Coronavirus - worldwide spread and control

Florida is again showing what not to do. Our governor has blamed a spike in numbers on a lab that dumped months worth of data on one day. Some results date back before the July 4th holiday. This gets into politics so it may not always be on the free pages. Here's one link to The Ledger and another to our local newspaper.

You have to count me as skeptical. Nobody was worried about thousands of tests not coming in until they showed up and made statistics look bad. The positive tests were real. The governor has not talked about "consequences" for other delays, which reduced the apparent peak last month. He now needs to explain the increased numbers of deaths we are seeing, over 100 reported per day, (150 today alone, 1147 in 7 days.) Either the mortality rate is higher than expected or there were under-reported case numbers. If this continues, this state alone could have the death toll of a substantial nation by year end. We have also seen an increase in hospitalizations, though we have not been overwhelmed.

We really didn't need less confidence in official reporting of health statistics. I've been using the alternative Community Dashboard for weeks. They don't have control of the raw data, but they do a better job of presenting it without trying to make it look better. The organization COVID act now has its own statistics, but I don't know how reliable these are. The pictures I get from different sources do not convince me the pandemic is under control.

 

don't know if this has been posted
Public Health England has changed its definition of deaths: here’s what it means
August 12, 2020

https://www.cebm.net/covid-19/public-health-england-death-data-revised/

 

Redefining death seems like an extreme way to improve statistics, but I'm sure this will be picked up by more governments. In the U.S., standard measures of excess deaths indicate we have already passed the 200,000 mark. What little I can learn from Russia suggests excess deaths there are about 3 times reported COVID-19 deaths. Individual doctors confirm this matches their experience. Actual health metrics are being treated as state secrets, which is never a good sign.

 

Again with the trying to beat a quarantine deadline.

I don't get it, any of it;

either people coming back from some places are at high risk of being infected or they are not, and if they are, what's with giving them advanced notice so they can come back early and infect people.

and why is the news covering this as if people are being 'clever' and 'resourceful' in rushing back early to try and 'beat' a quarantine.

Surely the people at the BBC can see that the whole situation is absurd.

 

When the pandemic hit and international travel stopped I felt sorry for people stuck abroad but I can't understand what is happening now. If you chose to have a holiday when you know that quarantines can be introduced with very little notice what do you have to complain about?

 

So true. People talk about the rules as if they are like the council wanting parking fees on a Sunday, something arbitrary, not a way to deal with a viral epidemic.

 

Been really struggling with this. Surely death certificates have been around long enough that primary and secondary causes of death are already there. Isn’t there already a well-tested system for this?

And when I want covid-19 related deaths counted, I want to count everyone who would not have died if not for covid 19. (In the same way as I want to count smoking related deaths when doing a study of that - yes it’s complicated ...but the challenges are not new).

The whole point of using death stats (as opposed to confirmed cases) is that in our modern world it should be very difficult to fail to count a death. Everyone should get a death certificate, irrespective of circumstances.

Horribly disappointing to see even death stats are being gamed.

 

Like it or not, it's bringing the English system into alignment with those of Wales, Northern Ireland and Scotland, which makes sense. I don't hold with having the cut-off point at 28 days after diagnosis, because that won't account for the number of people who sadly are kept on ventilators for much longer than that, but nor do I agree with marking anyone who has ever tested positive for Covid-19 and later died - a happy medium between the two is needed.

 

In one of those weird coincidences, while NZ health authorities were circling around that cool store at the centre of our latest outbreak I was listening to an audiobook recounting several people's childhood memories from Greenland.

What's the connection you might ask. Well, one of the contributors, Anne Knudsen, recounts an influenza outbreak in Scoresbysund (now called Ittoqqortoormiit), in Eastern Greenland, probably in the late 1950s. It was the middle of winter, the town had been completely cut off for several months, and completely in that part of the world really does mean completely. The only contact of sorts with the outside world was a plane from Iceland doing a flyover airdrop of two boxes of essential supplies - apparently they always dropped two identical boxes in case one of them ended up in a ravine or similarly inaccessible place. In this case the boxes were retrieved within 2 hours, in 30 degrees frost.

10 days later people in Scoresbysund started coming down with the flu. Apparently local doctor Jens Nielsen documented this and wrote a paper about it. Up until then it wasn't thought possible that the flu could spread this way.

Two things bug me about this story. One, I can't track down the paper. It's probably gathering dust in some forgotten archive. Two, a 10-day incubation period seems rather long for the flu. They didn't have fancy genome sequencing of viruses back then. So was that flu actually a flu or... another corona virus? Like the flu pandemic in 1889 that's now suspected to have been a corona pandemic (see post #3663).

The book is "Min barndom i Grønland" by Naja Marie Aidt and others. Danish only I think.

edited for clarity

 

What a complete shitshow.
Competence and confidence zilch .
Thread worth a read.

https://twitter.com/user/status/1294231733638959105

 

The problem should not be addressed by fighting over every individual death, like the "hanging chads" in the 2000 election. You need statistics that give people confidence they can tell what is going on, even if causes are hard to attribute. That is why we should always keep track of "excess deaths" compared to similar periods in the past. The example used in the debate in the U.K. is someone who dies in an automobile accident weeks after being discharged as recovered. Counting excess deaths when traffic is down is tricky, but you can adjust this based on past periods with little traffic. It won't tell you if an individual died as a result of impairment caused by SARS-CoV-2, but it will tell you if deaths in traffic accidents are unusually high for current conditions. Competent public health authorities always watch for trends in excess deaths to find problems nobody specifically anticipated.

Public confidence is the key here, and that is very low. Political leaders keep shopping for doctors who support their opinions. In this country we are seeing officials resign at a high rate: the CIO at HHS, the chief of staff and deputy at CDC. Our President has just appointed a new spokesperson for his coronavirus task force. This doctor is not even an infectious disease specialist or a pediatric specialist, yet he states as fact that risks to children caused by reopening schools are minimal without citing research or considering the role of children as carriers. Retrospective analysis of response to the 1957-8 "Asian Flu" pandemic showed that while elderly people were at increased risk, vaccinating children had more effect in reducing mortality because they were the common sources of infection. JAMA has considerable to say about this new infection in children. Latest reports show COVID-19 in children increasing rapidly.

Some schools in both Florida and Georgia which had started to resume classes last week are already reversing course. Our local schools in Orange County aren't scheduled to reopen until the August 21. My private sources tell me planning is not going well. By coincidence I predict Florida will pass 10,000 deaths that week, which can't be good publicity. (There will be different dates for this milestone, because the state has taken to reporting resident and non-resident deaths separately.)

BTW: Good news for our U.K. members, Britain is considering creating a pandemic response unit. Now, why would they do that?

Added: while I was typing a new report came in that the CDC was blindsided to learn they were going to deploy teams to help with school openings. Last time I checked we had some 13,000 school districts. The logistics of this deployment are, shall we say, challenging.
Added later: No, I did not mention Britain by mistake above. There will soon be an economic border between N.I. and Britain, but not one with the Republic of Ireland. Stormont will naturally coordinate epidemiology with the rest of Ireland.

 

Yes, it is tricky if the lockdown/social distancing/economic factors are reducing deaths due to other reasons like traffic reduced collisions as you mention. There is no "control" lockdown, that we can see what impact lockdowns have on deaths in the absence of an endemic virus...

I agree that it is important to have trust - something that is lacking due to two reasons. The first is poor communication between the government and the public about their policies. There is an assumption that everyone is connected to the internet and in the know about the reasons. (in Australia, they brought in a "mandatory" mask law without actually circulating masks, or making an effort to make sure almost all of the population actually knew about the requirement and the reasons why - and how to use a mask properly to reduce risk, but I digress).

The second is the media that doesn't pay any attention to the quality of the science that they are reporting, which leads to contradictory findings being published and much confusion. It is surprising the amount of people who think that acquired immunity to SARS-2 (whether due to infections or vaccines) is going to disappear within a year and I can only blame the media for hyping low-quality scientific reports and questionable scientific opinions on this topic.

 

Florida is in the middle of a weekend dip with only 3,779 new cases today, and only 107 newly reported deaths. For the week we had 40,610 new cases, 3,423 hospitalizations and 1,266 deaths reported.

This does not sound like any kind of control to me.

BTW: we are still reopening schools.

 

BGR reports on a study suggesting the first U.S. coronavirus cases date back to December 2019. I've been following case numbers with amateur models that don't make sense with official numbers unless there was a great deal of undetected community spread at the outset. This is also supported by studies based on genetic variations which show an origin in Wuhan in approximately mid-November. Unless there were many carriers experiencing mutations in parallel the early mutation rates don't make sense with known characteristics of this and other coronaviruses. Yes, it might have happened by chance, but that is unlikely unless you had many people throwing dice.

Here's my favorite reference on the genetics, Nextstrain.org. The diagrams are getting cluttered with later variations, but we still don't know about much prior to 25 Dec 2019. We could use sequences for more early samples, but few are available. Knowing how pathologists keep samples from unusual cases, I doubt the absence is accidental. For whatever reason, China does not wish to explore questions about the origin and early missteps in response. I don't have to buy into a conspiracy theory to believe that governments want to suppress evidence of incompetence. They do this all the time.

 

This model has far too many unverified assumptions to be any more than suggestive. Other models could just have likely predicted or assumed more undetected cases in late Jan/early Feb - not just in the USA, but Europe too. I would consider airports themselves as prime candidates for "superspreader" events.

There were multiple introductions from China and Europe - far more people were infected in China than reported. There was also an explosion in cases in Wuhan due to the communal banquets being held for Chinese New Year, right when the epidemic was blowing up and just before the city was locked down.

There is also the hypothesis (or more appropriately, propaganda) that keeps being pushed by the Chinese Government, despite the lack of evidence - namely that the virus originated in the USA or Italy etc. I guess the goal is to blame it on foreigners to preserve face.

 

I never really understood that viruses mutate as they go along from person to person until now. It has been reassuring that so far that this outbreak we are having in NZ right now is a new outbreak and not connected to strains of covid from anyone from quarantine that have tested positive.

How long would it take for a strain to change so much that it doesn't link to a previous strain from quarantine? How many transfers from person to person would it take? Or would it still show a link even if it was many persons removed?

 

I suspect unusual strains of disease can crop up at any time, even with common diseases. Back in the late 60s/early 70s my brother became seriously ill - very severe, widespread rash and high fever being the main symptoms that I can remember. He became so ill that he was admitted to hospital. I don't remember how long he was in hospital for - probably just a few days. It was discovered eventually that he had measles, and so he was discharged to recover at home. It was reported in the local paper a few weeks later that doctors in the area were being baffled by people suffering a severe illness which turned out to be measles with a rash which didn't look like the normal measles rash. This unusual strain of measles seemed to fizzle out fairly quickly and I never heard about it again after that. So it seemed to come and go within less than a year.

 

The link to england.nhs.uk in this tweet has some interesting data in it which is worth browsing :

https://twitter.com/user/status/1295275186024075265