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  1. #3016

    Re: covid-19 Virus Updates and Discussion

    Coronavirus surges on Colombia's Caribbean coast, doctors warn deaths underreported
    BOGOTA (Reuters) - Coronavirus cases and deaths are surging along Colombia’s Caribbean coast as the region becomes the epicenter of the pandemic in the Andean country, with doctors warning many deaths are going undetected.

    Colombia - Latin America’s third-most populous nation - has officially reported over 113,000 cases of coronavirus and just under 4,000 deaths among its 50 million inhabitants. The climbing figures pale in comparison with some neighboring countries, with regional giant Brazil exceeding 64,200 deaths on Saturday.

    Colombia’s Caribbean region accounts for close to 40% of the country’s reported cases and just over half its deaths, according to an analysis of government data by the World Health Organization (WHO).

    President Ivan Duque told Reuters last month his government was escalating its response to the pandemic in the Caribbean region, given the concentration of cases there, after taking strict measures to slow infection in cities like Cartagena.

    There is no definitive hypothesis about why there has been higher mortality in the coast region, but officials and doctors say flouting of social distancing rules and a higher incidence of certain other diseases may play a role.
    Atlantico province, with its port capital Barranquilla, has registered over 1,300 deaths - more than Bogota, even though Atlantico has only about one-third of the capital’s population. Doctors there say that despite an increased number of intensive care beds and stricter social distancing measures, deaths are likely being underreported in Barranquilla, which has a population of 1.2 million people.

    “We continue to think there is a dissociation in what is happening in the city and what is being reported officially,” Carmen Polo, a doctor in Barranquilla and president of the Colombian Association of Internal Medicine’s (ACMI) Caribbean chapter, told Reuters.

    Barranquilla health secretary Humberto Mendoza denied there was significant underreporting of deaths in the city.

    However, Polo, who works in the city’s Portoazul health center, said misinformation spread online about doctors injecting patients with the disease was deterring people from seeking treatment. Those who die at home with coronavirus symptoms are not classified as suspected cases and are not tested, she said. “But with the information provided by relatives and the clinical picture presented by the patient, you as a doctor most certainly know this person died of coronavirus,” Polo said.

    Juan Marquez, another Barranquilla doctor who will succeed Polo as the ACMI’s Caribbean chapter president in August, agreed deaths are slipping through the net. “Many patients have died - and are dying - in emergency rooms. Sometimes they don’t even make it to intensive care,” he said.

    Though Barranquilla has added around 200 ICU beds since the pandemic began, bringing the total operating to around 600, both Polo and Marquez said the units were operating near capacity.

    Though confirmed cases of coronavirus in the city’s ICUs stand at just under 80, Marquez said including suspected cases would show a substantial increase. “If we add cases which aren’t confirmed...we could multiply these numbers by two or three,” he said.

    Medellin’s mayor said on Twitter at the end of June his city had received ICU patients from Barranquilla. Health secretary Mendoza conceded some asymptomatic cases may go untested, but said Barranquilla had the highest rate of testing in the country.

    The city has performed more than 67,600 tests, which the INS reports is equivalent to just over 55,000 tests per million people. Nationally, this puts the city in second place to Colombia’s Amazonas province, according to INS figures.

    Health secretary Mendoza said ICUs are not the answer to tackling the disease, which needs to be confronted by stemming its spread. Young people with a low perception of coronavirus danger have not followed social distancing rules or used face masks diligently, he added. “Lack of diagnosis presents false information that there are no cases or that there is no mortality,” he said. “History will show the true performance of each region.”
    "And for my next fearless prediction..."

  2. #3017

    Re: covid-19 Virus Updates and Discussion

    Quote Originally Posted by Martini4me View Post
    Canada Crushing the Curve as US Cases Soar

    https://www.facebook.com/watch/?v=319038089128526
    Hopefully Trump is too distracted to try to open the border!
    A Canadian Slam winner? Inconceivable!

  3. #3018

    Re: covid-19 Virus Updates and Discussion

    PT, If you hear anything from your side about the status of the border, please let us know. I especially want to know, as you know, but you may well hear something before it is common knowledge here.

    If I were the Canadian government, I would be in NO rush to re-open the border. And I suspect that is exactly the way they will go as well.

    GH

  4. #3019
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    Re: covid-19 Virus Updates and Discussion

    WHO's Situation Report for July 5, 2020. Again, I am including the full text from the e-newsletter. There's a lot to digest.

    ::

    EPI UPDATE The WHO COVID-19 Situation Report for July 5 reports 11.13 million cases (203,836 new) and 528,204 deaths (5,195 new). The WHO reported more than 200,000 new cases in a single day for the first time on July 4, and it took only 6 days for the global cumulative incidence to go from 10 million to 11 million cases. The pandemic has been ongoing for more than 6 months, and it continues to accelerate. In terms of daily incidence, Asia, North America, and South America are reporting approximately the same number of cases, and Africa has surpassed Europe. Africa is now representing more than 8% of the global daily incidence, compared to less than 7% for Europe. Asia, North America, and South America all represent approximately 25-30%.

    India continued its recent increase, reporting a record high for daily incidence on July 5 (24,850 new cases) and remaining #3 globally. Pakistan has reported nearly 2 weeks of decreased daily incidence, and its total active cases reached a peak on July 1 (108,642 active cases). Since then, Pakistan’s active cases dropped below 100,000 for the first time since June 17—currently 95,407 active cases. Pakistan fell to #11 globally in terms of daily incidence. After reporting a steady increase in daily incidence to its highest daily total on July 1 (4,019 new cases), Bangladesh has reported 4 consecutive days of lower daily incidence—approximately 2,750-3,250 new cases per day. The increase in Bangladesh’s daily incidence appeared to be tapering off slightly toward the end of last week; however, additional data is needed to determine if this is the beginning of a longer-term trend. Bangladesh fell to #12 globally in terms of daily incidence.

    Brazil continues to report increasing daily incidence. Last week, Brazil reported 263,337 new cases, its highest weekly total to date. Brazil remains #2 globally, behind only the US, in terms of daily incidence. Mexico reported a record daily incidence on July 5 (6,914 new cases), and its epidemic continues to accelerate. Mexico remains #6 globally in terms of daily incidence. Broadly, the Central and South American regions are still a major COVID-19 hotspot. Including Brazil and Mexico, the region represents 5 of the top 10 countries globally in terms of daily incidence—including Colombia (#8), Chile (#9), and Peru (#10). Additionally,several other countries are reporting more than 1,000 new cases per day. Central and South America also represent 5 of the top 13 countries in terms of per capita daily incidence—Panama (#3), Chile (#6), Brazil (#7), Peru (#12), and Bolivia (#13).

    Overall, the Eastern Mediterranean Region remains a global hotspot as well, representing 5 of the top 11 countries in terms of per capita incidence: Bahrain (#1), Oman (#2), Qatar (#4), Kuwait (#8), and Saudi Arabia (#11). Additionally, nearby Armenia is #5. Notably, Qatar’s per capita incidence has fallen to #4 globally, decreasing by nearly 70% since its peak in late May. The region also includes several notable countries in terms of total daily incidence. In addition to Pakistan, Saudi Arabia is #7, Iran is #13, and several other countries in the region are reporting more than 1,000 new cases per day.

    South Africa is among the top countries globally in terms of both per capita (#9) and total daily incidence (#4). South Africa reported 6,945 new cases—its second highest daily total to date—and its epidemic continues to accelerate. Notably, most countries in Africa continue to report low per capita and total daily incidence. On a per capita basis, only 6 countries—Cape Verde, Djibouti, Mauritania, South Africa, Swaziland, and Western Sahara—are reporting more than 25 new daily cases per million population. With the exception of South Africa, these are relatively small countries. Over the past 2 weeks, only 4 African countries have reported more than 5,000 new cases—Egypt (20,020), Ghana (5,931), Nigeria (8,467), and South Africa (99,448).

    UNITED STATES
    The US CDC reported 2.84 million total cases (52,228 new) and 129,576 deaths (271 new). The US has reported more than 50,000 new cases for 4 consecutive days, including a record high of 57,718 on July 4. In total, 21 states (increase of 2) and New York City reported more than 40,000 total cases, including California with more than 250,000 cases; New York City with more than 200,000 cases; and Florida, New York state, and Texas with more than 175,000. The current daily incidence in the US is more than 50% higher than its first peak in mid-April. The daily incidence has more than doubled since June 9, up from 20,338 new cases per day to 47,389 yesterday (7-day average).

    The Johns Hopkins CSSE dashboard reported 2.90 million US cases and 130,007 deaths as of 11:30pm on July 6.

    AIRBORNE TRANSMISSION The WHO, US CDC, and other experts have continually emphasized that respiratory droplets are the main driver SARS-CoV-2 transmission; however, 239 scientists from 32 countries are reportedly challenging that notion in an open letter to the WHO. The authors argue that airborne transmission may be playing a larger role in the pandemic than previously believed, which would significantly impact future prevention strategies and the resources needed to fulfill them. While droplet transmission risk can be mitigated via physical distancing and barriers like face shields and face masks, airborne transmission would mean that virus particles could linger in the air for prolonged periods of time or travel longer distances, including via ventilation systems, instead of quickly settling on surfaces. If this is the case, mask usage could be necessary in many more environments, particularly indoors, even if the recommended physical distancing (e.g., 6-foot separation) is maintained. Additionally, individuals at elevated exposure risk, such as healthcare workers, could need N95 respirators instead of surgical or medical masks.

    The existing WHO guidance emphasizes that aerosol transmission is possible, including during aerosol-generating medical procedures, but it is not a primary driver of community transmission. The authors of the forthcoming letter criticize the WHO’s unwillingness to address emerging evidence supporting the role of aerosol/airborne transmission. Experts broadly acknowledge the difficult task the WHO faces in developing universal guidance for the world and navigating a complex political climate on a tight budget, but some believe that the WHO should reconsider the evidence. The letter will reportedly be published in the journal Clinical Infectious Diseases in the coming days.

    SUPERSPREADER EVENTS A number of reports have emerged over the past several weeks about “superspreader” events, which are events or gatherings that have been identified as a possible or likely source of numerous subsequent infections, potentially from as few as a single infected individual. Coverage of these events have increased in recent weeks, as countries, states, and cities have relaxed social distancing measures and resumed many normal community activities. Examples include exposures at weddings and birthday parties, dinner parties, university parties and spring break, family gatherings, and restaurants and bars, some of which have been linked to dozens of new cases. With bars and nightclubs closed in some locations, large parties with club-like atmospheres are reportedly being held at private residences. In several instances, an individual that attended these events felt healthy at the time and then were later determined to be infectious.

    The Independence Day holiday weekend in the US provided ample opportunity for these types of gatherings, and much like the Memorial Day holiday in late May, it could be several weeks before we begin to see any signs of increased transmission stemming from these events. The UK recently permitted bars to resume in-person operations, which reportedly resulted in crowding and disregard of physical distancing guidance that could provide similar elevated risk of transmission. Other upcoming opportunities for superspreading events include political rallies, debates, and conventions associated with the 2020 US elections. Notably, the Texas Republican party reportedly intends to host its election convention in person late next week, which could draw thousands of attendees as the state continues to report record daily totals for COVID-19 incidence, deaths, and hospitalizations as well as elevated test positivity.

    REVERSING COURSE ON SOCIAL DISTANCING A number of US states have reversed course on their efforts to relax social distancing measures, in response to recent concerning COVID-19 trends. One analysis published by The New York Times found that 19 states are pausing their recovery plans or reinstituting or strengthening existing social distancing restrictions. Multiple states recently announced the closure of businesses that pose elevated exposure risk, including bars, movie theaters, and gyms/fitness centers that were previously permitted to reopen. Some of these efforts have met significant opposition from business owners and patrons, and some states have had to threaten regulatory or legal action to prompt compliance with the new restrictions. Several states have also implemented mandatory mask use in many or all public spaces, including stores and restaurants. In fact, nearly half of all US states now have some form of mask mandate, including 7 that implemented new policies since the second half of June. Notably, analysis published by Forbes shows that 10 states are reporting level or decreasing COVID-19 incidence over the past 2 weeks, and 7 of these states had mandatory mask policies in place since at least the middle of May.

    In response to increasing COVID-19 transmission in Arizona, the Mexican state of Sonora implemented border restrictions in advance of the Independence Day holiday weekend. The policy limited border crossings from Arizona into Mexico to essential purposes only. Sonora’s beach towns are a common vacation destination for Arizonans. A number of beaches throughout Florida were also closed for the Independence Day weekend. Many of these beaches were previously open as Florida progressed through its recovery plan.

    As we have discussed previously, the effects of changes to social distancing policies and practice will likely not be immediately evident. The current ongoing surge in COVID-19 incidence followed several weeks after many states began to ease social distancing policies in late May and early June. People who were infected immediately prior to these most recent changes, or are infected as adherence increases, will likely not be detected for several days or possibly weeks.

    RACIAL INEQUITIES The New York Times published in-depth analysis of national and local racial and ethnic disparities, based on federal COVID-19 data on nearly 1.5 million COVID-19 cases. In the US, Black and Latino communities have been disproportionately affected by the epidemic compared to White communities. The study estimates that Black and Latino individuals are 3 times as likely to be infected by SARS-CoV-2 and twice as likely to die from COVID-19 as White individuals. Native Americans and Asians are disproportionately affected by COVID-19 as well.

    Notably, many racial and ethnic minorities work in essential jobs, including in healthcare settings and service or production jobs, many of which cannot be performed remotely. Continued contact at work, particularly in environments that facilitate transmission (e.g., meat processing facilities, warehouses, long-term care facilities), increases transmission risk among these populations. Additionally, racial and ethnic minorities are also disproportionately affected by comorbidities associated with increased risk of severe COVID-19 disease and death, which further compounds these disparities. There are many complex and interdependent factors that drive the elevated COVID-19 risk for racial and ethnic minorities, and further research is necessary to better characterize these relationships and implement effective interventions to mitigate their effects, both for COVID-19 and for many other health risks.

    SPAIN SARS-CoV-2 PREVALENCE Spain continues to study the national and sub-national prevalence of SARS-CoV-2 infection. Spain was among the hardest-hit countries early in the pandemic, and researchers have endeavored for several months to better characterize the scale of its epidemic. A new study published in The Lancet surveyed more than 35,000 households nationwide, using a randomized sampling methodology based on “province and municipality size.” In total, the study included more than 61,000 individual participants (75% response rate) who participated in both a questionnaire, including symptom history and COVID-19 risk factors, and a serological test. The study estimates the national seroprevalence to be 5.0%, with variations identified by age and location. Seroprevalence in children under the age of 10 was estimated at 3.1%, and seroprevalence was higher in Madrid (greater than 10%) and lower in coastal communities (less than 3%). The results also indicate that approximately one-fifth to one-third of SARS-CoV-2 infections could be asymptomatic or only mildly symptomatic, which could potentially correspond to 376,000 to 1.04 million infections nationwide.

    AUSTRALIA CLOSES STATE BORDER An outbreak of COVID-19 in Melbourne, Australia, has driven the Australian government to restrict border crossings between Victoria—where Melbourne is located—and New South Wales, the country’s two most populous states. The border closure goes into effect on July 8, and further details are expected in the coming days, including on exemptions and exclusions, particularly for those who live, work, and go to school on both sides of the border. The last time the border between Victoria and NSW was closed was in 1919, in response to the influenza pandemic.

    FEDERAL WORKFORCE BACK IN THE OFFICE US government employees under numerous government departments are beginning to return to the office. Each department is addressing the return of personnel differently. While many federal government offices and services can continue to function remotely, others (e.g., passport processing) may require in-person work. While some offices, particularly senior department leadership, are centralized in Washington, DC, others (e.g., Veterans Affairs) are distributed widely across the country, which makes it difficult to resume operations uniformly across their various facilities. Additionally, Washington, DC, is surrounded by Maryland and Virginia, both of which are implementing their own response and recovery plans, and many federal employees make their daily commute from their homes in these states.

    HYDROXYCHLOROQUINE Despite multiple previous studies that have failed to demonstrate efficacy, hydroxychloroquine continues to be evaluated as a possible treatment option for COVID-19. Clinicians at the Henry Ford Health System in Michigan (US) published findings from a recent study that indicate that the drug could provide treatment benefit. The study, published in the International Journal of Infectious Diseases (IJID), involved a retrospective review of 2,541 COVID-19 patients from March 10 and May 2. The researchers found that 13.5% of those treated with hydroxychloroquine died, compared to 26.4% of patients that were not treated with the drug. Notably, the study was not a randomized controlled trial (RCT), and the patients were prescribed hydroxychloroquine under “specific protocol criteria.” Other researchers have raised concerns about the study’s design, in particular that selection of patients based on specific criteria could potentially bias the results. The WHO announced on Saturday that it is discontinuing the hydroxychloroquine arm of its SOLIDARITY Trial, as interim data have not demonstrated sufficient treatment benefit. The WHO is also discontinuing the lopinavir/ritonavir arms of the trial.

    A study conducted by STAT News, in collaboration with Applied XL, evaluated the relative investments in studying various prospective COVID-19 treatment options. The researchers found that effort to study hydroxychloroquine far outweighs other possible therapeutics, including several that have already demonstrated efficacy against the disease; 1 out of every 6 studies has evaluated hydroxychloroquine. The STAT News study found that 237,000 total patients had been enrolled in hydroxychloroquine/chloroquine studies, which potentially hindered efforts to evaluate other drugs that might be more likely to demonstrate a positive effect by drawing patients away from those trials. Many of these smaller studies are conducted independently, as opposed to collaboratively (i.e., utilizing the same trial protocol across multiple facilities) in order to increase the sample size and statistical power. Larger studies, such as the UK’s RECOVERY Trial and the WHO’s SOLIDARITY Trial, have provided a common platform for conducting studies and compiling larger datasets across multiple testing sites. These studies have already yielded results, including demonstrating efficacy of dexamethasone as a COVID-19 treatment.


    https://www.who.int/docs/default-sou...sitrep-167.pdf
    Winston, a.k.a. Alvena Rae Risley Hiatt (1944-2019), RIP

  5. #3020

    Re: covid-19 Virus Updates and Discussion

    Having read the above, I still consider hydroxychloroquine to be an treatment that is not useful. The one trial that "demonstrates" benefit is not randomized. Many randomized trials have shown no benefit, or have shown harm. Many studies had to be closed before the initial accrual goals were reached because of the fact that interim analysis showed excessive toxicity on the arms using hydroxychloroquine and/or no evidence of efficacy. Note the comment in the last paragraph about trials with hydroxychloroquine having been done to such a degree that trials with other, potentially more useful drugs have not enrolled as well. This has not been stated, but at least in this country, I think we can thank our president for that drug getting FAR more attention for this disease than it deserved.

    GH

  6. #3021

    Re: covid-19 Virus Updates and Discussion

    Daniel Uhlfelder
    @DWUhlfelderLaw
    ·
    10m
    Florida Governor Ron DeSantis refuses to mandate masks.

    He refuses to temporarily close beaches.

    He announced today that public schools will open next month.

    His office has been closed to the public for almost 4 months to protect him from COVID-19.
    “No matter how cynical I get, I just can't keep up.” – Lily Tomlin.




  7. #3022
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    Re: covid-19 Virus Updates and Discussion

    Quote Originally Posted by GlennHarman View Post
    Having read the above, I still consider hydroxychloroquine to be an treatment that is not useful. The one trial that "demonstrates" benefit is not randomized. Many randomized trials have shown no benefit, or have shown harm. Many studies had to be closed before the initial accrual goals were reached because of the fact that interim analysis showed excessive toxicity on the arms using hydroxychloroquine and/or no evidence of efficacy. Note the comment in the last paragraph about trials with hydroxychloroquine having been done to such a degree that trials with other, potentially more useful drugs have not enrolled as well. This has not been stated, but at least in this country, I think we can thank our president for that drug getting FAR more attention for this disease than it deserved.

    GH
    I want to know who is funding all of these hydroxychloroquine "studies"... I don't think it will take long to figure out why so much time and effort has been wasted on these "studies"...
    Winston, a.k.a. Alvena Rae Risley Hiatt (1944-2019), RIP

  8. #3023
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    Re: covid-19 Virus Updates and Discussion

    One more thing... We have known for quite some time that racial and ethnic minorities have been disproportionately affected by COVID-19--both in terms of infection rates and deaths. I have been mulling a question in my mind for months now that I have not been willing to put to words because it is such a reprehensible and repugnant thing to suggest... But at some point, the question has to be asked:

    To what degree has the United States' response, or lack of a response, been a calculated strategy to rid the voter pool of populations who historically have voted for political opponents?
    Winston, a.k.a. Alvena Rae Risley Hiatt (1944-2019), RIP

  9. #3024
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    Re: covid-19 Virus Updates and Discussion

    1. Mishandling a national crisis like this is political suicide. Even in Trump's 2020.
    2. It REALLY disproportionately kills the elderly. So if it's a demographic shift, it's pro-Dem.

  10. #3025
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    Re: covid-19 Virus Updates and Discussion

    Quote Originally Posted by Woody View Post
    1. Mishandling a national crisis like this is political suicide. Even in Trump's 2020.
    2. It REALLY disproportionately kills the elderly. So if it's a demographic shift, it's pro-Dem.
    Did you read today's WHO report that I posted earlier? Racial and ethnic minorities contract the virus at 3 times the rate of whites and they die at 2 times the rate of whites. So I am operating on the assumption that roughly 2 times more racial and ethnic minority elderly individuals who contract COVID are dying compared to white elderly individuals. That's would not constitute a pro-Dem shift. Especially since older Black Americans are significantly more likely to vote than younger Black Americans.

    It's possible, however, that this is a faulty assumption on my part. I am not aware of any studies that have broken down the racial and ethnic composition of COVID deaths among the U.S. elderly. I have only read "the elderly are at elevated risk" and "racial and ethnic minorities, particularly Blacks and Latinos of all ages" have been disproportionately affected.

    So more data are definitely needed.

    That said, I see a lot of progressive folks almost bragging about how the red states are getting hammered by COVID. I want to know more about precisely who in these red states is getting sick and who in these red states is dying. Because a lot of these red states have enormous racial and ethnic minority populations, particularly Black folks and Latinos.
    Winston, a.k.a. Alvena Rae Risley Hiatt (1944-2019), RIP

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