Coronavirus Tidbits #47 5/13/20

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Announcements:

First, there is now a Resources Page here for the most commonly asked questions I’m getting.

Tidbits will likely be a bit shorter and a little less frequent for the next little bit. I have been immersed in it and I need to spend a little more time on self-care, which for me means seeing the spring flowers emerge and digging in the dirt.

Happy to continue to answer your questions/concerns as best I can, so don’t be shy about that.

News 

Unsafe bullying by Pence

Mike Pence traveled to Iowa to make a show of meeting food industry leaders, but all 5 of them were wearing masks. So before he came out, they were instructed to remove them, and they all did. https://interc.pt/2YOBCaS

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If 80% of Americans Wore Masks, COVID-19 Infections Would Plummet, New Study by De Kai Says

Check out his computer forecasting model, the masksim simulator, and video https://www.youtube.com/watch?v=yfeW2l8G_W4&feature=youtu.be

https://www.vanityfair.com/news/2020/05/masks-covid-19-infections-would-plummet-new-study-says

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Coronavirus blood-clot mystery intensifies

Very interesting description of some of the weird new clot-related things being seen.

clots appear in 20% to 30% of critically ill COVID-19 patients

https://www.nature.com/articles/d41586-020-01403-8

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Artificial intelligence systems aim to sniff out signs of COVID-19 outbreaks

using Twitter, social media, news reports, internet search queries, and other information streams for signs of disease outbreaks, scanned by AI.

HealthMap, a website run by Boston Children’s Hospital and Blue Dot are using this technology to spot outbreaks early.

https://www.sciencemag.org/news/2020/05/artificial-intelligence-systems-aim-sniff-out-signs-covid-19-outbreaks

https://www.cbsnews.com/news/coronavirus-outbreak-computer-algorithm-artificial-intelligence/

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Guido Menzio today: biggest ticket item in lockdown costs is the loss of human capital from inferior schooling. 10% loss in life earnings for every yr of school lost. Will also exacerbate inequality. This post agrees, estimating the cost: $2.5 TRILLION.

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Senate hearings:

Note: The White House allowed Fauci to testify to the Senate, which they control, but not the House. Nonetheless, it did not go all that well.

Sen. Lamar Alexander cluelessly asked if a vaccine would be available so colleges could reopen in the fall. Fauci politely replied, ““It’s a bit of a bridge too far.”

On Mortality:

“The United States and Germany are the two best in deaths per 100,000 people,” Trump said. “Frankly, to me, that’s perhaps the most important number there is.”

There’s just one problem: Trump is completely, massively wrong. For one thing, the U.S. death rate, per capita, is more than double Germany’s. The U.S. mortality rate of roughly 25 in 100,000 citizens, in fact, is among the 10 worst among major countries. By comparison, South Korea has recorded roughly 0.5 deaths per 100,000 citizens — a rate roughly 50 times lower.

Fauci warned that the true coronavirus death toll is almost certainly greater than the official tally of roughly 80,000 for NYC

On Reopening: Fauci: “My concern is that we will start to see little spikes that might turn into outbreaks.” Without testing and contact tracing, “there is a real risk that you will trigger an outbreak that you may not be able to control.”

Moving too quickly, he added, could lead to “suffering and death that could be avoided — but could even set you back on the road to trying to get economic recovery, because you’d almost turn the clock back, rather than going forward.”

the fact that Covid-19 is spreading through Capitol Hill and among West Wing aides could pose a credibility issue: How can the Senate and White House reasonably oversee a national reopening when it’s still not safe to gather in a hearing room?

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As U.S. meat workers fall sick and supplies dwindle, exports to China soar

No hypocrisy here, as Trump forces meat packing workers back into dangerous conditions but exports to China.

While pork supplies tightened as the number of pigs slaughtered each day plunged by about 40% since mid-March, shipments of American pork to China more than quadrupled over the same period, according to U.S. Department of Agriculture data. tmsnrt.rs/2YLF1XN

Consumers could see 30% less meat in supermarkets by the end of May, at prices 20% higher than last year.

https://www.reuters.com/article/us-health-coronavirus-usa-meatpacking-an-idUSKBN22N0IN

Diagnostics:

still an incredible, negligent lack of testing.

Adm. Giroir says the U.S. could be performing at least 40 million to 50 million tests per month by September. That would be 1.3 to 1.7 million tests per day.

Harvard researchers say there must be 900,000 tests per day by Friday in order to safely reopen.

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Eric Topol @EricTopol On April 8th, Wuhan reopened after 72-day lockdown Then 35 days w/ 0 cases Then 6 new cases (1 housing block) All 11 million people will be tested in next 7 days Contrast The US has no state >14 days w/ decline or 0 cases It’s reopening It has taken >3 months to do 10 M tests

Drugs:

Sadly paywalled article about botched rollout of Remdesivir, but

Distribution of Key Drug Was Flawed, Says White House Official

Dr. Deborah Birx said the process the Trump administration used to allocate the Covid-19 drug resulted in it not going where it was needed

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Gilead signs licenses for generic companies to make and sell remdesivir in 127 countries

Mixed bag–will temporarily increase access, but Gilead will certainly profit in other countries…Gilead has sparred with many countries and patient advocacy groups in the past over access to its HIV and hepatitis C treatments…. Public Citizen, the consumer group, noted that nearly half of the world’s population, or about 3.7 billion people, fall outside the licensing territories.

https://www.statnews.com/pharmalot/2020/05/12/gilead-generics-remdesivir-covid19-coronavirus-licenses/

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Massachusetts sets remarkable example of sharing and cooperation

After distribution of Remdesivir was secretive and inequitable, Mass hospitals agreed to share.

MGH got the drug, but Boston Medical Center, Beth Israel Deaconess Medical Center, and Brigham and Women’s Hospital received none. Several smaller hospitals–North Shore Medical Center, MelroseWakefield Hospital, and Southcoast Health–were given large amounts of drug.

The hospitals agreed to redistribute the drug through the State Health Dept–but have to make sure that doing so is legal. (What???)

https://www.bostonglobe.com/2020/05/07/nation/whos-getting-federal-distributions-coronavirus-drug-remdesivir-after-much-confusion-massachusetts-government-hospitals-team-up-share/

https://www.wbur.org/commonhealth/2020/05/12/remdesivir-distribution-massachusetts-hospitals-coronavirus-treatment

It is still unclear who decided on the initial bizarre allocation, nor what states that didn’t receive any drug will do.

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On the fantasy of a vaccine anytime soon:

We will need to think through needles, syringes, vials, cold chains – availability of needles in particular will be an amazing bottle neck:

“major glass producers have warned that a particular material, borosilicate tubing, is sold out and it could take up to two years to meet the U.S. vaccine need alone”

Producing and distributing hundreds of millions of vaccine doses will also require huge quantities of stoppers — which are made by just a handful of companies — as well as needles and refrigeration units.

https://www.politico.com/news/2020/05/11/coronavirus-vaccine-supply-shortages-245450

 

Devices:

Counterfeit masks reaching frontline health workers in US

from China

https://apnews.com/850d9e6834fc71967af6d3dda65ad874?utm_source=Twitter&utm_medium=AP&utm_campaign=SocialFlow

Epidemiology/Infection control:

Glo-Germ illustrates how germs spread at a buffet

watch the video

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Reopening thread by Chitra Akileswaran, MD, MBA @chitra_mdmba

On the fiasco of exposure, testing, etc. for a HCW

https://threadreaderapp.com/thread/1259927880252850176.html

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As Fox News stars echo Trump’s call to “reopen the country,” Fox extended the company’s work-from-home directive through June 15. The date could be delayed further.

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AP released CDC guidance: more restrictive than White House

full document available via https://apnews.com/d4fb9744fb3524b6aaff1036f3ba9cd2

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Spreading Covid via shoes

as medical staff walk around the ward, the virus can be tracked all over the floor, as indicated by the 100% rate of positivity from the floor in the pharmacy, where there were no patients. Furthermore, half of the samples from the soles of the ICU medical staff shoes tested positive. Therefore, the soles of medical staff shoes might function as carriers.

https://wwwnc.cdc.gov/eid/article/26/7/20-0885_article

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Fallout on other diseases:

Worst-case scenario, a 6 month disruption of antiretroviral therapy, could lead to 500,000 extra deaths from AIDS-related illnesses incl. TB, in sub-Saharan Africa over the next year. “This could effectively set the clock back by more than a decade to 2008”, says @DrTedros

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#StayAtHome:  suggestion that introduction of widespread working from home may have been major factor in getting R<1 in early stages, with increase in transmission when these measures were relaxed.

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On Meat Plant closures:

“the concentration of the meat industry..has given us a supply chain so brittle that the closure of a single plant can cause havoc… Four companies now process more than 80 percent of beef cattle in America; another four companies process 57 percent of the hogs.”

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Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

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When Will This Be Over? Sesame Workshop’s Tips For Parenting During A Pandemic

https://www.npr.org/2020/05/08/853142325/when-will-this-be-over-sesame-workshops-tips-for-parenting-during-a-pandemic?

Suggested read: The Risks – Know Them – Avoid Them

In assessing risk, Erin Bromage stresses looking at “dose and time” of your exposure. Particularly risky events were

Weddings, funerals, birthdays: 10% of early spreading events
Business networking: Face-to-face business networking

prolonged time in closed spaces.

https://www.erinbromage.com/post/the-risks-know-them-avoid-them

Politics:

Watch your back!

Senior White House economic officials are studying a plan by researchers at AEI and Hoover that would allow Americans to get cash immediately in exchange for curbing their Social Security benefits,

https://www.washingtonpost.com/business/2020/05/10/top-white-house-advisers-unlike-their-boss-increasingly-worry-stimulus-spending-is-costing-too-much/

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Attack on abortion rights:

In Arkansas, new law requires a negative #COVID test within 48 hours of a scheduled appointment to be able to get an abortion. Also in Arkansas, you cannot get a COVID test if you are asymptomatic and no one is turning tests around in 48 hours.

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Perspective: Kelsey D. Atherton @AthertonKD And that, ultimately, is what the pandemic is revealing. A nation that can sustain wars abroad for 20+ years in 7+ countries, but cannot muster the bare minimum political coherence to pay people to stay at home for three months in a pandemic, even if just to stabilize the economy. ~ ~ ~

Preparedness:

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Mother’s Day rant:

Feel good du jour:

A teacher barely knew her student’s parents. But she took in their newborn while they had covid-19.

https://www.washingtonpost.com/lifestyle/2020/05/08/teacher-barely-knew-her-students-family-she-took-their-newborn-while-they-fought-covid-19/

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Not Covid, but great news for friends at DNDI

Comic relief:

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Perspective/Poem

Wearing A Mask: Some Thoughts On Loving Thy Neighbor And On Being Fabulous During A Pandemic

Paula Bruno, PhD, LAc @2HeartsWellness

https://twoheartswellness.com/2020/05/02/wearing-a-mask-some-thoughts-on-loving-thy-neighbor-and-on-being-fabulous-during-a-pandemic/

Bits of beauty:

 

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