COVID-19 day 309: 📈 12+ million cases, 255K+ deaths and no end in sight : 23 November 2020

We had 83,227 hospitalized as of Sunday, a 40% increase over April peak. This number will grow, not shrink, in the next weeks; what vaccine news reports mean.

Sunday was day 308 since the first case of coronavirus disease was announced in the United States. Friday, Johns Hopkins reported 195,542 new cases, almost double the 99,321 new cases from three Fridays ago, 30 October. Friday we also passed 250,000 deaths. Then on Saturday, we crossed 12 million cases, six days after passing 11 million. The first million took 2.5 months.

North and South Dakota each have had more than 2,000 active cases per 100,000 people in the past two weeks. Wyoming and Iowa, more than 1,800. And the case loads are not going to go down anytime soon.

According to Microsoft’s dashboard, these are among the highest per capita case locations in the world. For the US, the data are 623 active cases per 100,000 people for the past two weeks.

Our medical system is under stress, which means more people will die than would have; that more health care workers will get sick and some will die. And that all of this is taking place during a lame duck presidency and Congress with no effective pandemic leadership. And with people pretending it’s 2019 and gathering for Thanksgiving.

I’m with Jan.

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

⓵ One big thing - Thanksgiving

Celebrating virtually or with the people you live with is the safest choice this Thanksgiving.

Thus proclaims the CDC website, date stamp 19 November 2020. (It’s not like Thanksgiving caught us unawares.)

Yet according to TSA, there were more than 1 million air travelers at U.S. airports on both Friday and Saturday. This is only the second and third time this many people have flown since the pandemic began.

IF your family has children, the odds are good that your “bubble is enormous.”

Hospitals are filling up across the country, with an increasing caseload easily projected based on growing daily cases. From the St. Louis Tribune:

“What keeps me awake at night is that we have not felt the admissions of the 4,000-patient-a-day caseloads. We’re going to feel that in the next week or so. But our hospital already is at 100% capacity,” said Dr. Sean Callahan, a University of Utah pulmonologist and critical care physician who oversees the hospital’s respiratory therapists.

And yet:

Who is Steven Crowder? An American-Canadian former FOX News “pundit” and YouTube “conservative late night comedy” act with 5M subscribers.

Watch and share this Washington Post Live discussion with Dr. Anthony Fauci (Facebook Live).

You’ve gotta use some common sense …. you’re in the home … the safest thing you can do is to confine the activities in your own home with the immediate occupants of that home…. (if you have people in your home who are not part of your immediate household) you should wear a mask indoors as much as you can.

Because this is not sustainable: hospitalizations are 40% greater than the April peak.

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⓶ Recommendations

🤓 Recommended reading

▪️ Imagine living in the basement of your home because your husband doesn’t think COVID-19 is real, that it’s “a virus that’s not as bad as the flu.”

Dr. Erica Carney, the city’s medical director of emergency medical services, in a city where the hospital beds are full:

As health care workers, we are no longer the front line. In the community you guys now are the front line.

‘They just don’t care.’ Anger toward COVID-19 deniers mounts as pandemic hits crisis. The Kansas City (MO) Star, 22 November 2020.

▪️ Native American populations have been hit hard by COVID-19 with “case rates 3.5 times higher than that of White individuals.” But not in the Oklahoma Cherokee Nation.

The tribe’s Covid response meets the approval of global health leaders. “It’s very impressive. It’s a reminder of how much leadership matters and how even under difficult circumstances, with limited resources, you can make a huge difference,” said Ashish Jha, dean of the Brown University School of Public Health. “It fits with what I’ve seen in the world. You see countries like Vietnam. They’re not a wealthy country, but they’ve been following the science and doing a great job.”

‘They’ve been following the science’: How the Covid-19 pandemic has been curtailed in Cherokee Nation. STAT News, 17 November 2020.

▪️ Whether it’s access to ventilators when a hospital is overwhelmed or access to scare vaccines when they first become available, sometimes there are insufficient medical resources relative to those who need or want them.

In August, a Harris Poll suggested Americans would rank access to a vaccine like this: health care workers (73%); people over age 55 (71%); essential workers (60%); and first responders (56%). This author argues that “public opinion should be taken into consideration” when academics and policymakers struggle with rationing health care.

Frameworks for medical rationing must be created of, for, and with the people. STAT News, 20 November 2020.

🔬 Research and medical news (all vaccine-related)

‼️ Important explainer here, including efficacy versus effectiveness.

From the headlines, you might well assume that these vaccines — which some people may receive in a matter of weeks — will protect 95 out of 100 people who get them. But that’s not actually what the trials have shown…

Efficacy and effectiveness are related to each other, but they’re not the same thing. And vaccine experts say it’s crucial not to mix them up. Efficacy is just a measurement made during a clinical trial. “Effectiveness is how well the vaccine works out in the real world,” said Naor Bar-Zeev, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

It’s possible that the effectiveness of coronavirus vaccines will match their impressive efficacy in clinical trials. But if previous vaccines are any guide, effectiveness may prove somewhat lower…

But there’s abundant evidence that people can get infected with the coronavirus without ever showing symptoms. And so it’s possible that a number of people who got vaccinated in the clinical trials got infected, too, without ever realizing it. If those cases indeed exist, none of them are reflected in the 95% efficacy rate…

“Vaccines don’t save lives,” said A. David Paltiel, a professor at the Yale School of Public Health. “Vaccination programs save lives.”

Two companies say their vaccines are 95% effective. What does that mean? Las Vegas Sun, MoneyControl, (NY Times News Service), 21 and 22 November 2020.

▪️ A reminder that we are still in uncharted water with regard to a COVID-19 vaccine.

Preliminary data suggest that the immunization was more effective in trial participants who received a lower dose… A regimen consisting of two full doses given a month apart looked to be just 62% effective. But, surprisingly, participants who received a lower amount of the vaccine in a first dose and then the full amount in the second dose were 90% less likely to develop COVID, compared with participants in the placebo arm.

Why Oxford’s positive COVID vaccine results are puzzling scientists. Nature, 23 November 2020.

▪️ How to distribute vaccines? And why the decision should not be left up to politicians.

Because vaccine supply will be limited at first, the decisions about who gets those first doses could save tens of thousands of lives…

But figuring out how to allocate vaccines—there are close to 50 in clinical trials on humans—to the right groups at the right time is “a very complex problem,” says Eva Lee, director of the Center for Operations Research in Medicine and Health Care at the Georgia Institute of Technology. Lee has modeled dispensing strategies for vaccines and medical supplies for Zika, Ebola, and influenza, and is now working on Covid-19. The coronavirus is “so infectious and so much more deadly than influenza,” she says. “We have never been challenged like that by a virus.”

Doing the Touchy Math on Who Should Get a COVID Vaccine First. Scientific American. 20 November 2020.

▪️ More on the challenges of vaccine distribution

Large urban hospitals across the U.S. are rushing to buy expensive ultra-cold freezers to store what’s likely to be the first approved Covid-19 vaccine. But most rural hospitals can’t afford these high-end units, meaning health workers and residents in those communities may have difficulty getting the shots.

We’re being left behind’: Rural hospitals can’t afford ultra-cold freezers to store the leading Covid-19 vaccine. STAT News, 10 November 2020.

⓷ Politics, economics and COVID-19

✅ More states are enacting measures to curtail the spread of the coronavirus. KFN documents 31 states that have imposed new restrictions since the beginning of November.

✅ On Saturday, the FDA granted emergency authorization for Regeneron, the second antibody treatment to get this emergency approval. It is drug is intended only for the patients with mild to moderate COVID-19 “who are at high risk of developing more severe symptoms. It's not for patients who are hospitalized because of COVID-19 or who require oxygen therapy because of the virus.”

📣 Yes, Alice, this could have been our life. Taiwan has one of the lowest case rates in the world: 0.257 per 10,000. Population: 23,816,775. That's in-between Texas, 370 cases, and Florida, 424 cases per 10,000.

Taiwan has had SEVEN COVID19 deaths. Texas: 20,296. Florida: 18,110. Read on ThreadReader.

✅ The Omaha World-Herald editorial board has called on Nebraska Gov. Pete Ricketts (R) to issue a statewide mask mandate.

❌ In Iowa, Tyson Foods Inc. has suspended managers “accused of participating in a betting pool on how many employees would become ill with COVID-19.”

🆘 A surprisingly large number of daily newspapers aren’t featuring COVID-19 news on the Sunday paper front page. But every Washington state daily did.

⓸ Key metrics

🦠 Friday, Johns Hopkins reported 11,910,858 (195,542 new) cases and 254,413 (1,878 new) deaths, an increase of 1.67 % and 0.74%, respectively, since Thursday. A week ago, the daily numbers increased by 1.75% and 0.79%, respectively.

  • Friday
    - cases 🔺30.4% compared to seven-day average; deaths 🔻16.6%
    - seven-day average: 🔺167,646 cases and 🔺1,440 deaths 
    - 2.12% cases leading to death
    - 49.7 cases/100K (CDC)
    - 1,173,523 cases last seven days (JH)

  • One week ago
    - cases 🔺29% compared to seven-day average; deaths 🔺62%
    - seven-day average: 🔺143,360 cases and 🔺1,180 deaths 
    - 2.28% cases leading to death
    - 41.5 cases/100K (CDC)
    - 1,003,519: cases last seven days (JH)

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: 11,650,817 (185,095 new) cases & 251,715 (2,045 new) deaths
    One week ago: 8,924,548 (90,155 new) cases & 228,100 (1,055 new) deaths

  • State data*:  11,755,246 (192,911 new) cases & 245,606 (1,869 new) deaths
    One week ago: 8,994,623 (97,808 new) cases & 221,406 (946 new) deaths
    KS reports only M-W-F; CT and RI report only M-F

  • WHO: 11,413,788 (164,560 new) cases & 248,571 (1,825 new) deaths
    One week ago: 8,763,682 (80,384 new) cases & 226,132 (1,059 new) deaths

🌎 30 October 

Johns Hopkins interactive dashboard (11.00 pm Pacific)

  • Global: 57,564,078 (665,668 new) cases & 1,372,182 (11,801 new) deaths
    One week ago: 45,584,149 (565,797 new) cases & 1,188,866 (7,839 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 intentionallyAlthough 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 @
📊 Visualizations: USWorld
🌐 Global news (at WiredPen)

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