Category: COVID through 2022

Redder = worse.  Source:  Analysis of counts of daily new cases, as maintained by the New York Times.

This is a state-level graph of my “misery index”.  One part is the number of new COVID-19 cases in the last week, per capital, annualized.  The second part is the change in that figure, from two weeks back to the current week.  (So that a state with a high and growing infection rate will appear worse off than a state with a high and stable infection rate).

The underlying data for 7/3/2020 are given below.  FWIW, Arizona now is at more-or-less the same level of new case growth per capita that New York was, at the height of the prior US coronavirus peak.

Virginia is colored green in the table below.  The reason for the increase in the Virginia “misery index” is that, four weeks ago, we had a low number of new cases, but that number had been falling.  Now we have roughly the same weekly count of new cases, but the number is stable.

 

You’ve probably seen news coverage of the Henry Ford Hospital study.  They showed that if you gave people hydroxychloroquine early in their COVID-19 hospitalization, it materially reduced the death rate.  This is apparently a different study, but similar to, the one that I referenced in Post #701.  This one provided hydroxychloroquine early in the admission.   The other combined it with zinc sulfate.  And these studies appear to contradict some earlier studies showing no benefits from hydroxychloroquine.

If you want a brief summary of all the reasons that hydroxychloroquine was a good candidate for a drug for treatment of COVID-19, see Post #701.  I won’t repeat all that here, except to say that it has nothing to do with the President. Continue reading Post #742: I guess I should comment on hydroxychloroquine

Source:  US Centers for Disease Control.

I keep trying to write a science-based post on flu vaccine and vaccines for other viral illnesses.  So far, the more I learn, the less I know.  More-or-less everything I thought I knew about flu, and flu vaccine, and vaccine effectiveness, was wrong.  And you can take it from there.

So I’m going to start just by putting out a few factoids, in separate posts.  Just stuff that I stumbled across, in the course of this.

To recap, a lot of people seem to look at flu vaccine as the model for a COVID-19 vaccine.  So I am too.  But I’ll tell you up front, I don’t think there’s any particularly sound basis for thinking that flu vaccine is a good model.  A model, sure, but no guarantee it’s a good model.

First, the economics are completely different.  We’ve seen a lot of commentary about the long time it will take to produce a COVID-19 vaccine.  All of that was based on the production of other vaccines.  And, in my opinion, all of that was dead wrong.  Production of a COVID-19 vaccine is in no way analogous to prior situations, as I outlined in Post #698  .  The UK is still on track to have AstraZeneca deliver the first doses of the Oxford vaccine in September 2020.  As in, two months from now.  And the US has bought into a big share of the first billion doses of that vaccine.

Second, the vaccine itself is completely different.  The seasonal flu vaccine consists of an injection of the actual flu virus itself, either dead or weakened.  By contrast, the leading COVID-19 vaccine candidate (the Oxford/Astrazeneca vaccine), is a different live virus, genetically modified to express one of the key surface proteins of the COVID-19 virus.  (So, presumably, antibodies to that protein will then flag COVID-19, if you are infected.)

Different production techniques, different approach, but presumably some similarity in method of action.

But in any case, I learned so many new facts that I thought I would share.  So here are the highlights of two of them:

Asymptomatic flu infections are common.

Flu vaccine is only modestly effective even when the CDC correctly predicts which flu strains will be prevalent in flu season. Continue reading Post #741: Flu vaccine, other viral vaccines, first two factoids

Source:  Wikipedia.

Stores such as 7-11s are an endoscope into the soul of the common man.  Name a little vice, or a venial sin, and they’ve got it covered.  At an affordable price.

Nicotine fit?  Pack of Marlboros is calling you from just behind the counter.  How ’bout a Slim Jim and a six of Bud to go with that?  Feeling lucky?  Scratchers and Lotto will handle that itch.  After a sugar rush?  Try the Slurpees.  Or maybe a doughnut, or some potato chips, if you’re jonesing for some carbs.  Plus coffee for the caffeine addicts.

And for that special alcoholic in your life, What’s the word, Thunderbird?  A wine with a taste described as ” … goes especially well with being face-down in the gutter.”

Condoms?  They’ve got you covered, and they’ll deliver.

But no porn.  Not since 1986.

There’s a point to this.  In every convenience store, there’s a special sin area.  It’s always behind the counter, line-of-sight for adult patrons standing at the register,  showcasing the goods for the client in need.  You’ve got your Trojans, your Zig-Zags.  The stuff that’s not illegal, but not exactly fit for high society either.  The stuff that, say, a teenage boy of good upbringing might want, but might not want to ask out loud where it’s kept.

And now, you’ve got your KN95s.  Those seductive little masks that the Government says you should leave alone.  Cloth masks are good enough for you, Citizen.  That’s what our Federal government tells you.  And you comply.  Yet you secretly lust for a real mask anyway, don’t you?  Sometimes a person needs a little, eh, protection, am I right?

Anyway, I happened to find myself in a local convenience store this afternoon.  (None of your business).  And as I was casually eyeballing the sin area (again, none of your business), lo and behold, along with the rubbers and the rolling papers, there was a discreet blue box of KN95 masks.  No price listed, but clearly for sale.  Guess if you really want one, you’ll ask.

Putting the KN95s next to the Trojans seems logical to me.  Same line of business, different orifice.  At least in terms of preventing the spread of disease.  Buying “protection” just takes on a different meaning.

In any case, I was heartened to see that KN95s are going that mainstream, despite the best efforts of the Federal government to ignore them and to ignore our changed situation.  I see a lot of people wearing what look like KN95s these days.  If you have an N95 or KN95, wear it when you’re in an enclosed public space.  It’s the best thing you can do for yourself and for your neighbors.

Don’t know where to buy one?  Maybe a little ashamed to order from some sleazy Ebay seller?  Just ask the clerk at your local convenience store.  They’ll set you up.

Keep one on hand, just in case.  Don’t think they’ll fit in your wallet, though.

Source:  Farm and Fleet.com

In the prior post, I noted that Virginia daily new cases were beginning to rise outside of the NoVA/Richmond/Accomack County area.  That’s the orange line above.  In fact, if not for declines in a Richmond suburban county (Chesterfield County), the increases for the orange line (everything outside of NoVA+) would be substantially higher.

I then started to drill down into the data, and soon realized that this is almost entirely due to a modest uptick in the Hampton Roads area.  (Plus a handful of other places that I think are due to unique circumstances).

The top six localities contributing to the uptick, five (in order) were:

• Chesapeake, VA
• Portsmouth, VA
• Virginia Beach, VA
• Norfolk, VA
• Hampton, VA

(The sixth was Botetourt County, which has a unique and unrelated set of problems.)

And the cause of this?  I found this news reporting, saying (emphasis mine):

The increases in Hampton Roads coincide with large increases in the number of people under the age of 30 contracting the virus, with some localities nearly doubling their percent of cases under 30 in June compared to before June, the Virginia Public Access Project reported Tuesday. 

As discussed in an earlier post, individuals under 30 are the primary drivers of the current outbreaks in Florida, Texas, and Arizona.  So this appears to be our own little piece of that, in much milder form.

It’s not clear that this can or cannot be blamed on bars.  At present, bars are open for indoor service at half-capacity.  At least, that’s the theory.  Possibly, with other restrictions.  Anyway, barring any other evidence, it suggests that socializing by young adults is the likely cause for the uptick in the Virginia numbers outside of NoVA+.

The graph above shows new COVID-19 cases per day, for the past 28 days, for Virginia (blue) and Fairfax County (orange).  This is updated to today (7/2/2020).

Whatever we’re doing in Fairfax County, let’s keep doing it.  New case counts for the past three days were 10, 14, and 22.  This is updated to yesterday, 7/1/2020.

But while Virginia as a whole has a stable case count, new cases are rising slightly outside of the NoVA/Richmond areas.  Those slight increases are being offset by further declines in new cases in NoVA (plus Richmond City and Accomack County).

It would be a stretch (i.e., it would be wrong) to try to attribute that slight increase to Phase II re-opening.  That began on 6/5/2020 in the areas outside of NoVA/Richmond/Accomack, and began one week later in NoVA+.  We all went to Phase III yesterday (7/1/2020).

That said, we’d certainly like to know why NoVA+ continues to make progress, but the rest of the state does not.

Vienna (ZIP 22180) is adding maybe a couple of cases per week at present.  Consistent with the low daily new case count in Fairfax County.  This is updated to yesterday 87/1/2020.

This bar can remain open.  Source: Clipart-library.com

Yesterday, the Governor decided that Virginia bars will remain closed during the initial part of Phase III of re-opening.  The law isn’t a blanket ban — some types of indoor bar areas remain open.  Just not those that could lead to the sort of mob scenes we’ve seen in other states.  Thus demonstrating, once again, that our state government seems to have pretty good sense.

This is, of course, in response to the spike in cases in FL, TX, AZ and to a lesser degree CA and other states.  The new cases have skewed heavily toward young adults, and the presumption is that socializing in bars is driving a lot of that.

I’m not quite sure how much direct evidence there is, that bars are the issue.  But beyond the younger age, there’s certainly a lot of circumstantial evidence.  Start from a short list of what you are NOT supposed to be doing (Japan’s Three Cs) …

Source: Japanese Ministry of Health, Labor, and Welfare.

… and then realize, that’s pretty much what bars are for.

Add in a lack of masks.  And toss with the fact that drinking liquids triples the production of droplets while talking, and that drinking sweet liquids vastly increases production of aerosols (droplets under 5 microns) while talking (see Post #723).  And it’s the aerosols that have been implicated in various “superspreader” events.  Leading to my conclusion that the fourth C should be “cocktails”.

Four Cs to avoid:  Closed spaces, crowded places, close-contact settings, and cocktails.  In short, avoid bars.

This should be contrasted with the massive spread of infection that so far as not occurred as a result of outdoor Black Lives Matter protest.  Those certainly had two of the three C’s, but so far I have read of only a handful of instances of COVID-19 being spread during those protests.  Thus validating epidemiology from both Japan and China suggesting that outdoor transmission of COVID-19 is rare.  (Though, to be clear, it’s definitely possible.)

But here’s the weird part.  After the fact, when all the young adults started showing up in the case counts, sure, now everybody knows that bars are a problem.  But, in fact, when states first published their re-opening strategies weeks to months ago, the one constant amidst all the variation is that they all hated bars.  In virtually every state, bars were among the very last places allowed to re-open.  Here’s Post #684, from almost two months ago:

Everybody hates bars, and I can’t quite figure out why.  Even the states that are opening up some limited forms of sit-down dining are still keeping bars shut.  It was just a strange point of consensus, given the variations that states adopted.

At the time the individual states were writing their guideline,s it was pretty well established that outdoor spaces were safer than indoor.  But there was nothing that I read that established bars as a major hazard.  There were only a handful of anecdotes.

In some sense, then, it’s merely a stroke of luck that bars were last on the list, and got treated the worst.  Else we’d already have opened them up fully here in Virginia.  And we might be going the way of Arizona.

But keeping them closed, now?  Luck has nothing to do with it.  That’s a result of having reasonably good state government.  And let’s thank the Governor for that.

Addendum:  You might reasonably ask, why not re-open bars and strictly enforce social distancing and mask wearing.  (Or, at least, I’ve been asking myself that.)  And I think the reasons for not doing that are largely practical.

First, in Virginia, enforcement of the state mask ordinance is via public health departments.  So, in theory, if there were enough public health officials around to cruse all the bars in Virginia, you might be able to have a strategy of shutting down those that did not comply.

But my guess is, there aren’t nearly enough public health department employees.  So I don’t think that enforcement via public health departments — as is written into the Virginia mask order — could deal with any widespread flouting of the law.

And then, think about the situation if you try to enforce this via the police. This, being mask wearing and social distancing in bars.  You’d be asking cops to break up large crowds of masked, drunken young people.  On a routine and ongoing basis.  If I were a cop, I wouldn’t want to be tasked with that.  And it’s not clear that we have enough cops even to be able to do that.  Particularly when the violation (masks use and social distancing) is kind of subjective in the first place.

In short, I think this is another case of mob rule.  Arguably, localities don’t have the on-the-ground ability to enforce COVID-19 rules in all the bars in Virginia.  And so, given the choice between letting the mob decide, and keeping  the bars shut so that mob can’t form, I think the Governor has taken the smarter option.

 

Source:  Florida Department of Highway Safety and Motor Vehicles.

Well, that’s a fairly important question, isn’t it?  Will we end up suffering for other states’ lack of ability to control COVID-19.  Will our slow and relatively cautious re-opening strategy — complete with mask mandate — all be for naught, given the craziness that was allowed to occur in (say) Florida and elsewhere?

I went looking for even a shred of data to support an answer one way or the other, and I seem to have failed.  All I can say, for sure, based on the above, is that it doesn’t appear to have happened yet.

Above:  Daily new cases in Virginia (blue) and Fairfax County (orange) reported through today, 6/30/2020.

But I came across a few things that I had not realized before.  Continue reading Post #736: Border patrol: Will there be spillovers from out-of-control states to others?

Count of daily new COVID-19 cases in Virginia, reported through 6/29/2020.

Source:  Analysis of new case counts from the Virginia Department of Health.

I keep reading popular press accounts that place Virginia among the states where new cases are increasing.  I think those writers must be looking at the day-to-day random variations, or something, then cherry-picking the days when the case counts are up.

And so, the only point of this posting is to say that if you’ve read the count of daily new cases is up in Virginia, you’ve read something misleading.  It’s just not so.  Not so far, anyway.

You do have to wonder whether there will be spillover to Virginia, from the states where cases are currently spiking.  I went looking for information on typical inter-state travel patterns — to try to guess how many people from FL, TX, and AZ were likely to visit Virginia on any given day — but failed.

So, as with so much of this pandemic, all we can do is wait and see.  We’ll get there when we get there.