Coronavirus - worldwide spread and control

As predicted above, Florida's numbers are going up as we leave the weekend behind. Tuesday Florida's DoH reported 2,673 new cases and 183 deaths. Some people are celebrating because we have fewer than 3,000 new cases per day.

I'm still trying to understand what is going on with a number of reported statistics. I know less about Georgia, but recall that case numbers went down when models predicted they would go up because of premature reopening. Then, weeks ago, a surge developed that was undeniable. I strongly suspect efforts to suppress or delay numbers that conflicted with political positions, but can't say for certain what is going on. What I can say is that I am far from the only person who distrusts official statistics. This seriously undermines efforts to get the public behind measures needed to control the virus.

I'm hoping you will be able to read this article in WIRED about statistics on minorities and poor communities. This isn't entirely simple racism. Governments of whatever political stripe which want to deny the seriousness of a problem, or claim more success than their due in dealing with it, are using any number of criteria to disqualify some reports. Communities with less access to healthcare or more motivation to hide infections, because of lower incomes, or simply those who generate less documentation for whatever reason, are being excluded.

One thing we should all have learned from previous epidemics is that you have to actively seek out clusters and possible superspreader events, regardless of any other criteria. Pressure to deny or minimize a problem steers official efforts in the opposite direction, and the ultimate effect is a much larger problem at a later date. I believe we are now seeing this.

Just for perspective I'll throw in this link to the role of statistics in the battle over smoking and cancer or storks and babies.

 

We are just now getting confirmation that the motorcycle rally in Sturgis, SD was a bad idea, at least for 70 people. This is likely a serious underestimate, because those who attended were among the least likely to report COVID-19 infections if they could avoid this.

Georgia is still experiencing a surge that might be hard to explain if you believe those earlier numbers. If you assume a gap in reporting, for whatever reason, the surge makes more sense. I'd be more likely to give various political leaders some slack if this change in statistics had not coincided with multiple statements saying that the large number of reported cases was an artifact of too much testing, and people at the top were encouraging less testing and less aggressive measures to find people to test.

Irony should be thick around this discovery of a superspreader event in Boston at a conference run by Biogen. I'm hoping you can access this article about tracing the genetics in the Washington Post. I have a subscription, but many of their COVID-19 articles are free. Here's an alternative link.

If they are right about 20,000 cases stemming from this one event, an assumed 1% case mortality rate would mean this mistake killed about 200 people, even if you completely ignore possible long-term health issues of survivors.

 

As predicted, Florida is back above 3,000 new cases per day. Florida's DoH reported 3,220 new cases and 153 deaths today.

 

sorry for the " like".
I can't imagine how it feels to be in Florida - please stay safe.

 

@anciendaze, I feel for you. My MIL and other in-laws live in Orlando, and we have other relatives in Tampa. My MIL encounters lots of people who don't wear masks, even in doctor's offices.

I live in Austin, and although it's much more progressive than the rest of the state, we had a terribly upsetting thing happen recently. We finally have a state-wide mask mandate, so stores have signs saying you must wear a face covering, and stores have disposable masks for anyone who wants to shop, but doesn't have a mask.

At one of my favorite little grocery stores, which has been around in some form since the 20s, a man came in without a mask, and when offered one, he grabbed a case of heavy glass bottles and broke every single window before he could be arrested. This is the kind of thing that happens when a health emergency is framed through a political lens.

A friend of mine in Olympia, Washington, said a customer pulled a gun on a clerk who asked him to wear a mask. It's hard to see how our country gets through this.

 

Meanwhile, high-level insanity continues. It seems the new CDC guidelines saying you don't need to test asymptomatic people were pushed through by appointees on the day the director of NIAID was having surgery.

Here in Central Florida we have an undesired public appearance on the NYT front page in a graphic showing outbreaks in colleges and universities. It's not even September and we already have 727 cases at U.C.F. One university, admittedly with a large student body, has more cases than some countries.

Added: I just checked statistics for college athletes who have had COVID-19. These are unusually healthy students, yet their mortality rate has been about 1/4 percent. Other members of the student body may not be in great health. What about faculty? A friend is a professor emeritus who still lectures. He is living with CML, and unusually vulnerable. This is getting highly personal.

 

BGR has an article on Florida schools spreading COVID-19. One complication with this is that I think they are including college students when they talk about "children". It's hard to be certain because the DoH doesn't directly list various categories the way they often appear in news. News organizations here have someone building a spreadsheet of totals in real time. You can then go back to compare numbers with those released days or weeks ago to see how much totals have changed. If you simply depend on the daily numbers released by the DoH, it's hard to tell how things have changed if you are looking for something the administration would like to ignore.

Some friends have retired from the public school system rather than risk exposure to a class. In another case a teacher I know at a private prep school was forced to conduct face-to-face classes to keep his job. The state is still fighting in court to force counties to conduct face-to-face classes to qualify for state funding, though they just lost a case in Leon County (around Tallahassee). This level of confusion is typical. Do the numbers apply to only ordinary public schools, or do they include private schools, colleges and universities? I'm not sure. What I can say is that we have quite a few thousand new cases as a result, and not neatly located in one place.

I think those who live in countries which have managed to control outbreaks will understand just how hard it is to control an outbreak of thousands of cases spread over a large and diverse school system.

Today I have to pause for a moment to consider the plight of those in Louisiana who fled the coast to escape a category-4 hurricane. If they were able to find a short-term rental they may have been able to avoid exposure to the virus. Those forced into public shelters are at higher risk.

Aside: if you haven't been there, you would be hard pressed to imagine how low that land is. On the old two-lane roads you often find the road is above water only because of a "borrow ditch" next to it. Even if you zip through on I-10, miles from the coast, you are essentially driving on a single bridge 20 or 30 miles long. What lies below you is called land, but the engineers who built the Interstate knew better than to count on it remaining land. A storm surge of 15-20 feet (4.5 to 6 meters) means large areas will suddenly become part of the ocean. A number of "natural features" that high turn out to be mounds constructed by native Americans before ignorant Europeans moved in.

Added: early reports indicate the storm surge "only" reached 3 to 4 meters. You might think this would mean you could survive by retreating to a second floor, even if the ground was only a meter or two above mean high water. There are two problems with this: 1) meters of wave action on top of the surge; 2) 150 mph winds ripping roofs off. You could "vertically evacuate" to a well-built three-story building that would not collapse when seawater ran through the lower floors, but it would still be a wild ride. Early pictures show lots of buildings with roofs gone. This is still not a worst case.

Aside: My family once stayed in a beachfront motel in Biloxi that later featured in a TV news report after Camille hit Biloxi. (No, I don't mean Katrina, that came later.) I had trouble identifying the place. There was a miniature lighthouse on the beach and a few nearby landmarks. But the only thing remaining of the motel was a concrete slab and a swimming pool filled with sand. Concrete block walls were simply gone, and even substantial plumbing fixtures like toilets and bathtubs disappeared, leaving disconnected pipes. This had a decided effect on my willingness to evacuate when warned of later storms.

So far, Florida has avoided the worst of this hurricane season, but I doubt this can last. I've never seen a season with 7 such storms making U.S. landfall before September. When storms force evacuations, I expect the number of COVID-19 cases to surge.

 

Just to follow up on hurricane Laura. I've just been able to watch live video of people driving into Lake Charles after the storm. First note: if they were able to drive in this was probably above the storm surge. The roads had downed trees and debris, but were not flooded or washed out. One big clue when you see an area hit by a strong surge is the presence of boats sitting in places where they are hard to explain. From the damage to trees I'd say they had winds to about 100 mph, but stopped well short of the nightmare of 150 mph. (Forces are more than doubled by this increase.) There is some localized extreme destruction which could be caused by tornadoes spawned by the storm. We still have to hear from places lower down or closer to the coast. Overall, it could have been a lot worse.

From the standpoint of epidemiology we still don't know the effect. It will take weeks to get utilities back; people who get power in less than three weeks will be lucky. There is a real problem with clean water in these circumstances. During hurricane season, I keep enough to survive two weeks. Emergency relief should reach me by that time. I have no idea how long it will take to restore sewage treatment in Louisiana. This could produce a separate epidemic.

Various unavoidable activities like obtaining food and water, or making essential repairs, will mean more interaction with people who may spread infection. We may not see the surge in cases for a month.

 

To add to the USA's Covid-19 management misery:

The CDC announced that only people with symptoms should be tested.

So now, the CDC is a failed institution and cannot be trusted for sound medical advice.

 

I keep reading reports of how the CDC and FDA are being pressured politically. I really worry about fast-tracked vaccines. We all want a Covid-19 vaccine, but we want one that is both safe and effective. It's troubling to read how corners are being cut and length of safety trials compressed in the effort to rush out a vaccine. If not enough people are willing to get the vaccine when it comes out, it won't be effective. Under the current circumstances, I'm not going to be first in line if I'm not confident in the safety and effectiveness, and I'm by no means an anti-vaxxer.

 

I've now seen video from the air of the worst-hit part of Cameron, LA. This is so close to maximum destruction the difference hardly matters. It will take weeks simply to assess the damage. The wind stayed below the threshold for Category 5, and the storm surge was "only" about 3 meters. Well-built buildings kept their roofs. Some on pilings may have escaped damage from the storm surge and wave action. Most structures were seriously damaged. We won't know what other damage took place until the water recedes.

What I can already see is that the water cut new channels through the lowlands. This means you can't simply clear the roads after the water goes down. Roads will need to be repaired, and some will require bridges over new channels. People living in the region will be displaced for months which may stretch to years. This will cause a new surge in COVID-19 cases, even if other epidemics are controlled.

The body count will go up, because few who failed to evacuate will have survived. Even so, the pandemic may ultimately be responsible for more deaths than those who died in the storm.

 

Other than tropical storms, motorcycle rallies, political conventions and fires in California, the other big spreading event is the opening of schools. Here's an effort supported by the NEA to track cases in U.S. schools. This is not part of the federal government. I can testify that reporting by various kinds of schools is uneven, and some people are being discouraged from reporting. Because these have been personal messages, I can't provide sources; I will only say examples are out there for those who look.

 

BGR reports on a Korean study of COVID-19 transmission on airplane flights, even if you take all reasonable precautions.

 

Florida's DoH reported today we have 3,815 new cases and 89 deaths. Getting those deaths below 100 per day is considered progress. Most deaths being reported now probably were caused by infections which took place in July.

I'm very much afraid there is an unstated policy of delaying reports of new cases and even deaths so that they will not affect the November election. This is not how you stop a pandemic.

 

To give U.S. leaders a break, I'll just mention that governments of other countries have done reprehensible things to hide bad news about the pandemic. I won't link it, because it is political, but those in the U.K. who care to might check on what Phil Moorhouse is saying about the subject "COVID in care homes".

Even more outrageous distortion is claimed in the case of Nicaragua, where hackers broke into government computer accounts and found what the minister of health was hiding. This is hard to verify, but the purported results are consistent with what has happened in similar countries that avoided lockdowns.

 

Just saw this story in WIRED about utter confusion about testing asymptomatic people who have been exposed.

This is not how you control a pandemic.

 

This one makes it hard to avoid politics, but the story should be available for free because it directly concerns COVID-19. If you have trouble, I'll find another source to link. Scott Atlas, a new adviser to the president on coronavirus is not an epidemiologist, though he was previously chief of neuroradiology. (How much does zapping brains teach you about viral diseases?) He is a professor on philosophy of government and public health policy. He has been quoted elsewhere as saying "eventually, everyone is going to get this." (The "herd immunity" idea, as best this can be defined based on sound bites.) He is in this state to push a policy of not testing asymptomatic people because this leads to shutdowns. (?) I'd rate him as an advocate for the virus.

In addition to pushing the idea that face-to-face classes are important, he is also in favor of team sports. He thinks the economic value of those sports is worth the risk. My estimate is that we have seen a mortality rate among athletes around 0.25%, and with thousands of athletes we are talking about more than a handful of lives. This also ignores deaths of others who get the infection from athletes. We just had a quarterback leave his team because his mother was dying of covid-19.

As for the claim that we can protect the most vulnerable while carrying out this policy of deliberately spreading the virus, I can only point to the horrible failure of Florida policy to date. We have admitted to 670,985 cases and 11,331 deaths. This may differ from other numbers you see because I'm counting non-resident infections and deaths that occurred here.

For comparison California has had some 707,000 and 12,939 deaths. Looks better here, until you realize California has a population of 39.8 million and Florida 21.5 million. What this state is doing, compared to California, should be considered wrong.

Added: after writing the above, I came up with a better description.

Have we reached the point of "both sides" culture where a task force for a pandemic must have an advocate for the virus?

 

I would have thought the surest way to spread Covid 19 to vulnerable people is to let it spread through the general population?