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| Disinfecting a nursing home, Spain |
Epidemic
Counts
European cases have passed a million, about half the world total. They are very substantially understated and I think the actual numbers infected are at least 10 million.Spain's daily new cases had been falling steadily since 25 March, down to a third of the maximum. Suddenly over the last few days, new cases have spiked threefold. This is the first time this has happened anywhere, but it is probably due to the long Easter weekend and delays in reporting. Germany, France and US cases also increased.
China has added 13,000 to their death count, to include late notifications and people dying at home. France added 15,000 deaths on 4 April for the same reasons, which did not occasion any comment.
Almost everywhere, thousands of deaths with COVID-19 symptoms but no testing confirmation have occurred – many in nursing homes. In Europe, some 42% to 53% of fatalities have been in nursing homes. Nursing home residents are ideal prey for the virus, as they’re usually aged over 80 and have other health conditions. They live in close quarters and some residents suffering from dementia cannot remember physical distancing rules and stick to them. Staff are overwhelmed, as many are off sick. Dead bodies have been found abandoned during disinfection by the army in Spain. Even in this age group however, many infected are symptomless.
In Montreal, Canada an outbreak at the nursing home Residence Herron triggered an investigation for gross negligence after 31 patients died in a few weeks and 61 cases were found. Elderly residents were left soiled and unfed after caregivers fled the premises when no PPE was available, with only two nurses remaining to care for 130 patients. Health authorities found residents dehydrated, unfed for days and lying listless in bed, some covered in excrement. Others had fallen to the floor. Two deaths had gone unnoticed for several days. A class action was also filed against the proprietors.
About 90% of the dead are over 70 in Italy, and 56% are over 80. Clearly, having a young population will substantially lower the death rate. Obesity is now recognised as a secondary risk factor, doubling the chance of severity, so a fatter population will also have more deaths.
Timing
Our re-analysis of the new cases pattern in Australia (originally done on 1 April) has suggested that the pandemic was arrested in Australia on March 25, the day the national lockdown began. This is very supportive of the success of sufficiently early lockdowns in limiting epidemics.
Our analysis confirms infections reach maximum 4-5 days before the new cases maximum, and daily deaths reach maximum 9-10 days later - in China, Italy and Spain. The case mortality rate at that time depends on the number of tests that have been undertaken, and varies a great deal between countries. However the true death rate is probably something like 0.7%, depending on risk factors and quality of care.
Our analysis confirms infections reach maximum 4-5 days before the new cases maximum, and daily deaths reach maximum 9-10 days later - in China, Italy and Spain. The case mortality rate at that time depends on the number of tests that have been undertaken, and varies a great deal between countries. However the true death rate is probably something like 0.7%, depending on risk factors and quality of care.
Spread
Some evidence has emerged that COVID-19 can be caught from dead bodies, indicating that care must be taken during their disposal. COVID also appears to live for a long period in the gut. In one patient it was found there 33 days after throat swabs turned negative.Geopolitical
While it is generally agreed that SARS-19 could not have been a deliberate creation (it has no microscopic serial numbers for a start 😀) there is some possibility of accidental release. A lab in Wuhan was apparently engaging in 'risky studies' on bat coronavirus as long ago as 2018. However, while circumstantial, it does not tie in with the early reports and academic papers showing a cluster of cases surrounding the Wuhan wet market.
President Trump believes numbers in China to be 'much higher, higher than America's'. The aim appears to be to deflect blame and discredit the idea that China succeeded in controlling the virus (without warning) where the US failed (with warning). Former LNP leader and US Ambassador Alexander Downer has also called for China to 'come clean'.
Response
The border between US and Canada will be closed "for many weeks to come". The pandemic may be threatening Canada's food supply.
Economy and society
The news is dominated by every aspect of coronavirus, and apart from regular analysis like this blog, there are articles on handwashing, air quality, food security, economic and labour market prognoses, being a good landlord, and everything possible.
State governors in the USA have formed several coalitions aimed at coordinating quarantine reductions, on the east coast and west coast.
Conservative workers and armed protesters in the USA have begun a series of street protests, saying that the economy is more important than the disease. President Trump has supported some of the groups, tweeting "Liberate Michigan".
Anti-vaxxers are terrified they may be forced to take a (non existent) vaccine (protesting since February).
In New Zealand it has been calculated that lockdown is costing more than NZ$1 billion per day, about $21 billion so far. This is more than New Zealand's annual health budget. The government has paid $10 billion in wage subsidies, which are supporting 60% of the workforce. There have been 9 deaths of people over 70, all with pre-existing conditions. It is claimed that many more lives could have been saved by spending the money in other ways. Typically about 3000 people die of respiratory illnesses every year in NZ.
Lockdown has had a few positive outcomes. Hospital ER attendance has fallen by a third in Australia. Work and sport-related injuries are way down, but there is a small increase in renovation and cooking injuries.
A sitcom in Spain about life during lockdown has proven to be a hit.
State governors in the USA have formed several coalitions aimed at coordinating quarantine reductions, on the east coast and west coast.
Conservative workers and armed protesters in the USA have begun a series of street protests, saying that the economy is more important than the disease. President Trump has supported some of the groups, tweeting "Liberate Michigan".
Anti-vaxxers are terrified they may be forced to take a (non existent) vaccine (protesting since February).
In New Zealand it has been calculated that lockdown is costing more than NZ$1 billion per day, about $21 billion so far. This is more than New Zealand's annual health budget. The government has paid $10 billion in wage subsidies, which are supporting 60% of the workforce. There have been 9 deaths of people over 70, all with pre-existing conditions. It is claimed that many more lives could have been saved by spending the money in other ways. Typically about 3000 people die of respiratory illnesses every year in NZ.
Lockdown has had a few positive outcomes. Hospital ER attendance has fallen by a third in Australia. Work and sport-related injuries are way down, but there is a small increase in renovation and cooking injuries.
A sitcom in Spain about life during lockdown has proven to be a hit.
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