COVID-19 day 74 : 📈 277,965 cases; 7,159 deaths : 03 April 2020

We're all supposed to be masked now; Spain and Italy have turned the corner; AL and MO issue stay-at-home orders; State Dept stops in-person passport service; we are living in a new normal

Apr 04, 2020

It’s day 74 since the first case of coronavirus disease was announced in the United States. Given that the coronavirus appears to be able to spread in the micro-droplets that result from the simple acts of talking and breathing, the CDC is now recommending masks-for-all (when outside). WHO agrees. But don’t bid up the price of masks needed for health care workers. Lots of make-your-own help.

Italy and Spain have turned the corner. The US and UK have not. However, this does not mean Spain and Italy should rescind their lockdown orders. Notice that bump in China’s line? That’s a trial opening, realization that the virus is still lurking, followed by closing again.

Thursday, Johns Hopkins reported 277,965 (245,559) cases and 7,159 (6,057) deaths in the US, an increase of 13.2 and 18.2 percent, respectively, since Thursday.

That case rate is 84 per 100,000; the death rate is 21.6 per million.
One week ago, the case rate was 38 per 100,000, and the death rate, 6.62 per million.

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I’ve not given myself a lot of time for systemic thinking: there’s work, there’s teaching, there’s my nightly one-hour lymphedema pump session (breast cancer side-effect), there’s cooking, there’s living in the initial epicenter of this pandemic in the US, there’s worrying about my father-in-law and husband. There’s this newsletter, which helps me process the day’s events.

But all of this busyness interferes with long-term thinking.

I’ve been watching China. China slammed the door on public movement more quickly and more firmly than Europe or the US. But in March, leaders allowed movie theaters to begin re-opening; promised to open more. And then near the end of March: slammed the doors again.

Because China saw infection rates rise. So they eliminated a temptation to gather.

That made this from the 01 April White House briefing feel logical:

Anthony S. Fauci, the nation’s top infectious-diseases expert and the face of the U.S. response, said we could “relax social distancing” once there’s “no new cases, no deaths,” but the real turning point won’t come until there’s a vaccine.

But logic can get in the way of envisioning.

What does this mean?

It means we are entering a new normal. The world for the next year or two will not be the same world as the prior two.

There will be more work from home. More virtual (streamed) events.

We will all know someone who dies too soon from this disease that is not like seasonal flu.

And this funny state of limbo?

It’s going to be a lot longer than just the month of April.

🤓Recommended reading

I was worried, for older relatives and colleagues, about the economy. I assumed if I got it, it would be mild. My biggest fear was that I would infect someone else.
It was mild until, suddenly, it wasn’t.

I’m a healthy millennial. Getting COVID-19 was so much worse than I expected. Toronto Star, 03 April 2020.

… the new AI tool found that changes in three features—levels of the liver enzyme alanine aminotransferase (ALT), reported myalgia [muscle pain], and hemoglobin levels—were most accurately predictive of subsequent, severe disease. Together with other factors, the team reported being able to predict risk of [Acute Respiratory Distress Syndrome] with up to 80 percent accuracy (emphasis added).

Experimental AI Tool Predicts Which Patients with Pandemic Virus Will Develop Serious Respiratory Disease. NYU news release, 30 March 2020.

🎦Recommended viewing

Weekend smiles (and and ear worm): six-year old Chinese prodigy plays I Wish You Love and Fly Me to the Moon (bossa nova guitar). More: Instagram @miumiuguitargirl

💃🏼Life hack

I am wary of data science firm judgments about adherence to social distancing guidelines based on mobile phone data. If you’re an information worker in an urban area, cool. If you live in rural America, where grocery stories, pharmacies and hospitals are much further away than that. That said, here’s one (with methodology, sorta).

⓵ Around the country

All 50 states, the District of Columbia, Guam, the Northern Mariana Islands, Puerto Rico and the US Virgin Islands have identified COVID-19 cases. The only state with no reported deaths remains Wyoming.

The Attorney General’s office is investigating the failed sale of 39 million masks to California hospitals. The “supplier” apparently never actually had possession. A hospital spokesman said no money had changed hands. (LA Times, tight paywall).
Florida has the worst unemployment system in the US: 12 weeks (not 26,) and maximum benefit was set at $275/week. And a broken website.
businesses in Florida pay an average yearly unemployment-insurance tax of $50 per employee — the lowest rate in the country, and less than one-fifth of the national average.
Like other states, there’s a record number of people in Florida trying to apply for unemployment benefits.
DeSantis said the state would resort to paper applications, build a mobile app to handle the flood of traffic and deploy hundreds, even thousands, of state workers to provide stopgap help.
Dear Gov. DeSantis: if your predecessor couldn’t build a website that worked with a $77.9 million budget, how do you expect to solve this problem by building a mobile app?
Both residents and visitors who travel to Maine must now self-quarantine for 14 days. Also, the order closes hotels any lodging operations to deter out-of-state visitors, including short-term rentals, camp sites, and RV parks.
The executive order also instructs visitors not to travel to Maine if they are displaying symptoms of COVID-19, the disease caused by the virus, and not to come to Maine if they are traveling from cities or areas that have been identified as infection hot spots.

Scott Gottlieb, MD @ScottGottliebMD

The 10 States with the lowest percentage of testing for #COVID19, based on tests conducted per capita.

🏠 Shelter in place

Two more Johnny-come-lately states joined the stay-at-home movement on Friday, bringing the total to 41 states plus the District of Columbia:

Alabama - Governor Kay Ivey expanded her order limiting social gatherings to 10 people to a stay-at-home order effective Saturday 04 April at 5 pm.
Missouri - Governor Mike Parson expanded his order limiting social gatherings to 10 people (21 March) to a stay-at-home order, effective Monday 06 April at 12:01 am until midnight on Friday 24 April.

Timeline of US shelter-in-place / stay-at-home orders.

Too many of these orders have exceptions for “religious services” including Florida, Michigan, Ohio, Texas. In Florida, cities and counties had passed orders that closed churches; it’s not clear which law will prevail. In Texas, the state law supersedes the local prohibition.

⓶ Around the world

The number of affected countries/territories/areas jumped from 29 at the end of February to 202 today (adding Malawi). Although early reports tied the outbreak to a seafood (“wet”) market in Wuhan, China, analyses of genomic data suggest that the virus may have developed elsewhere.

Australia wants all visits to go home. “…temporary visa holders who are unable to support themselves under these arrangements over the next six months are strongly encouraged to return home.”
In Beijing, new rule means that the only firms which can export medical supplies are those licensed to sell them domestically. This may help quell some gray market sales.
Is this relapse or false negatives on discharge?
A study by scientists from China and the United States found that 14.5 per cent of people discharged from hospital after being treated for Covid-19 later retested positive for infection.

⓷ Politics, economics and COVID-19

No in-person service: US Department of State has stopped issuing new passports except for emergencies. Mail-in renewal still works but there is no expedited option. Some USPS facilities are accepting in-person applications which must be scheduled.

If you don’t have a bank account (I had not heard the term “unbanked” until now), you’re probably not paying taxes. For coronavirus relief for those folks, “the check is in the mail” won’t be true until September, probably. What percentage of those checks will wind up in the hands of payday lenders?

Wisconsin Gov. Tony Evers wants to postpone Tuesday’s primary election and is calling a special session of the legislature on Saturday.

Wisconsin’s Republican-controlled legislature, not Evers, holds the power to reschedule the election, and GOP leaders have steadfastly opposed doing so. But Evers, a Democrat, has been criticized by some in his own party for not forcing the issue more aggressively.

Under the cover of the pandemic: