COVID IS SPREADING

     "We're in a national emergency. We need to act like we're in a national emergency."

              President Joe Biden

COVID is America's leading cause of death. New mutations have formed.

Happy days aren't here again. Not yet, anyway.

The inauguration brought a sigh of relief to a great many Americans. News stories are filled with metaphors of change. We hear of turning a page, a fresh start, and a brand new day. And the vaccines are at hand, and news stories  are about distribution. 

One thing hasn't changed. COVID is still here, and new mutations have formed. More people are now dying from COVID than any other cause, outpacing all the big ones: Cancer, heart disease, and strokes. COVID is understood primarily to kill elderly people, but even adults as young as 45 are more likely to die from COVID-19 than anything else.

I am going to let Richard Holmes tell the story. Richard Holmes is a college classmate who has spent forty years advising and managing military and civilian healthcare. He has Masters Degrees in Management and Health Management, and then a Ph.D in Management and Health Policy. He is an expert on COVID and he prepares written updates on the disease. I have repurposed his most recent long and detailed update with excerpts below as a Guest Post. I include a photo of him having finished a marathon. He has run 770 of them, including seven in every state.

This update was from Inauguration Day, January 20, 2021

COVID UPDATE: Guest Post by Richard Holmes

 

Coronavirus Variants. New mutations of the virus dominate projections, while they were not even mentioned just 50 days ago. The most widespread, usually called the United Kingdom (UK) variant, is the dominant strain now in the United Kingdom and has been identified in 60 countries and 20 U.S. states, and is projected to be the dominant strain by March in the USA. Its biggest impact is that it is 70% more infectious than the original strains. This variant is not more lethal than the original strains.

Richard Holmes

The South African mutation has been identified to have spread to dominate both South Africa and Zambia, and has also been found so far in 13 other countries including Australia, South Korea, and numerous European countries. While not more infectious, it is more alarming in that its mutated shape is likely less targeted by existing vaccines, with perhaps a 50% reduction in protection from vaccination. It has also caused increasing new reinfections in previously recovered COVID victims. 

Two new strains have been identified as emerging from the Brazilian Amazon. These strains had been identified in Japan and the United Kingdom, and early data suggests they are both more infectious like the UK strain, and can cause repeat infections like the South African strain. 

In the last week, a new strain has been reported in California, accounting for as much as one-third of cases at some southern California hospitals. It is too recent for evaluation of its relative rates of infection, mortality, or susceptibility to the vaccines.  

Current Status. The United States remains the overwhelming driver of the pandemic. It has suffered more total cases than the next three most infected countries combined (India, Brazil, and Russia) despite having only one-fifth of their combined population. It continued yesterday to have more new daily cases than the next five most currently infected countries combined. The U.S. implemented mandatory testing controls on inbound air passengers yesterday, while world health likely would be better helped by mandatory testing controls on outbound American passengers.  COVID-19 continues to be the leading cause of death in the United States, and has now lowered U.S. life expectancy by more than one year.

Florida Data-Suppression. The purposeful suppression of data on Florida cases and deaths gained greater emphasis in the last 50 days as the insider who had been publishing the actual data was arrested, and all of her electronics confiscated. This will permit tracing and extinguishing those local health department sources who had been providing actual statistics to be revealed.

 Testing. In the vast majority of states the undercounting is due to under-testing, as shown in the positivity rates described below.

Half of the US states (and the District of Columbia) are performing enough tests to detect the magnitude of cases, which requires positivity rates below 10%. Only three states have positivity rates below the 3% that is required to control pandemic spread through testing and tracing: Vermont, Hawaii, and Connecticut. Sixteen states have positivity rates between 10% and 20%. Five are between 20% and 30%: Kansas, Kentucky, Mississippi, South Dakota, and Utah. Three are between 30% and 40%: Alabama, Iowa, and Pennsylvania. Idaho and Puerto Rico have over 40% positivity rates. 

The high positivity rates are from the combined effects of widespread infections and under-testing. Harvard and the Brown University School of Public Health estimate 4 million tests per day are required in the USA to measure spread and trace contacts to control the pandemic. Yesterday, 2.02 million tests were conducted or just over half the amount needed.  

The China approach. China, with only one death in the last 242 days, reacted to an outbreak last week of 162 cases in Shijiazhuang, a city about half again as big as New York City, by locking down and testing the entire city, and building in six days a massive quarantine apartment building where each person isolated has a separate apartment with normal furnishings, TV and internet, and to whom meals are delivered three times daily. 

Vaccine distribution problems. Industrialized western countries are generally counting on vaccines currently being produced by Pfizer/BioNTech, Moderna, and AstraZeneca, all of which have approvals in multiple countries, and a Johnson & Johnson vaccine nearing the end of Phase III trials. However, demand far outstrips supply, and several additional problems plague rollout. In the U.S., the outgoing Trump administration was opaque about how much vaccine was being produced, stored, or could be made available, so the incoming Biden administration could not develop timelines or detailed plans for what will certainly become a massive federal effort to get vaccines out to the states. Further aggravating U.S. plans is that after the Trump administration promised hefty new shipments from what turned out to be a nonexistent reserve of the vaccines, many states expanded eligibility to younger age groups and then saturated the appointment slots with less vulnerable people before discovering that the states would receive little or none of the regular shipments previously expected.

Looking ahead. If Americans can be convinced to wear masks, hundreds of thousands of infections and tens of thousands of lives can be saved in the months to come, but disinformation is widespread and believed, and a major portion of the population have confused saving lives by wearing masks with unpatriotic behavior. It is reasonable to expect that Americans must still wear masks into the holiday season of 2021.

Just in. As of 5:23 a.m. today, January 23, Richard Holmes sent this: 

Of course this status was as of inauguration day, and things do not stand still. For example, most recently cited infection rates of the UK variant is double (100% more) as infectious than the wild (original) variant. The South African variant was reported yesterday for the first time in the Western Hemisphere, with a confirmed case in Panama in a sample taken on January 5th. The patient had reached Panama via Europe. It is likely that variant is also in the US, but our genomic testing is so backlogged and minimal that we haven’t yet observed it in a case.