Pandemicia coronavirus report #39

 

Testing in Liege, Belgium

Pandemicia coronavirus report #39

11 days since last report  - COVID must be becoming "old news". But it has far to go.

Epidemic

Global cases remain flat at 300,000 per day, though this is probably due to it moving to locations with less testing. US cases are still falling very slowly - now about 50,000 per day, similar to Brazil. India's cases have spiked to nearly 100,000 per day and it is probably already the centre of the world outbreak . Spain, Israel, Cuba, Switzerland, Romania, Bulgaria and Czechia have not been able to control their second blisters - in fact, all of Europe is ominous. It does not look good out there. Milestones - even tiny Panama and Dominican Republic have passed China in cases. Basically - these countries have not been able to bite the bullet on quarantine any more than Australia did, and it does not look good out there. 

On the positive side - Sweden brought its outbreak under control, Serbia and Singapore have controlled a second outbreak.Ghana has controlled its epidemic for now.  

Australia (mostly Victoria)

Australia was within one case of eliminating the virus, then got a  breakout more than twice the size of the first one, escaping from untrained casual staff at poorly conceived "quarantine hotels" in downtown Melbourne (yes really). This time - because it was transferred through the low-income casual workforce rather than the bourgeoisie it immediately got into several hundred old peoples homes, into tower blocks, and infected 2000 medical workers. About 1600 of these were infected on the job, a much higher proportion than in the first blister

     

Nevertheless, the country has dispatched the outbreak almost as well as the first time, giving Australia the unlikely distinction of being the first country to beat the virus twice. Restrictions were stepped up to "Level 4" for the first time and only applied in Melbourne, while internal State borders were closed. Full restrictions were applied a week after the inflection point had been reached, so were not strictly necessary. The rates of change for new cases on both the upside and downside of each blister are given as

FIRST. Rose at 22.8% per day fell at 11.5% per day

SECOND. Rose at 8.5% per day, fell at 6.5% per day 

 

Downside, Australia second blister

There has been a spike yesterday, which does not bode very well. 

Total deaths were 102 in the first blister, and are already 470 in the second. Deaths are lagging confirmed cases by 12 days and running at about 8% of confirmed cases (compared with 1.5% in the first blister). 

Based on the current curve and with 8% mortality, there would be another 185 deaths approximately. However - there is about a 45% mortality rate in aged care cases, and there are still 1020 active cases - meaning much higher casualties, around 460 to go.

Since last we posted the cluster diagram the picture has become much more extreme. The Rydges-on-Swanston cluster that started it all has been dwarfed. The Flemington public housing cluster is still the largest and has risen to 311, Epping Gardens is the largest single Aged Care cluster at 212, Al Taqwa remains the largest educational at 210 infections, Bertocci Smallgoods is the largest industrial cluster at 211, and the Royal Melbourne Hospital is the largest health cluster at 155. 

There are still small numbers of cases in NSW (13 per day) and Queensland (a single cluster).

Men infected twice

A Hong Kong man has been confirmed as the first to be infected twice, by different strains (which have a slightly different spike protein). He was first infected with a Chinese strain, then 4.5 months later with the European strain (which has a slightly different spike protein) while holidaying in Spain. the second was asymptomatic.

However in Nevada, a 25 year old man was infected twice and the second case was more severe. Two more cases have been reported in the Low Countries.

A traveller from Italy to Korea was infected in an airplane bathroom in March. 

Boston

The superspreading of COVID-19 has always made a joke of conventional epidemiological  modelling, at least while numbers are small. A study has found that it arrived on 80 separate occasions into Boston without spreading at all (R0=0) then finally was delivered on Feb 27 to a number of attendees at an executive convention of a drug firm in an infection spree that spread across America, Australia and Europe.

The same thing may well have happened in or prior to the Wuhan outbreak.   

Response

A stringency index based on nine measures of government action shows how New Zealand at one point had the highest government stringency and now has one of the lowest.  

Five countries that have pursued elimination or heavy suppression, with the USA

A modelling study has found that if a vaccine is applied to 75% of the population, it must have an efficacy of at least 70% to prevent an epidemic and 80% to stop an ongoing epidemic. The measles vaccine has an efficacy of 95-98 per cent, and the flu vaccine is 20-60 per cent. Given how ineffective COVID modelling has been up till now, the result awaits real world confirmation.  

New CDC guidelines discourage asymptomatic people in the USA from being tested, including all those exposed to the virus. Three states have refused to endorse the rules. CDC also advised shop staff not to argue with barefaced patrons.

Sweden, who chose to go it alone,  has recorded the highest six months death tally for 150 years. COVID-19 added about 10%. 

Apparently it was Victoria Police who pushed for private security to be used at COVID hotels in the botched response. 

366 people were moved out of a Travelodge COVID hotel that did not meet basic health standards.

Some tests and good practice are now emerging. Sleep away camps took more than 1000 students away from home with no infections. In Germany, 1500 volunteers attended Arena Leipzig in three different arrangements to see which worked best. 

Research appeared to show that blood thinners reduced the risk of death by 50% among seriously ill patients, who were 30% less likely to need a ventilator.

In July Australia reduced the numbers allowed back into Australia to 4000 a week (from about 7000), to ease the pressure on quarantine hotels. This will continue through October. 370,000 have returned, but 18000 are still stuck overseas. 

Geopolitical

Almost all the Republicans in the state senate in California have been 

quarantined after a sceptic tested positive.

Only in the United States and Britain have the populace been displeased with the way their governments handled the crisis. 94% in Australia like the way the government handled it. Pandemicia's opinion of Western governments is less sanguine - Great Planning Disaster.

Interesting commentary. Clearly centrally-run economies like New Zealand and China have considerable advantages in quasi-military situations like COVID, with rapid, uniform responses. "A centralised decision-making structure makes it easy for top-down decisions to be made and implemented quickly (such as a national lockdown or the design of the national alert levels system). But it may also make it harder to effectively monitor and enforce localised actions."

Australia and China have placed themselves on opposite sides of the political fence and are jockeying for influence in the Pacific over who will provide a vaccine, if it becomes available..

Economy and social

Only 11% of Victoria's aged care homes met accreditation standards and had minimal use of high-risk medicines, an inquiry was told. Focusing on quality rather than cost minimisation would result in considerable improvement in outcomes.

320 doctors that walked out last week in Kenya over pay delay and lack of good quality PPE have returned to work. 

The COVID situation has inflamed long-simmering resentments between shopping mall owners and tenants, with rent strikes by some chain stores. 

Princess Cruises has cancelled all cruises in 2021

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