Written by Steven Hansen
The U.S. new cases 7-day rolling average is 3.4 % lower than the 7-day rolling average one week ago. U.S. deaths due to coronavirus are now 8.0 % lower the rolling average one week ago. At the end of this post is a set of interactive graphs and tables for the world and individual states – as well as today’s headlines which include;
- Researchers are testing an experimental drug to halt sudden outbreaks in U.S. nursing homes
- CDC Confirms Soaring COVID-19 Rate Among Native Americans
- Pharmacists nationwide can now administer all scheduled shots to children as young as three
- Wide Range of Antibody Responses After ‘Mild’ COVID-19
- Spain, France And Germany Report Most Coronavirus Cases Since Their Lockdowns
- FDA has granted emergency use authorization to a coronavirus test made by a British company that gives results in about 12 minutes.
- Ultraviolet UVC sanitizers can be dangerous and have limited use against coronavirus
My continuing advice is to continue to wash your hands, wear masks, and maintain social distancing. No handwashing, mask, or social distancing will guarantee you do not get infected – but it sure as hell lowers the risk in all situations. In addition, certain activities are believed to carry higher risk – like being inside in air conditioning and removing your mask (such as restaurants, around your children/grandchildren, bars, and gyms). It is all about viral load.
The daily number of new cases in the U.S. is remaining stubbornly and embarrassedly high.
The following graphs show the 7-day rolling average for new coronavirus cases and deaths have been updated through 20 August 2020:
z coronavirus.png
Coronavirus Statistics For 20 August 2020 |
| U.S. Only | Global | U.S Percentage of Total | ||||
| Today*** | Cumulative | Today*** | Cumulative | Today | Cumulative | |
| New Confirmed Cases | 47,527 | 5,530,000 | 256,025 | 22,430,000 | 18.6% | 24.7% |
| Deaths** | 1,356 | 173,177 | 6,514 | 787,773 | 20.8% | 22.0% |
| Mortality Rate | 2.9% | 3.1% | 2.5% | 3.5% | ||
total COVID-19 Tests per 1,000 people | 2.06* | 208.29* | ||||
* as of 19 Aug 2020
** evidently several states included “probable” deaths today in the number
*** red color indicates record number
Coronavirus News You May Have Missed
Researchers are testing an experimental drug to halt sudden outbreaks in U.S. nursing homes. – New York Times
Nursing home residents make up just 1.2 percent of the U.S. population, but they account for about 40 percent of Covid-19 deaths.
But when the virus crept into Heartland Health Care Center in Moline, Ill., on the last day of July, the nursing home was not defenseless. Heartland was the first facility to participate in a large clinical trial of a drug that might protect residents from the infection in nursing homes and assisted living facilities.
Drug companies and the federal government often avoid testing drugs in older people, even if they are the ones who need treatment most. The elderly may have a range of complicating conditions that make it difficult to tell if the drug is working, and nursing home and extended care facilities are governed by a raft of complex regulations regarding privacy and access.
Experts say the new research, sponsored by Eli Lilly and the National Institutes of Health, is among the first large clinical trials to involve nursing home residents. And the scientists are delighted.
“These patients are so underserved,” said Dr. Rebecca Boxer, medical director of clinical trials at the Kaiser Permanente Institute for Health Research in Colorado. “They do not get access to innovative new drugs and trials.”
Coronavirus outbreak on fishing vessel may be evidence that antibodies prevent reinfection – KOMO News
Research on a coronavirus outbreak that occurred on a Seattle-based fishing vessel earlier this year may be the first direct evidence that antibodies to the coronavirus could prevent people from reinfection.
The report looks at an outbreak on a fishing vessel that sailed from Seattle in May. It found that three crew members who had neutralizing coronavirus antibodies prior to departure were spared from an outbreak that infected more than 85 percent of the boat’s crew members.
Before departing, the ship’s 122 crew members were all tested for coronavirus. This included having their blood drawn to see if they had coronavirus antibodies from a previous infection.
None of the crew members tested positive for coronavirus, however three had antibodies for coronavirus, indicating they had previously been infected.
The report says these types of antibodies found in the three crewmembers have been shown to be able to neutralize the virus and prevent infection in animals.
Despite testing all crew members for coronavirus, the fishing vessel had an outbreak that infected 104 of the 122 crewmembers. However, the three crew members who had the neutralizing antibodies did not show signs of reinfection or any symptoms of coronavirus.
CDC Confirms Soaring COVID-19 Rate Among Native Americans – MedPage
American Indian and Alaska Native (AI/AN) people had rates of COVID-19 infection three times higher than whites, CDC data from 23 states found.
Among 340,059 confirmed COVID-19 cases reported to the agency from January 22 to July 3, the rate of infection was 3.5 times higher for the AI/AN population than it was for whites (95% CI 1.2-10.1), and more so affected younger people in this population (median age 40 vs 51 years in whites), reported Sarah M. Hatcher, PhD, of the CDC COVID-19 Response Team, and colleagues.
Incidence varied greatly across states, with New Mexico reporting the highest disproportionate rate among AI/AN people, at 14.9-fold higher than white people, the researchers wrote in the agency’s Morbidity and Mortality Weekly Report.
Arizona, in which more than one-third of COVID-19 cases among AI/AN people have been documented, was excluded from the analysis due to a paucity of data, as were other states with fewer than 70% complete data on race/ethnicity, the team added.
“Historical trauma and persisting racial inequity have contributed to disparities in health and socioeconomic factors between AI/AN and white populations that have adversely affected AI/AN communities,” Hatcher and co-authors wrote. “[T]hese factors likely contribute to the observed elevated incidence of COVID-19 among the AI/AN population.”
White House says Georgia now leads nation in rate of new virus cases – AJC
Georgia reported the highest rate of new cases of the coronavirus in the country in the seven days ending on Friday, President Trump’s coronavirus task force said in its latest report, urging the state again to take stronger action to mitigate spread of COVID-19.
Though conditions in some areas of Georgia have improved modestly in recent weeks, the White House Coronavirus Task Force said Georgia remains in the red zone for severity of the outbreak as measured by rate of case growth and test positivity.
“Georgia’s small gains are fragile and statewide progress will require continued, expanded, and stronger mitigation efforts, including in all open schools,” according to the White House report, which was dated Sunday.
Georgia’s public colleges and universities are opening for the fall semester, and some colleges will offer a blend of distance and in-person learning. The University of North Carolina in Chapel Hill recently retreated to digital learning because of clusters of new infections.
In Georgia, a number of local schools systems have also reopened for in-person instruction, though infections have so far led to temporary school closures in Cherokee and Paulding counties. School quarantines have been reported in Floyd and Jackson counties.
Trump administration limits FDA review of some coronavirus tests – Politico
The Trump administration will allow coronavirus tests developed by individual laboratories — including commercial facilities run by Quest Diagnostics and LabCorp — to be used without an FDA review, a decision that public health experts warn could lead to broad use of flawed tests.
The Department of Health and Human Services outlined the decision in a notice published Wednesday.
The majority of coronavirus tests used now in the U.S. are made by device manufacturers, who still must seek FDA permission to market their products. But the lab-developed tests affected by the new policy are also in wide use.
Two senior administration officials told POLITICO that the new HHS policy is not specifically aimed at relaxing rules for coronavirus testing. Instead, they said, it is based on HHS’s determination that FDA does not have the authority to regulate lab-developed tests for any condition, including Covid-19.
“A review by the Office of the General Counsel found that the FDA’s assertion is on unfirm procedural and regulatory grounds,” one of the officials said. “They did not gain the authority to regulate LDTs by having gone through a notice and comment rulemaking period, which would be required for an assertion of authority like that.”
The Department of Health and Human Services is giving permission to pharmacists nationwide to administer all scheduled shots to children as young as three – New York Times
Two top U.S. health agencies have announced tangible steps in trying to confront health issues that are byproducts of the coronavirus pandemic — plummeting childhood vaccination rates and concern about the approaching flu season.
The Department of Health and Human Services is giving permission to pharmacists nationwide to administer all scheduled shots to children as young as three — including boosters for measles and other diseases — a step that makes immunization more convenient for parents. The flu vaccine is also an available option for children.
Protecting against the impending flu season in the United States is foremost in the minds of public health officials, who worry about the confluence of cases of flu and Covid-19 hitting hospitals this fall and winter.
And the Centers for Disease Control and Prevention said on Thursday that a high-dose flu shot aimed at better protecting people 65 and older will guard against four strains of the virus this year, rather than three.
Expands Guidance for School Re-Opening – American Academy of Pediatrics
As leaders in education and public health continue to discuss how to begin the next school year, the American Academy of Pediatrics offers updated guidance to support healthy and safe development for all children and adolescents, whatever form school takes.
In its guidance released Wednesday, the AAP emphasizes the need for federal assistance to support schools throughout the U.S. This includes schools where high levels of COVID-19 in the community make it unsafe to open for in-person learning right now.
The AAP routinely re-examines its clinical guidance during the pandemic to make sure the recommendations reflect the latest evidence. This update includes additional guidance on cloth face coverings to align with AAP recommendations; additional discussion about the decision to open schools based on community spread of COVID-19; and an expanded discussion regarding equity in education.
“The persistent racial and social inequities in our educational system, including disparities in funding, quality of school buildings, and resources for curriculum and teachers have only been exacerbated by the pandemic,” said AAP President Sally Goza, MD, FAAP. “Without more resources, these disparities will worsen. Whatever school looks like this fall, we must be innovative and promote the well-being of all children, particularly children living in marginalized communities.”
A recent Pew Research Center study found 1 in 5 teens are not able to complete schoolwork at home due to a lack of a computer or internet connection. This technological ‘homework gap’ disproportionately affects Black, Hispanic, and low-income families.
Wide Range of Antibody Responses After ‘Mild’ COVID-19 – MedPage
Patients hospitalized with mild COVID-19 in China exhibited a wide range of SARS-CoV-2-specific neutralizing antibodies, with a minority of patients with levels below the detectable limit of the assay, researchers found.
Out of 175 patients, 30% developed SARS-CoV-2-specific neutralizing antibody titers of less than 500, and 10 patients with neutralizing antibody titers under the detectable limit, reported Jinghe Huang, PhD, of Fudan University in Shanghai, and colleagues.
These titers tended to be higher in men versus women, and in older and middle-age patients versus younger patients, and those with indicators of stronger immune response, the authors wrote in JAMA Internal Medicine.
An accompanying editor’s note from JAMA Internal Medicine deputy editor Mitchell Katz, MD, mused about this contradiction between the patients with higher antibody levels compared to patients hit hardest by the virus.
“Men, older patients, and those with stronger inflammatory response and older age have generally fared worse, suggesting that the higher titers of antibodies do not necessarily lead to higher recovery rate,” wrote Katz, of NYC Health + Hospitals in New York City.
Trump Wanted FDA To Fast-Track Blood Plasma Therapy. What Is It? – NPR
Blood serum from recovered COVID-19 patients is also being studied as a means of preventing the disease.
It’s still unclear whether plasma treatments are effective for people with COVID-19. A recent non-peer-reviewed study posted online reported on more than 30,000 patients receiving convalescent plasma; it showed that the more antibodies there were in a particular batch of convalescent plasma, the more effective the plasma was in preventing death.
But the study was lacking a control group, that is, a group receiving a sham injection, so it’s difficult to make firm conclusions about the results. Other studies have failed to show a definitive benefit.
Nonetheless, according to press reports, the FDA was close to granting emergency use authorization for convalescent plasma when several senior officials at the National Institutes of Health raised objections. The NIH scientists argued that the evidence for the treatment’s efficacy was thin.
Spain, France And Germany Report Most Coronavirus Cases Since Their Lockdowns – NPR
The chart below shows coronavirus cases in the European Union and the United Kingdom, from early this year through Wednesday.
A test that gives results in minutes gets the F.D.A.’s emergency authorization. – New York Times
The Food and Drug Administration has granted emergency use authorization to a coronavirus test made by a British company that gives results in about 12 minutes.
It is an antigen test, the third one of that type that the F.D.A. has authorized.
Antigen tests work by rapidly detecting fragments of virus in a sample. They are speedy, but they tend to miss more infections than do slower tests based on a technology called polymerase chain reaction, or P.C.R.
In its authorization letter to LumiraDx, the British company, the F.D.A. noted that negative results from the antigen test do not rule out Covid-19 infection, and that a positive test should not be used as the sole basis for treatment.
The new test, which must be administered by a health care professional, is performed using a brick-sized device made by LumiraDx, and depends on swab samples collected from a patient’s nasal cavity. It is intended to be used for patients who have developed symptoms of Covid-19 within the past 12 days; the authorization does not address using it to screening people without symptoms.
“Actionable diagnostic results at the point of care lead to better health outcomes,” said Ron Zwanziger, chief executive of LumiraDx, in a statement. The company said it would start shipping the tests by the end of August, and produce 10 million tests by December.
Ultraviolet UVC sanitizers can be dangerous and have limited use against coronavirus, warns FDA – CNN
Lamps that use ultraviolet light to kill germs can inactivate coronavirus, but they are not always safe and it’s not clear how good a job they do at killing the virus, the FDA says on a newly posted advisory.
Ultraviolet light is part of the electromagnetic spectrum emitted by the sun and can be produced by light bulbs, also. UVC rays are absorbed by the ozone in the Earth’s atmosphere ozone, but rays of UVA and UVB do reach the Earth’s surface and can cause sunburn and skin cancer if people get too much.
The FDA said UVC wavelengths are better than UVA and UVB light at destroying viruses, but UVC lamps have their limits.
“The effectiveness of UVC lamps in inactivating the SARS-CoV-2 virus is unknown because there is limited published data about the wavelength, dose, and duration of UVC radiation required to inactivate the SARS-CoV-2 virus,” the FDA said in a newly posted statement.
Plus the lamps only work in limited circumstances, which don’t mimic many real life situations.
The following are foreign headlines with hyperlinks to the posts
Europe Coronavirus Infections Hit 4-Month High in France, Spain
Russia says it will test coronavirus vaccine on 40,000 people
WHO warns of a resurgence in Europe
Airbnb announces ‘global party ban’
CureVac in talks with EU to supply a potential vaccine
Coronavirus: Portugal added to UK’s safe travel list as Croatia is removed
Brazilian Congress makes masks mandatory, despite president’s veto
Sweden records highest death tally in 150 years in first six months of 2020
The following are additional national and state headlines with hyperlinks to the posts
Cleared by doctors, but not by the public: After COVID-19, survivors face stigma
New York Hospital Visitor Policies Too Strict for ICU, Docs Say
Did a mink just give the coronavirus to a human? Here’s what we know.
Lockdowns, Coronavirus, and Banks: Following the Money
Dr. Anthony Fauci Has Surgery To Remove A Polyp From Vocal Cord
Los Angeles Mayor Shuts Off Power At Hollywood Hills House That Hosted Large Parties
Trump administration moves to exempt teachers from quarantine requirements
GOP Sen. Bill Cassidy tests positive for Covid-19
American Airlines to suspend flights to 15 US cities amid funding debate
VA problems raise worries about mail slowdown, prescriptions
The U.S. Virgin Islands halts tourism as cases surge.
Today’s Posts On Econintersect Showing Impact Of The Pandemic With Hyperlinks
August 2020 Philly Fed Manufacturing Survey Index Declined
15 August 2020 Initial Unemployment Claims Climb Back Over One Million
Implications Of The COVID-19 Disruption For Corporate Leverage
A Dismantled Post Office Destroys More Than Mail Service
COVID-19 Death Rates By State In The US As Of 19 August 2020
Economic Damage Of COVID-19 Fueled By The West
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 although there is now a discussion of whether T-Cells play a part in immunity [which means one might have immunity without antibodies]
- Older population countries will have a higher death rate.
- There are at least 8 strains of the coronavirus. New York may have a deadlier strain imported from Europe, compared to less deadly viruses elsewhere in the United States.
- 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]. Note that using this data is dangerous as the actual flu cases are estimated and not counted – nobody knows how accurate these guesses are.
What we do not know about the coronavirus [actually there is little scientifically proven information]. Most of our knowledge is anecdotal, from studies with limited subjects, or from studies without peer review.
- How many people have been infected as many do not show symptoms?
- Masks do work.
- Do we develop lasting immunity to the coronavirus? Another coronavirus – the simple cold – does not develop long term immunity.
- To what degree do people who never develop symptoms contribute to transmission?
- The US has scaled up coronavirus testing – and the accuracy of the tests has been improving. However, if one loses immunity – the coronavirus testing value is reduced.
- Can children widely spread coronavirus? [current thinking is that they are becoming a major source of the pandemic spread]
- Why have some places avoided big coronavirus outbreaks – and others hit hard?
- What effect will the weather have? At this point, it does not seem hot weather slows this coronavirus down – and it seems air conditioning contributes to its spread.
- Outdoor activities seem to be a lower risk than indoor activities.
- Can the world really push out an effective vaccine in 12 to 18 months?
- Will other medical treatments for Covid-19 ease symptoms and reduce deaths? So far only one drug (remdesivir) is approved for treatment.
- A current scientific understanding of the way the coronavirus works can be found [here].
Heavy breakouts of coronavirus have hit farm workers. Farmworkers are essential to the food supply. They cannot shelter at home. Consider:
- they have high rates of the respiratory disease [occupational hazard]
- they travel on crowded buses chartered by their employers
- few have health insurance
- they cannot social distance and live two to four to a room – and they eat together
- some reports say half are undocumented
- they are low paid and cannot afford not to work – so they will go to work sick
- they do not have access to sanitation when working
- a coronavirus outbreak among farmworkers can potentially shutter entire farm
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 4 % [the 4% is the average of overall statistics – however in the last few months it has been hovering around 1.0%] – which makes it between 10 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.
There will be a commission set up after this pandemic ends to find fault [it is easy to find fault when a once-in-a-lifetime event occurs] and to produce recommendations for the next time a pandemic happens. Those that hate President Trump will conclude the virus is his fault.
Resources:
- Get the latest public health information from CDC: https://www.coronavirus.gov .
- Get the latest research from NIH: https://www.nih.gov/coronavirus.
- Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/.
- List of studies: https://icite.od.nih.gov/covid19/search/#search:searchId=5ee124ed70bb967c49672dad
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