Written by Steven Hansen
The U.S. new cases 7-day rolling average are 14.6 % LOWER than the 7-day rolling average one week ago and U.S. deaths due to coronavirus are now 5.2 % LOWER than the rolling average one week ago. Today’s posts include:
- U.S. Coronavirus New Cases are 63,736
- U.S. Coronavirus deaths are at 873
- U.S. Coronavirus immunizations have been administered to 65.4 % of the population
- The 7-day rolling average rate of growth of the pandemic shows new cases improved and deaths improved
- Why Clotting Happens When Platelets Are Low
- Here’s how some states plan to respond to the lifting of the F.D.A. pause on Johnson & Johnson
- Asymptomatic infection fuels spread of more infectious SARS-CoV-2 variants
- Blood Type Not a Factor in COVID-19 Risks in US Patients
- Household Members Face Higher Contagion Risk From UK Variant
- We can vaccinate our way out of this epidemic if all adults and adolescents get shots, says doctor
- No respite in India as country sets Covid-19 infection record for third straight da
- Are COVID Boosters Really Inevitable?
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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 lower.
In the scheme of things, new cases decline first, followed by hospitalizations, and then deaths.
The New Variants Are The Primary Cause Of This Fourth Wave
Even with vaccinations picking up, the fourth wave is now underway.
- the more people that are vaccinated reduces the pool of people that can be infected. Today we have removed over 65 % of the population from being infected which theoretically should reduce the infection rate by 65 % [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 65 % 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.
- In theory, 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.
The real question is whether the vaccines will be mitigating this surge – and to what extent.
Coronavirus News You May Have Missed
Why Clotting Happens When Platelets Are Low – MedPage
Reports of unusual blood clots in the setting of low platelets associated with COVID-19 vaccines have brought attention to these tiny blood cells tasked with preventing humans from fatally bleeding.
The European Medicines Agency has said that, as of April 20, there have been 287 reports of rare blood clots with low platelets after administration of the AstraZeneca vaccine, eight with Johnson & Johnson, 25 with Pfizer, and five with Moderna. The clots are notable because many have occurred in unusual and deadly locations in the veins that drain the brain (known as cerebral venous sinus thrombosis) and the abdomen (known as splanchnic vein thrombosis).
Platelets have a concave shape that looks like, well, a plate. They’re colorless, and have a lifespan of about 10 to 12 days. When a blood vessel becomes damaged, platelets crowd to the site and become activated: they change shape, release substances that promote clotting, and recruit clotting factors along with other platelets to promote more clotting. It’s a delicately balanced process. In a healthy person, the end result is a clot, which is normally a good thing because it prevents fatal bleeding.
It seems intuitive that having low platelets would increase the risk of bleeding. After all, without very many platelets around, it gets harder to form a clot. So why have these potentially vaccine-related clots occurred in the presence of low platelets?
Two Distinct Processes Lead to Low Platelets
In general, two distinct processes can result in thrombocytopenia, or low platelets. The first process involves platelet clearance, and it’s an immune process. Typically, macrophages engulf and clear old platelets when they’ve reached the end of their lifespans. If the clearance process gets out of control — say, with an autoimmune condition — it can lead to excess clearance and low platelets, according to Manila Gaddh, MD, of Emory University in Atlanta.
“With clearance, the body’s immune system actually destroys the platelets, which brings the platelet count down and can lead to bleeding,” Gaddh said.
The second process involves consumption of platelets when they become activated, and go about their normal job of stimulating the clotting system and aggregating to form blood clots. If the consumptive process gets out of control, platelets get used up and their numbers drop.
“In consumption, platelets are actually getting activated. That activates the clotting system to make the platelets aggregate together, which brings down the platelet count and favors clotting in the body,” Gaddh said.
Low Platelets and Vaccines
Both high clearance and consumption have been linked to vaccine-associated thrombocytopenia. These two distinct processes involve at least two different autoantibodies, according to Gaddh.
Immune thrombocytopenia (ITP) occurs when the body produces antibodies against platelets and directly attacks them. These autoantibodies clear platelets at a much faster pace than in normal people — even younger platelets get destroyed — and that lowers the platelet count. ITP has been associated with some medications, infections, and vaccines. The condition has also been associated with a slightly increased risk of blood clots.
Vaccinations with J&J coronavirus vaccine can resume immediately, CDC director says – CNN
Vaccinations with Johnson & Johnson’s coronavirus vaccine may resume immediately, Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said Friday.
The CDC and the US Food and Drug Administration lifted their recommendation for pausing use of the company’s Janssen vaccine after CDC advisers recommended it.
“We are no longer recommending a pause to the Johnson and Johnson vaccine,” Walensky said at a news conference. “I support the ACIP’s recommendation that the Johnson and Johnson Covid-19 vaccine be used for persons 18 years of age or older in the United States population under the FDA emergency use authorization, and I have signed this recommendation.”
“With these actions, the administration of Johnson and Johnson’s Covid-19 vaccine can resume immediately,” Walensky added.
Certain women under the age of 50 may have a small risk of developing a rare blood clotting syndrome, Walensky said.
“There is likely an association but the risk is very low,” Walensky said.
Here’s how some states plan to respond to the lifting of the F.D.A. pause on Johnson & Johnson. – New York Times
With the decision by the Food and Drug Administration on Friday to lift its recommended pause on administration of the Johnson & Johnson vaccine, many states are likely to start using it again in short order.
Several states, including Texas, Arizona, Alabama, Utah and Wisconsin, had said they expected to follow the recommendations of the F.D.A. and the Centers for Disease Control and Prevention once the decision was made. (The F.D.A. issued its new guidance after advisers to the C.D.C. voted to lift the pause.) Other states, including Washington State, had said they would wait until the conclusion of the C.D.C. meeting and then formulate their plans.
Dr. Karen Landers of the Alabama Department of Public Health said the state would “follow the guidance of the committee and C.D.C. if there is guidance to resume use of Johnson & Johnson.”
Shelby Anderson, a spokeswoman for the Washington State Department of Health, said the Western States Scientific Safety Review Workgroup was scheduled to convene after the C.D.C. meeting. “Right now, it’s too soon to say when a decision could be made,” she said.
Elizabeth Goodsitt, a spokeswoman for the Wisconsin Department of Health Services, said that the state would follow the federal recommendation, and that its plan was to allocate doses of the Johnson & Johnson vaccine primarily “to local health departments, as well as smaller providers, to offset the hub deliveries and storage challenges of Pfizer.”
In a statement, the Minnesota Department of Health said the vote “underscores the importance that is placed on vaccine safety.”
Asymptomatic infection fuels spread of more infectious SARS-CoV-2 variants – YouTube
[editor’s note: this video concludes that mass vaccinations are a mistake]
Blood Type Not a Factor in COVID-19 Risks in US Patients – Medscape
Blood type does not affect susceptibility to COVID-19 in U.S. patients, a new study suggests.
Researchers analyzed data on nearly 108,000 people from Utah, Idaho, and Nevada who were tested for COVID-19 and whose blood type was listed in their medical records. None of the blood types was linked with the risk of becoming infected, need for hospitalization or intensive care, according to a report published in JAMA Network Open.
Smaller studies from China, Italy and Spain have linked type A blood to higher COVID-19 risks and type O blood to lower risks, and a large study from Denmark tied blood type to COVID-19 severity. Studies from New York and Boston – like this new study – found no such links.
Study coauthor Dr. Jeffrey Anderson of the Intermountain Healthcare Heart Institute in Salt Lake City said in a statement that the effects of blood type can vary across populations.
“We looked at a lot of risk factors as to who might need to be hospitalized and who might need more advanced care, and… for our population at least, blood type is not on that list,” Anderson said.
Household Members Face Higher Contagion Risk From UK Variant – Reuters
Compared to people infected with less contagious coronavirus variants, those infected with the variant identified in the UK, known as B.1.1.7, are more likely infect their household members, according to new data.
During three weeks in February, researchers in Ontario, Canada, monitored people living with a COVID-19 patient in more than 2,500 roughly-comparable private households. During the two weeks after patients were diagnosed, the secondary attack rate – the rate was 31% higher when the patient was infected with the B.1.1.7 virus variant than when COVID-19 was caused by a less worrisome variant.
When the original infected person never developed symptoms, the secondary attack rate was 91% higher with B.1.1.7, the researchers reported on medRxiv ahead of peer review.
And when the original patient had no symptoms at first, and then became ill, the rate at which household members became infected was more than 200% higher when the patient carried the B.1.1.7 variant.
Since emerging in the UK, B.1.1.7 has spread to more than 100 other countries. It has now become the dominant coronavirus variant in the United States, according to the U.S. Centers for Disease Control and Prevention.
We can vaccinate our way out of this epidemic if all adults and adolescents get shots, says doctor – CNBC
[editor’s note: also read Dr. Scott Gottlieb says U.S. may never achieve ‘true herd immunity’ to Covid]
- Summertime in the United States could return to a pre-Covid-19 normal if 75% to 80% of the U.S. population is vaccinated, Dr. Peter Hotez said, but vaccine hesitancy could stop that from happening.
- Polls show that more than 40% of Republicans are not planning to get vaccinated
- “That’s where we’ve got to work harder, at reaching conservative groups…. that we have to fix,” Hotez said.
No respite in India as country sets Covid-19 infection record for third straight day – CNN
India reported 346,786 new cases of Covid-19 on Saturday — the third day in a row the country has set a world record for infections during the coronavirus pandemic, according to government and scientific tallies.
The related death toll for the previous 24 hours hit 2,624 — also a daily record for India — for 189,544 total fatalities.
The sky-rocketing Covid-19 infections are devastating India’s communities and hospitals. Everything is in short supply — intensive care unit beds, medicine, oxygen and ventilators. Bodies are piling up in morgues and crematoriums.
Twenty critically ill patients died at a Delhi hospital Friday night after its supply of oxygen was delayed by seven hours, according to Dr. DK Baluja, medical director at the Jaipur Golden Hospital.
Are COVID Boosters Really Inevitable? – MedPage
When Pfizer CEO Albert Bourla said people will likely need a COVID vaccine booster in 6 to 12 months, and that annual vaccines were possible, public health and infectious disease experts were quick to put on the brakes.
There aren’t enough data yet to make that call, said Paul Offit, MD, a vaccine expert at Children’s Hospital of Philadelphia.
“We’ll have a better idea in about 1 year,” Offit told MedPage Today.
Experts have said they do believe it’s likely that boosters will eventually be necessary. When that will be, how often they’ll be needed, and whether that will vary by vaccine brand, or by differences in immune response, is still anyone’s guess.
“I fully believe we are going to need boosters,” said Robert Schooley, MD, an infectious disease expert at the University of California San Diego. “It may be that we need to vaccinate more frequently if, over time, we have a less vigorous immune response. It may be that vaccines with potent immunity like the mRNA vaccines will need to be boosted less frequently than other vaccines using other platforms.”
“It may be that how soon we need to be revaccinated depends on how the virus evolves in terms of its ability to evade current vaccines,” he added. “These are all unknowns right now.”
Why is Schooley so certain that boosters will be a necessity? For one, breakthrough infections, while rare, have occurred after vaccination. Reinfections also have occurred, even though they appear to be less common — though their true rate remains unknown. The four other coronaviruses that regularly circulate through the population are able to reinfect people, so “there’s no reason to expect this will be different,” Schooley said.
While two other human coronaviruses, MERS and the first SARS, have shown a long-standing immune response in lab studies, these “don’t show if when you’re re-exposed, whether you get sick,” he said. “That’s where the rubber hits the road.”
The following are foreign headlines with hyperlinks to the posts
A three-day lockdown begins in Perth, Australia, after a case arises outside quarantine.
As pandemic surges anew, global envy and anger over U.S. vaccine abundance
Those who got covid between vaccine doses urge caution: ‘We were so close’
The following additional national and state headlines with hyperlinks to the posts
California Goes From Worst to First in Virus Infections
Florida Men Indicted for Selling Bleach as ‘Miracle’ COVID-19 Cure
California Public Schools See Biggest Enrollment Drop in 20 Years
Many Covid patients have new ailments months after recovering from mild cases, a C.D.C. study finds.
Netflix Subscriber Growth Slows After Pandemic Boost
Today’s Posts On Econintersect Showing Impact Of The Pandemic With Hyperlinks
Where Is The U.S. COVID-19 Pandemic Headed?
Labor Market Engagement And The Pandemic’s Impact On American Workers
After A Strong Crisis Response, Asia Can Build A Fairer And Greener Future
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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