COVID-19 Coronavirus Containment Efforts

[Ygggdrasil]

Reuters: In four U. S. State prisons nearly 3,300 inmates test positive for Coronavirus -- 96% without symptoms. And in this topic 53/55 were asymptomatic from the Philippines. It is becoming very evident that those at high risk are a subset with a collection of certain cofactors , all of which are so far unknown. These numbers above imply that the morbidly for this flu is probably much less than accepted now. I would like to see more investigation in identifying all the cofactors, in addition to the obvious ones.

Here's a link to the Reuters piece cited: https://www.reuters.com/article/us-...coronavirus-96-without-symptoms-idUSKCN2270RX

Presumably the prisons are removing sympotmatic prisoners who test positive, so there is somewhat of a selection for positive, asymptomatic individuals in the prisons.

Here's a nice summary from Scripps, which I posted earlier in another thread, collecting data from a variety of studies that tested a large population for the virus, summarizing the number of positive but asymptomatic individuals found:

In the studies that we have summarized in the table, the range of infection rates is wide: from 0.76% for residents of Iceland to 36% for residents of a Boston homeless shelter. It is striking, however, that the proportion of individuals who test positive for SARS-CoV-2, but who have no symptoms of COVID-19, remains consistently high: from approximately 31% to 88%, with a mean of 56%. Because of various limitations in the summarized studies, this likely overstates the overall population mean, which some observers have suggested is around 40%.

It should be noted that the summarized studies are essentially convenience samples. They do not purport to depict anything more than the circumscribed populations from which data were collected. Large, well-designed studies with representative samples are desperately needed to accurately assess the prevalence of those who are infected with SARS-CoV-2, yet are asymptomatic for COVID-19—and to determine their impact on the pandemic.

https://www.scripps.edu/science-and...te/about/news/sarc-cov-2-infection/index.html

In some of these cases, it is possible that the positive tests could be pre-symptomatic individuals (because the average incubation for the virus is ~5 days from initial infection with the virus to showing symptoms, many individuals who test positive and are asymptomatic may later show symptoms).

Hopefully, as more serological testing is done, we will get better ideas about the true number of infections and improve our estimates of the mortality rate.

 

[DennisN]

(Maybe someone who can speak Swedish can look through the FOHM site for more information about the time delay between when someone dies and when the death is recorded in the FOHM data).

I do. I let Google Translate do a translation to English of the FOHM page you linked to:

Latest updates on the outbreak of Coronavirus disease (covid-19). The page is updated daily with number of cases at. 14:00 or when the statistics are compiled.

Information about data sources

The number of cases reported in the statistics is based on laboratory-confirmed cases reported in accordance with the Infection Protection Act according to the reporting date. Data on the number of intensive care providers is obtained from the Swedish Intensive Care Register's special reporting module SIRI. The number of reported cases is constantly changing as people seek care and are examined for the virus. There is some delay in reporting and adjustments of data on new cases and deceased cases, so the numbers for recent days (especially during holidays) should be interpreted with caution. The statistics are compiled daily with notifications received until 11.30 the same day. The current and previous day's number is incomplete and will be complete only the following day.

The statistics of deceased persons are based on data reported so far to the Public Health Agency, and there can be differences compared to the regional reporting. The statistics show the number of people with confirmed Covid-19 who have died, regardless of the cause of death. The time series with the number of deceased per day contains only those cases where the date of the death is known, therefore the total number of deceased can differ from the number reported in the time series.

Laboratory-confirmed cases are an indicator for monitoring developments. Initially, people who were living in areas with known spread of Covid-19 were sampled. But since mid-March, people with symptoms consistent with Covid-19 infection who are in need of inpatient hospital care, healthcare personnel and elderly care, and people who are being tested in sentinel testing are primarily being tested. This means that people with mild symptoms are not asked to contact the healthcare and therefore do not end up in the statistics of reported cases. When using data, specify the source Public Health Authority.

(my bolding and with some translation corrections by me)

 

[bhobba]

I don't know how much of the strategy is due to economics.

I saw an interview with one of the Swedish epidemiologists responsible for their policy. It's based on the thinking everyone will get it anyway so spending a fortune and disrupting people's lives is not going to change long term outcomes. Australia has a different belief - we believe we can beat this - it will cost and likely 'destroy' the economy - I did another post that it's possibly over $6 million per life saved - but our ethos is it will not beat us. Our culture is we help out mates, and we have the symbol of the battler - it's striving against even overwhelming odds that's the true measure - winning is important, but to strive is heroic. Its part of Australian slang - you drongo - failing or being a bit stupid - but striving anyway. It's used as a mild form of insult meaning "idiot" or "stupid fellow", but you still tried. This usage derives from an Australian racehorse of the same name (apparently after the spangled drongo, Dicrurus bracteatus) in the 1920s that never won despite many places. The word drongo has been frequently used towards mates and can be used in a casual or serious tone.

As the NY Times article Astonunc posted said: 'what Australia and New Zealand have already accomplished is a remarkable cause for hope.' We will see if our hope is justified.

Thanks
Bill

 

[kadiot]

Check out these data-driven AI-projected COVID-19 end dates for the world and various countries courtesy of the Singapore University of Technology and Design (SUTD).

Of course these are just projections. Interesting nonetheless.

https://ddi.sutd.edu.sg/

 

[anorlunda]

An island could conceivably make the virus extinct on the island. But it would also have to ban all travel to the island until a vaccine is ubiquitous.

I was shocked to go to the store today (in Florida) and see that compliance with face masks dropped from nearly 100% 10 days ago to 10% today. In addition, more businesses are threatening to defy the guidelines. Also we again see pictures of big crowds on the beaches. Government's ability to enforce the guidelines is extremely thin. Success depends on voluntary compliance, and I think that is highly fluid and changing day by day.

 

[anorlunda]

Here is an idea I really like. Simple, useful, helpful. But most of us don't have 3D printers. But maybe several of our engineers will think of ways of manufacturing something like these things to distribute locally.

To be clear, the clever thing is the blue object in the picture. It simply removes the strain of the elastic bands from the ears. Health care workers are getting pain in their ears because they wear the masks so many hours.

https://reason.com/2020/04/27/south...to-create-ear-guards-for-health-care-workers/

 

[atyy]

An island could conceivably make the virus extinct on the island. But it would also have to ban all travel to the island until a vaccine is ubiquitous.

It could try allowing workers and students on long-term visas in. These workers would first have to be tested before their travel, then quarantined for 2 weeks (or more) after arrival. If they develop symptoms while in quarantine, they can be tested, hospitalized if needed, and their quarantine extended till recovery. This still allows asymptomatic people in quarantine out, but preliminarily it seems these might not have consistently high virus counts [https://www.nejm.org/doi/full/10.1056/NEJMc2001737 - Patient Z reported no clinical symptoms, but his nasal swabs (cycle threshold [Ct] values, 22 to 28) and throat swabs (Ct values, 30 to 32) tested positive on days 7, 10, and 11 after contact.], so they would at least be less infectious by the end of quarantine. If some social distancing is still in place, the risk of transmission can be further reduced. And of course, there must be the basic capability of tracing and quarantine of close contacts of any new cases to help break new chains of transmission.

 

[morrobay]

Let's define transmission as exposure that results in infection
As @Vanadium 50 said infection is a probability p with n exposures. So for example n = .1 So infection requires repeated contact with an infected person such as a family member. Or multiple exposures in a crowded/cluster environment. Given that one can avoid these scenarios becoming infected has very low probabilities . Sure there are some here that have been exposed but not infected. Fortunately for myself I have blood type O : The natural plasma Anti-A antibodies prevalent in the blood group O specifically inhibit the SARS-CoV proteins dependent on adhesion to ACE 2. Then even if there is transmission, without the host having cofactors, all of which at this time are unknown, then this virus just produces mild flu like symptoms. So I do not subscribe to "running scared "

 

[atyy]

Let's define transmission as exposure that results in infection
As @Vanadium 50 said infection is a probability p with n exposures. So for example n = .1 So infection requires repeated contact with an infected person such as a family member. Or multiple exposures in a crowded/cluster environment. Given that one can avoid these scenarios becoming infected has very low probabilities . Sure there are some here that have been exposed but not infected. Fortunately for myself I have blood type O : The natural plasma Anti-A antibodies prevalent in the blood group O specifically inhibit the SARS-CoV proteins dependent on adhesion to ACE 2. Then even if there is transmission, without the host having cofactors, all of which at this time are unknown, then this virus just produces mild flu like symptoms. So I do not subscribe to "running scared "

But you do subscribe to having controls and precautions in place. For example, you say "Given that one can avoid these scenarios becoming infected has very low probabilities ."

The relationship between blood type and a higher risk of being infected should be considered preliminary.

 

[Astronuc]

Testing, testing, testing - and early detection
https://www.pbs.org/wgbh/frontline/film/coronavirus-pandemic/

A study in Wuhan indicates the virus will spread and be persistent in confined areas with poor circulation. I expect this would apply to public transportation, including elevators.
https://www.nature.com/articles/d41586-020-00502-w

The length of treatment is a problem because there are only so many hospital beds. Hospital systems would get overwhelmed. The stay-at-home practice significantly reduced the number of infections and the number of cases needing hospitalization.
32 Days on a Ventilator: One Covid Patient’s Fight to Breathe Again
https://www.nytimes.com/2020/04/26/health/coronavirus-patient-ventilator.html
Jim Bello, 49 and healthy, fell gravely ill, highlighting agonizing mysteries of the coronavirus. Doctors’ relentless effort to save him was a roller-coaster of devastating and triumphant twists. He became ill on March 7, went to ER on March 13, and was soon put on a ventilator.

The ventilator by itself wasn't working, . . .

. . . so (on March 18) doctors turned to an 11th-hour method. An eight-person team repositioned Mr. Bello onto his back, inserted large tubes into his neck and leg, and connected him to a specialized heart-lung bypass machine.

Called extracorporeal membrane oxygenation, or ECMO, the technique siphons blood out of the patient, runs it through an oxygenator and pumps it back into the body. It is intricately challenging to manage and isn’t available at many hospitals.

So far, ECMO has been used for hundreds of Coronavirus patients worldwide, according to the nonprofit Extracorporeal Life Support Organization. Most are still on the machines, and data is incomplete, so survival rates are unclear.

Extraordinary measures needed for so many patients, and this is with stay-at-home and physical distancing for most of the nation!

 

[mfb]

Check out these data-driven AI-projected COVID-19 end dates for the world and various countries courtesy of the Singapore University of Technology and Design (SUTD).

Of course these are just projections. Interesting nonetheless.

https://ddi.sutd.edu.sg/

Despite the buzzwords this is an extremely simplified model that doesn't take into account any of the usual issues. It treats confirmed cases as total cases, ignoring the testing strategies, it doesn't take any government action and changed behavior into account and so on.

 

[mfb]

Keeping track of older predictions:

New confirmed cases in the US stabilized at ~25,000. They will reach a million in about 8 days and will have ~1/3 of the global reported cases by then.

It was 6 days instead of 8.
3,040,000 cases globally, 1,008,000 in the US.

Spain and Italy are at 200,000 total cases now but most of them recovered.
Spain started antibody testing on a larger scale and adds confirmed cases to their case count (currently 20,000). This detects infections that were missed before. It makes their total case count grow faster while the rate of new infections is actually low.

 

[kyphysics]

re: blood type correlation to infections, hospitalizations and deaths

What's the evidence that certain blood types may protect one better against infections, hospitalizations and/or death and vice versa (a blood type making one more likely to have those)?

 

[DennisN]

Reuters reports today that UK and Italy researchers are investigating some suspicious symptoms in children:

LONDON (Reuters) - Some children in the United Kingdom with no underlying health conditions have died from a rare inflammatory syndrome which researchers believe to be linked to COVID-19, Health Secretary Matt Hancock said on Tuesday.

Italian and British medical experts are investigating a possible link between the Coronavirus pandemic and clusters of severe inflammatory disease among infants who are arriving in hospital with high fevers and swollen arteries.

[...]

Professor Anne Marie Rafferty, the president of the Royal College of Nursing, said she had heard reports about the similarity between cases in infants and Kawasaki syndrome.

“Actually there’s far too little known about it and the numbers actually at the moment are really too small,” told Sky News. “But it is an alert, and it’s something that’s actually being explored and examined by a number of different researchers.”

Source: UK says some children have died from syndrome linked to COVID-19 (Reuters, April 28, 2020)

EDIT:

Another Reuters article about this from yesterday:

Italy, UK explore possible COVID-19 link to child inflammatory disease (Reuters, April 27, 2020)

[...]

A hospital in the northern town of Bergamo has seen more than 20 cases of severe vascular inflammation in the past month, six times as many as it would expect to see in a year, said paediatric heart specialist Matteo Ciuffreda.

Ciuffreda, of the Giovanni XXIII hospital, said only a few of the infants with vascular inflammation had tested positive for the new coronavirus, but paediatric cardiologists in Madrid and Lisbon had told him they had seen similar cases.

He has called on his colleagues to document every such case to determine if there is a correlation between Kawasaki disease and COVID-19. He aims to publish the results of the Italian research in a scientific journal.

[...]

Ian Jones, professor of virology at the University of Reading in Britain, said the NL63 virus uses the same receptor as the new Coronavirus to infect humans, but he also stressed it was too early to draw conclusions.

“We just have to wait and see if this becomes a common observation,” he said.

The American Academy of Pediatrics (AAP) has yet to see something similar in the United States, which has the greatest number of Coronavirus infections and deaths.”We are not aware of any reports of this phenomenon in the United States,” Dr. Yvonne Maldonado, who chairs the academy’s committee on infectious disease, said in an email, referring to a potential link between COVID-19 and Kawasaki-type symptoms.

[...]

EDIT 2:

A longer article about this phenomenon in UK from The Guardian yesterday:

At least 12 UK children have needed intensive care due to illness linked to Covid-19 (The Guardian, 27 april 2020)

[...]

In a letter to GPs in north London, reported by the Health Service Journal , NHS bosses said: “It has been reported that over the last three weeks there has been an apparent rise in the number of children of all ages presenting with a multi-system inflammatory state requiring intensive care across London and also in other regions of the UK.

“The cases have in common overlapping feature of toxic shock syndrome and atypical Kawasaki disease with blood parameters consistent with severe Covid-19 in children.

“There is a growing concern that a Sars-CoV-2-related inflammatory syndrome is emerging in children in the UK, or that there may be another, as yet unidentified, infectious pathogen associated with these cases.”

[...]

 

[DennisN]

I just read an article on USA Today which I thought was really good. I think it was one of the best I've read regarding Sweden's strategy which often have been discussed in international news lately.

It is an interview with Sweden's chief epidemiologist Anders Tegnell by USA Today.
I've personally been a bit confused regarding Sweden's strategy lately due to the various claims of international articles about the strategy (e.g. articles which have claimed that herd immunity has been the main objective while this has been denied by our chief epidemiologist).

I think this interview clarifies it rather good, at least for me.

I won't quote anything from it since I think it is worth to read the entire article.

The questions that USA Today asked Tegnell were these:

• What's the latest from Sweden?
• What is Sweden's COVID-19 strategy?
• What has voluntary social distancing meant for Sweden's economy?
• Have Sweden's voluntary measures led to more deaths more quickly than if it had imposed a mandatory lockdown?
• What if your strategy fails? Plan B?
• What's your take on the US strategy?

Interview: Swedish official Anders Tegnell says 'herd immunity' in Sweden might be a few weeks away (USA Today, April 28, 2020)

EDIT: Oh, I just saw the title is misleading. Tegnell says in the interview "We could reach herd immunity in Stockholm within a matter of weeks". He did not say so for Sweden as a whole.

 

[atyy]

EDIT: Oh, I just saw the title is misleading. Tegnell says in the interview "We could reach herd immunity in Stockholm within a matter of weeks". He did not say so for Sweden as a whole.

Hmm, I suppose that assumes the official case numbers are quite an undercount (due to testing criteria and if we take the upper end of the estimate of asymptomatic cases at 80%).

Currently, in all of Sweden there are about 20,000 cases. Stockholm's population is about 1,000,000. So going by official case counts, that is at most 2% of Stockholm, which is too low for herd immunity (roughly 50%) to be reached in a few weeks.

But if the true number of cases is 200,000, then Stockholm would be at 20%, and herd immunity is maybe plausible in a few weeks.

If Stockholm is at 20%, which is the upper end of what it might be in New York City, then it is interesting that the Swedish health system there has managed very well (no major problems) compared to NYC. Perhaps they had good plans in place for surge capacity.

 

[kyphysics]

I'd heard something about this vaguely in the past (something like doctors were giving patients lots of blood thinners before even treating them in some E.R.s), but more is coming out about it it seems:

https://www.yahoo.com/news/mysterious-blood-clots-covid-19s-latest-lethal-surprise-221046457.html

Mysterious blood clots are COVID-19's latest lethal surprise
Issam Ahmed and Ivan Couronne
AFPApril 27, 2020, 8:24 PM EDT

A medical team turns over a patient with COVID-19 in an intensive care unit in Stamford, Connecticut (AFP Photo/JOHN MOORE)
Washington (AFP) - After he had spent nearly three weeks in an intensive care unit being treated for COVID-19, Broadway and TV actor Nick Cordero's doctors were forced to amputate his right leg.
The 41-year-old's blood flow had been impeded by a clot: yet another dangerous complication of the disease that has been bubbling up in frontline reports from China, Europe and the United States.
To be sure, so-called "thrombotic events" occur for a variety of reasons among intensive care patients, but the rates among COVID-19 patients are far higher than would be otherwise expected.
"I have had 40-year-olds in my ICU who have clots in their fingers that look like they'll lose the finger, but there's no other reason to lose the finger than the virus," Shari Brosnahan, a critical care doctor at NYU Langone told AFP.
One of these patients is suffering from a lack of blood flow to both feet and both hands, and she predicts an amputation may be necessary, or the blood vessels may get so damaged that an extremity could drop off by itself. . . . .

Blood clotting seems a dangerous issue for some COVID patients.

Scary stuff if amputation is needed!

 

[DennisN]

Hmm, I suppose that assumes the official case numbers are quite an undercount

I agree, that seems to be a necessary assumption. And I personally would not be surprised if there is a quite large undercount, due to the restricted testing policy and that mild cases may not turn up in the healthcare and thus not be tested.

 

[kadiot]

What taking the worst case scenario meant in risk communications. They went from zero to Level 4. Lockdown in 33 days (contain, isolate, treat) and now they move to Level 3. Very strategic. Science and evidence-based and data-driven and oh I love the comms, soothing, re-assuring, strong when needed to do so but a lot of caring of their “bubble.”

https://www.cbsnews.com/news/new-zealand-coronavirus-community-spread-prime-minister-jacinda-ardern/

 

[kadiot]

Immunity? YES. Duration? We don't know yet. A study of survivors of SARS showed that about 90% had functional, virus-neutralising antibodies. Similar data is needed for individuals with SARSCoV2. In Korea, 2% of recovered COVID19 patients tested positive. In Wuhan, 5-10% of “recovered” patients later tested positive for SARS-CoV-2. Are these false positives? Were they really re-infected or the test picked up infection with other coronaviruses? Currently available antibody tests need MORE EVALUATION. They must also distinguish SARS-CoV-2 from infection with other coronaviruses.

 

[peanut]

How do you do social distancing in a bus, train, or trike? And how many people have their own cars?

 

[kadiot]

I just read an article on USA Today which I thought was really good. I think it was one of the best I've read regarding Sweden's strategy which often have been discussed in international news lately.

It is an interview with Sweden's chief epidemiologist Anders Tegnell by USA Today.
I've personally been a bit confused regarding Sweden's strategy lately due to the various claims of international articles about the strategy (e.g. articles which have claimed that herd immunity has been the main objective while this has been denied by our chief epidemiologist).

I think this interview clarifies it rather good, at least for me.

I won't quote anything from it since I think it is worth to read the entire article.

The questions that USA Today asked Tegnell were these:

• What's the latest from Sweden?
• What is Sweden's COVID-19 strategy?
• What has voluntary social distancing meant for Sweden's economy?
• Have Sweden's voluntary measures led to more deaths more quickly than if it had imposed a mandatory lockdown?
• What if your strategy fails? Plan B?
• What's your take on the US strategy?

Interview: Swedish official Anders Tegnell says 'herd immunity' in Sweden might be a few weeks away (USA Today, April 28, 2020)

EDIT: Oh, I just saw the title is misleading. Tegnell says in the interview "We could reach herd immunity in Stockholm within a matter of weeks". He did not say so for Sweden as a whole.

Thank you for sharing interview with Sweden's chief epidemiologist Anders Tegnell by USA Today. I'd like to share this article as it makes a lot of sense. No, this is not the "ethics of swine", not the utilitarian "greatest good for the greatest number". It is a scientific approach to what is fundamentally a scientific problem, that nevertheless withstands the scrutiny of ethical inquiry. Those who can develop a natural immunity to COVID are exposed to it, not like some biological bait but because we have to return to NORMALCY and whether partial lockdown or total lockdown, the abnormal can never be the NEW normal. Those with comorbidity and are at high risk are shielded from it: quarantined and cared for. Anything wrong with that?

https://varsitarian.net/sci-tech/20...oZ3FUXcP_KHQGV4ymGmHpU9ZdfB8SahE-jCbIiw1TvVok

 

[DennisN]

Thank you for sharing interview with Sweden's chief epidemiologist Anders Tegnell by USA Today. I'd like to share this article as it makes a lot of sense.

You're welcome!

Just for the record, I am personally not posting about this to either defend or promote the Swedish strategy.

I don't want to do that, since (1) I am not qualified to do it and (2) I think there are different circumstances for different countries, making comparisons quite difficult. That is one thing I have learned from this pandemic. I want to be very clear about that.

I just wanted to get a better understanding of our strategy myself, which I did not have before. And also, I was a bit annoyed by the mismatch between what I have seen reported in international news compared to our domestic news regarding the strategy. It confused me quite a bit for a while. And since Sweden has been frequently discussed lately, I wanted to try to clear some things up here in the thread.

When it comes to our strategy I can't say what I think of it yet, other than that I think there seems to be some positive things and some negative things. I'm observing it. Time will tell. And the debate in Sweden about it is likely not over.

 

[kadiot]

You're welcome!

Just for the record, I am personally not posting about this to either defend or promote the Swedish strategy.

I don't want to do that, since (1) I am not qualified to do it and (2) I think there are different circumstances for different countries, making comparisons quite difficult. That is one thing I have learned from this pandemic. I want to be very clear about that.

I just wanted to get a better understanding of our strategy myself, which I did not have before. And also, I was a bit annoyed by the mismatch between what I have seen reported in international news compared to our domestic news regarding the strategy. It confused me quite a bit for a while. And since Sweden has been frequently discussed lately, I wanted to try to clear some things up here in the thread.

When it comes to our strategy I can't say what I think of it yet, other than that I think there seems to be some positive things and some negative things. I'm observing it. Time will tell. And the debate in Sweden about it is likely not over.

No worries DennisN. I appreciate your posts updating us about Sweden's response to Covid-19. It attracted many comments and started what to me is interesting, rational exchange. Let us keep it up. Let us continue studying this option, on the premise that a prolonged and an indefinite lockdown is not sustainable. One important consideration is the rate of mutation of the virus, but even if the immunity does not last a life-time, immunity of a few years would be respite enough to allow us to bounce back, restart the economy. and to discover a vaccine.

https://www.jhsph.edu/covid-19/arti...wDwk4xaIh5nRX57gOpmVogtH8tndP3mDVqQpMtjJ9Qsxg

 

[BillTre]

Went to Costco a couple of days ago.
Here is the line to get in:

Here are lines to get out:

 

[mfb]

That is like one to two more week away, while we have about 8 more months to go right?

Deaths per day can go down, and do so in many countries. If deaths decrease as they do in many European countries then the US will be somewhere around that value in a month, and hopefully with low death counts afterwards.
So far I don't see a downwards trend in the number of new cases, but that might be caused by the collection of many states in different stages of their outbreak: New cases in NY went down, cases e.g. in Alabama seem to go up.

 

[Mary Conrads Sanburn]

EDITORIAL| VOLUME 8, ISSUE 5, E612, MAY 01, 2020

• Decolonising COVID-19
  • The Lancet Global Health
• Open AccessPublished:May, 2020

When WHO added Disease X to its R&D Blueprint in 2018, the reality of an unknown pathogen that could cause a serious international epidemic was just beyond the limits of the imagination. 2 years later, at the time of writing this Editorial—the beginning of April, 2020—over 1 million people around the world have been infected with COVID-19 virus and 80 000 people have died from the disease. One-third of the world's population is in lockdown. As the world's most advanced economies struggle to repurpose state and private sector capacity to meet the growing demands on health services, the spotlight is shifting to countries without formal social safety nets or the massive monetary injections needed to bolster their economies.
COVID-19 is yet to establish a firm foothold in low-income nations, but African countries are already feeling the economic impact of the stall in global demand for oil, gas, and commodity products. UNDP has estimated income losses of US$220 billion in low-income and middle-income countries (LMICs) and that nearly half of all jobs in Africa could be lost. This, combined with the potential health impact, could be catastrophic. A Comment published in The Lancet Global Health in April found that a rapid acceleration in the number of cases in west Africa, as has been seen in Europe, could quickly overwhelm vulnerable health systems that typically have fewer than five hospital beds per 10 000 population. UNDP has called on the international community to pool resources to not only support the public health response but also to prevent economic collapse in the poorest countries. Similarly, the African Development Bank has appealed for a globally coordinated fiscal stimulus. The UN Economic Commission for Africa's Executive Secretary, Vera Songwe, expressed her disappointment at the global response with a reminder that, “If one of us has the virus – all of us have it.”
But with many borders closed and wealthy nations increasingly looking inwards, we are reminded of the asymmetrical power structures that still dominate the largely high-income-country concept of global health and development, and the dangers of the poorest countries being left in the dark as traditional powers shift their focus to the overwhelming problems at home. “The global health model is based in large part on technical assistance and capacity building by the US, the UK, and other rich countries, whose response has been sclerotic and delayed at best”, wrote Sarah Dalglish in a letter to The Lancet in March. Criticising the established notion of global health expertise being concentrated in legacy powers and historically rich states, she laments that “relatively little has been heard from African veterans of the Ebola epidemics in west and central Africa”.
The scientific community has fervently responded to the call for a treatment for COVID-19, with the first results of Gilead's experimental antiviral, remdesivir, due to be released this month. However, in the rush to register trials—over 300 so far—a sinister undercurrent has re-emerged. At the beginning of April, two French doctors sparked an intense backlash over comments made during a live television discussion about COVID-19 trials in Europe and Australia by saying that the studies should be done in Africa first “where there are no masks, no treatments, no resuscitation”, reasoning that certain studies on AIDS had been carried out in prostitutes “because we know that they are highly exposed and that they do not protect themselves”.
Africa is a continent where the legacy of colonialism is particularly heavy. It is shocking to hear these remarks from scientists in the 21st century, at a time when the work of epidemiologists, infectious disease modellers, public health specialists and, indeed, all health workers, is in the public spotlight like never before. At the WHO press briefing on April 6, Director-General Tedros Adhanom Ghebreyesus responded plainly, “To be honest, I was so appalled, and it was at a time when I said we needed solidarity. These kinds of racist remarks will not help. It goes against solidarity. Africa cannot and will not be a testing ground for any vaccine…The hangover from a colonial mentality has to stop.”
Territorial colonialism may have ended long ago but this contemporary global health crisis can serve as a reminder that the colonisation of medicine, economics, and of politics, remains alive. We must reflect on practices that have their origins in 19th century imperialism and replace them with new systems that are rooted in values of recognition, reciprocity, and respect.
###
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30134-0/fulltext

 

[bhobba]

From our local newspaper.

Queensland scientists have made a major breakthrough in the race to develop a Coronavirus vaccine (the UQ Vaccine) with an experimental drug generating immunity levels higher than those recorded in people who have recovered from the virus.

Pre-clinical trials of the University of Queensland’s COVID-19 vaccine show the ability to raise high levels of antibodies that can neutralise the virus.

The breakthrough results of the molecular clamp technology were an excellent indication that the vaccine worked as expected, UQ project co-leader Professor Paul Young revealed.

Fingers crossed - we are on the way to beating this thing. I am now confident the UQ vaccine will be one of the 7 Bill Gates is going to manufacture so when level 3 trials are completed we can vaccinate the world. This is going to cost Gates billions but will save many lives.

Thanks
Bill

 

[bhobba]

the studies should be done in Africa first “where there are no masks, no treatments, no resuscitation”, reasoning that certain studies on AIDS had been carried out in prostitutes “because we know that they are highly exposed and that they do not protect themselves”.

Few things make me actually angry these days, but this does. Appalling. Politicians will do what they think will get them re-elected, but scientists must be better than this.

Thanks
Bill

 

[mfb]

Vaccine trials mean great monitoring and probably good healthcare for the participants. Sounds like a great thing to have, especially in countries where these are in a poor state overall.
Yeah, they could have phrased it more nicely.

 

[DennisN]

I just read a long interview with Dr. Michael Osterholm (an infectious disease epidemiologist) regarding his thoughts about the near future and possible long term developments of this pandemic including possible future numbers, multiple waves, comparison with the waves of the Spanish flu in 1918 and many other things. It was a very sobering read. To be honest, I found it was a quite scary read, which actually made me hesitate about posting it here. But I decided to post it:

Infectious disease expert: We're only in the second inning of the pandemic (CNN, 21 april 2020)

Some quotes:

[...]

I think it's very hard to realize that we're first in the first innings of this crisis. A quote keeps coming back to me from Sir Winston Churchill: "This is not the end. It is not even the beginning of the end, but it's perhaps the end of the beginning." I think that's where we're at right now. You might say we're in the second inning of a nine-inning game.

[...]

For several months, people kept pointing to Asia and saying, "If we just adopt the same response as China or Singapore or Japan, then we could bring this under control." Finally, people are realizing that these comprehensive -- some would consider them even extreme -- control measures adopted in Asian nations are starting to show the breaks in their effectiveness.

[...]

We are going to be dealing with Covid-19 on a global scale for months to come, trying our best to suppress it as much as possible.

[...]

And here is a recent short tv interview with him on MSNBC (0:58 - 6:30, 23 April 2020)

EDIT:

And in the first article there was a link to another interesting interview:

COVID-19 Is Here. Now How Long Will It Last?
(with Virginia Pitzer, ScD Associate Professor of Epidemiology (Microbial Diseases), Yale School of Medicine March 27, 2020)

Some quotes:

[...]

If pandemics happen in waves, should we be prepared for more periods of school closures, social distancing measures and event cancellations in the coming months?

V.P. It is unclear whether the experience with influenza is really indicative of what might happen with SARS-CoV-2. For example, we know that school-aged children play an important role in transmitting flu, but it is unclear whether the same is true for SARS-CoV-2, since children do not seem to experience much illness. If that is the case, we may continue to see cases of COVID-19 occurring throughout the summer. Nevertheless, it is unlikely that we will be able to eliminate SARS-CoV-2 completely, and other human coronaviruses are known to peak in the fall, so we may very well see a resurgence of disease next fall. More importantly, if control measures are lifted too soon, we are likely to see another peak in the disease until enough immunity has built up in the population, or until we are able to develop an effective vaccine against SARS-CoV-2.

[...]

Now for our rapid-fire round. How do these outbreaks end? How did we eventually curtail SARS and MERS? Is it a matter of scientists developing a vaccine to fight the virus? Is it the eventual establishment of herd immunity? Will another big outbreak happen if the SARS-CoV-2 virus mutates?

V.P. This epidemic is not like SARS or MERS. We were able to contain the 2003 SARS epidemic largely through case isolation and quarantine of known contacts because most individuals with SARS were symptomatic and only spread the disease to other individuals after they had been sick for a while. Similarly, most MERS infections are symptomatic, and the virus does not transmit very efficiently from person to person. With SARS-CoV-2, it is estimated that 50-60% of people who are infected don’t exhibit symptoms, but can still spread it to others, and even those who do develop symptoms are infectious before symptoms appear. Therefore, it is likely that this outbreak will only end when enough people have become immune to the virus, either through having been infected with it or through the development of a vaccine that provides effective immunity. Even then, it may be with us for a long time and to continue to cause seasonal epidemics, like flu and other human coronaviruses do.

Like all living things, the virus is likely to mutate. Most mutations are harmful to the virus, but occasionally a mutation can occur that makes it transmit more efficiently. Mutations in the flu virus, for example, can allow the virus to escape the immune response among people who had been infected with or vaccinated against a different flu virus in the past. However, the big changes that allow the flu virus to escape immunity often take place over multiple years, and not all viruses are able to evolve in a way that allows them to escape immunity.

 

[kadiot]

From our local newspaper.

Queensland scientists have made a major breakthrough in the race to develop a Coronavirus vaccine (the UQ Vaccine) with an experimental drug generating immunity levels higher than those recorded in people who have recovered from the virus.

Pre-clinical trials of the University of Queensland’s COVID-19 vaccine show the ability to raise high levels of antibodies that can neutralise the virus.

The breakthrough results of the molecular clamp technology were an excellent indication that the vaccine worked as expected, UQ project co-leader Professor Paul Young revealed.

Fingers crossed - we are on the way to beating this thing. I am now confident the UQ vaccine will be one of the 7 Bill Gates is going to manufacture so when level 3 trials are completed we can vaccinate the world. This is going to cost Gates billions but will save many lives.

Thanks
Bill

Go, Australia, go! At the moment, there are over 100 COVID19 SARSCoV Coronavirus vaccine candidates.

 

[bhobba]

Vaccine trials mean great monitoring and probably good healthcare for the participants. Sounds like a great thing to have, especially in countries where these are in a poor state overall.
Yeah, they could have phrased it more nicely.

If that's what will happen, then of course it's fine. But nothing along those lines was mentoned.

Thanks
Bill

 

[atyy]

India's Serum Institute to make millions of potential COVID-19 vaccine doses
https://www.channelnewsasia.com/news/asia/india-serum-institute-millions-covid-19-coronavirus-vaccine-12685698

They will make Oxford's Jenner Institute's vaccine candidate even though we don't know whether that will work. The Jenner Institute's vaccine uses adenovirus to display the antigen, a similar strategy as that of China's CanSino.

 

[kadiot]

Good News! Gilead Sciences: Data from a US study of Remdesivir (originally developed for Ebola & Marburg virus infection) showed the medication had met the primary endpoint in a clinical trial in treating COVID19 SARSCoV2 coronavirus. The US NIH will make the announcement soon.