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  1. #3706

    Re: covid-19 Virus Updates and Discussion

    Wait until Mr Distractor get a hold of the vaccaine news.
    2017 & 2018 Australian Open Champions

  2. #3707

    Re: covid-19 Virus Updates and Discussion

    Quote Originally Posted by patrick View Post
    Wait until Mr Distractor get a hold of the vaccaine news.
    One of the reasons I posted it is because he's going to decide it's not fast enough and not let sound practices be followed.

    I give it one to two days max.
    “No matter how cynical I get, I just can't keep up.” – Lily Tomlin.

  3. #3708

    Re: covid-19 Virus Updates and Discussion

    Aaron Rupar
    Trump motions for a reporter to take her mask off before she asks him a question

    Q: Why haven't you said anything about the US hitting 200,000 coronavirus deaths?

    TRUMP: "Go ahead. Uhhhhh. Anybody else?"
    “No matter how cynical I get, I just can't keep up.” – Lily Tomlin.

  4. #3709
    Forum Director
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    Re: covid-19 Virus Updates and Discussion

    WHO's Situation Report for September 22, 2020. A lot happening here.


    EPI UPDATE The WHO COVID-19 Dashboard reports 31.43 million cases and 967,164 deaths as of 6:30am EDT on September 23. At 35-40,000 deaths per week, the global mortality could surpass 1 million deaths in the next week.

    The US CDC reported 6.83 million total cases and 199,462 deaths. The US is averaging 41,141 new cases and 767 deaths per day. We expect the US to surpass 200,000 cumulative deaths in the CDC's afternoon update. In total, 22 states (no change) are reporting more than 100,000 cases, including California with more than 700,000 cases; Florida and Texas with more than 600,000; New York with more than 400,000; Georgia with more than 300,000; and Arizona, Illinois, and New Jersey with more than 200,000.

    The Midwest region of the US* is now reporting its highest average daily incidence to date. The increase began in mid-June, around the time incidence began to increase in the South, Southwest, and West; however, the Midwest incidence plateaued when other regions steadily declined. Over the past several weeks, the Midwest incidence has increased again. The timing of the recent surge coincides with the return to school, including in-person classes in some areas, and much of the increased incidence is among younger adults. The Midwest is now reporting its highest average incidence to date. According to data compiled by researchers at COVID Exit Strategy, Wisconsin’s daily incidence has more than doubled over the past 2 weeks, and the incidence in Nebraska and South Dakota has increased by 40% or more. Several Midwest states are also reporting concerning trends in terms of testing. Arkansas, Iowa, Kansas, Missouri, Nebraska, South Dakota, and Wisconsin are all reporting test positivity greater than 15% over the past 2 weeks, and Nebraska and Wisconsin have increased by more than 3 percentage points over that time.
    *States included in the Midwest are defined differently by different groups.

    The Johns Hopkins CSSE dashboard reported 6.91 million US cases and 201,204 deaths as of 12:30pm EDT on September 23.

    US CDC DROPLET VS AIRBORNE/AEROSOL GUIDANCE When we covered the inadvertent changes to US CDC guidance on SARS-CoV-2 transmission on Monday, archived versions of the site captured Friday-Sunday had not yet been posted. You can now view archived versions via the Internet Archive and compare them to the current version. We will continue to monitor CDC guidance for any changes, particularly any associated with the draft version that was published on Friday and then removed.

    WEDDING RECEPTION OUTBREAK An August wedding in Maine has been linked to more than 175 associated cases and 8 deaths, including many who did not attend the wedding. Notably, none of the associated deaths attended the wedding. Six of the 8 deaths were residents of a nearby long-term care facility, where an employee who lives with someone who attended the wedding is believed to have introduced the virus. Associated cases have been identified in multiple long-term care facilities and the county jail. The outbreak at the jail has been attributed to an employee who attended the wedding, and it has resulted in at least 84 cases, including nearly half of the incarcerated population and employees as well as 17 household contacts of employees.

    The wedding reportedly had 62-65 attendees and an indoor ceremony and reception, which violated the state prohibition on gatherings of more than 50 people, and attendees reportedly did not adhere to recommendations regarding physical distancing or mask use. All attendees had their temperatures checked before entering; however, this failed to identify infectious individuals. The Maine CDC issued an “imminent health hazard” citation to the event facility where the reception was held for failing to maintain social distancing measures, allowing too many people to congregate, and neglecting to collect contact information from wedding guests. The facility reportedly suspended all operations due to the outbreak. This case study highlights the potential for transmission at individual events to spill over into the community as well as the limitations of temperature or symptom monitoring to identify infectious individuals.

    K-12 SCHOOLS With no federal reporting guidelines, school COVID-19 reports continue to be fragmented. The New York Times has compiled information on the public availability of school-level COVID-19 data. Currently, 11 states have no public reporting for school-associated COVID-19 cases. Some states that do report COVID-19 cases do not do so clearly or explicitly, and data can be difficult to identify among other COVID-19 reporting. The level of reporting also varies by state, ranging from school- and district-level data to aggregated state-level data.

    Lawsuits continue to be a mechanism for forcing school reopenings or closures. Several teachers in Palm Beach, Florida, filed a lawsuit against the local school board to keep classes online. Conversely, a local school board in Oregon filed a lawsuit against state health and education officials to allow them to resume in-person instruction, despite the county having one of the highest incidence rates in the state. In New Mexico, a lawsuit has been filed claiming that differences in state COVID-19 requirements for public and private schools is unconstitutional. A spokesperson for the governor’s office argued that the differences in requirements for public and private schools are a result of private schools having “more flexibility” to respond during the pandemic. Private schools in New Mexico are only permitted to return to 25% capacity, whereas public schools can operate at up to 50% capacity for in-person classes. Notably, however, private schools can resume in-person classes for all grades K-12, but public schools are currently limited to grades K-5.

    MIDWEST RESURGENCE COVID-19 incidence is once again on the rise in the Midwest region of the US*. Analysis conducted by researchers at Harvard University identified 6 Midwest states as being at a “tipping point”—Arkansas, Missouri, Oklahoma, North and South Dakota, and Wisconsin—signaling the potential for increased transmission over the coming weeks if not quickly brought under control. Notably, Wisconsin Governor Tony Evers issued a new public health emergency declaration for the state and extended the statewide mask mandate as a result of the recent surge in COVID-19 incidence. As we covered previously, the Big Ten Conference, which largely consists of schools from Midwest states, announced that it will resume athletic competition, including football. Of note, the counties where 9 of the 14 schools** are located are reporting increasing COVID-19 incidence, including 2 that doubled compared to the previous week. As a whole, counties with Big Ten schools are reporting per capita incidence that is more than double the national average, including 4 that are approximately 3 times the national average or higher.
    *States included in the Midwest are defined differently by different groups.
    **There are 14 schools in the Big Ten Conference.

    HALLOWEEN & DÍA DE LOS MUERTOS As the weather cools, many are looking ahead to fall holidays. Halloween, widely celebrated throughout the US, and Día de los Muertos, an important Mexican cultural holiday, typically involve both family gatherings and community events. To mitigate the SARS-CoV-2 transmission risk linked to these holidays, the CDC published guidance on ways to safely participate in these celebrations. The guidance breaks down certain holiday-related activities for both Halloween and Día de los Muertos into low-, moderate-, and high-risk categories. Traditional trick-or-treating, in which children go house-to-house and adults give them candy, is considered a high-risk activity since it involves direct contact between numerous children and adults as well as the widespread movement of children around the community. Instead, the CDC suggests that families prepare individually packaged candy and place it outside the home in a way that children can take it with no contact necessary. For Día de los Muertos, the CDC suggests that families perform traditional activities only with members of their own households or meet with extended family members in outdoor settings with appropriate physical distancing to mitigate transmission risk.

    OCCUPATIONAL SAFETY Since the beginning of the pandemic, worker safety has been a primary concern, especially as many workers were quickly designated as “essential” and unable to work from home. While employers are required by law to minimize workplace hazards, the Occupational Safety and Health Administration (OSHA) is tasked with enforcing the implementation of worker safety laws. A commentary published in JAMA asserts that the federal government has not taken full advantage of OSHA’s authority to improve worker safety in the midst of COVID-19. While many businesses have taken steps to protect their employees, specific practices and the degree of implementation vary considerably across businesses and localities. The authors assert that a stronger federal presence and more stringent oversight of OSHA compliance would compel employers to take stronger actions to protect their employees against workplace COVID-19 hazards. They call on OSHA to implement an Emergency Temporary Standard (ETS) that would require all employers to create and implement an infection prevention and control plan during the pandemic. Some states have issued state-level ETSs, and a federal ETS mandate is currently being proposed to the US Senate.

    AIR TRAVEL TRANSMISSION As social distancing policies are relaxed and air travel is increasing around the world, airlines are implementing measures to reduce transmission risk, particularly onboard aircraft. Two recently published case studies address the risk of SARS-CoV-2 transmission related to air travel. Both studies were published in the US CDC’s Emerging Infectious Diseases journal, and both document suspected transmission between passengers and crew onboard commercial aircraft. Both case studies evaluate transmission dynamics onboard long-haul flights. In the first study, researchers used genomic analysis of clinical specimens to link 4 cases onboard a flight arriving in Hong Kong. The researchers hypothesize that 1 or 2 passengers (traveling together) infected 2 flight attendants during the flight. The other study investigated a cluster of 16 cases on the same flight arriving in Vietnam. The index patient is believed to have flown in business class, and 12 other business class passengers were infected—as well as 2 passengers and 1 flight attendant in economy class. The attack rate in business class was 62%, and it was 92% among passengers seated within 2 seats (approximately 2 meters) of the index patient. The prolonged exposure and close proximity of the passengers in business class suggests that the infections occurred during travel, whether during the flight or before the flight (eg, in business class lounge areas or standing in line during boarding). Researchers are still trying to understand the exact mechanisms and risk of in-flight transmission (eg, droplet/airborne versus fomite transmission).

    The US CDC has reportedly identified approximately 1,600 confirmed COVID-19 cases who flew while infectious and more than 11,000 contacts who may have been exposed during travel. Despite collaborating with airlines, health officials face a variety of barriers to conducting contact tracing for airline passengers, including testing insufficiencies and inaccurate or outdated contact information (particularly for international flights). Additionally, CDC guidance defines a close contact as anyone seated within 6 feet of a known case or anyone on a flight without assigned seating, which can overlook at-risk passengers seated farther away or those who may have had other forms of contact (e.g., using the onboard lavatories). Current CDC guidance to mitigate transmission risk during air travel suggests physical distancing, mask use, and frequent handwashing, but it also notes that avoiding travel is the best way to minimize risk. CDC officials stated that they have not yet confirmed SARS-CoV-2 transmission onboard a domestic flight; however, they emphasize that this does not mean that it has not happened or is not occurring.

    Many countries around the world continue to restrict American travelers, due in part to the current state of the US epidemic. Notably, restrictions on US travelers entering Canada and Mexico have been extended through at least October 21.

    VACCINE CLINICAL TRIALS Johnson & Johnson (J&J) announced that it commenced Phase 3 clinical trials for its candidate SARS-CoV-2 vaccine. Similar to other vaccines in Phase 3 trials, the J&J vaccine is built on an adenovirus vector to deliver the vaccine—the same platform used for its Ebola vaccine that was recently licensed in Europe. The J&J vaccine, developed by Janssen Pharmaceuticals, does offer several advantages over other vaccines in Phase 3 trials that could be particularly useful in terms of implementing vaccination campaigns. Unlike some other leading candidates, the vaccine is designed to require only 1 dose, and while it must remain refrigerated, it does not need to be frozen. The clinical trials will include 60,000 participants in Argentina, Brazil, Chile, Colombia, Mexico, Peru, South Africa, the United Kingdom, and the United States. In a press release from J&J, the company committed to publishing Phase 1/2 trial data in the near future.

    As concern persists regarding the potential for a vaccine to be authorized for use before Phase 3 trials are complete, the US FDA is expected to announce standards for issuing an Emergency Use Authorization (EUA) for a candidate vaccine. Amid ongoing political statements regarding the timeline for vaccine availability, the FDA guidance could increase transparency regarding how the candidate vaccines will be evaluated, including the metrics that must be met during clinical trials to receive the preliminary authorization. The standards are expected to be more stringent than those used for convalescent plasma and hydroxychloroquine, and reportedly, FDA officials have indicated that the standards for an EUA will be close to those required for a full authorization. By outlining the standards for an EUA, the FDA aims to build confidence that scientific evidence will drive the evaluation of candidate vaccines, rather than political influence.

    PEER REVIEW OF SARS-CoV-2 SYNTHETIC ORIGIN PREPRINT Perhaps more so than any event in history, preprint manuscripts and other publications outside of the traditional peer review process (e.g., press release) have been particularly impactful over the course of the COVID-19 pandemic. Considering the pace of discovery and the potential for analysis to inform pandemic response operations and policies, preprint manuscripts can disseminate information much more quickly than the peer review process would allow. However, peer review provides an independent check on publications and research, and bypassing this process can allow research that does not meet acceptable standards to be widely circulated.

    A recent preprint manuscript presents genomic analysis of the SARS-CoV-2 virus and concludes that the viral genome suggests that it is synthetic in origin, as opposed to a naturally occurring virus. The sensational claims and conclusions in the manuscript have the potential to garner significant public and media attention, and the nature of the conclusions could potentially impact global geopolitics and international COVID-19 response. The study and conclusions, however, have not been subjected to independent expert scrutiny. Several experts at the Johns Hopkins Center for Health Security endeavored to provide an analogue to the peer review process for this article and put the analysis in context for elected and appointed government officials, the media, and the public. The Center’s experts identified a number of flaws throughout the manuscript that call into question the validity of the analysis and findings.

    GARBAGE As Americans, and presumably citizens in countries around the world, stay home as part of social distancing efforts, they are generating more garbage. According to a report by NPR, garbage volume “spiked as much as 25%” in the spring, when most Americans were under some form of “stay at home” order or other social distancing policy. In addition to increased volume, the distribution of garbage is shifting from businesses to homes, and the trucks designed to empty large dumpsters are not necessarily able to be repurposed to collect residential garbage that may require navigating narrower streets or alleys. In some countries, such as Japan, existing garbage collection practices are being updated to reduce the risk of exposure for sanitation workers.

    Additionally, some cities are facing shortages of sanitation workers, which further challenges trash collection efforts. Sanitation workers are certainly essential, but it can be difficult to provide them with the same level of protection that other essential workers have. The CDC has published guidance for waste collectors and recyclers that includes recommendations for COVID-19 risk mitigation measures. In addition to general recommendations that are applicable to most businesses (eg, mask use, physical separation), the CDC recommends that sanitation workers practice enhanced hygiene, and it emphasizes the importance of personal protective equipment, including eye protection, gloves, and coveralls or uniforms. In particular, the CDC recommends avoiding contact with bodily fluids or items/surfaces contaminated with them; however, garbage often contains these items. In many cases, sanitation workers may not be able to avoid contact with garbage, which could potentially pose a transmission risk.
    Winston, a.k.a. Alvena Rae Risley Hiatt (1944-2019), RIP

  5. #3710

    Re: covid-19 Virus Updates and Discussion

    I talked today with a couple of colleagues from UK about covid-19. According to them testing currently is in shambles. One had a daughter (7) suspected of having covid, couldn't get government testing within a week anywhere within 200 miles. Tried private option (400 pounds) - those guys didn't actually test but sent him a kit to gather a sample on a child himself (ridiculous idea, you're unlikely to do it right) and and send it back to the testing site. Even then no results a week later.

    Here I know few people who had a test done and all got a result in 24 h.
    Roger forever

  6. #3711

    Re: covid-19 Virus Updates and Discussion

    Just to say that, if in the middle of a pandemic, Mexico celebrates DAY OF THE DEAD, the irony will be too much.
    Face it. It's the apocalypse.

  7. #3712

    Re: covid-19 Virus Updates and Discussion

    Isn't that still some time off?
    Roger forever

  8. #3713

    Re: covid-19 Virus Updates and Discussion

    A bit. November 2. But it truly is huge in Mexico. One of those celebrations I have always wanted to go.
    Mexicans make this dessert called "Pan de Muertos" (Dead people's bread) that is delicious.
    Last edited by ponchi101; 09-24-2020 at 07:11 AM.
    Face it. It's the apocalypse.

  9. #3714

    Re: covid-19 Virus Updates and Discussion

    Fauci finally loses his patience with Rand Paul
    Aaron Blake
    September 23, 2020 at 1:54 p.m. EDT

    Whenever Sen. Rand Paul and Anthony S. Fauci appear at the same hearing together, they are bound to clash. In May, they tangled over children’s susceptibility to the coronavirus. In June, Paul attacked Fauci for not being more optimistic about the coronavirus, saying that Fauci wasn’t the “end-all” and that he should be more humble about what he didn’t know.

    Through it all, Fauci has been characteristically diplomatic. But on Wednesday, he seemed to reach his breaking point.

    Paul (R-Ky.), as he often has, questioned the strict mitigation measures that states across the country had undertaken. He accused Fauci of being too laudatory of New York Gov. Andrew M. Cuomo (D), noting that Cuomo’s state experienced one of the worst outbreaks in the world.

    “How can we possibly be jumping up and saying, ‘Oh, Governor Cuomo did a great job’?” Paul asked. “He had one of the worst death rates in the world.”

    That outbreak, of course, was seeded very early on, before much of the more serious mitigation efforts began. And as Fauci rightly noted, the state now has one of the lowest test-positivity rates in the country.

    Fauci shot back: “No, you misconstrued that, senator, and you’ve done that repetitively in the past. They got hit very badly. They’ve made some mistakes. Right now — if you look at what’s going on right now, the things that are going on in New York to get their test-positivity 1 percent or less is because they are looking at the guidelines that we have put together from the task force of the four or five things: of masks, social distancing, outdoors more than indoors, avoiding crowds and washing hands—”

    Paul interrupted, positing that New York is actually in much better shape right now because it has attained some form of herd immunity.

    Fauci was again unimpressed.

    “I challenge that,” he said. He asked for more time to respond, “because this happens with Senator Rand all the time.”

    “You are not listening to what the director of the CDC [Robert Redfield] said,” Fauci added, “that in New York, it’s about 22 percent [that have tested positive]. If you believe 22 percent is herd immunity, I believe you’re alone in that.”

    Paul then suggested that New York’s immunity is actually higher, pointing to claims that an additional one-third of people have cross-reactivity — i.e., having been infected by a similar virus — and could be immune, “which would actually get you to about two-thirds.”

    Fauci again asked to rebut Paul.

    “I’d like to talk to you about that also, because there was a study that recently came out that preexisting immunity to coronaviruses that are common cold do not cross-react with the covid-19,” Fauci said.

    As has been the case before — and as Fauci reinforced — Paul’s claims are indeed highly questionable.

    New York did have a terrible outbreak, but it was also among the earliest, before much of the country embraced the measures Paul questions the necessity of. New York adopted some of the toughest measures, and it now has the third-lowest per-capita case rate among the 50 states.

    As for whether that is because of herd immunity? Redfield did indeed say at the same hearing that preliminary results of a government study show that “more than 90 percent of the population remains susceptible.” He added that the highest rate of total infection over the course of the outbreak in any state was 24 percent. There are divergent views about just how many infections are needed before herd immunity is achieved, but estimates have generally trended upward, given the coronavirus’s transmissibility, to as much as 65 to 70 percent.

    Paul suggested that New York might actually be close to that, if you add those who have been infected to those with preexisting immunity through cross-reactivity.

    Firstly, his math is off; it would actually get you to about the mid-50s. And secondly, data on cross-reactivity is indeed in much dispute — and it’s even less certain that it provides immunity. Fauci didn’t cite a specific study, but a study published last week found that “infection with endemic [human coronaviruses] produces little cross-reactivity” to viruses such as the current coronavirus.

    “While there are a few reports of cross-reactivity of T-cells (common cold coronaviruses and covid-19),” said Eric Topol, the director and founder of the Scripps Research Translational Institute, “there aren’t neutralizing antibodies (the main defense) or any evidence that this cross-reactivity is playing an important protective role and helping us get to a herd immunity of 70 percent or greater of the population protected.”
    “No matter how cynical I get, I just can't keep up.” – Lily Tomlin.

  10. #3715

    Re: covid-19 Virus Updates and Discussion

    Claire McCaskill

    JEFFERSON CITY, Mo. (AP) -- Missouri Republican Gov. Mike Parson, opponent of mandatory masks, tests positive for COVID-19.

    The only time I’ve seen him in a mask is in his political ads.

  11. #3716

    Re: covid-19 Virus Updates and Discussion

    Ok. Something a bit lite.
    Caracol TV, one of the largest TV stations in Colombia, pulled out this prank.
    As in everywhere in the world (shortages of A**holes do no exist) there are always people that are going around with their masks hanging from their necks. So, what Caracol did was this. Another person, apparently talking on their phone, approaches them, while having a conversation. Stopping next to the non-mask wearer, the conversation is something like this:
    "Yes man, I had a fever that you could not believe. Breaking in sweat, shivering, I spent Saturday night feeling like dying. I had an Ajiaco (a very tasty Colombian soup) and I could not taste anything! I know, I know, yes, I went and had a test done but they will give me the results in 4 days! Yes, I am scared to death, man, I really don't know what is going to happen to me!"
    Invariably, the people wearing the mask improperly start moving away and THEN they put their masks on correctly.
    I can't find it on YT, but if I do I will post.

    Further proof, as if any was needed: people are idiots. Frigging period.
    Last edited by ponchi101; 09-24-2020 at 02:01 PM.
    Face it. It's the apocalypse.

  12. #3717
    Everyday Warrior MJ2004's Avatar
    Join Date
    Dec 2008

    covid-19 Virus Updates and Discussion

    Madrid vs New York: a tale of two cities during Covid-19

    They were epicentres of the pandemic. But differing approaches to easing lockdown have seen their fortunes diverge

    In May, Madrid sought to break free from the nightmare of Covid-19. Death rates and infections had fallen since the days when the Spanish capital’s international exhibition centre had been converted into a 1,000-bed intensive care unit and an ice rink into a morgue, but economic life lagged far behind. The greater Madrid region sued the national government to relax lockdown measures — undeterred by the resignation of its director of public health in protest at the drive to open up. “If Madrid does not get going again, we will be destroying thousands of businesses, thousands of jobs,” Ignacio Aguado, the deputy head of the regional government, said shortly before the lawsuit. Within a month, the Madrid region, of 6.6m people, had broken completely out of the lockdown and the emergency powers wielded by Spain’s national government over the regions had lapsed. Plans to lift restrictions in phases according to criteria such as health resources and infections were effectively abandoned. Almost 6,000km away in New York City — which endured long weeks as the virus’s epicentre in the US, just as Madrid had been in Europe — a decision was taken to proceed much more slowly. It was a fateful parting of the ways for the two cities.

    Today Madrid is once again the worst hit region in Europe. Over the past week almost a quarter of the people it has tested for coronavirus have been positive; in New York City, the figure has been below 2 per cent since June 7. In the past seven days, there have been 331 infections per 100,000 of the population in Madrid; in New York City the equivalent figure is 25.2. The story of how Madrid and New York diverged is a tale of the grim consequences of mistakes made, particularly over phasing out the lockdown measures; of tensions between economic considerations and health; and of the emerging reality of a second coronavirus wave crashing over Europe. That now threatens the likes of France and the UK which have both seen a marked rise in cases.

    In May, Madrid sought to break free from the nightmare of Covid-19. Death rates and infections had fallen since the days when the Spanish capital’s international exhibition centre had been converted into a 1,000-bed intensive care unit and an ice rink into a morgue, but economic life lagged far behind. The greater Madrid region sued the national government to relax lockdown measures — undeterred by the resignation of its director of public health in protest at the drive to open up. “If Madrid does not get going again, we will be destroying thousands of businesses, thousands of jobs,” Ignacio Aguado, the deputy head of the regional government, said shortly before the lawsuit. Within a month, the Madrid region, of 6.6m people, had broken completely out of the lockdown and the emergency powers wielded by Spain’s national government over the regions had lapsed. Plans to lift restrictions in phases according to criteria such as health resources and infections were effectively abandoned. Almost 6,000km away in New York City — which endured long weeks as the virus’s epicentre in the US, just as Madrid had been in Europe — a decision was taken to proceed much more slowly. It was a fateful parting of the ways for the two cities. Today Madrid is once again the worst hit region in Europe. Over the past week almost a quarter of the people it has tested for coronavirus have been positive; in New York City, the figure has been below 2 per cent since June 7. In the past seven days, there have been 331 infections per 100,000 of the population in Madrid; in New York City the equivalent figure is 25.2. The story of how Madrid and New York diverged is a tale of the grim consequences of mistakes made, particularly over phasing out the lockdown measures; of tensions between economic considerations and health; and of the emerging reality of a second coronavirus wave crashing over Europe. That now threatens the likes of France and the UK which have both seen a marked rise in cases. The Empty Sky Memorial with The One World Trade Center seen in the background. New York has managed not only to contain the virus but to keep it suppressed

    The differences may be best encapsulated by how Madrid and New York dealt with their restaurants. Under Andrew Cuomo, New York governor, the state has been stubborn about lifting restrictions on indoor dining — a policy that has suppressed the virus but at a huge cost to businesses. A survey by the NYC Hospitality Alliance found that nearly 90 per cent of restaurants and bars could not pay their full rent in August, and said many had been “financially devastated".

    Miguel Hernán, an epidemiologist at Harvard University who advised the Spanish government on phasing out the lockdown, says Madrid has failed where New York has succeeded: by opening bars and restaurants too fast, not having enough people on hand to track and trace the progress of the disease, and not carrying out enough tests to map its full extent. In recent days an increasingly desperate Madrid government imposed new restrictions on 850,000 people in the areas worst affected by the virus — mainly poor southern districts of the city — where inhabitants will be prohibited from entering and exiting without due cause.

    Epidemiologists fear such steps will be insufficient to curb rampant infection rates — particularly because children have now returned to school after six months away, colder weather is pushing people indoors where the disease spreads more easily, and Spaniards are still socialising and visiting bars and restaurants, where the risk of infection is greater. “A key driver of decisions should be the occupancy of critical care beds and it’s hard to see how these measures will help avoid the saturation of hospitals,” says Prof Hernán. “The thing to guard against is the health system collapsing again . . . We need a plan.”

    ‘Death to our community’ Madrid’s government says that Covid-19 patients now take up about 40 per cent of ICU beds in the region — twice the level of the start of this month. Many doctors say the true level is much higher and that some emergency wards are already effectively full. For Madrid, some of the policies that could have made a difference in managing the disease in recent months — such as an efficient tracing system as countries such as Germany appear to have deployed — may now be unable to cope with the rapid rise in cases. Instead more broad brush measures, such as lockdowns, could be the only way out. “In June we tried to return to a certain normality with this drive to reopen the economy, with a false sense that the virus had been defeated,” says Pedro Alonso, a professor of global health at Barcelona university who heads the WHO’s malaria programme. “We didn’t make sufficient preparations and that is a large part of the reason why we have this second wave.”

    Given the importance of bars and restaurants to the Spanish economy — hospitality represents 6 per cent of gross domestic product and tourism 12 per cent — much of the restart consisted of opening places to eat and drink. On June 8 the region said it would reopen the interiors of bars and restaurants. The Madrid hospitality association — which says the sector in the region has lost 40,000 jobs this year — declared itself “very satisfied”. The impact of such measures is still not clear. Without better data on who visits bars and restaurants — in Spain, as in many other countries, customers do not have to fill out contact information — it can be very difficult to quantify the risk of eating or drinking in a public place. But a recent study of outpatients of healthcare facilities by the US Centers for Disease Control and Prevention suggested that people who are infected are twice as likely to have eaten at a restaurant as those who test negative. The Spanish health ministry congratulated itself on having completed a swift, safe phase-out from lockdown, which had become increasingly politically poisonous, with regions and opposition parties calling to regain the right to manage their own affairs. The public responded. Footfall figures show a much more dramatic Madrileño return to bars and restaurants — very much greater than New York City, but also considerably larger than Rome, Italy’s capital, which has not suffered the same kind of Covid resurgence as its Spanish counterpart.

    Within two weeks of the end of the lockdown, cases began to go up in Spain. “It’s what happens when you relax restrictions,” says Prof Hernan. “It can go fast or slow, but the key thing is to keep track and detect big changes in time.” Spain’s 17 autonomous regions — each with a medical system of its own — created further complications, particularly for compiling reliable national data from figures that were frequently late or based on different criteria. Commitments that regions entered into as part of the lifting of restrictions sometimes went unmet. In May, Madrid promised to hire 400 track and trace workers; in July the figure was still 182 — one for every 36,000 inhabitants. Today the number is around 1,000.

    “We are going to have 1,500 track and tracers in Madrid,” Isabel Díaz Ayuso, head of the regional government, said this week. “But with the current figures for Madrid, for track and trace to be efficient, we would need to track millions [of contacts] all the time.” Similarly, although Madrid performs roughly 20,000 diagnostic tests a day and is planning to carry out 1m rapid antigen tests — which identify proteins that make up the virus — this week, the sheer scale of contagion makes it difficult to keep up. The high proportion of positive results in the region — 23 per cent of all tests carried out — indicates that a significant number of cases are going undiagnosed. Ms Díaz Ayuso opposes any new regional lockdown, saying it will be “death to our community”. But others in her administration say it cannot be ruled out and the Spanish government has already called on Madrileños to limit their mobility to the utmost.

    Obdurate but effective New York’s story has been very different. In June case numbers were steadily dropping. Under a phased reopening plan set out by Mr Cuomo and Mr de Blasio, restaurateurs in the city were optimistic they would qualify to offer indoor dining by the July 4 holiday. Then state health officials noticed something in the reams of data they collect each day: bars and restaurants in upstate New York, which had already been allowed to reopen, were triggering upticks in infections. Mr Cuomo postponed the resumption of indoor dining, and did not say when he might reconsider his decision. It contributed to the staggering losses of New York City’s restaurants, many of which have been put out of business by the pandemic. Yet it also explains how New York has managed not only to contain the virus but to keep it suppressed while other cities in the US — which has suffered more than 200,000 deaths — and many in Europe, are seeing it roar back to life. “Certainly, the governor and [New York City] mayor [Bill de Blasio] have erred in the direction of favouring the health over the economic side of the crisis,” says Kathryn Wylde, president of the Partnership for New York City, a group of business and civic leaders. Ms Wylde describes their approach as “obdurate” but effective. New York City is on track to lose more than 600,000 jobs this year, and is facing a $9bn fiscal deficit. The state has paid as much money in unemployment benefits in the past six months — $43.7bn — as it has in the previous 20 years.

    Mr Cuomo’s team says it has followed the data, ignoring President Donald Trump’s tweets to “liberate” the city’s economy and critical newspaper editorials. From a slow start, the state now conducts more than 90,000 tests a day, keeping to a phased reopening plan in which each of the state’s 10 regions had to satisfy seven metrics before they could begin to resume activity. These included declining death and infection rates over a sustained period of days and minimum hospital capacity. If the numbers ticked up, then the reopening would be paused, or even reversed. New York public health officials have made adjustments along the way. When they discovered, for example, that infections were surging in other parts of the country they instituted a quarantine for many out-of-state travellers — Arizona, Minnesota, Nevada, Rhode Island and Wyoming were added to the list this week — even though that has piled further damage on the city’s moribund tourism and services industries. When neighbouring New Jersey announced in late August that it would resume indoor dining, Mr Cuomo initially shrugged. But days later, he finally relented and announced that city restaurants would be allowed to offer indoor dining from September 30 — but at no more than 25 per cent capacity. The city's business leaders may not be happy. But, says Ms Wylde, realise that the worst outcome of all would be “to reopen and have to shut down again”.

    Track and trace failings Spain’s national and regional authorities admit they are in a full-blown second wave. “It is less lethal, less fast”, Pedro Sánchez, prime minister, said this week, “but still very dangerous.” Yet some epidemiologists cast doubt on whether the second wave is so different from the first. The Spanish government acknowledges that in March and April it detected fewer than 10 per cent of cases — principally people who were gravely ill and hospitalised. That means, by definition, that official statistics failed to capture the demographic make-up of the remaining 90-plus per cent. Such a gap in the data appears to undermine the government’s insistence that the virus is now on average infecting much younger people — who are at less risk of death — than in the first wave. The lethality rate for Spain as a whole — the proportion infected by coronavirus who ultimately die — has more than doubled in September from 0.4 per cent to 0.9 per cent. Ms Díaz Ayuso, who has been criticised for blaming the disease’s resurgence on immigrants’ “way of life” in poor working class districts, argues that Madrid has been particularly badly hit because of its population density, and its role as a transport and business hub — and that it cannot be compared with any other region in Spain. But Mr Sánchez has noted that the rate of infection in Madrid is more than double the average in Spain as a whole, as is the rate of occupancy of intensive care beds in the region.

    The region remains crucial not just for the whole of Spain, but also a possible indicator of France and the UK, two of the other countries contending with big rises in cases. On Tuesday the British government announced another raft of measures, including forcing pubs and restaurants to close at 10pm and greater use of face masks, as it too sought to stave off wider lockdowns. The Madrid government is still reluctant to close down the hospitality industry. Its most recent measures shut public parks in the most infected parts of the city, but they allow bars and restaurants in those zones to stay open — albeit at half capacity and with an obligatory closing time of 10pm. Many epidemiologists fear the worst. “We still don’t have reliable data in real time to help manage the crisis, the phase-out of the lockdown wasn’t done with the correct attention to detail . . . and our track and trace capacity is clearly not enough,” says Prof Alonso. “We took short-cuts and we are paying for them.” There is no guarantee New York City's calm will last. One of Mr de Blasio's top health officials warned on Wednesday that lockdown measures could be reimposed after the city discovered rising infections in some Brooklyn neighbourhoods. Meanwhile, the city's school system, the nation's largest, is in the midst of a fitful return to class that could eventually throw hundreds of thousands of children together and create new risks of transmission. But for now the US city is in a far better place than Madrid. “The situation in Madrid is clearly uncontrolled,” says Prof Alonso. “Treatment has improved somewhat; care homes have been protected. Perhaps it won’t be as terrible as it was in March. But a reasonable assumption is that these large-scale infections will lead to a large-scale increase in serious cases and ultimately to a large-scale increase in deaths.”

    - FT Big Read

  13. #3718

    Re: covid-19 Virus Updates and Discussion

    Not sure bars and restaurants were the dominant culprit. I was in Germany (Bavaria) two weeks ago and there restaurants were open and full as well. Numbers growing there much slower for some reason.
    Roger forever

  14. #3719
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    Re: covid-19 Virus Updates and Discussion

    WHO's Situation Report for September 24, 2020.

    EPI UPDATE The WHO COVID-19 Dashboard reports 32.03 million cases and 979,212 deaths as of 6:34am EDT on September 25. At 35-40,000 deaths per week, the global mortality could surpass 1 million deaths in the next week.

    As the US surpasses 200,000 cumulative deaths and the global total approaches 1 million, we want to take a closer look at cumulative deaths at the national level. In terms of total cumulative deaths, the US maintains a sizable lead over all other countries. Brazil is #2 with nearly 140,000 deaths. India appears to be on a trajectory that could eventually surpass the US; however, it is currently reporting fewer than half of the US total, so the situation could change.

    On a per capita basis, the top 20 countries are largely divided between 2 groups: European countries affected severely early in the pandemic and Central and South American countries that peaked more recently. These groups are fairly easy to distinguish by the shapes of their curves in the figure, with European countries increasing sharply in April before leveling off and Central/South American countries increasing more slowly starting in May and June and just now beginning to taper off. The US is a notable exception, with peaks in the spring and summer. With more than 1,200 cumulative deaths per million population, San Marino is #1 globally; however, that corresponds to fewer than 50 total deaths nationwide. Peru is reporting more than 950 deaths per million population and steadily increasing, and it is on a trajectory to overtake San Marino in the coming weeks. With the exception of San Marino and Andorra, most of the countries in the top 20 have reasonably large populations. There is considerable overlap between the total and per capita top 20 lists, owing to the very large mortality totals in these countries, particularly in Europe and Central and South America.

    The US CDC reported 6.92 million total cases and 201,411 deaths as of 12 PM ET on September 24. The US is averaging 43,245 new cases and 732 deaths per day. The cumulative US COVID-19 mortality surpassed 200,000 deaths, representing more than 20% of the global total. After reaching a minimum of 34,371 new cases per day on September 12, following the Labor Day holiday weekend, the US has reported increasing incidence for nearly 2 weeks, surpassing its previous plateau and up to its highest average daily incidence since August 22. In total, 22 states (no change) are reporting more than 100,000 cases, including California and Texas with more than 700,000 cases; Florida with more than 600,000; New York with more than 400,000; Georgia with more than 300,000; and Arizona, Illinois, and New Jersey with more than 200,000.

    The Johns Hopkins CSSE dashboard reported 6.98 million US cases and 202,827 deaths as of 9:45am EDT on September 23.

    UNITED KINGDOM While the UK’s COVID-19 epidemic has not yet returned to the height of its first peak, it is nearly there and still accelerating rapidly. UK health officials forecast that the country could potentially reach 50,000 new cases per day by mid-October, nearly 10 times the current current daily incidence. The average number of daily deaths has also increased in the UK; however, the daily mortality is still considerably lower than it was at the height of the “first wave”—fewer than 40 deaths per day, compared to more than 800. COVID-19 hospitalizations are beginning to increase as well. Based on the current COVID-19 trends, the Chief Medical Officers for England, Scotland, Wales, and Northern Ireland all recommended moving their respective countries to COVID-19 Alert Level 4.

    UK Prime Minister Boris Johnson announced a number of policies to strengthen existing social distancing restrictions. The measures expand mandatory mask use, including for retail and hospitality businesses; prohibit in-person food and alcohol service after 10pm; and limit the size of gatherings, generally a maximum of 6 people with some exceptions. Businesses will also be required to display a QR code to support contact tracing efforts via a smartphone application, and businesses that repeatedly violate the restrictions will face fines of up to £10,000 (~US$12,700). Additionally, Prime Minister Johnson continued to encourage individuals to work from home to the extent possible. He also indicated that the restrictions could be in place for 6 months, which would potentially last through the majority of the 2020-21 influenza season. The new restrictions also resulted in a suspension of plans to allow spectators to begin returning to sporting events.

    BRAZIL SEROPREVALENCE A team of researchers published a pre-print examining the seroprevalence of COVID-19 in two Brazilian cities. From February to August, researchers conducted a cross-sectional monthly estimate of seroprevalence among blood donors samples from Manaus and Sao Paulo, Brazil. After adjusting for the sensitivity and specificity of their diagnostic tests and weighting their values to account for differences in sex and age, the researchers saw a peak in their Manaus collection with 51.8% of samples containing SARS-CoV-2 antibodies this past June. The researchers did note that Manaus’ community immunity waned in the following months falling to 40% and 30.1% in July and August respectively. While significantly lower than the Manaus sample, researchers saw a similar trend in the samples from Sao Paulo. The authors note that they are unsure what contributed to such high rates of seroprevalence among blood donors in Manaus, and share that other studies from the region present differing results despite covering a similar time period. They describe a number of possibilities for this difference, including test sensitivity and sampling methods. The authors present an argument for the possibility of community immunity in regions with high COVID-19 transmission, like Manaus, and cite challenges of potential waning immunity.

    CHINA TRAVEL RESTRICTIONS China’s early response to the COVID-19 pandemic included domestic travel restrictions. As the pandemic spread to other parts of the world, China also limited foreign travel into the country. China continues to keep a relatively low daily incidence rate of COVID-19 cases, and recently announced a roll-back of several external travel policies. Now foreign individuals with Chinese visas or residence permits can return to the country for economic or personal matters. They also have announced a reopening of their visa office.

    VACCINES ALLOCATION & DISTRIBUTION Earlier this week the WHO announced that 64 higher-income, “self-financing” countries are now part of the COVAX Facility to provide funding support for lower-income countries to purchase a future SARS-CoV-2 vaccine, and an additional 38 economies are expected to join soon. Of these, 29 are from Europe, participating as part of an agreement with the European Commission. A total of 156 countries are participating in the COVAX Facility, representing approximately 64% of the global population. Notably, the US and China are not participating. The allocation plan for the program expected to provide enough vaccine to cover approximately 20% of the population in receiving countries.

    REFUGEES & DISPLACED POPULATIONS The Norwegian Refugee Council published a report this week discussing the impact of COVID-19 on refugees and displaced populations. The report describes results of a survey of 1,400 people across 8 countries who have been impacted by conflict within their countries and/or have been displaced from their homes as well as more targeted surveys and needs assessments across a total of 14 countries. The survey found that 77% of respondents have lost their jobs or income since March, and 62% who normally receive financial support from family abroad are receiving less money now than they were before the pandemic. Financial insecurity is also impacting families’ ability to send children to school and pay for medical expenses, and the risk of eviction or other housing insecurity increased as well. Food insecurity has increased as well, with 70% reporting that their household has reduced the number of meals since the start of the pandemic. The report recommends that G20 countries scale up bilateral financial assistance and implement plans for debt relief for countries experiencing large numbers of internally displaced or refugee populations. Additionally, the report calls for national governments to explicitly include refugee and displaced populations in economic stimulus efforts and expand the reach of social support programs.

    The Internal Displacement Monitoring Centre published a report outlining the displacement among vulnerable populations amid the COVID-19 pandemic. The organization’s mid-year update reported more than 14 million new internal displacements across 127 countries in the first 6 months of 2020 alone. Of these, 4.8 million displacements were caused by violence, and 9.8 million were caused by disasters. Notably, the numbers displaced by violence was a sharp increase for several countries compared to previous years. Notably, the totals for the first half of 2020 were higher than the full-year 2019 total in Cameroon, Mozambique, Niger, and Somalia. Populations were displaced by disasters in countries representing all income categories, and many affected populations face prolonged displacement, particularly if their homes were destroyed.

    The pandemic is driving a myriad of downstream effects on displaced population. The report indicates that populations living in camps may not have access to appropriate testing or clinical care for COVID-19. Like the NRC report, financial, housing, and food insecurity have been exacerbated by COVID-19. The report also indicates that stress stemming from the pandemic and its downstream effects could be driving an increase in violence among displaced populations, particularly toward women and children. Finally, the pandemic is also impacting humanitarian aid operations, including aid workers being evicted by local communities over fear that they will bring COVID-19.

    PEDIATRIC VACCINE The world awaits a SARS-CoV-2 vaccine, but regardless of the timeline, it is clear that it will not be available for everyone initially. Beyond the initial limited supply, there are other barriers for some populations. Even if sufficient supply is available, a vaccine may not necessarily be authorized for use in children, due in part to their exclusion from ongoing clinical trials. The decision to omit children is supported by various leading experts, and it is a function of multiple factors both specifically in the context of COVID-19 and based on historical practice. One of the primary concerns is that children are not a high-risk group for severe COVID-19 disease, which places them as a lower priority from that perspective. Additionally, clinical trials in children traditionally only begin once safety and efficacy are established in healthy adults in order to reduce the possibility of harm in children. Some argue, however, that Phase 2 trials in children should begin soon, because children can still suffer from severe COVID-19 disease and because time is needed to assess possible long-term effects of vaccine candidates in children. As the age distribution of COVID-19 cases shifts toward younger individuals, it is clear that children and adolescents can transmit the infection, including to older or other high-risk individuals. Furthermore, ensuring that a safe and efficacious vaccine for children is available by the start of the 2021 school year could be an important tool for resuming normal social and economic activities, particularly for parents and guardians who are currently unable to return to work while their children are not in school.

    VACCINE CHALLENGE TRIAL The UK government is reportedly considering challenge trials for candidate SARS-CoV-2 vaccines. In contrast to traditional, placebo-controlled clinical trials, participants in challenge trials all receive the vaccine and are then deliberately exposed to the virus in order to determine the efficacy of the vaccine. According to the reports, the trial could begin in January 2021, and the effort is supported by 1Day Sooner, an organization that “advocates on behalf of COVID-19 challenge trial volunteers.” While challenges trials could potentially provide more rapid assessment of vaccine efficacy, it poses a number of ethical challenges, particularly in the absence of a more effective treatment or a well-characterized understanding of the required exposure dose. Some experts, including at the US National Institutes of Health argue that the additional protective measures and monitoring for challenge trials could actually prevent them from providing results more quickly than traditional clinical trials.

    PHUKET COVID-19 RESPONSE A new paper in EClinicalMedicine, details the potential impact of non-pharmaceutical interventions in limiting the spread of COVID-19. The paper examines the COVID-19 response in Thailand’s Phuket Island, one of Thailand’s most popular tourist destinations. The region maintained a relatively low number of COVID-19 cases despite a surge in activity earlier this spring. The paper provides a detailed outlook of state-run contact tracing efforts, and their process for quarantine. The findings suggest that 80% of new COVID-19 cases occurred in individuals they had identified as “high-risk” contacts. The authors suggest that this finding emphasizes the importance of contact tracing in an effort to identify such individuals and for proper quarantine as a necessary tool in stopping the chain of transmission.

    COVID-SNIFFING DOGS SARS-CoV-2 testing would likely be less scary or uncomfortable if it was conducted by puppies. Perhaps that is part of the motivation behind Finland’s new plan to deploy “coronavirus-sniffing dogs” at the Helsinki Airport. The airport is conducting a pilot project that uses specially-trained dogs to detect SARS-CoV-2 infection in passengers based on their scent. Dogs have been used in a similar manner to detect other infections or diseases that cause a distinct odor in patients, including cancer and Clostridium difficile, sometimes before the onset of symptoms. Samples are taken by swabbing passengers’ necks and then delivered to the dogs in a separate room. One researcher from the University of Helsinki indicated that the dogs can approach 100% sensitivity and can detect infection up to 5 days before the onset of symptoms. A similar program was also recently implemented in the Dubai International Airport. The use of dogs to detect SARS-CoV-2 has not been sufficiently assessed in scientific studies, so passengers identified by the dogs will be administered a more traditional test to confirm infection. Further research is needed to demonstrate the accuracy of this surveillance method, but it could provide rapid assessment capability, particularly for high-traffic areas like airports.

    **While the following topic is largely a US issue, it is an emerging storyline that we feel is important to cover today, instead of waiting until next week.**
    US FDA VACCINE REVIEW & AUTHORIZATION As we covered earlier this week, the US FDA signaled its intent to publish additional details regarding the process and standards for evaluating candidate SARS-CoV-2 vaccines undergoing Phase 3 clinical trials. According to multiple media reports, the proposed standards are currently under review at the White House, and some experts argue that the influence of officials outside of the FDA adds to concerns about the extent to which vaccine authorization decisions will be driven by political demands. US President Donald Trump suggested that the FDA announcement was politically motivated and that the forthcoming standards would need to be approved by White House officials. President Trump’s comments exacerbate a contentious debate regarding the independence and objectivity of US regulatory authorities and public health agencies and the role of appointed officials in reporting data and developing guidance.
    Winston, a.k.a. Alvena Rae Risley Hiatt (1944-2019), RIP

  15. #3720

    Re: covid-19 Virus Updates and Discussion

    DeSantis has officially opened up Florida.
    2017 & 2018 Australian Open Champions

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