Written by Steven Hansen
The U.S. new cases 7-day rolling average are 2.6 % HIGHER than the 7-day rolling average one week ago and U.S. deaths due to coronavirus are now 16.9 % LOWER than the rolling average one week ago. Today’s posts include:
- U.S. Coronavirus New Cases are 4,916
- U.S. Coronavirus deaths are at 101
- New COVID Cases are no longer falling
- Delta variant about doubles risk of hospitalization, Scottish study shows
- Coronavirus infections dropping where people are vaccinated, rising where they are not
- Novavax: Large study finds COVID-19 shot about 90% effective
- Researcher: ‘We Made a Big Mistake’ on COVID-19 Vaccine
- Let’s Recognize Childhood COVID as the Crisis It Is
- Study suggests COVID-19 in children is milder than the flu
- Concerns Mount Over Looming Surge in Bankruptcy as COVID Medical Debt Soars
- WHO says Covid is spreading faster than the global distribution of vaccines
- Russia, U.S. and other countries reach new agreement against cyber hacking, even as attacks continue
- Israel votes in new government amid parliament chaos, ending Netanyahu’s 12-year rule
- GM, Ford are all-in on EVs. Here’s how their dealers feel about it
- Plus a lot more headlines …
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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 continues to improve.
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 improving.
In the scheme of things, new cases decline first, followed by hospitalizations, and then deaths. The potential fourth wave did not materialize likely due to immunizations.
Coronavirus and Recovery News You May Have Missed
Covid Delta variant found in India may have mutated into a more dangerous drug-resistant Delta+ – Economic Times
The highly infectious Delta variant of Covid-19 that first surfaced in India is feared to have mutated into a more virulent version called AY.1 or Delta+ — one that is possibly capable of resisting even the monoclonal antibodies cocktail currently being prescribed as a cure for the virus.
According to Public Health England, an executive agency of the UK government’s health and social care department, 63 genomes of Delta (B.1.617.2) with the new K417N mutation had been identified so far on the global science initiative GISAID. In its latest report on Covid-19 variants, updated till last Friday, India had reported six cases of Delta+ as of June 7.
Dr Vinod Scaria, clinician and computational biologist at Delhi’s Institute of Genomics and Integrative Biology, said an important point to consider regarding K417N was “evidence suggesting resistance to monoclonal antibodies Casirivimab and Imdevimab”. This cocktail has received emergency-use authorisation in the country from the Central Drugs Standard Control Organisation.
Scaria tweeted on Sunday that among the emerging variants, Delta+ (B.1.617.2.1) was characterised by the acquisition of the K417N mutation that maps to the receptor binding domain and has also been associated with immune escape. “The variant frequency for K417N is not much in India. As Delta continues to evolve, acquiring new mutations, there is a lot of interest in understanding these mutations,” he wrote, naming the new mutant Delta+.
Israel votes in new government amid parliament chaos, ending Netanyahu’s 12-year rule – CNBC
- Israel’s Parliament, the Knesset, approved its new government on Sunday — and a new prime minister for the first time in 12 years — in a razor-thin 60-59 vote.
- The vote, which rang in the leadership of a very diverse and cobbled-together coalition of right-wing, left-wing, centrist and Islamist parties, ousted Israel’s longest-serving leader, Benjamin Netanyahu.
- It also has spared Israel from the prospect of a fifth election in less than two years.
Novavax: Large study finds COVID-19 shot about 90% effective – AP
Vaccine maker Novavax said Monday its COVID-19 shot was highly effective against the disease and also protected against variants in a large study in the U.S. and Mexico, potentially offering the world yet another weapon against the virus at a time when developing countries are desperate for doses.
The two-shot vaccine was about 90% effective overall, and preliminary data showed it was safe, the American company said. That would put the vaccine about on par with Pfizer’s and Moderna’s.
While demand for COVID-19 shots in the U.S. has dropped off dramatically and the country has more than enough doses to go around, the need for more vaccines around the world remains critical. The Novavax vaccine, which is easy to store and transport, is expected to play an important role in boosting supplies in poor parts of the world.
That help is still months away, however. The company, which has been plagued by raw-material shortages that have hampered production, said it plans to seek authorization for the shots in the U.S., Europe and elsewhere by the end of September and will be able to produce up to 100 million doses a month by then.
“Many of our first doses will go to … low- and middle-income countries, and that was the goal to begin with,” Novavax CEO Stanley Erck said.
Russia, U.S. and other countries reach new agreement against cyber hacking, even as attacks continue – Washington Post
Russia and the United States — along with 23 other countries — recently reaffirmed that states should not hack each other’s critical infrastructure in peacetime or shelter cyber criminals who conduct attacks on other countries.
But Russia, which was among the states originally agreeing to the norms at the United Nations, has violated them repeatedly over the years. Experts are skeptical those violations will halt unless the United States and its allies impose far more serious consequences.
President Biden is on an eight-day trip to Europe that will culminate in a meeting with Russian President Vladimir Putin on Wednesday. He will raise issues of cybersecurity, including his concern that Moscow is harboring hackers who have carried out damaging ransomware attacks against some of the United States’ most critical sectors. An attack last month led to a days-long shutdown of the country’s largest refined fuel pipeline, followed by an attack that disrupted the world’s largest meat processor.
“Ransomware attacks against critical infrastructure are of an even higher order of magnitude of concern for us,” national security adviser Jake Sullivan said Wednesday. “We do not judge that the Russian government has been behind these recent ransomware attacks, but we do judge that actors in Russia have. And we believe that Russia can take and must take steps to deal with it.”
The question now is whether Russia, and other countries such as China, which affirmed the cyber norms in May, can or will be held accountable.
Let’s Recognize Childhood COVID as the Crisis It Is – MedPage
COVID-19 demonstrates that infectious diseases needn’t be extraordinarily lethal to be devastating to public health. With some exception, in any given child, the most probable outcome of COVID-19 is, thankfully, a complete and uncomplicated recovery. But the calculus of risk changes drastically when considered from a public health lens, especially with considerations unique to children. For example, ethical considerations are more complex since children typically lack decision-making capacity, thus paternalism in their care is unavoidable (informed permission). This situation generally favors conservative approaches to their risk so they can grow to the stage of life where they do have capacity.
Deaths in childhood represent an extremely premature loss of life, and for that reason have larger effects on public health metrics, such as disability-adjusted life years. Ensuring the health of children is also critical for health equity. These are anodyne assertions: they amount to the simple truth that children are deserving of protection.
Let’s use influenza — another respiratory RNA virus of eminent public health importance, which has a mechanism of spread similar to SARS-CoV-2 — as a point of comparison. From 1999 to 2019, influenza was the eighth leading cause of death in children, yet this season, one pediatric flu death has been documented. This is likely due to aggressive non-pharmaceutical interventions (NPIs). Yet, in the same 2020-2021 season, the American Academy of Pediatrics reports (as of early June) 327 U.S. deaths in children, and the CDC reports 452 due to COVID-19 (both are underestimates, as these data are incomplete). COVID-19, in approximately 1 year, killed twice as many children as influenza does most years, and hundreds more in the same interval of time, despite painstaking efforts to prevent infection. This easily makes COVID-19 a leading cause of death in children.
Some have drawn distinctions between hospitalization with and hospitalization from COVID-19, which has merit: cases in children are usually milder or asymptomatic and they are screened within the hospital, so some cases certainly reflect incidental findings. Two such examinations have noted that nearly half of these pediatric hospitalizations were unrelated to COVID-19; we should be cautious about accepting the generalizability of these reports. But, for the sake of argument, applied to the entire U.S., that still amounts to approximately 100,000 pediatric hospitalizations caused by COVID-19 over the span of slightly more than a year, based on statistics generalized to the CDC estimates, or at least a minimum of 20,000, based on COVID-NET data. All estimates far exceed the number of hospitalizations during the pre-vaccine period for several vaccine-preventable diseases on the childhood vaccination schedule.
Cases are no longer falling – New York Times
The news about Covid-19 has been mostly positive in the U.S. over recent months. The vaccines continue to work well against every variant, and the number of Americans who have gotten a shot continues to rise.
But the U.S. still faces two problems. First, the pace of vaccinations has slowed, and a substantial share of Americans — close to one third — remains hesitant about getting a shot. These unvaccinated Americans will remain vulnerable to Covid outbreaks and to serious symptoms, or even death.
Second, the Delta variant — which appears to be both more contagious and more severe than earlier versions of the virus — is spreading rapidly within the U.S., after having first been identified in India. It now accounts for about 10 percent of cases, according to Dr. Scott Gottlieb, a former F.D.A. commissioner.
Together, these two forces help explain why new cases have stopped falling:
But the vaccines work
In addition to being more contagious, Delta also appears to be more severe. As my colleague Keith Bradsher reports about southeastern China, where the variant has been spreading: “Patients are becoming sicker and their conditions are worsening much more quickly.” (China has more detailed data than many other countries, because it conducts rapid, widespread testing.)But there is still one very big piece of encouraging news: The vaccines continue to work extremely well against the variants, based on the evidence so far. The best performing vaccines vastly reduce the number of Covid cases of any kind and virtually eliminate death.
“The Delta variant is by far the most contagious variant of this virus we have seen in the entire pandemic,” Dr. Ashish Jha said yesterday. “The good news is the data suggests that, if you’ve been fully vaccinated, you remain protected, that the vaccines hold up.”
The clearest place to see this pattern is Britain, where the Delta variant has spread widely and where the vaccination rate is high. In Britain, there is “still no sign of increase in deaths, well after the strain has become dominant,” as Dr. Eric Topol of the Scripps Research Translational Institute noted.
Source: The New York Times
Many experts are concerned that cases will eventually start to rise as Delta becomes the dominant form of the virus. “We are vulnerable,” Dr. Kavita Patel of the Brookings Institution told Yahoo News. On Twitter yesterday, Dr. Robert Wachter of the University of California, San Francisco, wrote: “I’ll now bet we’ll see significant (incl. many hospitalizations/deaths) surges this fall in low-vaccine populations due to combo of seasonality, Delta’s nastiness, & ‘back to normal’ behavior.”
Researcher: ‘We Made a Big Mistake’ on COVID-19 Vaccine – Mercola
[editor’s note: I know that many believe Mercola is off-base in his analysis. However, there are many studies now that confirm what was said in this article.]
- Canadian immunologist and vaccine researcher Byram Bridle, Ph.D., has gained access to Pfizer’s biodistribution study from the Japanese regulatory agency. The research, previously unseen, demonstrates a huge problem with all COVID-19 vaccines
- The assumption that vaccine developers have been working with is that the mRNA in the vaccines would primarily remain in and around the vaccination site. Pfizer’s data, however, show the mRNA and subsequent spike protein are widely distributed in the body within hours
- This is a serious problem, as the spike protein is a toxin shown to cause cardiovascular and neurological damage. It also has reproductive toxicity, and Pfizer’s biodistribution data show it accumulates in women’s ovaries
- Once in your blood circulation, the spike protein binds to platelet receptors and the cells that line your blood vessels. When that happens, it can cause platelets to clump together, resulting in blood clots, and/or cause abnormal bleeding
- Pfizer documents submitted to the European Medicines Agency also show the company failed to follow industry-standard quality management practices during preclinical toxicology studies and that key studies did not meet good laboratory practice standards
Coronavirus infections dropping where people are vaccinated, rising where they are not – Washington Post
States with higher vaccination rates now have markedly fewer coronavirus cases, as infections are dropping in places where most residents have been immunized and are rising in many places people have not, a Washington Post analysis has found.
States with lower vaccination also have significantly higher hospitalization rates, The Post found. Poorly vaccinated communities have not been reporting catastrophic conditions. Instead, they are usually seeing new infections holding steady or increasing without overwhelming local hospitals.
As recently as 10 days ago, vaccination rates did not predict a difference in coronavirus cases, but immunization rates have diverged, and case counts in the highly vaccinated states are dropping quickly.
Vaccination is not always even within each state, and The Post found the connection between vaccine shots and coronavirus cases at the local level comparing more than 100 counties with low vaccination rates (fewer than 20 percent of residents vaccinated) and more than 700 with high vaccination rates (at least 40 percent vaccinated).
Robust immunity against SARS-CoV-2 with Pfizer vaccine is mediated by memory B cells – News-Medical
A reassuring study, released as a preprint on the medRxiv* server, from a multi-institutional team of researchers in Italy suggests that with the Pfizer-BioNTech BNT162b2 vaccine, post-vaccination immunity against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is both robust and durable.
GM, Ford are all-in on EVs. Here’s how their dealers feel about it – CNBC
- General Motors is aiming to produce only EVs by 2035, with 30 new plug-in models arriving by 2025, a $27 billion investment.
- Ford, which is investing $22 billion in EVs and announced that 40% of its vehicles will be electrified by 2030, generated excitement with the recent debut of the F-150 Lightning all-electric pickup.
- Many auto dealerships are embracing the electric vehicle transition, but there are concerns about costs to be paid, staff training and impact on lucrative service department business.
Concerns Mount Over Looming Surge in Bankruptcy as COVID Medical Debt Soars – Newsweek
Case numbers and daily death tolls continue to drop, the majority of U.S. adults are fully or partly vaccinated, mask mandates are vanishing and summer socializing looks like it’s back on the calendar. But even as America keeps marching steadily toward a post-pandemic future, another COVID-19 crisis looms—a debt and bankruptcy disaster fueled by mounting medical bills associated with treatment, especially among the most financially vulnerable parts of the population.
As many as 12.5 million Americans could already be saddled with COVID-related medical debt, based on a LendingTree survey conducted in March. The nationally representative poll found that 60 percent of the respondents polled had medical debt, with about 10 percent stemming from the virus; the amount typically owed ranged from $5,000 to $9,999. That suggests the collective debt for COVID treatment so far could be between $60 billion and $125 billion.
That number will inevitably grow sharply in coming months, experts say, as a trio of factors kick in: Expenses will mount for COVID “long-haulers” with ongoing health problems; more medical bills related to the virus will pass from the seriously past due stage into collections; and a panoply of government measures that were designed to help people stay afloat during the pandemic will end, from eviction and student-loan-payment moratoria to enhanced unemployment benefits, making it harder for more people to pay off the accumulating bills for treatment. That in turn is expected to lead to a spike in personal bankruptcies by the end of 2021 and into 2022.
“A lot of people are getting bills they can’t pay,” says David Himmelstein, a professor at City University of New York School of Public Health at Hunter College and author of several seminal studies on medical bankruptcy. “We’re heading towards a mounting debt crisis for many people who have been sick during this COVID period that will ripple through the economy unless something is done about it.”
WHO says Covid is spreading faster than the global distribution of vaccines – CNBC
- The global spread of Covid-19 is moving faster than the global distribution of vaccines, World Health Organization officials said Monday.
- “That means the risks have increased for people who are not protected, which is most of the world’s population,” Tedros Adhanom Ghebreyesus, WHO director-general, said during a press briefing.
- While the number of new cases of the virus continues to decline worldwide, the number of deaths has not been declining at the same rate.
Delta variant about doubles risk of hospitalization, Scottish study shows – CNN
The Delta variant, which is also known as B1.617.2 and was first identified in India, is associated with approximately double the risk of hospitalization compared with the Alpha variant (or B.1.1.7) first identified in the UK, according to the preliminary findings of a Scottish study published Monday in The Lancet.
A research team from the Universities of Edinburgh and Strathclyde and Public Health Scotland analyzed data from 5.4 million people in Scotland as part of the “EAVE II” project. The study comes after Health Secretary Matt Hancock announced last week the Delta variant makes up 91% of new cases in the UK.
During the period included in the study, April 1 to June 6, there were 19,543 community cases and 377 hospitalizations, according to the study. Among those, 7,723 cases and 134 hospitalizations were found to be the Delta variant. Risk of admission was “particularly increased in those with five or more relevant comorbidities,” the study says.
The early findings suggest two Covid-19 vaccine doses provide protection against the Delta variant, but it may be a lower level of protection than against the Alpha variant. Vaccines were found to reduce the risk of being admitted to hospital, but strong protective effects against the Delta variant were not seen until at least 28 days after the first vaccine dose, the study added.
The Pfizer-BioNTech vaccine was found to provide 79% protection against infection from the Delta variant, compared with 92% against the Alpha variant, in community cases at least two weeks after the second dose.
[editor’s note: also read Delta variant “could spike a new epidemic heading into the fall,” former FDA commissioner warns]
Study suggests COVID-19 in children is milder than the flu – News-Medical
Researchers retrospectively analyzed the medical records of children in Turkey hospitalized because of coronavirus disease 2019 (COVID-19) or influenza and found COVID-19 to be milder than influenza in this group.
Several studies have suggested that COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is milder in children than in adults. However, some children develop multisystem inflammatory syndrome in children (MIS-C) after recovering from COVID-19.
Just like COVID-19, another respiratory disease caused by viruses is influenza, with similar symptoms such as cough, fever, and sore throat. It also spreads by airborne transmission. In healthy children, it usually lasts for a few days, and then the children start to recover, but it can be fatal in very young children and those with other diseases.
There are few studies as yet that compare these two diseases in children. In a new study published recently, researchers from Dicle University School of Medicine in Turkey compared influenza and COVID-19 in children to determine if they have any differences.
… Upon analyzing the data, the team found that the flu patients had higher hospital stays, higher rates of intensive care and ventilatory support, and higher mortality compared to COVID-19 patients. Steroid and oxygen use rates were also higher in the children hospitalized for influenza.
Both groups of children complained of cough, fever, and muscle pain. Children with the flu had higher rates of several symptoms like cough, fever, sore throat, and muscle pain, similar to what has been found before.
The following are foreign headlines with hyperlinks to the posts
Iraqi oil minister expects oil prices at $68-$75 in H2
Dartmouth Medical School said it is dropping charges against students who were accused of cheating when they accessed online course materials while taking exams.
Southeast China provided an unsettling look at the Delta variant, saying patients are getting sicker faster compared to the initial virus.
Philippines poorly prepared to deal with COVID-19, report says
Philippine Pres. Again Postpones Removing Country From U.S. Defense Pact
WHO Director Asks Leaders to COVID Vaccinate 70% of Globe by Next G7 Summit
A mass inoculation campaign in Thailand stumbles amid a severe outbreak.
Germany, where masks are often still mandated, considers loosening the rules.
UK study finds coronavirus vaccines “highly effective” against hospitalization from Delta variant
Small town in Brazil to give only half dose of AstraZeneca vaccine as part of trial
The following additional national and state headlines with hyperlinks to the posts
Bitcoin pops back above $39,000 after Musk suggests Tesla could accept the cryptocurrency again
Judge sides with Houston hospital, allowing vaccine mandate for staff
Thor Industries Now Has $14 Billion Order Backlog Amid Booming Demand For RVs
Bank of America: Everyone Knows The Fed Will Stop Tapering As Soon As The S&P Drops 10%
Hackers Stole Nearly 26 Million User Login Credentials for Sites Like Amazon, Google, Facebook
An American Medical Association survey indicated that 96% of physicians reported that they were fully vaccinated against COVID-19.
Why has the Biden administration yet to select a permanent FDA commissioner, especially after the agency’s controversial approval of Alzheimer’s drug aducanumab (Aduhelm)? Meanwhile the Alzheimer’s Association criticized the drug’s proposed $56,000 price tag.
Phillips announced a recall on certain ventilators and sleep apnea devices containing a foam component that can degrade and have possible toxic or carcinogenic effects for the user.
Why are women more likely to develop to “long COVID” than men?
What makes the elderly more susceptible to SARS-CoV-2 infection?
Study shows poor antibody response in naive elderly of nursing homes after mRNA vaccination
There are many modeling studies that suggest that large-scale screening for the presence of this virus can help curb transmission at this point, from people with few or no symptoms. A new study, released as a preprint on the medRxiv* server, points out the accuracy of antigen-detection rapid diagnostic tests (Ag-RDTs) for this purpose when used at the point-of-care.
Why Getting a COVID-19 Vaccine to Children Could Take Time
Vermont governor lifts restrictions as state becomes first to reach 80 percent vaccinated
TSA says airport screenings Sunday hit highest level since pandemic started
Main Delta COVID Variant Symptoms May Be Different From Original Virus
Oman COVID-19 Cases Triple in 1 Month, Hospital Beds Near Capacity
Unvaccinated Adults More Comfortable Going to Bars Than Vaccinated: Poll
California will end most of its pandemic restrictions on Tuesday.
One-third of Americans plan to retire later due to Covid-19, study finds
Today’s Posts On Econintersect Showing Impact Of The Pandemic and Recovery With Hyperlinks
The State of Joe Sixpack in 1Q2021: On Paper, Everyone’s Financial Position Improved
Was There A Better Way To Contain COVID-19?
Report: Ultra-Rich Pay Next To Nothing In Taxes
Warning to Readers
The amount of politically biased articles on the internet continues. 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. 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 as the variants are continuing to look for ways around immunity.
- 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.
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 12 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 effectiveness as it counts anyone who came down with a mild case of Covid-19 as a failure.
- 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.
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