COVID COVID-19 Coronavirus Containment Efforts

[nsaspook]

From Friday's paper:

https://www.inquirer.com/health/cor...-tracing-masks-small-gatherings-20201113.html

But now:

https://www.inquirer.com/health/cor...ng-hospital-news-20201116.html#card-996471612

Restrictions on private indoor gatherings are largely meaningless because as far as I can tell there is no way to enforce such things (but I'll let you know if I'm wrong about that...I'm dating someone who lives in Philly and that would complicate things...). But closing schools and forcing businesses to close is something the government can easily do, so they are doing it.

In Oregon at least it seems they just have no idea where people are getting infected so the only effective method is a shotgun approach to control because is works but the cost is horrendous vs targeted restrictions.

https://apkmetro.com/as-covid-19-surges-the-big-unknown-is-where-people-are-getting-infected/

Western nations face an enormous problem in combating the Covid-19 pandemic: Ten months into the well being disaster, they nonetheless know little about where people are catching the virus.

The issue is turning into extra acute as new cases are breaking records within the U.S. and Europe and strain grows on authorities to impose focused restrictions on locations which are spreading the virus, somewhat than broad confinement measures which are wreaking havoc on the economic system.
...
With no good understanding of the settings through which the virus is probably to be transmitted, a number of European countries have been forced to reintroduce indiscriminate lockdowns this autumn.

France, Germany, the United Kingdom. and different nations in latest weeks once more shut all eating places and bars, cinemas, theaters and in some situations nonessential outlets to stop well being techniques from collapsing beneath a flood of sufferers. U.S. states from New York to Utah additionally imposed new restrictions as each day new infections within the U.S. are hitting data.

Plenty of places that are high risk are still open but they are deemed essential like grocery stores or at least in Oregon, hair & massage parlors and tattoo shops while gyms are closed without much actual science of spreading the virus with current protections.

https://www.kptv.com/gyms-martial-art-schools-concerned-about-surviving-new-covid-19-restrictions/video_4c529f23-2014-51ec-a0ff-ba1d36428083.html
https://www.kgw.com/article/news/he...gain/283-4f6eb673-785e-4c29-9685-505f125bd254

https://www.bbc.com/news/newsbeat-54540188

Prof Ball says a lot of that risk can be dramatically lowered through things like effective air-conditioning, regular cleaning, social distancing and hand sanitising.
"From the data that I've seen from Public Health England, I'm not aware that there is a significant hotspot for infections in the gym environment.
"We know where the major risks are but after that we know there are other activities where people mix and where people mix, there is a chance of transmission occurring."

 

[Vanadium 50]

@Vanadium 50: Looking back at your earlier comment, would you agree that the system in El Paso is overwhelmed? If not, how much worse does it need to get?

Hmmm...wasn't flagged.

El Paso has 1120 present hospitalizations out of 6894 total. In April they had 1001 hospital beds with a surge capacity of 200. So you can see the problem.

However, if they had the nationwide average number of beds per capita, they would have 2200. I would argue (and have argued upthread) that this is a problem with under-hospitalization in general and is only exposed by Covid.

One other peculiar thing is that the deaths per hospitalization is about half of the national average. I do not understand that. It does match the late summer peak in hospitalizations (in Texas), again half the national average. This is consistent with admissions of people who are less sick on average, but it certainly doesn't prove it.

 

[nsaspook]

https://www.nature.com/articles/s41586-020-2923-3

We use data from SafeGraph, a company that aggregates anonymized location data from mobile applications, to study mobility patterns from March 1–May 2, 2020.

https://apnews.com/article/public-h...rus-pandemic-b984084e57c55b4ddc55fc420e757a46

This week, researchers from Stanford and Northwestern universities touted the benefits of occupancy caps after they used cellphone tracking of 98 million people to report that most infections happened at “super-spreader” sites including restaurants and fitness centers, because patrons are close together for longer periods.

Several San Francisco Bay Area counties decided to follow the city of San Francisco and banned indoor dining even though their case levels allow them to keep them open under the state’s rules.

Marin County’s health officer, Dr. Matt Willis, said restaurants have been the source of super-spreader events because families tend to linger and they can’t keep masks on while eating.

But not even all public health officials in the Bay Area see things similarly. Solano County public health officer Dr. Bela Matyas said the vast majority of cases have been traced back to casual gatherings.

“We’ve had no clusters we can attribute to restaurants, to gyms, to retail shopping, to any of those facilities,” Matyas said. “Because they have licensure on the line, they do a good job of enforcing social distancing.”

The study seems to be very much a rear-view mirror approach. They used data from March and May to say restaurants and fitness centers are “super-spreader” sites NOW? Hopefully updated data will show new insights as to how to approach this all in the coming months...

The world has changed since the spring. There is very little evidence today that restaurants and fitness centers are spreaders because they have been models of prevention under direct threat of government closure during the reopening phase unlike the packed pot shops and Baskin-Robbins near here.

https://www.statnews.com/2020/11/10...-sites-occupancy-limits-could-control-spread/

Analyzing what happened in the spring limits its applicability to the fall, said Adalja, who is also an infectious disease physician. There are many more mitigation measures in place now in public places, from face coverings to temperature checks to occupancy limits. “If you went to a restaurant in early March, it’s a very different experience than going to a restaurant in early November.”

There are also limits to what mobility data can tell us now, he said.

“We’ve seen in the epidemiology that now it’s not restaurants or even large gatherings that are driving spread, but small gatherings,” he said, although the summer surge in Sun Belt states was partly driven by people crowding into bars. Heading into winter, spread has happened more in people’s homes than in public places. That means “people wouldn’t be captured by mobility data because they’re at home, right there in their neighborhood.”

 

[mfb]

BioNTech/Pfizer have data for the full study now. 95% effective and safe, final analysis shows
170 cases, 162 in the placebo group, 8 in the equally sized vaccine group. Out of these 10 cases were severe, 9 in the placebo group one in the vaccine group.

We can expect more details "within days" - that will be the information necessary to get official approval in the US and the EU and probably elsewhere as well.

No serious side effects, 2% report headaches and fatigue, which is really nice.
The 95% number is based on infections at least a week after the second dose, but they also see an effect from the first dose alone.

We could see first vaccinations in December already, but wider distribution will only happen over the course of 2021. We'll need more than just two companies to get most people vaccinated.

 

[vela]

The study seems to be very much a rear-view mirror approach. They used data from March and May to say restaurants and fitness centers are “super-spreader” sites NOW? Hopefully updated data will show new insights as to how to approach this all in the coming months...

All studies only give you a backward looking view as you have to collect data before you can draw conclusions. The data from March and May suggest that restaurants and fitness centers can be super-spreader sites. The data doesn't say that these establishments now with some safeguards in place are still super-spreader sites, but they still could be if the measures taken are for some reason ineffective despite the owners' best intentions. The study did say that occupancy limits would likely cut down greatly on the spread that can occur.

The world has changed since the spring. There is very little evidence today that restaurants and fitness centers are spreaders because they have been models of prevention under direct threat of government closure during the reopening phase unlike the packed pot shops and Baskin-Robbins near here.

By the same token, is there good evidence today that they're in fact not still spreader sites despite the measures that have been put in place? We can make an educated guess based on what we've learned about how the virus spreads about the effectiveness any measures taken, to inform decisions on reopening these businesses, but this best guess still could turn out to be wrong.

Personally, I think businesses that have a good plan to deal with the virus should be allowed to operate and only closed if subsequent data show that the plan isn't working. The sledgehammer approach being used now in California seems to be based more on fear than reason and is only leading to frustration.

 

[Ygggdrasil]

BioNTech/Pfizer have data for the full study now. 95% effective and safe, final analysis shows
170 cases, 162 in the placebo group, 8 in the equally sized vaccine group. Out of these 10 cases were severe, 9 in the placebo group one in the vaccine group.

We can expect more details "within days" - that will be the information necessary to get official approval in the US and the EU and probably elsewhere as well.

Key information was not reported on that would be useful to know: 1) whether the vaccine just prevent symptomatic disease or whether it also prevents infection (which would halt transmission). 2) How effective is the disease at protecting older individuals (who often have weaker immune systems and usually don't respond as well to vaccination as other age groups).

No serious side effects, 2% report headaches and fatigue, which is really nice.

This figure is somewhat misleading and is not reported well in the news article you cite. The relevant statistic from Pfizer's press release is "Data demonstrate vaccine was well tolerated across all populations with over 43,000 participants enrolled; no serious safety concerns observed; the only Grade 3 adverse event greater than 2% in frequency was fatigue at 3.8% and headache at 2.0%."

Note that Grade 3 adverse events are defined as those that are severe or medically significant enough to require hospitalization or prevent normal daily activities but are not life-threatening.

So while severe fatigue and headache occur in ~4% and 2%, respectively, (non negligible rates given the vaccine will be administered to millions) these figures leave out reports of mild or moderate fatigue and headache. Based on the published results of the Phase I/II trial for BNT162b1 (not the exact version used for the Phase II/III trial, but very similar), ~100% of participants reported mild or moderate headache within 7 days of the second vaccination (vs 0% in placebo), and ~80-90% reported mild or moderate fatigue (vs ~ 10-20% in placebo) (based on a n=12, however, see Fig 3b from the paper linked above).

 

[nsaspook]

By the same token, is there good evidence today that they're in fact not still spreader sites despite the measures that have been put in place? We can make an educated guess based on what we've learned about how the virus spreads about the effectiveness any measures taken, to inform decisions on reopening these businesses, but this best guess still could turn out to be wrong.

Personally, I think businesses that have a good plan to deal with the virus should be allowed to operate and only closed if subsequent data show that the plan isn't working. The sledgehammer approach being used now in California seems to be based more on fear than reason and is only leading to frustration.

I agree completely. It's very hard to get local up to data data on where spread is happening.
https://www.washingtonpost.com/health/2020/11/12/covid-social-gatherings/

A record-breaking surge in U.S. coronavirus cases is being driven to a significant degree by casual occasions that may feel deceptively safe, officials and scientists warn — dinner parties, game nights, sleepovers and carpools.

Many earlier Coronavirus clusters were linked to nursing homes and crowded nightclubs. But public health officials nationwide say case investigations are increasingly leading them to small, private social gatherings. This behind-doors transmission trend reflects pandemic fatigue and widening social bubbles, experts say — and is particularly insidious because it is so difficult to police and likely to increase as temperatures drop and holidays approach.

https://www.clarkcountytoday.com/ne...ounty-small-private-gatherings-a-key-culprit/

Here’s the full list of sources of exposure for the 235 cases between Sept. 1-21 for whom there was data available:

• 41% – household member (97 cases)
• 20% – private social gathering, 1-10 ppl (48)
• 7% – health care setting (17)
• 5% – long-term care facility (12)
• 4% – office (10)
• 3% – manufacturing/warehouse (8)
• 3% – travel, out of state (8)
• 3% – private social gathering, 11-49 ppl (7)
• 3% – store – grocery (7)
• 2% – food establishment/restaurant (4)
• 2% – place of worship (4)
• 1% – public social gathering, 11-49 ppl (3)
• 1% – private social gathering, 50+ ppl (3)
• 1% – public social gathering, 50+ (2)
• <1% – public social gathering, 1-10 ppl (1)
• <1% – flight (1)
• <1% – store – general retail (1)
• <1% – preschool/childcare (1)
• <1% – travel, out of county (1)

https://www.oregon.gov/oha/PH/DISEA...nfections/Epidemic-Trends-and-Projections.pdf

Scenario Projections With the fitted model, we can explore outcomes under future scenarios. Predicting future trends in COVID-19 is extremely challenging. As illustrated in Figure 1, the estimated Re has fluctuated above and below 1 since reopening began in May. Indeed, the spread of this virus appears very sensitive to changes in how people are interacting with each other (e.g., wearing masks, physically distancing, being indoors with large groups). Unfortunately, we do not have measures of risk and protective behaviors over time, nor can we accurately predict them. Hence, we modeled two future scenarios with different assumptions about the Re value after November 6. 5 Figure 4 illustrates what could happen over the next month: • If Re were to be maintained at the estimated November 1 level (1.47): We would continue to see an exponential increase in new diagnosed cases. In a month, the projected number of new diagnosed cases would reach 500 per 100,000 people over a two week period. This rate translates to an average of 1,500 new diagnosed cases per day. • If behavior changes lowered the Re to the level of mid-October (0.91): New diagnosed cases would remain at historically high levels but would start decreasing again. These results highlight how the level of COVID activity depends strongly on the collective success of mitigation efforts in the coming months.

 

[bhobba]

One thing I have noticed, at least here in Aus, is first the total inability of bureaucrats to understand how contagious this thing is in the context of hotel quarantine, and way over the top desire for total lockdown when the first fails. The latest outbreak is just 37 at this stage, and was caused by a cleaner in the hotel moonlighting in a, get this, Pizza restaurant. It should be obvious you test all cleaners every day and they are to go straight home - no moonlighting - indeed after you get tested you are supposed to isolate anyway. It was in Adelaide, which is in the state of SA. So what they did is lockdown the whole of SA. There are only a few roads into Adelaide - why not just lockdown Adelaide. Beats me. Even then - why a total lockdown for 34 cases? I know the advice with this virus is to go early, hard and fast - but methinks - overkill.

Thanks
Bill

 

[PeroK]

One thing I have noticed, at least here in Aus, is first the total inability of bureaucrats to understand how contagious this thing is in the context of hotel quarantine, and way over the top desire for total lockdown when the first fails. The latest outbreak is just 37 at this stage, and was caused by a cleaner in the hotel moonlighting in a, get this, Pizza restaurant. It should be obvious you test all cleaners every day and they are to go straight home - no moonlighting - indeed after you get tested you are supposed to isolate anyway. It was in Adelaide, which is in the state of SA. So what they did is lockdown the whole of SA. There are only a few roads into Adelaide - why not just lockdown Adelaide. Beats me. Even then - why a total lockdown for 34 cases? I know the advice with this virus is to go early, hard and fast - but methinks - overkill.

Thanks
Bill

You can't have it both ways. You posted recently criticising the Australian government for allowing 800 deaths. Now, when the government comes down hard on any outbreak it's overkill. You have to decide which it is. You can't have a light touch on lockdown and no deaths. You can argue which is better, but you can't have both. Here's a thought for today:

The UK has twice as many deaths as Australia has confirmed cases.

 

[mfb]

Even then - why a total lockdown for 34 cases?

Because you don't want to wait until you have 300 cases. Or 3000. The earlier you take actions the fewer cases you get.

Key information was not reported on that would be useful to know: 1) whether the vaccine just prevent symptomatic disease or whether it also prevents infection (which would halt transmission). 2) How effective is the disease at protecting older individuals (who often have weaker immune systems and usually don't respond as well to vaccination as other age groups).

As far as I understand they don't have data on (1) because they didn't do regular COVID-19 tests. People only got tested if they felt sick (or if they were tested for other reasons - probably not enough to matter). For (2) they say in the press release that "Efficacy was consistent across age, gender, race and ethnicity demographics; observed efficacy in adults over 65 years of age was over 94%".

no serious safety concerns observed; the only Grade 3 adverse event greater than 2% in frequency was fatigue at 3.8% and headache at 2.0%."

Okay, that is worse than the news made it sound. I assume not many people go to a hospital because they feel tired or because of a headache, so we are probably looking at people who didn't go to work because of side effects.
Close to 100% mild side effects will scare some people, hopefully not too many.

I wonder how good the vaccine would be after the first dose. Toy scenario: You have N/5 doses for N people, do you get a larger benefit from giving two doses to N/10 people or one dose to N/5 people?
Sure, that's not what they want to get approved, so we'll never see this scenario, but nevertheless I think it's an interesting question.

 

[bhobba]

You can't have it both ways.

Fair enough. Overkill is better than it getting out of control. Anyway, the good news is it is working - no new cases today and the 37 cases included some suspected cases that have now been cleared - it is now only 22. Plus this particular strain has a short incubation period - usually less than 24 hours. And now it will not be allowed for those involved in hotel quarantine work to, in future, have second jobs while doing that work. And they will be tested weekly.

Thanks
Bill

 

[nsaspook]

https://www.nytimes.com/2020/11/17/health/coronavirus-immunity.html

How long might immunity to the Coronavirus last? Years, maybe even decades, according to a new study — the most hopeful answer yet to a question that has shadowed plans for widespread vaccination.
Eight months after infection, most people who have recovered still have enough immune cells to fend off the virus and prevent illness, the new data show. A slow rate of decline in the short term suggests, happily, that these cells may persist in the body for a very, very long time to come.
The research, published online, has not been peer-reviewed nor published in a scientific journal. But it is the most comprehensive and long-ranging study of immune memory to the Coronavirus to date.
“That amount of memory would likely prevent the vast majority of people from getting hospitalized disease, severe disease, for many years,” said Shane Crotty, a virologist at the La Jolla Institute of Immunology who co-led the new study.

https://www.biorxiv.org/content/10.1101/2020.11.15.383323v1.full.pdf

Notably, memory B cells specific for spike or RBD were detected in almost all COVID-19 cases,
with no apparent half-life at 5+ months post-infection. B cell memory to some other infections has been observed to be long-lived, including 60+ years after smallpox vaccination (58), or 90+ years after infection with influenza (59), another respiratory virus like SARS-CoV-2.

It looks like the only good news about the current infections rates is they are One and Done.

 

[BillTre]

I like the idea of a finer granularity to the way that anti-Covid actions are taken.
Especially for measures that are disruptive to economic functioning.
For this reason I would not favor a one size fits all global or national shutdown.

In my state, Oregon, these measures have sometimes been done county by county, such that the disruptions have their effects only where most needed. I am guessing that this will also lead to greater acceptance of the measures.
For example, there is a big difference between Covid rates in the Portland area (Oregon's largest city, in Multinoma and neighboring counties) and the southern coast, around Coos Bay (Coos and Curry counties), a low population density, relatively isolated area on the coast about 2 or 3 hundred miles form Portland.

I think that is what @bhobba was getting at.
However, granularity can have its drawbacks.
Too much fine granularity would lead to confusion about what one is supposed to do and its enforcement (if any).
There is a tradeoff there. Finding the proper balance it might not be easy.
Favoring more stringent measures would be favored from a health concern point of view.

The sledge hammer approach makes sense in some cases, such as where there is the less knowledge about what is going on.
If the new outbreak in Australia is a mutant Covid version that is more transmissible, more stringent measures may be appropriate.

Another factor to consider, as we get more experience dealing with Covid, the counter effects taken should evolve to be more effective and less economically intrusive.
However, recent history shows that such policy changes such can become fodder for poorly motivated politicians to rant on about, making preventive measures more contentious and damping their effect.

 

[Vanadium 50]

I like the idea of a finer granularity to the way that anti-Covid actions are taken.

I made this comment in the past - Copper Harbor Michigan and Detroit are as far apart as New York City and Nova Scotia. The problem is that political boundaries are not well matched to sensible sizes for measuring the severity of outbreaks (which seems to be larger than cities and smaller than states).

 

[Rive]

Already seven countries with 'mink' variant present

I _hope_ that it's not a big deal, but maybe it would be better to take this seriously.

 

[mfb]

Most of these "mink variants" seem to be no different than the others, we just know the virus was in minks in between.

North Dakota is racing towards 10% of the population as confirmed cases: 7% on Nov 6, 8% on Nov 12, 9% on Nov 18.
0.1% of its population has died from COVID-19, including David Andahl who won the election for the North Dakota Legislature after his death.
No sign of slow-down so far.

I found a bar chart of confirmed cases per US state (Nov 15) and removed the (political) original color:

 

[russ_watters]

North Dakota is racing towards 10% of the population as confirmed cases: 7% on Nov 6, 8% on Nov 12, 9% on Nov 18...
0.1% of its population has died from COVID-19...
I found a bar chart of confirmed cases per US state (Nov 15) and removed the (political) original color:

New Yorkers should be heartened to learn they were spared significant testing while the virus ravaged the state. North Dakotans should be dismayed that they missed the first wave. My county is lucky not to be a teeny tiny state (but larger than North Dakota), otherwise we might be listed here.

 

[Vanadium 50]

Interesting thing about North Dakota. They have the highest testing fraction in the country (one of four states where the number of tests exceeds the population at the 2010 census) at about twice the national average. People are getting sick, but the hospitalization per case and the deaths per case are both half the national average.

Clearly testing causes Covid.

 

[mfb]

With more tests we get a more realistic estimate how widely it is distributed.

but the hospitalization per case and the deaths per case are both half the national average.

Cases are 2.5 times the national average (currently at 3.5%), so overall North Dakota has above average hospitalizations and deaths per capita.

New Yorkers should be heartened to learn they were spared significant testing while the virus ravaged the state. North Dakotans should be dismayed that they missed the first wave.

Did I miss a particular reason to make fun of the situation?
North Dakota's deaths per capita are close to the value of New York already, and with the rapid rise they will probably exceed NY's rate soon.

 

[OmCheeto]

North Dakota's deaths per capita are close to the value of New York already, and with the rapid rise they will probably exceed NY's rate soon.

New Jersey is currently in the lead of deaths per capita, just slightly ahead of New York.
Plotted logarithmically, North Dakota should be #1 in the nation in about 2 weeks.

 

[Astronuc]

North Dakota population 762,062 (2019)

People tested = 331,169 PCR tests (on unique people); 11,378 antibody tests. Total PCR tests = 995,870, so some people are tested more than once. Perhaps one is tested daily while testing positive until one or two negative tests? https://covidtracking.com/data/#state-nd
https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases

 

[mfb]

Testing an infected person daily would be overkill. I assume it's done for some high profile people (or generally people who want to pay for it), but doing that for every random positive case would be a waste of resources.

Plotted logarithmically, North Dakota should be #1 in the nation in about 2 weeks.

Deaths in the next two weeks are largely from people already infected, so it's almost guaranteed to happen independent of what they might do in the future to slow the spread.

 

[OmCheeto]

Testing an infected person daily would be overkill. I assume it's done for some high profile people (or generally people who want to pay for it), but doing that for every random positive case would be a waste of resources.

My guess is the opposite, that they are testing non-infected, but high risk persons, frequently.According to UC Davis

Currently, COVID-19 tests are prioritized for the following groups:​

• Hospitalized and symptomatic individuals (or people about to be hospitalized for a procedure)
• Health care workers and people in group living facilities
• First responders and other social service employees
• People exposed to infected individuals in places where COVID-19 risk is high

Doh! I just found a post that agrees with you.

[edit: HCP stands for "Health Care Provider"]

Testing to determine when HCP with SARS-CoV-2 infection are no longer infectious
A test-based strategy, which requires serial tests and improvement in symptoms, could be considered to allow HCP with SARS-CoV-2 to return to work earlier than the symptom-based strategy. However, in most cases, the test-based strategy results in prolonged work exclusion of HCP who continue to shed detectable SARS-CoV-2 RNA but are no longer infectious. A test-based strategy could also be considered for some HCP (e.g., severely immunocompromised) in consultation with local infectious diseases experts if concerns exist for the HCP being infectious for more than 20 days. In all other circumstances, the symptom-based strategy should be used to determine when HCP may return to work.

ref: U.S. CDC

Makes sense to me.

 

[stefan r]

It was wise of the NZ government to constitute their country on an island (well, two major islands). The Federated States of Micronesia must have the best government in the world - zero cases.

New Jersey is effectively an island. All of the bridges already have toll booths where it would be simple to set up checkpoints. The entire east coast has a chain of barrier islands.

 

[mfb]

My guess is the opposite, that they are testing non-infected, but high risk persons, frequently.

That they do for sure. That's how they found the infections in the White House so quickly, for example.

New Jersey is effectively an island. All of the bridges already have toll booths where it would be simple to set up checkpoints. The entire east coast has a chain of barrier islands.

Can you imagine the consequences of closing all these bridges? Closing the land border north of NYC? How many commuters do you cut off?
Compare this to the number of commuters affected when you stop international flights to New Zealand.

 

[OmCheeto]

New Jersey is currently in the lead of deaths per capita, just slightly ahead of New York.
Plotted logarithmically, North Dakota should be #1 in the nation in about 2 weeks.

View attachment 272821

I've heard that people are suffering from "Covid fatigue".

Anyone heard of people suffering from Covid "Maths" fatigue?
Because, I think I've got it.

Although I understand why none of this makes sense, it still hurts my brain.

 

[DennisN]

Anyone heard of people suffering from Covid "Maths" fatigue?
Because, I think I've got it.

Yep. I got it during the first wave. I cured it by playing some computer games instead.

 

[bhobba]

I mentioned in the vaccine thread about a new nasal spray approach. It seems to have now gone further along the development cycle. A precis follows from an article in our local paper, unfortunately behind a paywall. Interestingly it seems to work against the common cold and flu as well - maybe even HIV.

'A nasal spray that not only stops COVID-19 but also prevents the common cold and influenza has been given government funding to start human trials. Developed by biotech company Ena Respiratory, the treatment works by stimulating the immune system's first line of defence against viruses and other germs. In September trials in ferrets showed it was 96 per cent effective at preventing the replication of the virus that causes COVID-19 in the nose, but has not been peer reviewed yet. The Australian Government has provided funding to continue research. Safety trials will begin in Sydney in December with efficacy trials beginning in March 2021. It is expected, if all goes well, to be on the market in 2022. People would be able to self-administer the spray several times a week to protect themselves from the virus. In recent years tests showed it could reduce and prevent all the major respiratory viruses including influenza, rhinovirus (which causes the common cold), Respiratory syncytial virus (RSV) and Coronavirus and may even work against HIV and the virus that causes cervical cancer. It is cheap to produce and works within 24 hours, much faster than a vaccine. It uses a synthetic molecule called INNA-051 discovered six years ago by Doherty Institute scientist Professor David Jackson.'

Interesting.

Thanks
Bill

 

[Astronuc]

I've heard that people are suffering from "Covid fatigue".

Anyone heard of people suffering from Covid "Maths" fatigue?
Because, I think I've got it.

View attachment 272896

Although I understand why none of this makes sense, it still hurts my brain.

I think in N Dakota, the virus has spread among older teens and 20-30 year olds. The mortality is high in the older populations of 60+

https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases
https://covid19.nj.gov/ - dashboard at bottom

One has to dig through the sites and dashboards

On a more personal level, family members, including the father, of a medical examiner and state senator in Wisconsin contracted the virus. The father, who already had dementia, died recently from COVID-19 complications.
https://www.nytimes.com/2020/11/20/us/wisconsin-coronavirus.html

 

[Ygggdrasil]

I mentioned in the vaccine thread about a new nasal spray approach. It seems to have now gone further along the development cycle. A precis follows from an article in our local paper, unfortunately behind a paywall. Interestingly it seems to work against the common cold and flu as well - maybe even HIV.

'A nasal spray that not only stops COVID-19 but also prevents the common cold and influenza has been given government funding to start human trials. Developed by biotech company Ena Respiratory, the treatment works by stimulating the immune system's first line of defence against viruses and other germs. In September trials in ferrets showed it was 96 per cent effective at preventing the replication of the virus that causes COVID-19 in the nose, but has not been peer reviewed yet. The Australian Government has provided funding to continue research. Safety trials will begin in Sydney in December with efficacy trials beginning in March 2021. It is expected, if all goes well, to be on the market in 2022. People would be able to self-administer the spray several times a week to protect themselves from the virus. In recent years tests showed it could reduce and prevent all the major respiratory viruses including influenza, rhinovirus (which causes the common cold), Respiratory syncytial virus (RSV) and Coronavirus and may even work against HIV and the virus that causes cervical cancer. It is cheap to produce and works within 24 hours, much faster than a vaccine. It uses a synthetic molecule called INNA-051 discovered six years ago by Doherty Institute scientist Professor David Jackson.'

I very much doubt that a nasal spray would protect against sexually transmitted diseases like HIV or HPV (unless you are doing something very strangely).

Here's a non-peer reviewed pre-print cited by the biotech company describing the treatment, which is based on a molecule that can activate the TLR2 receptor, involved in the innate immune system:

Prophylactic intranasal administration of a TLR2 agonist reduces upper respiratory tract viral shedding in a SARS-CoV-2 challenge ferret model
https://www.biorxiv.org/content/10.1101/2020.09.25.309914v1

Abstract:

Respiratory viruses such as coronaviruses represent major ongoing global threats, causing epidemics and pandemics with huge economic burden. Rapid spread of virus through populations poses an enormous challenge for outbreak control. Like all respiratory viruses, the most recent novel human Coronavirus SARS-CoV-2, initiates infection in the upper respiratory tract (URT). Infected individuals are often asymptomatic, yet highly infectious and readily transmit virus. A therapy that restricts initial replication in the URT has the potential to prevent progression of severe lower respiratory tract disease as well as limiting person-to-person transmission.

We show that prophylactic intra-nasal administration of the TLR2/6 agonist INNA-051 in a SARS-CoV-2 ferret infection model effectively reduces levels of viral RNA in the nose and throat. The results of our study support clinical development of a therapy based on prophylactic TLR2/6 innate immune activation in the URT to reduce SARS-CoV-2 transmission and provide protection against COVID-19.

I would worry about the prolonged effects of TLR2 stimulation if this were regularly used as a prophylactic throughout flu/coronavirus season. The major advantage of a vaccine over a prophylactic nasal spray would be that a vaccine would give lasting protection after 1-2 doses whereas the prophylactic nasal spray would likely have to be re-applied frequently to offer protection throughout the periods where the viruses are being transmitted.

 

[mfb]

The major advantage of a vaccine over a prophylactic nasal spray would be that a vaccine would give lasting protection after 1-2 doses whereas the prophylactic nasal spray would likely have to be re-applied frequently to offer protection throughout the periods where the viruses are being transmitted.

Might still be interesting if you need to go to a high risk area temporarily - or if you want to stop the spread of a new disease before it becomes a pandemic.

 

[Astronuc]

The number of virus-related deaths reported in the United States reached 2,216 — the equivalent of one death every 39 seconds, and the highest single-day death count since June 26. The figure has been climbing relentlessly, and health experts expect it to soon approach or exceed the single-day peak from early in the pandemic: 2,752 on April 15.

The number of cases is going up dramatically, and we may see over 200K new cases per day soon, but . . .

A far smaller proportion of people who catch the virus are dying from it than were in the spring

https://www.nytimes.com/live/2020/11/25/world/covid-19-coronavirus

 

[nsaspook]

The number of cases is going up dramatically, and we may see over 200K new cases per day soon, but . . .
https://www.nytimes.com/live/2020/11/25/world/covid-19-coronavirus

Is there a general consensus on what is driving the increasing numbers of cases even in locations with high conformance to control measures? Is the weather, virus mutations, or what?

 

[nsaspook]

Maybe this should be in 'weird' news.

https://www.theguardian.com/world/2020/nov/25/culled-mink-rise-from-the-dead-denmark-coronavirus

 

[Astronuc]

Is there a general consensus on what is driving the increasing numbers of cases even in locations with high conformance to control measures? Is the weather, virus mutations, or what?

I heard a couple of discussions that small group gatherings of people (and some larger gathers at bars or clubs or religions establishments) who relax indoors without masks are passing along the virus. I'm looking at two areas with comparable populations, one in NY state and the other in Washington state. The one in Washington state has twice the number of cases as the one in NY, and it appears to be related to the proportion of the population which decides not to observe precautions such as wearing masks and socially distancing. I have a colleague who has participated in gatherings without a mask, and he feels he's not at risk. Others he knows have had positive tests and not become seriously ill, and he's had to get tested at least one due to possible exposure. I am much more cautious, and I wear a mask in public, maintain distance to the extent possible and minimize my time around others outside of the home.

 

[mfb]

There is some confusion about the AstraZeneca/Oxford vaccine trial. Apparently some people got a lower first dose than planned (50%), and now the question is how to analyze that data.
Going by raw numbers a lower first dose seems to lead to a better protection - but that group has a younger average age, and it's unclear how that comparison would be once corrected for age.

https://www.theguardian.com/uk-news...ne-hit-90-success-rate-thanks-to-dosing-error
https://www.twincities.com/2020/11/25/astrazeneca-manufacturing-error-clouds-vaccine-study-results/

 

[mfb]

A strange victim of the pandemic: Scented candles. Since the beginning of the year Amazon reviews complaining about a lack of smell have gone up and average ratings have gone down. A lack of smell is a typical COVID-19 symptom.
Not a scientific study, but nevertheless an interesting data analysis.

 

[Office_Shredder]

The graph of reviews mentioning lack of smell by month seems pretty unconvincing to me.

I would guess the real problem is either a new customer base trying the candles, or a decrease in manufacturing quality because of supply chain issues.

The graph also suggests that maybe 3% additional customers complaining of lack of smell. If you think they went from a 5 to 1 star review, 4 stars * 3 percent of people is 0.12 stars, not a full star.

 

[mfb]

The graph of reviews mentioning lack of smell by month seems pretty unconvincing to me.

It is quite closely matching the trend of COVID-19 in the US. A first peak in April, and then another big peak in October/November.

I don't see how manufacturing problems could explain that (a lack of quantity doesn't lead to bad ratings), especially as unscented candles didn't drop that much in their rating.

The graph also suggests that maybe 3% additional customers complaining of lack of smell. If you think they went from a 5 to 1 star review, 4 stars * 3 percent of people is 0.12 stars, not a full star.

As discussed in the tweets, many reviews don't give a reason.

 

[Office_Shredder]

It is quite closely matching the trend of COVID-19 in the US. A first peak in April, and then another big peak in October/November.

What about the second peak in July that was bigger than the April one? And why are the cases per day supposed to be so b temporally correlated with lack of scent complaints, but the actual average review doesn't go up and down?

I don't see how manufacturing problems could explain that (a lack of quantity doesn't lead to bad ratings), especially as unscented candles didn't drop that much in their rating.
As discussed in the tweets, many reviews don't give a reason.

Manufacturing problems can result in your primary supply chain shutting down, so you go to a back up manufacturer whose stuff isn't as good.

 

[Keith_McClary]

A strange victim of the pandemic: Scented candles. Since the beginning of the year Amazon reviews complaining about a lack of smell have gone up and average ratings have gone down. A lack of smell is a typical COVID-19 symptom.
Not a scientific study, but nevertheless an interesting data analysis.

Moderately Confused by Jeff Stahler for November 27, 2020

 

[OmCheeto]

Although I knew about the anosmia, I never delved further into how long it lasted, nor thought about some serious implications:

Mysteries of COVID Smell Loss Finally Yield Some Answers
Explanations begin to arise at the molecular level for this vexing but commonplace symptom
By Stephani Sutherland on November 18, 2020
Scientific American

...
“The majority of patients lose smell like a light switch going off and recover it rapidly,” Datta says. “There’s a fraction of patients that have much more persistent anosmia and recover on longer time scales.”
...
“If the house were on fire, I wouldn’t know it. It’s very concerning.”
...
Carol Yan, a rhinologist at the University of California, San Diego, says that anosmia poses a real health risk. “It actually increases mortality. If you can’t smell and taste food, it can predispose you to harm, like rotten food or a gas leak,”

Smoke detector battery: √

 

[mfb]

What about the second peak in July that was bigger than the April one?

It was bigger by confirmed cases but clearly not by actual spread of the disease.
The average review is a long-term average, it went down continuously over 2020.

Manufacturing problems can result in your primary supply chain shutting down, so you go to a back up manufacturer whose stuff isn't as good.

Doesn't explain the difference between scented candles and unscented candles, and why everyone selling scented candles would suddenly have the same problem.

 

[Pythagorean]

A strange victim of the pandemic: Scented candles. Since the beginning of the year Amazon reviews complaining about a lack of smell have gone up and average ratings have gone down. A lack of smell is a typical COVID-19 symptom.
Not a scientific study, but nevertheless an interesting data analysis.

I wonder to what degree odor desensitization plays a role, due to wfh causing longer exposure time

 

[Ivan Seeking]

Is there a general consensus on what is driving the increasing numbers of cases even in locations with high conformance to control measures? Is the weather, virus mutations, or what?

Look at a map of infection rates by State. You tell me if you see a pattern. It isn't rocket science.
https://www.statista.com/statistics/1109004/coronavirus-covid19-cases-rate-us-americans-by-state/

Compare for example the infection rates in Idaho, North or South Dakota, to Washington, Oregon, or California.

 

[nsaspook]

Look at a map of infection rates by State. You tell me if you see a pattern. It isn't rocket science.
https://www.statista.com/statistics/1109004/coronavirus-covid19-cases-rate-us-americans-by-state/

Compare for example the infection rates in Idaho, North or South Dakota, to Washington, Oregon, or California.

My question was really about locations with high conformance to control measures like Washington, Oregon or California. For locations with low conformance to control measures it's not rocket science. Those people should be #2 on the list for emergency vaccination using the first doses because inoculation of the super-spreaders IMO will have the most bang for buck for reducing cases.

https://www.oregonlive.com/coronavi...1599-new-cases-and-9-deaths-are-reported.html

The Oregon Health Authority on Sunday announced a near-record 1,599 new positive or presumed positive Coronavirus cases as the state’s caseload remained high despite Gov. Kate Brown’s ongoing freeze.

https://projects.oregonlive.com/coronavirus/

 

[mfb]

New cases peaked earlier in November for many European countries, since then they have dropped again. New deaths begin to drop now.
Didn't check every single country, but that's the trend in Germany, France, the UK, Italy, Spain and Austria.

New restrictions contributed to that - we'll see how the situation evolves once they get loosened again. If it's linked to the outside temperatures then the winter will get ... interesting.

 

[PeroK]

New restrictions contributed to that - we'll see how the situation evolves once they get loosened again. If it's linked to the outside temperatures then the winter will get ... interesting.

We've also got Covidmas to get through!

 

[Astronuc]

The Coronavirus was present in the U.S. weeks earlier than scientists and public health officials previously thought, and before cases in China were publicly identified, according to a new government study published Monday. . . . "SARS-CoV-2 infections may have been present in the U.S. in December 2019, earlier than previously recognized," the authors said.

https://www.npr.org/sections/corona...eeks-earlier-than-previously-known-study-says

Researchers found Coronavirus antibodies in 39 samples from California, Oregon, and Washington as early as Dec. 13 to Dec. 16. They also discovered antibodies in 67 samples from Connecticut, Iowa, Massachusetts, Michigan, Rhode Island, and Wisconsin in early January — before widespread outbreaks in those states.

Despite the findings, widespread community transmission in the U.S. was unlikely until late February, the authors said.

 

[mfb]

Covid Pfizer vaccine approved for use next week in UK

Top [priority] are care home residents and staff, people over 80 and other health and social care workers.

800,000 doses arrive in the next days. That's enough for the first dose for a bit over 1% of the population. The 10 million doses that should arrive "soon" could cover the healthcare sector and probably more beyond that.