COVID-19, Year 2: 📈 One year after the first announced COVID-19 death, 513,000+ deaths : 01 March 2021

The steady decline in the U.S. seven-day case average hit a plateau, two weeks after the SuperBowl; we have US-grown variants of concern in California and New York City

Sunday 28 February 2021 marked 365 days since the first COVID-19 death was announced in Seattle, WA (29 February 2020). That was not the first COVID-19 death, but it was the first known death.

Reported deaths in those intervening 365 days: 513,091 (Johns Hopkins).

Many, perhaps most, of these deaths were preventable.

Had our death rate matched the weighted average of the other six G-7 nations (Canada, France, Germany, Italy, Japan, the United Kingdom and the United States), our death toll would have been 40% less, according to an analysis published in the Lancet this month:

Many of the cases and deaths were avoidable. Instead of galvanizing the U.S. populace to fight the pandemic, President Trump publicly dismissed its threat (despite privately acknowledging it), discouraged action as infection spread, and eschewed international cooperation. His refusal to develop a national strategy worsened shortages of personal protective equipment and diagnostic tests. President Trump politicized mask-wearing and school reopenings and convened indoor events attended by thousands, where masks were discouraged and physical distancing was impossible.

And from June 2020, STAT News:

“[B]etween 70% and 99% of the Americans who died from this pandemic might have been saved by measures demonstrated by others to have been feasible,” including Australia, Germany, Singapore and South Korea (21 January 2020 was also its first known case).

The damage doesn’t stop there. Only half of Republicans (25% of Americans) tell pollsters that they intend to get vaccinated. On the other hand, more than 4-in-5 Democrats (25% of Americans) plan to get vaccinated.

We need an independent investigation into how the federal government (mis)managed COVID-19 in 2020. An investigation that names names and sends people to prison, if laws were broken.

Trump and his henchmen along with culpable members of Congress, governors and their henchmen should be permanently banned from elected or appointed public office.

The dead deserve no less.

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Variants are us

Although more than a year has passed since the first case was detected in the U.S., our environmental assessment remains inadequate. A year ago, it was inadequate testing for infections. Now it’s inadequate testing for mutations.

The Biden Administration is in kickstart mode; the CDC reported more than twice as many genomes sequenced at the end of January (average 7,000 per week) compared with the first of the month (3,000). Then, as now, the federal government failed “to create the infrastructure and procedures needed to receive, process and share […] data on a national scale.” The Biden administration goal is 25,000 samples per week.

SARS-CoV-2 has developed at least three distinct variants (United Kingdom, B.1.1.7, fall 2020; South Africa, B.1.351, fall 2020; Brazil, P.1, January 2021). The New York Times reported that people in Brazil and South Africa who had been infected with the original virus had experienced “reinfections with the new variants.”

We are in a race against time because of these mutations. And in that race, we are falling behind,” Mara G. Aspinall, a biomedical diagnostics professor at Arizona State University, told the Washington Post.

Even when we get reports of testing, there’s little context; how significant is 1,900 in the context of number of samples?

Washington state officials detected the first case of the variant discovered in South Africa this week, but the infected person didn’t provide a good phone number and could not be contacted about the positive result…

As of Tuesday, the CDC had identified nearly 1,900 cases of the B117 variant in 45 states; 46 cases of B1351, which was first identified in South Africa, in 14 states; and five cases of the P.1 variant initially detected in Brazil in four states, Dr. Rochelle Walensky, the CDC director, told reporters Wednesday.

In January, the CDC predicted that the UK variant, B.1.1.7, could become the dominant variant in the U.S. in March due to its increased transmissibility.

Early last week, the New York Times and Los Angeles Times reported that a new variant discovered in California in December, B.1.427/B.1.429, is “more contagious” that the original virus, according to two studies (pre-prints). By the end of March, scientists project it “will probably account for 90% of the state’s coronavirus infections.”

Dr. Anthony Fauci, the nation’s top infectious disease expert, raised a further concern: A survival-of-the-fittest contest between the U.K. and California variants could accelerate the spread of the strain that’s best able to elude the effects of COVID-19 vaccines, he said. The best way to prevent this, he added, is to stop the spread of either variant by getting vaccinated, wearing masks and limiting exposure to others.

Also last week, scientists announced a new variant in New York City, B.1.526 (also in two pre-prints). This variant showed up in November and shares characteristics of variants found in South Africa and Brazil.

Given that the United States accounts for a quarter of the cases in the world, it is logical to assume mutations are rampant here. But without an aggressive attempt to identify them, “[w]e don’t even know what we don’t know,” according to Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists.

The U.K. (about one-fifth of the U.S. population) is a world leaders in “viral sequencing” according to the Wall Street Journal.

As of Jan. 29, the U.K. had submitted 44%, or around 190,000, of the genomes held in a global library run by the nonprofit Global Initiative on Sharing All Influenza Data, or Gisaid. That is around 5.1% of the nearly four million cases detected in the U.K.

In December, the Washington Post reported that only 0.3% of 18,229,260 U.S. cases had been genetically assessed for variants. We were 38th in the world. Australia had analyzed 58.6% of its documented 28,238 cases; Britain, 7.4% of 2,116,609 cases; Denmark, 11.7% of 114,047 cases; and New Zealand, 48.6% of 2,128 cases.

Current cases per 100,000: Australia, 114; Denmark, 3,650; New Zealand, 49; U.K., 6,162; U.S., 8,627. (I do not have data for Britain alone.)

The countries with the fewest cases per capita have put relatively more effort (and money) into genomic testing.

Decline in cases and deaths

Globally, daily cases reported to the World Health Organization have declined steadily since mid-January. According to WHO, “countries with the most substantial decline had seen peaks over the Christmas [season], and responded with increased public health and social measures.”

In the U.S., a steep and steady decline began on 11 January 2021 (rolling seven-day average). The rate began slowing on 18 February 2021; dipped to 70,594 on 21 February; rose to 73,604 and then dipped again Sunday (67,403).

The SuperBowl was 07 February.

Documented cases on 01 March 2021 match the level of early November 2020, which is equivalent to the summer peak. Buoyed by the decline in cases (the decline in deaths has lagged, considerably, as the chart below shows), governors have begun lifting restrictions.

“Everybody is tired, and everybody wants things to open up again,” Dr. [Ashleigh] Tuite said. “Bending to political pressure right now, when things are really headed in the right direction, is going to end up costing us in the long term.”

The decline in the seven-day average positive test rate has also begun to plateau.

Almost as many Americans are fully vaccinated (24,779,920, both shots) as Americans who have tested positive (28,605,523). But we are at a precarious moment, with an unknown number of variants and possibly premature relaxing of state restrictions.

It’s Groundhog Day, again.

Get vaccinated when you’re eligible; double-mask, regardless.

If you want to have dinner with a friend/couple who is/are also fully vaccinated (about two weeks after the second dose), you would be modeling Dr. Fauci.

There’s less of a risk that a pod of vaccinated people would get severely ill from Covid, but given the more contagious coronavirus variants and questions about whether the vaccines provide protection, it’s still important to maintain social distance and wear masks in public. Even if you are vaccinated, there’s still a risk that you could transmit the virus to someone who is not vaccinated.

Vaccinations are not a license to party hearty! Vaccines protect against severe illness (they don’t ward off the virus like garlic does vampires!), hospitalization and death.

Where are we today (28 Feb 2021)?

Shorts

🖥 If you’ve spent any time on state vaccine registration websites, this is not news: most violate the Americans with Disabilities Act as well as the Rehabilitation Act of 1973. KHN reports that “[a]t least 7.6 million people in the U.S. over age 16 have a visual disability.”

🏥 What it’s like to be hospitalized with Covid, when you’re a writer telling the tale. Meticulously detailed; horrifying; spellbinding.

“I do struggle with survivor’s guilt. If I’d gone to sleep in ICU and not woken up, I’d have known nothing of it. My family, friends, the people the pandemic has taught us to call “loved ones”, had to confront the possibility of bereavement, unsure for days whether I was going to live or die in isolation, unable to say goodbye. Like the doctors and nurses in the hospital, I can’t speak for them, but I’m left with the feeling that they all had a worse ride than I did.”

💻 What it’s like to search for the shot. First-person tales.

I am 83 years old, among those most-at-risk of death from Covid, and I have not touched another human being since March 14, 2020, when I left my tennis friends in Florida and returned home to Silver Spring, MD…

🚔 In New Zealand, Auckland is on a level 3 lockdown for seven days after one new case in the community which had no known link to another case. The mother has also tested positive. Police set up a border around Auckland; “gatherings outside of bubbles are prohibited”; and public venues are closed for the week. The remainder of the country is on level 2 for a week. Imagine a city in the U.S. doing this? A governor?

🪦 Organ transplant patient dies. A woman in Michigan become infected and died two months after receiving a “tainted double-lung transplant” from a donor who had shown no signs of illness before dying in a car crash. Routine nose and throat samples from both donor and recipient tested negative for SARS-CoV-2. However, after the patient tested positive, doctors tested fluid from deep within the donor lungs. It tested positive. Four days after the transplant, the surgeon tested positive, as well. Genetic testing showed a match. Warning to transplant teams to test deep in the lung.  

🦠 About one-third of U.S. adults remain uninterested in getting a COVID-19 vaccine. Vaccine resistance is “disconcertingly high among Republicans, young people, and certain minority populations.” How do we address vaccine dissent/deliberation/hesitancy/indifference? [If there is a hell, I hope that Andrew Wakefield, whose fraudulent 1998 paper in the British medical journal The Lancet jumpstarted the modern anti-vax movement, discovers what it’s like.]

👓 Lessons from a year of Covid, by Yuval Noah Harari, author of ‘Sapiens’, ‘Homo Deus’, ‘21 Lessons for the 21st Century’ and ‘Sapiens: A Graphic History’.

💉 On Saturday, the FDA gave the Johnson & Johnson (one-shot) vaccine an emergency use authorization (EUA). Remember that vaccinations are designed to keep us out of the hospital, to prevent severe disease and death. So please try to avoid news media framing of the three vaccines as sports teams in competitioin. As Dr. Fauci noted Sunday, “there were no hospitalizations and no deaths” during J&J trials. Unlike the Moderna and BioNTech-Pfizer vaccines, the J&J vaccine does not need to be kept super-cold and has a shelf life measured in months; it is more like the influenza vaccine.

Summary, Johns Hopkins

  • US: 28,605,523 cases; 513,091 deaths

  • Global: 114,065,230 cases; 2,530,712 deaths

Vaccine report, CDC 💉

  • Doses distributed to states: 96,402,490

  • Vaccinations given: 75,236,003

  • People who have both doses: 24,779,920

  • Record for daily doses administered: 2,429,823 (reported 28 February)

Context

16 September 2020: “We’ll be able to distribute 100 million doses by the end of 2020 and a large number much sooner than that.”

08 October 2020: “We may have up to 100 million doses by the end of the year, enough to cover especially vulnerable population.” 

15 December 2020: “We expect to have immunized 20 million of our American people” during the month of December. The Administration also pledged to distribute at least 40 million doses.

25 January 2021: “I think we may be able to get that to 1.5 million a day, rather than 1 million a day, but we have to meet that goal of a million a day.”

U.S. Hospitalizations, COVID Tracking Project

Deaths, global, Financial Times

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