COVID-19 Update XV

General Course of the Pandemic

The “hot spots” in the US (Arizona, California, Florida, the Deep South) have plateaued, albeit at a high rate of contagion. Hospitalizations and ICU admissions are also leveling off. Deaths, because they lag two weeks behind everything else, are increasing. There is a lot of concern that the Midwest will be the next hot spot. I live in Saint Louis, where we are experiencing an increase in the number of cases and ICU admissions.

Spain and most of the EU have renewed their state of alert. There is public dissatisfaction because the system for tracing contacts was not optimized after their initial surge was contained.

Vietnam recorded at least three deaths. The outbreak in Da Nang was isolated promptly. The rest of Southeast Asia has low levels of contagion, but far from zero. Australia’s shutdown of Melbourne continues. China has controlled its outbreaks.

Africa and the rest of the Americas will soon take over as having the dubious distinction of being #1 in all of the bad statistics.


Delays in obtaining test results continue to plague our country. Bill Gates expressed his frustration with our system in a recent interview. He feels that companies who take more than a few days to report test results should not get paid, because the delay renders the tests “garbage.”

Some public health experts advocate for distributing tens of millions of cheap antigen tests that use saliva and can be done at home, much like pregnancy tests.

He makes the point that, when we do millions of tests a day, we do not need a test that is 100% accurate. If we are testing ourselves every day, this argument seems logical to me.

An article in The New England Journal of Medicine advocates for increased use of antibody tests.

These tests tell us if we have been infected by Covid-19 in the recent (6 months) past. Although they do not tell us if we are infected now, it behooves us to find out how many of us have been infected. I have read opinions that say that ten times as many people have been infected as the number of positive tests that we have recorded. That would mean that 50 million people have been infected. We should do our best to find out, with hard numbers, if this is true.


No solid news in this regard. There has been no coordination among all countries to run well-designed studies to see which medicines may help. The UK, through its National Health Service, has given us the dexamethasone study and some information on remdesivir. The problem with limiting a study to one country is that it takes a long time to recruit enough patients to make the results meaningful. If every country in the world participated in each study, we could get answers within a few weeks. In the US there are dozens of studies going on at the same time; many of them on the same drug. It will be a long time before they produce results. Part of this lack of coordination is due to selfishness. Every doctor; every country wants to be known as THE ONE that came up with a “cure.” Nobody wants to share their methods or their results. The same nonsense is going on with vaccines.


Russia grabbed the headlines this week, announcing that they had a vaccine and that they were rolling it out.

Under “normal” circumstances, Phase III studies that recruit 30,000 or so subjects are done before a vaccine is released to the public. Russia has decided that they will skip Phase III and proceed to widespread vaccination. In order to convince the Russian people that their government means well, Mr. Putin’s daughter rolled her sleeve up to be one of the first to test the vaccine.

This is an adenovirus vaccine; the same vector that is used by the Oxford (Astra Zeneca) vaccine. Although the technology is similar, there are endless points at which the end products differ from each other. Meaning that if the Russian vaccine fails, that does not mean that the Oxford vaccine will.

Novavax proceeds with its vaccine version. Again, time will tell how effective and safe it will be.

Education and Mental Health

I am getting tired of the closings, the inconvenience, the arguments going on. Aren’t you? There is a strong temptation to grab at easy solutions of difficult problems. This is strikingly evident in the mess that school openings have turned out to be. I see no way that this situation will be brought to a happy (or least unhappy) conclusion without enormous federal funding. There are too many variables. Every district is different and requires tailor-made adjustments. I hope that someone in a position of authority realizes that our kids’ education and health should not be a political battleground.

The education problem is worldwide. The UN has released an article on the scope of the problem. I have added a link that you may find interesting.

Although children do not get as sick as adults do, some of them are hospitalized. As more children get infected, the number of deaths in the pediatric age group will increase. Imagine the uproar we will get if one child, just one, who is forced to go to school gets Covid-19 and dies. Please click on the link below to read about the increasing numbers.

Be patient. Be nice to strangers. Hang in there.

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