There was a better graph, that separated the place of death per day, rather than the cumulative number, but this one still shows the dark blue/light blue as a greater proportion of deaths at the end of the graph than at the start - indicating that deaths outside hospital are increasing (as a proportion of daily deaths, if not as an absolute number) against in-hospital deaths.
Here is a graph which might show the kind of thing you are looking for, embedded in a BBC article?
BBC news showed a graph, in which the UK looked second in the world, after US. I don't know the source of it, it looked horrible.
Probably listing "active cases" of COVID-19 where, at least in officially diagnosed cases, the U.K. is indeed second only to the U.S. Part of this may stem from the fact that virtually no one in the U.K. is classified as "recovered" from COVID-19, which would move them off the "active" list. I'm not sure why that is the case, if it's just a bureaucratic difference between the U.K. and elsewhere or if no one is actually recovering from COVID-19 within the U.K.
There was a better graph, that separated the place of death per day, rather than the cumulative number, but this one still shows the dark blue/light blue as a greater proportion of deaths at the end of the graph than at the start - indicating that deaths outside hospital are increasing (as a proportion of daily deaths, if not as an absolute number) against in-hospital deaths.
Here is a graph which might show the kind of thing you are looking for, embedded in a BBC article?
BBC news showed a graph, in which the UK looked second in the world, after US. I don't know the source of it, it looked horrible.
Probably listing "active cases" of COVID-19 where, at least in officially diagnosed cases, the U.K. is indeed second only to the U.S. Part of this may stem from the fact that virtually no one in the U.K. is classified as "recovered" from COVID-19, which would move them off the "active" list. I'm not sure why that is the case, if it's just a bureaucratic difference between the U.K. and elsewhere or if no one is actually recovering from COVID-19 within the U.K.
It's been like that forever. The UK government's daily reports (source here) don't give up to date data on recoveries. Not sure why that is but it is out of line with daily reports from other countries. Same can be said for the Serious/Critical column in wordometer.
I think up-thread there has been a discussion on cases per capita. If you look at it that way, there are still several countries ahead of the US, just saying.
Cases per capita matters in so far as the number of cases coming into the country may be proportional to that. But it shouldn't affect the number of cases once you've allowed for that until a significant percentage of the population has been infected, enough that herd immunity begins to slow the virus down.
It's just as easy to go from one case to fifty thousand in a population of five million as it is in a population of fifty million.
United Arab Emirates - 11,380 (9,110 / 2,181 / 89)
South Korea - 10,761 (1,593 / 8,922 / 246) 2.7%
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1. Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries nineteen of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Turkey and Russia. The number of known American dead from COVID-19 now exceeds the number of Americans killed in Vietnam.
No countries have joined the 10,000 case club since the last compilation.
In the worst affected European countries, the trends on deaths and new cases are definitely down. (In the UK that applies to hospital deaths only.)
In the USA, after two relatively low "death days" the daily rate (worldometer GMT day) has gone up again to over 2500. The number of new daily cases seems to be plateauing at a pretty high level (about 25,000) although the spread across States is changing.
I note that the reported daily death rate in Russia seems to be on the increase.
I think the UK figures from NHS re new cases and deaths in hospital are fine. We'll see from today the impact of reporting deaths in residential homes as well. It involves some sort of merger of NHS stats and ONS stats. Not sure to what extent that will be made retrospective. As AFZ observes they are transparent about both processes and presentations. Politicisation of the information is another matter.
There was an interesting article in the Guardian last week, dated 24 April, part of their This is Europe round up, entitled Is comparing Covid-19 death rates across Europe helpful? (link) which discusses the disparities in data recording across Europe. The UK isn't the only country not counting care home and home deaths, the article suggests this is true of Italy and Spain too, and that the death toll in care homes in France is understated, certainly as of the date of the article. Whereas Belgium is almost certainly overstating the Covid-19 deaths in care homes, which is why their figures look so high.
You could say that UK hospitals haven't been overwhelmed by covid cases, but care homes have. I don't know if there is a connection there, but care homes have been notoriously underfunded and neglected. 26 000 deaths counted, but there are many predictions that this is underreporting.
So far as I can tell, the accounting for care home deaths will still be lagged. The date of death and the date death certificates are received by ONS will make this an inevitable part of the accounting. To some extent this delay is a feature of hospital deaths reported to NHS, but there may be additional and unavoidable delays in certifying deaths in care homes.
The figures will gradually give a more accurate overall picture. It may indeed be that deaths in residential care become the majority reported as hospital deaths decline.
A little while ago I was panned for citing Gilead's drug as a possible therapeutic. The often-cited criticism was that had not undergone scientific testing by an unbiased party. Well, now it has.
The results of the study show that it shortens recovery time to 11 days vs the 15 day recovery time of the placebo. It also reduces the chances of death by about 30%.
Is it a miracle drug? Dr. Fauci admits, no; but it does show that there can be other drugs that will fight the disease, and that search continues.
In other news, CBS is reporting Oxford University Scientists believe their vaccine will be ready for mass distribution by September 2020. And CNN International is reporting a German company will have their vaccine available for distribution by the end of the year. As I understand it they are already beginning to mass-produce it so it can be quickly disseminated once it gets approval from the respective governments.
Florida medical examiners were releasing coronavirus death data. The state made them stop.
When the medical examiners’ list was available, it showed more deaths than the state’s count.
State officials have stopped releasing the list of coronavirus deaths being compiled by Florida’s medical examiners, which has at times shown a higher death toll than the state’s published count.
The list had previously been released in real time by the state Medical Examiners Commission. But earlier this month, after the Tampa Bay Times reported that the medical examiners’ death count was 10 percent higher than the figure released by the Florida Department of Health, state officials said the list needed to be reviewed and possibly redacted.
They’ve now been withholding it for nine days, without providing any of the information or specifying what they plan to remove.
On deaths from other causes: since the lockdown our* deaths-from-all-causes have held the same or slightly dipped, since our Covid-19 numbers are slowing way down, and—unexpectedly but understandably—a lot fewer people are dying in traffic accidents.
*Washington State (home of the first US diagnosis and first US official death, and early adopter of the lockdown).
On deaths from other causes: since the lockdown our* deaths-from-all-causes have held the same or slightly dipped, since our Covid-19 numbers are slowing way down, and—unexpectedly but understandably—a lot fewer people are dying in traffic accidents.
*Washington State (home of the first US diagnosis and first US official death, and early adopter of the lockdown).
Looks like Washington State is still bumping along. Can't seem to stay below 150 new cases on a sustained basis
United Arab Emirates - 11,929 (9,502 / 2,329 / 98)
South Korea - 10,765 (1,459 / 9,059 / 247) 2.7%
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1. Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries twenty of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Turkey and Russia.
No countries have joined the 10,000 case club since the last compilation.
200 new cases a day in Washington State looks like the kind of number that a good, well staffed, tracing system in that State should be able to manage in order to contain a spread. The problem for the USA, state by state, is that the levels of new cases a day are way above that for most states. They are also still way above that for the European countries hardest hit, even those there are signs of a slow decline.
It seems clear to me that no country or region should relax its protective guards until they have the means of measuring the incidence of new cases and the means of containing any spread.
If they don't have the testing and tracing capabilities, then there will be a spike. The only other factor (and I suppose we may get lucky) is if the infectiveness and virulence of COVID-19 declines on its own. I don't know if there are any signs of that happening.
Yes, I keep puzzling over that. NZ seems to show that you can drive numbers down to zero, but could the UK do that? There is also the prospect of vaccines and anti-virals, and then, what? We learn to live with it, and old people have to be sequestered permanently? At the moment, the idea of getting the Tube or going to a football match fills me with horror.
Yes, I keep puzzling over that. NZ seems to show that you can drive numbers down to zero, but could the UK do that? There is also the prospect of vaccines and anti-virals, and then, what? We learn to live with it, and old people have to be sequestered permanently? At the moment, the idea of getting the Tube or going to a football match fills me with horror.
I think because we let it get so bad it would take far longer for us to suppress it completely, and I don't think it would be politically possible to maintain the current level of lockdown, and economically tricky unless the government is willing to go to a full UBI or something similarly drastic.
Yes, I keep puzzling over that. NZ seems to show that you can drive numbers down to zero, but could the UK do that?
While nothing is impossible there are very significant differences that would suggest that driving number down to zero won't happen in the UK.
The biggest differences are the nature of UK and NZ geography and population. NZ is a low population nation (about 5M in an area not much different from the UK) with limited ports of entry (6 international airports - 4 of which only connect to Australia and Fiji). Although social distancing and self-isolation will be as difficult in cities and large towns, the same as anywhere else, there are still inherent advantages in slowing any outbreaks in lower population density countries. And, quarantining until testing clear of new arrivals is easier with only a few ports of entry and fewer passengers - but, I expect that when the world re-opens there will still be too many people travelling too NZ for that to be sufficiently effective to prevent some small outbreaks unless the NZ government decides to radically cut tourism (tourists are not going to want to travel all the way to NZ only to spend the first few days there in quarantine until they've been tested clear of the virus). Added to which I'll be surprised if any test could ever be 100% accurate - even if a fraction of a % of people tested clear aren't then there's always a very small risk of a tourist bringing it back in. Which means that not only does there need to be a lot of work to bring rates down to zero, that work needs to be maintained to catch and control any new outbreak to keep that rate very low. In the UK, we have far too many ways for people to enter the country for having quarantine and testing facilities to be effective at all of those ports of entry.
The next big difference is the starting point. NZ only had a small number of cases, this allowed trace and check methods to rapidly crack down on each local outbreak in an effective manner. The UK did at one point have a small enough number of cases that we could have done the same, but it was never going to stay that small without shutting down all ports of entry to prevent large numbers of people arriving here. As it happened, we very quickly developed too many cases that we lost control. That was probably inevitable, though the degree that we lost control (and hence the total number of people infected to date) wasn't inevitable if more decisive action had been taken earlier.
Which is the last big difference I'll mention. The UK government response was slow, uncertain, inadequate and frankly inept. In NZ, in contrast, the government took rapid, decisive and competent action that was more widely accepted as necessary by the people (in part I'm sure because Jacinda Ardern is a more respected politician than most UK politicians).
There is also the prospect of vaccines and anti-virals, and then, what? We learn to live with it, and old people have to be sequestered permanently?
That's going to depend on what we get. If it's just anti-virals that make treatment more effective and leaves patients in ICU and hospital for shorter periods then we'll see a relaxation, but we'll still need to take action to limit spread of the virus, and in particular to protect the most vulnerable. The same would be true if we have a low-efficacy vaccine (if 50% of those vaccinated become immune then that will slow but not stop spread of the virus, similarly if the vaccine is effective for a short period and then immunity is lost).
Of course, the ideal would be a very effective vaccine that provides almost universal immunity, which is cheap and easy to produce such that we can immunise the entire population within a couple of years (without needing regular boosters). At present there's no indication that we'll have a vaccine that's very effective, much less one we can produce 10B doses of in a couple of years.
Florida medical examiners were releasing coronavirus death data. The state made them stop.
When the medical examiners’ list was available, it showed more deaths than the state’s count.
State officials have stopped releasing the list of coronavirus deaths being compiled by Florida’s medical examiners, which has at times shown a higher death toll than the state’s published count.
The list had previously been released in real time by the state Medical Examiners Commission. But earlier this month, after the Tampa Bay Times reported that the medical examiners’ death count was 10 percent higher than the figure released by the Florida Department of Health, state officials said the list needed to be reviewed and possibly redacted.
They’ve now been withholding it for nine days, without providing any of the information or specifying what they plan to remove.
CNN had an investigatory report on this feature - just watched it. There may be an innocent explanation. Apparently CDC reporting guidelines require States to report deaths of State residents to avoid double counting, whereas the MEC records deaths in the State regardless of State residency. The Florida Department of Health released a list to CNN of non State residents who had died in Florida and so were not included in the Florida count. I'm not sure if it explains all of the discrepancy but CNN now has evidence that it explains at least some of it.
Interesting point made by Richard North in his blog, that a lot of the deficiencies shown by the UK govt, stemmed from relying on old documents about a flu epidemic, e.g., the NHS Operating Framework for Managing the Response to Pandemic Influenza, which is available online. Thus, less equipment would be needed for flu, less testing, and so on. I think Hunt has complained likewise, although now I can't find the reference. I don't know if this makes sense of the early alleged reliance on herd immunity. One problem is that researching such material takes huge amounts of time, and to what end?
This post comes with a caveat: this is my opinion and I cannot give you data to support it as no such data yet exists. However, it is logical and based on sound science such that's it's only a small leap.
I think we will have an effective vaccine quite soon. As an aside, the Oxford team who began human tests last week are known personally to my PhD (2nd) supervisor. They began working on a SARS-Cov2 vaccine in January - as soon as the gene sequence was published by Chinese researchers. Virologists and epidemiologists saw this threat for what it is. And they warned the governments of the world what was coming.
Vaccine effectiveness depends on two things: The immunogenecity of the vaccine (I.e. how good it is at producing an immune response and most importantly immune memory) and the variability / mutation rate of the infective agent.
For technical reasons I won't go into in this post* (I will later if people are interested) getting good immune memory to viruses can be very tricky. For this reason, the various vaccine research teams around the world are looking at different approaches. It may be that more than one will be needed. I will describe one.
All Coronaviruses have a surface protein called a 'Spike Protein.' This protein is critical for infection as it is the molecule that binds to the host cell to allow viral invasion of that cell. There are several steps that follow this binding but this is the first step to allowing infection. Thus the spike protein is an obvious target for a vaccine.
If you look at Spike proteins in all Coronaviruses across the whole genus, it seems to be the case that the exact shape of this protein determines which cells it can infect. That makes sense as it has to bind onto something on the host cell. Proteins on human cells are different to those of bats or dogs or chickens or pigs etc. Essentially, the shape of this spike protein defines which cells the virus is capable of infecting. The prevailing theory is that SARS-Cov2 was a bat virus whose spike protein mutated such that it could still infect bats but could also bind to human cells and hence it was able to move from bats to humans. This is often how 'new' viruses emerge. HIV is a mutation of SIV** and thus it became a virus able to infect humans rather than monkeys (although the mechanisms by which HIV enters cells in very different to coronaviruses, the principle is the same and the virus made the species jump). There are a lot of Coronaviruses that are known to infect animals that are completely harmless to humans.
There are several mechanisms by which the immune system* fights viruses and antibodies are generally considered to be less important, however, they are the easiest to understand in this context. In principle an antibody is a molecule that only recognises one molecule. Such that an antibody to Streptococcus will have no effect on E. coli. Antibodies to flu can't help fight Nisseria meningitidis (one of the bacteria that commonly causes meningitis). In fact for any common pathogen, you may well have multiple antibodies that recognize different molecules of the pathogen. And because the influenza viruses differ so much from each other, an antibody to one strain often has no effect on another strain. Unsurprisingly in biology, it's not actually that simple and there is often a degree of cross-reactivity but the principle is sound.
So to be immune to SARS-Cov2 you need antibodies to the SARS-Cov2 Spike protein. As I said, there are other parts of the immune system that are probably more important but this mechanism is still important and is the main one targeted by this vaccine.* If you have antibodies that bind tightly to the Spike protein then you make it impossible for the virus to bind to any of the cells, thus you can't get an infection. This binding is a vital step to allow viral invasion of the cell. Outside of a host cell, viruses are totally dormant and unable to replicate at all.
When exposed to a virus for the first time if takes several days for your body to generate antibodies. Immune memory means that if you see the same pathogen again, you can mount the antibody response much, much quicker.
So the point of the vaccine is to give you antibodies to the Coronavirus Spike protein such that if you meet it, you can inactivate the virus with antibodies and thus don't develop Covid-19.
If the antibody response is good enough, you won't get infected.
The other part of this is the mutation capability of the virus: what if the virus changes its Spike protein so the antibodies you have don't recognize it anymore? That is certainly possible but 2 things here are relevant; firstly, SARS-Cov2 doesn't seem to have a fast mutation rate and secondly, it's mutation capability is biologically limited. If the Spike protein changes too much, it will no longer be able to bind to the cells it needs to infect.
The oxford team are making a simian adenovirus with the SARS-Cov2 spike protein on it.
None of this is certain and researchers are desperately trying to do 10 years of development in under 2. However, they're not starting from scratch, there has been a lot of success in other (mostly non-human) Coronaviruses.
No guarantees but I am cautiously optimistic that this approach (and others I haven't described) will yield an effective vaccine.
AFZ
*I haven't discussed the vital role played by the innate immune system here. In terms of adaptive immunity to viruses, the cell-mediated immune system is more important than the antibody pathways (known as humoral immunity). The opposite is true for bacteria infections. However for a vaccine, a good antibody response to the virus might be enough for protection and similar vaccines to what I am describing here do also produce a cell-mediated immune response.
**This is a complete aside but in terms of how novel viruses emerge it's interesting. There are two types of HIV: -1 and -2. It was thought that essentially early on HIV split into these two groups but actually they're not actually related to each other directly. Analysis of the genetics show that both developed separately from SIV. The same could easily be true of SARS-Cov and SARS-Cov2, they could have a common ancestor that is a Zoonotic (non-human host) Coronavirus.
I was just reminded of the old joke, the operation was a success, but the patient died. So, govt operations on covid have been successful, and burials are now proceeding with greater speed and productivity. UK top of the European charts!
Which shows that the closure of Canadian travel to/from China before the USA and UK was the wrong move, probably politically and economically based, and, in my jaded and suspicious mind, possibly racist.
Which shows that the closure of Canadian travel to/from China before the USA and UK was the wrong move, probably politically and economically based, and, in my jaded and suspicious mind, possibly racist.
That's possible, although there may be a Y2K bug effect there (there isn't a problem because the solution solved it).
Indeed, if there hadn't been an early shut down of travel from China (travel to China seems irrelevant to covid19 cases in Canada) perhaps China would figure more highly in the number of covid19 cases. It could also show that closing down travel from the US and UK was done too late.
CNN had an investigatory report on this feature - just watched it. There may be an innocent explanation. Apparently CDC reporting guidelines require States to report deaths of State residents to avoid double counting, whereas the MEC records deaths in the State regardless of State residency. The Florida Department of Health released a list to CNN of non State residents who had died in Florida and so were not included in the Florida count. I'm not sure if it explains all of the discrepancy but CNN now has evidence that it explains at least some of it.
No, there is no innocent explanation. Sure, you could argue that the records of medical examiners might include out-of-state visitors or some other discrepancy from the "official figures" and that's at least arguable. (Given the loose residency laws of most states this is a questionable call. Do Florida traffic death statistics also exclude out-of-staters killed on Florida's highways?) But that doesn't explain entirely withholding that data from the public. As the article points out, these are public records and suppressing them reeks of a cover-up.
United Arab Emirates - 12,481 (9,947 / 2,429 / 105)
Romania - 12,240 (7,506 / 4,017 / 717)
South Korea - 10,774 (1,454 / 9,072 / 248) 2.7%
Ukraine - 10,406 (8,907 / 1,238 / 261)
Indonesia - 10,118 (7,804 / 1,522 / 792)
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1. Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries twenty of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Turkey and Russia.
Ukraine and Indonesia have joined the 10,000 case club since the last compilation.
Yes, I keep puzzling over that. NZ seems to show that you can drive numbers down to zero, but could the UK do that?
While nothing is impossible there are very significant differences that would suggest that driving number down to zero won't happen in the UK.
The biggest differences are the nature of UK and NZ geography and population.
One of the interesting features shared by some of the most effective countries at suppressing COVID-19 (New Zealand, Australia, South Korea) is the fact that they're effectively islands. Yes, South Korea isn't literally an island, but since the Korean DMZ isn't a traversable land border by any reasonable definition of the phrase it's effectively an island as far as human movements are concerned. This makes COVID-19 something that can be made into a largely domestic problem, assuming a willingness to control air travel. The U.K. is not quite an island, sharing a land border with the Republic of Ireland, the closing of which would create a whole bunch of other issues.
This is just me, a non-scientist, muttering aloud. (Polite!) comment is welcome, but not required.
--The spikes on the virus make me think of a burr from a plant--the kind of prickly mass that catches on your socks when you're hiking, probably trying to go off and start a new plant. (See the pics at the end of Method #3, "Methods of Dispersal of Fruits and Seeds: 4 Methods".)And some bit of news, weeks ago, said something to the effect that those spikes catch onto cells.
So might there be a way to somehow coat the spikes so they don't catch onto cells? And/or do something to coat our cells so the spikes don't catch as much? Or even (fanciful) do something very, very tiny to dispel a teeny, tiny bit of static, to keep cell and virus apart?
--FYI: I saw something on TV about work on a vaccine, and there was a representation of the virus having a lipid enclosure, finding a way to penetrate that, and bending/breaking the spikes. That's all I remember. Was probably on PBS.
If anyone feels inclined to laugh, kindly do it within your COVID mask and not in my face. Thx.
This is just me, a non-scientist, muttering aloud. (Polite!) comment is welcome, but not required.
--The spikes on the virus make me think of a burr from a plant--the kind of prickly mass that catches on your socks when you're hiking, probably trying to go off and start a new plant. (See the pics at the end of Method #3, "Methods of Dispersal of Fruits and Seeds: 4 Methods".)And some bit of news, weeks ago, said something to the effect that those spikes catch onto cells.
So might there be a way to somehow coat the spikes so they don't catch onto cells? And/or do something to coat our cells so the spikes don't catch as much? Or even (fanciful) do something very, very tiny to dispel a teeny, tiny bit of static, to keep cell and virus apart?
--FYI: I saw something on TV about work on a vaccine, and there was a representation of the virus having a lipid enclosure, finding a way to penetrate that, and bending/breaking the spikes. That's all I remember. Was probably on PBS.
If anyone feels inclined to laugh, kindly do it within your COVID mask and not in my face. Thx.
You can sort of do this, it's not a vaccine but an anti-viral; the idea (IANOMB*) is to create a molecule which either competes with the virus for places on the cell by binding to the same surface proteins, or competes with the cells by binding onto the receptors on the virus.
NZ moved from Alert level 4 to level 3 on Monday night and it seems to me that a lot of people forgot everything they had been told about social distancing. Also while we were at alert level 4 more people were dying, (19 so far), there seemed to be more of a sense of urgency. So we moved to 3 and it's "O goody we can have takeaways." Where the proverbial will really hit the fan is if on May 11, when the next review takes place, we don't move to level 2.
The loudest to complain will probably be those who have acted in a way to cause that to happen.
Comments
Wharrgarbl.
(Sorry, but this is the kind of comment that has me having one of these throw the computer out the window moments)
Here is a graph which might show the kind of thing you are looking for, embedded in a BBC article?
Probably listing "active cases" of COVID-19 where, at least in officially diagnosed cases, the U.K. is indeed second only to the U.S. Part of this may stem from the fact that virtually no one in the U.K. is classified as "recovered" from COVID-19, which would move them off the "active" list. I'm not sure why that is the case, if it's just a bureaucratic difference between the U.K. and elsewhere or if no one is actually recovering from COVID-19 within the U.K.
Yes. That's the one.
It's been like that forever. The UK government's daily reports (source here) don't give up to date data on recoveries. Not sure why that is but it is out of line with daily reports from other countries. Same can be said for the Serious/Critical column in wordometer.
It's just as easy to go from one case to fifty thousand in a population of five million as it is in a population of fifty million.
"Mike Pence Forgoes Mask During Mayo Clinic Tour Because F--k You, That’s Why: Apparently the Vice-President is above the clinic and federal government’s rules." (Vanity Fair)
Seems like a certain British leader did this without very good results.
Ah, we live in hope.
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1. Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries nineteen of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Turkey and Russia. The number of known American dead from COVID-19 now exceeds the number of Americans killed in Vietnam.
No countries have joined the 10,000 case club since the last compilation.
In the USA, after two relatively low "death days" the daily rate (worldometer GMT day) has gone up again to over 2500. The number of new daily cases seems to be plateauing at a pretty high level (about 25,000) although the spread across States is changing.
I note that the reported daily death rate in Russia seems to be on the increase.
Wasn't he also pictured early on, next to a highly sensitive piece of space hardware with "DO NOT TOUCH" on it, touching it?
(eta)
Ah, yes.
The figures will gradually give a more accurate overall picture. It may indeed be that deaths in residential care become the majority reported as hospital deaths decline.
The results of the study show that it shortens recovery time to 11 days vs the 15 day recovery time of the placebo. It also reduces the chances of death by about 30%.
Is it a miracle drug? Dr. Fauci admits, no; but it does show that there can be other drugs that will fight the disease, and that search continues.
In other news, CBS is reporting Oxford University Scientists believe their vaccine will be ready for mass distribution by September 2020. And CNN International is reporting a German company will have their vaccine available for distribution by the end of the year. As I understand it they are already beginning to mass-produce it so it can be quickly disseminated once it gets approval from the respective governments.
Fixed broken link. BroJames Purgatory Host.
I believe this is what's called "keeping the numbers down" in TrumpSpeak.
The USA death total now exceeds 60,000.
*Washington State (home of the first US diagnosis and first US official death, and early adopter of the lockdown).
Looks like Washington State is still bumping along. Can't seem to stay below 150 new cases on a sustained basis
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1. Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries twenty of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Turkey and Russia.
No countries have joined the 10,000 case club since the last compilation.
If they don't have the testing and tracing capabilities, then there will be a spike. The only other factor (and I suppose we may get lucky) is if the infectiveness and virulence of COVID-19 declines on its own. I don't know if there are any signs of that happening.
I think because we let it get so bad it would take far longer for us to suppress it completely, and I don't think it would be politically possible to maintain the current level of lockdown, and economically tricky unless the government is willing to go to a full UBI or something similarly drastic.
The biggest differences are the nature of UK and NZ geography and population. NZ is a low population nation (about 5M in an area not much different from the UK) with limited ports of entry (6 international airports - 4 of which only connect to Australia and Fiji). Although social distancing and self-isolation will be as difficult in cities and large towns, the same as anywhere else, there are still inherent advantages in slowing any outbreaks in lower population density countries. And, quarantining until testing clear of new arrivals is easier with only a few ports of entry and fewer passengers - but, I expect that when the world re-opens there will still be too many people travelling too NZ for that to be sufficiently effective to prevent some small outbreaks unless the NZ government decides to radically cut tourism (tourists are not going to want to travel all the way to NZ only to spend the first few days there in quarantine until they've been tested clear of the virus). Added to which I'll be surprised if any test could ever be 100% accurate - even if a fraction of a % of people tested clear aren't then there's always a very small risk of a tourist bringing it back in. Which means that not only does there need to be a lot of work to bring rates down to zero, that work needs to be maintained to catch and control any new outbreak to keep that rate very low. In the UK, we have far too many ways for people to enter the country for having quarantine and testing facilities to be effective at all of those ports of entry.
The next big difference is the starting point. NZ only had a small number of cases, this allowed trace and check methods to rapidly crack down on each local outbreak in an effective manner. The UK did at one point have a small enough number of cases that we could have done the same, but it was never going to stay that small without shutting down all ports of entry to prevent large numbers of people arriving here. As it happened, we very quickly developed too many cases that we lost control. That was probably inevitable, though the degree that we lost control (and hence the total number of people infected to date) wasn't inevitable if more decisive action had been taken earlier.
Which is the last big difference I'll mention. The UK government response was slow, uncertain, inadequate and frankly inept. In NZ, in contrast, the government took rapid, decisive and competent action that was more widely accepted as necessary by the people (in part I'm sure because Jacinda Ardern is a more respected politician than most UK politicians).
That's going to depend on what we get. If it's just anti-virals that make treatment more effective and leaves patients in ICU and hospital for shorter periods then we'll see a relaxation, but we'll still need to take action to limit spread of the virus, and in particular to protect the most vulnerable. The same would be true if we have a low-efficacy vaccine (if 50% of those vaccinated become immune then that will slow but not stop spread of the virus, similarly if the vaccine is effective for a short period and then immunity is lost).
Of course, the ideal would be a very effective vaccine that provides almost universal immunity, which is cheap and easy to produce such that we can immunise the entire population within a couple of years (without needing regular boosters). At present there's no indication that we'll have a vaccine that's very effective, much less one we can produce 10B doses of in a couple of years.
Croesos
CNN had an investigatory report on this feature - just watched it. There may be an innocent explanation. Apparently CDC reporting guidelines require States to report deaths of State residents to avoid double counting, whereas the MEC records deaths in the State regardless of State residency. The Florida Department of Health released a list to CNN of non State residents who had died in Florida and so were not included in the Florida count. I'm not sure if it explains all of the discrepancy but CNN now has evidence that it explains at least some of it.
I think we will have an effective vaccine quite soon. As an aside, the Oxford team who began human tests last week are known personally to my PhD (2nd) supervisor. They began working on a SARS-Cov2 vaccine in January - as soon as the gene sequence was published by Chinese researchers. Virologists and epidemiologists saw this threat for what it is. And they warned the governments of the world what was coming.
Vaccine effectiveness depends on two things: The immunogenecity of the vaccine (I.e. how good it is at producing an immune response and most importantly immune memory) and the variability / mutation rate of the infective agent.
For technical reasons I won't go into in this post* (I will later if people are interested) getting good immune memory to viruses can be very tricky. For this reason, the various vaccine research teams around the world are looking at different approaches. It may be that more than one will be needed. I will describe one.
All Coronaviruses have a surface protein called a 'Spike Protein.' This protein is critical for infection as it is the molecule that binds to the host cell to allow viral invasion of that cell. There are several steps that follow this binding but this is the first step to allowing infection. Thus the spike protein is an obvious target for a vaccine.
If you look at Spike proteins in all Coronaviruses across the whole genus, it seems to be the case that the exact shape of this protein determines which cells it can infect. That makes sense as it has to bind onto something on the host cell. Proteins on human cells are different to those of bats or dogs or chickens or pigs etc. Essentially, the shape of this spike protein defines which cells the virus is capable of infecting. The prevailing theory is that SARS-Cov2 was a bat virus whose spike protein mutated such that it could still infect bats but could also bind to human cells and hence it was able to move from bats to humans. This is often how 'new' viruses emerge. HIV is a mutation of SIV** and thus it became a virus able to infect humans rather than monkeys (although the mechanisms by which HIV enters cells in very different to coronaviruses, the principle is the same and the virus made the species jump). There are a lot of Coronaviruses that are known to infect animals that are completely harmless to humans.
There are several mechanisms by which the immune system* fights viruses and antibodies are generally considered to be less important, however, they are the easiest to understand in this context. In principle an antibody is a molecule that only recognises one molecule. Such that an antibody to Streptococcus will have no effect on E. coli. Antibodies to flu can't help fight Nisseria meningitidis (one of the bacteria that commonly causes meningitis). In fact for any common pathogen, you may well have multiple antibodies that recognize different molecules of the pathogen. And because the influenza viruses differ so much from each other, an antibody to one strain often has no effect on another strain. Unsurprisingly in biology, it's not actually that simple and there is often a degree of cross-reactivity but the principle is sound.
So to be immune to SARS-Cov2 you need antibodies to the SARS-Cov2 Spike protein. As I said, there are other parts of the immune system that are probably more important but this mechanism is still important and is the main one targeted by this vaccine.* If you have antibodies that bind tightly to the Spike protein then you make it impossible for the virus to bind to any of the cells, thus you can't get an infection. This binding is a vital step to allow viral invasion of the cell. Outside of a host cell, viruses are totally dormant and unable to replicate at all.
When exposed to a virus for the first time if takes several days for your body to generate antibodies. Immune memory means that if you see the same pathogen again, you can mount the antibody response much, much quicker.
So the point of the vaccine is to give you antibodies to the Coronavirus Spike protein such that if you meet it, you can inactivate the virus with antibodies and thus don't develop Covid-19.
If the antibody response is good enough, you won't get infected.
The other part of this is the mutation capability of the virus: what if the virus changes its Spike protein so the antibodies you have don't recognize it anymore? That is certainly possible but 2 things here are relevant; firstly, SARS-Cov2 doesn't seem to have a fast mutation rate and secondly, it's mutation capability is biologically limited. If the Spike protein changes too much, it will no longer be able to bind to the cells it needs to infect.
The oxford team are making a simian adenovirus with the SARS-Cov2 spike protein on it.
None of this is certain and researchers are desperately trying to do 10 years of development in under 2. However, they're not starting from scratch, there has been a lot of success in other (mostly non-human) Coronaviruses.
No guarantees but I am cautiously optimistic that this approach (and others I haven't described) will yield an effective vaccine.
AFZ
*I haven't discussed the vital role played by the innate immune system here. In terms of adaptive immunity to viruses, the cell-mediated immune system is more important than the antibody pathways (known as humoral immunity). The opposite is true for bacteria infections. However for a vaccine, a good antibody response to the virus might be enough for protection and similar vaccines to what I am describing here do also produce a cell-mediated immune response.
**This is a complete aside but in terms of how novel viruses emerge it's interesting. There are two types of HIV: -1 and -2. It was thought that essentially early on HIV split into these two groups but actually they're not actually related to each other directly. Analysis of the genetics show that both developed separately from SIV. The same could easily be true of SARS-Cov and SARS-Cov2, they could have a common ancestor that is a Zoonotic (non-human host) Coronavirus.
I hope and pray that this cautious optimism is justified.
https://nationalpost.com/news/politics/canadas-early-covid-19-cases-came-from-the-u-s-not-china-provincial-data-shows
Which shows that the closure of Canadian travel to/from China before the USA and UK was the wrong move, probably politically and economically based, and, in my jaded and suspicious mind, possibly racist.
No, there is no innocent explanation. Sure, you could argue that the records of medical examiners might include out-of-state visitors or some other discrepancy from the "official figures" and that's at least arguable. (Given the loose residency laws of most states this is a questionable call. Do Florida traffic death statistics also exclude out-of-staters killed on Florida's highways?) But that doesn't explain entirely withholding that data from the public. As the article points out, these are public records and suppressing them reeks of a cover-up.
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1. Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries twenty of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Turkey and Russia.
Ukraine and Indonesia have joined the 10,000 case club since the last compilation.
One of the interesting features shared by some of the most effective countries at suppressing COVID-19 (New Zealand, Australia, South Korea) is the fact that they're effectively islands. Yes, South Korea isn't literally an island, but since the Korean DMZ isn't a traversable land border by any reasonable definition of the phrase it's effectively an island as far as human movements are concerned. This makes COVID-19 something that can be made into a largely domestic problem, assuming a willingness to control air travel. The U.K. is not quite an island, sharing a land border with the Republic of Ireland, the closing of which would create a whole bunch of other issues.
Why do you keep doing this?
This is just me, a non-scientist, muttering aloud. (Polite!) comment is welcome, but not required.
--The spikes on the virus make me think of a burr from a plant--the kind of prickly mass that catches on your socks when you're hiking, probably trying to go off and start a new plant. (See the pics at the end of Method #3, "Methods of Dispersal of Fruits and Seeds: 4 Methods".)And some bit of news, weeks ago, said something to the effect that those spikes catch onto cells.
So might there be a way to somehow coat the spikes so they don't catch onto cells? And/or do something to coat our cells so the spikes don't catch as much? Or even (fanciful) do something very, very tiny to dispel a teeny, tiny bit of static, to keep cell and virus apart?
--FYI: I saw something on TV about work on a vaccine, and there was a representation of the virus having a lipid enclosure, finding a way to penetrate that, and bending/breaking the spikes. That's all I remember. Was probably on PBS.
If anyone feels inclined to laugh, kindly do it within your COVID mask and not in my face. Thx.
You can sort of do this, it's not a vaccine but an anti-viral; the idea (IANOMB*) is to create a molecule which either competes with the virus for places on the cell by binding to the same surface proteins, or competes with the cells by binding onto the receptors on the virus.
*I am not a molecular biologist.
Possibly I should go to bed.
The loudest to complain will probably be those who have acted in a way to cause that to happen.