Written by Steven Hansen
There was a significant upward bump today for both new cases and deaths (two steps forward and one back). Following is a set of interactive graphs and tables for the world and individual states – as well as today’s headlines on coronavirus which include topics on strokes in young adults and the growing evidence of significant asymptomatic spread of COVID-19.
Coronavirus News You May Have Missed
COVID-19 Linked to Large Vessel Stroke in Young Adults – Medscape
Physicians in New York City, which still leads the nation in reported COVID-19 cases, are reporting significantly more acute, large vessel strokes in young adults infected with COVID-19.
In a rapid communication to be published online April 29 in the New England Journal of Medicine, investigators led by Thomas Oxley, MD, PhD, department of neurosurgery, Mount Sinai Health System, report five cases of large vessel stroke over a 2-week period in COVID-19 patients under age 50 years. This represents a sevenfold increase in what would normally be expected.
The five cases had either no, or mild, COVID-19 symptoms.
How disease sleuths are using genomics to track the coronavirus – Knowable Magazine
Unfortunately for genetic detectives, the Covid-19 virus changes a little too slowly for optimal tracking of transmission chains, Wohl notes. HIV, in contrast, mutates so quickly that each person usually carries a unique genotype, allowing epidemiologists to pinpoint the exact source of each new infection. For the Covid-19 virus, each viral lineage accumulates about 30 new mutations per year, which works out to about one new mutation per two links in the transmission chain. As a result, exactly the same viral genome sequence can be found in several people, so genome-trackers can narrow transmission down only to a handful of suspects.
Additional uncertainty comes from the fact that researchers can’t possibly sequence viruses from every infected individual in a widespread pandemic. As of April 20, nearly 2.5 million people worldwide had been infected with SARS-CoV-2, but Nextstrain listed just 4,558 sequences. That can lead to false conclusions. “The beautiful danger is it looks like it can tell you a lot of enticing stories,” says Hodcroft. “But we don’t know that the scenario is exactly what happened.”
In late February, for example, sequencers found patients in Germany and Italy who shared the same unusual viral mutation. Since the German patient had gotten sick sooner, this led some researchers to suggest that the virus had spread from Germany to Italy. In reality, though, both German and Italian patients could have caught the virus from some third person, yet unidentified, whose virus was not sequenced.
Still, these limitations have not kept genomic epidemiology from playing a key role in the Covid-19 pandemic. The approach has helped public health officials identify the pathogen, trace its travels and recognize community spread promptly. And in the months ahead, the method may have more to contribute.
Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility – The New England Journal of Medicine
SARS-CoV-2 can spread rapidly after introduction into skilled nursing facilities, resulting in substantial morbidity and mortality and increasing the burden on regional health care systems. Unrecognized asymptomatic and presymptomatic infections most likely contribute to transmission in these settings. During the current Covid-19 pandemic, skilled nursing facilities and all long-term care facilities should take proactive steps to prevent introduction of SARS-CoV-2. These steps include restricting visitors and nonessential personnel from entering the building, requiring universal use of face masks by all staff for source control while in the facility, and implementing strict screening of staff. Our data suggest that symptom-based strategies for identifying residents with SARS-CoV-2 are insufficient for preventing transmission in skilled nursing facilities. Once SARS-CoV-2 has been introduced, additional strategies should be implemented to prevent further transmission, including use of recommended personal protective equipment, when available, during all resident care activities regardless of symptoms.5Consideration should be given to test-based strategies for identifying residents and staff with SARS-CoV-2 infection for the purpose of excluding infected staff and cohorting residents, either in designated units within a facility or in a separate facility designated for residents with Covid-19.
As mass coronavirus testing expands in prisons, large numbers of inmates are showing no symptoms. In four state prison systems — Arkansas, North Carolina, Ohio and Virginia — 96% of 3,277 inmates who tested positive for the coronavirus were asymptomatic, according to interviews with officials and records reviewed by Reuters. That’s out of 4,693 tests that included results on symptoms.
The numbers are the latest evidence to suggest that people who are asymptomatic — contagious but not physically sick — may be driving the spread of the virus, not only in state prisons that house 1.3 million inmates across the country, but also in communities across the globe. The figures also reinforce questions over whether testing of just people suspected of being infected is actually capturing the spread of the virus.
“It adds to the understanding that we have a severe undercount of cases in the U.S.,” said Dr. Leana Wen, adjunct associate professor of emergency medicine at George Washington University, said of the Reuters findings. “The case count is likely much, much higher than we currently know because of the lack of testing and surveillance.”
Black light experiment reinforces COVID-19 medical message: Don’t touch your face – 3WBTV
You’ve heard the advice from doctors for weeks now — during this pandemic, it’s important to wash your hands and not touch your face.
Dr. David Quimby is the medical director of epidemiology and infection prevention at CHI Health.
“Don’t touch your face,” he said. “It’s a respiratory infection which includes the airways and the lungs. That’s the portal of entry and the portal of exit. If you have a bad lung infection, every breath that comes out has little droplets of viral particles in it.”
How easy is it to get germs from our hands to our faces and vice versa? WOWT decided to put it to the test under a black light.
This lotion glows under a black light. A few people in the newsroom put it on and went about their day to see where the now easy-to-spot germs would spread.
Miami-Dade has tens of thousands of missed coronavirus infections, UM survey finds – Miami Herald
About 6 percent of Miami-Dade’s population — about 165,000 residents — have antibodies indicating a past infection by the novel coronavirus, dwarfing the state health department’s tally of about 10,600 cases, according to preliminary study results announced by University of Miami researchers Friday.
The study, spurred by Miami-Dade County officials, will be an ongoing weekly survey based on antibody testing — randomly selecting county residents to volunteer pinpricks of their blood to be screened for signs of a past COVID-19 infection, whether they had tested positive for the virus in the past or not. The goal is to measure the extent of infection in the community.
Friday’s results, based on two weeks of countywide antibody testing and about 1,400 participants, found that about half of the people who tested positive for antibodies reported no symptoms in the 14-17 days before being tested. If the trend holds, the findings could have major implications for understanding not only the number of people infected, but also how many have symptoms and, in turn, how the virus spreads.
ER Physician Drops Multiple COVID-19 Bombshells – YouTube
Why Private Equity Is Cutting Doctor Pay and Organizing Our Pandemic Response – Big
The way to understand the response to the pandemic is to recognize that America has been transformed, temporarily, into a planned economy. A planned economy requires central planners directing resources. So who are they and how do they operate? Today I’m going to write about one group of central planners, the fusion of government and the financial sector in the network of funds we call private equity. It’s a notable set of actors making important political decisions under-the-radar as we speak. For instance, private equity funds are making the meaningful political decision to cut doctor pay for those on the front lines of the epidemic, which is a serious public policy choice.
China Says Wuhan Has No Hospitalized Coronavirus Cases: Live Coverage – zephymet
China says Wuhan has no more hospitalized coronavirus patients.
Wuhan, the original epicenter of the pandemic in China, now has no coronavirus patients in its hospitals, a government official said on Sunday.
The city, an industrial metropolis of 11 million, was the first to experience total lockdown and road bans as its hospitals became overwhelmed with patients. Officials reported 46,452 total infections and 3,869 deaths from Wuhan in a tally published Sunday, though critics believe the actual figures to be higher.
Once debilitated by the virus, Wuhan has been showing signs of recovery and each milestone has been celebrated. Capsule hospitals that had been set up in Wuhan stadiums and gymnasiums were cleared in March, and the government allowed outbound traffic on April 7 after ending its lockdown.
Children in Spain go outside for the first time in weeks as the country’s lockdown begins to ease. – The New York Times
Children took to the streets of Spain on Sunday for the first time in six weeks, as part of the government’s plan to gradually ease a nationwide lockdown in response to improved coronavirus numbers.
The rules allow children to take a stroll for one hour within one kilometer (0.6 miles) of their home, accompanied by an adult. And the sight of parents pushing strollers and teenagers riding skateboards brought a semblance of normalcy to Madrid and elsewhere.
| U.S. Only | Global | U.S Percentage of Total | ||||
| Today | Cumulative | Today | Cumulative | Today | Cumulative | |
| New Cases | 48,529 | 939,053 | 99,968 | 2,840,000 | 48.5% | 33.1% |
| Deaths | 2,172 | 53,189 | 5,929 | 201,315 | 36.6% | 26.4% |
| Mortality Rate | 4.5% | 5.7% | 5.9% | 7.1% | ||
| total COVID-19 Tests per 1,000 people | 0.91 | 15.64 | ||||
Today’s Posts On Econintersect Showing Impact Of The Pandemic With Hyperlinks
Helping State And Local Governments Stay Liquid
Protectionism And Dependence On Imports Of Essential Medical Equipment
Frauds Targeting Main Street Investors – Investor Alert
Unpaid Absence From Work Because Of COVID-19
Infographic Of The Day: Federal Budget In Fiscal Year 2019
‘Reopen’ Protest Movement Created, Boosted By Fake Grassroots Tactics
Coronavirus Economic News 25April 2020
Coronavirus Disease News 25April 2020
Coronavirus And Economic Interdependence
Coronavirus INTERACTIVE Charts
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Analyst Opinion of Coronavirus Data
There are several takeaways that need to be understood when viewing coronavirus statistical data:
- The global counts are suspect for a variety of reasons including political. Even the U.S. count has issues as it is possible that as much as half the population has had coronavirus and was asymptomatic. It would be a far better metric using a random sampling of the population weekly. In short, we do not understand the size of the error in the tracking numbers.
- Just because some of the methodology used in aggregating the data in the U.S. is flawed – as long as the flaw is uniformly applied – you establish a baseline. This is why it is dangerous to compare two countries as they likely use different methodologies to determine who has (and who died) from coronavirus.
- COVID-19 and the flu are different but can have similar symptoms. For sure, COVID-19 so far is much more deadly than the flu. [click here to compare symptoms]
- From an industrial engineering point of view, one can argue that it is best to flatten the curve only to the point that the health care system is barely able to cope. This solution only works if-and-only-if one can catch this coronavirus once and develops immunity. In the case of COVID-19, herd immunity may need to be in the 80% to 85% range. WHO warns that few have developed antibodies to COVID-19. At this point, herd immunity does not look like an option.
- Older population countries will have a higher death rate.
- Each publication uses different cutoff times for its coronavirus statistics. Our data uses 11:00 am London time. Also, there is an unexplained variation in the total numbers both globally and in the U.S.
- The real question remains if the U.S. is over-reacting to this virus. The following graphic from the CDC puts the annual flu burden in perspective [click on image to enlarge].
What we do not know about the coronavirus [actually there is little scientifically proven information]. Most of our knowledge is anecdotal – not backed by scientific studies:
- Is social distancing at 6 feet correct? Some are saying 4 meters (13 feet). And what is the correct social distance if one rides a bike?
- Will warm weather and higher humidity slow the coronavirus spread? Will September see another spike in cases? Next Winter may see more cases than seen previously.
- Should we decontaminate products (such as food) that are brought into the house?
- Does one develop immunity after recovering from coronavirus?
- Is COVID-19 mutating? How will this impact the ability to create immunization or even immunity?
- Are ventilators damaging patients – should oxygen be used instead?
The bottom line is that COVID-19 so far has been shown to be much more deadly than the data on the flu. Using CDC data, the flu has a mortality rate between 0.06 % and 0.11 % Vs. the coronavirus which to date has a mortality rate of over 5 % – which makes it between 45 and 80 times more deadly. The reason for ranges:
Because influenza surveillance does not capture all cases of flu that occur in the U.S., CDC provides these estimated ranges to better reflect the larger burden of influenza.
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