Every State’s Current Plan For Lifting The Lockdown can be found at: Here’s Every State’s Plan For Lifting The Lockdown
“Hopefully We Can Test Everyone Who Needs It by End of May, Start of June.” — Dr. Fauci
“America Works When America Is Working.” — Vice President Pence
62% of Georgia voters disapprove of Governor Kemp’s decision to ease restrictions on restaurants, theaters and close-contact businesses such as barbershops and nail salons over the past week.
An overwhelming majority of voters — about 80% — said they are worried a family member will be exposed, with 52% extremely or very worried.
- Recent Developments and Headlines
- Numbers and Trends
- Antibody Testing
- Potential Treatments
- New Scientific Findings
- New Concerns
- The Road Back?
- How Lethal Is It?
- Stories From The Frontline
- Projections and Our (Possible) Future
- Practical Tips
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A. Recent Developments and Headlines
Note: All changes noted in this Update are since the 4/28 Update
Sources: New York Times Coronavirus Updates, New York Post Coronavirus Updates, Zero Hedge Coronavirus Updates, Drudge, Breitbart, Wall Street Journal, Coronavirus White House Task Force Briefing, NY Governor Daily Briefing, and Worldometers
- Worldwide Total Cases = 3,136,508 (+2.4%) (+74,032)
- Worldwide New Cases (3 day avg) = 72,638 (-7.2%) (-5,585)
- US Total Cases = 1,035,765 (+2.5%) (+25,409)
- US New Cases (3 day average) = 25,038 (-12.0%) (-3,401)
- Worldwide deaths = 217,813 (+3.0%) (+6,364)
- US deaths = 59,226 (+4.4%) (+2,469)
- NY deaths = 23,114 (+2.2%) (+491)
- Global coronavirus restrictions loosening, allowing for some return to normalcy
- 14 states that are home to more than 95 million people have started reopening their economies or announced their reopening plans
- The facts on who’s most endangered show many of us can go back to work
- Survey reveals 80 percent of workers would not feel safe if their state reopened now
- Nearly 9 in 10 Americans worry economy will collapse
- Consumer Confidence Record Crash
- NY Gov. Andrew Cuomo: Nobody ‘Blew the Bugle’ on Wuhan Outbreak in January, Including Me
- ‘Quarantine fatigue’ continues for second week, showing a worrisome trend, researchers say
- Antibody tests are being rolled out across New York City
- Almost 25% Of New York City Residents Have Coronavirus Antibodies
- California Gov. Gavin Newsom says schools may restart in late July
- Trump says he’ll sign coronavirus liability executive order that helps meat producers
- “Corona-Killing” UV Bots Could Be Deployed At Military Bases
- Store Visits Spike As States Lift Lockdowns, Even As Millions Remain Unemployed
- US Intel Officials Believe 45,500 Corpses Were Incinerated In One Fortnight In Wuhan
- Iran sees another drop in deaths
- For 3rd time, Italy reports more recoveries than new cases in a day, but total cases top 200k
- Google CEO says return to the office won’t happen until June 1
- Russia sees record spike in coronavirus cases and deaths
- Russia extends lockdown until May 11 as Putin warns of ‘long and difficult path ahead’
- CDC models updated to reflect slightly more US deaths
- Florida reports drop in COVID-19 cases
- Spanish official apologizes for spraying beach with bleach
- Vilnius launches novel ‘outdoor cafe’ concept
- Portugal latest EU member to release plans to end lockdown
- Netherlands reports lowest single-day death toll in more than a month
- Surfers return to NZ beaches as the country officially reopens
- France won’t allow large gatherings until at least September
- Australia reopens Sydney’s Bondi Beach despite nearby ‘hotspot’
- NHS releases data showing COVID-19% could be 50% higher in England & Wales
- Indians reportedly resist reopening push over fears of viral spread
- Brazil emerging as new ‘hot spot’ as Bolsonaro continues to deny virus
- Pandemic Passports And The Danger Of Immuno-Discrimination
- “Money Is Running Out” – Vegas Struggles To Survive Shutdown
- Oklahoma Urges Trump To Declare COVID-19 An “Act Of God” To Help Oil Industry
- House Democrats Won’t Return To Washington Next Week After All; Senate Set To Reconvene Monday
- First Negative Oil Prices, Now Sicily Will Pay Tourists To Visit
- Amazon, Walgreens and CVS face heartburn drug shortage after coronavirus study revealed
- Senator Cotton: I Think Future Coronavirus Legislation Will Include Counteracting China
- Pelosi to Trump: Ice Cream in My Freezer Is Better Than ‘Lysol in Somebody’s Lungs’
- Lawsuit Demands China Pay $200 Billion to Nigeria in Coronavirus Damages
- Andrew Cuomo: One Person with Coronavirus in Nursing Home Like ‘Fire Through Dry Grass’
- Connecticut Gov. Ned Lamont: Social Distancing Part of ‘New Normal’
- Businesses Ask SCOTUS to Overrule PA Governor’s Stay-at-Home Order
- North Carolina Governor OKs NASCAR to Race at Charlotte
- Report: The Lakers, Net Worth $4.4 Billion, Were the Only NBA Team to Apply for PPP Loan
- CA Relaxed Directive Requiring Nursing Homes to Take Coronavirus Patients
- Woman Takes NYPD Car for Joyride Through Harlem, Gets Stuck in Traffic
- Venezuela: With No Ambulances or Taxis Available, Woman Gives Birth on Sidewalk
- Iran: Over 700 Die After Drinking Methanol as ‘Cure’ for Chinese Coronavirus
- Mexican Cartel Gunmen, Cops Paddle Coronavirus Lockdown Violators
- 101-Year-Old New York Woman Overcomes Cancer, Spanish Flu, Coronavirus
- Report: Russian Doctor Falls Out Window During Tense Coronavirus Argument
- Michael Moore: Coronavirus ‘Should Act as a Warning from Mother Nature’
- Virginia Meets Most Criteria Gov. Northam Needed for Phase One Reopening
- Judge: Ralph Northam Lacks Authority to Close Indoor Gun Range During Coronavirus Shutdown
- Mississippi Mayor Suspends Open Carry During Coronavirus Crisis
- Pope Francis Calls for ‘Obedience’ to State Lockdowns
- Ramadan: French Police Told to Lay Off Muslims
- Italy’s Ban on Public Worship ‘Unacceptable, Illegitimate, Unconstitutional’
- Paris No-Go Suburbs Breaking Lockdown Measures Three Times More Than Average
- Matteo Salvini Attacks Italian Prime Minister Conte: ‘It Is Time for Italy to Reopen’
- Easing lockdowns makes day-to-day choices more difficult
- CDC recommends social distancing for pets after some test positive for coronavirus
- USS Kidd Arrives in San Diego to Treat COVID-19 Outbreak; First Cases Emerged More than A Month After Hawaii Port Visit
- Amazon, Walmart, Target, FedEx and Instacart workers to hold ‘unprecedented strike’ on Friday over virus risk
- Nearly 70 dead in horrific outbreak in vererans’ home
- JetBlue, Delta seek U.S. OK to suspend flights to 25 U.S. airports
- US considering coronavirus testing on some international flights
- MLB discussing plan to start season in late June, playing in home stadiums with realigned league
- Coronavirus Widens Europe’s North-South Economic Divide
- Trouble in paradise: Spanish holiday island reels from coronavirus
- Video of mass coronavirus grave in Iran sparks higher death toll fears
- De Blasio blasts Jewish community for massive Brooklyn funeral
- Coronavirus battle is ‘recipe’ for disaster for health care workers
- House of Representatives cancels return to Washington over doctor’s coronavirus concerns
- ‘Trolls’ went straight to homes and might have changed movies forever
- Pole dancing instructor sues Zoom after ‘uninvited men’ interrupt online classes
- Starbucks expects to reopen 90 percent of its stores by June
- Nursing homes care about their patients. Does Gov. Cuomo?
- Americans won’t be rushing back to sporting events, concerts
- Lithuanian city will become one big open-air cafe as lockdown is lifted
- NYC noise complaints skyrocket following stay-at-home order
- NYC’s emergency food program is ‘starving people’
- MTA will hire more cops if NYC keeps ignoring homeless in subways
- Sweden records deadliest week of century after resisting lockdowns
- More blood on Gov. Cuomo’s hands amid nursing home coronavirus crisis
- Hard-hit Long Island veterans home reports 52 coronavirus deaths
- Gov. Cuomo plays blame game for coronavirus’ American invasion
- NYC mapping coronavirus genome to help track future outbreaks
- California small businesses sue officials over coronavirus closures
- De Blasio: ‘Strong day’ as NYC coronavirus hospitalizations, ICU tolls down
- Celebrity dermatologist’s clients are desperate for Botox during lockdown
- Spanish official apologizes for trying to disinfect beach with bleach
- Tokyo Olympics may hinge on a coronavirus vaccine
- NIH investigating Wuhan lab at center of coronavirus pandemic
- Attorney General Barr tells prosecutors to look for coronavirus orders that violate Constitution
- FDA asks manufacturers to make hand sanitizer less appealing to drink
- Some patients who survive COVID-19 may suffer lasting lung damage
- US passes South Korea in virus testing as Trump unveils expanded effort
- A study finds the coronavirus in tiny airborne droplets in Chinese hospitals
- As the U.S. infection rate passed 1 million, shopping malls in several states said they will reopen
- Greece has defied the odds, so far
- Migrant dormitories in Singapore make social distancing nearly impossible
B. Numbers & Trends
Note: The numbers in this update only include cases that have been (i) confirmed through testing, and (ii) reported. The actual number of cases may be materially higher than confirmed cases, which means that the number of actual deaths from COVID-19 and recoveries may both be materially higher than reported.
1. Confirmed Total Cases and New Cases
- Total Cases = 3,136,508 (+2.4%)
- New Cases = 74,032 (+7.0%) (+4,818)
- New Cases (3 day average) = 72,638 (-7.2%) (-5,585)
- Total Cases = 1,322,706 (+1.7%)
- New Cases = 21,435 (-12.4%) (-3,028)
- New Cases (3 day average) = 23,403 (-7.6%) (-1,916)
- Total Cases = 494,774 (+2.4%)
- New Cases = 11,548 (+5.5%) (+598)
- New Cases (3 day average) = 11,370 (-2.6%) (-300)
- Total Cases = 1,035,765 (+2.5%)
- New Cases = 25,409 (+9.5%) (+2,213)
- New Cases (3 day average) = 25,038 (-12.0%) (-3,401)
- US States & Territories:
- 45 States > 1,000 cases (+1),
- 39 States > 2,500 cases (+1), plus DC
- 28 States > 5,000 cases (+0)
- 19 States > 10,000 cases (+1): NY, NJ, MA, IL, CA, PA, MI, FL, LA, CT, TX, GA, MD, OH, IN, CO, WA, VA & TN
- 13 States > 20,000 cases (+1): NY, NJ, MA, IL, CA, PA, MI, FL, LA, CT, TX, GA & MD
- 5 States With Largest Number of Total Cases:
Change in Total Cases (%)
Change in New Cases (#)
|Change in New Cases (%)|
- Top 5 States = 54.8% of Total US Cases (-0.3%)
- NY & NJ = 40.1% of Total US Cases (-0.4%)
- For more information on US States and territories, see https://ncov2019.live/data & https://www.worldometers.info/coronavirus/country/us/
2. Serious or Critical Cases
- Worldwide serious or critical cases = 56,965 (+688)
- US serious or critical cases = 15,298 (+1,112)
- US serious or critical cases = 1.8% of Active Cases compared with worldwide percentage of 2.9%
- Worldwide deaths = 217,813 (+3.0%) (+6,364)
- Europe deaths = 126,422 (2.0%) (+2,425)
- US deaths = 59,226 (+4.4%) (+2,469)
- NY deaths = 23,114 (+2.2%) (+491)
- Deaths per 1M population of 5 Countries with Largest Number of Confirmed Cases:
- Spain: 510 (+7)
- Italy: 453 (+7)
- France: 362 (+5)
- UK: 319
- US: 179 (+7)
- US Total Confirmed Case Fatality Rate = 5.6% compared with a Worldwide Confirmed Case Fatality Rate of 6.9%
- [Note: The number of cases in which infected people recovered without being tested is believed to be a large number, which would substantially reduce the fatality rate. US health officials have estimated that the US actual fatality rate is 1% or less, but we do not have yet have sufficient data to calculate or estimate the actual fatality rate.]
- Worldwide recoveries = 953,309 (+3.5%) (+31,995)
- Worldwide recoveries = 30.4% of Total Worldwide Cases
- US recoveries = 142,238 (+2.3%) (+3,428)
- US recoveries = 13.7% of Total US Cases (-0.1%)
C. Antibody Tests
1. Highly Accurate Antibody Tests Can Now Be Purchased Online
- [PURCHASE THE TEST HERE: COVID-19 Immune Response]
- Quest Diagnostics is the first company to make its antibody test available for purchase online
- Customers can purchase the test for themselves for $119 without a visiting a doctor’s office
- Results will be available online within two days of having their blood drawn
- Antibody testing is meant to detect if someone has already been infected and developed immune cells that may help fight off coronavirus
- Quest mostly runs Abbott’s highly accurate antibody test, which is 100% specific to coronavirus antibodies, and 99.5% sensitive
- Quest operates more than 2,000 centers across the US where patients could have their blood drawn and tested for coronavirus antibodies
- Last week, Quest said it was launching its COVID-19 antibody test service for healthcare providers to order on behalf of patients and said it expected to perform more than 200,000 tests a day by mid-May.
- Quest said on Tuesday people who buy the test online will be prompted to schedule an appointment for a blood draw at one of its 2,200 patient service centers across the US, and the test results will be available on the company’s patient portal MyQuest, within two days of the blood draw.
- Food and Drug Administration (FDA) regulators have now given emergency use authorization to seven antibody tests in the US.
- But relaxed regulations intended to help expand desperately needed diagnostic and antibody testing have cleared the way for a rush of antibody tests to come to the market without FDA authorization and amid questions over their accuracy.
- More than 100 antibody tests are now available but haven’t been reviewed by the FDA’s stringent eye for accuracy and reliability.
- Reports have emerged of some of these un-reviewed antibody tests returning false-positive results.
- We don’t really know how much protection antibodies would afford someone who had been exposed to coronavirus and developed them, but the false-positive result would lead someone who had never been exposed to believe they had – and may have immunity to reinfection.
- Accuracy in antibody testing is described by two measures: specificity and sensitivity.
- If a test is highly specific, that means that it runs a very low-risk of reacting to antibodies to a different infection and is instead very exact at picking up antibodies to the virus that causes COVID-19.
- Its sensitivity is a measure of how infrequently a test fails to identify a patient who has definitively had coronavirus and should have developed antibodies to it.
- Quest Diagnostics primarily uses Abbott’s antibody test, which is approved by the FDA and is 100 percent specific and 99.5 percent sensitive, according to its maker.
D. Potential Treatments
1. Race for Coronavirus Vaccine Accelerates
- The race for a vaccine to combat the new coronavirus is moving faster than researchers and drugmakers expected, with Pfizer Inc. joining several other groups saying that they had accelerated the timetable for testing and that a vaccine could be ready for emergency use in the fall.
- Pfizer said Tuesday it will begin testing of its experimental vaccine in the U.S. as early as next week. On Monday, Oxford University researchers said their vaccine candidate could be available for emergency use as early as September if it passes muster in studies, while biotech Moderna Inc. said it was preparing to enter its vaccine into the second phase of human testing.
- Johnson & Johnson said earlier this month it shaved months off the usual timelines for developing a vaccine, and expects to start human testing of a coronavirus candidate as soon as September, with possible availability on an emergency-use basis in early 2021.
- “This is a crisis right now, and a solution is desperately needed by all,” said Pfizer Chief Executive Albert Bourla.
- The experimental vaccines still face a gauntlet of testing to make sure they work safely, which could derail efforts. Many promising drugs and vaccines wind up faltering during rounds of study.
- Adding to the potential obstacles, researchers say, is the fast-moving nature of the virus and measures to limit its spread. They have complicated efforts to set up some studies and find patients for research, delaying efforts and even closing some trials.
- Yet research into a coronavirus vaccine has moved at a relatively rapid clip, infectious-disease experts say.
- “I’m not aware of any vaccine that’s been developed after only a year to a year-and-a-half after identifying a pathogen. It usually takes years,” said Walter Orenstein, associate director of the Emory Vaccine Center in Atlanta. “People are moving very, very quickly with this.”
- The effort has been expedited, Dr. Orenstein said, by rapid discoveries about the virus and vaccine-making technologies. Yet he said he is skeptical a safe and effective vaccine could be available soon, given all the testing required.
- Vaccines can take years to hatch and then test to make sure they work safely—so long that researchers weren’t able to ready vaccines against previous viral outbreaks like Ebola in West Africa before they had petered out.
- There aren’t any drugs or vaccines that have been proven to fight off the new coronavirus and are approved for use. Before granting approval, federal health regulators can authorize an experimental vaccine’s use during a public health emergency.
- New York-based Pfizer is working on vaccine candidates with Germany’s BioNTech SE. The shots are based on an emerging gene-based technology known as messenger RNA, or mRNA, which carry instructions from DNA to the body’s cells to make certain proteins.
- Testing of a vaccine, which has already started in Germany, could start in the U.S. as early as next week if health regulators sign off, Pfizer’s Mr. Bourla said. Results from the study could come as early as next month, he said.
- If further testing also proves successful, Pfizer could start distributing the vaccine on an emergency basis in the fall and receive approval for widespread distribution by year’s end, Mr. Bourla said.
- Pfizer is investing $500 million in coronavirus vaccine and drug research, and is spending another $150 million to ready its manufacturing capabilities so the company can quickly make large quantities of antiviral agents, including a vaccine that succeeds in testing.
- “You can imagine the demand for something like that will be extremely, extremely high,” Mr. Bourla said.
- Oxford University researchers last week began vaccinating people for a 1,100-subject study testing the safety of their candidate and monitoring its efficacy, according to Adrian Hill, director of the university’s Jenner Institute, which develops vaccines.
- If the vaccine candidate proves safe, the researchers aim to explore whether it protects against the coronavirus in a 5,000-subject trial starting in late May, Dr. Hill said.
- The researchers could know whether the vaccine works by September, and emergency distribution could begin as early as that month. “That is the target timeline. It will be tough to do that, but it is not impossible,” Dr. Hill said. The New York Times reported Monday on the Oxford group’s progress.
- Moderna, which is also developing an mRNA vaccine, said it had asked the FDA to authorize the next phase of testing, a standard request before starting a new vaccine trial, and it could begin as early as May.
- The study would test the experimental vaccine in about 600 healthy volunteers to see if it was safe and triggered the production of antibodies that could neutralize the coronavirus.
- If the vaccine shows signs of working safely in the study, Moderna said the third and final phase of testing could start in the fall. The company said it could seek FDA approval to sell the vaccine by year’s end, if it succeeds in testing.
- Merck & Co., a longtime maker of vaccines, said it is talking to potential partners about three different technologies to manufacture coronavirus vaccines.
- Merck Chief Executive Ken Frazier said Tuesday drugmakers will need to develop more than one coronavirus vaccine to meet demand world-wide. He also said different vaccines might have different profiles that could benefit certain groups of people over others.
- “It could be that the vaccines that very older people need who are very vulnerable may be different, for example, than the vaccines that you would give to healthy children,” Mr. Frazier said.
- Mr. Frazier wouldn’t provide potential timing for Merck’s coronavirus vaccine efforts, though he said he doesn’t view the company as behind rivals even as their vaccines have begun testing in patients.
2. UV light could be new tool in fight against COVID-19
- President Donald Trump’s comments about possibly injecting patients with disinfectants to treat COVID-19 may have overshadowed his remarks at the same time about the use of ultraviolet light. But the treatment of UV light has been studied in the lab before as a medical treatment.
- “Supposedly we hit the body with a tremendous, whether it’s ultraviolet or very powerful light,” is what Trump said last Thursday during a coronavirus briefing.
- Few people may have known what the president was referring to but Josh Disbrow, the CEO of AYTU Bioscience in Englewood, did.
- “There’s knowledge that UVA and really all UV light kills bacteria and viruses,” Disbrow said.
- Disbrow’s company has a contract with Cedars-Sinai Medical Center in Los Angeles to distribute a medical device called Healight.
- The technology is still under development but if it’s perfected, it could offer a revolutionary approach to treating intubated patients.
- “They’ve already got the tube down their throat, obviously, delivering air and then this would go down the catheter would essentially slide down the tube opening. It would emit light, very bright, it’s a very specific wattage,” Disbrow said.
- Cedars-Sinai Medical Center does not have FDA approval to test their product for clinical use but is seeking Emergency Use Authorization (EUA) from the federal government.
- One key is to prove the device is safe. Unfiltered UV light is dangerous to human cells. Disbrow says Cedars-Sinai is developing technology that filters out dangerous UVC light and only uses UVA light to kill a variety of bacteria and viruses, including COVID-19.
- “There’s a lot of hope and lot of candidates in the pipeline. This may be one that presents a unique option,” said Disbrow.
- If the FDA approves a clinical study and if it shows real promise, AYTU BioScience hopes it could start delivering the tiny devices to hospitals within 6 months.
- “The hope is to save as many lives as we possibly can as quickly as we can,” said Disbrow.
- If Healight works as hoped, it could eventually be used to treat anyone who tests positive with coronavirus before they become deathly ill. It could also have broader applications to treat any hard-to-kill bacteria or virus, not just COVID-19.
3. Can Estrogen and Other Female Sex Hormones Help Men Survive?
- Men are more likely than women to die of the coronavirus, so scientists are treating them with something women have more of: female sex hormones.
- As the novel coronavirus swept through communities around the world, preying disproportionately on the poor and the vulnerable, one disadvantaged group has demonstrated a remarkable resistance. Women, whether from China, Italy or the U.S., have been less likely to become acutely ill — and far more likely to survive.
- Which has made doctors wonder: Could hormones produced in greater quantities by women be at work?
- Now scientists on two coasts, acting quickly on their hunches in an effort to save men’s lives, are testing the hypothesis. The two clinical trials will each dose men with the sex hormones for limited durations.
- Last week, doctors on Long Island in New York started treating Covid-19 patients with estrogen in an effort to increase their immune systems, and next week, physicians in Los Angeles will start treating male patients with another hormone that is predominantly found in women, progesterone, which has anti-inflammatory properties and can potentially prevent harmful overreactions of the immune system.
- “There’s a striking difference between the number of men and women in the intensive care unit, and men are clearly doing worse,” said Dr. Sara Ghandehari, a pulmonologist and intensive care physician at Cedars-Sinai in Los Angeles who is the principal investigator for the progesterone study. She said 75% of the hospital’s intensive care patients and those on ventilators are men.
- And pregnant women, who are usually immunocompromised but have high levels of estrogen and progesterone, tend to have mild courses of the disease. “So something about being a woman is protective, and something about pregnancy is protective, and that makes us think about hormones,” Dr. Ghandehari said.
- Some experts who study sex differences in immunity, however, warned that hormones may fail to be the magic bullet that some are hoping for; even elderly women with Covid-19 are outliving their male peers, and there is a drastic reduction in levels of hormones for women after menopause.
- The genesis of the estrogen trial at the Renaissance School of Medicine at Stony Brook University on Long Island stemmed from a similar observation, said Dr. Sharon Nachman, the trial’s principal investigator, who credited a Stony Brook surgeon, Dr. Antonios Gasparis, with the idea.
4. Arthritis drug may help fight severe coronavirus cases
- An arthritis drug may actually save lives in severe cases of coronavirus, according to a report.
- Tocilizumab — which is sold under the brand names RoAcemtra and Actemra to help treat rheumatoid arthritis — showed “clinical benefit” in patients who had the virus according to an unpublished study conducted by Paris university hospital trust, Canada’s CTV News reported.
- The drug was used in a study of 129 patients who had moderate-to-severe viral pneumonia as a result of COVID-19. Half of the patients were given two shots of the medicine — which sells for $870 a dose — along with antibiotics, while the other half were given the normal antibiotic treatment, the outlet reported.
- The patients who were given tocilizumab were less likely to die and less likely to need to be put on life support compared to the control group, researchers found.
- Tocilizumab may prevent cytokine storms — severe reactions to foreign bodies that causes the immune system to attack healthy cells, researchers found. Cytokine storms occur in severe cases of COVID-19 and can be deadly, CTV News reported.
- While the study has not yet been published and further research needs to be done on possible side effects, the hospital released the preliminary results “for public health reasons,” CTV reported.
E. New Scientific Findings & Potential Advances
1. Virus Likely to Keep Coming Back Each Year & Unlikely to Decline Much During Summer
- Chinese scientists say the novel coronavirus will not be eradicated, adding to a growing consensus around the world that the pathogen will likely return in waves like the flu.
- It’s unlikely the new virus will disappear the way its close cousin SARS did 17 years ago, as it infects some people without causing obvious symptoms like fever. This group of so-called asymptomatic carriers makes it hard to fully contain transmission as they can spread the virus undetected, a group of Chinese viral and medical researchers told reporters in Beijing at a briefing Monday.
- With SARS, those infected became seriously ill. Once they were quarantined from others, the virus stopped spreading. In contrast, China is still finding dozens of asymptomatic cases of the coronavirus every day despite bringing its epidemic under control.
- “This is very likely to be an epidemic that co-exists with humans for a long time, becomes seasonal and is sustained within human bodies,” said Jin Qi, director of the Institute of Pathogen Biology at China’s top medial research institute, the Chinese Academy of Medical Sciences.
- A consensus is forming among top researchers and governments worldwide that the virus is unlikely to be eliminated, despite costly lockdowns that have brought much of the global economy to a halt. Some public health experts are calling for the virus to be allowed to spread in a controlled way through younger populations like India’s, while countries like Sweden have opted out of strict lockdowns.
- Anthony Fauci, the director of U.S. National Institute of Allergy and Infectious Diseases, said last month that Covid-19, the disease caused by the virus, could become a seasonal ailment. He cited as evidence cases now showing up in countries across the southern hemisphere as they enter their winter seasons.
- While some, including U.S. President Donald Trump, have expressed hope that the virus’s spread will slow as the temperature in northern hemisphere countries rises in the summer, Chinese experts on Monday said that they found no evidence for this.
- “The virus is heat sensitive, but that’s when it’s exposed to 56 degrees Celsius [132.8 degrees Farenheit] for 30 minutes and the weather is never going to get that hot,” said Wang Guiqiang, head of the infectious diseases department of Peking University First Hospital.
- “So globally, even during the summer, the chance of cases going down significantly is small.”
2. Study finds coronavirus bits linger in air of crowded spaces
- A new study published Monday in the journal Nature Research revealed that bits of COVID-19’s genetic materials were found floating in the air of hospital toilets, in an indoor space holding large crowds and in rooms where medical staff removed protective gear.
- Researchers, who analyzed two hospitals in the pandemic’s epicenter in Wuhan, China, did not seek to establish whether these airborne particles could cause infections. Scientists are still learning more about this new coronavirus, so the question of whether it can spread through airborne particles is still being debated.
- The World Health Organization has advised that airborne particle transmission is likely to be limited to specific circumstances, such as in medical settings where COVID-19 patients are being intubated or when other invasive procedures are being performed.
- Led by Ke Lan of Wuhan University, scientists in the Nature Research study set up aerosol traps in and around two Wuhan hospitals.
- Although they discovered few aerosols in patient wards, supermarkets and residential buildings, many more were found in toilets and two areas that had large crowds passing through, including an indoor space near one of the hospitals.
- Higher concentrations were found in rooms where medical staff remove protective equipment, which may imply that particles contaminating their gear became airborne again when masks, gloves and gowns are removed.
- “Our results indicate that room ventilation, open space, sanitization of protective apparel and proper use and disinfection of toilet areas can effectively limit the concentration of SARS-CoV-2 RNA in aerosols,” the researchers wrote in the study’s abstract. “Future work should explore the infectivity of aerosolized virus.”
3. Scientists say new disinfectant protects surfaces from coronavirus for 90 days
- Researchers at a top university in Hong Kong say they have developed a new anti-microbial coating that can be sprayed on surfaces to kill most bacteria and viruses –including the coronavirus — for up to 90 days.
- Known as MAP-1, the anti-microbial coating has been designed for use across a range of surfaces including glass, metals, plastic, leather and fabrics, according to the Hong Kong University of Science and Technology (HKUST).
- The surface coating lasts “significantly longer” than conventional disinfectants that use alcohol or bleach, which lose their function as the liquids evaporates, according to HKUST. To help achieve this, it relies on heat-sensitive polymers that its inventors say responds to contamination from touch or droplets. It does this by releasing a larger amount of disinfectant when it senses an increase in temperature that can take place whenever our hands touch a surface or when moisture from droplets.
- The anti-viral coating is expected to hit stores in Hong Kong in May following clinical tests in the city back in February, according to Reuters. Shopping malls, schools, churches and sport training facilities in Hong Kong have used the coating, according to researchers, who also say its ingredients are non toxic. HKUST did not immediately respond to a request for comment about whether there were plans for MAP-1 to be made available in the US or other countries.
F. New Concerns
1. Cancer patients over twice as likely to die from coronavirus
- Having certain cancers makes the coronavirus exponentially more lethal.
- While cancer patients are generally more vulnerable to infections, new research finds that people with blood and lung cancers as well as cancer which has metastasized — meaning it has spread throughout the body — are almost three times as likely to die as a result of contracting COVID-19.
- “Our results showed COVID-19 patients with cancer had higher risks in all severe outcomes,” reads the abstract of a study published Tuesday in the journal Cancer Discovery.
- The authors — from the US, China and Singapore — compared the cases of 105 patients with cancer and COVID-19 to 536 COVID-19 patients who did not have cancer, but were in the same age range, at 14 hospitals in Wuhan, China.
- They found that cancer patients had an almost threefold higher death rate from the novel virus than those who were cancer free.
- Cancer type, age and treatment stage were also factors. Lung cancer patients, for example, are already suffering from reduced lung function, and are especially vulnerable. Also, those with blood cancers — including leukemia, lymphoma and myeloma — which compromise the immune system, are vulnerable.
- Treatments including chemotherapy and surgery, while helping fight cancer, can leave patients at higher risk of succumbing to COVID-19, as they also suppress the immune system.
- Experts had suspected cancer patients were more vulnerable, but the new study now confirms it. The research “reflects what we had heard previously — that cancer patients are more susceptible to the virus, and that the course of the infection is worse and the outcomes are worse,” writes American Cancer Society Deputy Chief Medical Officer J. Leonard Lichtenfeld in The Washington Post. (He was not involved in the study.)
- In addition to posing an increased threat of death to cancer patients, the coronavirus has also delayed cancer-related surgeries for over 1,000 NYC patients. Those cancer patients who have managed to receive medical care have had to risk contracting the virus in the process.
2. Three New York children with coronavirus have rare inflammatory syndrome
- Three children with the coronavirus in New York are also being treated for a rare inflammatory condition, similar to the one that has sparked concerns in the UK and Italy.
- The kids, who range in age from 6 months to 8 years, all had fever and inflammation of the heart and the gut, according to a specialist at Columbia University Medical Center.
- “Right now, we’re at the very beginning of trying to understand what that represents,” Dr. Mark Gorelik told Reuters.
- Of the three New York patients, one is critically ill, one is in intensive care and the third has been discharged.
- Gorelik, a pediatric rheumatologist and immunologist, was called in to evaluate whether the children had Kawasaki disease, a condition thought to be linked to infection that causes inflammation in the walls of blood vessels.
- He said he believes the children likely don’t have that illness, but a similar process that shares an underlying mechanism with Kawasaki.
- “This has very similar features,” Gorelik said.
- Italian and British medical experts are investigating a possible link between the coronavirus outbreak and clusters of severe inflammatory disease among infants, who have arrived at the countries’ hospitals with high fevers and inflamed arteries.
- The syndrome has been largely undetected in the United States, according to the American Academy of Pediatrics.
- The three New York cases follow a report of a 6-month-old admitted to at Stanford University’s Lucile Packard Children’s Hospital with Kawasaki disease who was later diagnosed with COVID-19.
- It’s possible that the coronavirus comes in two phases for children, who so far have been spared some of the disease’s more serious complications.
- They may suffer an initial infection and then a secondary immune response that kicks in some weeks later, Gorelik said.
- “It seems a week to two weeks later, you may have the immune system responding in a very disorganized way,” he said.
3. Medication Shortages Are the Next Crisis
- Widespread critical-medication shortages are the next big crisis of the coronavirus pandemic.
- Some hospitals, including in New York, are running low on paralytic agents that are needed to safely intubate patients. Steve Corwin, the president and CEO of New York–Presbyterian, recently noted on MSNBC that his hospital is even running short on solutions needed for dialysis.
- I am fortunate to work in the emergency department of one of the best-resourced hospitals in the country, Brigham and Women’s Hospital in Massachusetts. But already, when I order intravenous fentanyl, which doctors use to minimize pain and keep patients breathing safely and comfortably while on mechanical ventilators, an alert pops up reminding me that there’s a national shortage. Am I sure I want to use this medication? Of course I’m sure. The frequency of alerts and the number of drugs in undersupply are shocking developments in a rich country.
- Throughout the pandemic, the United States has been playing catch-up. We’re still not testing enough, even though public-health officials saw that problem coming from miles away. Hospitals continue to run low on personal protective equipment. It is too soon to know whether 11th-hour attempts to increase those supplies will succeed. Too many lives hang in the balance to play wait-and-see with our medications too.
- In addition to drugs for patients on mechanical ventilators, including sedatives such as etomidate, paralytics, and pain meds, we also need to fast-track the production of antibiotics such as azithromycin, cefepime, and others that we use to treat pneumonia. We need a steady supply of hydroxychloroquine, although not for patients with COVID-19—no compelling evidence shows that it actually benefits those with the virus. Yet because many are using hydroxychloroquine for the coronavirus, we are now low on the drug for patients with conditions it’s known to help, such as lupus and rheumatoid arthritis.
- Here are steps the federal government can take now to make sure that hospitals are well stocked during the pandemic and after it passes, when doctors turn to operations delayed by the COVID-19 surge. First, it needs to improve data collection to track how manufacturing capacity is stacking up against medical demand. Then, it needs to compel pharmaceutical companies and their suppliers to accelerate the production of needed drugs.
- The data infrastructure is already in place. For some 20 years, the FDA has run a drug-shortage tracking program. In 2011, in response to a deficit of cancer treatments, anesthesia, and other critical-care medications, President Barack Obama issued an executive order urging drug manufacturers to report supply issues early so that any bottlenecks in production could be addressed in a timely way.
- The FDA should build on this program by requiring drug manufacturers to disclose the companies that make their ingredients. Right now, this disclosure is voluntary. The FDA would then need to take tracking a step further and demand that suppliers of ingredients also release production information. Although obtaining this kind of authority may require a change in executive rules at the FDA or a presidential executive order, it is worthwhile. By knowing where companies get their essential compounds, the FDA can keep tabs on the supply of ingredients, identify any production hiccups early, and guarantee that the ingredients are reserved for medical use. Some reagents needed to make vital medications, for example, are also used in cosmetics and other nonessential products.
- State and federal officials can already anticipate equipment and staffing shortfalls at hospitals by looking at the CDC’s records on caseloads and capacity. But expanding the system to allow hospitals to report the undersupply of medications as well will help public-health officials know when and if it is prudent for the government to step in to direct deliveries, prioritizing areas of maximal need and anticipating other shortages before they become critical.
- More robust tracking will help the White House wield the Defense Production Act to its fullest extent and in the most effective way. Although in normal times the government is not involved in the distribution of drugs, these are not normal times. The president should therefore use the DPA’s allocation authority to direct private companies to sell and ship drug ingredients only to priority users. Companies including Amazon are already voluntarily prioritizing the sale of supplies such as hand sanitizer to hospitals. But if medical-ingredient companies sell to producers of nonessential products such as skin care instead of to drug manufacturers, the government should coerce them to act. If domestic companies increase production of these active chemical substances, the U.S. will also be less reliant on manufacturers in China, which are of course outside the authority of the DPA and therefore can’t be forced to respond to the needs of American hospitals. And finally, the White House should use DPA authority to direct manufacturers to sell medications to hospitals or regions most in need according to expanded CDC reports.
- If the president is reluctant to continually use the DPA, the government can also compel companies to fill the medication gap in other ways. Recently, for example, the FDA issued guidelines to allow compounding pharmacies, which typically fill prescriptions only for individuals, to temporarily fill them for hospitals. Money can always incentivize companies to speed up production too. The Department of Health and Human Services and the Centers for Medicaid and Medicare Services can temporarily offer higher payments for medications, including generics. Better financial margins will spur manufacturers to make these drugs more quickly.
- Finally, after improving the tracking of drugs and increasing production, the government should make sure that hospitals don’t face scarcity again in the near future. It can do that by replenishing the Strategic National Stockpile now with medicine that doctors use in treating the coronavirus, as the pandemic will likely be here for many more months before a vaccine is available.
- Doctors are only as good as our teams, our equipment, and our medicines. If we get the PPE we need, our teams will stay safe. If we receive much-needed equipment—tests, ventilators, IV pumps—in time, fewer of our patients will die needlessly. But if we can’t provide medications that make what we do effective, all our efforts will be for naught.
G. The Road Back?
1. New York Will Have Coronavirus ‘Circuit Breaker’ in Place as Economies Reopen
- As New York prepares to let businesses reopen with the easing of the coronavirus pandemic, the state will have measures in place that will signal another outbreak of the disease and the need to curb activity once again, Gov. Andrew Cuomo said Tuesday.
- In particular, Mr. Cuomo said that if either the hospital system in an area of the state hits 70% of capacity or if the rate of transmission reaches 1.1—meaning for every person who has the virus, another 1.1 are infected—that would constitute what he called a “circuit breaker.” Currently, the statewide transmission rate is about 0.8, meaning less than one person is infected.
- “We want to reopen but we want to do it without infecting more people or overwhelming the hospital system,” he said at a press conference.
- The Democratic governor’s announcement came as the state continued to see a decline in hospitalizations from the virus, with the number falling on Tuesday by 173 patients to 12,646.
- The daily death toll also fell, albeit just by two individuals, to 335, the state reported. Still, that is less than half the 799 deaths recorded on April 8, the peak daily figure so far. In all, the state has recorded more than 17,000 deaths.
- Mr. Cuomo reasserted that contact tracing would be key to the state’s ability to reopen safely. The process calls for determining what individuals an infected person may have been in contact with, so such people could then go into immediate quarantine and thereby limit the potential spread.
- To allow for such tracing, Mr. Cuomo said the state would need to have at least 30 tracers for every 100,000 residents, which equates to a workforce of roughly 6,000 tracers based on New York’s population of more than 19 million.
- Mr. Cuomo said Tuesday the state could tap those already working in state and county health departments, but would also have to bring on additional employees for the task.
- “This is something that no one has ever done before,” said Mr. Cuomo.
- Former New York City Mayor Michael Bloomberg has also pledged more than $10 million to help with the tracing efforts.
- Mr. Cuomo continued to say that the state’s approach to reopening would be regional, with areas less affected by the virus, particularly upstate, being able to start ahead of other locales.
- The governor also re-emphasized that the state would follow the CDC recommendations for a phased approach to reopening, allowing industries that are less at risk of spreading the virus with appropriate precautions, such as construction and manufacturing, to start ahead of the rest.
- While Mr. Cuomo sounded notes of optimism about the state’s recovery, he also indicated that restrictions and closures may still be the order of the day. In particular, he indicated that the New York State Fair, which draws hundreds of thousands annually and is scheduled to open this year on Aug. 21, may be in jeopardy.
- “Everything is about reducing density,” Mr. Cuomo said.
- Meanwhile, Mr. Cuomo and New Jersey Gov. Phil Murphy have announced the formation of advisory councils to assist with each state’s reopening plans.
- The councils will both be composed of experts and leaders from various industries and sectors of the community.
- “No one’s seen how an advanced economy returns and recovers from a global pandemic,” said Mr. Murphy, a Democrat, at a Tuesday press conference. “We are writing this set of rules for the first time and together.”
2. The biggest US mall owner prepares to reopen 49 properties
- The biggest mall owner in the U.S. is preparing to open a number of its properties across the country, as states such as South Carolina and Georgia start to reopen during the coronavirus pandemic, according to an internal memo that was obtained by CNBC.
- Simon Property Group is reopening 49 of its malls and outlet centers Friday through Monday, the memo said, including Haywood Mall in Greenville, South Carolina, and Lenox Square in Atlanta. [NOTE: We will have a report in this weekend’s Update on Friday’s opening at Lenox Mall in Buckhead].
- Business hours at the malls and outlet centers will be limited to 11 a.m. to 7 p.m. Monday through Saturday, and noon to 6 p.m. Sunday, to allow for cleaning overnight, according to the memo. Simon said it will regularly sanitize high-touch areas such as food court tables, escalators, door knobs and electronic directories. And it is encouraging retailers to do the same in their stores.
- Meantime, Simon said it will encourage shoppers to take their temperatures before going to the mall. At the mall, it will make free temperature testing available to customers, using infrared thermometers, it said.
- Free CDC-approved masks and hand sanitizing packets will also be available to the shoppers who ask for them. Simon said it will encourage shoppers to wear masks or some sort of facial coverings while they shop. Simon is mandating its employees wear masks while they are working and take “frequent breaks for handwashing.”
- To ensure its employees and shoppers maintain distance, Simon is taking a number of steps. Those include: Putting tape over every other sink and urinal in restrooms, putting decals on floors to direct traffic flow, limiting food court seating and keeping play areas and drinking fountains closed.
- It said it will limit the number of entrances to each property and make sure that occupancy does not exceed one person per 50 square feet of space, using traffic measuring technology.
- Per the memo, Simon is also encouraging retailers and other tenants to use technology, such as Apple Pay, that allows for contactless transactions.
- It will be left up to the retailers at these properties — such as Macy’s, American Eagle and Victoria’s Secret — to decide whether they wish to reopen for business. Many have furloughed the majority of their store workers, and it could take some time to bring them back. Retailers will also be tasked with stocking fresh inventory and selling through stale merchandise that has been sitting on shelves.
- It remains unclear how fast people will want to return to malls. A little over 45% of consumers expect to avoid shopping centers and malls even after the lockdown ends, according to a study by Coresight Research. More people will avoid malls than movie theaters or public transportation, it said.
- NOTE: It’s interesting that customers feel most safe at grocery stores at 54%. In our opinion, grocery stores are LESS safe than malls because of the high traffic, tight spaces at a grocery store compared to a shopping mall which has much more space and LESS traffic.
3. Thermal imaging cameras could play “critical role” in keeping people safe from COVID-19
- Thermal imaging cameras are the latest devices businesses hope will help reopen the economy while keeping people safe from the threat of COVID-19. The cameras are used to scan temperature from a safe distance, and if a fever — a common coronavirus symptom — is detected, the company could require further screening or deny the person entry altogether.
- “What we’re seeing is there will be a new normal that will involve thermal screening as a frontline tool,” Chris Bainter, director of global business development at FLIR Systems, told CBS News’ Jericka Duncan. FLIR has been producing thermal imaging cameras since the SARS epidemic in 2003, when it gained widespread use in Asia.
- Since the outbreak, companies like Flexible Systems, Thermal Guardian, CrowdRx and many more have begun manufacturing the cameras for use in airports, healthcare centers and even apartment buildings in New York, where the pandemic has hit particularly hard.
- A store in Georgia, City Farmer’s Market, has already set up thermal imaging cameras to scan customers as they enter the store.
- If a customer’s temperature is above 100.4 degrees, they are given a flyer that asks them to leave to protect others, and offers that the store does their shopping for them.
- “The key is that application is not about an absolute temperature measurement. It’s more about detecting those individuals with elevated body temperature higher than the last 10 people that had been screened,” Bainter explained.
- Bainter, who predicted the camera could play “a critical role” in reopening the economy, dismissed any privacy concerns or worries that this specific technology could be a gateway to “surveillance culture.”
- “If you’ve seen a thermal image… you can’t really detect exactly who that individual is,” he said. “We aren’t really focused on collecting data of any sort, it’s more about as a screening tool.”
- However, he cautioned the screening tool “doesn’t detect coronavirus,” and called for further precautions to be taken before businesses could be deemed safe.
- “Thermal solutions for elevated body temperature are only one part of what needs to be a comprehensive environment health and safety program for these businesses,” Bainter said.
4. Meet ‘Salus’ – The Pentagon’s New COVID-Hotspot, Panic-Buying Predicting AI
- A new predictive technology developed by the Pentagon can anticipate product shortages could help military personnel move supplies to retailers or hospitals with geographical precision before a shortage develops during a public health crisis.
- The Joint Artificial Intelligence Center (JAIC) developed the new prototype artificial intelligence tool that predicts and addresses shortages of food, water, medicine, and other essential goods in a geographical region during crisis times. “You have to be looking a little in the future,” said Nand Mulchandani, chief technical officer at the JAIC, who recently spoke with Defense One.
- Called Salus, the new tool combines data from the Census Bureau, Medicare, hospitals, and can forecast community spreading of a virus in a geographical region, as well as pulling data from retailers and warehouses of product inventories, and develop a predictive model of where shortages could potentially be seen, right down to specific zip codes or even stores.
- The military is working toward a “common view and a predictive capability to truly understand where the next problem sets are going to be and bringing to bear all of the logistical capability.”
- The new tool has already been field test with communication systems of Northern Command and National Guard, which are both supporting FEMA’s efforts in combating the coronavirus spread.
- Mulchandani told Defense One that the AI tool is flexible in determining different types of problems that could occur by altering the data used.
- He said Salus was first tested by determining and developing a model of where shortages of ventilators, masks, and other medical supplies could be seen.
- “The next question really was resource allocation like food,” he said
- It’s a given that JAIC is working on a predictive model to determine where food shortages could develop because our reporting over the last month suggests shortages could start in May.
- The tool gives the Pentagon and the government the ease of mind that during a public health emergency, supply disruptions could be addressed quickly and even preemptively. All in the effort to contain or completely mitigate the consequences of what disruptions can trigger, such as social unrest.
G. How Lethal Is It?
1. New Data Suggest the Coronavirus Isn’t as Deadly as We Thought [Opinion by Andrew Bogan, Wall Street Journal]
- The Covid-19 shutdowns have been based on the premise that the disease would kill more than two million Americans absent drastic actions to slow its spread. That model assumed case fatality rates—the share of infected people who die from the disease—of 1% to 3%. The World Health Organization’s estimated case-fatality rate was 3.4%.
- Some experts have questioned this assumption. They argue that known cases are likely only a small portion of the true number of infections, and thus high case-fatality rates could be off by orders of magnitude. We don’t know what portion of infections have gone undetected for a lack of tests, restrictive qualifications to get tested, and a potentially large incidence of mild illness or asymptomatic infection.
- New data support the skeptics’ view—a preliminary study by a Stanford team conducted a seroprevalence study of Santa Clara County, Calif., on April 3 and 4. They studied a representative sample of 3,300 residents to test for the presence of antibodies in their blood that would show if they had previously been infected with the novel coronavirus.
- The county is home to about two million people in the heart of Silicon Valley, including San Jose, the state’s third-largest city. It has the largest known number of cases in Northern California and saw some of the earliest cases of community spread in the U.S.
- The researchers found that the percentage of infections was indeed vastly larger than the roughly 1,000 known positive cases in the county at the time of the study. The preliminary results—the research will now undergo peer review—show that between 2.5% and 4.2% of county residents are estimated to have antibodies against the virus. That translates into 48,000 to 81,000 infections, 50 to 85 times as high as the number of known cases.
- That may sound scary, but it’s great news. It suggests that the large majority of people who contract Covid-19 recover without ever knowing they were infected, and that the U.S. infection fatality rate may be more than an order of magnitude lower than authorities had assumed. Based on this seroprevalence data, the authors estimate that in Santa Clara County the true infection fatality rate is somewhere in the range of 0.12% to 0.2%—far closer to seasonal influenza than to the original, case-based estimates.
- Outside California as well, preliminary data are emerging to support a more hopeful picture. In New York City, a study published in the New England Journal of Medicine examined 215 women entering two hospitals to give birth between March 22 and April 4. These patients had a Covid-19 infection rate over 15%. Of expectant mothers who tested positive for active infections, 88% were asymptomatic at the time of admission. That infection rate is about 10 times the rate of known cases in the city as a whole as of April 17—and New Yorkers have been tested for Covid-19 far more extensively than residents of other states.
- This study looked only at active infections, not past infections as in Santa Clara County. So in that population of pregnant women, 15% infected is a lower bound. Many others may have had a past infection only detectable on serologic tests for antibodies against the virus.
- Similar proportions of infections to cases are now being discovered around the world: 30 times in Robbio, Italy; 10 times in Iceland; 14 times in Gangelt, Germany; 27 times in Denmark. Germany and Denmark are now leading Europe in reopening their economies in the coming week. Sweden, concerned all along with the accuracy of early assumptions, never closed down its economy.
- This is not to deny that Covid-19 is more serious than influenza. Its symptoms are sometimes crueler, and it is fiercely infectious—it escaped the draconian lockdown of Wuhan and spread globally in a few months. In some places, like Northern Italy and New York, it has stretched hospital capacity and endangered or killed frontline health-care workers. Tens of thousands are dead world-wide, and there’s no vaccine. So a path forward demands continued monitoring of seroprevalence as well as new case testing, identifying and protecting those most vulnerable to more serious or even fatal infections, and supporting hospital capacity to handle surges of respiratory intensive-care patients.
- Yet if policy makers were aware from the outset that the Covid-19 death toll would be closer to that of seasonal flu than the millions of American deaths predicted by early models dependent on inputs that now look inaccurate, would they have risked tens of millions of jobs and livelihoods? The science to support better modeling and decision making is rapidly becoming available. One hopes that it will inform better policy decisions.
Source: WSJ here.
H. Stories From The Frontline
1. Georgians oppose opening the economy
- A broad majority of Georgia voters support a statewide shelter-in-place to combat the spread of the coronavirus, according to a University of Georgia survey released as Gov. Brian Kemp debates whether to extend stay-at-home orders set to expire Thursday night.
- Survey results:
- About one-half [50%] of registered Georgia voters support the [stay-at-home] mandate, and an additional one-quarter of voters “somewhat back it.”
- 10% of Georgians oppose the [stay-at-home mandate] idea; the rest are neutral or undecided.
- Regarding the reopening of business: 62% of Georgia voters disapprove of Kemp’s decision to ease restrictions on restaurants, theaters and close-contact businesses such as barbershops and nail salons over the past week
- Majorities of Democrats, Republicans and independents opposed Kemp’s decision to reopen the businesses, with only about one-third of Republicans saying they somewhat or strongly approved of his move.
- An overwhelming majority of voters — about 80% — said they are worried a family member will be exposed, with 52% extremely or very worried.
- Georgians are largely divided on the steps Kemp has taken to contain the pandemic, with about 44% saying the measures are appropriate while 41% say the state hasn’t “gone far enough.”
- An additional 15% say the state has gone “too far,” a group composed of roughly even numbers of Democrats, Republicans and independents.
- A plurality of voters — 45% — approve of how the state is responding to the crisis, compared with about one-third that disapprove.
- About half of Georgians support the way the federal government is handling the pandemic, including 71% of Republicans and about one-third of Democrats and independents.
- Only one-third of Georgians are satisfied with how Congress has handled the outbreak.
- Georgians gave the highest marks to local governments (60%) and public health officials, who netted an approval rating from roughly two-thirds of registered voters.
- Overall, about 75% of Georgians supported government mandates requiring “certain businesses to close,” including three-quarters of Republicans and about 85% of voters over the age of 65.
- There’s even broader public support for the decision to shutter in-person classroom learning over the rest of the academic year, with 80% of Georgians saying they favor or somewhat favor the decision and 10% opposed.
- Half of Georgians say their employment situation hasn’t changed, about one-quarter say they’re working less and 13% have lost their jobs. Of those, Democrats were slightly more likely to be out of work than Republicans or independents.The personal behavior of Georgia voters has drastically changed, too.
- A majority of Georgians report increased use of masks and a ramp-up in hand washing. About one-half also say they’re more likely to stock up on groceries and other essentials. And about 60% say they’re engaging in more social distancing. One area where behavior hasn’t yet undergone a vast overhaul: personal finances. Nearly 40% of Georgians say they’ve had no change in their personal savings habits, while about 23% are saving less.
- When it comes to giving back, about one-third of Georgians say they’ve donated to charities, and smaller proportions said they bought restaurant gift cards, sewed masks or donated to food pantries.
- The favorite method to support the community during the pandemic? Ordering more food from restaurants for takeout than usual. A slim majority of Georgians — 51% — reported taking that step.
- The online survey of 1,233 registered Georgians was conducted between April 21 and 25, shortly after Kemp announced plans to begin rolling back economic restrictions. It’s the first public statewide poll since the coronavirus restrictions took effect earlier this month. The margin of error is 3.1 percentage points. [NOTE: This was not a scientific poll — online polls tend to be less accurate]
I. Projections and Our (Possible) Future
1. IHME Model Increases Coronavirus Death Projections, with Biggest Jumps in States Not Yet Reopened
- The Institute for Health Metrics and Evaluation (IHME) released an update to its epidemiological model that projects an increase in coronavirus deaths to 74,073 in the United States by August 4.
- The new projections represent a 9% increase from the April 22 updated projections of 67,641 coronavirus deaths in the country.
- About half of the 6,432 projected death increases are in five states. Four of those five states (New York, Massachusetts, Michigan, and Connecticut) are among those hardest hit by the coronavirus pandemic that are not yet reopened, while one state (Texas) has recently announced it has begun to reopen its economy. As of Tuesday there have been 56,933 deaths in the United States due to coronavirus, according to Worldometer.
- According to the update released along with Monday’s new projections:
- At least part of this increase is due to many states experiencing flatter and thus longer epidemic peaks. Further, updated data indicate that daily COVID-19 deaths are not falling very quickly after the peak, leading to longer tails for many states’ epidemic curves.
- In combination – less abrupt peaks and slower declines in daily COVID-19 deaths following the peak – many places in the US could have higher cumulative deaths from the novel coronavirus.
- Across the US, the predicted peak for daily COVID-19 deaths appeared to be on April 15, reaching 2,698 deaths. While most states seem to have passed their epidemic peaks, seven –Hawaii, Mississippi, Texas, Wyoming, Utah, Nebraska, and North Dakota – may be experiencing their peaks now or could be in the coming weeks. . . [M]any states are seeing daily COVID-19 deaths falling more slowly than the speed at which deaths rose to peak levels. These slower trajectories are contributing to higher cumulative COVID-19 deaths being estimated through the epidemic’s first wave.
- Projected coronavirus deaths in New York increased by 699, from 23,232 in the April 22 update to 29,390 in the April 27 update. Projected coronavirus deaths in Massachusetts increased by 1,255, from 4,242 in the April 22 update to 5,498 in the April 27 update. Projected coronavirus deaths in Connecticut, which borders both New York and Massachusetts, increased by 334, from 3,006 in the April 22 update to 3,340 in the April 27 update.
- Projected coronavirus deaths in Michigan increased by 407, from 3,379 in the April 22 update to 3,785 in the April 27 update.
- In Texas, where Gov. Greg Abbott recently announced an aggressive reopening plan, projected coronavirus deaths increased by 415, from 1,241 in the April 22 update to 1,656 in the April 27 update.
J. Practical Tips & Other Useful Information
1. A ‘nanofiber’ mask fabric manufactured in Oklahoma filters 9 times as many tiny, potentially dangerous particles as a bandana, independent tests show
- After the clothing designer Chloe Schempf and her friends discovered that certain blue shop towels were effective for homemade face masks, the president of a particle-testing equipment company offered to test a wide range of materials for her with the same machine used by N95 mask makers.
- They tested products as varied as coffee filters and vacuum-cleaner bags: 20 materials that people on the internet have been using to make masks at home while the worldwide shortage of N95 masks continues.
- Their experiment found that the most effective material for blocking 0.3-micron particles was not, in fact, the blue shop towels, but a “nanofiber” material manufactured by a company in Oklahoma. A swatch of the fabric paired with cotton filtered 84% of particles, the test found. This compares with folded cotton bandanas, which filtered less than 10%.
- For context, a commercially built N95 mask filters at least 95% of particles, the president of the particle-testing company, Tom Kennedy of TSI, told Business Insider. Kennedy also said homemade masks could never reach N95 protection because professional mask construction involved precision manufacturing.
- Still, capturing 84% of tiny particles was noteworthy. The only other material that came close was a combination of cotton and 3M’s Filtrete Furnace Filter, and 3M clearly warns consumers not to use the furnace filter in homemade masks. In fact, the makers of most of the alternative materials, including the blue shop towels, are warning consumers that their products are not intended for masks.
- In contrast, Filti is advertising its material as safe for homemade masks and is selling it to the public.
- “We designed this — the Filti face-mask material — so people can use it in a cotton mask or they can use it 100% by itself,” Filti’s founder, Andy McDowell, told Business Insider.
So what is this Filti stuff?
- Schempf discovered the material because a wallet manufacturer that had pivoted to mask making was using it and had sent it to her, she told Business Insider.
- Made by NXTNano, the material is typically used in commercial filtering products.
- McDowell is also the sales director at NXTNano. He spun off a second company, Filti, before the COVID-19 pandemic to take the remnants from NXTNano’s production and turn them into consumer products. He was originally thinking he could sell them to consumers for furnace filters and the like.
- But once the coronavirus crisis began, the folks at Filti turned 100% toward consumer mask-making efforts. It now takes NXTNano remnants, cuts them into smaller pieces, and makes one side softer to be more comfortable to wear against the face. NXTNano is also promoting its material as suitable for N95 masks.
- NXTNano says the fabric is made from a patented process that spins various types polymers into exceptionally long and thin strands.
- “The No. 1 pushback is that people say, ‘nanofibers’ and the word they will key on is ‘nano’ like ‘nano particles,'” he said. They picture tiny individual fibers, but that’s not right. A nanofiber is actually a very thin, long fiber that forms a continuous network, he says. Filti fibers are nanometers across but kilometers in length.
- “It’s like a bowl of spaghetti but with only one noodle,” McDowell said.
- McDowell told Business Insider the material was being used in some masks that meet N95 filtration standards, but he declined to say which mask makers were using it, citing nondisclosure agreements.
- Business Insider could not verify that this fabric has achieved any kind of formal approval to be used in masks; however, some researchers are generally studying the use of various forms of nanofibers in N95 masks, and scientists in South Korea have been experimenting with nanofiber mask making during the COVID-19 worldwide shortage. Other nanofiber equipment vendors are also advertising the material as suitable for masks, but they are not selling the finished fabric to the public.
- What is clear is that the particle testing done by TSI was conducted independently from Filti. Schempf simply gathered a bunch of materials she had heard about, including the Filti samples sent to her by the wallet company, and sent them to TSI. TSI tested them “blind,” Kennedy said, meaning it didn’t know which fabric was which.
- All of this means there’s no objective evidence that Filti’s fabric is safe to use for hospital-quality masks, as its makers claim, but there is evidence that it filters far better than a cotton bandana.
- Filti is selling its fabric from its website for $30 for 21 square feet, which the company estimates is enough to sew 50 to 80 masks, depending on their size.
- These masks cannot be washed, McDowell says. He says they can survive being in the oven for 30 minutes at 150 degrees, but there isn’t solid research to show this is a safe and effective method to sterilize a mask, particularly if it has actually been exposed to COVID-19.
- The CDC advises that wearing a bandana outside is far better than wearing nothing, as this could keep a sick person from widely spreading their germs. A well-fitting mask with better filtering should protect someone better than a bandana, however, says TSI’s Kennedy.
- And that’s why home mask makers like Schempf have been on a mission to find materials that filter well, are breathable, and can be bought by the public, at least until the N95 mask shortage is over.