COVID-19 Update XIII

General Course of the Pandemic

Cases in the “hotspots” of Arizona, Texas, and Florida are leveling off, although at a high level. California is still on an upward slope. Many other states have increasing caseloads; they do not show up in bright red because they have smaller populations. For a more “granular” report go to the latest map and case count from the New York Times.

On the international front:

Some countries that had the outbreak under control have noticed upswings in the number of cases. Spain is concerned enough to have reinstituted restrictions throughout, mot prominent in Catalonia. Vietnam, the world leader in control of the virus, had one case appear in Da Nang: a city heavy on tourism. If you were there on vacation yesterday, you just earned two extra weeks of stay, whether you planned it this way or not. Hong Kong; Australia; South Korea have the same story. Africa and the rest of the Americas are doing poorly. S

School reopenings:

We have, again, managed to turn a conversation on how to best serve our children into political chaos and disarray. This one hurts me to the bone, because if there is anything that all of us agree on is that we want our kids to learn and grow up healthy. The CDC has modified its guidelines for safe operation of schools.

Unemployment benefits expired three days ago. The ban on evictions, and the temporary suspension of penalties for being late on student loans, expire in a few days. In Missouri, the ban on evictions never existed. We are soon to see thousands of people thrown out on the street. The bipartisan law that gave everyone an extra $600 a week did a lot to keep people fed and warm; it also lowered the number of people who qualified as being in a state of poverty. Republicans want that extra $600 to be lowered to $200, because there were (many) people who were making more money on unemployment than they were while working. This is true. It is also true that all of these people were very low-income earners; the ones that use extra money to spend it, not save it. These are the same people who will remain unemployed if restaurants and hotels continue to operate at little or no capacity. No chance that these people will refuse to go to work: their place of employment cannot hire them. It is also true that nobody can live on unemployment (about half your “normal” pay) plus $200 a week.

Many people made fun of our president for suggesting that UV light be used to treat people afflicted with the virus. There is an interesting TED talk about using UVC light to sterilize indoor spaces, thus making it less likely that there will be transmission in places like bars and restaurants. The UVC light does not penetrate human skin or eyes, so it is deemed safe. This is not, I repeat, not a treatment. Just a theoretical preventive.

Testing

There are many ideas on how to increase the efficiency and number of tests performed. This week there is nothing new on using multiple specimens to run one test, or on testing sewage. I found these suggestions on how to ramp up what we have interesting.

Treatment

The British company Synairgen reported last week that their inhaled interferon therapy markedly reduced the shortness of breath provoked by the virus, while decreasing mortality and length of hospital stay.

Vaccines

The three main (Western) candidates will go into large-scale (Phase III) testing now. As I have said in the past, several large problems have to be dealt with. While Phase II studies recruit a few young and healthy people, Phase III studies must enroll a larger sample (about 30,000 volunteers) that represent the population as a whole. That means that the study directors must find thousands of people with chronic diseases (like diabetes and hypertension) to agree to participate AND remain available for follow-up for months and even years. It may well turn out that those who agree to participate consider themselves healthier than the average diabetes or asthma patient. If that happens, we will not get a good idea if the vaccine works for the sicker people. Underserved populations, that have a well-deserved mistrust of medical researchers, have to be convinced that this time they will not be taken advantage of. It is likely that the three vaccines tested will have different degrees of “success.” We will, for sure, be subjected to claims from all three that they are the best, and that the only reason that Vaccine A showed better numbers is that they recruited fewer old people, or failed to record deaths properly, and so forth. The studies are more likely to come up with a valid conclusion when they are conducted in areas where there is a lot of ongoing contagion. If, through some coincidence, the number of infections in a population sharply decreases once the study starts, it may take years to come up with a sign that the vaccine works (or not).

I saw a YouTube profile on Sarah Gilbert, the lead researcher for the Oxford group. I found it almost as engaging as watching a movie about a medical hero. Her lab was close to having no money to continue to operate. Now they stand to be the first vaccine to finish their trials. To give hope to billions of human beings. Hope that you enjoy it.

I hope that you like the new format to the updates. The reason for the change is to try to reach a wider audience. I very much want to read your comments and suggestions. If you want to do me a huge favor, forward this content to everyone that you are linked to. I promise that I will remain objective, and that I will continue to scour everything that comes out in order to give you a readable summary.

Be kind. Wear a mask. Say “thank you” a lot.