I’ve watched the Sunday morning talk shows for decades. Today was the first time I felt the need to take notes. On CBS’ “Face the Nation”, the first 40 minutes was on coronavirus, but Margaret O’Brien led off by stating that the federal government has not approved their requests for government guests: for Dr. Fauci for 3 months, and for the CDC, never. The first guest was the Houston mayor, who indicated that their testing facilities are being overwhelmed by noon each day. Test results are delayed days, and have gone from 10% positive in mid-June to 25% positive now. Next guest was the Miami mayor, where the city has taken various measures allowed by the governor, including curfews, beach closures, and an indoor mask order (inside spaces) April 18 now applying to indoor and outdoor public spaces. The mayor believes the main problem is that residents “have let their guard down”. The positive test rate has gone from 8% in mid-June to 20%+ now. As you know, experts recommend a positive test rate of below 3% to re-open.
Next guest was Dr. Scott Gottlieb, the former FDA commissioner, who said the following: (1) at the peak of the New York outbreak, there were 35,000 cases per day, and testing was catching 1 in 20 infections (Since infections are multi-day events, this does not mean 700,000 actual cases per day), and (2) we are headed to 60 to 75,000 cases per day this week, and testing is catching 1 in 12 infections (I take these numbers to mean there has been no improvement in our ability to drive down the number of infections). He said the case fatality rate has gone down but it can’t currently be measured (I would agree with both statements).
Dr. Gottlieb said to expect deaths to go over 1,000 per day in the next two weeks (I agree). He sees Arizona as the worst situation in the country, but also mentioned Texas and Florida, and saw Georgia as getting worse. States where R0 is greater than 1 have gone from 10 to 40 (this is stating pretty clearly that the spread is currently beyond control). His math on infections was that 60% of those infected show symptoms (i.e., 40% are asymptomatic); 10% to 15% get COVID pneumonia (I take that to mean lung complications); and 2% to 5% are hospitalized. I’m unsure exactly how these percentages apply, but believe they refer back to the number of infections — that is, if 100,000 were infected, 60,000 are symptomatic and 2,000 to 5,000 are hospitalized.
Dr. Gottlieb also indicated that the current supply of remdesivir would be adequate if the infection levels stay where they are, but not if they continue to expand (given that spread is currently out of control, this says the supply will not be adequate without a dramatic reversal of the current situation). Moreover, because remdesivir has a long manufacturing cycle, it is now too late to address the supply problem. Dr. Gottlieb also dismissed hydroxychloroquine as an alternative. He said the studies demonstrate it does not help the seriously ill or have value as a prophylactic. He said it could possibly help mild cases on an outpatient basis, but there was no evidence of that, and other evidence was contra-indicative (probably referring to the adverse side effects, like heart attacks), so it should not be used.
I would commend to you the segment on Meet the Press today with Dr. Nahid Bhadelia, an infectious disease expert at Boston University School of Medicine — you can find the full MTP episode online, she’s about 18 minutes in. Andrea Mitchell displayed a graph showing that the US is running about 55,000 cases per day [note: severely underreported as per Dr. Gottlieb’s comments] while the EU (with a larger population) is running about 3500 cases per day [much more accurate than our count because they are able to effectively contact trace, test, and isolate at their case level].
Andrea played a clip of Mr. Trump claiming our high testing was causing the high case numbers here, and asked Dr. Vidalia if Mr. Trump was wrong, and what does testing do? “The President is wrong”, she said. “If this was a war, we wouldn’t want less intelligence; if this were a flood, we wouldn’t fail to survey the land.” She also said the worst affected counties have no option but to close again. The entire clip is perhaps 3 minutes and worth your time.
World news on COVID-19 is not good: https://www.nbcnews.com/news/world/who-reports-record-increase-global-coronavirus-cases-n1232922 (link replaced 7/6/21). Interesting that Australia is locking down a hotspot; the US needs to rethink how far it will go in quarantining people in the future. As far as “learn to live with it”, in some ways a workable political strategy as dead people don’t vote. It’s not much of a public health strategy, though.
https://www.foxnews.com/health/cases-dip-world-sets-record (link updated 8/15/20). The headline ignores that cases dip every weekend due to the weekend reporting effect …
COVID-19 battering Latin America: https://www.cnn.com/2020/07/04/health/latin-america-coronavirus-health-systems-intl/index.html (link replaced 7/6/21).
Virus is airborne: https://www.irishtimes.com/life-and-style/health-family/239-experts-with-one-big-claim-coronavirus-is-airborne-1.4298154 (link updated 8/15/20). This makes an excellent point as to why mask wearing is needed indoors when in public, and that includes your workplace. It does suggest that broader use of N95 masks may help manage R0.
Kinase inhibitors: https://bestlifeonline.com/coronavirus-treatment-2/ (link replaced 7/6/21).
News on RNA-based vaccines: https://www.kff.org/news-summary/news-outlets-examine-various-aspects-of-research-development-of-novel-coronavirus-vaccine/ (link replaced 7/6/21; Washington Post is a paid subscription).
Economic/market outlook: https://markets.businessinsider.com/news/stocks/economic-outlook-forecaster-us-recovery-unlikely-stock-correction-christophe-barraud-2020-7 (link replaced 10/14/21). “Maybe take some protection”? (Insert condom joke here.) The 2022 part makes complete sense to me …
Here’s an opposite view, which does not make sense to me: https://markets.businessinsider.com/news/stocks/stock-market-outlook-high-unemployment-drive-equities-rally-recession-paulsen-2020-7 (link replaced 7/6/21). Apparently, if things are bad, there’s nowhere to go but up.
And, hey, somebody’s actually checking the math: https://www.marketwatch.com/story/this-is-the-simple-reason-you-cant-believe-the-pe-ratio-for-the-russell-2000-right-now-2020-07-05 .
WSJ: State round-up: https://www.wsj.com/articles/states-with-earlier-success-now-battle-coronavirus-spikes-11593860400?mod=djemHL_t . “Personally planning for the increase in the fall”? Scary from a public health official – there has never been any evidence that COVID-19 was seasonal, considerable evidence to the contrary, and, damn it, this is not the flu …
Reality batters politics: https://thehill.com/homenews/sunday-talk-shows/505904-fda-commissioner-declines-to-confirm-trump-claim-that-99-percent (link replaced 7/6/21). Be true to the facts; weakness is dangerous, and unfortunately it can be contagious. The only possible way the 99% comment could be true is if a result other than death is considered harmless. And: https://www.reuters.com/article/us-usa-election-republican/too-soon-to-say-if-safe-to-hold-republican-convention-in-florida-u-s-official-says-idUSKBN2460MI (link replaced 1/2/21). Not really. Convention dates are August 24-27, just over 7 weeks away. Florida seems unlikely to hit its peak in the next two weeks, and this holiday weekend has likely increased the spread. And Gov. Desantis has ruled out a lockdown: https://www.detroitnews.com/story/news/nation/coronavirus/2020/07/04/florida-virus-case-record-second-day/112061796/ . Hope the nursing homes are totally locked down, but there’s still entry risk from unquarantined staff. Remember that the convention is not only a risk to Jacksonville, but to all 50 states and US territories when the delegates return home. I wonder what happens if, before the convention, other states require the delegates to quarantine on return home.
Actor President steps in: https://autos.yahoo.com/bill-pullman-promotes-freedom-masks-164917670.html (link replaced 7/6/21). Anything to get people to wear masks. But there’s a darker backstory: https://ew.com/movies/bill-pullman-donald-trump-independence-day/ .
The mask news is getting weirder: https://thehill.com/homenews/state-watch/505900-kansas-governor-calls-on-gop-county-chair-to-remove-cartoon-comparing (link replaced 7/5/21). Good update: https://apnews.com/14c464d55ec75051a29358c1a58f8403 (link updated 8/15/20).
The virus is not harmless to the young: https://www.cnn.com/2020/07/05/us/penn-state-student-dies-coronavirus/index.html (link replaced 7/6/21).
Another problem with Black Swan events: https://www.bloombergquint.com/business/goldman-lowers-u-s-gdp-forecast-sees-4-6-contraction-in-2020 (link replaced 7/6/21). Looking at current pandemic trends, even given that the lockdowns of the second quarter created a lower base, the 25% looks too optimistic for the next 3 months. Their prior 33% prediction may be standing in the way of greater unbiased current assessment. If consumer spending remains stalled for the next two months (as they say), it’s hard to see 25% growth over the next 3 months.
A plague of locusts, in Africa and now in South America: https://www.sciencealert.com/the-locust-plagues-in-east-africa-are-sending-us-a-message-and-it-s-not-a-good-one (link replaced 7/6/21).
A Black Swan event from 1945: https://www.thevintagenews.com/2018/12/31/paul-newmans-wwii-service/ . It’s helpful to keep in mind that the butterfly flapping its wings can have a positive effect, too.
For those of you interested in getting beyond the slogan “Defund the Police”: https://www.cnn.com/2020/07/05/us/cahoots-replace-police-mental-health-trnd/index.html (link replaced 10/14/21). Eugene is the largest metropolitan area in Oregon after Portland/Salem, about 100 miles south of us, but less than 1/10th Portland’s size. The U of O is an important part of the city, but there’s more to the area than the Ducks. We do have community service agencies in Portland, and they do operate vans, but they do not have the working relationship with police to the extent this article describes in Eugene.
From what I’ve observed over the years here, more community services as an alternative to police involvement would be a good thing, both for the police and the community. Making it work is the hard part. Although, here in Portland last night, in response to protesters firing “commercial fireworks” at downtown government buildings, a state of emergency was declared and the police tear-gassed the protesters; it’s worth some effort to develop alternatives. Besides tear gas being banned in war, the prolonged coughing it causes subjects the crowd (and therefore the surrounding community) to increased risk of coronavirus spread.