Covid-19 Diary : Thursday 18 March, 2021

Yesterday and today both saw new case numbers in the US increase over those of a week ago.  That’s not to say we’re heading to the next “wave” of new case growth, but the always perplexing plunge in new case numbers seems to have run out of steam for a while.

The really strange thing about this is that we are vaccinating more and more people every day.  If – and that’s a big if – the drastic drop in cases since early January is vaccine related, there’s no reason why it should stop, because every day a larger percent of the country have been vaccinated.  The “herd immunity” concept, whatever it truly might be, is becoming stronger every day, both as a result of vaccinations and possibly as a result of people who have been infected directly with the virus, too.

As you’ll know from our earlier commentaries, I’ve never thought the almost five-fold drop in daily new cases was a result of any type of herd immunity, and I’ve never seen any credible explanation for what caused it, and similarly, have no idea for why numbers have now leveled out again.  On the other hand, to seize the optimistic side of the stick, maybe, like a couple of weeks ago, the last two days are semi-random anomalies and on Friday, numbers will start dropping again.  Let’s hope so.

Another possible explanation – previously offered for the drop in cases, and now maybe also relevant for the rise in cases again, is the country’s overall compliance with mask-wearing and social distancing.  But I disagree, and now for a new reason, too.

I’d earlier disagreed that better compliance rates were driving the drop in cases, because according to measures such as the IHME numbers, there had been very little change in compliance in December/January/February, although for sure there has been a reduction in social distancing in March.  The new reason for doubting any link between these measures and new case numbers are these two interesting articles (one  two), that point to very similar case rate numbers between states that had very different approaches to mask wearing and social distancing.

I have always believed that both social distancing and mask wearing were important and impactful on virus spreading rates, and indeed, I still favor that point of view, because it seems so “obvious” and intuitive that it should be so.  But, as our history of infection rate data increases and becomes more meaningful, it is hard to see obvious links to prove that belief, and I’ve certainly become much less obsessive about mask wearing while outdoors and not in a high-density situation with lots of other people close to me.

The virus continues to puzzle and perplex.

Talking about continuing to puzzle and perplex, the issue of pre-hospitalization treatments certainly continues to puzzle and perplex.  Here’s an article that talks about investigating new treatments – it starts off encouragingly, but then discards both ivermectin and hydroxychloroquine with one liner unattributed statements referring to their lack of value.  As you surely know, the evidence steadily continues to overwhelmingly show more and more support for the use of both.

This article takes a different approach, starting from the fundamental and surely obvious point that telling newly infected people to do nothing and wait until they become seriously sick is not sensible.  Rather than scrambling to try and counter the virus once it has taken over one’s body, it is so much easier and better to apply early easy treatments, the same as with most other diseases.  Imagine if the response to someone with cancer was “wait until you’re so unwell you need to be hospitalized, and then we’ll see what we can do”.

Although I’ve followed much of the virus situation closely over the last 15 months, I’ve never really understood why Scott Atlas, a Trump-era advisor on the virus and how to respond to it, was so vilified and hated.  And before you rush to tell me, pause for a moment and examine how it is you think you know the things you’re about to share.

Apparently, he never said many of the things he is alleged to have said, and in some cases, clearly said completely the opposite.  Here’s an excellent article that offers a must-read response to his critics.  It is relevant both to the virus and the times we live in, in general.

They say a picture is worth a thousand words.  So there’s not much else to add to this picture of an instantly recognizable politician, in first class on an American Airlines flight between Boston and Washington, and, ahem, not wearing his mask, even though seated next to another passenger and clearly neither eating nor drinking at the time.

Surely this is the ultimate expression of “do as I say, not as I do”.

American Airlines says it is “looking in to it”.  There’s no “looking in to it” for normal passengers like you and me – we must wear masks or risk being banned for life.  But people like Kerry need not follow the same rules.

Current Numbers

There were no changes in US state rankings.  Aruba and Panama swapped places in the minor country list.  In the major country list, Spain and the Netherlands swapped places yet again, and France moved ahead of the UK.

There were no changes in death rate positions.

US Best and Worst States

Rank Cases/Million Deaths/Million
A week ago Now A week ago Now
1 Best HI (19,833) HI (20,135) HI (316) HI (319)
2 VT (26,443) VT VT (338) VT (348)
3 ME ME AK AK
4 OR OR ME (538) ME (541)
5 WA (46,032) WA (46,759) OR (549) OR (558)
47 IA (117,038) IA (118,045) MS (2,306) MS (2,331)
48 UT (117,585) UT (118,635) MA (2,401) MA (2,431)
49 RI RI RI (2,419) RI (2,449)
50 SD (129,047) SD (130,223) NY (2,516) NY (2,547)
51 Worst ND (132,176) ND (133,064) NJ (2,681) NJ (2,711)

 

Top Case Rates Minor Countries (cases per million)

Rank One Week Ago Today
1 Andorra (143,890) Andorra (147,286)
2 Montenegro (130,594) Montenegro (136,556)
3 Gibraltar Gibraltar
4 San Marino San Marino
5 Slovenia Slovenia
6 Luxembourg Luxembourg
7 Israel Israel
8 Panama Aruba (80,531)
9 Aruba (77,251) Panama (80,109)
10 Lithuania (75,671) Lithuania (76,981)

 

Top Case Rates Major Countries (cases per million)

Rank One Week Ago Today
1 Czech Republic (127,367) Czech Republic (134,198)
2 USA (90,044) USA (91,337)
3 Portugal (79,852) Portugal (80,198)
4 Sweden Sweden
5 Belgium Belgium
6 Spain Netherlands
7 Netherlands Spain
8 UK (62,256) France (63,962)
9 France UK (62,825)
10 Brazil Brazil
11 Italy Italy
12 Poland (48,904) Poland (52,470)

 

Top Death Rate Major Countries (deaths per million)

Rank One Week Ago Today
1 Czech Rep (2,110) Czech Rep (2,249)
2 Belgium (1,922) Belgium (1,944)
3 UK (1,837) UK (1,848)
4 Italy (1,675) Italy (1,720)
5 USA (1,636) USA (1,662)
6 Portugal (1,635) Portugal (1,645)
7 Spain (1,541) Spain (1,559)
8 Mexico (1,482) Mexico (1,508)
9 Peru (1,456) Peru (1,493)
10 France (1,374) France (1,402)

I Am Not a Doctor, But….

Various treatments had positive news this week.  This one in particular is puzzling because of its apparent simplicity – nitric oxide in a non-gaseous form used as a nasal spray This one – using azithromycin and antihistamines, had a very small sample size, but as a type of “challenge trial” showed an astonishingly strong outcome.

Propolis is something I’ve written about before, so it is interesting to see a new study affirming its potential.

And good old aspirin – possibly the original “wonder drug” – is being cited again for its anti-viral properties and value as a Covid remedy.  Is there anything aspirin can’t help us with?  (Well, yes, of course there is, but you get the point, I’m sure!)

Here’s an interesting summary table showing the benefits of various different possible treatments.  Clearly there are very many possible ways to attack the virus; it is a tragedy that so few are being used.

This article, headlined “Censorship Kills” very clearly states the tragedy of the hundreds of thousands of deaths resulting from shunning ivermectin and hydroxychloroquine.  Has there ever been, in our modern history, a comparable story of gratuitous preventable death combined with an utter lack of consequence for the perpetrators?

This is an interesting story – an article advocating ivermectin was reviewed by four different leading figures and accepted for publication in a peer-reviewed journal, and prepublished prior to appearing in print.  Then, an unknown person made unclear representations that caused the journal to change its mind for vague reasons and withdraw the article.

Conspiracy theorists – and, the more I see the irrational hate contrasted with the growing reality of benefit with ivermectin, the more I find myself becoming one such person – could have a field day speculating about what happened to silence the article’s publication, how and why.  Something is very wrong.

But there is a happy ending, of sorts (even though people continue to die needlessly every day) – a different peer reviewed journal is now about to publish a positive article on ivermectin.

Yet another virus variant, this time a French variant, with an interesting twist being that it may also be harder to test when using the current PCR type testing.

And lastly in this section, here are some fascinating snippets of miscellanea.

Vaccine News

Much has been made of the suspending of vaccination campaigns using the AstraZeneca vaccine by European nations.  We now also have a clear statement of the concern – there have been 37 cases of blood clotting as a result of 17 million vaccinations.  Is this really a worry?  Odds of 1 in almost 500,000?

Indeed, as this article explains, 37 cases out of 17 million is less than the normal incidence of clots that one might expect to encounter, just as a normal ordinary thing.

This tongue in cheek response puts it very nicely.  Here’s a much more complicated commentary.

There should be one consideration in particular – the first is how many of the 17 million people who didn’t suffer from blood clots might otherwise catch the virus and die from it.  Is the benefit of the vaccine ten times greater than the risk?  Or maybe 100 times?  1,000 times?  If you had a choice of two options, one of which had a one in 500,000 chance of serious illness and possibly death, and the other of which had a one in 500 chance of serious illness and possibly death, which would you choose?  Isn’t that rather a no-brainer choice?

Instead, this “out of an abundance of caution” response by a series of panicky European governments gives more ammunition to anti-vaxxers.

I’d recently wondered why we in the US were holding on to our own stockpile of the AstraZeneca vaccine.  We haven’t approved it for use in the US, and we’ve contracted way more than we need doses of the three vaccines that have been approved.  The AstraZeneca vaccines were not needed and doing us no good, while other countries were desperate for them.

The US has now announced it will “lend” 4 million doses of this vaccine to Mexico and Canada.  That is great, but why lend them?  It isn’t as though we need or want them back again.  Why not sell them?

Timings And Numbers

We continue to steadily grow the number of vaccinations given.  There is now over one third of the US population who have received at least one dose of the vaccine, and 40% of the UK population.

This chart, a rolling 7 day average of new case rates, shows the recent uptick in cases in both the EU and South America, let’s hope the US doesn’t follow suit.

Closings and Openings

Iceland has announced that anyone who has been vaccinated is now welcome to visit.  We expect this policy will start to be embraced elsewhere too in the foreseeable future, although the EU is currently thinking of limiting its approach to only fellow Europeans.  Do they think a vaccinated European is safer than a vaccinated American?

We’re starting to see talk of cruising reappear.  There are cruises now operating out of the Bahamas (thereby avoiding US restrictions), and the concept of cruises to Alaska might be on the table from July, but not if Canada is on the itinerary.  Alaskan cruises, departing from Seattle, have invariably included a “technical/compliance” stop in Canada so as to avoid the most restrictive elements of the Jones Act, but Canada has decided not to allow Alaskan cruise visits all the way through until February next year.

We think that is a ridiculously long period of restriction.  Anything could happen between now and then – we’re told in the US that we could have essentially our entire population vaccinated by some time in May, for example.

In the UK, P&O is starting to operate “cruises to nowhere” that will sail around the coast but not have any port stops, and which will only be open to vaccinated passengers.  We’re not sure how popular those cruises will be.  Port stops are an essential element of the cruise experience for most passengers.

The louder you talk or shout, the more virus particles you are thought to expel.  So perhaps it is not surprising that when Disney and other theme parks open in California, there are moves to outlaw screaming.

Good luck with that……

 

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