Coronavirus Update 5-6

“I have hairstylists that are going hungry because they’d rather feed their kids. So, sir, if you think the law is more important than kids getting fed then please go ahead with your decision but I am not going to shut the salon.”   — Shelly Luther, jailed 7 days for reopening her salon in violation of court order 

“Unbelievable and shocking. So, the UK government is following the science of scientists who don’t even follow their own science. What a shameful shambles. Professor Ferguson’s excuse is he thought he was immune from COVID-19 after having it – despite there being zero scientific proof people who’ve had it actually get immunity. And this guy’s the No1 ‘expert’ on whom the government is basing its entire coronavirus strategy?”  — Piers Morgan

“If we leave this purely up to the physicians and the epidemiologists, we’ll be locked in our houses for another year.  I don’t think that’s reasonable.  The country should consider a middle path.”  — Former NJ Governor Chris Christi

Today’s Features

• Recent Developments and Headlines
• Numbers and Trends
• Risks of Mutation – More Infectious Strain of Coronavirus Identified
• Antibody Testing – CRISPR used to create a simple, cheap at-home test
• Vaccines – Human testing beings in US
• Concerns & Unknowns 
• Symptoms – COVID Toes a common symptom of young & healthy
• New Scientific Findings
• Taking on the Coronavirus in the Subway
• Projections & Our (Possible) Future – The Cost of Relying on Models
• C19 Riddle – Why are some places affected so much worse than others? 
• Limits of Science
• Practical Tips

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Available Resource:  Having put together almost 70 daily updates, our team has compiled and distributed a tremendous amount of information about the coronavirus and COVID-19 and we are happy to share what we know.  So, if you have any questions regarding the virus or disease, please feel free to contact either pwduval@gmail.com or brian.sivy@gmail.com.  We’d be happy to respond by email or arrange a call with you or anyone you know as soon as we can.

A. Recent Developments and Headlines

Note: All changes noted in this Update are since the 5/4 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

• A White House task force is winding down as the Trump administration pushes to reopen the nation
• UK overtakes Italy for biggest death toll in Europe
• Former FDA director dismisses New York Times 3,000 death per day projection
• NYT points out US cases, deaths are still growing ex-NY Metro Area
• Italy reports lowest daily new cases in 2 months
• Florida reports record 72 daily deaths Tuesday
• Sweden says it has evidence of viral spread as early as November
• Hong Kong to further relax restrictions
• Russia reports 30,000+ cases in 72 hours
• Australia and New Zealand start planning to open borders to each other
• Unemployment Kills: The Longer Lockdowns Last, The Worse It Will Get
• A Fifth Of Wendy’s Restaurants Said To Be Out Of Beef As Shortage Spreads
• Elvis Was King, Ike Was President, & 116,000 Americans Died In A Pandemic – And Nothing Was Shut Down
• US Universities Creating Social-Credit-Style COVID-Surveillance System
• The UK Is Now Home To The Deadliest COVID-19 Outbreak In Europe
• New York Reports Over 1,700 Previously Undisclosed Deaths at Nursing Homes
• Dr. Anthony Fauci: Coronavirus Likely Wasn’t Created in Wuhan Lab
• Zero Coronavirus Deaths, First Day Since March
• Mexican Health Officials Stop Sharing Coronavirus Case Estimates
• Nigeria: Doctors Go on Strike over Insufficient Coronavirus Protection
• Azar: Trump’s Reopening Recommendations ‘Based on the Soundest Scientific Evidence and Modeling’
• Netanyahu Eases Virus Restrictions: ‘We Have Greatly Succeeded’
• Colorado Medic Who Went to Assist NYC Dies of Coronavirus
• Demonstrators in Boston Flock to State House in Protest of Governor’s Orders
• Government scientist Neil Ferguson, 51 – whose death toll projections sparked lockdowns – QUITS after admitting he allowed married mistress, 38, to break stay-at-home rules to visit him for trysts
• Prof Ferguson allowed the woman to visit him at home during the lockdown while lecturing the public on the need for strict social distancing
• Do as I say, not as I do: UK Scientist pushing social distancing defies rules with lover
• US State Department: Billions Given to Unaccountable W.H.O. Better Spent Using Other Global Health Partners
• Apple and Google Promise to Ban Location Tracking in Apps Using ‘Contact Tracing’ Tech
• Philadelphia Reports Manhattan Derailed: Neglected Subways Cause Problems for New York amid Pandemic
• CDC Document Claiming Increased Coronavirus Deaths in June Not Based on Task Force Data
• Thermal Camera System Helps Keep Apartment Residents Safe During Coronavirus Pandemic
• Dallas salon owner jailed for reopening in violation of court order
• White House to wind down coronavirus task force
• ‘Safe’ Becomes Rural Tourism Pitch to a Distancing Public
• Texas Governor Admits Dangers of Reopening State 
• President Trump admits US reopening will cost more lives
• To find a coronavirus vaccine, can we ethically infect people with a disease with no cure?
• Washington region a new coronavirus hotspot
• Months before Florida leaders had any clue, coronavirus was creeping through the state
• As California prepares to reopen retail, Gov. Newsom says, ‘We’re not going back to normal’
• Israel Institute for Biological research finds antibody that neutralizes coronavirus
• Author of chart projecting 3,000 coronavirus deaths per day says report was not ready to be shared
• As new infections tail off, Hong Kong cautiously eases restrictions
• Blood tests of 100,000 Israelis will try to assess exposure to Covid-19 on a nationwide scale
• UK overtakes Italy with Europe’s highest official coronavirus death toll
• New York Times headquarters won’t reopen until September 
• Florists Scramble to Deliver Mother’s Day Bouquets with Less Inventory Available
• Social distancing picnic blanket might be summer’s must-have accessory
• Billionaire Sam Zell Sees Economy Permanently Scarred by Pandemic
• First Socially-Distanced Concert in Arkansas Next Week
• Frontier Airlines Will Guarantee Empty Middle Seat For $39
• Bahamas, Haiti want negative COVID tests from returning citizens. Antigua wants same from tourists.
• Coronavirus may have arrived in Sweden in November: Public Health Agency
• Thousands of people in Cuba may have had early, undiagnosed cases of coronavirus
• Lebanon extends virus shutdown, PM warns of second wave
• Trump says ‘some’ deaths possible as states lift coronavirus lockdowns
• Quarantined Americans are watching a lot of HGTV, Food Network
• Tyson will reopen Iowa plant where hundreds were sickened
• Model predicts 350,000 coronavirus deaths if all states fully reopen 
• Scientists call on WHO to provide guidance on indoor humidity in coronavirus battle
• NYC bulks up 311 staff as social-distancing complaints see record weekend
• In coronavirus wake, ‘targeted lockdown’ could be better for public health, economy
• Most Americans think first responders deserve more appreciation 
• Army offers $25M for development of wearable coronavirus detector
• Zimbabwean reveals struggle of staving off coronavirus with dwindling water supply
• Detroit automakers want to reopen plants in 2 weeks
• UK’s obese residents may be forced to stay home after lockdown
• 1 in 5 NYC workers will be jobless by June, comptroller predicts
• Study shows new coronavirus mutation appears stronger, more contagious
• In Texas, reopened malls and restaurants draw few customers
• Norwegian Cruise Line sees troubled waters as ships stay anchored
• Nurse says treating coronavirus patients was ‘1,000 times worse’ than expected
• New Delhi imposes 70 percent coronavirus tax on liquor sales
• Chris Christie: US should reopen because there will ‘be deaths no matter what’
• Man microwaves cash in effort to kill coronavirus (Spoiler: That was stupid)

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.

Sources: Worldometers and  ncov2019.live

1. Confirmed Total Cases and New Cases

• Worldwide:  
  • Total Cases = 3,724,518 (+2.2%)
  • New Cases = 81,247 (+2.1%) (+1,665)
  • New Cases (5 day avg) = 84,060 (-1.1%) (-958)
• US: 
  • Total Cases = 1,237,633 (+2.0%)
  • New Cases = 24,798 (+0.3%) (+85)
  • New Cases (5 day avg) = 28,522 (-4.1%) (-1,206)
• US States:  
  • 45 States > 1,000 cases (+0), 
  • 41 States > 2,500 cases (+0)
  • 35 States > 5,000 cases (+0), plus DC
  • 21 States > 10,000 cases (+1): NY, NJ, MA, IL, CA, PA, MI, FL, LA, CT, TX, GA, MD, OH, IN, CO, WA, VA, TN,  NC & IA
  • 16 States > 20,000 cases (+1): NY, NJ, MA, IL, CA, PA, MI, FL, LA, CT, TX, GA, MD, IN, OH & VA
  • 5 States With Largest Number of Total Cases: 

State	Total Cases	Change in Total Cases (%)	New Cases	Change in New Cases (#)	Change in New Cases (%)
NY	330,139	0.8%	2,765	(726)	(20.8%)
NJ	131,705	1.8%	2,360	453	23.8%
MA	70,271	1.7%	1,184	124	11.7%
IL	65,962	3.3%	2,122	(219)	(10.3%)
CA	58,625	4.5%	2,536	1,306	106.2%
Total	656,702	1.7%	10,967	938	9.4%

• Top 5 States = 53.1% of Total US Cases (-0.1%)
• NY & NJ = 37.3% of Total US Cases (-0.4%)
• Trends:  Top 5 States and NY/NJ percentages of total cases are declining as their average number of new cases continue to decline while new cases in other States are increasing 
• 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 = 49,256 (-383)
• US serious or critical cases = 16,179 (+129) 
• US serious or critical cases = 1.7% of Active Cases compared with worldwide percentage of 2.2%

3. Deaths

• Worldwide deaths = 258,027 (+2.3%) 
• Worldwide new deaths = 5,786 (+41.3%) (+1,691)
• US deaths = 72,271 (+3.4%) 
• US new deaths = 2,350 (+77.5%) (+1,026)
• NY deaths = 25,204 (+1.0%) 
• NY new deaths = 260 (-12.2%) (-36)
• Deaths per 1M population of 5 Countries with Largest Number of Confirmed Cases: 
  • Spain: 548 (+4) 
  • Italy: 485 (+4) 
  • United Kingdom: 433 (+10)  
  • France: 391 (+5) 
  • United States: 218 (+7) 
  • New York: 1,285 (+14)
  • US Total Confirmed Case Fatality Rate = 5.8% 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.]

4. Countries/States Under The Microscope

• Sweden
  • Total Cases = 23,216 (+404)
  • Deaths = 2,854 (+85)
  • Deaths per 1 million population = 283 (+9)
• Georgia
  • Total Cases = 29,892 (+454)
  • Deaths = 1,295 (+49)
  • Deaths per 1 million population = 126 (+5)

C. Risks of Mutuation

1. A now-dominant strain of the virus appears to be more contagious 

• Scientists have identified a new strain of the coronavirus that has become dominant worldwide and appears to be more contagious than the versions that spread in the early days of the C19 pandemic, according to a new study led by scientists at Los Alamos National Laboratory.
• The new strain appeared in February in Europe, migrated quickly to the East Coast of the US and has been the dominant strain across the world since mid-March, the scientists wrote.
• In addition to spreading faster, it may make people vulnerable to a second infection after a first bout with the disease, the report warned.
• The 33-page report was posted on Thursday on BioRxiv, a website that researchers use to share their work before it is peer reviewed, an effort to speed up collaborations with scientists working on C19 vaccines or treatments. That research has been largely based on the genetic sequence of earlier strains and might not be effective against the new one.  

[Note: the report can be found at Spike mutation pipeline reveals the emergence of a more transmissible form of SARS-CoV-2]

• The mutation identified in the new report affects the now infamous spikes on the exterior of the coronavirus, which allow it to enter human respiratory cells. The report’s authors said they felt an “urgent need for an early warning” so that vaccines and drugs under development around the world will be effective against the mutated strain.
• Wherever the new strain appeared, it quickly infected far more people than the earlier strains that came out of Wuhan, China, and within weeks it was the only strain that was prevalent in some nations, according to the report. The new strain’s dominance over its predecessors demonstrates that it is more infectious, according to the report, though exactly why is not yet known.
• The report was based on a computational analysis of more than 6,000 coronavirus sequences from around the world, collected by the Global Initiative for Sharing All Influenza Data, a public-private organization in Germany. Time and again, the analysis found the new version was transitioning to become dominant.
• The Los Alamos team, assisted by scientists at Duke University and the University of Sheffield in England, identified 14 mutations. Those mutations occurred among the nearly 30,000 base pairs of RNA that other scientists say make up the coronavirus’s genome. The report authors focused on a mutation called D614G, which is responsible for the change in the virus’ spikes.
• “The story is worrying, as we see a mutated form of the virus very rapidly emerging, and over the month of March becoming the dominant pandemic form,” study leader Bette Korber, a computational biologist at Los Alamos, wrote on her Facebook page. “When viruses with this mutation enter a population, they rapidly begin to take over the local epidemic, thus they are more transmissible.”
• The report contains regional breakdowns of when the new strain of virus first emerged and how long it took to become dominant.
• Italy was one of the first countries to see the new virus in the last week of February, almost at the same time that the original strain appeared.
• Washington was among the first states to get hit with the original strain in late February, but by March 15 the mutated strain dominated. New York was hit by the original virus around March 15, but within days the mutant strain took over. The team did not report results for California.
• Scientists at major organizations working on a vaccine or drugs have told The Times that they are pinning their hopes on initial evidence that the virus is stable and not likely to mutate the way influenza virus does, requiring a new vaccine every year. The Los Alamos report could upend that assumption.
• If the pandemic fails to wane seasonally as the weather warms, the study warns, the virus could undergo further mutations even as research organizations prepare the first medical treatments and vaccines. Without getting on top of the risk now, the effectiveness of vaccines could be limited. Some of the compounds in development are supposed to latch onto the spike or interrupt its action. If they were designed based on the original version of the spike, they might not be effective against the new coronavirus strain, the study’s authors warned.
• “We cannot afford to be blindsided as we move vaccines and antibodies into clinical testing,” Korber wrote on Facebook. “Please be encouraged by knowing the global scientific community is on this, and we are cooperating with each other in ways I have never seen … in my 30 years as a scientist.”
• David Montefiori, a Duke University scientist who worked on the report said it is the first to document a mutation in the coronavirus that appears to make it more infectious.
• Although the researchers don’t yet know the details about how the mutated spike behaves inside the body, it’s clearly doing something that gives it an evolutionary advantage over its predecessor and is fueling its rapid spread. One scientist called it a “classic case of Darwinian evolution.”
• “The new strain is increasing in frequency at an alarming rate, indicating a fitness advantage relative to the original Wuhan strain that enables more rapid spread,” the study said.
• Still unknown is whether this mutant virus could account for regional variations in how hard C19 is hitting different parts of the world.
• In the US, doctors had begun to independently question whether new strains of the virus could account for the differences in how it has infected, sickened and killed people, said Alan Wu, a UC San Francisco professor who runs the clinical chemistry and toxicology laboratories at San Francisco General Hospital.
• Medical experts have speculated in recent weeks that they were seeing at least two strains of the virus in the U.S., one prevalent on the East Coast and another on the West Coast, according to Wu.
• “We are looking to identify the mutation,” he said, noting that his hospital has had only a few deaths out of the hundreds of cases it has treated, which is “quite a different story than we are hearing from New York.”
• The Los Alamos study does not indicate that the new version of the virus is more lethal than the original. People infected with the mutated strain appear to have higher viral loads. But the study’s authors from the University of Sheffield found that among a local sample of 447 patients, hospitalization rates were about the same for people infected with either virus version.
• Even if the new strain is no more dangerous than the others, it could still complicate efforts to bring the pandemic under control. That would be an issue if the mutation makes the virus so different from earlier strains that people who have immunity to them would not be immune to the new version.
• If that is indeed the case, it could make “individuals susceptible to a second infection,” the study authors wrote.
• It’s possible that the mutation changes the spike in some way that helps the virus evade the immune system, said Montefiori, who has worked on an HIV vaccine for 30 years. “It is hypothetical. We are looking at it very hard.”

Source: Study reports mutant coronavirus that may be more contagious

D. Antibody Testing

1. New CRISPR-based test could be a simple, cheap at-home diagnostic

• The revolutionary genetic technique better known for its potential to cure thousands of inherited diseases could also solve the challenge of C19 diagnostic testing, scientists announced on Tuesday. A team headed by biologist Feng Zhang of the McGovern Institute at MIT and the Broad Institute has repurposed the genome-editing tool CRISPR into a test able to quickly detect as few as 100 coronavirus particles in a swab or saliva sample.
• Crucially, the technique, dubbed a “one pot” protocol, works in a single test tube and does not require the many specialty chemicals, or reagents, whose shortage has hampered the rollout of widespread C19 testing in the U.S. It takes about an hour to get results, requires minimal handling, and in preliminary studies has been highly accurate, Zhang told STAT. 
• Because the test has not been approved by the FDA, it is only for research purposes for now. But minutes before speaking to STAT on Monday, Zhang and his colleagues were on a conference call with FDA officials about what they needed to do to receive an “emergency use authorization” that would allow clinical use of the test. The FDA has used EUAs to fast-track C19 diagnostics as well as experimental therapies, including remdesivir, after less extensive testing than usually required.
• For an EUA, Zhang said, the agency will require his lab to validate the test, which they call STOPCovid, on several samples. Although “it is still early in the process,” Zhang said, he and his colleagues are confident enough in its accuracy that they are conferring with potential commercial partners who could turn the test into a cartridge-like device, similar to a pregnancy test, enabling C19 testing at doctor offices and other point-of-care sites.
• “It could potentially even be used at home or at workplaces,” Zhang said. “It’s inexpensive, does not require a lab, and can return results within an hour using a paper strip, not unlike a pregnancy test. This helps address the urgent need for widespread, accurate, inexpensive, and accessible C19 testing.” Public health experts say the availability of such a test is one of the keys to safely reopening society, which will require widespread testing, and then tracing and possibly isolating the contacts of those who test positive.
• The scientists are also in discussions with the Gates Foundation about distributing the testing kits. “It could be especially valuable in places where there is not the capacity for centralized testing,” Gootenberg said.
• Other labs are also developing CRISPR-based C19 tests. Last month scientists at the University of California, San Francisco, and Mammoth Biosciences reported that theirs takes roughly 40 minutes, compared with 4 to 6 hours for the traditional swab tests (which use a biochemical reaction called PCR and require numerous reagents). But that test appears to produce false negatives slightly more often than the PCR test. It also requires two steps, similar to one that Zhang developed in February; that adds complexity and increases the chances that samples will cross-contaminate.
• Zhang’s February test is being used by hospitals in Thailand. But with his colleagues, he has spent the last two months creating the one-step version.
• “The key advance for STOP is the simplification into a single-step reaction, which prevents cross contamination during step-to-step liquid transfers,” he said. “That makes it suitable for point-of-care use.”
• Existing “home” C19 diagnostic tests such as that from LabCorp allow people to collect the sample — that is, swab themselves — at home. The actual test must be done at a lab. Currently approved point-of-care C19 diagnostic tests, such as Abbott ID NOW and Cepheid GeneXpert, require specialized and expensive instrumentation and technical expertise, limiting widespread use. Abbott’s has also been plagued by false negatives, meaning it sometimes fails to detect the coronavirus.
• The MIT scientists tested STOP on nasopharyngeal swabs from C19 patients and on saliva samples from healthy people to which the new coronavirus was added. STOP had 100% specificity — it never “found” the coronavirus if the microbe wasn’t really there — and 97% sensitivity, meaning if the virus was present, the test missed it only 3% of the time. The existing PCR test misses up to 30% of cases, scientists have said.
• The scientists have prepared enough material so far for 10,000 tests, and are making it free to researchers who want to evaluate its potential diagnostic use.

Source: Stat News here. 

E. Vaccines

1. Coronavirus Vaccine Enters Human Testing in U.S.

• Researchers at the New York University Grossman School of Medicine in Manhattan and the University of Maryland School of Medicine in Baltimore said Tuesday they began injecting people with the first of 4 vaccine candidates from Pfizer and Germany’s BioNTech.
• The clinical trial will help the researchers evaluate whether the candidates are safe, which produces the strongest immune response that could fend off the coronavirus, and what the dose should be. Pfizer plans to advance the candidate that proves most promising. Testing of the vaccine candidates in Germany began last month.
• Results from the 360-person study in the U.S. could come as early as next month, but the vaccine will still need to undergo additional testing in more patients, said Kathrin Jansen, Pfizer’s head of vaccine research and development.
• The plan is to “weed out, weed out, weed out, focus on what’s good and move on,” Dr. Jansen said. “It’s a quick elimination.”
• A vaccine could be ready for emergency use as early as the fall if testing indicates it works safely, Pfizer Chief Executive Albert Bourla told The Wall Street Journal last week, though the company would keep studying it in clinical trials.
• The U.S. government has the authority to grant limited use of a vaccine or drug during a health emergency, before testing is complete.
• Several potential coronavirus vaccines have entered human testing, including candidates from Moderna Inc. and Oxford University.
• The vaccine efforts have advanced quickly compared with typical vaccine R&D timelines, though some experts have expressed concern over whether testing will be rigorous enough to adequately assess if the shots can safely protect people from contracting the coronavirus.
• Adding to the challenges of deciphering whether a coronavirus vaccine works, researchers say, is uncertainty about how immunity develops against the virus.
• Without that knowledge, researchers are relying on their understanding of previous coronaviruses and antibodies that neutralize viruses, said Kirsten Lyke, a professor of medicine at the University of Maryland School of Medicine, who is helping lead the Pfizer trial.
• Four out of every five study subjects will get the vaccine, while the remaining subjects will take a placebo.
• The vaccine uses a gene-based technology known as messenger RNA. Messenger RNA, or mRNA, carries instructions from DNA to the body’s cells to make certain proteins. An mRNA vaccine has never been approved to prevent any infectious disease.
• Mark Mulligan, director of the Vaccine Center at NYU Langone Health, said he doesn’t expect challenges enrolling patients.
• “People, frankly, are sick of this virus and they want to do whatever they can to fight back,” he said. “The public recognizes that in order to start returning to normalcy, we’ve got to get people protected, and vaccines hold the greatest hope for that.”
• Aside from working on a vaccine, Pfizer is also trying to develop an antiviral treatment that could begin testing this summer, and it is testing whether rheumatoid-arthritis drug Xeljanz helps fight C19, the disease caused by the coronavirus.
• Pfizer plans to soon manufacture the vaccines at its facilities in Massachusetts, Michigan and Missouri, as well as Puurs, Belgium, with additional locations to come.

Source: WSJ here. 

F. Symptoms

1. ‘COVID toes’ illustrate how much is still unknown about the disease

• Dr. Lindy Fox, a dermatologist, said her practice is seeing “many, many patients” with toes and fingers turning purple and pink, a symptom now being linked to C19.
• “Almost too many to count,” she said. “Dermatologists are being inundated with calls from people saying, ‘What are these purple changes on my toes and fingers?'”
• And what is alarming is the majority of people with this symptom never thought they were even exposed to the coronavirus.
• “They’re usually teenagers or young adults that had absolutely no other symptoms of C19,” said Dr. Raman Madan, a dermatologist at Northwell Health Huntington Hospital on Long Island.
• “It seems to be happening in people who are completely without symptoms otherwise,” Dr. Alisa Femia, the director of inpatient dermatology at NYU Langone, said. “They’re younger, healthier.”
• “It’s becoming a sign that C19 may be more prevalent in our society than we actually realized,” said Dr. Fox, who is with the University of California San Francisco, and also a member of the C19 task force for the American Academy of Dermatology, which has created a registry of patients to study numerous skin issues people are experiencing. The latest is skin discoloration dubbed “COVID toes.”
• “We looked back and saw this was happening in France, Italy, Spain,” she said.
• Dr. Madan said C19 has manifested into just about every rash you can imagine.
• “People are breaking out in hives, red blotches all over their body and even developing rashes that look like chickenpox,” he said.
• Dr. Madan said that it is entirely possible we could see even more new symptoms materialize from C19 moving forward.
• “I wouldn’t be surprised by that at all,” Dr. Madan said. 
• The COVID toes condition tends to go away on its own within about a week and you will not have long-term damage to your skin, doctors said. But if you do get this symptom, you should call your doctor and get tested for C19 as well as the antibody test.

Source: ‘COVID toes’ are emblematic of how much is still unknown about the disease

G. New Scientific Findings & Theories

1. New Evidence Children Transmit the Coronavirus

• Among the most important unanswered questions about C19 is this: What role do children play in keeping the pandemic going?
• Fewer children seem to get infected by the coronavirus than adults, and most of those who do have mild symptoms, if any. But do they pass the virus on to adults and continue the chain of transmission?
• The answer is key to deciding whether and when to reopen schools, a step that President Trump urged states to consider before the summer.
• Two new studies offer compelling evidence that children can transmit the virus. Neither proved it, but the evidence was strong enough to suggest that schools should be kept closed for now, many epidemiologists who were not involved in the research said.
• Many other countries, including Israel, Finland, France, Germany, the Netherlands and the United Kingdom have all either reopened schools or are considering doing so in the next few weeks.
• In some of those countries, the rate of community transmission is low enough to take the risk. But in others, including the United States, reopening schools may nudge the epidemic’s reproduction number — the number of new infections estimated to stem from a single case, commonly referred to as R0 — to dangerous levels, epidemiologists warned after reviewing the results from the new studies.
• In one study, published last week in the journal Science, a team analyzed data from two cities in China — Wuhan, where the virus first emerged, and Shanghai — and found that children were about a third as susceptible to coronavirus infection as adults were. But when schools were open, they found, children had about three times as many contacts as adults, and three times as many opportunities to become infected, essentially evening out their risk.
• Based on their data, the researchers estimated that closing schools is not enough on its own to stop an outbreak, but it can reduce the surge by about 40 to 60% and slow the epidemic’s course.
• “My simulation shows that yes, if you reopen the schools, you’ll see a big increase in the reproduction number, which is exactly what you don’t want,” said Marco Ajelli, a mathematical epidemiologist who did the work while at the Bruno Kessler Foundation in Trento, Italy.
• The second study, by a group of German researchers, was more straightforward. The team tested children and adults and found that children who test positive harbor just as much virus as adults do — sometimes more — and so, presumably, are just as infectious.
• “Are any of these studies definitive? The answer is ‘No, of course not,’” said Jeffrey Shaman, an epidemiologist at Columbia University who was not involved in either study. But, he said, “to open schools because of some uninvestigated notion that children aren’t really involved in this, that would be a very foolish thing.”
• The German study was led by Christian Drosten, a virologist who has ascended to something like celebrity status in recent months for his candid and clear commentary on the pandemic. Dr. Drosten leads a large virology lab in Berlin that has tested about 60,000 people for the coronavirus. Consistent with other studies, he and his colleagues found many more infected adults than children.
• The team also analyzed a group of 47 infected children between ages 1 and 11. Fifteen of them had an underlying condition or were hospitalized, but the remaining were mostly free of symptoms. The children who were asymptomatic had viral loads that were just as high or higher than the symptomatic children or adults.
• There is a significant body of work suggesting that a person’s viral load tracks closely with their infectiousness. “So I’m a bit reluctant to happily recommend to politicians that we can now reopen day cares and schools.”
• The researchers stratified the data from these contacts by age and found that children between the ages of 0 and 14 years are about a third less susceptible to coronavirus infection than those ages 15 to 64, and adults 65 or older are more susceptible by about 50 percent.
• They also estimated that closing schools can lower the reproduction number — again, the estimate of the number of infections tied to a single case — by about 0.3; an epidemic starts to grow exponentially once this metric tops 1.
• In many parts of the United States, the number is already hovering around 0.8, Dr. Ajelli said. “If you’re so close to the threshold, an addition of 0.3 can be devastating.”
• However, some other experts noted that keeping schools closed indefinitely is not just impractical, but may do lasting harm to children.
• Jennifer Nuzzo, an epidemiologist at Johns Hopkins University’s Bloomberg School of Public Health, said the decision to reopen schools cannot be made based solely on trying to prevent transmission.
• “I think we have to take a holistic view of the impact of school closures on kids and our families,” Dr. Nuzzo said. “I do worry at some point, the accumulated harms from the measures may exceed the harm to the kids from the virus.”
• E-learning approaches may temporarily provide children with a routine, “but any parent will tell you it’s not really learning,” she said. Children are known to backslide during the summer months, and adding several more months to that might permanently hurt them, and particularly those who are already struggling.
• Children also need the social aspects of school, and for some children, home may not even be a safe place, she said.
• “I’m not saying we need to absolutely rip off the Band-aid and reopen schools tomorrow,” she said, “but we have to consider these other endpoints.”

Source: New Studies Add to Evidence that Children May Transmit the Coronavirus 

2. Europe’s first coronavirus case was in December

• A Frenchman was stricken by the coronavirus back in December — a month before the contagion was thought to have reached Europe, scientists have confirmed after testing old samples.
• Amirouche Hammar, a fishmonger in Paris, told French TV how late last year he had been left coughing up blood with the now-known classic symptoms of C19, including chest pains and breathing difficulties.
• He was told it was “not normal flu” when he went to a hospital on Dec. 27 — but at the time the pandemic was completely unknown.
• It would be four days before Chinese authorities first alerted the WHO to the mysterious viral pneumonia killing people in Wuhan — and almost a month before it was first reported in France.
• The 43-year-old dad was finally confirmed to have been infected after doctors reviewed retrospective samples of 14 patients treated for pneumonia between December and mid-January, according to a study published in the International Journal of Microbial Agents.
• “Identifying the first infected patient is of great epidemiological interest as it changes dramatically our knowledge” of the disease’s spread, wrote Dr. Yves Cohen, one of the French researchers.
• Of particular note, the fishmonger had not traveled to Wuhan, like the two people who were assumed to be the first confirmed cases in France on Jan. 24. The European nation has since had almost 170,000 confirmed cases and more than 25,000 deaths, data showed Tuesday.
• Cohen told BFM-TV that when Hammar first sought treatment they figured he was simply suffering from a form of viral pneumonia.
• “We told ourselves, ‘It’s a virus that we haven’t discovered,’ but we stopped there,’” he said.
• But Hammer says the symptoms that left him rushing to an emergency room at 5 a.m. now appear to be classic signs of the illness that has killed more than 252,000 worldwide.
• “They said, ‘Perhaps you have an infection, a pulmonary infection, although it’s not certain. But what you have is very serious, very serious, because you are coughing blood. It’s not normal flu,’” he recalled.
• Christian Lindmeier, a spokesman for the WHO, described the findings as “exciting news” and said they could help scientists better understand the evolution of the new coronavirus.
• “This gives us a whole new picture on everything, and yes of course, it would be great if all countries who have unspecified cases of pneumonia in the recent months, and even in December, and in even in November, would check them against C19,” he said.

Source: Europe’s first coronavirus case was in December: scientists 

H. Taking on Coronavirus in the Subway 

1. NYC will use powerful ultraviolet lamps to kill the coronavirus on subways and buses

• According to the New York Daily News, the Metropolitan Transportation Authority will begin using powerful ultraviolet light as part of its beefed-up sanitization program on subways and buses. The effort is part of a partnership with Columbia University, which theorizes that UV light can be used to kill diseases on the transit system.
• Starting May 11th, UV lamps will be placed inside subway cars and buses at two rail yards and bus depots. The lamps emit rays called “UVC,” a relatively obscure part of the spectrum that consists of a shorter, more energetic wavelength of light that can be harmful to humans if exposed directly.
• UVC is particularly good at killing organic material — whether in humans or viral particles — but the jury is still out on whether it can be effective in destroying the novel coronavirus. UVC lamps and robots are commonly used to sanitize water, objects such as laboratory equipment, and spaces such as buses and airplanes. If the MTA results are good, transit officials said they will expand it to include more trains and buses.
• “At this critical and unprecedented time, the MTA is exploring every solution scientists and the market have to offer in our effort to ensure the transportation system is safe for our customers and employees,” said Mark Dowd, MTA chief innovation officer, in a statement. “The pilot project involving this proven UV technology is another example of that as we look for alternative ways to effectively reduce risk on train cars and buses. We thank Columbia University for its partnership and are hopeful this new technology in transit provides a more effective and efficient option than our current disinfecting efforts.”
• President Donald Trump infamously touted ultraviolet light and disinfectant as potential treatments for people who are sick with C19, despite both being very harmful to humans. The president later claimed that he was being sarcastic.
• Last week, New York Gov. Andrew Cuomo and New York City Mayor Bill de Blasio announced the extraordinary step of shutting down subway service from 1AM to 5AM every evening starting on May 6th for extensive disinfecting.
• The MTA has reported a 90% drop in ridership since the start of the pandemic, with the agency curtailing some train and bus service to address the drop in demand. Many essential workers still count on transit to get to and from work every day. So far, over 80 MTA employees have died from the virus.

Source: NYC will use powerful ultraviolet lamps to kill the coronavirus on subways and buses

I. Projections & Our (Possible) Future

1. The Dubious C19 Models, The Tests, & Now, The Consequences [By F. William Engdahl, Global Research]

Dubious C19 Models

• Two major models are being used in the West since the alleged spread of coronavirus to Europe and USA to “predict” and respond to the spread of C19 illness. One was developed at Imperial College of London. The second was developed, with emphasis on USA effects, by the University of Washington’s Institute for Health Metrics and Evaluation (IHME) in Seattle. What few know is that both groups owe their existence to generous funding by The Bill and Melinda Gates Foundation.
• In early March, Prof. Neil Ferguson, head of the MRC Centre for Global Infectious Disease Analysis at Imperial College London issued a widely-discussed model that forecast possible C19 deaths in the UK as high as 500,000. Ferguson works closely with the WHO. 
• That report was held responsible for a dramatic u-turn by the UK government from a traditional public health policy of isolating at risk patients while allowing society and the economy to function normally. Days after the UK went on lockdown, Ferguson’s institute sheepishly revised downwards his death estimates, several times and dramatically. His dire warnings have not come to pass and the UK economy, like most others around the world, has gone into deep crisis based on inflated estimates.
• Ferguson and his Imperial College modelers have a notorious track record for predicting dire consequences of diseases:
• In 2002 Ferguson predicted that up to 50,000 people in UK would die from variant Creutzfeldt-Jakob disease, “mad cow disease”, possibly to 150,000 if the epidemic expanded to include sheep. A total of 178 people were officially registered dead from vCJD. 
• In 2005, Ferguson claimed that up to 200 million (!) people worldwide would be killed by bird-flu or H5N1. By early 2006, the WHO had only linked 78 deaths to the virus. 
• Then in 2009 Ferguson’s group at Imperial College advised the government that swine flu or H1N1 would probably kill 65,000 people in the UK. In the end, swine flu claimed the lives of 457 people. 
• Yet the same Ferguson group at Imperial College, with WHO endorsement, was behind the panic numbers that triggered a UK government lockdown. 
• Ferguson was also the source of the wild “prediction” that 2.2 million Americans would likely die if immediate lockdown of the US economy did not occur. 
• Based on the Ferguson model, Dr. Anthony Fauci of NIAID reportedly confronted President Trump and pressured him to declare a national health emergency. 
• Much as in the UK, once the damage to the economy was begun, Ferguson’s model later drastically lowered the US fatality estimates to between 100,000 to 200,000 deaths. In both US and UK cases Neil Ferguson relied on data from the Chinese government, data which has been shown as unreliable.
• Neil Ferguson and his modelling group at Imperial College, in addition to being backed by WHO, receive millions from the Bill & Melinda Gates Foundation. Ferguson heads the Vaccine Impact Modelling Consortium at Imperial College which lists as its funders the Bill & Melinda Gates Foundation and the Gates-backed GAVI-the vaccine alliance. From 2006 through 2018 the Gates Foundation has invested an impressive $184,872,226.99 into Ferguson’s Imperial College modeling operations.
• Notably, the Gates foundation began pouring millions into Ferguson’s modelling operation well after his catastrophic lack of accuracy was known, leading some to suggest Ferguson is another “science for hire” operation.

University of Washington

• More recently, the forecast models being used to justify the unprecedented lockdown measures across the US have been developed at the University of Washington Institute for Health Metrics and Evaluation (IHME) in Seattle.
• Its C19 model forecasts deaths and the use of hospital resources such as hospital beds, ICU beds and ventilators. At the end of March the model from IHME also “predicted” up to 2.2 million American coronavirus deaths unless drastic lockdown measures were followed. By April 7 IHME models revised that down to up to 200,000 deaths. Their last down revision puts deaths at just over 60,000. The claim is that the down revisions are informed by actual data. Yet the wildly inaccurate projections were the ones used to impose catastrophic social and economic restrictions across the USA.  [Note: as discussed in our 5/5 Update, the IHME model has been revised (again) to project deaths of approximately 134,500 deaths by August 4.]
• Alex Berenson, a former New York Times reporter questioned the IMHE model:
• “Aside from New York, nationally there’s been no health system crisis. In fact, to be truly correct, there has been a health system crisis, but the crisis is that the hospitals are empty,” he said. “This is true in Florida where the lockdown was late, this is true in southern California where the lockdown was early, it’s true in Oklahoma where there is no statewide lockdown. There doesn’t seem to be any correlation between the lockdown and whether or not the epidemic has spread wide and fast.”

• IHME claims its revisions are result of the lockdown taking effect even though that would take weeks to show up.
• Like Neil Ferguson at the Imperial College London, the University of Washington’s IHME is another project of the Gates Foundation. It was created in 2007 with a major grant from the Bill & Melinda Gates Foundation. In May 2015 IHME and the World Health Organization signed a major agreement to collaborate on data used to estimate world health trends. Then in 2017 IHME got an additional $279 million from the Gates Foundation to expand its work over the next decade. That, in addition to another $210 million gift in 2016 from the Bill & Melinda Gates Foundation to fund construction of a new building to house several UW units working in population health, including IHME. In other words, IHME has been a crucial piece of the Gates global health strategy for more than 13 years.
• They have been turning out highly inflated models for state-by-state emergency room demands. Those inflated projections, from New York to California and beyond have wreaked havoc on the entire health care system. When one IHME model predicted a need for 430,000 intensive care beds across the US in March, states went into panic mode from New York to California to Pennsylvania and beyond. By the third week of April the reality was that hospital beds were empty and untold numbers of other operations had been canceled to make room for C19 patients who never materialized.

Faulty Tests

• The wide variety of different tests that are supposed to tell whether one is infected with the coronavirus have added a crucial element to the perfect dystopian storm that is raging globally. Simply put, the tests are not that reliable.
• A leading German laboratory reported in early April that, according to WHO recommendations, C19 virus tests are now considered positive, even if the specific target sequence of the C19 virus is negative and only the more general corona virus target sequence is positive. This can lead to other corona viruses such as cold viruses also triggering a false positive test result. That means you can have a simple cold and you are deemed coronavirus positive. Little wonder that the tally of coronavirus “infected” is exploding over the past weeks. But what does that number really mean? We simply don’t know. Yet our politicians are glibly shutting down entire economies and causing inconceivable social damage based on false model projections and WHO’s dodgy testing guidelines.
• In Germany the Robert Koch Institute (RKI), the government agency leading the C19 response, has deliberately refused to list the actual daily number of persons tested despite requests. Prof. Christopher Kuhbander, author of a detailed study states:
  • “The reported figures on new infections very dramatically overestimate the true spread of the corona virus. The observed rapid increase in new infections is almost exclusively due to the fact that the number of tests has increased rapidly over time. So, at least according to the reported figures, there was in reality never an exponential spread of the coronavirus. The reported figures on new infections hide the fact that the number of new infections has been decreasing since about early or mid-March.” 
• Yet the uncritical media presentation of endless statistics from the head of the RKI have fostered unprecedented anxiety and fear in the population of Germany.
• Californian physician Dr. Dan Erickson described his observations regarding C19 in a press briefing. He stated that hospitals and intensive care units in California and other states have remained largely empty so far. Dr. Erickson reports that doctors from several US states have been “pressured“ to issue death certificates mentioning C19, even though they themselves did not agree. In Pennsylvania the state was forced to remove some 200 “coronavirus” deaths after doctor autopsy revealed death from pre-existing causes such as heart or lung diseases.
• The more that actual facts are emerging around this pandemic and its consequences, it is becoming clear we are being told to commit economic and social suicide based on wrong methods and wrong information.

Source: The Dubious COVID Models, The Tests, & Now, The Consequences (originally published at here.)

2. New University Of Pen Model Predicts 350,000 Deaths By End Of June If All States Fully Reopen

• Governors have a lot to consider before fully reopening. If they open too quickly, that could result in more deaths, according to a new model from the Wharton School at the University Of Pennsylvania.
• Reopening states’ economies certainly comes with a cost, and that could result in more deaths.
• But some economists argue not only can you put a value on human life, but they urge elected officials to do just that when making policy decisions.
• The Wharton School just unveiled a model that looks at several different scenarios that could happen as states begin to lift stay-at-home orders.
• “The economic costs have been enormous and we are suffering really significant, unprecedented costs as a result of these policies,” said Alex Arnon, senior analyst at The Penn Wharton Budget Model.

• Here’s what the model shows: if states continue stay-at-home orders, the model predicts, nationwide, roughly 117,000 COVID-19 deaths from May 1 through the end of June, with 18.6 million jobs lost.
• Partially reopening would result in additional deaths during the same time, with 14 million jobs lost.
• But if all states fully reopen, it estimates nearly 350,000 COVID-19 deaths by the end of June, with a half-million jobs lost. So, the data shows the number of deaths could surge if states open too quickly.
• “How we value lives against economic outcomes, these are decisions that we need to make democratically through our elected officials,” said Arnon.
• So what is the value of a human life? Pre-COVID-19 the Centers for Disease Control and Prevention and other federal agencies put it at roughly $10 million a person.
• As for the Wharton model during the pandemic.
• “We are not trying to put a value on the lives, we cannot do that, but we do want to give people and policy makers some scale of what the tradeoffs are,” Arnon said.
• The simulator uses data from Johns Hopkins, the American Community Survey and other sources and the data is updated weekly, so the results could change.
• The model can be seen at Coronavirus Policy Response Simulator: Health and Economic Effects of State Reopenings

Source: Coronavirus Latest: New University Of Penn Model Predicts 350,000 Deaths By End Of June If All States Fully Reopen

J. C19 Riddle

1. Why Does the Virus Wallop Some Places and Spare Others?

• The coronavirus has killed so many people in Iran that the country has resorted to mass burials, but in neighboring Iraq, the body count is fewer than 100.
• The Dominican Republic has reported nearly 7,600 cases of the virus. Just across the border, Haiti has recorded about 85.
• In Indonesia, thousands are believed to have died of the coronavirus. In nearby Malaysia, a strict lockdown has kept fatalities to about 100.
• The coronavirus has touched almost every country on earth, but its impact has seemed capricious. Global metropolises like New York, Paris and London have been devastated, while teeming cities like Bangkok, Baghdad, New Delhi and Lagos have, so far, largely been spared.
• The question of why the virus has overwhelmed some places and left others relatively untouched is a puzzle that has spawned numerous theories and peculations but no definitive answers. That knowledge could have profound implications for how countries respond to the virus, for determining who is at risk and for knowing when it’s safe to go out again.
• There are already hundreds of studies underway around the world looking into how demographics, pre-existing conditions and genetics might affect the wide variation in impact.
• Doctors in Saudi Arabia are studying whether genetic differences may help explain varying levels of severity in C19 cases among Saudi Arabs, while scientists in Brazil are looking into the relationship between genetics and C19 complications. Teams in multiple countries are studying if common hypertension medications might worsen the disease’s severity and whether a particular tuberculosis vaccine might do the opposite.
• Many developing nations with hot climates and young populations have escaped the worst, suggesting that temperature and demographics could be factors. But countries like Peru, Indonesia and Brazil, tropical countries in the throes of growing epidemics, throw cold water on that idea.
• Draconian social-distancing and early lockdown measures have clearly been effective, but Myanmar and Cambodia did neither and have reported few cases.
• One theory that is unproven but impossible to refute: maybe the virus just hasn’t gotten to those countries yet. Russia and Turkey appeared to be fine until, suddenly, they were not.
• Time may still prove the greatest equalizer: The Spanish flu that broke out in the United States in 1918 seemed to die down during the summer only to come roaring back with a deadlier strain in the fall, and a third wave the following year. It eventually reached far-flung places like islands in Alaska and the South Pacific and infected a third of the world’s population.
• “We are really early in this disease,” said Dr. Ashish Jha, the director of the Harvard Global Health Research Institute. “If this were a baseball game, it would be the second inning and there’s no reason to think that by the ninth inning the rest of the world that looks now like it hasn’t been affected won’t become like other places.”
• Doctors who study infectious diseases around the world say they do not have enough data yet to get a full epidemiological picture, and that gaps in information in many countries make it dangerous to draw conclusions. Testing is woeful in many places, leading to vast underestimates of the virus’s progress, and deaths are almost certainly undercounted.
• Still, the broad patterns are clear. Even in places with abysmal record-keeping and broken health systems, mass burials or hospitals turning away sick people by the thousands would be hard to miss, and a number of places are just not seeing them — at least not yet.
• Interviews with more than two dozen infectious disease experts, health officials, epidemiologists and academics around the globe suggest four main factors that could help explain where the virus thrives and where it doesn’t: demographics, culture, environment and the speed of government responses.
• Each possible explanation comes with considerable caveats and confounding counter-evidence. If an aging population is the most vulnerable, for instance, Japan should be at the top of the list. It is far from it. Nonetheless these are the factors that experts find the most persuasive.

The Power of Youth

• Many countries that have escaped mass epidemics have relatively younger populations.
• Young people are more likely to contract mild or asymptomatic cases that are less transmissible to others, said Robert Bollinger, a professor of infectious diseases at the Johns Hopkins School of Medicine. And they are less likely to have certain health problems that can make C19, the disease caused by the coronavirus, particularly deadly, according to the World Health Organization.
• Africa — with about 45,000 reported cases, a tiny fraction of its 1.3 billion people — is the world’s youngest continent, with more than 60 percent of its population under age 25. In Thailand and Najaf, Iraq, local health officials found that the 20-to-29 age group had the highest rate of infection but often showed few symptoms.
• By contrast, the national median age in Italy, one of the hardest hit countries, is more than 45. The average age of those who died of C19 there was around 80.
• Younger people tend to have stronger immune systems, which can result in milder symptoms, said Josip Car, an expert in population and global health at Nanyang Technological University in Singapore.
• In Singapore and Saudi Arabia, for instance, most of the infections are among foreign migrant workers, many of them living in cramped dormitories. However, many of those workers are young and fit, and have not required hospitalization.
• Along with youth, relative good health can lessen the impact of the virus among those who are infected, while certain pre-existing conditions — notably hypertension, diabetes and obesity — can worsen the severity, researchers in the United States say.
• There are notable exceptions to the demographic theory. Japan, with the world’s oldest average population, has recorded fewer than 520 deaths, although its caseload has risen with increased testing.
• The Guayas region of Ecuador, the epicenter of an outbreak that may have claimed up to 7,000 lives, is one of the youngest in the country, with only 11 percent of its residents over 60 years old.
• And Dr. Jha of Harvard warns that some young people who are not showing symptoms are also highly contagious for reasons that are not well understood.

Cultural Distance

• Cultural factors, like the social distancing that is built into certain societies, may give some countries more protection, epidemiologists said.
• In Thailand and India, where virus numbers are relatively low, people greet each other at a distance, with palms joined together as in prayer. In Japan and South Korea, people bow, and long before the coronavirus arrived, they tended to wear face masks when feeling unwell.
• In much of the developing world, the custom of caring for the elderly at home leads to fewer nursing homes, which have been tinder for tragic outbreaks in the West.
• However, there are notable exceptions to the cultural distancing theory. In many parts of the Middle East, such as Iraq and the Persian Gulf countries, men often embrace or shake hands on meeting, yet most are not getting sick.
• What might be called “national distancing” has also proven advantageous. Countries that are relatively isolated have reaped health benefits from their seclusion.
• Far-flung nations, such as some in the South Pacific and parts of sub-Saharan Africa, have not been as inundated with visitors bringing the virus with them. Health experts in Africa cite limited travel from abroad as perhaps the main reason for the continent’s relatively low infection rate.
• Countries that are less accessible for political reasons, like Venezuela, or because of conflict, like Syria and Libya, have also been somewhat shielded by the lack of travelers, as have countries like Lebanon and Iraq, which have endured widespread protests in recent months.
• The lack of public transportation in developing countries may have also reduced the spread of the virus there.

Heat and Light

• The geography of the outbreak — which spread rapidly during the winter in temperate zone countries like Italy and the United States and was virtually unseen in warmer countries such as Chad or Guyana — seemed to suggest that the virus did not take well to heat. Other coronaviruses, such as ones that cause the common cold, are less contagious in warmer, moist climates.
• But researchers say the idea that hot weather alone can repel the virus is wishful thinking.
• Some of the worst outbreaks in the developing world have been in places like the Amazonas region of Brazil, as tropical a place as any.
• “The best guess is that summer conditions will help but are unlikely by themselves to lead to significant slowing of growth or to a decline in cases,” said Marc Lipsitch, the director of the Center for Communicable Disease Dynamics at Harvard University.
• The virus that causes C19 appears to be so contagious as to mitigate any beneficial effect of heat and humidity, said Dr. Raul Rabadan, a computational biologist at Columbia University.
• But other aspects of warm climates, like people spending more time outside, could help.
• “People living indoors within enclosed environments may promote virus recirculation, increasing the chance of contracting the disease,” said Mr. Car of Nanyang Technological University.
• The ultraviolet rays of direct sunlight inhibit this coronavirus, according to a study by ecological modelers at the University of Connecticut. So surfaces in sunny places may be less likely to remain contaminated, but transmission usually occurs through contact with an infected person, not by touching a surface.
• And tropical conditions may have even lulled some people into a false sense of security.
• “People were saying ‘It’s hot here, nothing will happen to me,’” said Dr. Doménica Cevallos, a medical investigator in Ecuador. “Some were even going out on purpose to sunbathe, thinking it would protect them from infection.”

Early and Strict Lockdowns

• Countries that locked down early, like Vietnam and Greece, have been able to avoid out-of-control contagions, evidence of the power of strict social distancing and quarantines to contain the virus.
• In Africa, countries with bitter experience with killers like H.I.V., drug-resistant tuberculosis and Ebola knew the drill and reacted quickly.
• Airport staff from Sierra Leone to Uganda were taking temperatures (since found to be a less effective measure) and contact details and wearing masks long before their counterparts in the United States and Europe took such precautions.
• Senegal and Rwanda closed their borders and announced curfews when they still had very few cases. Health ministries began contact tracing early.
• All this happened in a region where health ministries had come to rely on money, personnel and supplies from foreign donors, many of which had to turn their attention to outbreaks in their own countries, said Catherine Kyobutungi, executive director of the African Population and Health Research Center.
• “Countries wake up one day and they’re like, ‘OK, the weight of the country rests on our shoulders, so we need to step up,’” she said. “And they have. Some of the responses have been beautiful to behold, honestly.”
• Sierra Leone repurposed disease-tracking protocols that had been established in the wake of the Ebola outbreak in 2014, in which almost 4,000 people died there. The government set up emergency operations centers in every district and recruited 14,000 community health workers, 1,500 of whom are being trained as contact tracers, even though Sierra Leone has only about 155 confirmed cases.
• It is not clear, however, who will pay for their salaries or for expenses like motorcycles and raincoats to keep them operating during the coming wet season.
• Uganda, which also suffered during the Ebola contagion, quickly quarantined travelers from Dubai after the first case of coronavirus arrived from there. Authorities also tracked down about 800 others who had traveled from Dubai in previous weeks.
• The Ugandan health authorities are also testing around 1,000 truck drivers a day. But many of those who test positive have come from Tanzania and Kenya, countries that are not monitoring as aggressively, leading to worries that the virus will keep penetrating porous borders.
• Lockdowns, with bans on religious conclaves and spectator sporting events, clearly work, the World Health Organization says. More than a month after closing national borders, schools and most businesses, countries from Thailand to Jordan have seen new infections drop.
• In the Middle East, the widespread shuttering of mosques, shrines and churches happened relatively early and probably helped stem the spread in many countries.
• A notable exception was Iran, which did not close some of its largest shrines until March 18, a full month after it registered its first case in the pilgrimage city of Qum. The epidemic spread quickly from there, killing thousands in the country and spreading the virus across borders as pilgrims returned home.
• As effective as lockdowns are, in countries lacking a strong social safety net and those where most people work in the informal economy, orders closing businesses and requiring people to shelter in place will be difficult to maintain for long. When people are forced to choose between social distancing and feeding their families, they are choosing the latter.
• Counter-intuitively, some countries where authorities reacted late and with spotty enforcement of lockdowns appear to have been spared. Cambodia and Laos both had brief spates of infections when few social distancing measures were in place but neither has recorded a new case in about three weeks.
• Lebanon, whose Muslim and Christian citizens often go on pilgrimages respectively to Iran and Italy, places rife with the virus, should have had high numbers of infections. It has not.
• “We just didn’t see what we were expecting,” said Dr. Roy Nasnas, an infectious disease consultant at the University Hospital Geitaoui in Beirut. “We don’t know why.”

Roll of the Dice

• Finally, most experts agree that there may be no single reason for some countries to be hit and others missed. The answer is likely to be some combination of the above factors, as well as one other mentioned by researchers: sheer luck.
• Countries with the same culture and climate could have vastly different outcomes if one infected person attends a crowded social occasion, turning it into what researchers call a super-spreader event.
• That happened when a passenger infected 634 people on the Diamond Princess cruise ship off the coast of Japan, when an infected guest attended a large funeral in Albany, Ga., and when a 61-year-old woman went to church in Daegu, South Korea, spreading the disease to hundreds of congregants and then to thousands of other Koreans.
• Because an infected person may not experience symptoms for a week or more, if at all, the disease spreads under the radar, exponentially and seemingly at random. Had the woman in Daegu stayed home that Sunday in February, the outbreak in South Korea might have been less than half of what it is.
• Some countries that should have been inundated are not, leaving researchers scratching their heads.
• Thailand reported the first confirmed case of coronavirus outside of China in mid-January, from a traveler from Wuhan, the Chinese city where the pandemic is thought to have begun. In those critical weeks, Thailand continued to welcome an influx of Chinese visitors. For some reason, these tourists did not set off exponential local transmission.
• And when countries do all the wrong things and still end up seemingly not as battered by the virus as one would expect, go figure.
• “In Indonesia, we have a health minister who believes you can pray away C19, and we have too little testing,” said Dr. Pandu Riono, an infectious disease specialist at the University of Indonesia. “But we are lucky we have so many islands in our country that limit travel and maybe infection.”
• “There’s nothing else we’re doing right,” he added.

Source: The Covid-19 Riddle: Why Does the Virus Wallop Some Places and Spare Others? 

K. The Limits of Science

1. Why science can’t actually tell us what we should do [By Rich Lowry, New York Post]

• If you thought the coronavirus presented difficult policy questions, don’t worry — we have science.
• California Gov. Gavin Newsom tweeted the other day, “The West Coast is — and will continue to be — guided by SCIENCE.”
• Former Vice President Joe Biden urged President Trump, “Follow the science, listen to the experts, do what they tell you.”
• The invocation of science as the ultimate authority capable of settling questions of how we should govern ourselves is a persistent feature of modern Western life going back several centuries and has always been a mistake. It is especially so in this crisis, when so much is still unknown about the coronavirus and immensely complicated and consequential public-policy questions are in play.
• Modern science is obviously one of the wonders of our age. We owe it an unimaginable debt — for technological advancements in medicine, transportation, industry, communication, computing and more.
• Of course, our policymakers should be informed by facts and reason, but science has a limited competency. Once you are outside a lab setting and dealing with matters of public policy, questions of values and how to strike a balance between competing priorities are involved, and they simply can’t be settled by people in white lab coats.
• Science can make the atom bomb; it doesn’t tell us whether we should drop it. Science can tell us how to get to the moon; it doesn’t tell us whether we should go. Science can build nuclear reactors; it doesn’t tell us whether we should deploy them.
• Invoking scientists in this crisis is a little like saying, “My economic policy is going to be guided by an ECONOMIST.” Well, good for you. But is your economist on the left or on the right? What are his assumptions? Does he care most about inequality or dynamism? Is he Paul Krugman or Art Laffer? Both muster facts and research in support of their positions.
• Science can indeed settle debates once and for all — we don’t argue about heliocentrism anymore. But an extraordinary feature of the coronavirus is how poorly understood it is. We don’t know how many people have it, what the death rate is, what the long-term health consequences of having a severe case are or how best to treat it, among other things.
• The models of how the virus would spread and how many would be hospitalized and die were invested with a certainty they didn’t deserve. They were all over the map, and some have failed to accurately predict the course of the disease even a couple of weeks in the future.
• If we are going to unquestioningly accept expert opinion, we’d better prepare for whiplash. At first, the elite consensus was that wearing masks was unnecessary. Now, we are told, it’s an essential piece of getting out of this mess.
• We worried about running out of ventilators, but in recent weeks some doctors have been wondering whether they have been overused.
• Then there are the big questions. Science can’t tell us how we should think about the trade-off between economic misery caused by shutdowns and the public-health risks of reopenings. It can’t determine the balance between shutting down a hospital’s elective surgeries so it can prepare for a COVID-19 surge and tanking its business, forcing it to furlough employees.
• The people in our political debate who are most volubly insistent that they are simply following “the science” tend also to be most resistant to nuance and prone to fervency rather than scientific dispassion. They are using “science” as a bludgeon and conversation-stopper.
• Obviously, science already has made an enormous contribution to our fight against the coronavirus and may — through therapies or a vaccine — go a long way to solving this crisis. But life is not an equation, and neither is politics or policy.
• We, as a self-governing people, will have to decide the important questions about how to respond to the coronavirus going forward, not the doctors on TV or the researchers in the labs.

Source: Why science can’t actually tell us what we should do

L. Practical Tips & Other Useful Information

1. This science-backed face mask made by an MIT-founded fashion brand is the best we’ve found yet

• As restrictions begin to loosen in the coming weeks, getting “back out there” is going to look a little different. Companies including Uber and JetBlue are requiring masks for all passengers, while places like Washington, D.C., and L.A. have mandated wearing them in grocery stores. That’s not to mention city- and statewide ordinances that mandate that anyone who is outside—for any reason—must wear a mask. Plus, it’s the CDC’s official recommendation. While homemade bandanna and T-shirt masks were great in a pinch (and technically pass regulations), we’re betting you and health experts would both prefer something robust as the world reopens. And while some masks made by fashion and shoe companies are very stylish, it’s hard to tell what’s actually effective from what’s just aesthetic.
• Enter MIT-founded fashion brand Ministry of Supply, which has built a mask with scientific standards and informed choices in material, design, and filtration. It was initially developed for frontline health workers, but in light of recent CDC recommendations, MoS has also made it available for consumer purchase. The Maskº ($50) is 3D printed to make for extremely efficient production times (each takes less than 9 minutes to weave). Made of a viscose and polyester blend, it’s machine washable, and the hygroscopic material pulls moisture to the core of the fiber, making it soft, breathable, and dry after even hours of wear. Because it’s 3D printed, MoS was able to quickly iterate new prototypes in hours and test the shape and texture of different fabrics, meaning the resulting mask is a great fit and very comfortable (important if you don’t want people constantly touching their face to adjust).
• While the Maskº can be worn without a filter for consumer use, it comes with a set of tested filters that are Nelson Labs certified, which were developed in counsel with MoS’s healthcare advisers at the MIT spinout MakerHealth. To get nerdy about it, each melt-blown polypropylene filter boasts a higher than 95% Bacterial Filtration Efficiency (BFE) rate and a 95% Particulate Filtration Efficiency (PFE) measurement at 0.1 microns. Translation: It stops a high percentage of droplets and particles from getting in or out. And to address the problem of ill-fitting masks, Ministry of Supply separated the production of the mask frame (which determines the fit and comfort of the mask) from the filter. This two-part structure allows the brand to use special production techniques (i.e., 3D-print knitting and die-cutting) to create the mask frame, and work on the filter technology separately, resulting in a better-fitting and more effective mask.
• The Maskº comes in seven different colors (if that matters to you) and the starter Maskº Kit comes with 10 filters—which are recommended for only eight hours of use a piece. You can buy refill 10-packs of additional filters ($20) after you use your first batch. There’s also a give-back element: Ministry of Supply will donate a mask to frontline healthcare workers for each kit purchased. If you want to donate more, there’s an option to make a purchase for donations exclusively on the MoS website.
• Ordering for a partner or your family? Currently, if you purchase two Maskº Kits, you can receive a third for free. All you have to do is add three Maskº Kits to your cart to receive the promotion.
• THE MASK KIT can be purchased for $50 at 3D Print-Knit Mask° Kit
• Disclaimer: Ministry of Supply face masks are not devices intended for use in the diagnosis of a disease or other conditions or in the cure, mitigation, treatment, or prevention of disease and do not meet the definition of a medical device as set forth in section 201(h) of the FD&C Act. The Ministry of Supply masks are nonmedical masks and are not N95 respirators or surgical masks.

Source: This science-backed face mask made by an MIT-founded fashion brand is the best we’ve found yet 

2. A Guide to Grocery Delivery During the Pandemic—and After

• Amy Gebler says she’s “obsessed” with scoring delivery time slots for groceries, which have become a rarity as demand for doorstep drop-offs soars during the coronavirus crisis. “I have carts on three different platforms and I’m constantly refreshing,” said the 48-year-old single mom based in Seattle, one of the country’s first coronavirus hot spots.
• During the day, the delivery websites for Amazon Fresh, Safeway and QFC, the local Kroger -owned chain, are a constant fixture on her laptop as she works. In the middle of the night, she’ll check the apps for availability. Once a time slot appears, Ms. Gebler snags it immediately, no matter what’s in the basket. “I have three teenagers in the house. Once I order food, it’s all gone within days.”
• The deliveries are also often incomplete, since out-of-stock items are automatically removed. So she’ll fill up another cart and start repeatedly refreshing again. “It’s kind of my entertainment for the night,” Ms. Gebler said.
• In many cities, in-store shoppers face long lines to enter, empty shelves for high-demand provisions and other stressed customers trying to maintain the sanctioned 6 feet of distance. Meanwhile, online, you peruse goods from the comfort of your couch and the haul is dropped off right at your front door. It’s not just about convenience: For high-risk people, essential workers and working parents, it’s a lifeline. The Centers for Disease Control and Prevention recommends home delivery or curbside pickup if possible.
• That’s why delivery slots are getting scarce—and slot squatting is becoming a national pastime. With Instacart orders more than six times higher than they were at this time last year and stores limiting in-store traffic, you need to be quick to click. You also need to be careful: Some people are resorting to potentially harmful auto-refresh browser extensions and scripts.
• I talked to companies providing delivery nationwide and shopping mavens like Ms. Gebler to get some answers: How do the many services differ and how do you set yourself up for checkout success? Here’s what they said.

Instacart

• Minimum order: Starts at $35, varies by store
• Fees: 5% or $2 minimum service fee plus various delivery fees starting at $3.99
• Membership: Optional; $99-a-year Instacart Express; no extra delivery fee for orders $35 and up
• Locations : 5,500 U.S. cities
• Pro tips: Have your cart ready to go—delivery windows, when they are available, show up on the checkout page. An Instacart spokeswoman said the highest volume of orders is placed on Sundays, so avoid getting groceries that day if you can.
• It’s a myth that new time slots are released at midnight. Delivery availability fluctuates throughout the day, according to the Instacart spokeswoman, so keep refreshing. And try different retailers: While a delivery window might not be open when shopping at one grocer, you might get one by picking another. (Fun fact: Instacart lets you buy from Costco without a membership.)
• Pre-tipping can help, too. Instacart says shoppers pick from different batches of orders, and they can see details like each batch’s estimated tip and delivery distance before accepting.
• Choose replacement items ahead of time, so you don’t have to worry about approving products in real-time (and potentially missing messages from the Instacart shopper). You can edit your cart until the shopper reaches the store, unlike the other services. Also, a new “Fast & Flexible” feature pairs you with the first available shopper, rather than pegging you to a specific delivery window.
• An Instacart employee shopped a Safeway grocery store preparing a delivery order in Tucson, Ariz., April 4.

Amazon Fresh/Whole Foods/Prime Now

• Minimum order: None; $35 minimum to avoid delivery fee
• Fees: From $4.99 to $9.99
• Membership: Exclusive to $119-a-year Prime members
• Locations: Over 2,000 U.S. cities and towns across the three services
• Pro tips: Like Instacart, you’ll want to have your items ready to go when a delivery time slot becomes available. The Alexa voice assistant can streamline this process: Say, “Alexa, add [product] to my Whole Foods cart.”
• The first hour of grocery pickup at Whole Foods is dedicated to at-risk customers.
• The home pages for Prime Now and Fresh show the day’s delivery availability, but you’ll want to refresh the checkout page for new delivery windows. Be sure to confirm your preferred address and payment method in account settings.
• You may find more availability through Whole Foods in-store pickup. Amazon recently announced that the first hour of grocery pickup will be reserved for customers age 60 and older, those with disabilities and people defined as high risk. Participation is on the honor system—verification isn’t required.
• Navigating this trifecta of Amazon same-day delivery—Prime Now, Fresh and Whole Foods—can be confusing, especially for customers with all three options in the same city. They all provide delivery in as soon as two hours with no extra fee, provided you’re a Prime member and spend at least $35. Currently, Prime members who are new to the services need to join a wait list in some cities.
• The primary difference is selection. Whole Foods has a larger swath of organic produce and specialty items. Fresh offers groceries, plus pharmacy products like allergy medications and beauty products, as well as products like Kindles and clothing. Prime Now is a separate app that can fulfill Whole Foods pickup orders, and delivery from Amazon-owned services and select local stores.

Walmart

• Minimum order: $30
• Delivery Fees: Either $7.95 or $9.95, depending on the delivery window
• Membership: Delivery included with $98-a-year (or $13-a-month) Delivery Unlimited; free 15-day trial
• Locations: 1,600 U.S. cities
• Pro tips: New time slots for delivery up to seven days in advance open up every morning, so check back for new windows then. While you’re able to reserve times before you shop, those times do expire, so it’s a good idea to have your cart ready for checkout. You can change your order after it’s placed, before the cutoff time, typically the same day as the scheduled delivery. The time is determined by anticipated in-store traffic—for example, if your scheduled date is a busy day for that location, the cutoff time for a 7 p.m. delivery could be 10 a.m. that morning, a Walmart spokeswoman said.
• At checkout, you can select which items should be substituted if they’re out of stock, but you can’t pick the replacements.
• You can also schedule a no-contact pickup, where an associate will place your groceries in your already open trunk. For the fastest service, when you arrive, check in and have your parking spot number ready.

General Tips

• What about those Chrome extensions and scripts? There are a number of “delivery checker” browser tools that notify you of available delivery slots—but they’re not coded or even authorized by the retailers. They’re tempting, and some tech-savvy shoppers (including me) have used them successfully. But experts say there are serious risks with installing software from unknown authors.
• Malicious browser extensions can harvest personally identifiable information, log keystrokes to obtain passwords or inject intrusive ads into sites, according to Ido Safruti, co-founder of security firm PerimeterX. Pay close attention to the permissions an extension asks for—an extension to help find Amazon delivery slots shouldn’t be able to read every website you visit, and it shouldn’t need access to data or keyboard events, he said.
• As for scripts, Mr. Safruti says it’s impossible to know what they’re doing without reviewing the code. If you don’t understand scripting language and can’t verify the author, don’t run the script, he advised.
• Use Nextdoor’s Help Map if you need a neighborly hand. The feature shows people in your vicinity who are willing to run errands on your behalf.
• Check with local bakeries and restaurants. Many eateries are now selling produce and pantry items alongside their takeout menu. Delivery apps can help here: An UberEats search for “pantry” yielded a San Francisco bakery offering bread flour, sold out nearly everywhere else, and another selling bleach, sanitizer, paper towels and toilet paper. A query for “produce” in Grubhub revealed a nearby brunch spot selling a veggie box and fresh eggs.
• If you don’t need same-day delivery, try meal kits, farm boxes or restaurant suppliers. The caveat: You’ll pay a bit more, you won’t get to select your own produce and pantry staples, like cooking oil, typically aren’t available through these programs. LocalHarvest is a directory of farmers that sell goods directly to individuals. Imperfect Foods ships ugly produce and surplus products around the country. Meal-kit companies like Sun Basket and Hello Fresh are still taking new customers. Some restaurant-supply sites, like Choco (SF, Chicago, DC, Seattle, and NYC) and Pepper Pantry (serving greater NY and Boston areas), pivoted to home delivery.
• Forming groups can be useful to meet minimums, but the apps make it tricky. If you and your neighbors pool together to make orders, you can often meet minimums more easily—especially with restaurant suppliers that require bulk orders. Instacart has a group-ordering feature that allows multiple accounts to add to the same order, but you would still have to divvy up the bill later. Also, many grocers impose item limits and when out-of-stock items need replacement approval, someone needs to make the call fast.
• If you do share a delivery, always remember to take precautions in handling your neighbors’ groceries.
• And finally, please tip—generously if you can. The gig workers doing your shopping are taking on the risk of potentially exposing themselves to infection, so customers can stay safe at home. That extra effort warrants a bigger tip than usual—so if you’re able, consider upping the amount.

Source: A Guide to Grocery Delivery During the Coronavirus Pandemic—and After