Post #774: How about some vaccine acid tests?

 

Image source:  Source:  Grainger Industrial

What I’m suggesting is that proposed vaccines that have passed Phase I (safety) testing ought to be tested, right now, in places where large oubreaks are common.  While those outbreaks are happening. Places like prisons, meat-packing plants, nursing homes, hospitals, and other high-risk environments.

If nothing else, if these vaccines have some effectiveness, you’d be doing the workers and inmates in those situations a favor.  But in addition, there’s a good, solid arithmetic behind doing such acid tests:  You’d know your answer to “does this vaccine work” far faster than you would using standard Phase II drug testing, which relies on community members to volunteer, and then be randomized into treatment and control groups.  And that would be doing us all a favor.

The only hard part is how to do it in a way that actually generates a usable test of the vaccine.  And even that part isn’t rocket science.  It just has to skirt an ethics question and get some cooperation among state, federal, and private-sector entities.


Continue reading Post #774: How about some vaccine acid tests?

Post #773: COVID-19 vaccine: 1: The Russians have it right …

2:  The US is screwing it up.

3:  The major drug companies might be able to save us, despite ourselves.

4:  But the stupidity of The American People may yet snatch defeat from the jaws of victory.

This is one of a series of posts about vaccines for viral illness, and about a COVID-19 vaccine.  See Post #741 for a quick run-through of flu vaccine effectiveness.  My posts tend toward TL/DR, so in this post I’m only going to address Item 1:  The Russians have it right.

To cut to the chase, this is basic game theory.  Suppose you had a COVID-19 vaccine candidate that might be effective, but might be just a harmless placebo.  That is, it has passed Phase I (safety) clinical trials.  What’s the smartest thing you could do with it?  Continue reading Post #773: COVID-19 vaccine: 1: The Russians have it right …

Post #772: Virginia daily new coronavirus case counts are up, part data glitch, part real rise. ADDENDUM

Yesterday Virginia reported 2000+ new COVID-19 cases, but that high one-day count was due to the Commonwealth clearing up a backlog of previously uncounted cases.  That said, a) those cases were real (just not all occurring yesterday), and today (8/8/2020) saw another 1300 cases. Continue reading Post #772: Virginia daily new coronavirus case counts are up, part data glitch, part real rise. ADDENDUM

Post #771: Aerosol transmission of COVID-19, revisited. Why won’t the CDC change its position?

Source of illustrations below: COMMENTARY: COVID-19 transmission messages should hinge on science. March 16, 2020, Lisa Brosseau, ScD, author, on line at the University of Minnesota Center for Infectious Disease Research and Policy.  Used without permission here, under a claim of fair use.

To cut to the chase, I think there would be some extreme political fallout if the CDC changed its position on aerosol transmission of COVID-19.  And that — not scientific evidence — is why the CDC is not going to say that aerosol transmission of COVID-19 is a significant problem.  The rest of this posting just lays out the reasoning behind that assertion. Continue reading Post #771: Aerosol transmission of COVID-19, revisited. Why won’t the CDC change its position?

Post #769: Still 1000 new cases/day in Virginia

This post updates my standard charts to today, 8/3/2020.  There was another apparent “spike” in the case count today, but it has all the earmarks of being driven by a backlog in data reporting, not in any real uptick.  Note that the lines on the second chart move perfectly in synch.  The only thing these two areas have in common is the data reporting system.

The data source for these charts is the Commonwealth of Virginia’s case counts, via the Department of Health.

Below:  Recent trend, blue = Virginia, Orange = Fairfax County.  It’s a pretty good bet that today’s high count in Fairfax is a result of data reporting backlog, not a surge in new cases.  We continue to trend along at 1000 cases/day for the Commonwealth, 60/day for Fairfax County.

Below:  Late-reopening areas (Blue, NoV + Richmond + Accomack), versus early-reopening areas (orange).  At the outset of the pandemic, the “late reopening” areas had most of the cases.  That’s why they re-opened later.  But that changed somewhere around the third week of July.  Due to the higher daily case growth shown below, cumulative total cases in the “early reopening” areas exceed that of the “late reopening” areas.

As note elsewhere on this website, the high growth in the early-reopening areas is largely due to the Hampton Roads area (Portsmouth, Norfolk, Virginia Beach, and adjacent cities and counties).

Town of Vienna (ZIP 22180) continues to see roughly one new case per day.  The ZIP code has about 24,000 residents.  This past week we passed two milestones (not shown).  More than 10% of the residents of 22180 had been tested for coronavirus, and more than 1% have had coronavirus.

 

Post #768: Have we stopped being stupid yet? Part two.

Have we stopped being stupid yet?  In the US, regarding COVID-19?

We can update Post #760 with a resounding, nope, not yet. 

Source:  zippythepinhead.com  This image is copyright Bill Griffith, and is used without permission.  But with the notation that “Are we having fun yet??” in fact originates with Bill Griffith/Zippy the Pinhead, but has been so frequently copied that many people incorrectly believe the source is apocryphal.

You’ve probably seen the recent news articles about the Georgia summer camp that had to close down back in June when more than 200 (out of 500) kids attending it tested positive for coronavirus.  After just a few days of operation.  But before you start feeling sorry for the victims of this unfortunate accident, read the CDC report on that.  It’s the release of the CDC report that is triggering the current news stories.

Consider that the camp directors did the following (per the article above).

  1.  No masks for the campers.
  2. Lots of vigorous indoor singing and cheering in the living quarters.
  3. No open windows.

This is being discussed as if it provides some sort of lesson for the re-opening of schools.  Other than the fact that kids can get coronavirus, I sure don’t see that.  I see this as a one-off act of astounding stupidity.

I am particularly dumbfounded by the decision to have vigorous indoor singing and cheering, with no open windows, and no masks.  Given what we have known for some months now, it would be hard to think of a more efficient way to spread coronavirus.

I mean, just pause for a second.  What I’m going to say next has all been documented in various posts here. I’m not even going to bother to cite the prior posts, but search “singing” to find them if you want.

Singing:  We had one superspreader event at a choir practice (Mount Vernon, Washington) early this spring.  We’ve had several similar singing-related events (in the US and elsewhere) since then.  We’ve had several countries, including Germany, ban singing in church.  We’ve had at least one state (California), ditto.  We’ve had many mainstream religious (including Catholics, Episcopal, and Lutheran) ban or sharply curtail singing in religious services.

We’ve had research on the books for years showing that singing generates large amounts of aerosol (airborne) particles.  And when you get right down to it, singing was known to be a hazard back when the major worry about airborne disease was tuberculosis.

In short, there was no shortage of information, back in June, to tell you that singing was a major risk.  Any sort of rudimentary Google search would have told you that.  And yet, this camp’s curriculum involved vigorous singing and cheering.

Indoors, with no open windows.  We’ve had considerable epidemiological evidence that outdoor settings are vastly safer than indoor settings.  Virtually every state re-opening has stressed doing your business outdoors, when possible.  For example, outdoor seating at restaurants was opened up well before indoor seating in the state re-opening plan.

That’s almost certainly due to aerosol (airborne) transmission of disease, even if the CDC can’t bring itself to say so.  Outdoor settings rapidly dilute any aerosol (airborne, under 5 micron) particles that float in the air.  Droplets, by contrast (over 5 microns) fall to ground in either indoor or outdoor settings.

Without masks.  Because?  Because the President won’t wear one?  Because Republican leaders have been foolishly stubborn on this issue?  Because going mask-less demonstrates your political fidelity?  Because they think they’re uncomfortable?  Beats me.  I’ve been wearing mine faithfully in enclosed public spaces for months now.  I really absolutely cannot get my mind around people who would balk at that.

Particularly for their children.  I mean, I figured that once it got down to an Abraham and Isaac scenario, Republicans would balk.  That seemed to be the case with school closures.  Even die-hard adherents of the President balked when it came to risking their children’s lives by ignoring the pandemic.  But, apparently, in this case, hundreds of parents figured it was A-OK to send their kids to a live-in summer camp without masks.

And, of course, as icing on the cake, even though the CDC mentions no open windows, and singing, it can’t use the a-word in its writeup.  (That’s aerosol or airborne transmission.)  The lack of open windows ONLY matters if aerosol transmission is a common route.  And the main reason that singing matters is that it produces vast amounts of aerosols (equivalent to coughing).  And yet, while the CDC can mention both the closed windows and the singing, use of the a-word is forbidden.

So the only real lesson I take away from this event is that schools should avoid being this incredibly butt-stupid.  I mean, yeah, indoor choir practice is cancelled indefinitely, for starters. And we can take it from there.

The CDC does us all a great disservice by refusing to acknowledge the presence of aerosol transmission of COVID-19.  If you read the CDC write up, it reads in a completely inconsistent fashion.  In a nutshell, it says:  “look at all the things these folks did right, except for these few items, and yet COVID-19 still spread, what a lesson that is for school reopening”.  That writeup is every bit as convoluted as it sounds.  A far simpler and more coherent summary would have said:  “this camp did not avoid a situation with high risk of aerosol transmission of COVID-19”.  (That situation being vigorous indoor singing, no open windows, no masks).

But if you can’t say the a-word (aerosol, airborne), you can’t say that.  And so the CDC writeup reads like the gibberish that it is.

Contrast your takeaways from the CDC report — if you have any — with the Japanese, who start their guidance with talk about ventilation.  They can do that, because they don’t have a bunch of hide-bound bureaucrats running the show, and the acknowledge the dangers of aerosol transmission of COVID-19.

If you want to read something helpful about school re-opening, read this Atlantic article about outdoor schooling.  Apparently this was done back in the 1918 flu epidemic.  And, to me at least, it makes great sense today.

Outdoor settings appear to be vastly safer than indoor settings for transmission of COVID-19.  Any in-person schooling should therefore take place outdoors, to the greatest extent possible.  But if you can’t admit that aerosol transmission is real, you can’t give that advice to the US public.  And that’s a pity.

Post #767: Aerosol transmission of COVID-19

Source:  Japan ministry of health.  Note that the #1 item is about enclosed spaces with poor ventilation.

There’s an article in today’s New York Times that is is a must-read on the subject of aerosol (airborne) transmission of COVID-19.

It has more-or-less everything you’d need to  know on this subject in one place, including a brief summary of the extent to which various masks offer protection against airborne virus.  (They all work some, some work better than others.) Continue reading Post #767: Aerosol transmission of COVID-19

Post #766: Hygiene theater.

Source:  Washington Post.

I rarely ditto a news article, but this one, in the Atlantic, is well worth the read.  Cleaning/disinfecting surfaces, as a way to reduce COVID-19 transmission, is more-or-less a total waste of time.  Hospitals and other health care institutions need to do that.  Nobody else does.

This is one of those issues where a) the CDC flip-flopped its guidance, b) a lot of unhelpful and unrealistic research was published, and c) when the CDC flip-flopped its position, it worded things so vaguely that it took experts to figure out what the heck they were saying.

Its yet another example of a garbled message from the CDC.  Garbled and weasel-worded to the point where nobody outside of a few experts really understood what the CDC was trying to say.

I mentioned this in passing, back in Post #724 (6/20/2020), in the section titled:

Fomites are no longer considered a major threat

Fomites being inanimate objects that might have little droplets of infectious matter on them.

That change in CDC guidance is now more than a month old.  But it appears to have been almost completely ignored.  The gist of it is that you are extremely unlikely to catch COVID-19 by touching inanimate objects. It’s possible, but apparently it’s hugely unlikely in a community (non-hospital) setting.

Just how unlikely?  A scientist quoted in the Atlantic article said, emphasis mine:

“In the entire peer-reviewed COVID-19 literature, I’ve found maybe one truly plausible report, in Singapore, of fomite transmission. And even there, it is not a slam-dunk case. ”

Source:  Donald Schaffner, a food-microbiology professor who studies disease contamination at Rutgers University.   From The Atlantic.

The Atlantic article fills in a lot of the details, including an explanation from a qualified scientist as to why the original research on “how long the virus can remain on a surface” was misleading.  Among other things, some of that research used virus concentrations that were 100 times stronger than would ever occur in real life.  As they put it, you’d have to have 100 infected people line up and sneeze on the same door handle to achieve the virus concentrations used in the research.

To see why this garbled guidance matters, just consider what’s going to happen when schools re-open.  That’s laid out in the Atlantic article cited above.  Consider the effort and expense wasted on cleaning that could be spent on something more meaningful, such as providing teachers with high-quality masks.

Yes, you should still wash your hands.  It costs you nothing to do that.  And there is some very slight chance that you could pick up COVID-19 by touching something in a community (non-hospital) setting.  But the bottom line is that businesses and governments are wasting a lot of time and money on cleaning.  And it’s all for show.  It’s hygiene theater.

Post #765: That was not a one-day spike in Virginia COVID-19 cases

The seven-day moving average for Virginia is up to 1100 new COVID-19 cases per day.  Fairfax County is up to about 80 a day.  The big “spike” reported yesterday was an artifact of data reporting, as noted on the Virginia Department of Health website.

Below, blue = Virginia, Orange = Fairfax County

*

Below:  Blue = NoVa + Richmond + Accomack, Orange = rest-of-state.  As above, yesterday’s spike is an artifact of data reporting.

Town of Vienna ZIP codes.  We seem to be adding about one new case a day in ZIP 22180.