COVID-19 day 286: 📈 Winter is coming. US cases cross 9 million; deaths, 230,000 : 01 November 2020

Fauci speaks out; 18 summer Trump rallies likely led to 30,000 cases and 700 deaths; more on wastewater surveillance; a Missouri eighth-grader died from SARS-CoV-2 this weekend

Sunday was day 286 since the first case of coronavirus disease was announced in the United States. Since last week, our total cases have exceeded 9 million; we’ve had more than 550,000 cases in a seven-day period; and daily case reports have almost hit 100,000 (CDC, state data, and Johns Hopkins). And on Saturday, Dr. Anthony Fauci outlined why we need an “abrupt change” in COVID-19 policy.

Sections (no jump links, sorry!)
1, One big thing; 2, Recommendations; 3, Politics, economics & COVID; 4, Key metrics;
5, Resources

⓵ One big thing - White House rhetoric

The rhetoric from the White House has become more delusional, the lies bolder.

Trump signed the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) in March. It created a 20% supplement for hospitals, for example, when a patient has pneumonia or spends time on a ventilator due to COVID-19. The hospital must supply a positive COVID-19 test to receive the supplemental Medicare reimbursement. There is no bounty on deaths.

Yet on Friday, in Waterford Township, MI, Trump asserted without basis that doctors “get more money if someone dies from Covid… Our doctors are very smart people. So what they do is they say, ‘I’m sorry but everybody dies of Covid.’… It's like $2,000 more, so you get more money.”

Moreover, Medicare patients are a fraction of all patients. Through August 15, there were only 284,316 COVID-19 Medicare patients hospitalized when the US case count was 5 million.

On Thursday, states reported 89,837 new cases and that 1,290 Americans had died from coronavirus, up from 70,007 cases and 848 deaths the week before. That’s a 52% increase in deaths. Yet that morning, Trump tweeted “Deaths WAY DOWN” and “Doing much better than Europe.” That night, Donald Trump Jr. said COVID-19 deaths had declined “to almost nothing.”

They were both lying. Here’s Johns Hopkins:

Clearly, a steady pace of around 1,000 deaths a day (seven-day average) is not “almost nothing.” It is half of the peak rate in April, when hospitals were overrun and doctors were struggling to learn how to treat the disease. The seven-day average of deaths has not dipped below 500 since the 21 April 2020 peak of 2,067.

Reviewing deaths per million around the globe reveals just how much Trump lies:

  • Brazil, 753.1

  • Mexico, 712.7

  • US, 697.9

  • Sweden, 588

  • Japan, 14

  • South Korea, 9 (first case 21 January, just like US)

  • New Zealand, 5

  • Taiwan, 0.29

Trump continues to repeat his lie that we have more cases because we test more. Israel tests more of its citizens per million than we do. It reported 7.9 cases per 100,000 on Saturday. The US reported 24.7 cases per 100,000. The chart shows per capita cases.

Susan R. Bailey, president of the American Medical Association, said Trump’s allegation of COVID-19 overcounting, which he has made several times, “is a malicious, outrageous, and completely misguided charge.” (AP)

As others have noted, this claim is as ludicrous with COVID as it would be with cancer: just stop screening, and cancer deaths will magically decline!

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⓶ Recommendations

🤓 Recommended reading

We have held 58 presidential elections; this is the 59th. Review all those historical elections and play “what if” should you desire.
Historical Presidential Elections. 270 To Win.

Where is your state on this list? The top 10 states in terms of per capita cases are all rural states. Only two have a positive test rate in the single digits, and neither are below 5%. Two - Montana and South Dakota - have no free ICU space. Via CovidActNow.

🔬 Research and medical news

Estimate of cases from Trump rallies

Public health officials traced outbreaks from Trump rallies in Minnesota and Oklahoma. USA Today analysis showed that COVID-19 cases surged in the wake of his rallies in at least five places. CNN found similar correlation.

Now two Stanford economists estimate that 18 summer Trump rallies likely resulted in more than 30,000 cases and 700 deaths.

▪️ The Effects of Large Group Meetings on the Spread of COVID-19: The Case of Trump Rallies. SSRN, 30 October 2020.

White House cases

In October, at least 50 individuals employed at or visiting the White House tested positive for COVID-19. Two of those infected were New York Times journalists Michael D. Shear and Al Drago, who had “significant, separate exposure to White House officials in late September” but who had not spent time around one another.

Mr. Shear traveled with Mr. Trump and other staff on Air Force One on Sept. 26, when Mr. Trump approached within five or six feet without a mask. Mr. Drago covered the Judge Barrett event that day and a news conference the next day near officials who were not wearing masks and later tested positive. Both journalists wore masks.

Because “the administration did not take basic steps to track the outbreak,” chose not to conduct contact tracing after the Rose Garden event and did not employ the Centers for Disease Control and Prevention to assist, the NYT decided to conduct its own investigation. The Times worked with Trevor Bedford, a geneticist at Fred Hutchinson Cancer Research Center and the University of Washington, to sequence a sample from each man.

On Twitter, Dr. Bedford wrote, “We find that WH1 and WH2 are descended from viruses circulating primarily in the USA in March and April 2020.” In addition, the “transmission chain leading to the White House cluster has circulated in the US for 5 or 6 months collecting an additional 5 mutations that have not been recorded in other sequenced samples.”

▪️ Tests Show Genetic Signature of Virus That May Have Infected President Trump. NY Times, 01 November 2020.
▪️ Viral genome sequencing places White House COVID-19 outbreak into phylogenetic context. medRxiv, 01 November 2020.
▪️ Twitter, Dr. Trevor Bedford tweets. Thread Reader, 01 November 2020

Hydroxychloroquine

As I reported on 06 April 2020:

Economic adviser Peter Navarro “is convinced based on his reading that the drug works against the coronavirus and speaks about it enthusiastically.” Yet “[m]ost members of the task force support a cautious approach to discussing the drug until it's proven.”

We now know that in early April the White House ordered that 23 million hydroxychloroquine tablets be taken from the Strategic National Stockpile and shipped to a dozen states, “enough pills for 1.4 million covid-19 patients, according to public records obtained by The Post in response to a Freedom of Information Act request.”

The Post review found that the process was marked by haphazard planning, little or no communication to local authorities about the flow of pills into their communities, and a lack of public accounting about where they ended up…

The White House ordered more than a third of the tablets sent to the three major drug distributors in the United States with instructions to deliver them not only to hospitals but also retail pharmacies in five U.S. cities, despite the FDA controls, according to public records… All three distributors told The Post they did not ship to retail pharmacies, despite the administration’s request.

▪️ White House sidestepped FDA to distribute hydroxychloroquine to pharmacies. Washington Post, 31 October 2020.

Wisconsin summer camp super-spreader event

In July, 152 attendees traveled from 21 states to Wisconsin for an overnight summer high-school retreat in Wisconsin (02 July - 11Aug). Organizers required students to test positive within seven days of travel or to have a positive antibody test within the past three months. They were “to self-quarantine within their households for seven days before travel and to wear masks during travel.”

One student became sick on 03 July and is assumed to be the source of the outbreak: 116 attendees (76%) confirmed (78; 51%) or probable (38; 25%).

▪️ Extensive, rapid COVID spread at summer high-school camp detailed. CIDRAP, 29 October 2020.

Tracking SARS-CoV-2 in wastewater

The CDC is finally developing a wastewater surveillance strategy (23 October). In May, I told you how wastewater could provide early and localized data about outbreaks. In June, I told you that Finland, Germany, and the Netherlands had launched national wastewater surveillance testing. In July, I shared a Seattle Times overview of how this testing works. Here’s an updated overview; example from Massachusetts.

▪️Sewage testing shows a country flush with coronavirus cases. CNN, 29 October 2020.

⓷ Politics, economics and COVID-19

✅ Austria, Belgium, Britain, France, Germany, Greece, and Ireland have implemented lockdowns “to try to keep their hospitals from being overwhelmed amid vast second-wave surges.”

🦠 Georgia Gov. Brian Kemp is in quarantine after being at two events with US Rep. Drew Ferguson, who tested positive for the coronavirus Friday. On Sunday, the CDC said that Kemp and other voters in quarantine can vote if they wear a mask and maintain physical distance.

❌ Scott W. Atlas, neuroradiologist at the Hoover Institution, is the herd immunity evangelist on the White House Coronavirus Task Force who currently has Trump’s ear. He recently gave an interview to RT where he claimed lockdowns are “killing people.” On Sunday, he apologized (on Twitter!) for not knowing that RT is a registered foreign agent, a Russian-owned outlet spreading propaganda. Lying or naive? Regardless, you cannot make this stuff up.

📣 Unlike Australia, Japan and other countries that have managed this pandemic more skillfully than the United States, neither the Trump COVID task force nor Health and Human Services publicly share community-level data, including which hospitals are reaching capacity. The key verb is share: those data are collected and analyzed daily.

✈️ A 38-year-old Texas woman died of COVID-19 on a Spirit Airlines Las Vegas to Dallas flight on 24 July 2020. The plane diverted to Albuquerque. No agency asked for the “passenger manifests to aid in tracking down people who might have been exposed.” One of the four flight attendants was never notified. It’s a story of dropped balls, right and left. We were six months into the pandemic at that point.

🦠 An eighth grader has died from SARS-CoV-2 in Missouri this weekend. He was attending school in the classroom.

⓸ Key metrics

🦠 Friday, Johns Hopkins reported 9,044,255 (99,321 new) cases and 229,686 (1,030 new) deaths, an increase of 1.11% and 0.45%, respectively, since Thursday. A week ago, the daily numbers increased by 1.00% and 0.42%, respectively.

  • Friday
    - cases 🔺26% compared to seven-day average; deaths 🔺26%
    - seven-day average: 🔺78,971 cases and 🔺816 deaths
    - 2.54% cases leading to death
    - 23.2 cases/100K (CDC)
    - 537,501 cases last seven days (CDC)

  • One week ago
    - cases 🔺32% compared to seven-day average; deaths 🔺22%
    - seven-day average: 🔺63,228 cases and 🔺771deaths
    - 2.64% cases leading to death
    - 18.5 cases/100K (CDC)
    - 428,795 cases last seven days (CDC)

Note: the seven-day average is important because dailies vary due to factors other than actual case numbers, particularly over a weekend.

🇺🇸 30 October

  • CDC: 8,924,548 (90,155 new) cases & 228,100 (1,055 new) deaths
    - One week ago: 8,553,827 (83,851 new) cases & 224,221 (828 new) deaths

  • State data*: 8,994,623 (97,808 new) cases & 221,406 (946 new) deaths
    - One week ago: 8,600,269 (63,846 new) cases & 217,026 (362 new) deaths
    KS reports only M-W-F; CT and RI report only M-F

  • WHO: 8,763,682 (80,384 new) cases & 226,132 (1,059 new) deaths
    - One week ago: 8,403,121 (82,630 new) cases & 222,507 (943 new) deaths

🌎 30 October

Johns Hopkins interactive dashboard (11.00 pm Pacific)

  • Global: 45,584,149 (565,797 new) cases & 1,188,866 (7,839 new) deaths
    - One week ago: 42,148,875 (507,566 new) cases & 1,143,495 (6,992 new) deaths

* Johns Hopkins data, ~11.00 pm Pacific.
State data include DC, Guam, the Northern Mariana Islands, Puerto Rico and the US Virgin Islands

The virus was not created in a lab and the weight of evidence is that it was not released intentionally. Although early reports tied the outbreak to a market in Wuhan, China, analyses of genomic data have suggested that the virusdeveloped elsewhere.

⓹ Resources

👓 See COVID-19 resource collection at WiredPen.
📝 Subscribe to Kathy’s COVID-19 Memo :: COVID-19 Memo archives
🦠 COVID-19 @ WiredPen.com
📊 Visualizations: US, World
🌐 Global news (at WiredPen)

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