Written by Steven Hansen
The U.S. new cases 7-day rolling average are 1.0 % LOWER than the 7-day rolling average one week ago and U.S. deaths due to coronavirus are now 12.1 % LOWER than the rolling average one week ago. Today’s posts include:
- U.S. Coronavirus New Cases are 60,495
- U.S. Coronavirus deaths are at 1,531
- U.S. Coronavirus immunizations have been administered to 34.6 % of the population
- The 7-day rolling average rate of growth of the pandemic shows new cases improved and deaths worsened
- Map Shows Which Parts of U.S. Are Still Struggling to Contain COVID
- The virus is still spreading in parts of the U.S., adding an urgency to vaccinations at a critical moment.
- Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019
- Cancer Patients Respond Poorly to First COVID mRNA Vax Dose
- Skin Swabs Could Be Used to Rapidly Identify COVID-19 Infection
- Sustained neutralising antibodies in the Wuhan population suggest durable protection against SARS-CoV-2
- Association of vitamin D levels, race/ethnicity, clinical characteristics with COVID-19 test results
- Child Vaccinations Likely Needed to Reach Herd Immunity
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Hospitalizations Are The Only Accurate Gauge
Hospitalizations historically appear to be little affected by weekends or holidays. The hospitalization growth rate trend is improving.
source: https://gis.cdc.gov/grasp/covidnet/COVID19_3.html
Historically, hospitalization growth follows new case growth by one to two weeks.
As an analyst, I use the rate of growth to determine the trend. But, the size of the pandemic is growing in terms of real numbers – and if the rate of growth does not become negative – the pandemic will overwhelm all resources.
The graph below shows the rate of growth relative to the growth a week earlier updated through today [note that negative numbers mean the rolling averages are LOWER than the rolling averages one week ago]. As one can see, the rate of growth for new cases peaked in early December 2020 for Thanksgiving, and early January 2021 for end of year holidays – and it now shows that the coronavirus effect is now shrinking.
In the scheme of things, new cases decline first, followed by hospitalizations, and then deaths.
Will The New Variants Cause The Next Spike?
Maybe and maybe not. It all depends on vaccinations:
- the more people that are vaccinated reduces the pool of people that can be infected. Today we have removed over 34 % of the population from being infected which theoretically should reduce the infection rate by 34 % [it is unproven whether the vaccines prevent a vaccinated person from being a carrier of the virus even though showing no signs]. If the vaccines are shown to stop transmission, then in theory it would reduce the infection rate by double the percent vaccinated [in this case you prevent your own infection and do not pass it along to another].
- it is also unknown what the effective rate of the current vaccines is against mutations that seem to appear almost daily. As an example, if the effective rate drops to 60%, it means the 34 % reduction in the infection rate discussed above is almost cut in half. The South African and Brazilian variant is reported somewhat immune to the current vaccines.
- The pandemic should be over immediately if everyone could be vaccinated today. The problem is that every day brings a new mutation (which would not appear if the pandemic was stopped). The longer the immunization process takes – the more ineffective the vaccine will become.
- It is not clear whether the vaccine prevents those vaccinated from spreading the virus. It seems to be well documented that it normally stops the virus from taking hold and when it does not – the infection is mild.
Coronavirus News You May Have Missed
Cancer Patients Respond Poorly to First COVID mRNA Vax Dose – MedPage
Barely one-quarter of patients with cancer obtained protection against COVID-19 after one dose of the Pfizer/BioNTech vaccine, a prospective study showed.
The data found a “strikingly low” 28% immune efficacy rate in patients with cancer, including 13% in patients with blood cancers. In contrast, first-dose seroconversion occurred in 97% of a healthy control group, Adrian Hayday, PhD, of King’s College London, and co-authors concluded in a report posted to the preprint server medRxiv.
A second dose at day 21, however, brought adequate immunity to nearly all the cancer patients, they said.
“These data support prioritization of cancer patients for an early (21-day) second dose of the BNT162b2 vaccine,” Hayday and colleagues wrote in the preprint. “Given the globally poor responses to vaccination in patients with hematological cancers, post-vaccination serological testing, creation of herd immunity around these patients using a strategy of ‘ring vaccination,’ and careful follow-up should be prioritized.”
“Delayed boosting potentially leaves most solid and hematological cancer patients wholly or partially unprotected, with implications for their own health, their environment, and the evolution of variant-of-concern strains,” the researchers added. “Prompt boosting of solid cancer patients quickly overcomes the poor efficacy of the primary inoculum in solid cancer patients.”
In general, patients with cancer have been excluded from clinical trials of COVID-19 vaccines, following evidence of sustained immune dysregulation, inefficient seroconversion, and prolonged viral shedding after COVID-19 infection. The exclusion has raised questions about the vaccines’ safety and efficacy in patients with cancer, Hayday and co-authors noted.
SARS-CoV-2 infections were first reported in Wuhan, China, in 2019, and quickly became a global pandemic, as declared on March 11, 2020. SARS-CoV-2 is highly infectious and COVID-19 is variable in its presentation, with many infected individuals, as detected by viral nucleic acid screening, being asymptomatic.
In The Lancet, Zhenyu He and colleagues report their cross-sectional study of serological responses of more than 9500 individuals from 3600 households in Wuhan, the early epicentre for the COVID-19 outbreak. The study was initiated shortly after lockdown in Wuhan ceased in April, 2020, with follow-up over two timepoints (June and October-December, 2020). In this cross-sectional, longitudinal serosurvey of Wuhan residents, the authors estimated the penetration of the virus into the community who were selected using a population-stratified, random-sampling approach. They also examined the development and durability of SARS-CoV-2 neutralising antibodies, the putative correlate of protection in COVID-19.
In the Wuhan population sampled by He and colleagues, 532 (5·6%) of 9542 participants were positive for pan-immunoglobulins against SARS-CoV-2 at baseline, giving an adjusted seroprevalence of 6·92% (higher than an earlier report, which estimated a seroprevalence of 3·2-3·8%). More than 80% of those surveyed who were seropositive were asymptomatic. As a city of 11 million people with 9 million residents as estimated during lockdown, quick extrapolation of these estimates suggests that approximately 622 800 individuals in Wuhan would have been infected as of April, 2020, far exceeding the cumulative number of confirmed cases in Wuhan (50 333 as of April 17, 2020). If the seroconversion rate is an accurate reflection of exposure to SARS-CoV-2, the apparent disparity between low case numbers and high seroconversion rate seems to suggest that most seroconverted individuals produced antibodies to SARS-CoV-2 after asymptomatic infection. Accordingly, by occupation group, the highest seroconversion rate was seen in health workers and in those with known COVID-19 contacts in the past 5 months. This observation suggests a relay of exposure that frequently resulted in asymptomatic transmission chains because, when the full population of Wuhan was screened in May, 2020, few additional, asymptomatic cases were detected compared with the known number of confirmed cases in April, 2020. Although separating transmitting from non-transmitting asymptomatic individuals with COVID-19 is probably impractical, the transmission outcomes from these two patient cohorts would suggest that different management regimens might be considered.
He and colleagues detected neutralising antibodies in 39·8% of the seropositive subgroup; encouragingly, the proportion was sustained over the 9-month study period, indicating that putative protection was durable when it occurred. Moreover, titres of neutralising antibodies were lower in individuals who had asymptomatic infections, compared with those with symptomatic infection and confirmed cases. The reason why those with asymptomatic disease developed lower neutralising antibody titres than those with symptomatic disease might be simply explained by different levels of exposure to SARS-CoV-2 antigens. Whether the levels of neutralising antibodies, or their transient appearance, also affected the so-called transmissibility potential would require further investigation.
[editor’s note: if the virus is still propagating in a population that has largely achieved seroconversion and asymptomatic infections of any remaining previously unexposed, then the repeated population exposure will actually lead to prolonged reinforcement of existing immune responses, and maintenance of both circulating antibodies and “memory” t-cells in lymph nodes.]
Association of vitamin D levels, race/ethnicity, clinical characteristics with COVID-19 test results – EurekAlert
Are differences in vitamin D levels greater than levels traditionally considered sufficient (30 ng/mL) associated with having test results positive for coronavirus disease 2019 (COVID-19) in White and in Black individuals?
Findings In this cohort study of 4638 individuals with a measured vitamin D level in the year before undergoing COVID-19 testing, the risk of having positive results in Black individuals was 2.64-fold greater with a vitamin D level of 30 to 39.9 ng/mL than a level of 40 ng/mL or greater and decreased by 5% per 1-ng/mL increase in level among individuals with a level of 30 ng/mL or greater. There were no statistically significant associations of vitamin D levels with COVID-19 positivity rates in White individuals.
Meaning These findings suggest that randomized clinical trials to determine whether increasing vitamin D levels to greater than 30 to 40 ng/mL affect COVID-19 risk are warranted, especially in Black individuals.
Child Vaccinations Likely Needed to Reach Herd Immunity – WebMD
The United States probably won’t reach herd immunity until children are vaccinated, Anthony Fauci, MD, said.
“We don’t really know what that magical point of herd immunity is, but we do know that if we get the overwhelming population vaccinated, we’re going to be in good shape,” Fauci said Thursday during a hearing of the Senate Health, Education, Labor and Pensions Committee. “We ultimately would like to get and have to get children into that mix.”
Fauci, director of the National Institute of Allergy and Infectious Diseases, said he has estimated 70-85% of the population would need to be vaccinated or immune to reach herd immunity.
Herd immunity occurs when a large part of the population becomes immune to a virus, through vaccination or infection, and the virus has nowhere to go.
On Wednesday, Fauci told the House Committee on Energy and Commerce that high school students might start being vaccinated in the fall and younger children in early 2022, CNBC reported.
Skin Swabs Could Be Used to Rapidly Identify COVID-19 Infection – Medscape
Researchers at the University of Surrey have found that non-invasive skin swab samples may be enough to detect COVID-19.
In a study published by Lancet EClinicalMedicine, sebum samples were collected from 67 hospitalised patients (30 were COVID-19 positive and 37 were COVID-19 negative) by gauze swab. Lipidomics analysis was carried out using liquid chromatography mass spectrometry, identifying 998 reproducible features.
The results show that lipid levels were depressed in COVID-19-positive participants, indicative of dyslipidemia; P=.022 and P=.015 for triglycerides and ceramides, respectively, with effect sizes of 0.44 and 0.57.
Partial least squares-discriminant analysis showed the separation of COVID-19-positive and COVID-19-negative participants, with sensitivity of 57 per cent and specificity of 68 per cent, improving to 79 per cent and 83 per cent, respectively, when controlled for confounding comorbidities.
The authors say, given that sebum samples can be provided quickly and painlessly, sebum is worthy of future consideration for clinical sampling.
Matt Spick, co-author of the study from the University of Surrey, said: “COVID-19 damages many areas of metabolism. In this work, we show that the skin lipidome can be added to the list, which could have implications for the skin’s barrier function, as well as being a detectable symptom of the disease itself.”
Map Shows Which Parts of U.S. Are Still Struggling to Contain COVID – Newsweek
A new map of the United States shows which areas across the country are still struggling to contain the spread of the coronavirus.
The map, which was shared on Twitter Friday by Politico health care reporter Erin Banco, uses five classifications to determine “areas of concern” as the nation continues to grapple with the pandemic.
Those classifications are low or moderate burden areas, emerging hot spots, hot spots, sustained hot spots, and high or moderate burden areas that are resolving.
According to the map, states across the Northeast—Pennsylvania, New York, New Jersey and Massachusetts—as well as areas in North Carolina, South Carolina and Florida are largely considered sustained hot spots.
The virus is still spreading in parts of the U.S., adding an urgency to vaccinations at a critical moment. – New York Times
Even with the accelerated pace of vaccinations, worrisome variants are spreading. Some states, especially on the East Coast, have struggled for weeks to make any progress in reducing cases. At the same time, governors are starting to relax restrictions on businesses like bars, indoor gyms and casinos, and many Americans are dining in newly reopened restaurants, replanning summer weddings that were abruptly canceled in 2020 and booking spring break trips.
Last week, air travel in the United States rose to its highest level since the pandemic hit, and airline executives said that bookings in the coming months indicate an eagerness from Americans to begin traveling in large numbers again.
The path ahead — and public guidance about how people should behave in this moment — seems uncertain, even contradictory. Epidemiologists said they viewed the current moment in the pandemic as a sprint between vaccinations and newly confirmed cases, particularly those caused by variants that can be more contagious. Dr. Anthony S. Fauci, the nation’s top infectious-disease expert, warned Friday “that it’s really quite risky to declare victory before you have the level of infection in the community to a much, much lower level than 53,000 cases per day.”
… But there are warning signs in the data.
Vermont, which escaped the worst of the pandemic in 2020, has struggled all of this year to curb an outbreak. Michigan, which had appeared to bring the virus under control in January, has seen case numbers increase by more than 80 percent over the last two weeks, though they remain well below their December peak. In South Florida, infection levels have remained persistently high, with about 1,000 cases reported each day in a single county, Miami-Dade.
Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019 – Anesthesia & Analgesia
A new study is adding to the growing body of evidence that low-dose aspirin helps lessen the harsher effects of contracting the coronavirus.
The study, conducted by George Washington University researchers and published in the journal Anesthesia and Analgesia, examined the records of 412 patients admitted to U.S. hospitals with COVID-19 from March to July of last year.
Of those, nearly 24% had taken aspirin seven days or less before of hospital admission or within 24 hours after admission. More than 40% of those patients had improved results in key areas compared to patients who did not take the cheap, widely available drug.
“Aspirin may have lung-protective effects and reduce the need for mechanical ventilation, ICU admission, and in-hospital mortality in hospitalized COVID-19 patients,” the report concluded.
The researchers warned that a randomized controlled trial would be needed to establish a causal relationship, but a study conducted around the same time last year in Israel also found a link between taking so-called baby aspirin and better COVID-19 outcomes.
Major coronavirus variant found in pets for first time – Science
The variants of SARS-CoV-2 that keep emerging aren’t just a human problem. Two reports released this week have found the first evidence that dogs and cats can become infected by B.1.1.7, a recent variant of the pandemic coronavirus that transmits more readily between people and also appears more lethal in them. The finds mark the first time one of the several major variants of concern has been seen outside of humans.
B.1.1.7 was first identified in the United Kingdom and that’s where some of the variant-infected pets were found. The U.K. animals suffered myocarditis—an inflammation of the heart tissue that, in serious cases, can cause heart failure. But the reports offer no proof that the SARS-CoV-2 variant is responsible, nor that it’s more transmissible or dangerous in animals. “It’s an interesting hypothesis, but there’s no evidence that the virus is causing these problems,” says Scott Weese, a veterinarian at the University of Guelph’s Ontario Veterinary College who specializes in emerging infectious diseases.
Since December 2020, scientists have identified multiple variants of concern that appear more transmissible or are able to evade some immune response. B.1.351, for example, was first detected in South Africa, and a strain called P.1 was first found in Brazil. The B.1.1.7 variant drew early attention because of its rapid rise in the United Kingdom; it now comprises about 95% of all new infections there.
So far the impact of these variants on pets has been unclear. Though there have now been more than 120 million cases of COVID-19 around the world, only a handful of pets have tested positive for the original SARS-CoV-2—probably because no one is testing them. Infected pets appear to have symptoms ranging from mild to nonexistent, and infectious disease experts say companion animals are likely playing little, if any, role in spreading the coronavirus to people.
The following are foreign headlines with hyperlinks to the posts
For a Mount Everest trek, a Bahraini sheikh arrived with 2,000 Covid vaccine doses.
A Pew Research Center analysis showed about 75 million more people in India fell into poverty last year because of the pandemic-induced economic recession
Sniffer dogs in Thailand taught to detect COVID-19 in human sweat proved nearly 95% accurate during training and could be used to identify coronavirus infections at busy transport hubs, the head of a pilot project told Reuters.
Covid rise in Europe makes foreign holidays unlikely, UK experts warn
Asia once led the coronavirus battle. Why is it behind on vaccines?
Coronavirus Israel Live: Cases Continue Decline as Nearly Half of Israelis Fully Vaccinated
The following additional national and state headlines with hyperlinks to the posts
Mar-a-Lago partially closed due to COVID-19 outbreak
White House Easter Egg Roll is canceled again because of the pandemic.
The $3,000 child tax credit might not be sent in monthly payments, IRS says
U.S. gasoline demand is approaching normal levels as Americans once again hit the road amid the economic recovery and the Covid-19 vaccine rollout.
Royal Caribbean will resume cruises in the Caribbean in June — with a fully vaccinated crew
The coronavirus has forced millions of students and their parents to unexpectedly grapple with online learning in the past year. Now, a new study from the CDC shows that the remote learning has taken a physical and emotional toll on them.
The IRS is planning to implement a fix for taxpayers who had unemployment income in 2020 and filed and paid taxes before new legislation made some of those benefits tax free. “Do not file an amended return at this time,” IRS Commissioner Charles Rettig said during a Thursday hearing with the House Ways and Means Committee.
Does Smoking Blunt The Vaccine? What About Painkillers?
Today’s Posts On Econintersect Showing Impact Of The Pandemic With Hyperlinks
Is State Capacity Unrelated To COVID-19 Spread?
The Evolving Relationship Between COVID-19 And Financial Distress
Engendering The Recovery: Budgeting With Women In Mind
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.
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 when recovering from COVID-19. Herd immunity does not look like an option without immunization 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 significantly higher death rate as there is relatively few hospitalizations and deaths in younger age groups..
- There are at least 8 strains of the coronavirus. California and 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.
What we do or 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. Unfortunately, early in the pandemic, many health experts — in the U.S. and around the world — decided that the public could not be trusted to hear the truth about masks. Instead, the experts spread a misleading message, discouraging the use of masks.
- Current thinking is that we develop at least 5 months of immunity from further COVID infection.
- The Moderna and Pfizer vaccines have an effectiveness rate of about 95 percent after two doses. That is on par with the vaccines for chickenpox and measles. The 95 percent number understates the effectivenessas it counts anyone who came down with a mild case of Covid-19 as a failure. But turning Covid into a typical flu — as the vaccines evidently did for most of the remaining 5 percent — is actually a success. Of the 32,000 people who received the Moderna or Pfizer vaccine in a research trial, only one contracted a severe Covid case.
- To what degree do people who never develop symptoms contribute to transmission? Research early in the pandemic suggested that the rate of asymptomatic infections could be as high as 81%. But a meta-analysis, which included 13 studies involving 21,708 people, calculated the rate of asymptomatic presentation to be 17%.
- The accuracy of rapid testing is questioned – and the more accurate test results are not being given in a timely manner.
- Can children widely spread coronavirus? [current thinking is that they are a minor source of the pandemic spread]
- Why have some places avoided big coronavirus outbreaks – and others hit hard?
- Air conditioning contributes to the pandemic spread.
- It appears that there is increased risk of infection and mortality for those living in larger occupancy households.
- Male patients have almost three times the odds of requiring intensive treatment unit (ITU) admission compared to females.
- Outdoor activities seem to be a lower risk than indoor activities.
Treatments with solid scientific support:
- Dexamethasone
- Proning, or turning someone on their stomach
- Remdesivir
- Baricitinib
Treatments with potential but limited evidence:
- ECMO, or extracorporeal membrane oxygenation
- fluvoxamine
- Cyclosporine
- Famotidine
- Intravenous immunoglobulin
- Ivermectin
- Interferons
Drugs shown to be ineffective:
- The combination of lopinavir-ritonavir
- Hydroxychloroquine
- Insulin
- High dose zinc and vitamin C
- Convalescent plasma
- Monoclonal antibodies
- Tocilizumab
- Anti-coagulants
- A current scientific understanding of the way the coronavirus works can be found [here].
There is now a vaccine available – the questions remain:
- will there be any permanent side effects that will appear months from now,
- how long immunity will last [we can currently say we do not know if it will last more than 4 months],
- there is no solid evidence yet the vaccine will block transmission
Heavy breakouts of coronavirus have hit farmworkers. Farmworkers are essential to the food supply. They cannot shelter at home. Consider:
- they have high rates of 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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