infectious-disease expert warned Sunday that the next three months might be the “darkest of the entire pandemic,” citing what he described as a “major problem in messaging” related to COVID-19. “We do have vaccines and therapeutics coming down the pike,” Dr. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said on NBC’s “Meet the Press” on Sunday. “But when you actually look at the time period for that, the next six to 12 weeks are going to be the darkest of the entire pandemic.” Osterholm told the “Meet the Press” host Chuck Todd that despite some progress, “vaccines will not become available in any meaningful way until early to third quarter of next year.” “And even then, half of the US population, at this point, is skeptical of even taking the vaccine,” Osterholm said. “So what we have right now is a major problem in messaging.” As Business Insider previously reported, the race to establish a COVID-19 vaccine has already surpassed records for speed, prompting concern that the vaccine is being rushed for political purposes despite a rare joint pledge from drugmakers to ensure that the vaccine is developed safely. Osterholm on Sunday said part of the messaging problem was the lack of a “lead” voice to guide Americans during the latest stage of the pandemic. Osterholm is just one of numerous epidemiologists who for months have warned that the COVID-19 pandemic would worsen in the fall and winter months. “Friday, we had 70,000 cases, matching the largest number we had seen back during the really serious peak in July,” he said Sunday. “That number, we’re going to blow right through that. And between now and the holidays, we will see numbers much, much larger than even the 67,000 to 75,000 cases.”

CDC: Pandemic results in 299,000 more U.S. deaths than in typical year – The coronavirus pandemic has left about 299,000 more people dead in the United States than would be expected in a typical year, two-thirds of them from covid-19 and the rest from other causes, the Centers for Disease Control and Prevention reported Tuesday. The CDC said the novel coronavirus, which causes covid-19, has taken a disproportionate toll on Latinos and Blacks, as previous analyses have noted. But the CDC also found, surprisingly, that it has struck 25- to 44-year-olds very hard: Their “excess death” rate is up 26.5 percent over previous years, the largest change for any age group.It is not clear whether that spike is caused by the shift in covid-19 deaths toward younger people between May and August or deaths from other causes, the CDC said. As states reopen and more tests are conducted, coronavirus cases continue to ravage the U.S. The Post spoke with experts to determine what wave we’re in. (Video: Adriana Usero, Allie Caren/Photo: Sarah Hashemi/The Washington Post)The report comes with just two weeks left in a presidential campaign whose central issue is President Trump’s handling of the pandemic. Trump has sought at every turn, including in remarks Monday, to minimize the virus’s impact, despite a covid-19 death toll that is likely to be the third-leading cause of mortality in the United States this year, behind heart disease and cancer. That stance has proved to be the president’s enduring weakness as the election looms Nov. 3.His Democratic opponent, former vice president Joe Biden, has made his plans to tackle the pandemic the major focus of his bid to capture the White House.“The number of people dying from this pandemic is higher than we think,” said Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, who has conducted independent analyses of excess mortality. “This study shows it. Others have, as well.”The United States is in the midst of another sharp increase in coronavirus infections, this one centered in the upper Midwest and Plains states. The seven-day rolling average of cases, considered the most accurate barometer, is near 60,000 per day. At least 220,000 people have died of covid-19 so far, according todata kept by The Washington Post.The new CDC data covers Feb. 1 to Oct. 3. Woolf said the total is likely to reach 400,000 by the end of the year. Overall, the CDC found that “excess deaths have occurred every week since March, 2020,” with a peak during the week of April 11 and another during the week ending Aug. 8. Those dates roughly coincide with the virus’s surge into the New York metro area near the start of the outbreak and a second major rise across the Sun Belt when many states reopened too soon in an effort to revive flagging economies.

U.S. Suffered Almost 300,000 Excess Deaths During Coronavirus Pandemic, CDC Reports – Almost 300,000 more Americans have died during the first ten months of the coronavirus pandemic than would be expected in an average year, the Centers for Disease Control and Prevention (CDC) reported Tuesday. The agency found that there were an estimated 299,028 excess deaths in the U.S. between Jan. 26 and Oct. 3. That’s a higher death toll than the 221,078 deaths officially attributed to COVID-19, according to the latest figures from Johns Hopkins University.”This is one of several studies, and the bottom line is there are far more Americans dying from the pandemic than the news reports would suggest,” Dr. Steve Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University who conducted a study along similar lines, told The New York Times.Excess death studies are valuable for understanding public health threats precisely because deaths from a particular cause may have been undercounted, the CDC explained. In the case of COVID-19, an excess death study will catch cases that have been misdiagnosed or misattributed on the death certificate. Two-thirds of the excess deaths in the study were directly attributed to the coronavirus, but others could have been indirectly caused by the new disease.”There are many factors that could contribute to an increase in deaths indirectly due to the pandemic, with disruptions to health care being one factor,” study author Lauren Rossen, from CDC’s National Center for Health Statistics, told Reuters. For example, Woolf told The New York Times that his study, which looked at excess deaths from March 1 to April 25, found huge increases in deaths from conditions like diabetes, heart disease and Alzheimer’s. “It’s important for people who have these conditions to not delay or forgo medical care because of their fears of the virus,” Woolf said. “In many cases, the danger of not getting care is much greater than the risk of exposure to the virus.” The CDC got their figures by comparing deaths in 2020 every week during the study period with the average deaths for that week from 2015 to 2019. They found that excess deaths have occurred every week in the U.S. since March, peaking in the weeks ending April 11 and August 8. The breakdown by age group was as follows:

• Under 25: two percent decrease
• 25-44: 26.5 percent increase
• 45-64: 14.4 percent increase
• 65-74: 24.1 percent increase
• 75-84: 21.5 percent increase
• Over 85: 14.7 percent increase

The study also confirmed that the pandemic has taken a higher toll on racial minority groups than on white Americans. Hispanic Americans saw the highest percent increase of deaths in 2020 at 53.6 percent. The rest were as follows:

• Asian Americans: 36.6 percent increase
• Other or unknown ethnicity: 34.6 percent increase
• Black Americans: 32.9 percent increase
• Indigenous Americans: 28.9 percent increase
• White Americans: 11.9 percent increase

Does America Have A COVID Problem Or An Obesity Problem? –While we have previously reported – and by now it is common knowledge – that Covid-19 usually kills only the very old with virtually no deaths in the 45 and under category and most deaths in the 75 and over category.Indeed, as Deutsche Bank’s Jim Reid noted when discussing the average age of fatalities from Covid, “it is remarkably consistent around the 80-82 year old mark.”Then overnight, Bloomberg’s John Authers pointed out how startling this mortality rate varies from country to country, when referencing another chart from Jim Reid:As Authers writes, “The U.S. is a remarkable outlier. How can that possibly be?” According to Reid, a small part of this might be down to many of the other countries having an older population. For example, Italy’s median age is 45 (43 in Europe), whereas it is 38 for the US.However, another explanation offered by the Bloomberg commentator, which feeds into the political debate of the moment, “is that all the other developed countries on this chart have some form of universal state-provided healthcare.” But rather than get embroiled in that debate, Authers instead looks at the normal average age of people when they die. The following is a chart of life expectancy (in years) at birth for all the members of the Organization for Economic Cooperation and Development:As shown in the chart above, the U.S. – which as we discussed last week is turning into a banana republic with just a 50% share of the population in middle-income households, roughly the same category as Turkey, China and, drumroll, Russia – has lower life expectancy than the Czech Republic or Chile, and is lagged only by countries that are significantly poorer. It trails the other major economies by several years, in many cases roughly equal to the gap in the age at which Covid-19 victims die.According to Authers, instead of focusing on Covid, “it might make sense for the U.S. healthcare debate to revolve around treating this as a national disgrace and trying to make common cause over fixing it, rather than having an arid political argument, but I digress.” Which brings us to the topic at hand, namely does America have a covid problem, or is it just an extension of America’s far more serious problem of obesity. To wit, tne of its greatest life-shortening effects is diabetes. Here are the most recent OECD numbers on diabetes prevalence:

Some People Think Covid-19 Hospitalizations Are Level — Menzie Chinn – Reader Bruce Hall writes yesterday: Cases continue to escalate; deaths do not; hospitalizations are basically level. The hyperbole around cases is unfortunate because infections are not categorized for action since asymptomatic to severe are lumped together. I do not think this assertion regarding current hospitalizations are correct (and by definition, those are not asymptomatic cases, so the argument against using cases numbers does not apply). And where hospitalizations go, fatalities have usually followed. Figure 1: Covid-19 related current Hospitalizations (blue, left scale), fatalities, seven day moving average (red, right scale). Source: Covid Tracking Project, accessed 10/20/20. On that graph, the increase is 31.9%. You can call that a “minor fluctuation” if you want; I think most would disagree.

As the Coronavirus Surges, a New Culprit Emerges: Pandemic Fatigue: NYT – The United States surpassed eight million known cases this past week, and reported more than 70,000 new infections on Friday, the most in a single day since July. Eighteen states added more new coronavirus infections during the seven-day stretch ending on Friday than in any other week of the pandemic.In Europe, cases are rising and hospitalizations are up. Britain is imposing new restrictions, and France has placed cities on “maximum alert,” ordering many to close all bars, gyms and sports centers. Germany and Italy set records for the most new daily cases. And leaders in the Czech Republic described their health care system as “in danger of collapsing,” as hospitals are overwhelmed and more deaths are occurring than at any time in the pandemic.The virus has taken different paths through these countries as leaders have tried to tamp down the spread with a range of restrictions. Shared, though, is a public weariness and a growing tendency to risk the dangers of the coronavirus, out of desire or necessity: With no end in sight, many people are flocking to bars, family parties, bowling alleys and sporting events much as they did before the virus hit, and others must return to school or work as communities seek to resuscitate economies. And in sharp contrast to the spring, the rituals of hope and unity that helped people endure the first surge of the virus have given way to exhaustion and frustration.“People are done putting hearts on their windows and teddy bears out for scavenger hunts,” said Katie Rosenberg, the mayor of Wausau, Wis., a city of 38,000 where a hospital has opened an extra unit to treat Covid-19 patients. “They have had enough.” Ann Vossen, a medical microbiologist in the Netherlands, where daily cases doubled this past week, said people across Europe “let go too much.” She added, “This is the result.”

Cameron Peak Fire: COVID-19 cases nearly double among firefighters – The fight is on against the Cameron Peak Fire, but the Colorado wildfire – the largest in state history – is not the only battle its firefighters are facing. COVID-19 cases among Cameron Peak firefighters and support personnel nearly doubled last week, going from 23 confirmed cases on Oct. 7 to 43 on Wednesday. It is the second-largest active COVID-19 outbreak in Larimer County, according to outbreak data posted by the county health department. Cases connected to Colorado State University, which have been combined into one outbreak in outbreak data, make up the largest outbreak in the county. The surge in cases related to the wildfire marked the largest increase in COVID-19 cases among fire personnel since the first eight days of September, when 20 positive cases were reported, according to a U.S. Forest Service spokesperson. The Cameron Peak Fire was deemed the site of an outbreak on Aug. 25, less than two weeks after the fire began in the Roosevelt National Forest between Cameron Peak and Chambers Lake. An outbreak is defined by CDPHE as two or more cases within 14 days. Since beginning Aug. 13, the Cameron Peak Fire – fueled by hot, dry weather and high winds – has grown to 203,604 acres with 62% containment as of Sunday night. Most recently, 1,464 personnel were listed as working the fire. Despite daily temperature checks, COVID-19 screening, mask wearing and handwashing stations for fire personnel, the fire’s COVID-19 cases have increased primarily because personnel and fire crews are joining the fire effort from other areas with their own COVID-19 outbreaks, a Forest Service spokesperson added. Those who do test positive for COVID-19 are isolated and given medical attention, if needed. Fire personnel are contact tracing and isolating as needed, in keeping with Larimer County and Centers for Disease Control and Prevention guidelines, the spokesperson said. Aside from the Cameron Peak Fire’s main medical unit, they also have a separate COVID-19 unit to monitor fire personnel and support them in isolation.

Ohio breaks record of coronavirus hospitalizations, active cases: The Wake Up for Tuesday, Oct. 20, 2020 – cleveland.com – The number of COVID-19 patients in Ohio hospitals has more than doubled in the last month to a record of 1,154 on Monday, reports Rich Exner. The patient count stood at just 586 on Sept. 19. It moved over 1,000 last Tuesday and to the record of 1,154 on Monday, topping the previous record of 1,122 set on July 28. Based on estimates, a record 27,512 Ohioans currently have the coronavirus, up from a recent low of 15,771 on Sept. 26. This means that 1-in-64 Ohioans is now known to have contracted the virus.

Record-shattering 4,591 coronavirus cases as state catches up on reporting; record 218 COVID-19 hospitalizations (WBAY) – The Wisconsin Department of Health Services cautions that it’s working through a backlog of positive test results after state system upgrades over the weekend, resulting in a high number of newly reported coronavirus cases and extremely high positivity rate. We’ll need to put an asterisk next to the record-shattering numbers reported Tuesday when 4,591 new cases were added in the past 24 hours. That’s 33.61% of the 13,661 tests received — 1 in 3 coming back positive — which also shatters the positivity record for any day with more than 10,000 tests. In fact, the only positivity rate we could find that was higher was on March 14, when the state reported a total of 8 tests and all of them were positive. The DHS says negative test results could still be uploaded to its reporting system over the weekend but not positive tests; these are only being imported into the system now that the system updates are completed. The state emphasizes the 7-day rolling averages are a more accurate representation of the state’s COVID-19 situation while it works through the backlog of data for the next few days. Based on the state’s last 7 reports, Wisconsin is adding an average 3,424 new coronavirus cases per day. The positivity rate’s 7-day average is up to 21.7%, an all-time high in the state’s reporting. The death toll rose 33 to 1,633. That’s shy of the one-day record of 34 deaths set exactly one week ago. Six deaths were added to Shawano County’s death toll. Five were added in Marathon County. After the state’s report was issued, the Appleton Health Department reported two more people died — one in their 70s, the other in their 80s, both from Outagamie County.

New York COVID-19 Cases Top 2,000 For First Time Since May- Live Updates — NY Gov Andrew Cuomo took a break from bashing his colleagues in charge of CT and NJ to reveal Wednesday that NY’s daily numbers have topped 2,000 for the first time since May. Today’s update on the numbers:Of the 124,789 tests reported yesterday, 2,026 were positive (1.62% of total).Total hospitalizations are at 950.Sadly, there were 7 COVID fatalities yesterday. pic.twitter.com/w5XytHYXgN – Andrew Cuomo (@NYGovCuomo) October 21, 2020Total hospitalizations, meanwhile, were steady at 950. NYC Mayor Bill de Blasio has just unveiled his plan for distributing COVID-19 vaccines to everybody in NYC, a difficult undertaking that will likely rank among the most challenging tasks.According to the post, the mayor will launch a two-phase framework, which will begin by providing a limited number of doses for health-care personnel and other front-line workers. Presently, the city is enrolling providers in the Department of Health and Mental Hygiene’s Citywide Immunization Registry.While Phase 1 will begin as soon as the FDA delivers its emergency use authorization approval, phase two likely won’t arrive until 2021 and will see more availability for the general public.The city is recruiting and preparing “community providers” who will administer the vaccine in the city, and it will work with the state to figure out how to maximize distribution efforts to get the vaccine nto the vans.City will work with New York state to guarantee maximum distribution of safe, effective, free vaccine Spain has officially joined the US, India, Brazil and others in the 1 million+ confirmed COVID-19 cases club.Across Europe, an FT analysis has found that the second wave of the virus to hit Europe is far less deadly than the wave seen back in the spring, even though the Continent and the UK largely decided against lockdowns and other more serious measures.Finally, the Czech Republic announced new restrictions on business and movement in a bid to regain control of the coronavirus pandemic, which is growing faster in the central European nation than anywhere else in the EU. Health Minister Roman Prymula said that the new measures were necessary because in the absence of any action, the Czech health system risked being overwhelmed by early November. ; After reporting another daily record on Tuesday, the pace of new COVID-19 cases reported worldwide slowed, with just 387,768 new cases, according to Johns Hopkins.

1 in 4 New York City transit workers contracted COVID-19: survey -One in four New York City transit workers report having had COVID-19 at some point this year, according to a poll commissioned by the MTA’s largest union. The TWU Local 100 survey – conducted by NYU epidemiologist Robyn Gershon – polled 645 city transit workers, 24 percent of whom reported contracting the coronavirus. Of the workers surveyed, 90 percent said they fear contracting the virus at work. Transit workers repped by TWU were the hardest hit by the virus among MTA workers, accounting for more than 90 of the 131 agency employees killed by the deadly respiratory illness. In March and April, thousands of workers called out sick, forcing massive subway cancellations. The MTA, meanwhile, was slow to institute protective measures demanded by workers, and initially prohibited employees from wearing masks at all, citing CDC guidance at the time. Transit officials have since instituted a mask mandate – now backed up by a $50 fine – along with protective measures for bus drivers and expanded break-room space. “We put the city on our shoulders when the pandemic hit, and we are still carrying it forward,” union president Tony Utano said in a statement. MTA rep Abbey Collins disputed the survey’s findings, which she dismissed as “a poll, not a study.”

October 21 COVID-19 Test Results – The US is now mostly reporting 700 thousand to 1 million tests per day. Based on the experience of other countries, the percent positive needs to be well under 5% to really push down new infections (probably close to 1%), so the US still needs to increase the number of tests per day significantly (or take actions to push down the number of new infections). There were 739,443 test results reported over the last 24 hours. There were 57,294 positive tests. Over 14,700 Americans deaths from COVID have been reported in October. See the graph on US Daily Deaths here. This data is from the COVID Tracking Project. The percent positive over the last 24 hours was 7.7% (red line is 7 day average). For the status of contact tracing by state, check out testandtrace.com. And check out COVID Exit Strategy to see how each state is doing. The second graph shows the 7 day average of positive tests reported. The dashed line is the July high. Note that there were very few tests available in March and April, and many cases were missed (the percent positive was very high – see first graph). By June, the percent positive had dropped below 5%. Everyone needs to be vigilant or we might see record high 7-day average cases before the end of October.

CDC says the U.S. is now seeing a ‘distressing trend’ in coronavirus outbreak – A top official at the Centers for Disease Control and Prevention said Wednesday that the agency is seeing a “distressing trend” in the United States’ coronavirus outbreak. Jay Butler, the CDC’s deputy director for infectious diseases, said Covid-19 cases are now growing “really in all parts of the country,” with particularly high transmission in the Midwest. “Unfortunately, we are seeing a distressing trend here in the United States,” he told reporters on a call. He said the surge is likely due to the arrival of cooler temperatures, adding, “Smaller, more intimate gatherings of family, friends and neighbors may be driving transmission as well, especially as they move indoors.” “I recognize that we are all getting tired of the impact Covid-19 has had on our lives,” he said. “We’re tired of wearing masks, but it continues to be as important as it has ever been and I would say even more important than ever as we move into the fall season.” The U.S. is now reporting roughly 60,000 new Covid-19 cases daily, growing nearly 17% compared with a week ago, according to a CNBC analysis of data compiled by Johns Hopkins University. Figures are based on a weekly average to smooth out fluctuations in daily reporting. Only two states – Hawaii and Virginia – reported declines greater than 5% as of Tuesday. The U.S. still has the worst outbreak in the world, with more than 8.2 million cases and at least 221,122 deaths, according to Hopkins data. Health officials and infectious disease experts fear the situation could become dire as flu season begins and hospitals risk reaching capacity. “If steps are not taken to reduce transmission at the community level, it’ll come to no surprise that health-care systems start to feel a pinch and start to head towards capacity and beyond capacity,” Dr. Isaac Bogoch, an infectious disease specialist and professor at the University of Toronto, told CNBC in a recent interview. Butler said the U.S. will likely have a safe and effective coronavirus vaccine “very soon,” adding that he is “cautiously optimistic” a vaccine will be available in limited quantities by the end of the year. Secretary of Health and Human Services Alex Azar said on the same call that Pfizer and Moderna, front-runners in the Covid-19 vaccine race, are “very close if not fully enrolled in their trials.”

8 states set single-day coronavirus case records last week – 8 states set new highs last week for coronavirus infections recorded in a single day, according to the COVID Tracking Project (CTP) and state health departments. Montana, West Virginia, and Wyoming surpassed records from the previous week. Cases and hospitalizations are rising in Michigan, a state that initially fought the pandemic with strict mitigation efforts, alongside states that took less action against the spread of the virus this spring. Records broken:

• Oct. 12: Kansas (2,055).
• Oct. 15: Montana (723) and Michigan, which reported over 2,000 cases. Some infections that would normally be included in the previous day’s tally were included here due to a laboratory processing slowdown.
• Oct. 16: Minnesota (2,290), North Dakota (864), Wisconsin (3,861), West Virginia (498), and Wyoming (290). Wyoming’s PCR test data decreased by over 1,000 with no explanation, possibly to eliminate duplicate or redundant information, per CTP.
• In Minnesota, 20 to 24 year-olds account for the highest percentage of coronavirus cases, as the elderly continue to die at higher rates, per the state’s last weekly COVID-19 report.
• Wisconsin has seen over 1,000 people hospitalized per day from Oct. 14 to Oct. 18. Gov. Tony Evers (D) signed an emergency order on Oct. 1 to allow health care providers licensed in other states to practice in Wisconsin. The most COVID-19 cases have been recorded in 18 to 24 year-oldsoverall.
• Wyoming’s health department has recorded the most lab-confirmed cases in 19 to 29 year-olds.

The big picture: Coronavirus infections increased in 38 states and Washington, D.C. over the last week, according to a seven-day average tracked by Axios. Coronavirus hospitalizations are also increasing in 39 states. Record case highs have usually meant that more hospitalizations and other serious outcomes are on the way, CTP analysts wrote in September.

U.S. coronavirus hospitalizations hit two-month peak, midwest setting new records every day (Reuters) – The number of COVID-19 patients in U.S. hospitals hit 40,000 for the first time since August on Wednesday, according to a Reuters tally, as the nation battles a surge in infections led by Midwest states. Hospitals have seen a 36% rise in coronavirus patients over the past four weeks and Midwest hospitals are setting new records every day. So far in October, 16 states have reported their highest daily numbers of hospitalized COVID-19 since the pandemic started, including the Midwest states of Iowa, Kansas, Missouri, Nebraska, North Dakota, South Dakota and Wisconsin. Hospitalizations of virus-stricken patients have set records in every region except the Northeast. Hospitalizations are a closely watched metric because they are not influenced by how much testing is done. In addition to hospitalizations reaching 40,264 on Wednesday, the seven-day average of new cases of COVID-19 have risen 45% in the past four weeks and is also approaching levels last seen during the summer peak, according to a Reuters analysis. On Friday, the U.S. recorded 69,478 new cases, the highest single-day total since July 24 and the fifth-highest single-day total since the start of the pandemic. Wisconsin Governor Tony Evers announced that a field hospital in the Milwaukee suburbs admitted its first COVID-19 patient since it opened last week. “Folks, please stay home,” Evers said. “Help us protect our communities from this highly contagious virus and avoid further strain on our hospitals.” In New Mexico, the governor warned on Monday that the state’s healthcare resources might not be enough if coronavirus cases continue to rise at the current pace. The U.S. National Institutes of Health (NIH) has started a late-stage trial to evaluate if immune-modulating therapies from three drugmakers can help reduce the need for ventilators for COVID-19 patients and shorten their hospital stay. The study will enroll up to 2,100 hospitalized adults with moderate to severe COVID-19 symptoms in the United States and Latin America.

COVID-19 surges across U.S. as some hospitals stretched (Reuters) – Several U.S. states, many of them in the Midwest, reported record single-day increases in COVID-19 infections on Thursday, further evidence that the pandemic is accelerating anew as cooler weather takes hold in many parts of the country. Indiana, North Dakota, Illinois, Montana, Oklahoma, Utah and Ohio posted daily records on Thursday, according to a Reuters analysis, while Florida reported more than 5,500 new cases, its highest single-day increase since Aug. 15. Twenty-eight states have reported their daily record high of COVID-19 cases in the month of October alone. On Wednesday, the number of coronavirus deaths reported across the country reached its highest in two months. Increases in deaths tend to trail spikes new infections by several weeks. The U.S. Food and Drug Administration on Thursday formally approved Gilead Sciences Inc’s antiviral drug remdesivir, which has been in wide use under an emergency authorization, for treating patients hospitalized with COVID-19. It is the first drug officially approved for the disease in the United States. Since the pandemic reached the United States earlier this year, the nation has lost more than 222,000 lives, the world’s highest total as well as one of the highest per capita death rates, especially among developed nations. (Graphic: tmsnrt.rs/35hBCSa)The autumn resurgence and dire predictions that the spread would further accelerate in the cold winter months have once again cast a harsh spotlight on President Donald Trump’s handling of the pandemic. A report released on Wednesday by Columbia University estimated that between 130,000 and 210,000 COVID-19 deaths could have been avoided in the United States, calling the federal government’s response to the pandemic an “enormous failure”.

US passes single-day record for new COVID-19 cases – The U.S. set a new record for new coronavirus cases in a single day Friday as the country undergoes an alarming new surge in infections. According to the COVID Tracking Project’s tally, there were more than 83,000 new confirmed COVID-19 cases across the country Friday, surpassing the U.S.’s past record of 75,687 on July 16. About 1.3 million tests were conducted Friday. The alarming milestone comes as experts warn that the pandemic could continue to worsen in the coming months as the weather gets colder and people stay indoors, where the virus is more easily spread.The number of hospitalizations for the coronavirus across the country has spiked 40 percent in the past month, and while the death rate has remained stable, that figure tends to lag behind increases in cases. The most significant spikes are taking place in the Midwest and West. California saw more than 6,000 new cases Friday, while Wisconsin saw more than 4,600 new cases, and Michigan and Pennsylvania saw more than 2,000 new cases each. And with so many states experiencing surges, experts warn a national spike is inevitable.“We still have tens of thousands of known cases, probably hundreds of thousands of actual cases, happening every day, and what that means is that we have a tremendous number of small little outbreaks ready to burst,” Michael Mina, assistant professor at Harvard’s Center for Communicable Disease Dynamics, told The Hill earlier this month.New cases began rising in September, which experts say could have been caused by school reopenings, Labor Day festivities and overall lax following of guidelines regarding social distancing and mask-wearing.The milestone also comes less than two weeks before Election Day, and while there has been a historic rise in mail-in and early voting, millions of Americans are still expected to gather at polling places to cast their ballots on Nov. 3. Experts had said they hoped cases would be lower to try to offset a virtually-guaranteed winter spike. “You can’t enter into the cool months of the fall and the cold months of the winter with a high community infection baseline,” Anthony Fauci, the government’s leading infectious diseases expert, said this month. “The baseline fluctuated and never went down to the level that I would have hoped it went down to.”

COVID cases: US sets record 83,757 daily cases, highest since summer — The U.S. topped the one-day record for new coronavirus cases, according to Johns Hopkins University data, surpassing the previous summer high. At the height of the surge, on July 16, the U.S. saw more than 77,362 reported new cases of COVID-19. On Friday, the U.S. reached 83,757 new daily cases, according to by Johns Hopkins University. The news comes on the heels of a study by the University of Washington School of Medicine that projected more than 500,000 Americans could die by the end of February in part because of the nation’s current patchwork of COVID-19 mandates and the inconsistent use of masks to prevent virus spread. “We are heading into a very substantial fall-winter surge,” said Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington’s School of Medicine. “We expect that surge to steadily grow throughout different states, and at the national level continue to increase as we head towards quite high levels of daily death in late December and January.” The new cases record may be a product of virus seasonality, pandemic fatigue and the return of schools and universities, said Bob Bednarczyk, assistant professor of global health and epidemiology at Emory University’s Rollins School of Public Health. “It’s really a number of factors coming together,” he said. “And what I worry is that they’re starting to come together in a perfect storm.” Experts say SARS-CoV-2, like other coronaviruses, is a seasonal virus that circulates easier in the fall and winter months – similar to influenza. Michael Mina, an assistant professor of epidemiology at Harvard T. H. Chan School of Public Health, said this seasonality is because of the virus’s molecular structure and biology andthe fact people stay indoors during the colder months. Bednarczyk said Americans also may be getting lax as the pandemic drags on. “Pandemic fatigue is a real thing,” he said. “People are just starting to get tired of wearing masks and staying distant, and taking personal stock of what they potentially feel safe doing in terms of trying to come back to a sense of normalcy.” Mina predicts the spike in cases will greatly exceed the surge seen in the summer. The U.S. missed an opportunity to suppress COVID-19 spread in preparation for the fall, he added, and now the nation is faced with impossible decisions. “There are truly no good solutions anymore,” he said.

October 23 COVID-19 Test Results – The US is now mostly reporting 700 thousand to 1 million tests per day. Based on the experience of other countries, the percent positive needs to be well under 5% to really push down new infections (probably close to 1%), so the US still needs to increase the number of tests per day significantly (or take actions to push down the number of new infections).There were 1,123,341 test results reported over the last 24 hours.There were 83,010 positive tests (new record). Over 16,800 Americans deaths from COVID have been reported in October. See the graph on US Daily Deaths here. This data is from the COVID Tracking Project. The percent positive over the last 24 hours was 7.4% (red line is 7 day average).For the status of contact tracing by state, check out testandtrace.com. And check out COVID Exit Strategy to see how each state is doing. The second graph shows the 7 day average of positive tests reported.The dashed line is the July high. Note that there were very few tests available in March and April, and many cases were missed (the percent positive was very high – see first graph). By June, the percent positive had dropped below 5%.

Michigan doctors warn in open letter that health care systems are at risk of being overwhelmed by resurgent pandemic – In a dire open letter issued Thursday, leading physicians at hospitals and health care systems across the state of Michigan warn of an impending “capacity crisis.” COVID-19 hospitalizations are up 80 percent statewide in recent weeks, they write, and action is urgently needed to “prevent another catastrophic surge in hospital admissions and COVID-19 deaths.” “If Michigan doesn’t change its approach to this disease,” there is a danger of “exceeding the capacity of our hospitals as we did in Southeast Michigan this past spring,” the doctors warn, recalling the gruesome scenes from April when Detroit’s Sinai-Grace Hospital, completely overwhelmed by coronavirus cases, resorted to piling the dead one on top of another in unrefrigerated rooms. The overwhelming of the health care system by COVID-19 has already contributed heavily to the more than 80,000 additional “excess deaths” recorded across the US since January of this year, over and above the 220,000 deaths caused directly by the disease. Signed by 28 Chief Medical Officers and Chief Clinical Officers across Michigan, representing 110 of the state’s 137 hospitals, the statement explains that “regardless of state law, executive orders, or local public health directives, hospitals and healthcare systems across the state are standing as a united front in our policies and interventions in order to fight the spread of COVID-19.” This is a reference to the fact that this month Michigan’s Supreme Court overturned as unconstitutional Democratic Governor Gretchen Whitmer’s emergency orders implementing limited lockdown measures earlier this year. “Our hospitals and healthcare facilities will continue requiring staff, patients, and visitors to follow public safety protocols, including mask-wearing, screenings upon entry to our facilities, and limitation of visitors,” the doctors write.

Covid-19 Fatalities and Excess Fatalities – Menzie Chinn – The most recent “excess fatality” count remains solidly in the positive region, despite the severe under-reporting bias in the most recent observations. To see this, consider the most recent estimates for each of the previous vintages of “excess fatalities” calculated as actual-expected. Figure 1: Excess fatalities, 10/21 vintage (chartreuse), 10/7 vintage (purple red), 9/30 vintage (violet), 9/23 vintage (chartreuse), 9/16 vintage (red), 9/9 vintage (green), 9/2 vintage (orange), 8/25 vintage (blue). Note excess fatalities differ from CDC series which are bounded below at zero. Source: CDC , various vintages, and author’s calculations. This pattern suggests to me we should take with circumspection (1) the most recent counts of excess fatalities as they are likely to be revised substantially upward; and (2) administrative counts, either from CDC or from alternative compilations, as they are possibly missing many actual Covid-19 related deaths. Extending point (1), it is likely that excess fatalities were indeed falling for some time in August, but are possibly rising again given the size of the revisions in recent weeks’ data (The Economist has a discussion of excess fatalities around the world; the Excess Death Tracker is here.) Here are the various series of interest, latest available. Figure 2: Weekly fatalities due to Covid-19 as reported to CDC for weeks ending on indicated dates (black), excess fatalities calculated as actual minus expected (teal), fatalities as tabulated by Our World in Data (dark red). Note excess fatalities differ from CDC series which are bounded below at zero. Light green shading denotes CDC data that are likely to be revised. Source: CDC 10/21/2020 vintage, OurWorldinData version of 10/22 accessed 10/22/2020 and author’s calculations. One conclusion that seems obvious: Cumulative excess fatalities through week ending 8/25 are substantially higher than administratively defined Covid-19 cumulative fatalities. Woolf et al. (JAMA, October 12, 2020) reports that March through July (ex-CT, NC): Of the 225 530 excess deaths, 150 541 (67%) were attributed to COVID-19. Joinpoint analyses revealed an increase in deaths attributed to causes other than COVID-19, with 2 reaching statistical significance. US mortality rates for heart disease increased between weeks ending March 21 and April 11 (APC, 5.1 [95% CI, 0.2-10.2]), driven by the spring surge in COVID-19 cases. Mortality rates for Alzheimer disease/ dementia increased twice, between weeks endingMarch 21 and April 11 (APC, 7.3 [95% CI, 2.9-11.8]) and between weeks ending June 6 and July 25 (APC, 1.5 [95% CI, 0.8-2.3]), the latter coinciding with the summer surge in sunbelt states. 225,530 excess fatalities reported by Woolf et al. for this period exceeds the 221,848 in the CDC excess fatalities estimates I’m reporting above, and obviously far above the 160,092 administratively defined Covid-19 deaths. Update, 5/12 3:13PM Pacific: CDC reports excess deaths by age and ethnicity, in this report dated October 23 (for data running through October 3).

Coronavirus cases top 40M worldwide -The number of coronavirus cases worldwide has surpassed 40 million,according to data from Johns Hopkins University.The world hit the new high-water mark amid a “second wave” that has built since August in Europe. Various European government officials have reintroduced restriction and closures of businesses like bars and restaurants, CNBC noted.Some European nations have also implemented curfews in response to the second wave. Slovenia, for example, will impose one for the first time from 9 p.m. to 6 a.m. beginning Tuesday, according to The Associated Press. France and Belgium have imposed similar curfews. In May, Slovenia became Europe’s first to declare its epidemic over after the rate of new cases slowed to only a few daily.Europe has now surpassed the U.S. in number of new infections per 1 million people, according to CNBC. As of Monday, the U.S. reported a seven-day average of 162 cases per 1 million people, compared to 187 per million in Europe, according to CNBC.World Health Organization data, meanwhile, puts the total worldwide figure slightly lower, at 39.8 million. This includes 18.7 million cases in the Americas, 8.5 million in Southeast Asia, 7.9 million in Europe and just 1.26 million in Africa.The U.S., India and Brazil remain the three hardest-hit countries,according to a Reuters analysis. Daily increases are up around 347,000 cases over the past week in each nation, an increase of more than 50,000 per day from the first week of October. In Europe, according to the Reuters analysis, new case growth is over 150,000 a day. This includes record daily jumps in the Netherlands, Germany, Austria, Poland, Ukraine, Cyprus, the Czech Republic and Italy, which was the original European epicenter of the virus. Seventeen percent of global cases and almost 22 percent of deaths worldwide are in Europe, according to the news service.

Iran coronavirus deaths top 30,000 – Iran surpassed 30,000 deaths due to the coronavirus amid the worst outbreak in the Middle East region. Health Ministry spokeswoman Sima Sadat Lari said the total death toll has reached 30,123 people with 4,721 patients in critical condition, according to the Associated Press. With more than 526,000 cases since February, the country has struggled as death tolls continue to rise while the government resists calls for a complete lockdown. Many patients are being treated in hospitals as COVID-19 positive officials say, but have yet to be tested. These patients, along with false negatives and those who do not display symptoms as listed by the World Health Organization, are not counted among the positive cases meaning the numbers may be much higher than what is currently being reported. Mask mandates in Tehran have been announced and businesses and schools that were recently reopened have now shut down. Government officials have also announced their intent to begin contact tracing those who test positive. Travel bans on five major Iranian cities have been announced, including the capital city of Tehran and the holy city of Mashhad, AP reported. The increased cases come as Iran is bracing for the upcoming flu season. Iran’s Red Crescent Society said U.S. sanctions were preventing the import of the flu vaccines they need. The government of Iran has been hesitant to enact any wide-reaching mandates to stop the spread of COVID-19. Iran initially tried to downplay the severity of the pandemic but Deputy Health Minister Iraj Harirchi has since warned that the country’s true death toll could double. Harirchi tested positive for the coronavirus in February after at first downplaying the virus. Restrictions to movement helped to lessen the spread earlier this year, but those restrictions were quickly lifted. Iran’s economy was already languishing before the pandemic due to sanctions by the U.S.

As virus surges, Iran breaks one-day record for deaths again — – Iran’s single-day death toll from the coronavirus smashed a record set less than a week ago, with 337 dead confirmed Monday as a resurgence of infections is overwhelming hospitals.On social media, Iranian news outlets dramatically dubbed the day “Black Monday” and lamented the grim milestone – which represented a significant increase over Iran’s previous one-day record of 279 set Wednesday.The Islamic Republic emerged early in the pandemic as a global epicenter of the virus and has since seen the worst outbreak in the Middle East, with deaths topping 30,000, as fatalities have soared in recent weeks. Health officials announced last week that Iran’s capital, Tehran, had run out of intensive care beds for virus patients and overwhelmed hospitals across the city suspended all nonemergency treatments.On Sunday, the Health Ministry reported that Dr. Mohammad Zare Joshaghani, the director of one of Tehran’s biggest hospitals, had died of the virus – a reminder of the toll the pandemic has taken on health workers, in particular. But the government has resisted a total lockdown because it does not want to further weaken an economy already devastated by unprecedented US sanctions. On Monday, Health Ministry spokeswoman Sima Lari sought to shift responsibility for the surge to Iranians, scolding them for failing to take precautions.

COVID-19 resurgence devastates Spanish working class – With coronavirus cases rising rapidly across Spain, it is devastating the lives and livelihoods of workers. Last Wednesday, Spain passed the threshold of 900,000 cases, having recorded half a million infections in less than two months. This puts Spain at seventh in the world by total number of cases. As Spain officially records 12 – 15,000 new positive tests a day, it will reach the grim milestone of one million total infections within days. The official death toll stands at well over 30,000, while new figures from the National Institute of Statistics (INE) indicate that just under 59,000 excess deaths have occurred since the pandemic began. Around 11,000 have died since July alone according to INE, more than double the Health Ministry’s official figures, which recorded 5,400 fatalities. Daily deaths range between around 100 and 250. The Madrid region, hit hardest by the resurgence of the virus, is hiding the true extent of the resurgence, tampering with its daily figures to downplay the threat to life. Over the last months, it has omitted thousands of cases from its daily tallies, before retroactively modifying the infection figures as much as a fortnight later, without notifying the public. On 2 October, for example, Madrid published figures indicating that 1,005 new coronavirus cases had been detected in the region the previous day; a week later, going back to the official statistics, this figure had been changed to 2,422 – more than double the initial announcement. An even larger discrepancy can be seen in the infection statistics reported on 24 September, when 828 positive cases were originally announced. But by 13 October, that day’s figures were nearly five times as high, at 4,324. Even as COVID-19 rips across Spain and the world, the Socialist Party (PSOE)-Podemos government is refusing to take any serious measures to contain it. Schools, universities and non-essential workplaces remain open, providing perfect breeding grounds for the coronavirus.

Global report: record Covid cases and new lockdowns across Europe –Regions in Spain and Italy have returned to lockdown and Ireland will do so from Wednesday as countries across Europe continue to report new Covid infection highs and governments struggle to contain the second wave of the pandemic. The northern Spanish Navarre region, where the number of cases per 100,000 people is 945 against 312 nationally, announced a two-week lockdown from Thursday that will be stricter than measures imposed on Madrid by central government. People will only be allowed in and out of Navarre for work, university studies, to care for relatives, or for emergencies, the regional government said. Restaurants, cafes and bars will be closed, while shops may open at 40% capacity but close by 9pm. The lockdown in and around the capital, the source of bitter arguments between the central and regional government, is due to expire this Saturday amid media reports that the regional government is considering the introduction of a curfew. Ireland is set to become the first EU country to return to lockdown, the taoiseach, Michefll Martin, confirmed late on Monday, issuing a nationwide “stay at home” order but insisting schools will stay open.The measures come into effect for six weeks from midnight on Wednesday and will see all non-essential retail businesses close, bars and restaurants limited to takeaways, and people required to stay at home with a 5km travel limit for exercise. In Italy, the southern region of Campania said it would ask central government to give permission for a night-time curfew from this weekend, after the northern region of Lombardy got the green light for a similar 11pm to 5am lockdown from Thursday.Local officials in both regions warned their health systems risked being overwhelmed, with the mayor of Naples saying Campania had just 15 intensive care beds left and experts predicting ICU admissions could leap from 100 to 600 in Lombardy.Poland’s parliament, meanwhile, postponed an emergency debate on new rules to boost the number of medics available to treat Covid-19 cases and make wearing face masks in public legally binding, after opposition parties demanded clarifications.Doctors have demanded more support for the health system after reports of patients dying when ambulances couldn’t find a hospital to admit them.Poland reported 9,291 new infections on Tuesday, its second highest daily figure.Hungary is also holding back on new measures despite growing criticism of the response of Viktor Orbfln’s government. During the first wave, Hungaryrecorded relatively low numbers of infections and deaths.This month, however, more Hungarians have died of coronavirus than in the previous four months put together. According to the European Centre for Disease Control (ECDC), the country currently has the third-highest rolling seven-day death rate per million in the bloc, behind the Czech Republic and Romania.Russia recorded a record high of 16,319 new cases on Tuesday, including 4,999 in the capital Moscow, while Germany is putting the Bavarian municipality of Berchtesgadener Land under lockdown from 2pm on Tuesday. Greece scrapped a plan to allow a limited number of spectators back into sporting events, the prime minister’s office said on Tuesday. “Conducting the games even with a few spectators … would send a wrong message to citizens,” it said, after the country registered 438 new Covid-19 infections on Monday. Beyond Europe, Iran’s daily infections surpassed 5,000 – a new record. There were also 322 new deaths. The president, Hassan Rouhani, said the worst-hit country in the Middle East was now “facing a larger wave of the virus” than earlier in the year.

COVID-19 pandemic surges despite limited curfew measures across Europe — Last week saw record devastation in Europe from COVID-19 with 700,000 new cases and 8,000 deaths from the virus – the highest since the pandemic began. The virus is spreading despite the limited health measures, such as regional curfews or closures of restaurants and bars, that the European ruling classes have taken in response to the resurgence of the pandemic. These record figures underscore the bankruptcy of state policy of returning workers to work, and students to school to guarantee a continued flow of profits to the banks amid a raging pandemic. Millions of workers and youth are being exposed to a potentially deadly virus whose long-lasting impact on health is still largely unknown as part of a politically-criminal “herd immunity” policy. At a press conference in Copenhagen Thursday, World Health Organization (WHO) regional director for Europe Hans Kluge said the situation is of “great concern.” He said COVID-19 is the “fifth leading cause of deaths and the bar of 1,000 deaths per day has now been reached.” While the number of deaths has not yet reached the levels of April 2020, Kluge warned however that without firmer prevention policies, projections showed by January 2021, mortality levels could be four to five times those recorded in April. Citing the same epidemiological models, Kluge said that the generalized wearing of masks by 95 percent of the population, compared to an estimated less than 60 percent currently, could save 281,000 lives by February 1 in the 53 countries of the region. In contrast, the limited measures taken by most European governments in recent days do not represent a move away from a “herd immunity” policy that threatens catastrophic loss of life. They are an attempt to lull to sleep workers and youth increasingly angry at pandemic policies that, by refusing to let youth and non-essential workers shelter at home, are leading Europe to disaster. Yesterday, Spain became the first European country to log 1 million cases of COVID-19, six weeks after becoming the first European country to log 500,000 cases.

At least nine countries in Europe hit record-high daily COVID-19 cases – New coronavirus infections hit record highs in at least nine European countries Thursday – as some nations announced tougher restrictions to stop the disease from spreading, according to reports. The nine hard-hit nations – including Italy, France and Germany – saw the highest daily increase in cases since the pandemic began, according to CNN and other outlets. “The general situation has become very serious,” Lothar Wieler, the president of Germany’s RKI public health institute said at a press conference in Berlin. “We have to expect that the virus will continue to spread rapidly.” Overall, France reported 41,622 new cases in the 24 hours leading up to Thursday evening, and Italy recorded 15,199. Spain, which this week became the first European nation to hit 1 million cases, recorded 20,986. Meanwhile, Germany reported 11,287 new cases while the Netherlands saw 9,283 and Portugal recorded 3,270. Poland also broke its daily infection record with 12,100 new cases, along with the Czech Republic, which reported 14,968 and Greece, which reported 882. In response to the rising case load, Ireland, Greece and the Czech Republic set in place stricter curfew and mask-wearing rules – but stopped short of implementing lockdowns, according to Bloomberg News. Greece set a new curfew from 12:30 a.m to 5 a.m. in all areas deemed to be at-risk, including Athens, Prime Minister Kyriakos Mitsotakis announced Thursday. In Ireland, officials installed a midnight curfew and closed all non-essential businesses for six weeks, officials said. Spanish authorities are also considering a curfew in its capital city, Madrid.France imposed a curfew on Paris and eight other cities last week. More than 41,500,000 COVID-19 cases have now been recorded across the country since the virus emerged late last year, according to Johns Hopkins University. More than 1,135,000 people have died, though fatality rates in the US have declined sharply.

COVID-19 Records Shattered Across Europe As France Tops 40k New Cases- Live Updates – More records are being set in Europe Thursday. France reported more than 40,000 new cases on Thursday (41,622 to be exact), a new record, as French health authorities prepare to expand restrictions beyond Paris and the eight other metro areas where the virus is gaining momentum.The new curfew measures will cover 2/3rds of the population, doubling the number affected to roughly 46 million.Ireland, meanwhile, is beginning its 6-week lockdown on Thursday. New highs were also reported in the Netherlands and Greece on Thursday. In Greece, Prime MInister Kyriakos Mitsotakis announced on Thursday that there would be a curfew in place between 1230 and 0500 in Athens and second-city Thessaloniki.The Netherlands reported 9,283 new infections, topping 9k for the first time, while in Denmark, officials reported 760 new cases over the last 24 hours, also a record.Finally, after photos of people partying in Stockholm caused a stir, the Swedish government has enacted a cap on the number of patrons allowed inside nightclubs at 50. Greece reported a third straight record with 882 new cases bringing the total to 28,216. It also reported 15 more deaths, bringing its death toll to 549. Spain just reported 20,986 new cases, making it the latest European nation to report a new record on Thursday. Earlier, neighboring Portugal reported a record 3,270. Florida posted 5,558 new cases on Thursday, its highest daily tally since mid-August.

UK COVID-19 deaths surge to more than 1,100 over last week — Friday’s death toll of 224 took COVID-19 fatalities in the UK over the last seven days past the grim milestone of 1,000, to 1,142. The virus is spiralling out of control, with official figures showed 141,741 new cases over the same one-week period, with the rolling 7-day average for daily new cases eclipsing 20,000 for the first time. The R (Reproduction) rate of the virus remains above 1 nationally, with an estimated daily growth rate range of 3 to 6 percent. Large areas of the UK were placed under local lockdowns over the last 24 hours, including six million people placed under the highest tier restrictions. Despite the massive resurgence of the deadly disease, the government, which rules on behalf of big business, is yet to enforce a national lockdown comparable with that put in place from March 23 – which saved hundreds of thousands of lives. It was the premature ending of the national lockdown from June onwards, and the opening of schools, colleges and workplaces to facilitate the profitmaking of big business, that produced this disastrous situation. The “firebreak” lockdown announced by the Welsh government this week came into operation last night at 6 p.m., covering its population of 3.1 million. People in Wales are to stay indoors unless they need to travel for an essential reason. Non-essential retail is closed, and those shops that are open can only sell essential goods. Workers are to work from home wherever possible, with exceptions for essential workers. Pubs and restaurants will close, as will places of worship. Yet these restrictions will only be in place for 17 days. Children from years 9-13 cannot attend school but pupils in years 7 and 8 are allowed to return after the half-term break. Those who are taking exams can also attend, as can children who attend special schools or pupil referral units. Scottish National Party First Minister Nicola Sturgeon announced a five-level system for restricting movements and limiting physical contact. The highest level of the five entails more restrictions than the highest of England’s three tiers already in place. Greater Manchester, in the north of England, was moved from Tier 2 “high” restrictions to Tier 3 “very high” by central government. The move, covering a population of nearly 3 million people, was imposed after local Labour Party mayor Andy Burnham was unable to reach a deal with Prime Minister Boris Johnson over the financial support available to local business.

Brazil’s Sao Paulo Pushes For Mandatory COVID Vaccinations –In September, Brazil’s wealthiest and most populous state Sao Paulo went into contract with Chinese vaccine developer Sinovac Biotech, with the expectations to receive 46 million doses of CoronaVac. CoronaVac has been in Phase 3 testing in the South American country since July. On Friday, Sao Paulo Governor Joao Doria said if the COVID-19 vaccine is approved by the National Health Regulatory Agency (ANVISA), then mandatory vaccinations would follow, according to the Rio Times. Doria told reporters Friday, Oct. 16, that: “In Sao Paulo, it will be mandatory, except for those with a medical note and a certificate stating that they cannot [take the vaccine].” Just weeks ago, he told other reporters that Sao Paulo “will be one of the first places in the world to vaccinate the public.” He said his administration has already obtained 6 million CoronaVac doses for potential distribution. Citing local media, RT News said Sao Paulo could have the CoronaVac vaccine approved as early as December. The trials are expected to be wrapped up this weekend, with results expected sometime early next week. Doria has spent the last couple of months blasting President Jair Bolsonaro’s handling of the public health crisis – accusing him of “politicizing” the vaccine.Bolsonaro recently responded to Doria’s comments, saying that the Health Ministry will not make vaccination mandatory. Bolsonaro also cited federal laws that determine it’s up to the federal government to decide if vaccinations are mandatory. Bolsonaro, who routinely downplayed the pandemic, and contracted the virus in July, has been widely criticized by Doria and other critics for incompetence. On Saturday, virus-related deaths in the South American country rose 461 to 153,675. Brazil now registers more than 5,224,362 virus cases. Brazil leads all other BRIC countries in deaths per million inhabitants.

With a half-million COVID cases daily, WHO warns world is at a critical juncture – The fall and winter surge of COVID-19 cases, as predicted, has begun. The number of cases across North America and Europe is rising exponentially in some regions. There have been more than 42.4 million cases of COVID-19 globally, with 1.14 million deaths thus far. On Friday, the number of daily new cases neared the 500,000 mark. Global deaths have consistently tracked above 6,000 four days running. At the World Health Organization Friday press briefing on the COVID-19 pandemic, Director-General Tedros Adhanom Ghebreyesus ominously warned, “We are at a critical juncture in this pandemic. Particularly in the Northern Hemisphere. The next few months will be very tough and some countries are on a dangerous track. Too many countries are seeing an exponential increase in cases and that is now leading to hospitals and ICUs close to or above capacity, and we are still only in October. We urge leaders to take immediate action to prevent further unnecessary deaths, essential health services from collapsing and schools shutting again. As I said it in February and I am repeating it today, ‘This is not a drill.’” He strongly urged that world leaders could still “turn this around.” During the question and answer session, epidemiologist Dr. Maria Van Kerkhove noted that many regions might reach their limits in ICU capacity in the next few weeks across Europe and North America. In what amounted to a plea, she cautioned that countries need to take “an honest assessment” of the situation immediately, utilizing all the data available to make “course corrections and necessary changes” to achieve the goals of reducing transmission and saving lives. Dr. Mike Ryan reinforced these warnings: “We don’t have to see deaths track back to the horrific levels they were as a proportion of all cases as in the springtime. Things have changed, we are better, we are better now. We must prevent transmission. But we also need to focus on reducing the toll, which will rise in the coming days, I have no doubt. But we need to also put more investment in ensuring that our frontline system does not collapse in the face of an ever-increasing caseload of sick patients.” On Thursday, the United States reported 74,301 new cases. This was the fourth-highest total ever and the highest since July 24 when the number of daily cases peaked at 79,000. The seven-day moving average death rate has also edged upwards over 800. More problematic has been the rapid rise in hospitalized patients, which exceeded 41,000 across the country, a 33 percent increase in the last three weeks. Sign up for the WSWS Health Care Workers New

COVID-19: Examining Theories for Africa’s Low Death Rates – As the threat of a COVID-19 pandemic emerged earlier this year, many felt a sense of apprehension about what would happen when it reached Africa. Concerns over the combination of overstretched and underfunded health systems and the existing load of infectious and non-infectious diseases often led to it being talked about in apocalyptic terms. However, it has not turned out quite that way. On September 29th, the world passed the one million reported deaths mark (the true figure will of course be higher). On the same day, the count for Africa was a cumulative total of 35,954. Africa accounts for 17% of the global population but only 3.5% of the reported global COVID-19 deaths. All deaths are important, we should not discount apparently low numbers, and of course data collected over such a wide range of countries will be of variable quality, but the gap between predictions and what has actually happened is staggering. There has been much discussion on what accounts for this. As leads of the COVID-19 team in the African Academy of Sciences, we have followed the unfolding events and various explanations put forward. The emerging picture is that in many African countries, transmission has been higher but severity and mortality much lower than originally predicted based on experience in China and Europe. We argue that Africa’s much younger population explains a very large part of the apparent difference. Some of the remaining gap is probably due to under reporting of events but there are a number of other plausible explanations. These range from climatic differences, pre-existing immunity, genetic factors and behavioural differences. Given the enormous variability in conditions across a continent – with 55 member states – the exact contribution of any one factor in a particular environment is likely to vary. But the bottom line is that what appeared at first to be a mystery looks less puzzling as more and more research evidence emerges. The most obvious factor for the low death rates is the population age structure. Across multiple countries the risk of dying of COVID-19 for those aged 80 years or more is around a hundred times that of people in their twenties. This can best be appreciated with a specific example. As of September 30th, the UK had reported 41,980 COVID-19 specific deaths while Kenya, by contrast, had reported 691. The population of the UK is around 66 million with a median age of 40 compared with Kenya’s population of 51 million with a median age of 20 years. Corrected for population size the death toll in Kenya would have been expected to be around 32,000. However if one also corrects for population structure (assumes that the age specific death rates in the UK apply to the population structure of Kenya), we would expect around 5,000 deaths. There is still a big difference between 700 and 5,000; what might account for the remaining gap?There has been no shortage of ideas for other factors that may be contributing.

.