Recent Developments & Information
June 9, 2020
“From the data we have, it still seems to be rare that an asymptomatic person actually transmits onward to a secondary individual. It’s very rare.”Dr. Maria Van Kerkhove, head of WHO’s emerging diseases and zoonosis unit
“The risk of infection by COVID-19 appears to be reduced by half among current smokers.”Conclusion of Study titled Smoking and the risk of COVID-19 in a large observational population study
“Preliminary results from more than 750,000 participants suggests type O blood is especially protective against the coronavirus.”23andMe
Index Of Featured Stories & Links
Note: All of the stories listed below are included in this Update, but we have included links to the stories upfront so that you can quickly jump to a story if you want.
- WHO Says What?!
- Asymptomatic spread of coronavirus is ‘very rare,’ WHO says (!)
- WHO has new guidelines on face masks
- Potential Treatments
- Androgen deprivation may reduce risk for men (and maybe women too) [Highly Recommended]
- Israeli study points to nicotine as a potential therapeutic for C-19 (!)
- Cow’s antibodies four times better than convalescent plasma at preventing the coronavirus from entering cells (!)
- New Scientific Findings
- 23andMe Provides More Evidence That Blood Type Plays Role in Virus
- At Least Half of Singapore’s new C19 cases are symptomless
- Drug targets enzymes that enable virus to invade cells
- U.S. Navy test shows 60% of carrier crew have antibodies
- Concerns & Unknowns
- C19 Stalks Large Families in Rural America
- The Road Back?
- Let the children play
- Projections & Our (Possible) Future
- Shutting down schools, banning large gatherings and stay-at-home orders prevented half a billion coronavirus cases worldwide and 60 million in the US
- How Many People Actually Have C19? Significant Global Differences in Undetected Cases
- You can access all of the updates on our website at https://dailyC19post.com/ and on Facebook at https://www.facebook.com/groups/2467516816834782/group_quality/. Please share the website and Facebook addresses with anyone you believe might be interested in the updates. Also, some have asked me to attach a copy of the update to each email, so I will do that going forward.
- We are happy to add anyone to the distribution list – just let me know. And, for those of you that are on social media, feel free to forward or post any or all of our updates or recommendations. Also, please forward to me any information than you believe should be included in any update, including any precautions that you recommend. Comments and suggestions are always welcome.
- We do not endorse, and may not agree with, any opinion or view included in this Update. We include a wide spectrum of opinions and views as we believe that it gives perspective on what people are thinking and may give insights into our future.
A. Our World As Seen Through Headlines
(In No Particular Order)
- WHO says asymptomatic carriers actually not that infectious
- WHO said the outbreak was worsening, a day after a record number of new cases was reported around the world
- New York City Begins Reopening After 3 Months of Outbreak and Hardship
- California reports statewide decline in cases while LA County cases near 64,000
- NY State reports 0.2% jump in new cases as NYC reopens
- NY Gov. Cuomo says central NY region ready to enter ‘Phase 2’
- Satellite Data, Internet Searches Suggest COVID-19 Hit China ‘Long Before’ Previously Known: Harvard
- Israeli Prime Minister warns that if trend continues restrictions will be reinstated, as number of new daily cases hits 169
- Concern In Greece Over Resurgence Of Coronavirus Cases
- Surge in Latin America as global coronavirus toll pass 400,000
- India reports another record jump in new cases with approx. 10,000
- Pakistan hospitals running out of beds as cases pass 100,000
- Florida reports slowdown following last week’s spike in new cases
- Each day of protests could result in about 3,000 new cases
- Hundreds could die from coronavirus for each day of protests: experts
- Brazil Is in Coronavirus Free Fall — Hospitals are on the brink of collapse, cemeteries are burying people in mass graves
- Summer camp may not be canceled, after all
- Distance learning in most school districts is not working and students are falling behind at alarming rates
- New Zealand Ends Social Distancing After Eliminating Covid-19
- U.K. Kicks Off Quarantine That Will Further Slam Airlines
- Kansas resident tests positive for COVID-19, attended protest without mask
- Mother Contracts COVID-19 While Pregnant, Baby Is Born Healthy with Antibodies
- Children only make up 0.06% of Coronavirus Deaths in NYC
- CDC warns of protests and COVID-19 spread
- Hospitals Got Bailouts and Furloughed Thousands While Paying C.E.O.s Millions
- Reps. Kuster, Jeffries introduce bill to ensure mass production of COVID-19 vaccine
- Coronavirus Positive Tests in Minnesota Drop from 10% to 8% in Two Weeks Despite Riots
- Bars, Gyms, Professional Sports to Reopen this Week in California
- Five University of Alabama Football Players Tested Positive for Coronavirus
- Ohio Restaurants Sue Dr. Acton, Gov. DeWine over ‘Unconstitutional’ Coronavirus Guidelines
- NYC Begins Phased Reopening with Stores Destroyed by Riots
- Amusement Parks Six Flags, Coney Island, Great Wolf Lodge to Reopen
- Iranian Dissidents Say over 50,000 Have Died of Coronavirus
- AP Sources: MLB 76-Game Season, Up to 75% Salaries
- Casinos in Las Vegas have reopened, with dealers behind Plexiglas, frequently sanitized dice and temperature checks
- Boston is one of the few places hospitals allow priests to perform last rites, after they were trained to safely anoint Covid-19 patients
- Canada reopened its border with the U.S. to allow in immediate family members of Canadian citizens and permanent residents
- New York will allow groups of 150 to gather this month for graduations, Gov. Cuomo says
- Norwegian Scientist Claims To Have Proof Coronavirus Was Created in a Lab
- Dr. Fauci: Hero, Liar, Or Sociopath?
- Public-health ‘professionals’ keep showing how unprofessional they really are
- As business trickles back, hotels compete on cleanliness
- NFL coronavirus protocols include locker-room social distancing
- ‘All-pet private jet’ to reunite animals stranded during coronavirus pandemic
- New NYC coronavirus cases at lowest level since pandemic began: de Blasio
- Gov. Phil Murphy says public pools will reopen in New Jersey
- CDC says 40% of Americans surveyed tried bleach to wash food
- NJ resident buried before family notified of coronavirus death
- Cruise ship finally returns home after six-month coronavirus odyssey
- Coronavirus disrupts global fight to save endangered species
- Gov. Cuomo says elective surgeries can resume in NYC
- Gov. Cuomo rides subway to work on first day of NYC reopening
- Brazil stops publishing its running coronavirus death toll
- Istanbul residents ignore coronavirus rules on first weekend out
- Movie sex scenes will be replaced with CGI wizardry to cut coronavirus risk
B. Key Numbers & Trends
Notes: Unless otherwise noted, all cases/deaths are confirmed cases/deaths that have been reported. All numbers reported in this Update are as of the end of the most recent reporting period (reporting periods end each day at 11:59 pm Greenwich Time, or 7:59 pm NYC Time), and all changes reflect changes since the day preceding the end of the most recent reporting period. Green highlights indicate a decrease or no change and yellow highlights indicate an increase.
1. Cases & Tests
- Worldwide Cases:
- Total Cases = 7,189,868 (+1.5%)
- New Cases = 107,270 (-6,968)
- Growth Rate of New Cases (7 day average) = 1.8% (+0%)
- New Cases (7 day average) = 120,963 (+386)
- The number of new cases worldwide has been decreasing for the last 4 days and the growth rate in new cases has decreased for the last 5 days. However, the number of new cases has been generally trending higher and has been over 100,000 cases for 13
- US Cases & Testing:
- Total Cases = 2,026,493 (+1.0%)
- New Cases = 19,044 (+139)
- Growth Rate of New Cases (7 day average) = 1.1% (-0.1%)
- New Cases (7 day average) = 21,722 (-481)
- Total Number of Tests = 21,725,064 (+433,387)
- Percentage of positive tests (7 day average) = 4.6% (+0)
- The 7 day average growth rate of new cases declined slightly, which is positive (and continuing) trend.
- The 7 day average number of new cases has decreased 481 (-2.2%), which is a positive trend, particularly in light of large number of tests
- No change in the 7 day average percentage of positive tests, which is also a positive trend and perhaps the best indicator that the virus is not spreading on a large scale (although there may be hotspots where the virus is spreading significantly)
- Worldwide Deaths:
- Total Deaths = 408,240 (+0.8%)
- New Deaths = 3,159 (-223)
- Growth Rate of Deaths (7 day average) = 1.1% (-0.5%)
- New Deaths (7 day average) = 4,441 (-42)
- US Deaths:
- Total Deaths = 113,005 (+0.5%)
- New Deaths = 586 (+213)
- Growth Rate of Deaths (7 day average) = 0.8% (+0%)
- New Deaths (7 day average) = 876 (-20)
- While new deaths increased 586 (+57.1%) since yesterday, the number of deaths has generally been trending down (new deaths have been less than 1,000 for four consecutive days).
- Although no change since yesterday, the growth rate of new deaths has generally been decreasing, which is a positive trend.
3. The Virus is Slowing Down
- While overall cases continue to climb, the rate of growth has slowed considerably in the US and worldwide since early April
- At the beginning of April, there were approximately 430,000 cases in the US, and the growth rate in new cases was 8.4%. Today, the number of cases has grown to 1.9 million cases, but the growth rate has fallen to 1.2%, a decrease of 85.7% in the growth rate.
|Source: The Covid Tracking Project|
- Worldwide, we are seeing a similar trend. Globally, there were approximately 1.5 million cases, and the growth rate in new cases was 6.0%. Today, the number of global cases has grown to 6.8 million cases, but the growth rate has fallen to 1.9%, a decrease of 68.3% in the growth rate.
|Source: The Covid Tracking Project|
- Another way to observe the declining growth rate of the virus is to observe the data on a logarithmic scale. A log scale is helpful to compare the growth rates between countries — the steepness of the line corresponds to the growth rate.
- As can be shown in the log chart below, the growth rate of cases rose sharply until the second week of April (April 10). As shown in the chart above, the growth rate began dropping significantly around April 10.
- Germany and Italy have both seen significantly declines in case growth rates
- Sweden, as has been noted in several news articles, has seen a recent increase in case growth rates.
C. WHO Said What?!
1. Asymptomatic spread of coronavirus is ‘very rare,’ WHO says
- Coronavirus patients without symptoms aren’t driving the spread of the virus, World Health Organization officials said Monday, casting doubt on concerns by some researchers that the disease could be difficult to contain due to asymptomatic infections.
- Some people, particularly young and otherwise healthy individuals, who are infected by the coronavirus never develop symptoms or only develop mild symptoms. Others might not develop symptoms until days after they were actually infected.
- Preliminary evidence from the earliest outbreaks indicated that the virus could spread from person-to-person contact, even if the carrier didn’t have symptoms. But WHO officials now say that while asymptomatic spread can occur, it is not the main way it’s being transmitted.
- “From the data we have, it still seems to be rare that an asymptomatic person actually transmits onward to a secondary individual,” Dr. Maria Van Kerkhove, head of WHO’s emerging diseases and zoonosis unit, said at a news briefing from the United Nations agency’s Geneva headquarters. “It’s very rare.”
- Government responses should focus on detecting and isolating infected people with symptoms, and tracking anyone who might have come into contact with them, Van Kerkhove said. She acknowledged that some studies have indicated asymptomatic or presymptomatic spread in nursing homes and in household settings.
- More research and data are needed to “truly answer” the question of whether the coronavirus can spread widely through asymptomatic carriers, Van Kerkhove added.
- “We have a number of reports from countries who are doing very detailed contact tracing,” she said. “They’re following asymptomatic cases. They’re following contacts. And they’re not finding secondary transmission onward. It’s very rare.”
- If asymptomatic spread proves to not be a main driver of coronavirus transmission, the policy implications could be tremendous.
- A report from the CDC published on April 1 cited the “potential for presymptomatic transmission” as a reason for the importance of social distancing.
- “These findings also suggest that to control the pandemic, it might not be enough for only persons with symptoms to limit their contact with others because persons without symptoms might transmit infection,” the CDC study said.
- To be sure, asymptomatic and presymptomatic spread of the virus appears to still be happening, Van Kerkhove said but remains rare. That finding has important implications for how to screen for the virus and limit its spread.
- “What we really want to be focused on is following the symptomatic cases,” Van Kerkhove said. “If we actually followed all of the symptomatic cases, isolated those cases, followed the contacts and quarantined those contacts, we would drastically reduce” the outbreak.
2. WHO has new guidelines on face masks
- The World Health Organization (WHO) on Friday announced changes to its guidelines on who should wear a mask during the C19 pandemic and where they should wear it.
- The new guidance recommends that the general public wear cloth masks made from at least three layers of fabric “on public transport, in shops, or in other confined or crowded environments.”
- It also says people over 60 or with preexisting conditions should wear medical masks in areas where there’s community transmission of the coronavirus and physical distancing is impossible, and that all workers in clinical settings should wear medical masks in areas with widespread transmission.
- It’s a major update to the agency’s April 6 recommendations, which said members of the general public “only need to wear a mask if you are taking care of a person with C19” or “if you are coughing or sneezing.” And it’s important advice for countries around the world battling the virus, especially those in South America, the Middle East, and Africa, where the rate of C19 transmission appears to be accelerating.
- At a WHO press conference on June 3, Michael Ryan, an infectious disease epidemiologist and the executive director of the WHO’s Health Emergencies Programme, said WHO still believes that masks should primarily be used “for purposes of source control — in other words, for people who may be infectious, reducing the chances that they will infect someone else.”
- And on Friday, WHO Director-General Tedros Adhanom Ghebreyesus offered a few words of warning as part of the announcement: “Masks can also create a false sense of security, leading people to neglect measures, such as hand hygiene and physical distancing. I cannot say this clearly enough: Masks alone will not protect you from C19.”
- But the changes finally bring the WHO in line with many countries around the world that have made masks mandatory in crowded public spaces, including Cuba, France, Cameroon, Vietnam, Slovakia, and Honduras. While it has not made masks a requirement, the US Centers for Disease Control and Prevention (CDC) has since April 3 suggested “wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain.”
- Many health experts have wondered why it’s taken this long for the WHO to update its mask guidelines, given the accumulation of evidence that they may be helpful and have few downsides.
- Eric Topol, a research methods expert and director of the Scripps Research Translational Institute, calls WHO’s delay “preposterous.” He adds, “I have great respect for the World Health Organization — but they got the mask story all wrong, and we have lost people because of it.” Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University, agrees, saying, “Everyone should be wearing a mask.”
[Note: The CDC’s primary justification for recommending that people where masks (after saying for months that it was not necessary) was to prevent asymptomatic transmission of the virus. But, as noted in the prior story, the WHO has ow concluded that asymptomatic transmission of the coronavirus is “very rare”. So, the CDC’s rationale for recommending masks now seems to be invalid (unless the CDC disagrees with the WHO’s conclusions regarding asymptomatic transmission). But, it is odd that the WHO would pivot and recommend that people wear masks at about the same time that it concluded that asymptomatic transmission was very rare.]
D. Potential Treatments
1. Androgen deprivation may reduce risk for men (and maybe women too)
- In January, one of the first publications on those sickened by the novel coronavirus in Wuhan, China, reported that three out of every four hospitalized patients were male. Data from around the world have since confirmed that men face a greater risk of severe illness and death from C19 than women and that children are largely spared.
- Now, scientists investigating how the virus does its deadly work have zeroed in on a possible reason: Androgens—male hormones such as testosterone—appear to boost the virus’ ability to get inside cells.
- A constellation of emerging data supports this idea, including C19 outcomes in men with prostate cancer and lab studies of how androgens regulate key genes. And preliminary observations from Spain suggest that a disproportionate number of men with male pattern baldness—which is linked to a powerful androgen—end up in hospitals with C19. Researchers are rushing to test already approved drugs that block androgens’ effects, deploying them early in infection in hopes of slowing the virus and buying time for the immune system to beat it back.
- “Everybody is chasing a link between androgens … and the outcome of C19,” says Howard Soule, executive vice president at the Prostate Cancer Foundation, who on 13 May ran a Zoom call presenting the newest research that drew 600 scientists and physicians. A second call scheduled for today will discuss incipient clinical trials.
- Epidemiological data from around the world have confirmed the early reports of male vulnerability. In Lombardy in Italy, for example, men comprised 82% of 1591 patients admitted to intensive care units (ICUs) from 20 February to 18 March, according to a JAMA paper. And male mortality exceeded that of women in every adult age group in another JAMA study of 5700 New York City patients hospitalized with C19.
- Now, researchers are on the trail of a mechanism for this male bias—an effort led by prostate cancer researchers, who have a deep acquaintance with androgens.
- Christina Jamieson of the University of California (UC), San Diego, who has developed organoids to study prostate cancer, recalls that she was in a Zoom meeting honing ideas on how to link her research to C19 when her sister, also a UC San Diego scientist, sent her a one-word text. It read: “TMPRSS2.”
- It was 16 April, and within minutes Jamieson had found the publication that prompted the text: a Cell paper by Markus Hoffmann of the Leibniz Institute for Primate Research and colleagues. The paper sent a lightning bolt through the prostate research community, because it showed that infection with the coronavirus relies in part on TMPRSS2, a membrane-bound enzyme. The enzyme cleaves the “spike” protein on the coronavirus’ surface, allowing the virus to fuse with the host cell’s membrane and get inside the cell.
- Jamieson and other prostate cancer researchers were familiar with the enzyme, because in about half of all prostate cancers, a TMPRSS2 mutation revs up an oncogene that kicks cell growth into overdrive. In the prostate, TMPRSS2 is produced when male hormones bind to the androgen receptor. “Doing research, it’s like you’re trying to throw an anchor into the vast ocean of possibilities,” Jamieson says. The discovery that TMPRSS2 helps the virus enter cells “felt like the anchor hit ground.”
- Researchers haven’t established that androgens control TMPRSS2 in the lung—ground zero for the coronavirus infection—as they do in the prostate; studies in lung tissue and cells from mice and humans come to conflicting conclusions.
- But after the Cell paper was published, Andrea Alimonti, head of molecular oncology at Università della Svizzera italiana, strengthened the androgen link by looking at data on more than 42,000 men with prostate cancer in Veneto in Italy. He and colleagues found that patients on androgen-deprivation therapy (ADT)—drugs that slash levels of testosterone—were only one-quarter as likely to contract C19 as men with prostate cancer not on ADT, they reported in the Annals of Oncology (see table, below). Men on ADT were also less likely to be hospitalized and to die, although numbers were small.
A protective treatment?
In one Italian study, men with prostate cancer who received drugs that suppress androgens were much less likely to be infected with the coronavirus.
|Men on androgen-deprivation therapy (ADT)||Men not on ADT|
|Total men with prostate cancer||5273||37,161|
|Number infected with coronavirus||4||114|
|Estimated cases per 10,000||8||31|
MONTOPOLI ET AL., ANNALS OF ONCOLOGY, HTTPS://DOI.ORG/10.1016/J.ANNONC.2020.04.479 (2020)
- Another retrospective study, still unpublished, controlled for age and other medical conditions and got similar results: Of 58 patients with prostate cancer who contracted the coronavirus, the 22 taking ADT were significantly less likely to be hospitalized and to need supplemental oxygen, says William Oh, a prostate cancer physician-scientist at the Icahn School of Medicine at Mount Sinai. “Our conclusion supports the hypotheses that androgen signaling might increase the risk of severe outcomes from C19 and that androgen deprivation may limit those severe outcomes,” Oh says.
- Two small studies have reported that men with male pattern baldness are overrepresented among hospitalized C19 patients. This type of baldness is associated with high levels of dihydrotestosterone (DHT), a key metabolite of testosterone, in the scalp. An April study of 41 Spanish men hospitalized for C19 found that 71% had male pattern baldness; the background rate in white men is estimated at 31% to 53%. A second study published last month found that 79% of 122 men in three Madrid hospitals with C19 had male pattern baldness.
- More circumstantial evidence comes from stem cell biologist Faranak Fattahi, of UC San Francisco. Her team found a strong link between a measure of active androgens in the blood and the severity of C19 disease in data from several hundred male patients in the UK Biobank; they did not find this effect in women.
- Such evidence is already inspiring possible therapies. Matthew Rettig, an oncologist who directs prostate cancer research at UC Los Angeles, is leading a double-blind, randomized, placebo-controlled trial of the androgen-suppressing drug degarelix in 200 veterans hospitalized with C19 in Los Angeles, Seattle, and New York City. Patients in the active arm will receive a single injection that virtually zeroes out testosterone levels within 3 days. That reduces expression of the TMPRSS2 gene, at least in the prostate, to almost nil. Side effects include hot flashes and breast growth and “are equivalent to surgical castration,” Rettig says.
- But whereas in prostate cancer, the injections are given month after month, “This study only involves a one-time dosage. It’s temporary,” Rettig says. He hopes to learn in 4 to 5 months whether the treatment helps keep patients off ventilators and reduces mortality.
- Several other antiandrogen trials are in the offing in the United States and Europe. Prostate cancer researcher Catherine Marshall of Johns Hopkins University is preparing a trial of bicalutamide, an older, inexpensive androgen receptor blocker, in 20 patients hospitalized within 3 days after they tested positive for C19. Her group will compare outcomes with patients who don’t receive the drug. “We think that if this works it’s going to work by decreasing the viral load in patients,” Marshall says. “That’s why we are doing it earlier in people’s course of disease.”
- Women are being included in the trial, she adds, because they have androgens, although at lower levels than men, and because estrogens have been shown to help heal acute lung injury. Bicalutamide raises estrogen levels as well as suppressing androgen activity. Marshall says of the emerging wave of trials: “All these trial ideas have been team science at its best and probably at its fastest.”
- Adding to the promise of antiandrogens is lab-based evidence from Fattahi’s study. Her team screened FDA-approved drugs in heart cells in the lab to see which ones reduced levels of the essential coronavirus receptor, angiotensin-converting enzyme 2 (ACE2). Key hits included finasteride and dutasteride, drugs that block the conversion of testosterone to DHT, according to a 15 May preprint. Finasteride is FDA-approved to treat male pattern baldness and dutasteride for prostate enlargement. Dutasteride also reduced ACE2 levels in healthy human lung alveolar cells.
- Although researchers pursuing the androgen link caution that their hypothesis remains just that until it is borne out in lab and clinical studies, they’re optimistic. “When all evidence points to the same thing it’s very satisfying,” Fattahi says.
2. Israeli study points to nicotine as a potential therapeutic for C-19
“The risk of infection by C19 appears to be reduced by half among current smokers,” researchers have found
- Smoking may offer some protection against the coronavirus, an Israeli study has found. The results support recent similar findings by researchers in France, China and Italy, although a British study has found the opposite.
- Noting that conflicting reports exist regarding the impact of smoking on the likelihood of contracting the coronavirus, the Israeli team led by Dr. Ariel Israel undertook a population-based study pulling in data from over three million adult members of the Clalit Health Service, Israel’s largest healthcare provider.
- Their results, presented in a non-peer reviewed paper published in medRxiv on Friday, found that “the risk of infection by C19 appears to be reduced by half among current smokers.”
- Of the more than three million adults included in the study, 114,545 had been tested for the virus, of whom just 4% tested positive. The researchers matched those who tested positive to those testing negative at a ratio of 1:4, taking into account as closely as possible variables such as age, sex and ethnicity. They found that among those who had tested positive, 9.8% were smokers against 19% of the overall population.
- A previous smoking habit also appeared to confer some benefit, as 11.7% of those tested positive were former smokers against 13.9% in the general research population. Therefore, those who had previously smoked had a 19% lower risk of catching the virus, the results suggested.
- These results appeared to hold even when previously existing conditions were taken into account – and of those who did test positive, there was no evidence that smoking worsened the symptoms of the disease.
- “The magnitude of association observed for current smoking, with odds of infection reduced by about a half in smokers, suggests a genuine protective effect of smoking on the risk of C19.”
- The findings reflect comparable results in a recent study carried out by Prof. Zahir Amoura from Pitié Salpétrière Hospital in Paris, who found that, of 482 C19 patients that presented to the hospital between February 28 and April 9, just 4.4% of in-patients and 5.3% of outpatients were daily smokers, against 25.4% of the general population.
- That study also found that smokers were 80% less likely to develop severe symptoms, leading researchers to suggest that the nicotine in cigarettes binds to cell receptor sites, preventing the virus from taking hold by blocking access.
- Similarly, University College, London, surveyed 28 papers and found the number of coronavirus victims who were smokers was “lower than expected”; a review of 13 Chinese studies found just 6.5% of 5,300 people hospitalized with corona were smokers; and a study by America’s Center for Disease control found that a mere 1.3% of more than 7,000 people who tested positive were smokers, against 14% of all Americans, according to The Daily Mail.
- On the other hand, Dr. Nicholas Hopkinson’s team at Imperial College, London, assessed data from 2.4 million users of the COVID Sympto Study app, developed by Kings’s College London and Zoe.
- On first use the app records key characteristics such as location, age, height, weight, smoking and common disease. Of the group, 11% were recorded as smokers, a little below the national average of 14%.
- The study found that, of “standard users” – that is, someone who had not been tested for coronavirus – smokers were 14% more likely to experience three core symptoms of the disease: fever, a persistent cough and shortness of breath, The Daily Mail reported.
- “Our results provide compelling evidence for an association between current smoking and individual risk from C19, including symptom burden and risk of attending hospital,” the researchers wrote in their paper.
- Despite this counter-evidence, some researchers are looking into nicotine as a potential therapeutic for C19. They are giving nicotine patches to patients to see whether they reduce the instance and severity of coronavirus, particularly as the drug appeared to have beneficial effects in countering a phenomenon known as a cytokine storm, which occurs when the natural immune response goes into overdrive – an effect that can result in death.
- “Nicotine has effects on the immune system that could be beneficial in reducing the intensity of the cytokine storm,” Dr. Konstantinos Farsalinos, from the University of West Attica, Greece, wrote in Internal and Emergency Medicine, according to The Daily Mail.
- “The potential benefits of nicotine… could explain, at least in part, the increased severity or adverse outcome among smokers hospitalized for C19, since these patients inevitably experience abrupt cessation of nicotine intake during hospitalization.
- “This may be feasible through repurposing already approved pharmaceutical nicotine products such as nicotine patches.”
3. Cow’s antibodies four times better than convalescent plasma at preventing the virus from entering cells
- The latest recruits in the fight against C19 are munching hay in a South Dakota barn. A biotech company has coaxed genetically modified cows to pump out human antibodies that subdue the coronavirus and it plans to start clinical trials of them this summer.
- “This is promising,” says Amesh Adalja, an infectious disease physician at the Johns Hopkins University Center for Health Security. “We want to have as many countermeasures as we can.”
- To manufacture antibodies for treating or preventing diseases, companies typically turn to sources such as cultured cells or tobacco plants. But almost 20 years ago, researchers began to develop the approach now pursued by SAb Biotherapeutics of Sioux Falls, South Dakota, to produce antibodies on the hoof.
- The company genetically alters dairy cows so that certain immune cells carry the DNA that allows people to make antibodies. That upgrade enables the animals to manufacture large quantities of human antibodies against a pathogen protein injected into them, such as the “spike” surface protein of the new coronavirus.
- “Essentially, the cows are used as a giant bioreactor,” says viral immunologist William Klimstra of the University of Pittsburgh, who has been analyzing the bovinemade antibodies’ potency against the coronavirus.
- Cows make good antibody factories, and not just because they have more blood than smaller animals engineered to synthesize human versions of the proteins. Their blood can also contain twice as many antibodies per milliliter as human blood, says Eddie Sullivan, SAb Biotherapeutics’s president and CEO.
- The animals may provide another advantage. Most companies trying to produce antibodies to combat C19 have pinned their hopes on mass-producing identical copies of a single version, a so-called monoclonal antibody that homes in on and attaches tightly to a particular section of a virus.
- Instead of making just one antibody variety, the cows fashion polyclonal antibodies, a range of the molecules that recognize several parts of the virus. “That’s the natural way that our bodies fight disease,” Sullivan says. This diversity may make the cow’s proteins more powerful than monoclonal antibodies, he says, and they may remain effective even if a virus mutates.
- When the C19 pandemic erupted, SAb Biotherapeutics had already completed a clinical trial with cow-generated antibodies against Middle East respiratory syndrome, which is caused by another coronavirus. Developing that treatment “gave us the initial knowledge to focus on the right target,” Sullivan says. Within 7 weeks the cows were generating antibodies against the coronavirus’ spike.
- Before the animals start to release these antibodies into their blood, the cows need a starter immunization—a DNA vaccine based on a portion of the virus’ genome that preps their immune system. Then comes the injection that contains a piece of coronavirus’ spike protein, which serves as the virus’ passkey to cells. Each month, one cow can yield enough antibodies to treat several hundred patients, Sullivan says.
- In test tube studies, Klimstra and colleagues recently pitted the antibodies against so-called convalescent plasma from the blood of C19 survivors. Rich in polyclonal antibodies, the plasma is being tested in clinical trials as a treatment for the virus. The cow antibodies were four times better than convalescent plasma at preventing the virus from entering cells, the company announced last week.
- The biotech hopes to begin a clinical trial within the next couple of months, Sullivan says, and wants to test whether infusions of antibodies sifted from the cows’ blood prevent healthy people from getting infected by coronavirus and prove beneficial for patients who are already sick.
- Not everyone thinks the cows are the best choice for making antibodies, however. Infectious disease physician Manish Sagar of Boston University Medical Center says he will remain skeptical “until I see further proof that production of antibodies in cows is a lot more feasible and economically viable” than other methods. So far, no antibodies generated by the animals have been approved for treating any disease.
- But infectious disease specialist Jeffrey Henderson of Washington University School of Medicine in St. Louis describes the cow-produced antibodies as “the logical next step” to the convalescent plasma he has been studying. “The whole approach,” he says, “is based on sound science and on past experience going back more than a century.”
E. New Scientific Findings & Other Research
1. 23andMe Provides More Evidence That Blood Type Plays Role in Virus
- Research from genetic-testing giant 23andMe Inc. found differences in a gene that influences a person’s blood type can affect a person’s susceptibility to C19.
- Scientists have been looking at genetic factors to try to determine why some people who contract the new coronavirus experience no symptoms, while others become gravely ill. In April, 23andMe launched a study that sought to use the millions of profiles in its DNA database to shed light on the role genetics play in the disease.
- Preliminary results from more than 750,000 participants suggests type O blood is especially protective against the coronavirus, the virus that causes C19, the company said on Monday. The findings echo other research that has indicated a link between variations in the ABO gene and C19.
- Many other groups, including 23andMe competitor Ancestry Inc., are combing the genome to help make sense of the virus. It is known that factors such as age and underlying health conditions can determine how people fare once they’ve contracted C19. But those factors alone don’t explain the wide diversity of symptoms, or why some people contract the disease and others don’t. Studying the genetics of the people who are more susceptible to coronavirus could help identify and protect those more at risk, as well as help speed treatment and drug development.
- Several other studies looking at both severity of illness and susceptibility to disease have also suggested blood type plays a role.
- Research published last week prior to peer review suggested blood type may play a role in the severity of patients’ reactions to the coronavirus. That study looked at the genes of more than 1,600 patients in Italy and Spain who experienced respiratory failure and found that having type A blood was linked to a 50% increase in the likelihood a patient would require a ventilator. An earlier Chinese study turned up similar results regarding a person’s susceptibility to C19.
- “There have also been some reports of links between C19, blood clotting, and cardiovascular disease,” said Adam Auton, lead researcher on the 23andMe study. “These reports provided some hints about which genes might be relevant.”
- The 23andMe study, which looked at susceptibility rather than severity of illness, included 10,000 participants who told the company they had C19.
- The research found that individuals with type O blood are between 9% and 18% less likely than individuals with other blood types to have tested positive for the virus. However, there was little difference in susceptibility among other blood types, the study found. When the researchers adjusted the data to account for factors like age and pre-existing illnesses, as well as when it restricted the data to only those with high-probability of exposure like health-care workers, the findings were the same.
- Auton said that while this evidence is compelling, there is still a long way to go.
- “It’s early days; even with these sample sizes, it might not be enough to find genetic associations,” he said. “We’re not the only group looking at this, and ultimately the scientific community may need to pool their resources to really address questions surrounding the links between genetics and C19.”
2. At Least Half of Singapore’s new C19 cases are symptomless
- At least half of Singapore’s newly discovered coronavirus cases show no symptoms, the co-head of the government’s virus taskforce told Reuters on Monday, reinforcing the city-state’s decision to ease lockdown restrictions very gradually.
- Tiny Singapore has one of the highest infection tallies in Asia, with more than 38,000 cases, because of outbreaks in cramped dormitories housing thousands of migrant workers.
- It reopened schools and some businesses last week after a near two-month lockdown, but many residents are still required to work from home and mix socially only with their families.
- “Based on our experience, for every symptomatic case you would have at least one asymptomatic case,” said Lawrence Wong, adding that the discovery was made in recent weeks as Singapore ramped up testing.
- “That is exactly why we have been very cautious in our reopening plans,” Wong said.
- Singapore has not previously disclosed how many asymptomatic cases it has recorded. Wong did not reveal the number of asymptomatic cases in Singapore, which has reported 6,294 infections in the last two weeks, mainly among migrant workers.
- China said 300 symptomless C19 carriers in its central city of Wuhan, the pandemic epicenter, had not been found to be infectious.
- But some experts say asymptomatic infections are common, making for a huge challenge in controlling the disease as countries start exiting lockdowns. [Note: This contradicts the WHO’s recent finding that asymptomatic transmission of the virus is “very rare”.]
- Wong said that while asymptomatic individuals had fewer opportunities to spread the virus as they were not coughing or sneezing, there have been cases of asymptomatic transmission in Singapore, especially between patients living in close quarters.
- “People have commented – why are we not reopening the economy faster?” Wong said. “We have to take a more cautious approach. There are still asymptomatic cases which we may not have detected circulating in the community.”
- Nations are looking to harness technology to track the spread of the disease.
- Singapore plans to give all its 5.7 million residents a small Bluetooth device, worn on a lanyard or carried in a handbag, to trace interactions with virus carriers.
- The first devices could be rolled out to a pilot group by month-end, Wong said, adding that the government would ensure the confidentiality of any data collected.
3. Drug targets enzymes that enable virus to invade cells
The coronavirus enlists the help of two enzymes on the surface of human cells in order to invade them. A new study suggests that a compound that inhibits both enzymes could make a highly effective treatment.
- When disease-causing viruses break into their hosts’ cells, it is invariably an “inside job.” Viral pathogens can only invade cells and replicate with the assistance of the cells’ own molecular machinery.
- The coronavirus is no exception. Before the new coronavirus can enter a human cell, enzymes called proteases on the cell’s surface must split open the protein spikes that give the virus its characteristic crown-like appearance.
- This splitting changes the shape of the spikes, exposing the binding sites that allow the virus to gain entry to the cell.
- The spikes of coronaviruses contain three “cleavage sites,” where particular proteases can split the proteins. A coronavirus can, therefore, only invade cells that bear the appropriate proteases.
- The cleavage sites and their respective proteases help determine how pathogenic the virus is, which tissues it can infect, and whether it can jump from species to species.
- Scientists at the University of California, Riverside’s School of Medicine and the Sanford Burnham Prebys Medical Discovery Institute, in La Jolla, wanted to find out whether a compound that inhibits two particular proteases would protect cells from invasion by the coronavirus.
- Their findings have been published in the journal Molecules.
- A previous study had suggested that one of the proteases, called furin, is used by some of the most pathogenic coronaviruses. It may be one factor that helps the coronavirus spread so easily.
- Rather than working directly with the coronavirus, the researchers used anthrax toxin as a model.
- This is because furin not only helps viruses infect cells, it also activates anthrax toxin, allowing it to enter and kill cells.
- Crucially, furin cleaves the same sequence of peptides — the units that form protein — in both the SARS-CoV-2 spike protein and the anthrax toxin. This makes the toxin an ideal model.
- First, the researchers checked whether their agent, called compound 1, could protect human cells in a dish from the toxin.
- Once they confirmed this, they went on to investigate whether compound 1 would protect mice from the toxin.
- They discovered that even a single dose of the compound significantly improved the animals’ survival.
- Compound 1 inhibits both furin and another protease, called TMPRSS2.
- In their paper, the scientists argue that further research is needed to develop compounds like theirs that inhibit both proteases, rather than just one. Alternatively, a cocktail of different protease inhibitors could also work, they argue.
- The study authors cite two lines of evidence for their argument.
- First, when scientists in the past have genetically engineered host cells so that they were unable to make furin, this has failed to stop the virus from infecting the cells.
- Second, when the authors of the present study looked at the peptide sequence of the coronavirus spike protein, they found evidence that newly acquired mutations allow the virus to exploit both furin and TMPRSS2 cleavage sites.
- These mutations have given the virus the ability to infect a wider variety of tissues in the body.
- “In other words, the coronavirus, unlike other, less pathogenic strains, can more efficiently use both proteases, TMPRSS2 and furin, to start the invasion of host cells,” says Maurizio Pellecchia, a professor of biomedical sciences at the University of California, Riverside, who led the research team.
- “While TMPRSS2 is more abundant in the lungs, furin is expressed in other organs, perhaps explaining why the coronavirus is capable of invading and damaging multiple organs.”
- A clinical trial of the TMPRSS2 inhibitor camostat in people with C19 recently began.
- However, research from the team in California suggests that camostat is a poor furin inhibitor. “Our current study, therefore, calls for the development of additional protease inhibitors or inhibitor cocktails that can simultaneously target both TMPRSS2 and furin and suppress the coronavirus from entering the host cell,” says Prof. Pellecchia.
- He and colleagues are seeking funding to design and develop protease inhibitors that target both TMPRSS2 and furin.
- In addition to treating C19, such agents could combat other highly pathogenic coronaviruses that may jump from other species into humans.
- “The funding would allow us to explore new possibly effective therapeutics against C19 and support studies that could have far-reaching applications — to ward off possible future pandemics,” says Prof Pellecchia.
A limitation of the study
- The new research was a lab-based, preclinical study. Clinical trials would, therefore, be needed to test whether an agent such as compound 1 is safe and effective in people.
- One shortcoming of protease inhibitors is that they work by disabling enzymes that the body needs for everyday functioning.
- While protease inhibitors have proved highly effective in treatments for HIV, for example, they can cause severe side effects in some people.
- Cells use furin, in particular, to activate a wide variety of important proteins.
4. U.S. Navy test shows 60% of carrier crew have antibodies
- A U.S. Navy investigation into the spread of the coronavirus aboard the Theodore Roosevelt aircraft carrier has found that about 60% of sailors tested had antibodies for the virus, two U.S. officials told Reuters on Monday, suggesting a far higher infection rate than previously known.
- In April, the Navy and the CDC started conducting serology tests to look for the presence of specific antibodies that are created by the immune system’s attack response to the presence of the virus and remain in the blood for a period of time.
- More than 1,100 aboard tested positive for the virus as of April, less than 25% of the crew.
- The spread of the virus on the ship put into motion a series of events that led to the captain of the ship being relieved of his command after the leak of a letter he wrote calling on the Navy for stronger measures to protect the crew.
- One sailor from the ship died from the coronavirus and several others were hospitalized. But broadly, sailors, who are generally healthier and younger, faired better than the general population and most showed no symptoms whatsoever.
- The officials, speaking on the condition of anonymity, said that about 400 volunteers participated in the serology tests, lower than the 1,000 volunteers that were sought, but enough to provide statistically relevant data about how the virus spread aboard one of world’s largest warships.
- The Roosevelt has about 4,800 personnel on the ship.
- The serology test results appear to track closely with data from the Roosevelt in early April, which showed that 60% of the sailors who were testing positive for the virus itself – not antibodies – were in fact symptom-free.
- Medical groups, such as the American Medical Association, have warned that serology tests can lead to false positives.
- The CDC has said that definitive data is lacking on whether individuals with antibodies are protected against reinfection from the coronavirus.
- In addition to the serology tests, volunteers were also swabbed again for C19, the respiratory disease caused by the virus, as well as asked to answer a short survey.
E. Concerns & Unknowns
1. C19 Stalks Large Families in Rural America
- The Woods family did everything together at the house on Paden Road in Gadsden, Ala. They gathered there before going to high-school football games on Friday nights. They ate there after church on Sundays, when the family matriarch, Barbara Woods, would make chicken and dressing for her children and grandchildren.
- And this spring, they grew sick there together. For weeks in early April, seven family members staying in the three-bedroom home were stricken by the new coronavirus, several of them recounted. Five ended up in the hospital. Two died.
- “I was just wishing that we had extra rooms, so we could have separated,” said Ms. Woods, 71, who for years owned a barbecue restaurant in Gadsden, a rural town 60 miles northeast of Birmingham. “It has been devastating.”
- Communities are reopening after months-long lockdown orders managed to slow the spread of C19 in some places. But the lockdowns have done little to thwart the virus’s transmission within packed households. Outside of institutional settings like assisted-living facilities, large, multigenerational homes have emerged as one of the most dangerous places to be during the outbreak—a weak spot in the country’s public health response especially in the event of another wave of infections in the fall, as some experts fear.
- A Wall Street Journal analysis found that, across the country, the virus has spread more widely in places with the most crowded households, not necessarily places with the largest or densest populations. Remote, rural hamlets where extended families live under the same roof have turned deadlier than some of the densest blocks of Manhattan or Chicago, the analysis found. In both contexts, the virus has zeroed in on crowded homes, sometimes wiping out generations in a matter of days.
- Housing analysts and some government agencies consider a home with more than one resident per room to be crowded. Nationwide—4 million homes, or about 3%—fall into this category, according to census data.
- The Journal analyzed all 1,487 U.S. counties with at least 50 C19 cases, as of June 7. The 10% with the highest rates of crowding accounted for 28% of the coronavirus cases among those 1,487 counties, according to census and Johns Hopkins University data.
- The Journal also found that in selected areas—including Cook County, Ill., New York City and Wayne County, Mich.—ZIP Codes with the largest share of households of at least five people have disproportionate shares of their counties’ C19 infections. The problem is particularly acute in poorer and minority communities, according to data from some cities, where extended families often live together and lack space and resources to isolate anyone who falls ill.
- Families that live on Indian reservations often live in crowded homes, which the census defines as more than one occupant per room. These areas have also seen some of the highest infection rates in the nation.
- As states reopen, stopping transmission of the virus within households will be key to preventing a second wave of infections, said Dr. Ashish Jha, a health-policy professor at the Harvard T.H. Chan School of Public Health.
- San Francisco, Kansas and the Navajo Nation in the Southwest are among the places that have encouraged sick people to leave their homes and stay in alternative housing sites and hotels that have been converted into quarantine facilities. Yet, persuading people to do so has been difficult, health workers say, and there is little appetite among public officials to make the sick leave their families.
- “I’m 110% opposed to anything forcible on this,” said Dr. Jha. But if the U.S. can’t find a way to control intra-household infections, he said, “that will lead to more community transmission.”
- On the Navajo Nation, where roughly 175,000 people are scattered across a three-state swath of the Southwest, household crowding has contributed to one of the country’s worst outbreaks. Some 18% of homes have five or more people and 14% are classified as crowded, among the highest rates in the country, according to census data.
- The Navajo Nation’s coronavirus death rate was 154 per 100,000 people as of June 5—compared with 123 in New York state, 136 in New Jersey and 33 for the U.S. overall.
- Tina Harvey lives with her extended family in a cluster of several small houses in the tiny Navajo village of Tes Nez Iah, Ariz. None of the structures have running water, not uncommon on the reservation, making it difficult to wash hands regularly. Ms. Harvey, a 55-year-old home health-care worker, has watched with horror as “Big Cough-19” or “Invisible Parasite-19,” as the coronavirus is known in Navajo, struck family member after family member.
- First, she said, it was her brother, Amos Tso, 71, who fell ill in April after returning from New Mexico, where he had gone to have toes amputated due to an infection. On April 4, his niece, one of numerous family members caring for Mr. Tso, drove him to an Indian Health Service clinic after he began experiencing body aches and breathing problems. Seven days later, he was dead from C19.
- In one trailer, four of the six family members who stayed there began running fevers, coughing and suffering body aches, Ms. Harvey said. They all tested positive for the coronavirus and were sent home with Tylenol and cough syrup, she said.
- In a second trailer, another sister and her husband, in their 60s, fell ill. Their grandson, who lived with them and was sick too, drove them to an IHS hospital in Shiprock, N.M. The couple died days later.
- The IHS didn’t respond to a request for comment on Ms. Harvey’s family’s case.
- In all, 11 family members got sick, including Ms. Harvey, who was hospitalized for nearly two weeks. “It has been very hard—what has happened to us,” she said. “Right now, people are scared to turn up the road to our house. ‘Those people over there. They all have coronavirus. They’re dying.’ That’s what we’ve been hearing.”
- Tribal leaders and health officials said it has been difficult to keep the virus from ricocheting through crowded homes on the reservation.
- Hoping to get sick people out of their households, the IHS and tribal health officials have set up quarantine sites where more than 165 people were staying as of Friday, mostly in converted hotel rooms. Health officials were also deploying isolation tents for those who want to remain on their land.
- The infections on the reservation have spilled into surrounding communities. McKinley County, part of which lies on the reservation, comprises about 3.4% of New Mexico’s population but has nearly a third of its C19 cases, according to state data. About 14% of the county’s homes are crowded, compared with 3.5% statewide, according to census data.
- Household crowding is also helping fuel the outbreak in urban areas.
- A study from New York University’s Furman Center found that in New York City, the areas hit hardest by the disease weren’t those with the densest population; they were the ones with the greatest household crowding among renters.
- The Journal analysis found that in Chicago, ZIP Codes where crowded households are most common accounted for a disproportionate share of the city’s coronavirus cases. The Humboldt Park neighborhood on Chicago’s West Side, for example, has a household crowding rate more than eight times as high as the Evergreen Park area, on the city’s outskirts. Its infection rate is twice as high.
- Household crowding frequently overlaps with other risk factors, studies show. It is more common in poorer neighborhoods, where residents are more likely to have underlying health conditions and to still be working outside the house during the outbreak.
- C19 has disproportionately hit African-Americans and Latinos, several studies have shown. Black and Latino households are almost twice as likely to be multigenerational as white households, according to the Pew Research Center.
- In California, the three counties with the highest coronavirus rates—Kings County, Imperial County and Los Angeles County—are majority Latino and Black and have among the highest rates of household crowding in the country.
- In Azusa, Calif., a working-class, mostly Latino city in eastern Los Angeles County, the Ramirez family took strict precautions to avoid spreading the coronavirus. By mid-March, no one was working outside the home except Guillermo Ramirez, said his wife, Luciana Ramirez. His job driving trucks for an asphalt company was among work Gov. Gavin Newsom deemed essential.
- A study from the Public Policy Institute of California found that essential workers are at higher risk of contracting C19—and more likely to live in crowded homes.
- Mr. Ramirez, 47, wore a mask and gloves on the job, and he would spray off his shoes before coming into the five-bedroom house. Only he and Guillermo Jr., his 25-year-old eldest son, shopped for food, and they washed the groceries off before bringing them inside, Ms. Ramirez said. Still, after spending Easter Sunday watching movies and playing games with her children and grandchildren, Ms. Ramirez began to feel feverish.
- She isolated herself in the bedroom, and Mr. Ramirez moved to the living room. But within days, the virus had swept through the household. Ultimately, all 10 people living there—Mr. and Ms. Ramirez; four of their children; three grandchildren and Ms. Ramirez’s mother, who was staying with them at the time—tested positive for C19.
- By late April, the entire family had isolated from one another in their rooms and wore masks. Their 26-year-old daughter, who lives down the street, dropped groceries outside the front door. Their 12-year-old son, who was asymptomatic, slept on the couch and left food and water outside his relatives’ rooms.
- First, Guillermo Jr. went to the hospital. Then Mr. Ramirez himself. Then Ms. Ramirez’s mother. On April 28, Mr. Ramirez called his wife from the Emanate Health Inter-Community Hospital in West Covina at 3 a.m., telling her he was frightened and she needed to pick him up. By 8 a.m., she said, he was dead.
- Ms. Ramirez, 46, said the family tried desperately to keep from spreading the virus to one another—even after the funeral, they continued to wear masks at home—but it was impossible once the disease was in the house.
- “It is a big house, but you have to pass each other through the hallways,” Ms. Ramirez said. “We took it serious. We got hand sanitizer. We got masks. We got our gloves. We got Lysol. We sprayed our shoes. We did everything right and we still got it, and it affected us this way.”
- Recognizing that simply staying at home won’t stop transmission of the virus, countries in Asia have adopted more drastic measures. Singapore and South Korea required all people who test positive for C19 to move into isolation or medical facilities; Vietnam and Hong Kong extended mandatory out-of-home quarantining to contacts of the sick as well.
- In Italy, where multigenerational households are common and most people with C19 remain at home, the country’s National Health Institute found that one in five people who have tested positive in April and early May were likely infected by family members, the second-highest source of infection after nursing homes.
- A study from the London School of Hygiene & Tropical Medicine found that in a city of four million people, home-based isolation would result in a 20% reduction in coronavirus cases, while isolation in quarantine centers would cut cases by 59%.
- In the U.S., quarantine centers have been used sparingly. Because testing hasn’t been as widespread as in some other countries, many people have passed the virus to loved ones before even realizing they are sick.
- Kansas officials have set up quarantine centers in six counties across the state, including Ford County, where outbreaks at two meatpacking plants have sickened workers and their family members. The county of 33,600 people has more than 1,800 confirmed cases, the highest total in the state. According to census data, 18% of households in Ford County have five or more people and 7.1% are crowded, both well above the national average.
- As of Saturday, only 8 Covid-positive people were checked into the quarantine center in Ford County, state health officials said. Statewide, just 12 of more than 300 available rooms for infected residents were occupied. Public-health officials and immigrant advocates said some workers in the county, who may be undocumented, are wary of using the facilities. A Ford County official said the quarantine centers were working well.
- San Francisco has contracted with hotels to provide more than 1,000 rooms where people who get sick can isolate and are provided with three meals a day. But convincing the sick to leave their families can be difficult, said Trent Rhorer, director of San Francisco’s Human Services Agency.
- “Often, the family bond is strong—you have multigenerational households and they all rely on each other for income, or to cook, or to clean,” Mr. Rhorer said.
F. Projections & Our (Possible) Future
1. Shutting down schools, banning large gatherings and stay-at-home orders prevented half a billion coronavirus cases worldwide and 60 million in the US
- Half a billion infections of the novel coronavirus were prevented worldwide from lockdowns, a new study finds.
- Researchers found that stay-at-home orders, business shutdowns and school closures prevented up to 60 million infections in the US alone.
- Additionally, the guidelines helped avert 470 million more cases from cropping up across Asia and Europe.
- Several American politicians argued that these shutdowns would wreak havoc on the economy, resulting in millions of job losses and tanking stock markets.
- But the team, from the University of California, Berkeley, says the findings show the policies were imperative to preventing the spread of the virus.
- For the study, published in the journal Nature, the team looked at interventions such as school closures, stay at home orders and lockdowns in five countries. [Read Nature: The study]
- They included China – where the virus originated – South Korea, Iran, Italy, France, and the US.
- Researchers found that so-called ‘anti-contagion policies’ significantly helped reduce the number of coronavirus cases in each of the six counties.
- In the US, such action prevented an additional 60 million people from contracting C19, the disease caused by the new virus.
- ‘In the absence of policy actions, we estimate that early infections of C19 exhibit exponential growth rates of roughly 38 [percent] per day,’ the authors wrote.
- ‘We estimate that across these six countries, interventions prevented or delayed on the order of 62 million confirmed cases, corresponding to averting roughly 530 million total infections.’
- Results shows that if restrictions hadn’t been put in place, other countries would have also been hit much harder.
- China would have seen 250 million more infections, South Korea would have seen 38 million more and Iran would have seen 54 million more.
- In Europe, 49 million infections were prevented in Italy, and 45 million were prevented in France.
- ‘Societies around the world are weighing whether the health benefits of anti-contagion policies are worth their social and economic costs,’ the team wrote.
- It comes as a second study from Imperial College London found that lockdowns prevented 3.1 millions deaths in Europe. [Read the Study here: Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe]
- Also published in Nature, the team looked at data from 11 countries on the continent, including the UK, Italy, Spain and Germany, from March 2, 2020 to May 4, 2020.
- They looked at how fatalities corresponded with non-pharmaceutical interventions such as school closures and national lockdowns.
- ‘This data suggests that without any interventions, such as lockdown and school closures, there could have been many more deaths from C19,’ said Dr Samir Bhatt, study author from the MRC Centre for Global Infectious Disease Analysis, Jameel Institute at Imperial College London.
- ‘The rate of transmission has declined from high levels to ones under control in all European countries we study. Our analysis also suggests far more infections in these European countries than previously estimated.’
[Note: In our view, the conclusions of the study should be viewed with some skepticism as it is based on assumptions on how the virus would have spread without any lockdowns, and there are an increasing number of studies calling into question how much of the population is actually susceptible to infection and other studies questioning the effectiveness of lockdowns.]
2. How Many People Actually Have C19? Significant Global Differences in Undetected Cases
According to a study, the number of undetected cases of infected persons differs significantly in different countries.
- The demographic scaling model developed by researchers at the Max Planck Institute for Demographic Research in Rostock and University of Helsinki makes it possible to estimate the actual number of C19-infections in different countries with just a minimum of data. According to this model, the number of cases in Germany is only 1.8 times higher than the number of confirmed cases. For Italy, however, the researchers estimate that the number of infected is 6 times higher than the number of confirmed cases reported by the health authorities.
- “For the ten countries most affected by the C19 pandemic, we used our demographic scaling model to estimate the number of unreported cases of infected people,” says Mikko Myrskylä, Director at the Max Planck Institute for demographic Research in Rostock, Germany. According to data from May 13, 2020, there are on average four times as many infected people as there are confirmed cases.
- For Italy, the model estimates about 1.4 million infected people which is six times higher than confirmed cases reported by the health authorities. The researchers estimate for the U.S. that there have been 3.1 million people infected with C19, which is more than twice as many cases as officially reported. In Germany, on the other hand, where a large number of people are tested for C19, the model estimates the number of unreported cases to be only 1.8 times as high.
- In all ten countries with the highest number of C19 deaths (as of May 13), the number of infected persons is most likely higher than the number of confirmed cases. If the distance between the red bar (number of confirmed cases) and the dark grey bar (probable estimate) is large, the number of confirmed cases is far from the probable number of infected people. Credit: © Max Planck Institute for demographic Research
- “However, the uncertainty of our model estimates is large,” adds Christina Bohk-Ewald, co-author of the paper and currently working at the University of Helsinki. With a probability of 95%, the estimated total number of cases is between twice and eleven times as high as the number of confirmed cases. The differences between the individual countries are also large. The researchers present their model in a paper which is available online as a pre-print version on medRxiv but has not been peer-reviewed.
- For their model calculations the researchers mainly used data on C19 deaths, infection fatality rates, and life tables. However, since C19 infection fatality rates are not yet known for most countries, the researchers transferred it from one reference country to other countries using the so-called remaining life expectancy. This demographic parameter allows to control for cross-country differences in the age structure, previous illnesses in the population, and the health care systems of the different countries.
- The demographic scaling model is based on two main assumptions: firstly, it assumes that the number of people who have died of C19 is fairly accurately recorded. Secondly, it assumes that the infection fatality rates from a reference country (in this case Hubei, China) are transferable to other countries after demographic adjustment. The three Max Planck researchers are aware that these two assumptions are only approximations and do not apply perfectly everywhere.
- Nevertheless, the researchers are convinced that they have developed a widely applicable model which provides useful estimates of the actual number of individuals who are infected with C19, using only minimal input data. “Our model can also be used to check the plausibility of estimated infection numbers from other studies which measure, for example, the prevalence of antibodies in the population,” says Christian Dudel. According to Dudel, the antibody tests, which are only carried out regionally, are often not representative for the entire population of a country.
G. The Road Back?
1. Let the children play
- As we round Memorial Day weekend and prepare for summer, there will be something important missing from parks across the country, the sounds of kids enjoying organized sports. If you’re like our family, your spring sports were canceled and now summer sports leagues are canceling as well. This is unnecessary and should be reversed. Let the kids play!
- According to the latest C19 data in Colorado, children ages 0-9 make up 2.07% of all cases and 0.00% of all C19 deaths. Even in hard-hit places such as New York City, the deaths of children ages 0-17 make up .06% of all C19 deaths.
- So why are we making kids stay inside and forgo youth sports activities? It sure isn’t to protect kids from C19. No, with a majority of deaths coming from older people, we are attempting to flatten the curve by keeping families isolated. Rather than targeting our stay-at-home orders toward those most vulnerable, they are so broad to include people that aren’t dying from the virus.
There is a better solution
- Youth sports could help reduce the overall health, social, and psychological effects of C19. According to William Bryan, the acting head of the Science and Technology Directorate at the Department of Homeland Security, “Our most striking observation to date is the powerful effect that solar light appears to have on killing the virus, both surfaces and in the air. We’ve seen a similar effect with both temperature and humidity as well, where increasing the temperature and humidity or both is generally less favorable to the virus.”
- Moreover, vitamin D produced by the body exposed to sunlight may help combat the effects of C19. According to Northwestern University, “Not only does vitamin D enhance our innate immune systems, it also prevents our immune systems from becoming dangerously overactive. This means that having healthy levels of vitamin D could protect patients against severe complications, including death, from C19.”
- Sports get kids outside, where the sunlight kills the virus, and produces essential vitamins to keep kids healthy and surviving C19. In addition, youth sports provide plenty of other benefits for children, including reducing obesity, improving cognitive skills, and encouraging hard work, sportsmanship, and teamwork ethics.
- For the past 5 years, I’ve been coaching all four of my children in youth sports. This includes coaching soccer, baseball, basketball, and flag football. Most of these sports leagues have a very small number of people on a field at one time. Teams are made up of 10 kids, and the only people attending games are family members.
- We can practice social distancing by keeping the spectators far apart. We can avoid unnecessary contact before and after the game. We can keep older and more vulnerable family members away from the games. We can do all this while letting the kids enjoy sports this summer.
- It’s time for the stay-at-home orders to target those most likely to suffer from C19. America’s children have lost out on one spring sports season already, a semester of school with their peers, and are likely spending more time in front of screens than ever before. Let’s give American children their summer back. Long days full of friends and sports. Let them play!
Source: Let the children play