COVID-19 day 90 : 📈 759,696 cases; 40,683 deaths : 19 April 2020
SC follows Jacksonville, FL, to open beaches; MD to release some prisoners; CO health care workers as counter-protesters; COVID-19 appears to be affecting the brains of some patients
It’s day 90 since the first case of coronavirus disease was announced in the United States. Easter was two weeks ago.
Life is uncertain. Right now, the uncertainty level has been ratcheted up by a factor of 100 or maybe even 1,000.
We don’t know how many people have been infected, either here or abroad.
We don’t know how many people have died, either here or abroad.
We don’t know when there will be a treatment.
We don’t know if exposure leads to immunity.
We don’t know when exposure leads to disease.
We don’t know why some people are deathly ill and others asymptomatic.
We don’t know when it will be safe to go back to work or school, hug our friends and family, gather in crowds at a restaurant, movie or sporting event.
Trump’s “liberate” tweets and a handful of conservative groups are praying on uncertainty and fear. The result was weekend demonstrations around the country, demanding that state governors re-open businesses.
Add to that, a Stanford statistician - who made (negative) waves in mid-March with a First Person essay in STAT News - has been claiming that the virus is no riskier than seasonal flu, a conclusion that appears shaky given probable selection bias. There are other issues - not the least being the person authoring a WSJ op-ed failed to mention that he’s an author on the paper (and a hedge fund manager - what?). Here is one peer review (read if you are curious about the negative impact false positives have on research) and the Twitter discussion.
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Sunday, Johns Hopkins reported 759,696 (735,242) cases and 40,683 (39,089) in the US, an increase of 3.3% and 4.1%, respectively, since Saturday. A week ago, the daily numbers increased by 5.2% and 7.28%, respectively.
That case rate is 229.51 per 100,000; the death rate is 122.91 per million.
One week ago, the case rate was 168.45 per 100,000; the death rate, 66.79 per million.
🤓Recommended reading
How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes. Science Magazine, 17 April 2020. Excerpt below; long; printing recommended.
What Have Epidemiologists Learned About the Coronavirus? New Yorker, 16 April 2020.
🔬Research and medical news
On the USS Theodore Roosevelt, 600+ sailors (4,800 total) have tested positive; approximately 60% of them are currently asymptomatic. Defense Secretary Mike Esper:
It has revealed a new dynamic of this virus: that it can be carried by normal, healthy people who have no idea whatsoever that they are carrying it.
Not it has not; this is not new. It wasn’t new when Georgia Gov. Brian Kemp (R) said it, and it’s not new now.
The National Institutes of Health is launching a public-private partnership between federal researchers and 16 pharmaceutical companies to coordinate and accelerate COVID-19 treatment.
About 5% of coronavirus patients become critically ill; “the virus acts like no microbe humanity has ever seen.”
“[The disease] can attack almost anything in the body with devastating consequences,” says cardiologist Harlan Krumholz of Yale University and Yale-New Haven Hospital, who is leading multiple efforts to gather clinical data on COVID-19. “Its ferocity is breathtaking and humbling”…
How the virus attacks the heart and blood vessels is a mystery, but dozens of preprints and papers attest that such damage is common. A 25 March paper in JAMA Cardiology documented heart damage in nearly 20% of patients out of 416 hospitalized for COVID-19 in Wuhan, China. In another Wuhan study, 44% of 138 hospitalized patients had arrhythmias…
If these folks are not dying of lung failure, they’re dying of renal failure,” says neurologist Jennifer Frontera of New York University’s Langone Medical Center, which has treated thousands of COVID-19 patients…According to one preprint, 27% of 85 hospitalized patients in Wuhan had kidney failure…
Frontera says neurologists are needed to assess 5% to 10% of coronavirus patients at her hospital. But she says that “is probably a gross underestimate” of the number whose brains are struggling, especially because many are sedated and on ventilators….
… a growing body of evidence suggesting the new coronavirus, like its cousin SARS, can infect the lining of the lower digestive tract, where the crucial ACE2 receptors are abundant. Viral RNA has been found in as many as 53% of sampled patients’ stool samples.
🎦Recommended viewing - prescribing laughter again
This time, of the Broadway kind. 👨🎤
⓵ Around the country
Colorado. Health care workers as counter-protesters.
In Colorado Springs, US Air Force cadets were spaced eight feet apart for commencement.
Iowa:
Ohio: Inmates in the state prison system account for 21% of the total confirmed COVID-19 cases in the state. Marion Correctional Institution accounts for 78% of the inmate cases (1,828). Inmates not testing positive (667) have been quarantined. No deaths yet.
South Carolina: Opening beaches and non-essential retail stores on Tuesday, following the lead of Jacksonville, FL.
Washington. State police estimated that 2,500 protesters rallied in the state capitol, Olympia, on Sunday.
The greater DC area - District of Columbia, Maryland and Virginia - collectively have 23,027 cases with 812 deaths ( 150.63 cases/100,000 and 53.12 deaths/1M).
Nonessential businesses will remain closed until May 15 in the District, May 10 in Maryland and May 8 in Virginia, where a stay-at-home order remains in place until June 10. Leaders have warned against letting up on efforts to slow the spread of the coronavirus. The District and Maryland have ordered residents to wear masks in public, such as when they go to stores or use public transportation.
In Maryland, the governor signed an executive order to release prisoners at high-risk for “COVID-19 complications.” Sex offenders are not eligible.
All 50 states, the District of Columbia, Guam, the Northern Mariana Islands, Puerto Rico and the US Virgin Islands have identified COVID-19 cases and all have at least one death.
⓶ Around the world
Australia: Winter is coming, and researchers have found the virus is more “virulent” in colder temperatures.
Australia’s winter officially starting on June 1 and many lockdown measures are expected to begin being lifted around the end of May.
Spain records the lowest daily death toll in a month.
“Today we have 410 deaths, clearly below the 500 we’ve had on average. It offers hope, although we have to be careful,” said Fernando Simón, the head of Spain’s public health emergency department told a press briefing.
For context, the US had 1,594 deaths in the past 24 hours.
Sweden. The refrain is too widespread and too heartbreaking. “Staff with no masks or sanitiser fear for residents as hundreds die in care homes”
United Kingdom. Prime Minister Boris Johnson skipped five briefings on COVID-19 in early days of the outbreak.
Meanwhile, scientists like Imperial College’s Neil Ferguson were sounding the alarm by mid-January. Ferguson sent the government a report on Jan. 25 warning that the virus' infectivity could be higher than the Spanish flu's, and that there needed to be a 60% cut in the transmission rate — which could only be achieved with a national lockdown.
The number of affected countries/territories/areas jumped from 29 at the end of February to 208 today. 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.
⓷ Politics, economics and COVID-19
On Sunday, Trump said to expect test swabs availability to increase by 20 million per month. He did not name the company tagged by the Defense Production Act.
Seema Verma, the Medicaid and Medicare administrator, also announced on Sunday night that the administration was set to release guidelines for reopening the health care system to allow for elective procedures and surgeries.
Neiman Marcus is expected to file for bankruptcy protection this week. Ostensibly a casualty of the retail shutdown. I have little sympathy:
Neiman Marcus’ borrowings total about $4.8 billion, according to credit ratings firm Standard & Poor’s. Some of this debt is the legacy of its $6 billion leveraged buyout in 2013 by its owners, private equity firm Ares Management Corp and Canada Pension Plan Investment Board (CPPIB).
LBOs should be illegal. An official government pension board owns a retail chain?
⓸ Case count
There is a lag between being contagious and showing symptoms, between having a test and getting its results. The virus was not created in a lab.
🌎 19 April
Globally: 2 241 359 confirmed (81,153 - new) with 152 551 deaths (6,463 - new)
The Americas: 821 860 confirmed (37,589 - new) 38 258 deaths (2,516 - new)
Johns Hopkins interactive dashboard (11.00 pm Pacific)
Global confirmed: 2,404,325 (2,330,259)
Total deaths: 165,238 (160,721)
Recovered: 624,798 (598,228)
🇺🇸 19 April
CDC: 720,630 ( 690,714) cases and 37,202 (35,443) deaths
Johns Hopkins*: 759,696 (735,242) cases and 40,683 (39,089)
State data*: 724,926 (724,926) identified cases and 34,273 (34,273)
Total tested (US, Johns Hopkins): 3,882,002 (3,723,634)
View infographic and data online: total cases, cases/100,000 and deaths/million.
* Johns Hopkins data, ~11.00 pm Pacific.
State data include DC, Guam, the Northern Mariana Islands, Puerto Rico and the US Virgin Islands
See US (state/territory) total cases, cases/100,000 and deaths/million as infographics.
⓹ What you can do
Stay home as much as possible, period.
Digestive problems may be a symptom.
Resources
👓 See COVID-19 resource collection at WiredPen.
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🦠 COVID-19 @ WiredPen.com