Pandemicia coronavirus report #44

 

 

Pandemicia coronavirus report #44

Epidemic

The figure shows the enormous increase in cases in Europe, which have been crawling up ever since they reduced quarantine in mid July. This is only the EU, and this time countries outside the EU are also badly affected. Unfortunately this will go on and on for years until so called "herd immunity" is reached - involving a huge number of deaths, certainly 0.5% and possibly 1% of the population - and up to 15% of those over 70. The eventual upside estimate is over 4 million deaths in Europe.

The case figure is somewhat misleading in that in the first blister, there were no tests available due to the lack of preparedness. Only the severely ill were tested and up to 15% died in Italy, Spain and the UK. The true figures were probably more like 350,000 a day while at the moment they are "only" 100,000 a day, similar to the USA and Brazil at the peak. 

Korea managed to control a second outbreak in June and has brought a third outbreak in August below a hundred cases a day. It does highlight the difficulties with keeping a pure test-and-trace strategy going, no matter how good. Iran is also effectively in a third blister.

The second outbreak is now beginning to ramp up in the USA with the onset of cold weather, which causes more people to stay inside where infection is much easier. Forty states have rising cases, and seventeen have hit new highs. . Hospitalisations have risen in nine states. A study has estimated there will be 400,000 extra deaths in the USA this year, 20% more than normal. A third of these are due to people not attending doctors for other complaints, such as heart disease.

Similar excess death figures have been revealed in Europe, with mortality 37% above normal in UK and Spain,  and about 206,000 previously unaccounted for deaths in 19 countries.

Australia soldiers on effectively trying to eradicate the virus, with cases below thirty a day. They are so few that their progress can actually be identified, generally tracked down to a few non-complying superspreaders.

The first outbreak in country Victoria since the Colac meatworks has started in Shepparton, due to a man who drove to Kilmore just outside Melbourne on authorised business, infected people there, then drove onward to Shepparton, sitting in a coffee shop for three hours infecting everyone.

About one in ten people worldwide have probably had the virus, according to the WHO. This is about 20 times the current total.

The disease

The CDC has finally acknowledged airborne spread. They have apparently also dropped their mortality estimates. 

There seems to be a drop in the mortality rate worldwide, down from 2 or 3 percent to 0.65% (including asymptomatic cases). This may be due to people wearing masks getting a lower viral load.  (This was reported in Italy on 1 June)

Another possibility we raised early on is possible immunity in a sector of the population - but this remains unproven.

935 cases of multisystem inflammatory syndrome have been reported in people under 20, and about 30 in adults. This appears to be a post-infection process.

Coronavirus can survive on skin for 9 hours, and on hard surfaces for 4 weeks. 

Response

In response to the rapid rise in cases, France has instituted a curfew in 9 cities, Czechia has put in Stage 2 restrictions, Russia has introduced distance learning. A three tier system has gone in in Britain, but even the highest level is only Level 1 restriction. This many cases would have put the whole of Australia  (or China) into heavy lockdown months ago - but it is too late for Britain and they are just trying to slow things down slightly.

People turned away from testing centre in Shepparton

Test-and-trace has worked better in NSW because of their devolved system which worked better in an epidemic. NSW never had thousands of mystery cases like Victoria or superspreader events. In Victoria, however, a legacy of cuts left the Department of Health and Human Services under-resourced and highly centralised. Surge contact tracing capacity had to be built from a smaller base. NSW got much better after the first blister, but Victoria did not learn (Mystery cases as a proportion of all known locally acquired infections between June 1 and October 10: NSW 3% VIC 22%).

A few scientists with extreme views continue to push for accelerated herd immunity in the USA, and have had some hearing. Lobbying by business interests to discontinue lockdowns continues. WHO and mainstream scientists regard the argument as unethical. 

The US has failed to implement yet another tool, genomic epidemiology, which we dealt with here in our first posts. 

Geopolitical

President Trump returned to work only four days after being diagnosed, a record. He received a cocktail from Regeneron of the four known effective treatments (bleach and chloroquinine were not involved, remdesvir and dexamethasone were) - people have only received this very expensive emergency treatment in laboratory tests. His oxygen level started to drop once. The infection did keep him out of spotlight during a critical time for electioneering.   

Doctors on the White House coronavirus task force have been sidelined by Scott Atlas: He's a neuroradiologist with no background in infectious diseases, who has won Trump's favor while asserting that the pandemic is nearly over, that social distancing and masks don't work, and that vulnerable people should be sequestered in nursing homes while the coronavirus is allowed to spread naturally through the rest of the population.

Although about 40 white house staffers have been infected, there has been little attempt to track their contacts. A Rose Garden tightly packed event on Sep 26 has led to about ten infections.

Six men were charged with attempting to kidnap Michigan governor Gretchen Whitmer, calling her a "tyrant" for her lockdown measures, and others for fomenting civil war. This began after President Trump publicly assailed her, tweeting "LIBERATE MICHIGAN". An FBI informer infiltrated the meetings and gathered evidence for the arrests.

Governments worldwide have cracked down on 'digital liberty' following the pandemic. People in 45 countries have been charged. The usual proponent is involved in the study, the libertarian Freedom House. While the issue seems trivial next to the progress of the disease, there may be ramifications. 

Police have raided the homes and offices of France’s health minister, public health director and former prime minister as part of an investigation into the country’s response to the pandemic, alleging a "lack of will" in fighting the first wave.

Economy

The budget in Australia was delayed from Maty until October 6. It was a record 11% of GDP deficit. It was disappointing in that it once again "privatised recovery" counting that paying businesses was equal to creating activity. In a situation where spending is severely depressed, this is unlikely to work. Big tax cuts were given in the form of moving tax brackets upwards - most of this will go to high income earners. Payments of $100 a week to businesses to hire people under 35 are welcome, but raises the spectre of older workers being sacked. Instant asset writeoffs were given to companies, which is alleged to produce 50,000 new jobs. Rapid writeoff of R&D is unlikely to do very much, Australian firms are notoriously reluctant on R&D and do not utilise the existing incentives. Big 'shovel ready' infrastructure projects by the states have been run forward. 23000 new homecare packages for $1.2b were announced, enabling elderly to stay at home

A billion dollars was removed from university funding and transferred to math/science courses. This will lead to a dramatic increase in the price of arts and environmental courses.

Working from home has been a universally positive experience in the public sector, representing a major shift in management mindset. On this issue, COVID has come along at the right time 


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