Written by Steven Hansen
The U.S. new cases 7-day rolling average is 24.9 % HIGHER than the 7-day rolling average one week ago. U.S. deaths due to coronavirus are now 6.1 % HIGHER than the rolling average one week ago. U.S. hospitalizations due to COVID-19 are now 11.0 % HIGHER than the rolling average one week ago. Today’s headlines include:
- Daily new cases in the U.S. set an all-time record of 101,273
- Daily new cases in the World set an all-time record of 518,757
- US passes 9 million COVID-19 infections
- Seeking Common Ground in ‘Herd Immunity’ Debate
- Household spread of Covid-19 is common and quick
- Why some people are superspreaders and how the body emits coronavirus
- Who Gets COVID-19 Vax Next: Model Offers ACIP Several Options
- The COVID-19 pandemic has drawn attention to a trend that began in the mid-1970s: The economy has produced too many low wage jobs
- Now That More Americans Can Work From Anywhere, Many Are Planning To Move Away
- Hospital Traces COVID Cluster to Break Room
- US GDP shows largest quarterly growth rate on record, but recovery is far from complete
- European Hospital Bed Capacity Compared
The recent worsening of the trendlines for new cases should be attributed to going back to college/university, cooler weather causing more indoor activities, possible mutation of the virus, fatigue from wearing masks / social distancing, holiday activities, and continued loosening of regulations designed to slow the coronavirus spread.
My continuing advice is to continue to wash your hands, wear masks, avoid crowds, 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 – and the evidence to-date shows a lower severity of COVID-19. 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 – and outdoor activities are generally safe if you can maintain social distance.
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Hospitalizations (grey line) and Mortality (green line) For Week ending 24OCT2020
source: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
Coronavirus News You May Have Missed
Seeking Common Ground in ‘Herd Immunity’ Debate – Medpage
Complete lockdowns may not be a sustainable way to combat the COVID-19 pandemic, but experts are still debating which public health interventions the U.S. should impose to reduce viral transmission in the coming months.
Medical and public health experts contested methods put forth in the Great Barrington Declaration and the John Snow Memorandum in a virtual panel on Friday, disagreeing about whether the U.S. should adopt a “focused protection” method to achieve natural herd immunity, or continue further restrictions. The panel was hosted by Johns Hopkins University.
“Herd immunity is the endpoint of this pandemic no matter what strategy we pick,” said Jay Bhattacharya, MD, PhD, a health economist at Stanford University in California and co-author of the Great Barrington Declaration. “The only question at hand is, how do you get there the safest?”
The Great Barrington Declaration, which was written by Bhattacharya and two other scientists in early October, encourages governments to lift lockdown restrictions on young and healthy people while placing protection measures on vulnerable groups. This “focused protection” method would allow COVID-19 to spread in a population where it is less likely to be fatal, achieving widespread herd immunity that is not dependent on a vaccine.
The John Snow Memorandum was written in response to proposals for natural infection to achieve herd immunity, which was called “a dangerous fallacy unsupported by scientific evidence.” The memorandum, which received more than 6,400 signatures of support from scientists and health experts, does not encourage complete lockdowns, but states that restrictions should continue to suppress viral transmission, and advocates for social and economic programs to prohibit further turmoil.
… In response to how the U.S. might employ a middle-of-the-road approach, Bhattacharya said that “focused protection is the balance,” acknowledging both the harms of lockdown and the danger of the virus to vulnerable populations.
Dowdy agreed that targeting the approach is key: “We need to be thinking about how to be focused in our protection,” he said. “But it’s not a one-size-fits-all strategy.”
[editor’s note: this post deserves a full read to understand the pathways to ending the pandemic]
European Hospital Bed Capacity Compared – Statista
Europe is battling against a second wave of the coronavirus and that has seen some of its biggest economies reinstate their national lockdowns. People in France will only be allowed to leave their homes for essential reasons from Friday while Germany will impose less severe measures from Monday.
As the number of hospitalisations and deaths mount across the continent, which health systems are best equipped to deal with a surge of patients? According to data released by Eurostat in July, Germany had the most hospital beds per 100,000 inhabitants of any European country in 2018 with 800 (Germany’s total here dates from 2017).
Elsewhere, neighbouring France had 591 available hospital beds per 100,000 of the population in 2018 while Italy had 314. The figure is considerably lower in the United Kingdom at just 250. Surprisingly, perhaps, Sweden had the lowest number of hospital beds out of all countries in the dataset with just 214.
You will find more infographics at Statista
Why some people are superspreaders and how the body emits coronavirus – National Geographic
… the rapid spread of the novel SARS-CoV-2 virus has reignited interest in research into how our lungs launch infectious material into the air, namely the tiniest respiratory droplets called aerosols. Understanding how aerosols form in the body is crucial to figuring out why this virus spreads so readily and what’s fueling so-called superspreading events, where a small number of disease carriers end up infecting many individuals. Such incidents are a hallmark of COVID-19.
… To aerosol scientists like Morawska who are more focused on the physics, an aerosol is any particle, wet or dry, that can be suspended in the air for minutes to hours. Aerosols are usually less than 100 micrometers in size, or about the width of a human hair. The human respiratory tract produces a wide variety of aerosols, from tiny droplets only a few micrometers across to globules around 100 micrometers, and even gobs bigger than aerosols that are visible with the naked eye and are more typically described as respiratory droplets.
… “Clearly there’s got to be some type of underlying physiological reason that causes people who are speaking at about the same amplitude and the same pitch to emit wildly different numbers of particles,” Ristenpart says. One possibility, he says, is that the thickness of the fluid and how it reacts to deformation can vary between people. Previous research has shown that inhaling salt water mist that’s less viscous than mucus-packed respiratory fluid made individuals produce fewer aerosol particles overall. On the flip side, folks with fluid that is naturally higher viscosity may be producing more aerosols.
Complicating matters is that a respiratory infection can cause changes in the respiratory fluids. For example, the viscosity of the respiratory lining increases during bronchial infections such as bacterial pneumonia and severe influenza due to the loss of water and increased production of cellular proteins. Chronic conditions like asthma and cystic fibrosis can also thicken up the fluids.
[editor’s note: this post deserves a full read as it is hard to summarize]
Now That More Americans Can Work From Anywhere, Many Are Planning To Move Away – NPR
As coronavirus cases continue to spike and working from home seems permanent, many Americans are planning to set off to live in new places.
An astonishing 14 million to 23 million Americans intend to relocate to a different city or region as a result of telework, according to a new study released by Upwork, a freelancing platform. The survey was conducted Oct. 1-15 among 20,490 Americans 18 and over.
The large migration is motivated by people no longer confined to the city where their job is located. The pandemic has shifted many companies’ view on working from home. Facebook announced plans for half of its employees to work from home permanently. The company even hired a director of remote work in September to ease the transition.
“As our survey shows, many people see remote work as an opportunity to relocate to where they want and where they can afford to live,” says Adam Ozimek, chief economist at Upwork. “This is an early indicator of the much larger impacts that remote work could have in increasing economic efficiency and spreading opportunity.”
Another study conducted by United Van Lines, a major household moving company, found that people wanted to relocate out of New York state at a higher rate than the national average. And, by the beginning of September, the requests to leave San Francisco had grown to more than double the U.S. average. The survey was conducted between March and August.
Nationally, there is a 32% increase in moving interest compared to this time last year, the United Van Lines survey found. The most common reasons associated with pandemic-influenced moves were: concerns for personal and family health and wellbeing, desires to be closer to family, changes in employment status or work arrangement (including the ability to work remotely) and desires for lifestyle change or improvement of quality of life.
Hospital Traces COVID Cluster to Break Room – Medpage
A COVID-19 cluster involving 15 staff members at Holyoke Medical Center in western Massachusetts probably started in a break room, the hospital’s chief executive said.
“We traced it back to employees eating a meal together in a break room, and obviously when you eat a meal you take your mask off, and they contracted it from one employee who was positive,” Holyoke CEO Spiro Hatiras told Western Mass News.
Hatiras said the hospital has since put capacity limits on break rooms.
The employees who became ill began to show symptoms two weeks ago. Of the 15 who tested positive, 10 worked exclusively in the emergency department, according to reports.
As of Monday, two staff members were cleared to return to work. The rest remain at home, according to the local news outlet. The hospital did not return a MedPage Today request for comment as to their various conditions.
Hatiras warned about “COVID fatigue,” even among hospital employees: “We want to make sure that people interpret the guidelines appropriately. What you find sometimes with this fatigue is that 6 feet sometimes becomes 5 feet, sometimes 4 feet.”
US GDP shows largest quarterly growth rate on record, but recovery is far from complete – The Conference Board
US real gross domestic product (GDP) expanded by 33.1 percent (annualized) during the third quarter of 2020, following a 31.4 percent contraction in Q2. While this was the largest quarterly growth rate on record, the US economy remains 3.5 percent smaller than it was prior to the pandemic in Q4 2019.
Third quarter GDP growth was driven primarily by a large rebound in consumption and stronger inventories and investment. While consumption was the largest contributor to overall growth this quarter, it remains approximately $436 bln below its Q4 2019 level (about 3.3 percent lower). Although spending on goods (many of which are imported) exceeded prepandemic levels, the strength was more than offset by a deterioration in spending on services, which are mostly produced domestically. Inventories, which fell sharply in the second quarter, improved in Q3 and contributed seven percentage points to overall GDP growth. Investment activities also helped Q3 growth. Residential investment exceeded Q4 2019 levels by $31.3 bln, but nonresidential investment was still down $136.7 bln. Meanwhile, government spending and net exports were a drag on growth in Q3. Government spending fell $38.3 bln, pulling overall GDP growth down by 0.68 percent. An uneven rebound in export and import growth yielded an annualized trade deficit of over $1 tln—the largest on record.
Looking ahead, given the resurgence in new COVID-19 cases, the limited recovery in the labor market, and uncertainty over passage of another fiscal stimulus package, it is unlikely that economic activity will significantly improve in Q4 2020. We anticipate incremental growth in the months ahead but do not expect the US economy to return to a prepandemic level of output until the second half of 2021.
Who Gets COVID-19 Vax Next: Model Offers ACIP Several Options – Medpage
It’s generally agreed that healthcare workers should be first in line for COVID-19 vaccines. Who comes next, however, may depend on whether the goal is to prevent infections or deaths, according to a presentation at the CDC’s Advisory Committee on Immunization Practices (ACIP) on Friday.
A modeling study found that prioritizing adults ages 65 and older would avert more COVID-19 deaths, but prioritizing adults with high-risk medical conditions and essential workers would avert more COVID-19 infections, said Matthew Biggerstaff, ScD, of the CDC.
“Timing of the campaign is a really important factor in the potential impact of the vaccine,” he said at the ACIP meeting dedicated to COVID-19, describing three scenarios when the vaccine is distributed: before incidence rises, as incidence rises, or as incidence falls.
Not only that, but the type of vaccine plays a role, whether infection-blocking, meaning it will help stop transmission of the virus, or disease-blocking, meaning it will help reduce severity of illness, but have no bearing on whether people get infected.
ACIP will be responsible for ultimately deciding which populations receive the vaccine once the FDA approves a COVID-19 vaccine, likely under emergency use authorization (EUA). Previous proposals stated that healthcare workers would be vaccinated in in phase 1a, while phase 1b would take in essential workers” and adults ages 65 and older and those with high-risk medical conditions such as COPD, heart disease, diabetes and kidney disease.
Almost 27,000 people who worked at hotels and restaurants in the Milwaukee area made less than the median wage of $40,700 a year and did not get health insurance through their employer in 2018. That’s an estimated 41% of the total jobs in the hospitality sector.
In the retail sector, 21,540 people, or 27% of the workforce, are in the same category.
The estimates are from an interactive tool — “Visualizing Vulnerable Jobs Across America” — compiled by the Brookings Institution. They measure the percentage of workers in 380 metropolitan areas who are the most vulnerable in the economic downturn bought on by the pandemic.
This downturn differs from others not only in how swiftly it hit, but also how its impact has been concentrated in a few sectors of the economy.
It has had a disproportionate effect on people who work as waiters, taxi drivers, janitors and in an array of other service jobs.
… Brookings, a public policy research organization based in Washington, D.C., refers to these jobs — low pay, no insurance — as vulnerable. It found that 19% of U.S. jobs, or almost one in five, paid less than the median wage, adjusted for location, and did not provide health care benefits in 2018.
In a first for the U.S., Cuomo requires visitors to New York to undergo testing. – New York Times
Gov. Andrew M. Cuomo ordered every visitor to New York to be tested for the coronavirus upon entry, making the state the first to have such a requirement during the worst phase of the pandemic so far.
Mr. Cuomo unveiled the order as the United States is approaching a seven-day average of nearly 100,000 new cases, and deaths from the virus inch closer to 1,000 per day.
New York previously maintained a weekly list of states from which visitors were required to quarantine for two weeks, but abandoned it as the number of states experiencing intense community spread grew to more than two dozen. Mr. Cuomo said that by the state’s own standards, New York’s rise in cases over the past week would have put it on its own quarantine list.
“There will be no quarantine list, there will be no metrics,” the governor said at a news conference on Saturday.
England to enter second lockdown in days, says Boris Johnson – CNN
England will enter a second national lockdown in the coming days, British Prime Minister Boris Johnson has announced. The decision came hours after the UK passed the grim milestone of one million coronavirus cases.
The month-long shutdown will come into effect from Thursday after a parliamentary vote early next week, Johnson said during a news conference on Saturday evening.
“We must act now to contain the autumn surge,” he said.
Johnson was forced to make the announcement on Saturday after the government’s plans were leaked to numerous national newspapers the previous evening. The plan had been initially to announce the measures on Monday.
The strict lockdown will see the closure of pubs, restaurants and non-essential businesses, including hair salons and gyms. Schools, universities and playgrounds will stay open.
People will only be able to leave their homes for specific reasons: education, work (if they are unable to work from home), to shop for food, for health reasons, or for exercise and recreation outdoors, either with that person’s household or with one person from another household.
Household spread of Covid-19 is common and quick – CNN
The spread of Covid-19 among members in a household after one person is infected is “common” and occurs quickly after illness onset, according to a new study from the US Centers for Disease Control and Prevention.
The person exposed or suspected of having Covid-19 should be isolated before getting tested and before test results come back to protect others in the home, said the study, published Friday in the CDC’s Morbidity and Mortality Weekly Report.
“Because prompt isolation of persons with COVID-19 can reduce household transmission, persons who suspect that they might have COVID-19 should isolate, stay at home, and use a separate bedroom and bathroom if feasible,” wrote a CDC-led team of researchers.
In addition, all members of the household should wear masks at all times in common spaces, the team said.
… Infection was quick: Over half of the people (53%) who lived with someone battling Covid-19 became infected within a week, researchers found. Some 75% of these secondary infections occurred within five days of the first symptoms in the initial patient.
“Substantial transmission occurred whether the index patient was an adult or a child,” researchers said.
A 53% household infection rate, the study said, is higher than what has been documented so far. To date, related research has reported only a 20% to 40% infection rate.
The following are foreign headlines with hyperlinks to the posts
England to enter second lockdown in days, says Boris Johnson
The following are additional national and state headlines with hyperlinks to the posts
Add Skin Conditions to COVID-19 Long-Hauler Effects
El Paso County Judge Orders Shutdown Of Nonessential Businesses
Disney lays off over 11,000 employees
100 things to do while inside due to a pandemic
Decision reversed: Walmart returning guns to sales floor
Thanksgiving airline bookings have plummeted.
Trump rallies led to more than 30,000 Covid cases, Stanford researchers say
Leaving New York: High earners in finance and tech explain why they left NYC
Study: Trump rallies may be responsible for an estimated 700 Covid-19 deaths
Today’s Posts On Econintersect Showing Impact Of The Pandemic With Hyperlinks
Has Trust In Science Become A Partisan Issue?
3Q 2020 GDP: “V” Stands For Vacuous
COVID Changing Behavior Of Job Seekers
Warning to Readers
The amount of politically biased articles on the internet continues to increase. And studies and opinions of the experts continue to contradict other studies and expert opinions. Honestly, it is difficult to believe anything anymore. A study usually cannot establish cause and effect – but only correlation. Be very careful what you believe about this pandemic.
I assemble this coronavirus update daily – sifting through the posts on the internet. I try to avoid politically slanted posts (mostly from CNN, New York Times, and the Washington Post) and can usually find unslanted posts on that subject from other sources on the internet. I wait to publish posts on subjects that I cannot validate across several sources. But after all this extra work, I do not know if I have conveyed the REAL facts. It is my job to provide information so that you have the facts necessary – and then it is up to readers to draw conclusions.
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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