COVID19 Roundup--Mostly Good News

Today we'll try to stay focused beyond the numbers and provide links to articles and blogs that discuss developments and trends that will play out increasingly in the coming weeks.

Obviously, the questions of more widespread testing and potential specific treatments for COVID19 lead the way.

Naturally politics is involved at every step of the way. Don Surber has done the hard work--slogging through liberal propaganda--to arrive at the truth:

Democrats fear a cure

The biggest fear for Democrats today are chloroquine and hydroxychloroquine. Democrat governors in Michigan and Nevada have banned their use to fight COVID-19, not because the drugs may harm people but because the drugs may work.

The party's flying monkeys in the press are casting shade on this possible cure.

Surprised? Me neither. Trading on the deaths of innocent people is par for the course for The Despicable Party. The liberal flying monkeys are doing their best to paint Trump as anti-science and worse but, as we've discussed for weeks now, the knowledge of chloroquine's (and its derivatives) potent antiviral action has been known for well over a decade. The drug itself and its potential side effects have been known for many decades as well. Who should get chloroquine+ treatment and when is a question that can be easily sorted out:

What About Herd Immunity?

Everybody talks about 'herd' immunity, but do we really know what we're talking about? The concept is simple enough--it's a bit like vaccination, only the vaccine is developed naturally through enough people acquiring the disease and recovering with an acquired immunity. If enough people develop that 'natural' immunity the disease is thwarted of new victims and stops spreading--or, ideally, dies out.

However, there are problems with using this as a deliberate strategy.

* The most obvious problem is calculating the percentage of a given population that must develop an immunity in order to protect the non-immune portion of the population. A good example of that balance would be the flu vaccine. 

* Another problem has to do with whether the vaccine is or is not highly immunogenic. If it's not, it may be relatively ineffective in building up immunity in the general population. A good example of that, again, is the flu vaccine. 

* Since a large percentage of the given population must become infected to develop a 'natural' immunity and produce a 'herd' immunity effect, the possibility that a large number of people will die becomes a consideration. Even a 'low' mortality rate translates into large numbers of dead people if the disease spreads widely enough. 

* The question also arises, How long will any acquired immunity last? If you forgo social distancing instead adopt the quest for 'herd' immunity as a deliberate strategy--in the absence of a vaccine or a specific medication, which is  the situation we're currently in--but the acquired immunity is short lived, then you'll have killed off a substantial number of people for no particular benefit.

These are the questions that experts in epidemiology and infectious disease are wrestling with. Back on March 13, 2020, Science Media Centre published the views of a fairly large number of UK experts--expert comments about herd immunity--seeking answers to just these questions.

Because so many people have advocated living life as 'normal' while waiting for 'herd' immunity to kick in, I wanted to address this issue so we all know more or less what we're talking about while evaluating policies for dealing with this pandemic. To accomplish this I've taken the liberty of pasting in some (not all) of the responses and editing them. There's a certain amount of repetition, but I think that's a good thing.

One reminder. Comparison is regularly made in these responses to the flu. But, as these scientists all know, This Is Not The Flu! Also, you will see that not all of these scientists are on the same page with one another.

Larry Johnson: Cuomo's Corona Panic

Earlier this morning I referred in a comment to Cuomo's hysteria. Larry Johnson goes into that a bit, with some very informational details. It probably explains why the American public appreciates Trump's performance in this crisis, as opposed to hysterical panic mongers among the media and ruling elite. Johnson also provides some much needed details that also explain the daunting task facing our healthcare system in attempting to come to grips with this pandemic. The risk of system overload is very real.

Johnson begins Cuomo's Corona Panic by quoting Cuomo's juvenile--and deeply ignorant--tirade from yesterday:

[Cuomo] is now accusing the Feds of dragging their feet in getting NYC 30,000 ventilators. Here is the quote: 

"What are you doing sending 400 when I need 30,000 ventilators," Cuomo said. "You're missing the magnitude of the problem." 

No Cuomo, you do not understand. For starters, you do not have 10,000 patients on a ventilator now. The number of patients who test positive does not mean that all will require a ventilator. The numbers available so far indicate most who test positive for corona virus are not being hospitalized. That means the numbers for ventilators are not going to skyrocket and immediately outstrip the existing capability.

...

Shame on him. He has a duty to help educate his constituency. Let us start with the production reality--you cannot magically produce ventilators overnight. The existing manufacturers have limited, not UNLIMITED, capabilities to expand production.

That's good, but then Johnson digs deeper, based on his own experience as working his way through college as a Respiratory Therapy Tech and handling patients on ventilators.

UPDATED: New England Journal of Medicine: Where We Are, What To Expect

The venerable New England Journal of Medicine (NEJM) published an editorial today that was authored by Anthony S. Fauci, M.D., H. Clifford Lane, M.D., and Robert R. Redfield, M.D.: Covid-19 — Navigating the Uncharted. The authors of the editorial discuss an article, also appearing in the NEJM, by a team of Chinese doctors: Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia. While Fauci and his co-authors don't explicitly say so, it seems clear from what they do say that they believe the COVID19 pandemic will play out in the US in a very similar way to what is described by the Chinese doctors.

Before providing what I view as the highlights of the editorial, I want to point out that the editorial confirms the basic features of SARS-CoV-2 that we've been discussing for the past month. Compared to SARS-Classic--the 2003 version--COVID19 or SARS2 is 1) considerably less deadly than SARS-Classic but deadlier than seasonal flu, while 2) possessing a high "efficiency of transmission." Those combined factors make SARS2 a very worrisome disease. Its ease of transmission allows it to spread rapidly and that fact has already allowed it to kill far more people than the deadlier SARS-Classic.

Of particular note, Dr. Fauci states that SARS2 in the US "may ultimately be more akin to those of a severe seasonal influenza ... or a pandemic influenza". That mirrors what President Trump has said. Before anyone starts high fiving, however, realize that a severe seasonal influenza in the US kills around 60K people. Since we don't take the kind of measures against seasonal flu that are being taken against SARS2--to limit the spread of the disease--we can assume that Fauci believes that without the measures that are being taken the death toll might be considerably higher.

So, the highlights--beginning with references to the conclusions presented by the Chinese doctors in their article:

Where Do We Stand: Transparency, COVID19, Flu

Last night I did a post that summarized a theory advanced by a doctor who comments at Steve Sailer's blog: Does COVID19 Piggyback On The Flu? If you haven't read it yet, I urge you to do so, because it will be the background to what follows. Here's a summary of the basic idea that the doctor is advancing:

What the doctor does is examine vaccination rates around the world--concentrating on the flu, for obvious reasons--including looking at which age groups get vaccinated and whether the countries in question tend  to have bad flu seasons. The idea is that people who contract COVID19 are, in effect, getting hit with a double whammy. COVID19 is preying on people whose immune system is compromised to one degree or another, and in particular--no surprise--with regard to respiratory diseases. To me, this seems like an idea worth examining, because the demographics of this pandemic seem to vary so widely around the world.

We've already discussed how different the demographics are for Italy and Germany--and the social networking is undoubtedly a factor as well. Unfortunately, Germany is the one country for which data is missing re vaccination. The US also seems not to be tracking too closely with Italy's demographic mortality rates or even infection rates among different age groups  (recall the Milwaukee demographics that I linked this morning--apparently those are fairly typical for the US). There's gotta be an explanation for these discrepancies, and this makes some sense to me.

Let me be clear: I'm not suggesting that COVID19 is just the seasonal flu. It's NOT just the seasonal flu. Nevertheless, the data we have so far suggests that it would be worthwhile examining whether COVID19 is a "fellow traveler" with the flu. What I mean is that what we seem to be seeing is that COVID19 appears to hit hardest those groups that have the lowest rate of flu vaccination in countries that typically have bad flu seasons.

This morning I recalled that a common meme among COVID19 minimizers has been: If COVID19 is so deadly, why did only 17% of the passengers on the Diamond Princess cruise ship contract the virus, in an environment that noted epidemiologist Michael Osterholm deemed ideal for spreading it? Putting that together with the theory advanced by Sailer's doctor-commenter, I did a quick search regarding what vaccincations are either required for passengers on cruise ships. I can't tell you how strictly the policies are enforced, but I can tell you that cruise companies want their passengers to be very healthy and to be pretty much fully vaccinated. Measles leads the list of vaccines, but influenza is right up there, too. This would at least appear to support the doctor's theory: Healthy populations that are fully vaccinated for the flu will typically have a low infection rate.

Obviously my views on medical matters should carry no weight. I'm simply saying this seems a worthwhile line of inquiry. Transparency in these matters would be very helpful for the general public to protect itself. Public health officials have relevant demographic-medical information already in their possession. They should be making it available but are not doing so. That's a problem that no one is addressing.

Does COVID19 Piggyback On The Flu?

As I understand it, that's what a NY doctor is suggesting to Steve Sailer in a lengthy comment: Does a Flu Vaccination Help Save Your Life? I hope it's true, because for the first time in my life--that I can remember for sure--I had a flu vaccine. I also got the pneumonia vaccine, and this was in early January before COVID19 was really on my radar. I've remarked to my wife that I believe that--at a minimum--these vaccinations could help prevent us from meeting up with COVID19 with rundown immune systems.

What the doctor does is examine vaccination rates around the world, including looking at which age groups get vaccinated and whether the countries have bad flu seasons. (Ray SoCal sent me a link this morning that did a bit of this, but just with Italy.) The idea is that people get hit with a double whammy. To me, this seems like an idea worth examining, because the demographics of this pandemic seem to vary so widely around the world.

We've already discussed how different the demographics are for Italy and Germany--and the social networking is undoubtedly a factor as well. Unfortunately, Germany is the one country for which data is missing re vaccination. The US also seems not to be tracking too closely with Italy's demographic mortality rates, where there seems to be almost a genocide of the oldies (recall the Milwaukee demographics that I linked this morning--apparently those are fairly typical for the US). There's gotta be an explanation for these discrepancies, and this makes some sense to me. Read these excerpts and see what you think:

I’m wondering if people who are being hospitalized and who are likely to crump are much more likely to be those who have co-infections with COVID and influenza, *particularly if they have no comorbidities or are not old*. 

I think that is what explains why the US has hospitalizations rates break down the way they do (which was confusing me), why Italy is getting hammered all at once, and why places like South Korea and Japan have ridiculously low hospitalization rates of people, particularly those who are young. 

The US vaccinates the elderly the most (pretty well to be fair), the young (6-17) second most, 50-65 third most, and the lowest people from 18-49 (basically only 25-30 percent of people). 

But that age group in the US--which I've seen elsewhere gets vaccinated at about a 48% rate--seems to be providing a pretty high percentage of COVID19 patients. Hmmmm.

This REALLY Isn't The Flu

ABC news did a story about a doctor at George Washington University Hospital who has developed a way to show everyone what the Wuhan virus can do to your lungs. It's not the flu, and it's not pneumonia--he wants people to understand that. To me, this is a major reason why we need to be careful about going back to "normal," or adopting rash strategies like quarantining "old people" and letting the rest roam free. And what can I say about the article in the WSJ this morning that advocates: 

Expose First Responders to the Coronavirus

Young workers who have to quarantine could volunteer to build immunity.

The author, Michael Segal, is a neurologist, so I guess he's one of those "experts."

Well, back to the expert at George Washington U. Hospital--See how COVID-19 can damage a person's lungs in 3D virtual reality. I can't embed the video, but I found an image. As the doctor explains, "the blue part is the more normal lung, but anything you're seeing yellow is lung that's being destroyed by the virus":

WASHINGTON D.C. (WJLA) — A doctor at George Washington University Hospital wants everyone to know exactly how COVID-19 can damage your lungs.

Dr. Keith Mortman, Chief of Thoracic Surgery, created a virtual rendering of lungs from an actual patient being treated at the hospital. 

Mortman thinks the first-of-its-kind view inside the lungs of a patient with COVID-19 has a powerful message for the public. 

"This patient is a gentleman in his late 50s, who initially had a fever and a non-productive cough like many other people," Dr. Mortman explained. "Respiratory symptoms progressed quite rapidly, to the point where he did need to be intubated and put on the ventilator." 

A virtual reality, 360-degree rendering shows what the virus does to the human body. 

"So what you're seeing in the video, essentially the blue part is the more normal lung, but anything you're seeing yellow is lung that's being destroyed by the virus," Dr. Mortman said. 

"It's quite alarming to see, in all honesty, because unlike your garden variety pneumonia that might affect only one small part of the lung or unlike the common flu, what you're seeing in this video is really the widespread diffuse damage to the lung," Dr. Mortman added.

It's not the flu, it's not pneumonia, and "recovery" doesn't necessarily mean what you think it means. Do people who are exercised about "the economy" understand this? We need to be careful about getting back to "normal." At a minimum, give Trump some breathing space on this.

ADDENDUM: Will Chamberlain asks:

THE TRAP: Are Pelosi and Schumer dragging their feet to get President Trump to reopen the economy before we’re prepared?

Well, it's a legit question. I didn't watch that, but ...

This Is The Type Of Transparency We Need Nationwide

One of my brothers lives in the Milwaukee area. He sent this Milwaukee County COVID-19 Dashboard page. Unfortunately I can't paste it in here. To me, this is close to a model for what should be, but isn't, available on a nationwide basis.

If you follow the link you'll see that there's a scalable map that aggregates cases by census tract. In addition it has information on the following categories:

Total Confirmed Cases in Milwaukee County: 295

Total Confirmed Deaths in Milwaukee County: 3

Confirmed Cases by Municipality

Confirmed Case Count by Age Range

Total Positive Case Count by Day

I particularly call your attention to the section Confirmed Case Count by Age Range which confirms that--if this pattern is in any way typical of the US--sequestering oldies is a questionable strategy

I can't paste it, but here's how the numbers come out:

0-9: 1

10-19: 4

20-29: 42

30-39: 48

40-49: 65

50-59: 54

60-69: 52

70-79: 25

80+: 4

Of course there are lots of factors that go into that. For example, we don't know what percentage of the total population within the age group those numbers represent. The sample size for Milwaukee is relatively small, as are the total deaths, but that's probably true for many similarly sized cities in the US. Also, note on the map that there does appear to be a bit of a pattern to the cases in a geographic sense.Nevertheless, one assumes it all must mean something.

This Is Not The Flu--Anecdotal Stuff

Michael Snyder has a blog at Zerohedge that provides ... anecdotal stuff, to try to drive home the concept that so many still fail to grasp: THIS IS NOT THE FLU. Yes, I'm aware that Snyder thrives on alarmism. Nevertheless ...

The blog is titled It's Not "Just The Flu": Here's Why You Definitely Don't Want To Catch COVID-19. He begins with a general description that contains an important reminder: people don't "recover" quickly. Even with chloroquine treatment from Doc Didier, the patients too 5-6 days to recover. Without it, it takes much longer. That alone should tell you that this is different from any flu most of us have had experience with. I've edited out hyperbolic terms that don't come from the patients:

Can you imagine being in “blinding pain” for weeks, constantly gasping for air as you feel like you are being suffocated, ...?  As you will see below, coronavirus survivors are telling us about their ... ordeals, and they are warning us to do everything that we can to avoid this virus.  Of course they are the lucky ones.  ...  So those that survive should consider themselves to be very fortunate, but many of those same individuals will be left with permanent lung damage.  

This virus attacks the respiratory system with a ferocity that is shocking doctors, and those that are still attempting to claim that COVID-19 is “just like the flu” need to stop, because they are just making things worse.

He then presents first person accounts from five survivors, ranging in age from 12 to 55. Well, no first person account from the 12 year old--she's on a ventilator, currently in stable condition. The accounts describe people fighting for their lives. I remember the worst flu I ever had, when I was in my mid 30s. I was so weak that I literally crawled down the hall to the bathroom and back. But I didn't feel the way these people describe it. And I was over it in a few days. I didn't even miss a full week of work.

UPDATED: Definitely Not Just Oldies--The 'Simple' Solution

Earlier in Not Just Oldies I noted that European healthcare officials were reporting that--contrary to earlier impressions--Covid-19 is not simply an "old persons' disease. For example, at that time reports were coming out of France that of critical cases over 50% were over the age of 60. Netherlands was reporting similar statistics.

Now the CDC is reporting, according to NBC, that American statistics reflect the European experience. Of course, the disease still skews old, but it takes in a large swath of people still in the prime of life. For example:

Centers for Disease Control and Prevention, which, after studying more than 4,000 cases in the U.S., showed that about

40 percent of those hospitalized were ages 20 to 54.

Among the most critical cases, 12 percent of intensive care admissions were among those ages 20 to 44, while 36 percent were for those 45 to 64.

About 80 percent of people in the U.S. who have died from COVID-19 were 65 and over, with the highest percentage among those over 85.

So, nearly half of critical cases fell between the ages of 20 and 64. The worst outcome (death) was heavily among those over 65, but that's a lot of critical care patients in the two middle quartiles using up increasingly scarce healthcare resources.

The point is, the "simple" solution that has been appearing recently in opinion columns--quarantine people over 65 and allow the rest of the population to roam free--urns out after even a cursory examination of the data to be not so simple at all. In some very real sense the mortality or death rate gives a false impression. People who die no longer occupy an ICU bed. I'm going to bet that those who survive this disease after entering an ICU will have occupied space for far longer than those who died. That's the devilish thing about this pandemic--it 'attacks' our actual healthcare system as much as individuals. Attacks and overwhelms. Allowing people in the middle two quartiles to roam freely invites collapse of our healthcare system because hospitalization rates for Covid-19 are far, far higher than for seasonal flu. The more freely roaming people from the two middle quartiles who become infected, the more that rate will come back to haunt the entire healthcare system. This is what 'flattening the curve' is really about, far more than about the mortality rate alone.

UPDATED: What A Super Spread!

This is how it works: How an Upscale Connecticut Party Became a Coronavirus 'Super Spreader'.

About 50 guests gathered on March 5 at a home in the stately suburb of Westport, Conn., to toast the hostess on her 40th birthday and greet old friends, including one visiting from South Africa. They shared reminiscences, a lavish buffet and, unknown to anyone, the coronavirus. 

Then they scattered. 

The Westport soirée — Party Zero in southwestern Connecticut and beyond — is a story of how, in the Gilded Age of money, social connectedness and air travel, a pandemic has spread at lightning speed. The partygoers — more than half of whom are now infected — left that evening for Johannesburg, New York City and other parts of Connecticut and the United States, all seeding infections on the way. 

Westport, a town of 28,000 on the Long Island Sound, did not have a single known case of the coronavirus on the day of the party. It had 85 on Monday, up more than 40-fold in 11 days.

I had a niece living there until last September or October. Got out just ahead of the bug. Lots more at the link.

UPDATE: Just heard from my niece:

Sadly I know a fellow mom my age [back in Westport, CT] with 3 kids who is very sick. In hospital on a ventilator. She’s the picture of healthy... nutritionist, incredible athlete/marathon runner.

Osterholm: Living And Dying With Covid-19

Below is a youtube interview of Michael Osterholm. He raises some important points, although without offering solutions--he wants all to talk about these things, which I guess we're doing here. My one reservation is the emphasis he places on developing a vaccine. You'll see, reading between the lines of my partial transcript, that he's not really optimistic about that. If you've read his book you'll know what he thinks about the whole matter of vaccines and their effectiveness with regard to diseases like the flu--and presumably also regarding coronaviruses. The common cold is a coronavirus--have you had your common cold vaccine this year? Then why do you think you'll be getting a Covid-19 vaccine any time soon.

That's why I was disappointed that he didn't mention--nor was he asked--about possible new treatments (like chloroquine) that attack the virus itself rather than attempt to alleviate the symptoms.

Here's a partial transcript. The entire video is only about 4 minutes. What I've done here is offer most of Osterholm's more important remarks, without the questions.

He sees as a positive development that the world is finally waking up to the fact that we can't ignore this. 

We're having the discussions and taking the actions that we really needed to do to address this. 

There's a tremendous misconception about "bending the curve." This virus is likely going to be here until we have a vaccine--which, if I were to be optimistic, I'd say would be 18 months. 

When we try to "bend the curve" we suppress cases, but all we're doing is postponing them, not eliminating them. 

I hear this notion that we'll be in this till April or August--I think we're gonna be in this for many, many months. We have to bend the curve every day, not just one time. 

We have to have a conversation about how we're gonna die with this virus ... but we also have to consider how we're gonna live with it. And we hafta figure that out. Do these measures that we're taking work, and do we envision an America that for the next 18 months will be in lockdown? 

As soon as China goes back to work and people are on subways and trains and all the different forms of transportation, when they're cheek to jowl in manufacturing plants, when they're in public places, I for one believe that we're gonna see a resurgence of cases. 

I'm not saying that we shouldn't try to bend the curve. Postponing cases means that they're just gonna happen later, which means that we continue to drag this out. That's the hope. We hafta do that. But the hope also includes that we'll have a vaccine. Otherwise the 20 to 60 per cent of Americans that we believe will get this WILL get this. Our hope is that we'll suppress this, but we'll only be saved when we have a vaccine.