Non-Trump coronavirus news and analysis
May 20, 2020 11:58 AM   Subscribe

 
From the Gilead link at StatNews; the older drug is called GS-441524:

We see numerous advantages to using GS-441524 rather than remdesivir as an anti-Covid-19 therapy. GS-441524 is easier to synthesize and dissolves in water, which can speed manufacturing and enable higher dosing. It is a smaller molecule than remdesivir, which would make it easier to produce an aerosolized formulation for inhalable therapeutic and prophylactic treatment...And it is also less toxic than remdesivir. For these reasons, we do not see the point of making a significantly more complex drug like remdesivir when what actually reaches infected lungs is GS-441524.

The attractive profile of GS-441524 from both manufacturing and clinical perspectives raises this question: Why hasn’t Gilead opted to advance this compound to the clinic? We would be remiss for not mentioning patents, and thus profits. The first patent on GS-441524 was issued in 2009, while the first patent for remdesivir was issued in 2017.

posted by mediareport at 12:02 PM on May 20, 2020 [11 favorites]


Given GS-441524’s optimal properties, we — along with the millions of people awaiting an effective treatment for Covid-19 — are left to wonder why Gilead isn’t giving it the same attention it is giving remdesivir. The world can only hope it isn’t for the sake of protecting its intellectual property.

Don't hope too hard.
posted by grumpybear69 at 12:06 PM on May 20, 2020 [21 favorites]


I think the patents of drugs are going to be tossed out the window, if one country or region has a proven therapy drug or vaccine and the others don't.

I can't see any of the major players - China, the US, India, the EU, etc.- standing by and not poaching from others.
posted by lesbiassparrow at 12:13 PM on May 20, 2020 [4 favorites]


Gilead, maker of remdesivir, has a safer, more effective and easier to manufacture version of the drug, patented in 2009, but is not developing it.

GS-441524 has never been tested in humans. Remdesivir has been through the full clinical trial process.

Gilead has an enormous amount of data I would imagine about both of these compounds, they didn't come up with a much harder to manufacture version for the hell of it.

Also, if it was patented in 2009, there's still plenty of time left on that clock given how much money could be made in the next 12 months from an effective Covid-19 drug.
posted by atrazine at 12:32 PM on May 20, 2020 [22 favorites]




"As Covid-19 races its way across Africa, there are two stories happening at once. The first is of governments using their armies and militarized police to beat, threaten, and shoot their way to public health. This is the story of Kenyan police killing more people than the disease in the week after its first recorded case and of a pregnant woman dying on the street because Ugandan police would not let her motorcycle taxi take her to a hospital after curfew. It is the story of governments closing their borders too late, diverting money to security instead of hospitals, and waiting for someone from somewhere else to save them.

"The second is of communities knitting together their meager resources to fill the gap of failed services and absent states. It is the story of tailors across informal settlements in Nairobi and Mombasa sewing face masks out of scrap fabric and handing them out free after price gouging by commercial suppliers. It is a young man renting speakers, tying them to his motorcycle, and riding through his neighborhood to let people know about a new disease. It is translators offering their services without charge to put together public awareness campaigns in Somali, Maa, Zulu, Lingala, Fan Oromo, or any of the thousands of other languages spoken on the continent. It is markets and small businesses making water jerricans available for mandatory handwashing long before governments required it.

"Both of these stories are true, but only the first one is on track to enter the archives of how Africa navigated the pandemic." (by Nanjala Nyabola, for The Nation)
posted by ChuraChura at 12:51 PM on May 20, 2020 [50 favorites]


I think the patents of drugs are going to be tossed out the window, if one country or region has a proven therapy drug or vaccine and the others don't.

I like your optimism. My prediction is that a treatment will be developed in Germany, or Cuba, or even China, and its developers will offer it to the United States for free, and the regime will refuse it because they can't profit off of it.
posted by Faint of Butt at 12:54 PM on May 20, 2020 [8 favorites]


Resveratrol is a notorious false positive in cell drug screens due to being an amphipathic compound that perturbs membranes in general if memory serves.
posted by benzenedream at 1:05 PM on May 20, 2020 [2 favorites]


I do wish this ghoul gets his day in the Hague
Bolsonaro Touts Chloroquine for All as Brazil’s Virus Toll Surges.
At writing Brazil is third in terms of official number infected and cases are soaring. Rio has stopped giving number of obits in its daily report. Grim Grim Grim
posted by adamvasco at 1:09 PM on May 20, 2020 [19 favorites]


Antibody testing results: COVID-19 infections exceed confirmed cases
Good or bad the number of asymptomatic carriers *might* be much larger than thought. But that also lowers the fatality rate.

Recovered patients who tested positive for COVID-19 likely not reinfected | Live Science
*Maybe* those second positive tests were false positives picking up inactive virus remnants. Maybe there is actually some immunity for a time as with other things.
posted by zengargoyle at 1:19 PM on May 20, 2020 [6 favorites]


A couple of brief news items from New Zealand
- Prime Minister Ardern is floating the idea of moving the country to a four day work week as part of Covid economic recovery. (likely would be optional and down to businesses to determine if it works for them)

- Last nine days the country has gone 0 0 0 1 0 1 0 0* 0 in new cases (*excluding 4 NZer's who came home from Uruguay post-recovery but hadn't been counted in NZ figures to avoid double-counting between NZ/Uruguay to the WHO, but have now been added to NZ totals as historic cases)

- NZ's population may have finally reached 5 million as ex-pats and travelers came home
posted by inflatablekiwi at 1:38 PM on May 20, 2020 [18 favorites]


What is the national mood in New Zealand now that Covid's been eliminated, anyway? Jubilation? Smug satisfaction? Relief? Dread of a future wave from overseas? Anger at the authorities? People singing "We don't know how lucky we are"?

Right-wing pundits worldwide keep harping on the idea that "lockdowns cause psychological damage and death worse than Covid-19". Are there a lot more depression and suicides visible? Does it seem like the economy is recovering?

Sorry for all the questions, but I'm really curious about the potential future. Every New Year's Eve, people always quip that "They're already in next year in New Zealand!" But in terms of the Covid threat ... you really are.
posted by Harvey Kilobit at 1:57 PM on May 20, 2020 [14 favorites]


Two recent posts about the progress of Oxford and Moderna vaccines.
posted by value of information at 1:57 PM on May 20, 2020 [2 favorites]


Suicide rates have been lower in NZ, it seems.

I think there is a general and growing sense of relief, but at the same time, for a lot of people, their lives are a terrible mess as a result of our national measures and in some cases the impact of international changes too. I don't make too much of a fuss about how annoying and stressful this time is, because I've kept my job on full pay and I feel very lucky when I see what others have been through and are going through.

Little anecdote for you. At my workplace, which is an IT services firm where we have all been able to work from home, we reopened the office this week, having divided the staff into two teams who will work alternate weeks so social distancing can be maintained. Returning to the office is optional. I saw the register of who signed in and confirmed for myself, only about 15% of the people who would normally be in the building were there, compared to a max 50%. It seems a lot of people prefer home, and a lot of people don't want to take public transport -- public transport is currently limited in capacity to comply with social distancing and so it's very uncertain whether you'll fit on a train or bus. So anyway, I think there is a long way to go before we hit "normal" and it may never be like it was before.
posted by i_am_joe's_spleen at 2:14 PM on May 20, 2020 [26 favorites]


What is the national mood in New Zealand now that Covid's been eliminated, anyway?

I'll let others, like i_am_joe's_spleen above, answer more accurately (I talk with my family and friends there daily, but am not in-country to be clear), but everyone I've talked to there is largely relieved, but pretty worried about the future given the massive drag on the economy (which I guess is the same as most places). There is an election in NZ later this year. The (right of center) opposition have had some very dramatic drops in the polls and struggled to gain traction given public sentiment has been strong supporting the current (left of center led coalition) Government through this and other traumatic events in the current government's term (notably the Christchurch terrorist shootings), that could result in some nasty politics for the next few months if desperation to claw back some ground kicks in.

It's been weird living out of NZ and regularly hearing positive news about NZ in the media here in the US. I mean its weird even hearing about NZ when you live here - John Oliver Last Week Tonight news stories on those crazy NZer's aside - let alone hear analysis about NZ government policy. Strange times.
posted by inflatablekiwi at 2:33 PM on May 20, 2020 [11 favorites]


Gilead, maker of remdesivir, has a safer, more effective and easier to manufacture version of the drug, patented in 2009, but is not developing it.

Was GS-441524 patented in 2009? A WIPO patent search on Methods of treating feline coronavirus infections suggests a patent was granted in 2018. But it also shows that the patent is shared between Gilead and the University of California. Even if tests can show this can be safely metabolized to the pro-drug that remdesivir is metabolized to (in humans), revenue would likely have to be shared. Gilead is the lone holder on a remdesivir synthesis patent and so there is probably more money to be made by trialing that. I wonder where Statnews got the 2009 date. Are there any specialists here who could comment?
posted by They sucked his brains out! at 2:35 PM on May 20, 2020


Interestingly, GS-441524 is being sold on the black market to help vets treat FIP for desperate cat owners.
posted by They sucked his brains out! at 2:38 PM on May 20, 2020 [4 favorites]


In my hometown in Canada, in common with many other locales, COVID-19 is hitting seniors particularly hard. One 64-bed retirement home saw an outbreak on 10 May, which had spread to 49 residents and staff by May 15. On the afternoon of Saturday the 16th, an evacuation of the building began: the residents were moved to two nearby hospitals. The relocation has been described as "chaotic" by the executive vice-president of clinical operations at St. Joseph’s Healthcare, one of the two hospitals involved. However, by a little after midnight that night, 62 residents were in the two hospitals (two had elected to return to their families), a number of the ailing staff were under isolation orders, and the building was vacant for save for security and cleaning staff. Not a news story, one might think.

Except on Sunday evening the family of one of the residents of the retirement home contacted the owners of the home because they were unable to locate their family member in either hospital. A search of the empty retirement home on Sunday evening, revealed one resident had been overlooked and left behind for eighteen hours.

The retirement home is privately owned and operated on a for-profit basis by a group associated with the family that operated the former Royal Crest Lifecare chain, which folded in 2003 in the largest bankruptcy of long-care retirement homes in Ontario history. A family member of another resident has called the care her uncle received there "disgusting."

As of today, four residents from the retirement home have died due to complications from COVID-19, and its residents and staff account for more than half the 170 active cases in the city.
posted by ricochet biscuit at 2:42 PM on May 20, 2020 [15 favorites]


There was an interesting article in the Toronto Star about how outcomes at privately run long-term care facilities have been significantly worse than non-profit or public ones. It mentions how over the last decade the biggest private operators have paid out $1.5 billion in dividends to shareholders and they paid out $138 million in executive compensation. The message being that if that money had been paid into the facilities or workers they might not be in the situation they are in now. Arguably better regulation could help things going forward but that really depends on the government of the day having an interest in regulating, which our current one really doesn't - they've been conducting inspections of some of these facilities by phone.
posted by any portmanteau in a storm at 3:40 PM on May 20, 2020 [17 favorites]


John Campbell reviews the South Korean study (mentioned above) which indicates that re-infection from the virus appears unlikely. 290 out of 10,000 recovered patients tested positive for the virus again after a couple of months. But this was due to harmless virus RNA fragments retained in some respiratory lining cells - and generating false positives in the test. None of the 290 were shown to have infected others.
posted by rongorongo at 3:40 PM on May 20, 2020 [7 favorites]


I am in the opposite position from inflatablekiwi as an American who is unexpectedly in NZ for the duration. Both of our hosts began working from home when this all started and their companies have decided it's best if that continues for a while.

I think it's important to read the article i_am_joes_spleen linked to, especially if you are American, to get some perspective. (Linking again to save people scrolling.) Several of these stories feel like something you might have read about a place in the US even before the pandemic, which gives some perspective on where NZ was vs. the US before we went into this.
Also, many stories are tourism-related. It's a big part of the economy here, and globally it won't bounce back for a long time.

Like everyone else said, people do seem concerned about the future. Then they bring up the US and say, "It could be a lot worse." (I only have a few interactions out of our lockdown bubble so inflatablekiwi and i_am_joes_spleen may have alternate perspectives on this.)

The contrast I'm seeing is: in the US there is an attitude (not among everyone, but some people) of "if there only weren't any lockdowns then our economy would be fine!" Here in NZ it seems more of "this would have been worse if we hadn't locked down." I'm also not seeing much of a push to open borders in order to boost the economy, beyond a trans-Tasman bubble with Australia if they get their infection rates down. (I've seen a couple of people like Winston Peters float the test balloon of opening borders with China, but it has not gained traction.) New Zealand is an island, but the US thinks like an island.

Regarding the right-of-center (National) party drop in the polls, that has not been helped by the leader, Simon Bridges, who really put his foot in it with messaging. I have never seen a politician dragged like that, ever. I gather there's going to be a leadership challenge in the next week.
posted by rednikki at 4:27 PM on May 20, 2020 [21 favorites]


Survey finds 87% of America’s nurses forced to reuse protective equipment (Guardian)
The vast majority of America’s nurses say they have not been tested for Covid-19, are reusing personal protective equipment (PPE), or have exposed skin or clothing while caring for Covid-19 patients, a new survey has shown. The nationally representative survey finds that “dangerous healthcare workplace conditions have become the norm” since Covid-19 spread widely in the US, said the union which conducted the survey. More than 100 nurses have died since the beginning of the pandemic. “We’ve known for years we’re behind,” said Jean Ross, president of National Nurses United. “Not because we couldn’t have what we needed – because we are the richest country on the planet – but because of greed, because of the profit system that doesn’t really look out for the welfare of patients. Therefore it couldn’t possibly look out for the welfare of workers.”
posted by katra at 4:59 PM on May 20, 2020 [15 favorites]


What is the the national mood in New Zealand now?

Great gratitude we don't live in the UK/US, and that we currently have sane politicians who believe in reality*. For many (most?) it's a whole new economy tho'. International tourism is 20% of foreign earnings, and depends on foreign temporary workers (temp/low pay/black market), so some towns have collapsed overnight e.g. Queenstown.

Personally things are a bit quieter but not catastrophic - queries still coming in. There are some unknowable unknowns though. Thankful I don't design hotels and avoid working for the financial class. I've focussed on client needs more than their wants which is more secure, and I still get to make some beautiful spaces.

I think there's a few things that've helped NZ re elimination (eradication is a way off tho'), 1 - we've had recent experience with a cattle disease - Mycoplasma bovis that was, arguably deliberately, handled very badly by then National Party (which is odd, since they always bray about being the farmers' party)- IMO they wanted to leave it for Jacinda, 2, a lot of people here understand biology and 3, seeing Australia handle their fire disaster so very badly worried people here so we were already on a kind of emergency footing.

* The National Party have laid a whole tray of bad eggs for the September election tho' and I pray they all rot in the carton.
posted by unearthed at 12:39 AM on May 21, 2020 [11 favorites]




I know they'd probably have to do safety trials for GS-441524, but given that remdesivir seems to be metabolised almost directly into it, it seems unlikely that it would be less safe than remdesivir. If you take remdesivir you'll have a bunch of GS-441524 in your system soon enough.

I mean, I'm not a scientist. But the risk of directly doing an efficacy trial of the stuff seems low compared to the potential upside.
posted by BungaDunga at 1:21 AM on May 21, 2020


South Africa will be moving most of the country to Level 3 lockdown (except probably for Cape Town which has 60% of all cases and is expected to stay on Level 4) on the 1st June and schools will also re-open nationwide. We're doing this despite the fact that we are probably 2 - 3 months away from the winter peak because it's becoming clear we might not have a choice - the economic and societal impact of COVID-19 might be too great to overcome if lockdown carries on as is.
  • We were headed into a recession before COVID-19 hit.
  • SA government bonds are junk rated, so we can't borrow money to subsidise people staying home without pushing our already record high debt levels into IMF bailout territory, which the ANC has stated is a political no no.
  • Government revenue is probably cratering as firms lay off people (less income tax), people buy less (less VAT), people drive less (less petrol tax), smoking and alcohol sales are banned (less "sin" taxes) and propery sales are also close to zero (less transfer duty)
  • The longer that schools remain closed, the greater the probability that kids from economically poor and rural areas will simply not return into the educational system. Over 1500 schools in poor and rural have been broken into and vandalised during the last 2 months as well.
  • Lockdown is not enforcable in townships - participants in the informal economy live a day to day existence and if they don't get out and hustle/work they don't eat.
posted by PenDevil at 1:42 AM on May 21, 2020 [10 favorites]


Some scary statistics on what's happened with the increase in Protective Service Officer powers in Victoria, Australia: During the pandemic, the top reasons for arrest by PSOs were theft, shop theft and being drunk in a public place
posted by daybeforetheday at 3:32 AM on May 21, 2020 [3 favorites]


No-one I know is demanding everything be reopened - in fact, quite the opposite, a lot of people are expressing concern that we are reopening business and resuming economic activity too soon, before we're allowed to even see friends and family. People are incredulous that you're allowed to let a property surveyor into your house, but not your sister; and that you're allowed (encouraged) to spend all day in the factory with work colleagues but then isolate when you get home.

The problem is that there are two parallel ways of looking at these measures.

The first is objective risk from the activity to the people involved.

The second is cumulative effect on transmission. To understand cumulative effect, you need to understand:

1) The objective risk per unit of activity. How much risk of spreading is there for a surveyor walking through your house vs your sister visiting vs spending all day at the factory. I would think that if your sister walks through your house in PPE, spending as little time as possible and touching as little as possible, not using bathrooms or drinking anything, then the objective risk would be the same. My sister's visits are usually a little different from that. There's also the practical issue that it is much easier to train a small number of people on a set of rules than it is to train everyone.

2) How much of such activity will happen across the country if it is allowed. There probably are not many people currently buying and selling houses, I would imagine that even though it is allowed people are doing this much less than usual and anyway despite how it sometimes feels there are a limited number of estate agents and surveyors. If you allow people to visit their families, everyone in the country will do that all at once so the effect is enormous.

Those two factors will tell you how much effect allowing the activity will have on the total spread. You can then compare that with the benefits of allowing the activity.

These benefits are the social effects of seeing friends and family, the economic effects, the educational effects etc.

Obviously it isn't possible to compare a social benefit easily to an economic one (although economists make a career out of doing just that) but generally we can use a framework of separating things that are permanently lost vs just delayed.

If someone's mental health declines due to not seeing their family, there is no guarantee that they will fully recover by seeing their family extra once they can. I wonder if the government's perspective isn't overly informed here by their own social situation - when Conservatives think of the country at large, they are thinking of people who live with their families in suburban houses. Those people may be missing seeing their friends and extended families but they are spending more time with their immediate families and from that perspective, the loss from being able to socialise more broadly may seem quite modest.

Education is contested, most specialists appear to believe that ground lost now can only be made up later with great difficulty. I'm not sure I buy that, surely you could open schools earlier next year / run summer sessions but I am not an expert and I accept that there may be massive logistical challenges to doing that.

Economically, some activities can be delayed. Some kinds of shopping will just be delayed, if no one buys clothes now they will still need them eventually and as long as shops still exist by then they may have some "catch-up demand". On the other hand much of our shopping is desire based and may simply never catch up. One reason why garden centres have been allowed to open is that they do substantially all their sales for the year in a very short period now (also they're largely outside).

I imagine that you, I, and most of MetaFilter have a view of the appropriate balance between the benefits that capital and labour derive from the economy that is rather different from that of the current government. That doesn't change the fact that when a system loses economic output, there is less for all of us. A billionaire shop owner makes money when their employees work to sell things for them but so do the employees.

It is then for the government to put together a package of rules which:
-Maximise the total benefits from re-opening; while
-Minimising the contribution to transmission

All while they can't actually measure the second part of that equation except with a massive lag.

Not just that, but the challenge with turning scientific and economic advice into public health advice means that they simultaneously need to:
-Carry out that optimisation
-Come up with a set of rules which people can understand (you could come up with a very elaborate set of rules for who could meet and under which circumstances which would be scientifically and economically justifiable but you would confuse people)
-Seem fair to people - easy at either extreme but hard when you're balancing different interests against each other in the middle. For instance I can hire my family to come work in my house but I cannot have them here socially. There are very sensible reasons for that from a balance point of view as laid out above, but it just seems wrong.
posted by atrazine at 4:45 AM on May 21, 2020 [6 favorites]




‘How Could the CDC Make That Mistake?’The government’s disease-fighting agency is conflating viral and antibody tests, compromising a few crucial metrics that governors depend on to reopen their economies. Pennsylvania, Georgia, Texas, and other states are doing the same.
The Centers for Disease Control and Prevention is conflating the results of two different types of coronavirus tests, distorting several important metrics and providing the country with an inaccurate picture of the state of the pandemic. We’ve learned that the CDC is making, at best, a debilitating mistake: combining test results that diagnose current coronavirus infections with test results that measure whether someone has ever had the virus. The upshot is that the government’s disease-fighting agency is overstating the country’s ability to test people who are sick with COVID-19. The agency confirmed to The Atlantic on Wednesday that it is mixing the results of viral and antibody tests, even though the two tests reveal different information and are used for different reasons.

This is not merely a technical error. States have set quantitative guidelines for reopening their economies based on these flawed data points.

Several states—including Pennsylvania, the site of one of the country’s largest outbreaks, as well as Texas, Georgia, and Vermont—are blending the data in the same way. Virginia likewise mixed viral and antibody test results until last week, but it reversed course and the governor apologized for the practice after it was covered by the Richmond Times-Dispatch and The Atlantic. Maine similarly separated its data on Wednesday; Vermont authorities claimed they didn’t even know they were doing this.
Welp. Juking the stats is bipartisan now.
posted by tonycpsu at 6:13 AM on May 21, 2020 [11 favorites]


After Coronavirus, Office Workers Might Face Unexpected Health Threats

Stagnant plumbing systems in emptied commercial buildings could put returning employees at risk of Legionnaires’ and other illnesses.

posted by NotLost at 6:54 AM on May 21, 2020 [2 favorites]


Then and now photo gallery: 1918 Flu Pandemic vs. 2020 COVID-19 Pandemic, Imgur, sneedville, 5/20/2020. History echoes again.
posted by cenoxo at 6:54 AM on May 21, 2020 [5 favorites]


Lockdown Delays Cost at Least 36,000 Lives, Data Show (NYT / MSN reprint)
If the United States had begun imposing social distancing measures one week earlier than it did in March, about 36,000 fewer people would have died in the coronavirus outbreak, according to new estimates from Columbia University disease modelers. And if the country had begun locking down cities and limiting social contact on March 1, two weeks earlier than most people started staying home, the vast majority of the nation’s deaths — about 83 percent — would have been avoided, the researchers estimated. Under that scenario, about 54,000 fewer people would have died by early May.

The enormous cost of waiting to take action reflects the unforgiving dynamics of the outbreak that swept through American cities in early March. Even small differences in timing would have prevented the worst exponential growth, which by April had subsumed New York City, New Orleans and other major cities, the researchers found. [...] The results show that as states reopen, outbreaks can easily get out of control unless officials closely monitor infections and immediately clamp down on new flare-ups. And they show that each day that officials waited to impose restrictions in early March came at a great cost. [...] All models are only estimates, and it is impossible to know for certain the exact number of people who would have died. But Lauren Ancel Meyers, a University of Texas at Austin epidemiologist who was not involved in the research, said that it “makes a compelling case that even slightly earlier action in New York could have been game changing.”
posted by katra at 7:51 AM on May 21, 2020 [8 favorites]


All 50 States Are Now Reopening. But at What Cost? (NYT)
“We really are playing with fire here in a very broad sense," said Charles Courtemanche, an economist at the University of Kentucky. In a recent paper for the journal Health Affairs, he estimated that the number of confirmed cases in the United States, which reached a million at the end of April, would have been closer to 35 million without the restaurant closures and stay-at-home orders that began in mid-March. [...]

A forecast from the University of Pennsylvania’s Penn Wharton Budget Model estimated that the number of cumulative deaths from the virus in the United States would rise to 157,000 from the current about 92,000 by the end of July if states maintained restrictions. A partial or full reopening could bring an additional 15,000 or 73,000 deaths, respectively. Researchers found that the biggest risk for negative health outcomes was probably not state regulations, but people’s own behavior. If Americans get out of the habit of social distancing — returning to their pre-pandemic behavior by not wearing masks or staying six feet apart — the forecast predicted that deaths could rise by as many as 135,000.
posted by katra at 8:09 AM on May 21, 2020 [2 favorites]


'All the psychoses of US history': how America is victim-blaming the coronavirus dead (Lois Beckett, Guardian) (previously)
To Dunbar-Ortiz and other historians, Americans’ push to reopen the economy during a pandemic, and some Americans’ willingness to hold armed demonstrations in order to do so, looks like a case of almost psychotic repetition. It’s not a new idea that thousands of people must die to preserve America’s “business as usual”. It’s not a new assumption many of those people will be brown or black. [...] The coronavirus culture war is “kind of a petri dish of all the psychoses of US history”, as Dunbar-Ortiz, the author of An Indigenous People’s History of the United States, put it. [...] The terror for Americans now is not that coronavirus is an unprecedented challenge: it’s that all this is so devastatingly familiar.
posted by katra at 8:45 AM on May 21, 2020 [6 favorites]


During the pandemic, the top reasons for arrest by PSOs were theft, shop theft and being drunk in a public place

As a former Melbourne resident I can say on the basis of first and reliable second hand experience that "being drunk in a public place" is the official charge most frequently laid when caught in the act of being insufficiently obsequious to a police officer, that PSOs are even more likely than proper police officers to lay that charge for that reason, and that all an Aboriginal and/or rough-sleeping person needs to do in order to be insufficiently obsequious to the kind of officer inclined to use that charge for that reason is to exist within their field of vision.
posted by flabdablet at 9:42 AM on May 21, 2020 [10 favorites]


Meanwhile in the Scottish Parliament. What about croquet?
posted by rongorongo at 9:50 AM on May 21, 2020


If Americans get out of the habit of social distancing — returning to their pre-pandemic behavior by not wearing masks or staying six feet apart

I mean...this is definitely what's happening, and what was always going to happen in the absence of proper national leadership. The second the GOP (let's not let the rest of the fuckers off the hook) turned this into a culture war battlefield, we were all fucked. Because even absent the usual American psychoses, without reliable, accurate, and consistent public messaging / leadership, people are tired, and without a sense of cohesion or common mission, they're just saying "fuck it."

I'm in Brooklyn, in a fairly hard hit area -- at the peak it was sirens all fucking day long, and I'm pretty sure my neighbor across the hall is either dead or still in the hospital -- and still, still, there are plenty of people who've just said fuck it. (Actually, if I'm being honest, it's all young people, and mostly young men who don't seem to give a shit.) I mean, I get it, on one level: this fucking sucks, and the weather is nice, and all I fucking want is a margarita at an outside table. And at some point you just want to stop being afraid. But most of the people I care about (including myself) have varying degrees of increased risk, so. Sucks for us.

The only thing saving NYC from much of the same dumbassery is that our restaurants and bars aren't open (and that NYC overhead means most of them are gone forever).
posted by schadenfrau at 10:07 AM on May 21, 2020 [19 favorites]


Stagnant plumbing systems in emptied commercial buildings...

Not to mention damage caused by stagnant air in emptied commercial buildings — Malaysian Leather Shop Opens After 53 Days Of Quarantine Only To Find All Of Their Products Had Molded [w/photos]:
Did you ever wonder what happens to the world without the presence of human beings? The answer is simple: nature will take over. Just look at how nature claimed this department store in Malaysia when mold began to grow on all the leather products. When the department store opened after being closed for almost two months, they were surprised to find that all their leather-made merchandise was moldy.
...
Malaysia, in particular has suffered as their lockdown started back in March to stop the spread of coronavirus. Since then, all non-essential businesses such as this leatherwear department store have been closed indefinitely. On May 10th, exactly 53 days after the start of lockdown, the Malaysian government finally allowed all businesses to reopen. So, now the employees of this particular department store are back at work, they were in shock to see that everything is moldy....
Mashable SE Asia has the same story, with a dubious statement from the shopping mall implying this was not mold:
A Facebook page called Borneo Sabah TV that had initially shared the post, issued an apology after being contacted by the mall in question.

"According to a representative from Metrojaya (MJ) Suria Sabah [mall website], all the items in the premise are in good condition contrary to what the viral image depicts. Due to the MCO, many items in the premise were dirty and dusty. They had to be cleaned," the page clarified.
In the photos, note the lack of any 'dirt' or 'dust' on the display shelves the leather items are sitting on, or on adjacent (apparently non-leather) items.
posted by cenoxo at 10:28 AM on May 21, 2020 [6 favorites]


An op-ed from the Guardian talking about at least two nations in Africa that had early, thorough, innovative, appropriate-to-their-economy reactions to the coronavirus which seem to be working. Lots to learn from Senegal and Ghana.

Hesperian, who publish Where There Is No Doctor, is keeping their Covid-19 sheet updated and translating it into as many languages as they can. Free, straightforward, downloadable.
posted by clew at 11:32 AM on May 21, 2020 [14 favorites]


Young adults are also affected by Kawasaki-like disease linked to coronavirus, doctors say (WaPo / MSN reprint)
Those coming in now are mostly previously healthy children and young adults who suddenly develop fever, abdominal pain and/or nausea and vomiting and rashes that can be signs of more serious problems. Many of the patients have antibodies to the novel coronavirus — suggesting they may have been infected weeks earlier and the condition may be a delayed immune response.

While the overall number of covid-19 patients has dropped off sharply in New York City and other early hot spots, the number of children and young adults with the inflammatory condition continues to mount. As of this week, more than 20 states have reported cases with the total number estimated to be several hundred. New York City has reported 147 children with the condition. On Wednesday, Children’s National Hospital in the District announced it had 23 cases. [...] James Schneider, a pediatric critical care doctor at Northwell Health, emphasized this illness is not something that can be treated at home. Patients with the syndrome have needed blood pressure medications, steroids, anticoagulants, immunoglobulin and sometimes ventilators to get better. A few have gone into cardiac arrest and had to be revived through CPR or cardiopulmonary resuscitation.
posted by katra at 11:54 AM on May 21, 2020 [5 favorites]


I mean, I'm not a scientist. But the risk of directly doing an efficacy trial of the stuff seems low compared to the potential upside.
posted by BungaDunga at 1:21 AM on May 21 [+] [!]


I am a a chemist, though this is well outside my field. Even closely related molecules like that can have very different toxicity. For example, using a prodrug can ensure it doesn't go to certain parts of the body where it will cause problems. Also it can protect the drug on the way to being used, if part of the body would chew up the actual drug for example.

Plus the ensuring it is safe part is the HARDEST and LONGEST part of testing- it would be faster to get one that has finished that stage of testing to helping people by orders of magnitude. I've seen a LOT of chemists online including ones who do work in drug discovery talking about how naive the idea to use that one is, as there is almost certainly a reason they chose to chase a harder molecule.
posted by Canageek at 11:59 AM on May 21, 2020 [6 favorites]


They were surprised to find that most contacts of people with Covid-19 were workers from the NHS, care homes or care provider agencies – and that those people were not always happy to stop work and go into isolation for seven to 14 days. “The majority were in health and care settings. That’s the really big and worrying message here.
posted by adamvasco at 12:19 PM on May 21, 2020


Dutch official advice to single people: find a sex buddy for lockdown (The Guardian, May 15, 2020) In a typically open-minded intervention, official guidance from the Dutch National Institute for Public Health and the Environment (RIVM) has been amended to suggest those without a permanent sexual partner come to mutually satisfactory agreements with like-minded individuals. [...] “Discuss how best to do this together,” the RIVM suggests. “For example, meet with the same person to have physical or sexual contact (for example, a cuddle buddy or ‘sex buddy’), provided you are free of illness. Make good arrangements with this person about how many other people you both see. The more people you see, the greater the chance of (spreading) the coronavirus.”

The RIVM also has advice for those in a relationship with someone infected by coronavirus or in quarantine with suspected symptoms of the disease. “Don’t have sex with your partner if they have been isolated because of (suspected) coronavirus infection,” the RIVM says. “Sex with yourself or with others at a distance is possible (think of telling erotic stories, masturbating together).”
posted by Iris Gambol at 12:55 PM on May 21, 2020 [6 favorites]


apparently the word is seksbuddy. SEKSBUDDY!
posted by Justinian at 2:59 PM on May 21, 2020 [15 favorites]


Exactly. (And I'd thought Ireland's 'cocoon' coinage was a terrifically novel approach to coronavirus distancing advice... seksbuddy beats the pants off that.)
posted by Iris Gambol at 3:04 PM on May 21, 2020 [1 favorite]


Planned Parenthood > COVID-19 and Your Sexual Health:
Can you get COVID-19 from sex?

You can get COVID-19 if you’re within 6 feet of someone who has it when they cough, sneeze, or breathe out. And COVID-19 is also spread through direct contact with saliva (spit) or mucus. So intimate activities that involve being physically close to someone, or coming into contact with their spit — like kissing — can easily spread COVID-19.

COVID-19 may also spread through feces (poop). So it may be possible to get COVID-19 from sexual activities that could expose you to fecal matter, including unprotected oral sex on an anus, or putting a penis or sex toy in your mouth after it’s been in someone’s anus.

Scientists have found COVID-19 in semen (cum), but they don’t know yet if it can spread from one person to another through semen. There’s no evidence so far that the virus is in vaginal fluids. Either way, it’s always a good idea to use barriers like condoms, to help protect you and your partner from infections that can definitely spread through sex.
Some people with COVID-19 might not have symptoms, or their symptoms may be mild. So you can’t know for sure if someone has COVID-19 based on how they look or feel.

More questions (with answers) in the article: • How can I safely have sex during the COVID-19 pandemic? • How can I connect with my partner while I’m social distancing? • How can I stay safe while staying at home if I’m in an abusive relationship?
posted by cenoxo at 3:05 PM on May 21, 2020 [3 favorites]


This is interesting. Democracies in fact had better compliance with restrictions than authoritarian states.

"even though autocracies imposed more restrictions on travel and the movement of people, geographic mobility declined about 20% more sharply in democracies when they introduced the same policies."

Link.
posted by i_am_joe's_spleen at 4:06 PM on May 21, 2020 [2 favorites]


Because this is the worst timeline:
There is apparently a card circulating for people who do not want to wear facemasks. The card states they have a medical condition that prevents them from wearing a facemask, they do not need to disclose it, and that not allowing them to shop is discrimination under the ADA.
@BoozyBadger lays out that the ADA has carve outs [threadreader] that make it not apply in this case and how even if it did apply stores could still prevent entry.

Also hilariously a picture of one of the laminated cards offered up invokes HIPAA (probably because ADA and HIPAA are the only two medical laws the average layperson knows) but spells it HIPPA. And again there are public health carve out to HIPAA.

I've seen the semen thing a few places. Maybe I'm just too vanilla but is there a lot of sexual activity out there involving exposure to semen that don't also include being within 6' of each other's exhalations?
posted by Mitheral at 4:14 PM on May 21, 2020 [8 favorites]


Someone hasn't seen Eyes Wide Shut, and is to be envied.
posted by Iris Gambol at 4:58 PM on May 21, 2020 [6 favorites]


You gotta love how the same turdnuggets who support Independent freethinking homophobic freedom when it comes to say, baking cakes are all *real mad!* about a private business reserving the right to serve someone without a mask.
posted by aspersioncast at 10:38 PM on May 21, 2020 [19 favorites]


Immunity certificates [...] This is literally the worst idea.

Indeed, as per a German professor of social philosophy and ethics in healthcare, an American bioethicist at Stanford, Nature ("Ten reasons why immunity passports are a bad idea"), and the WHO.
posted by progosk at 1:40 AM on May 22, 2020 [6 favorites]


Why some Covid-19 patients infect many others, whereas most don’t spread the virus at all?

There talks about the “dispersion number” (k) for the virus. Virus which have a lower k number are more likely to be spread by cluster events than by direct 1 to 1 transmission. It would appear that Covid 19 (like SARS and MERS) has a low k number: it may be that 10% of cases lead to 80% of the spread. That means that a lockdown release process that specifically restricts those events and work practices that have been dangerous (cruises, choir practices, meat packing operations, etc) - may still work even if it is lenient on other forms of social contact.
posted by rongorongo at 2:22 AM on May 22, 2020 [11 favorites]


winterhill, it's especially terrible given that people are (understandably, given how the media has focused on case counts and deaths) mostly unaware that a significant fraction of those who become infected end up having what is expected to be long term, if not permanent, organ damage. Yeah, you'll probably live if you're 20, but maybe your quick release from purgatory won't be so nice when it turns out you have trouble climbing stairs due to reduced lung function.
posted by wierdo at 3:05 AM on May 22, 2020 [9 favorites]


Scientists believe cannabis could help prevent and treat coronavirus

It's probably bullshit but it's going to make shelter in place a little bit harder for some people.
posted by rdr at 4:22 AM on May 22, 2020 [2 favorites]


There's also research being done on artemisia annua, spurred by TCM and Malagasy experiences, I guess.
posted by progosk at 4:57 AM on May 22, 2020


Afua Hirsh wrote about this in the Guardian yesterday
Why are Africa's coronavirus successes being overlooked?
posted by adamvasco at 9:04 AM on May 22, 2020 [4 favorites]


I've been going through Florida's coronavirus data and I found some discrepancies in the reporting of "positivity rates." Positivity rates are the rates of positive tests versus totals. Beyond the fact that Florida switches around its numbers for the same date, I strongly suspect that Florida is mixing antibody tests with PCR test results.

These numbers jump around more than what I would expect from legitimate data revisions. The problems in data began about the time Rebekah Jones was forced out of her position (May 5th). For example, the May 3rd positivity rate changed from 4.68% in the May 5th report to 2.41% (still May 3rd) in the May 11th report.

Governor De Santis regularly crows about how Florida's rates are low, giving contradictory numbers as evidence. Florida's numbers are well below those of other states. For example, over the week of 5/14 to 5/20 Florida's positivity rate was 2.62% compared to the 7.15% median of the other states I looked into.

I went into detail regarding my investigations in my blog.
posted by dances_with_sneetches at 11:36 AM on May 22, 2020 [8 favorites]


> I've been going through Florida's coronavirus data and I found some discrepancies in the reporting of "positivity rates." Positivity rates are the rates of positive tests versus totals. Beyond the fact that Florida switches around its numbers for the same date, I strongly suspect that Florida is mixing antibody tests with PCR test results.

You've been scooped:
Kristen Nordlund, a spokesperson for the CDC, told us that the inclusion of antibody data in Florida is one reason the CDC has reported hundreds of thousands more tests in Florida than the state government has. The agency hopes to separate the viral and antibody test results in the next few weeks, she said in an email.
But your additional detail and analysis of the situation is a welcome addition to the conversation!
posted by tonycpsu at 11:47 AM on May 22, 2020 [4 favorites]


GS-441524 has never been tested in humans. Remdesivir has been through the full clinical trial process.

That's fair, but the points made about GS-441524 being easier to manufacture (3 steps instead of 7) and likely easier to administer (subcutaneous injection and inhalable aerosol instead of needing an IV hookup) seem so valuable that it remains surprising that they're not at least looking to move it into human trials - particularly given how much better it performs than remdesivir in non-human animals.

Also, if it was patented in 2009, there's still plenty of time left on that clock

It's 10 years off the 20-year patent length for drugs in the US. You and I may feel that's enough, but I think it's fair to say that, given the uncertainty around this pandemic, bean counters at Gilead may think differently.
posted by mediareport at 1:50 PM on May 22, 2020 [1 favorite]


Tonycpsu. The first link says that the CDC is reporting 31% more in numbers than Florida. I'm relying on Florida's reporting and saying that their own numbers don't match up. And, I'm saying that Florida's numbers jump up and down when it comes to positivity rate.

I've been poring over the COVID Datbase numbers. They have a lot of problems on their own: but I do believe they are conscientious.
posted by dances_with_sneetches at 1:54 PM on May 22, 2020 [2 favorites]


Good story from India on nurses' discomfort during long shifts in PPE while they're menstruating, and the breaking down of cultural barriers to talking about that with their male colleagues:

The menstrual discomfiture is increased many folds by dehydration, physical isolation, mental exhaustion, being in a PPE in sweltering heat, and genital rashes she says they are likely to get from wearing the same pad for long periods of time. The complete lack of acknowledgement of this when assigning duties, especially by men in charge, speak of a condition that is affecting hundreds of thousands of menstruators, but is not being mainstreamed into conversations.
posted by mediareport at 2:08 PM on May 22, 2020 [4 favorites]


It's 10 years off the 20-year patent length for drugs in the US. You and I may feel that's enough, but I think it's fair to say that, given the uncertainty around this pandemic, bean counters at Gilead may think differently.

The profit window for the drug is maybe 2 years at most until herd immunity emerges? If there was a safer, easier version that is still covered by patents why would they not use it?
posted by benzenedream at 3:32 PM on May 22, 2020


maybe 2 years at most until herd immunity emerges?

We're not even sure at this point if individuals who recover become immune, let alone the herd. Your question seems a bit out in front of what we know for certain about the eventual shape of this pandemic.

If there was a safer, easier version that is still covered by patents why would they not use it?

As atrazine mentioned above, and which I neglected to consider, remdesivir has been through human trials and was approved for human use during an Ebola breakout a few years back; the easier to make version, even though it's shown a lot of promise in animals (according to the article, in some ways it appears more effective than remdesivir), would have to go through time-consuming human trials. But come on - a version of the drug that's already been proven extremely safe and highly effective in animal trials *and* can also be injected subcutaneously or aerosolized into a spray, instead of requiring an IV hookup like remdesivir does?

How is that not worth developing?
posted by mediareport at 4:43 PM on May 22, 2020 [1 favorite]


The profit window for the drug is maybe 2 years at most until herd immunity emerges?

Any effective anti-virus therapy has possible use for many other viruses in addition to new coronaviruses for years to come.

There are billions of dollars at stake. Whenever there are billions of dollars of profits at stake you can expect corrupt medical decisions.
posted by JackFlash at 5:33 PM on May 22, 2020


even though it's shown a lot of promise in animals (according to the article, in some ways it appears more effective than remdesivir), would have to go through time-consuming human trials. But come on - a version of the drug that's already been proven extremely safe and highly effective in animal trials

If it hasn't been in phase I in humans it hasn't been proven extremely safe. Drug companies do not usually make worse acting derivatives (which are harder to make) of existing drugs for no reason. The other alternative to all the Big Pharma Conspiracy theories is that Gilead knows something bad about the precursor that you don't. Note that all the decisions about these patents were made when coronaviruses were a niche cold virus responsible for only a few deaths a year in the elderly, SARS and MERS had both been contained, and there was no real market for these drugs. Now I can believe that Gilead's HCV drug candidates have been optimized for a long patent life and maximum profitability, because they had a decade to plan it all out with a somewhat fixed disease state.
posted by benzenedream at 6:57 PM on May 22, 2020 [3 favorites]


COVID Underdogs: Mongolia - according to this account, Mongolia's response to COVID-19 outdid everyone, in part because they didn't wait or hesitate on any action.
posted by ZeusHumms at 7:19 PM on May 22, 2020 [8 favorites]


Record virus infections, deaths are ravaging Latin America (AP)
Latin America’s two largest nations — Mexico and Brazil — reported record numbers of infections and deaths almost daily this week, fueling criticism of their presidents, who have slow-walked shutdowns in an attempt to limit economic damage. [...] Infections also rose and intensive-care units were swamped in Peru, Chile and Ecuador, countries lauded for imposing early and aggressive business shutdowns and quarantines. [...] The Colombian town of Leticia, which lies along the Amazon River at the border of Brazil and Peru, has nearly 1,300 cases. Residents reeling from the illness and a loss of income are placing red cloth flags outside homes with tin roofs to show they are going hungry.
WHO declares that South America is the new coronavirus epicenter (WaPo live blog)
The disease has been gaining momentum on the continent for several weeks, but in recent days the number of cases has exploded, setting off public health emergencies in Ecuador, Chile, Peru and, most significantly, Brazil. [...] [Michael Ryan, the director of the WHO emergency program,] specifically noted Brazil’s chaotic response to the virus.

Earlier this week, the government moved forward with plans to enable the widespread use of hydroxychloroquine in coronavirus treatment — despite serious misgivings over its efficacy. Brazilian President Jair Bolsonaro, who has minimized the severity of the disease and dismissed its victims, is enamored of hydroxychloroquine. He has already pushed out two health ministers who had urged caution over its use. A large study published Friday found that people who were treated with the drug were significantly likelier to die than those who were not. “The government in Brazil has approved the use of hydroxychloroquine and chloroquine for broader use,” Ryan said. “The current clinical evidence does not support the widespread use of the medicine for the treatment of covid-19.”
posted by katra at 10:05 PM on May 22, 2020 [3 favorites]


immunity: not certain of bearing, but TWiV guest (ep. 607) & columbia-mailman school of public health professor jeff shaman described a study (w/ principal author marta galanti, in paper here: uncertain as to publication or level of peer review) reviewing "the immune response to the widespread endemic coronaviruses HKU1, 229E, NL63 and OC43" as a potentially "useful reference for understanding repeat infection risk." those are those four coronaviruses that circulate among the population and understood to be among the causes of what we call the "common cold."
To contextualize the issue of protective immunity to SARS-CoV-2, we here present findings from a recent proactive sampling project carried out in New York City (NYC) that documented rates of infection and re-infection among individuals shedding seasonal CoV (types: HKU1, 229E, NL63 and OC43). The results are discussed and analyzed in the broader context of coronavirus infections.
it made for some interesting reading; he described and discussed it with TWiV hosts.

related: some of the TWiV guests have speculated (i think frequent guest daniel griffin of the weekly view from new york hospitals among them) that that syndrome called kawasaki's may have been being caused by one/some of the endemic CoVs all this time, but never (?) noticed/considered against the background noise of common coldery.
posted by 20 year lurk at 10:16 PM on May 22, 2020 [4 favorites]


Re Remdesivir vs GS-441524.

I think it is interesting but I also think that the one reason that Gilead is *not* doing this is because of patent life or maximising revenue.

Here's why: If it was indeed the case that it was extremely safe (and a phase I trial could be run extremely quickly and could have been run at any time in the last few months) then a readily manufacturable, inhalable drug would of course be vastly better and more profitable.

If remdesivir even works at all, it will work much better in early infections. All the evidence is that serious illness comes in the second and third week and is an immune pathology, viral titres are already falling even in the most seriously ill patients. All antivirals work better early. Tamiflu works great... but only if you take it early which is why it's barely used.

An IV drug cannot be used early except by people who know how to give themselves IV injections, which is quite a niche group of people. Remdesivir was tested early on IM as well but didn't work so well. IM & subcutaneous injections are much easier to self administer .

If you could make an oral antiviral, maybe packaged in an inhaler like asthma meds, you could ship them out to people as soon as they develop symptoms. Same day delivery. Maybe send extra so that others in the household can dose as prevention. High risk workers get them pre-issued so they can dose themselves immediately if The sales volume of that would be fucking bananas. You could sell a few billion doses this year if you could make them. And it's easier to make! Compare that to a difficult to make antiviral treatment (Remdesivir) that has niche applications at best. Sure you could keep Remdesivir under patent for longer but there is no guarantee it will make any money after that. Meanwhile, an orally available antiviral that works against our boy Covid? Money printer go brrrrrrrr.
posted by atrazine at 4:57 AM on May 23, 2020 [5 favorites]


immunity: not certain of bearing, but TWiV guest (ep. 607) & columbia-mailman school of public health professor jeff shaman described a study (w/ principal author marta galanti, in paper here: uncertain as to publication or level of peer review) reviewing "the immune response to the widespread endemic coronaviruses HKU1, 229E, NL63 and OC43" as a potentially "useful reference for understanding repeat infection risk." those are those four coronaviruses that circulate among the population and understood to be among the causes of what we call the "common cold."

Yes, what an incredible piece of basic scientific research. I loved that episode, love TWiV and the whole TWix family.

The hosts have also wondered if maybe each of the common cold Coronaviruses was like this when it first emerged. Children get mild disease, adults die at a much higher rate. All four common cold coronaviruses emerged when the average global age was much older, science was much less advanced, and we might just not have realised what was happening. Since then, we all get infected by these viruses as kids, build up enough immunity to not die of them when we get them again as adults, so we think they are "naturally" mild.

If that is the case then it is possible that permanent immunity via a vaccine or otherwise may be impossible but a vaccine may still be able to stop the outbreak and reduce severity down to a common cold.
posted by atrazine at 5:02 AM on May 23, 2020 [3 favorites]


My preference would be to take the hammer to all of this and have 2-3 weeks of European-style Really Harsh Lockdown up here - no family visits, no outdoor exercise, no takeaway food places or bloody pubs, no sitting in the park or on the beach, stay inside except if you're an essential worker or if you're taking one trip per week to buy food.

Family visits are already banned. I'm not clear why people should give up outdoor exercise or sitting in parks which are extremely low risk activities and critical to people's wellbeing.

The only reason those things were ever banned elsewhere is to make it easier to police the ban on going to other people's houses, not because those activities are risky in and of themselves. (If you're allowed to exercise then the only way that the police can stop you visiting other people is if they literally see you go inside a house that isn't your own.)

You're right that London is a bit of a special case. The majority of London workers either:
-Work in offices and can therefore work from home essentially indefinitely. I would expect that many London office workers will not go back to regular office work until the back end of the summer.
-Or they work in restaurants, bars, cafes, spin studios, whatever providing services for the above. People in this category are not allowed to work in that capacity in London or anywhere else and anyway there is no point them doing so if they have no customers.

On the other hand, because of the absolute requirement to use public transport to go into work in central London, re-opening London is particularly high risk.

I think that there are two options in terms of regional differences:
1) What they are doing now - keeping them to a minimum to aid messaging. I disagree that it is confusing having different rules in Wales and Scotland. There have been differences between English and Welsh rules for many things for years and Scotland has had a completely different legal system forever. It might make it confusing for media commentators but individuals know the countries they live in, they still only have to learn one set of rules. They may feel that having further regional differences will make it too complicated though.

2) Set out a framework for what is allowable within which different regions can have different statuses. If I can see that London and the Home Counties is a "3" but Manchester is a "4" and I have a table that shows me what that means for work, socialising, and education, I think that is simple enough for people to follow.

The danger with that is that even if you can make it simple enough to understand, you erode a sense of national solidarity. I think the government may judge that although there is evidence that it could be done, the loss of solidarity would be too great a price to pay. Not an easy decision to make either way.
posted by atrazine at 5:18 AM on May 23, 2020 [1 favorite]


UK news today is that Dominic Cummings, Boris Johnson's adviser and Vote Leave man, broke lockdown rules in March by driving across the country from London to Durham with his wife (who was already sick with covid) and child, apparently because he was worried he would also become ill and wanted his parents to be able to look after their 5-year-old in that case. (A representative Guardian article here.) Coincidentally, it was also his mother's birthday that weekend. It was reported to Durham police at the time, who say they spoke to "the owner of the house" where Cummings stayed. (Number 10 denies that this happened.)

The story broke last night and in response what seems like the entire Tory cabinet has been parading across twitter today to back up Cummings by saying that "any parent would have done the same to look after their child" and castigating objectors for "scoring political points". Neatly ignoring the fact that government advice was at the time very very unequivocal that if you or a member of your household showed covid symptoms you should absolutely not leave your house for any reason. Also, Cummings's brother-in-law lives in London, so the idea that there was no one closer than 230 miles away they could ask for help seems ridiculous. But then, I'm just one of the herd.
posted by Cheerwell Maker at 9:46 AM on May 23, 2020 [10 favorites]


Is it true that the UAE has tested more than 10% of their population?. Were they already well stocked with testing reagents due to MERS?
posted by benzenedream at 10:00 AM on May 23, 2020


I would have been fine with him and his wife going up to stay at his parent's guest house if there was genuinely no-one in London who could look after their kid if they both got too ill. It's arguably not even against the rules since there was always a pragmatic exception for caring for vulnerable people.

But... I find it difficult to believe there was no-one in London who could have been come and done it in an emergency. As you say, there are members of the family who live in London. Maybe they had to work / were in a vulnerable category?

Also, it now appears that after he recovered, he went back to London (fine) but was then spotted back in Durham on the 19th of April (definitely not fine). If that's true I don't see how he doesn't resign at least temporarily tomorrow.
posted by atrazine at 12:23 PM on May 23, 2020 [3 favorites]


Personally, I'm worried about the way the lockdown is slowly drifting away.

Yeah, I was visiting a friend and her young daughters yesterday (outside, in the yard, distanced, as they looked for worms and roly poly bugs in the garden), and we both agreed that we don't give a fuck what North Carolina has suddenly, with little evidence of an ongoing decline in infections, decided is acceptable. We're going to keep distancing, avoid gatherings, and wear masks indoors throughout the summer and probably into the fall, when we're pretty sure we'll watch NC elementary schools open, have half- to two-thirds-attendance at best, and then abruptly close again within a month as the inevitable spike occurs.

Vox just posted another good article, 6 feet away isn’t enough. Covid-19 risk involves other dimensions, too, about how to think about the various factors involved in social distancing - time, air circulation, etc - as states stupidly ease their lockdowns. Familiar stuff by now, but the links to relevant studies make it a good one-stop article for convincing folks, with easy-to-understand concepts like, "Imagine people are smoking, or farting really bad, and try to avoid breathing it in."
posted by mediareport at 1:04 PM on May 23, 2020 [7 favorites]


Checking in with Hollywood, the key barrier right now to restarting movie production in the US and UK is the refusal of insurers to cover any coronavirus risk for new productions. Insurers were hit hard by the shutdown so their first move was to eliminate pandemic coverage going forward. Discussions are happening about the federal government getting involved, as the US did with the Terrorism Risk Insurance Act after 9/11, limiting insurers' exposure after they refused to cover any future terror-related claims.

Posted yesterday at Deadline: NY Rep To Introduce Production-Friendly Insurance Bill Tuesday As Insurers Propose FEMA-Run Solution

More from last week: Reopening Hollywood: Will Prohibitive Insurance Hobble Production Restart & Will Government Have To Step In?

Similar discussions are happening in the UK.

Blumhouse Plans Film Shoot on Universal Lot Despite Insurance Risks
posted by mediareport at 1:31 PM on May 23, 2020 [1 favorite]


The lifting of lockdowns and the world picking up and keeping going and the deaths just rolling on... I started reading about the Spanish Flu and it was barely covered by the press at the time, or after the fact. European countries fighting WW1 tried to cover it up, the US president never made a single statement, even though it was killing more people than the war. So very many deaths and so much public denial. I don't see why it couldn't happen again. Eventually people get inured or fatalistic to risks. I saw videos of French people during the Hong Kong flu, 'if you get it, you get it.'

I've been finding my mini-survey of 20th century pandemics somewhat comforting but also very alarming. The best thing I found though was this video/article about remote learning in 1925 in New Zealand.
posted by Salamandrous at 6:46 PM on May 23, 2020 [3 favorites]


It would be cool if some enterprising film producer would revive drive-in theaters for the grand opening of their picture. I found a website that says there are 325 active drive-in theaters in the US. Make safe cinema the point. Hell, we need some sort of safe communal diversion.
This crisis could go on a year or more. It might be worth the investment to restore some more.
And I would have no objection to drive-in churches if they need to get some daytime use out of them.
posted by dances_with_sneetches at 9:07 PM on May 23, 2020 [3 favorites]


drive-in/drive-through church. ain't that the americanest of americanic innovations. can't believe that 1) hasn't been done already and 2) isn't the fastest growing religion in the world.
posted by 20 year lurk at 9:29 PM on May 23, 2020 [1 favorite]


The New York TImes marks 100,000 US Covid-19 deaths with a front page comprised solely of death notices. Kudos to whoever thought up that idea - thousands of names are much more evocative than bare numbers.
posted by rongorongo at 10:42 PM on May 23, 2020 [3 favorites]


Burhanistan: Drive-in movie theaters are making a comeback thanks to coronavirus

That seems to be happening in the Netherlands, too. Article in Dutch (NRC).
And they never were big here in the first place because the intended audience did not usually have a car.
posted by Too-Ticky at 1:30 AM on May 24, 2020


So what does that mean for all the people who have spent the past two months assiduously following the rules, often at great cost to their own mental and physical health? Could I, at the first sign of suicidal ideation, have gone and visited a friend in a different county and helped nip it in the bud rather than dealing with it for months?

Yes of course. If you honestly believed that you were in danger and that this was the most expedient way of dealing with it then that would be perfectly reasonable. We don't need a perfect mechanical following of the distancing rules for them to work, just for everyone to do the very best they can under the circumstances.

Could all those people who have had to sit at home while family members died in distant hospitals actually have travelled?

Probably not, no. The way the guidance is set up is to prevent acute harm but unfortunately not to prevent the more diffuse harm cause by not being present when a family member dies.
posted by atrazine at 4:29 AM on May 24, 2020 [1 favorite]


For the UK government Herd Immunity is still the goal. It has always been the goal.
They just want to cause 200,000 deaths in six months instead of two.
posted by fullerine at 5:09 AM on May 24, 2020 [1 favorite]


For the UK government Herd Immunity is still the goal. It has always been the goal.
They just want to cause 200,000 deaths in six months instead of two.


Why would that make any sense? There are only two reasons why someone might pursue such a scheme:

1) They don't think any of the other measures will work. That might have been believed in February but we know now there are other ways.

2) You think other measures will take so long and do so much damage to your society that lots of deaths in the short term are preferable to an expensive lockdown.

We know that (1) can't now be true. If (2) is true then it only makes sense to have a much shorter lockdown period. No point having months of lockdown in order to achieve some kind of herd immunity.

Also, had that been the plan, they would have released lockdown measures much earlier to keep circulating infection high but manageable. There's now barely any left and if they just let it rip come the first of June, we'll hit a second peak at the end of the summer / run up into fall.
posted by atrazine at 6:27 AM on May 24, 2020


Nothing the British government does makes sense. It's depressing.
posted by mumimor at 6:39 AM on May 24, 2020


2) You think other measures will take so long and do so much damage to your society that lots of deaths in the short term are preferable to an expensive lockdown.
Replace society with economy.
The idiocy of it all is that the economy is pretty much fucked either way.
Also, had that been the plan, they would have released lockdown measures much earlier to keep circulating infection high but manageable. There's now barely any left and if they just let it rip come the first of June, we'll hit a second peak at the end of the summer / run up into fall.
The initial plan was no lockdown, "taking it on the chin" remember.
The lockdown was only implemented when the premier league and others said "we're not having this blood on our hands" and locked themselves down.

Whether the government were optimistic and assumed the crash and recovery would be quicker or whether they didn't care about the deaths is kind of a moot point. All the evidence points to infecting as many people as possible whilst damaging the economy as little as possible. Building nightingale hospitals (currently mothballed) were unnecessary if you were looking to seriously curtail the spread of the virus. Extensive testing (which was dropped in March) is unnecessary if you assume most people will be infected.

All of the preventative measures (lockdown, testing, PPE) have been drive by reaction to the public backlash not by government planning. The plan has always been Herd Immunity.

I can honestly see the callous logic behind a Herd Immunity plan. If you don't care about the deaths and the electoral impact then it really is the quickest way to get back to "normal". The cost to the populous is immense, but then we're having hard brexit at the end of the year so I don't think they give a shit about that.
posted by fullerine at 7:25 AM on May 24, 2020 [8 favorites]


I can honestly see the callous logic behind a Herd Immunity plan. If you don't care about the deaths and the electoral impact then it really is the quickest way to get back to "normal". The cost to the populous is immense, but then we're having hard brexit at the end of the year so I don't think they give a shit about that.

It's fairly simple: you won't get forest fires for a while if you let this one burn everything down. Call it "Pandemic Brexit," because it's really not that different from what Brex is doing economically: throwing caution to the wind and saying, "what if?"

"Nobody is saying jumping off a cliff can't teach you about flight, and a big part of success is in knowing what doesn't work."
posted by rhizome at 8:55 AM on May 24, 2020 [4 favorites]


Another solid article to help folks judge the risk of various settings based on what we know about coronavirus infections as they've happened at those places in the past, from the Salt Lake Tribune. Useful as a pointer to folks who might need convincing. I know lots of folks who work at, manage or own bars and restaurants, so it's really hard for me to say to them: DON'T OPEN, so I keep my mouth mostly shut. But that's definitely what I want to say.
posted by mediareport at 9:26 AM on May 24, 2020 [12 favorites]


I own a shop that will probably be reopening on June 1st, against my better judgement, but I'm not sure I have a lot of choice in the matter. We can't switch to online orders in a way that will cover our rent, so if we stay closed much longer we won't reopen at all. I'm lucky in that I'm mostly only endangering myself -- I do most of the staffing, and my one part-time employee is a college student who had COVID in March -- but it's still scary.

And I know the two most likely scenarios are a) we won't have enough business to recover anyway, and b)what customers we DO have will be those taking the fewest precautions. So that sucks.
posted by nonasuch at 9:36 AM on May 24, 2020 [6 favorites]


Nothing the British government does makes sense.

Everything the current British government does makes perfect sense if you simply base your understanding of it on the assumption that those in charge are a useless shower of know-nothing self-promoting own-horseshit-believing upper-class-twit blowhards without a shadow of a clue about how anything works other than the totally supine British media, whom they know full well will never ask more of them than an endless supply of anodyne, asinine jolly hockey sticks and rah rah press releases to run as-is on the front pages.

It's depressing.

It really is.
posted by flabdablet at 9:59 AM on May 24, 2020 [14 favorites]


Arrogant and offensive.

Can you imagine having to work with these truth twisters?


-official UK Civil Service account

(edit: now gone- a screenshot here)
posted by vacapinta at 10:05 AM on May 24, 2020 [6 favorites]


The initial plan was no lockdown, "taking it on the chin" remember.

I'm not clear that it was. That phrase was only ever used in the context of something they weren't going to do. The government claim that it was never "the plan", I think that is true in the narrowest possible sense that they never formally decided to do it, it was clearly discussed, it was obviously something being very seriously considered. The thing is - unlike other plans, it doesn't even need to be "the plan" because it happens by default.

I think the government has very real questions to answer about the early handling of the pandemic, about the lack of capacity to do more than they did on tracing and testing, about the lack of surge capacity in the NHS, and most of all on the timing of distancing measures. We know that they decided on a lockdown strategy on the 16th - they didn't actually do the full lockdown thing till the 23rd. The maths is clear: timing is everything.

If they had done on the 16th what they did on the 23rd, we would now be hearing from the government how much better we had reacted than Italy, Spain, probably even France. They sure wouldn't have dropped that comparison chart, however questionable it always was.

It is the only consequential decision they made this year - everything else either didn't matter, or is a result of structural factors (most of which are the fault of the same party if not quite the same government) or is a direct consequence of the timing decision.

That being said - I think there is no evidence at all that they have secretly changed their minds back to pursuing herd immunity. If they did then we might expect to see the following:

-A very early easing, substantially earlier than elsewhere because if you pursue that strategy you want the virus to smoulder through the population over the summer so that by the time you hit October you have built enough herd immunity to get through the winter. The timing in the UK is not wildly at odds with other European countries, a little earlier in some regards but actually pretty cautious.

-Deep, genuine skepticism at the very top of government (i.e. Boris) that things like vaccines were coming. If you are a massive, preposterous optimist like Boris Johnson who really does believe that he is picked for special things by divine powers, then of course you think that there will be a working vaccine in September. If you believe that, why would you pursue a herd immunity strategy? Get a bunch of people killed just in time for it to be pointless?

I think ascribing any deep well worked out secret plots to a government unable to keep a bluebell spotting trip a secret is a bit unrealistic. Who was it that said that conspiracy theories were a flavour of sci-fi where the central conceit was that world was run by hyper competent people?

(Lol at that tweet. Someone clearly YOLOing their way out after deciding that the defence of Cummings' trip to spot wildflowers was a step too far for them)
posted by atrazine at 11:17 AM on May 24, 2020 [2 favorites]


And for further posterity the BBC broadcast it.
posted by adamvasco at 11:17 AM on May 24, 2020 [2 favorites]


Top marks for giving us political drama to entertain us but I might have preferred that drama not to coincide with a once in a century pandemic.
posted by atrazine at 11:34 AM on May 24, 2020


I'm not clear that it was. That phrase was only ever used in the context of something they weren't going to do. The government claim that it was never "the plan", I think that is true in the narrowest possible sense that they never formally decided to do it, it was clearly discussed, it was obviously something being very seriously considered. The thing is - unlike other plans, it doesn't even need to be "the plan" because it happens by default.
So what you're saying is they thought about Herd Immunity, discussed it and decided against it but it was incompetence not malice which meant an ineffective lockdown strategy was the result.
If they had done on the 16th what they did on the 23rd, we would now be hearing from the government how much better we had reacted than Italy, Spain, probably even France. They sure wouldn't have dropped that comparison chart, however questionable it always was.

It is the only consequential decision they made this year - everything else either didn't matter, or is a result of structural factors (most of which are the fault of the same party if not quite the same government) or is a direct consequence of the timing decision.
Again, you're saying they had one chance to get this right and chose the path which was closest to Herd Immunity but did so out of incompetence and not because that was the plan all along? Are you Keir Starmer in disguise?

If someone keep making "mistakes" leading to their desired outcome when do they stop becoming mistakes?
Deep, genuine skepticism at the very top of government (i.e. Boris) that things like vaccines were coming. If you are a massive, preposterous optimist like Boris Johnson who really does believe that he is picked for special things by divine powers, then of course you think that there will be a working vaccine in September. If you believe that, why would you pursue a herd immunity strategy? Get a bunch of people killed just in time for it to be pointless?
Who on Earth thinks a vaccine is going to be here by September? I think Boris and those around him are some of the dumbest people to hold office in the last hundred years and I doubt even they are stupid enough to think a working vaccine will be here before mid 2021 at the earliest.

Implying I'm some sort of truther who is dealing in conspiracy theories is a bit low even for Meltafilter.
posted by fullerine at 12:09 PM on May 24, 2020 [1 favorite]


Union says UPS distribution center in Tucson has COVID-19 outbreak, calls for temporary closure
The union, Teamsters Local Union Number 104, sent out a press release saying the outbreak has endangered approximately 700 employees and strained the company's ability to deliver packages.

"Although both UPS and the Arizona Department of Health Services have refused to disclose the extent of the outbreak; we believe at least 36 employees at the facility have tested positive for COVID-19, including three employees that have been admitted to intensive care units," the statement says.

...

The union also said UPS transferred workers from Colorado, New Mexico and Utah to Arizona due to outbreak-related disruptions — generating concern regarding inter-state spread of COVID-19.
posted by MrVisible at 1:54 PM on May 24, 2020 [2 favorites]


Well shit. The cover of tomorrow's Mail...

Didn't see that coming. Not sure where Johnson goes now.
posted by howfar at 2:46 PM on May 24, 2020 [4 favorites]


I would have been fine with him and his wife going up to stay at his parent's guest house if there was genuinely no-one in London who could look after their kid

Cummings is 48. His parents will be in their 70s (actually I just checked.) Most of the co-morbidities for covid are just really likely for over-65s, hypertension, diabetes, general health vulnerabilities. WHAT THE FUCK WAS HE THINKING PLANNING COVID EXPOSURE FOR VULNERABLE PEOPLE IN THEIR 70s??? The whole edifice of his excuses rests on the grandparents looking after his child because his wife was sick and he knew he'd been exposed. Either that's a lie or he's even stupider and more callous than has been obvious up to now, which would be difficult but hey.

A week before the uk lockdown my daughter, a teacher, was sent home from work with covid symptoms to self-isolate. She is a single parent, she and her child live on their own. She then became not seriously ill, but ill enough. At this point lockdown was declared, shops became stripped of basics and home delivery was impossible, even though she was an regular existing deliveree. This was a stressful time, me and the spousal unit desparate to chip in, do her shopping, have the child stay with us etc. My 4 adult children got together and made helpful plans to totally remove us from the possibility of coming into contact with my daughter while possibly infectious and backed this up with very firm instructions to us! I've never been so told off in all my adult life! By all of them. I think they actually put the fear of god into each other. And - they were right, because the phycological effect of thinking you caused your parents' deaths must be devastating. Maybe not to Cummings.

What an ignorant, arrogant chancer.
posted by glasseyes at 3:24 PM on May 24, 2020 [19 favorites]


not to prevent the more diffuse harm cause by not being present when a family member dies.

atrazine, while I think the balance between continuing lockdown and the psychological emotional and economic harms resulting from it absolutely needs a lot of difficult analysis and open discussion, brushing off the harm to a family of their child dying alone in hospital as diffuse harm is very wrong. It is actual harm and is the sort of thing that leads to life altering consequences up to and including suicides.
posted by glasseyes at 3:45 PM on May 24, 2020 [3 favorites]


Not sure where Johnson goes now
Eh, they've got Gove in the wings haven't they
posted by glasseyes at 3:47 PM on May 24, 2020


Yes. That's why Johnson seems to be fucked. I'm not celebrating, I'm observing.
posted by howfar at 3:52 PM on May 24, 2020


Cummings being harrassed in the street. By ordinary people. James Fenton twitter

I should have added in my post above, beyond the catastrophe that the death of a child is, circumstances can make it even more unbearable.
posted by glasseyes at 4:00 PM on May 24, 2020 [1 favorite]


So what you're saying is they thought about Herd Immunity, discussed it and decided against it but it was incompetence not malice which meant an ineffective lockdown strategy was the result.

Yes. I think they were completely unprepared, panicked when they realised the consequences of any kind of "herd immunity" strategy and then floundered for a few critical days.

Again, you're saying they had one chance to get this right and chose the path which was closest to Herd Immunity but did so out of incompetence and not because that was the plan all along? Are you Keir Starmer in disguise?

I'm not saying that they had one chance to get it right, every day earlier or later would have made a differences. Once again though, yes I am saying it was incompetence.

Who on Earth thinks a vaccine is going to be here by September? I think Boris and those around him are some of the dumbest people to hold office in the last hundred years and I doubt even they are stupid enough to think a working vaccine will be here before mid 2021 at the earliest.

It's not just that they're dumb, which many of them are. It's that they think they're really smart and also that on some level they believe that this entitles them to the universe delivering for them. I'm sure that Johnson for all his intellectual limitations on some level understands that it is vanishingly unlikely. That he's been briefed that if we're lucky we'll get some doses of a partially effective vaccine and very likely nothing at all this year. But also, I do think that on some level his bizarre sense of grandiose optimism tells him that there will be a vaccine in time for rugby season.

Of course I'm not implying that you're a truther, I just think the evidence is consistent with a late (and therefore inherently incompetently executed) lockdown. I think that if they were genuinely planning a herd immunity strategy all along, they would have acted differently, and I think that they're not competent enough to pull off such a strategy without bringing in people outside of the inner circle of weirdos which would therefore leak.

It's a good thing they weren't as the most important thing to do in such a strategy is to ensure the absolute cocooning of all the vulnerable which has been done shambolically.

glasseyes: yes, that's absolutely true. I was thinking of the ripples of grief that spread out from the death of a beloved elderly relative rather than the concentrated horror of losing a child. Diffuse was the wrong word. I do still think it's the case that the regulations place an inappropriately low value on processing that grief.

Cummings is 48. His parents will be in their 70s (actually I just checked.)

That's true but apparently they went up so that his sister and niece could help, obviously there's no way people in their 70s could safely help in that situation.
posted by atrazine at 5:27 PM on May 24, 2020 [1 favorite]


Once again we see a government that is meant to be so good at comms, being really bad at it.

Potential options (for sane people):

1) I accept that while I acted in my family's interests, it was a breach of the spirit of the rules and will therefore be resigning.

2) While I maintain that I acted correctly and within the rules, I accept that by becoming the story I'm distracting from the government's important public health message and will therefore be resigning.

3) I didn't think it was a breach of the rules, but having seen people's reaction, I must now accept that the majority of the country read those rules to forbid doing what I did. I therefore think it best to resign.

4) Sorry I broke the rules and I shouldn't have. I am resigning.

Or even a variation of those where he didn't resign but did apologise. Not sure that would have done the trick though.

None of those would convince everyone but on Saturday Conservative voters were still polling 43% he should stay 41% he should go. He wouldn't have had to take much sting out of the tail to shut the story down. I can't imagine what that polling says now.

What did we get instead? "I was right to do what I did. I'd do it again. It doesn't matter what you think" Great. Now even the Daily Mail says he has to go.

If he resigns now, it's after costing an enormous amount of public trust. A quick Friday night resignation would have been the end of it and realistically he could come back in 6 months anyway.

What he's missing is it does matter. If he was a private citizen then it would be different. Whether he acted within the rules would be between him and a police officer and potentially a judge. Both have been really reluctant to actually fine people, he might even have gotten away with it. But he's not just a guy. Even if he believes that he acted correctly (I think he does believe that) he should still have resigned to protect the core public health messaging.

Luckily we're so far down the curve now that enforcement is getting less important but god help us all if we have to lock down again regionally or nationally because this government does not have the moral authority to do that anymore.

Also: allegedly there are family members who live in London who could have helped out with childcare. Why didn't they? I'll tell you why: I bet they weren't in London either. They can hardly say that though - sorry no childcare in London, the whole extended family on both sides was already at their country houses.
posted by atrazine at 5:42 PM on May 24, 2020 [6 favorites]


a useless shower of know-nothing self-promoting own-horseshit-believing upper-class-twit blowhards without a shadow of a clue about how anything works other than the totally supine British media

and now, apparently, not even that.
posted by flabdablet at 10:39 PM on May 24, 2020


Exclusive: Oxford University Covid-19 vaccine trial has 50 per cent chance of 'no result' — Project leader Prof Hill warns against 'over-promising', as vaccine success is far from guaranteed, The Telegraph, Bill Gardner, 5/23/2020 [alternate link]:
It began in January as a “little lab project”, soon after a curious new disease emerged in China. Little more than four months later, the eyes of the nation - and perhaps the world - are firmly upon Professor Adrian Hill and his team at Oxford University.

This week, the pharmaceutical giant AstraZeneca announced a $1.2 billion deal with the US government to produce 400 million doses of the unproven coronavirus vaccine first produced in Prof Hill's small Oxford lab. Meanwhile, the British Government has agreed to pay for up to 100 million doses, adding that 30 million may be ready for UK citizens by September. The stakes could hardly be higher.

If proven effective, the ZD1222 vaccine would allow people to leave their homes, go back to work, and rebuild the economy. But Prof Hill, director of the university’s Jenner Institute, revealed that his team now faces a major problem, throwing the September deadline into doubt. In short, their adversary is disappearing so rapidly in the UK that the next phase of trials has only a 50 per cent chance of success. Without Covid-19 spreading in the community, volunteers will not catch the disease, leaving scientists unable to prove that their vaccine makes any difference....
More details in the article.

From even the greatest of horrors, irony is seldom absent. — H. P. Lovecraft
posted by cenoxo at 10:45 PM on May 24, 2020 [3 favorites]


For the UK government Herd Immunity is still the goal. It has always been the goal.
They just want to cause 200,000 deaths in six months instead of two.


We might note that Sweden, which adopted "herd immunity" as a policy - has a per capita death rate which is 35% less than the UK's as of today (source). If I was in charge of a government that saw the Imperial College warnings about the potential death rates from this strategy - then I would have made the same decision to avoid it that the UK did. But that study seems to have not accounted for the details of a country's policy as implemented- and those details matter a great deal.

The trick with a successful strategy for herd immunity, seems to be that you still have to remember to test, track and isolate. You must still try your best to shield vulnerable people (something Sweden did not do all that well, in common with other countries). Finally, you still need to restrict likely super-spreading events such as large gatherings. In other words, you still need a very detailed policy of regulation and monitoring. You may be thinking of your population as a herd - but you still need to treat them as individuals who matter.

At this point, I don't think there is any evidence to say that herd immunity is the kind of poor decision it was warned to be. Instead, what is important, is to (very quickly) come up with a clearly communicated campaign that is then regularly tweaked based on measurement, understanding of the virus and lessons from other countries. The important difference is not between lock-down and herd immunity: it is between clear top-down policy and laissez faire confusion. The Westminster government seem to be proponents of the latter; the Cummings debacle illustrates it perfectly. Whether the government has been driven more by incompetence, more by laziness or more by malevolent complacency does not matter: the results are equally lethal.
posted by rongorongo at 2:22 AM on May 25, 2020 [5 favorites]


We might note that Sweden, which adopted "herd immunity" as a policy

I don't think aiming for herd immunity is the official Swedish policy, though I don't know what they were aiming for, and it seems whatever it was, they are beginning to admit they failed.
posted by mumimor at 2:59 AM on May 25, 2020 [5 favorites]


This is why they were so eager to get the vaccine out into human trials. With no circulating virus, all you get is a big safety trial.

Watch: we are going to see another trial started in one of the US states that is lifting their lockdown early, or in Brazil, or somewhere else. The Chinese are facing this exact problem which is why there has been such a stand-off about the US and the Chinese not working together - the Chinese really want to test their vaccine but they don't have enough virus left to do so.
posted by atrazine at 3:26 AM on May 25, 2020 [2 favorites]


I don't think that the U.K.'s response is the one to contrast with herd immunity.
posted by dances_with_sneetches at 3:28 AM on May 25, 2020 [1 favorite]


This is why they were so eager to get the vaccine out into human trials. With no circulating virus, all you get is a big safety trial.

(If you are strongly repelled by animal testing please skip ahead).

John Campbell talks about progress on the Oxford/Astrazenica and the Boston Beth Israel Deaconess Medical Center vaccines. At this stage both seem to be running parallel human (safety) and animal (efficacy) trials. Both are preparing for scaled up human trials. Both trials used rhesus monkeys and it sounds like they infected them by squirting the virus up their noses.

My presumption is that, for a human trial to be signed off - something like this will have to be done to volunteers. But, I am note sure there is an implication that those volunteers need to be placed in the middle of an outbreak. I imagine that it would be more reassuring to say "we gave everybody a dose with X much viral load using method Y and they were OK" rather than "We took them round a supermarket in [outbreak epicentre] and they were OK".

Would be interested to hear from those who could describe how human trials work at that stage and whether a rarity of outbreaks is actually a barrier to progress.
posted by rongorongo at 3:53 AM on May 25, 2020 [1 favorite]


It's Not Obesity. It's Slavery
NYTimes opinion by Sabrina Strings
Dr. Strings is an associate professor of sociology at the University of California at Irvine
Despite the lack of clarity surrounding these findings, one interpretation of these disparities that has gained traction is the idea that black people are unduly obese (currently defined as a body mass index greater than 30) which is seen as a driver of other chronic illnesses and is believed to put black people at high risk for serious complications from Covid-19.
These claims have received intense media attention, despite the fact that scientists haven’t been able to sufficiently explain the link between obesity and Covid-19. According to the Centers for Disease Control and Prevention, 42.2 percent of white Americans and 49.6 percent of African-Americans are obese. Researchers have yet to clarify how a 7 percentage-point disparity in obesity prevalence translates to a 240 percent-700 percent disparity in fatalities.
posted by mumimor at 4:24 AM on May 25, 2020 [17 favorites]


So you almost always have to do animal model trials first to show some indicator of safety and immunogenicity, whether you can really trial efficacy of a vaccine under experimental conditions is a judgement call to be honest because we don't often know enough of how a disease spreads in the real world to do it.

Then you do a human safety trial. Then you look at efficacy. Even if you wanted to do human challenge trials, we don't know what viral inoculum, and dosed where to use to simulate a real world infection. Use too much and you might kill healthy volunteers (even if they've received a vaccine that would protect them under real conditions), use too little and it's not a realistic test.

The next step of animal trials that could be run is to inoculate one animal and then let it spread to other vaccinated and non-vaccinated. Rhesus monkeys are not humans but it would provide some information.
posted by atrazine at 4:47 AM on May 25, 2020 [1 favorite]


Without Covid-19 spreading in the community...

If that's all you're worried about, South America has you covered.
posted by CheeseDigestsAll at 5:53 AM on May 25, 2020 [1 favorite]


In which, during a live interview, New Zealand Prime Minister Jacinda Ardern discuss gatherings of up to 100 people being allowed as NZ goes another three days in a row with no new cases all while a 5.9 magnitude earthquake hits and she barely flinches. She had just finished discussing that, although building consent regulations are being relaxed to encourage DIY/small construction as part of the recovery, her fiancée (Clark Gaylord) isn’t allowed to build *another* shed in their backyard (he has *two* already) when the quake hit - as if to emphasize her point more bluntly to him

Meanwhile the new leader of NZ’s opposition, Todd Muller of National (NZ’s version of the conservatives / born-to-rule pony fuckers party), is hauled up only a few days after successfully challenging for the job for having a MAGA hat on display in his office.
posted by inflatablekiwi at 7:32 AM on May 25, 2020 [11 favorites]


Missed the edit window: That would be Clark Gayford. Also Prime Minister Ardern missed the opportunity to give the most kiwi response ever - her “yes....no” in the interview should have been a “yeah....nah” to make it perfect.

Also is anyone else watching the bullshit Dominic Cummings UK press conference - what is the noise in the background?
posted by inflatablekiwi at 8:38 AM on May 25, 2020


Ugh - Clarke Gayford - how many times can I get it wrong. Also so Dominic Cummings’ excuse for driving to a tourist castle for a lookie-lu is that he needed to test if his eyesight was good enough to even drive. That’s a new one..I’m sure the locals appreciated him using their roads as an ocular test circuit.
posted by inflatablekiwi at 8:53 AM on May 25, 2020 [3 favorites]


Fair enough. Curious if it is playing as badly inside the UK as it appeared to me as an outsider. It really seemed like “I’m not sorry and I don’t think I broke the rules (and if I did it was because I’m important), you shouldn’t care about what I did either, but you should blame the media”.
posted by inflatablekiwi at 9:57 AM on May 25, 2020 [1 favorite]


Fair enough. Curious if it is playing as badly inside the UK as it appeared to me as an outsider. It really seemed like “I’m not sorry and I don’t think I broke the rules (and if I did it was because I’m important), you shouldn’t care about what I did either, but you should blame the media”.

It's going down very poorly, to put it mildly. Look, that the SNP, Labour, and people on Metafilter don't like him doesn't matter. All the stuff he's done up to now has not made people in his boss' supporter base mad. They correctly realised that, unfortunately for the rule of law, "normal" people don't really care about things like illegal prorogations.

They've incorrectly assumed that this is another story that is purely a Westminster bubble story.

They are very, very wrong. My neighbours and in-laws are all home counties tories, many big fans of Boris, lots of Brexit voters, all that stuff. (they're very useful because they're completely disjoint with the rest of my social set) They're all angry. I've never seen a single one of these people care about anything in politics and now reactions range from disbelief to actual fury.

I am actually stunned by how badly they have misread this. How can they not realise that it doesn't matter whether he thought it was justified? He doesn't have to even admit that he was objectively wrong, just some inkling of contrition and recognition.

I mean. It's completely unprecedented. No government under any circumstance has been so under attack for so long and just refused to budge. I'm beginning to develop a sort of horrified... admiration is probably the wrong word, but the level of chutzpah here is just beyond the real!

I was ready to accept that maybe there could be a sequence of events which might make the original drive up acceptable. Still not great and should probably be a resigning issue, but whatever - this government is completely opposed to what I want generally so I can't expect much from them.

But the excuse for driving to Barnard Castle. That he wanted to see if he was up to it? Mate, if I wanted to check if I was still ok to drive I wouldn't take a four year old with me and I wouldn't go 30 miles away!

I think they've just realised the central insight of the Donald Trump: No matter how much the media and other politicians will be outraged over the violations of norms and values, people will fall into line behind class interests if you just refuse to budge. I have a horrible feeling that he's going to stay and that two weeks from now this will be a vague memory.
posted by atrazine at 10:35 AM on May 25, 2020 [14 favorites]


I have a horrible feeling that he's going to stay and that two weeks from now this will be a vague memory.
This is I think the most likely option.
It's weapons grade passive/aggressiveness and for a good part of the Tory base his excuse will be enough for them to forget it.

Unless of course there's more revelations coming out. There's been a few whispers that he's been back and forth to Durham quite a bit in the past few months.
posted by fullerine at 10:45 AM on May 25, 2020 [3 favorites]


They've incorrectly assumed that this is another story that is purely a Westminster bubble story.
The video of Cummings walking down the street with people yelling out their windows at him is remarkable.

On the comedy side: Story checks out.
Also: @DaveRoss86 I feel sorry for that Professor who lost his job for shagging during the lockdown. He should've just said he was worried his penis had stopped working and he wanted to double check.

On one hand, I wouldn't be surprised if it becomes yet another thing that conservatives can brazen out. On the other hand, everybody in the UK has been locked inside for two months but there hasn't been anybody to blame or get angry at. Until this weekend.
posted by Homeboy Trouble at 12:33 PM on May 25, 2020 [4 favorites]


Taking the lesson from the US. Sure, people will get angry. They won't do anything about it.
posted by ctmf at 12:53 PM on May 25, 2020


On one hand, I wouldn't be surprised if it becomes yet another thing that conservatives can brazen out. On the other hand, everybody in the UK has been locked inside for two months but there hasn't been anybody to blame or get angry at. Until this weekend.
For a lot of the middle class this pandemic is the first time their privilege hasn't inoculated them from any meaningful consequences. Their usual "follow the rules" and "do as your told" behaviors aren't working as a shield so to have someone flout the law in such a way undermines the belief that it is the behavior and not their privilege which protects them.

It is telling that the anger from the right is largely about Cummings breaking the rules. Nobody asked how many people he could have infected on his jaunt. The outrage is "why are you above the law?" not "why would you risk your parent's lives?"

I think that although Cummings may survive this it has been damaging, especially to Johnson.
posted by fullerine at 1:08 PM on May 25, 2020 [3 favorites]


I think the focus on the rule breaking is for this reason:

We are not called upon to carry out careful individual risk assessments in this time. We have been asked to observe a set of specific rules. Even in cases where we know or think we know that a particular activity could be done safely, we are asked to follow the rules.

My in laws have a massive garden and live nearby. Could we have gone there and sat ten meters away, eat off paper plates and take away anything we touched when we left? Sure. Would that have been a risky activity? No, it would have been very safe since both our households have been completely isolated.

Did we do it? No, on the grounds that we all have to follow the same rules for a short period. The reason for that is to keep the advice for everyone clear - this would only actually work if we really did do it that way, you can bet that most people would end up being way too close or sharing items, or using the bathroom or whatever. Also to keep the advice equitable - not everyone has a big garden to see their family in so it is not fair to allow that behaviour for anyone.

A lot of people have been like us. Following to the letter rules that they know are probably stricter than they need to be out of a sense of solidarity. So the rule breaking is actually the thing.

You know what? If he drove up all the way, stopped maybe once in an isolated area for the kid to piss in a bush or something, and then went straight into an isolated house - then yeah, the actual infection risk is extremely minimal. That's why no-one is focusing on it, because it ends up being a fact specific argument that he might win. The point is though - many of us have things that we *could* have done, that we probably could have done safely, and that we made the difficult decision not to do. That is why it stings.
posted by atrazine at 1:30 PM on May 25, 2020 [20 favorites]


Some American nurses are facing pay cuts. But around the world, many are getting huge raises.Washington Post; Danielle Paquette; May 24 2020
Hazard pay has become a rallying cry and a source of controversy around the world as health-care workers risk their lives on the front lines — often without adequate supplies or protection. Ghana is offering some of the globe’s most generous additional benefits while a number of nations move to expand their support for those laboring in highly infectious environments. [...]

In Ghana, which had recorded 6,683 cases and 32 deaths as of Sunday, officials made a bet that happier employees would be more effective virus fighters.

“When people are motivated, they do their work from their hearts,” said Patrick Aboagye, who leads the Ghana Health Service, the country’s public health system.
posted by ZeusHumms at 1:41 PM on May 25, 2020 [7 favorites]


With masks and sanitized hands, Italian Catholics return to church (Washington Post, May 24, 2020) Priests across the country filled their homilies with references to the past three months: the more than 30,000 who have died of the coronavirus, the passage of so many people without funerals, the economic suffering. But the day was a trial run for all the ways in which religious services will look different, perhaps for months to come, in one of the world’s most Catholic countries. [...]

Among the rules: reduced capacities in church buildings, social distancing in pews, no holy water, masks for everyone.[...] Priests may still hear confession, but not in booths.
posted by Iris Gambol at 3:07 PM on May 25, 2020 [1 favorite]


A good primer at Why are there so many coronavirus infections at meat plants? (The Irish Times, May 21, 2020), including:

Can the process contribute to the spread of the virus?
Possibly. The gruelling nature and pace of the meat processing, cutting up so many animals in a short space of time, means butchering can involve strenuous physical exertion and heavy breathing by employees. The boning hall of a plant can also involve large numbers of workers congregating around a common table in another physically demanding part of the process.

What other conditions might lead to the spread of the virus?
Conditions in plants can be hot with workers butchering warm carcasses with knives that must be repeatedly sterilised at high temperatures. This can create a steamy atmosphere. Some plants can be poorly ventilated, contributing to the spread, while physically distancing may not have been observed in worker common areas such as at sinks or in canteens and changing rooms.
posted by Iris Gambol at 3:25 PM on May 25, 2020 [11 favorites]


This is an amazing read. Straight talk in USA Today, a long interview with Dr. Michael Olsterholm, director of Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota:
Q. Will the economy bounce back quickly?

A. Six months from now, the economic picture in this country is going to look a lot worse than it looks now. There'll be more unemployment. There's gonna be a higher likelihood of this disease having much more impact on our communities. How are we preparing to get the American workers through that now? How are we preparing national and international supply chain issues now?

Q. Aren’t other countries showing the way forward?

A. Please don't tell me that I just have to do what they do in Korea. Or I have to do what they do in Singapore. Or I have to do what they do in New Zealand. Every one of those (nations) is vulnerable to this virus tomorrow. Look what's happened in the last 72 hours in Seoul. And yet last week, I had people telling me if we just did it like Korea did we'd be OK. I've been an adviser to the people in Singapore working on this issue. Don't tell me Singapore has it down. We just all have to confront the fact that there's not a magic bullet, short of a vaccine, that's gonna make this go away. We're going to be living with it, and we're not having that discussion at all.

Q. How can leaders in this country improve the conversation about moving forward?

A. Using my baseball analogy, where I said we're only on the second inning of a nine-inning game, we've got to figure out: How do you declare balls and strikes? Four weeks ago, we had everybody agreeing that we're going to reopen (once we) have 14 days of reduced occurrence of illness. Then, when it got another couple of weeks along and that wasn't happening, we just threw all that out the window without ever saying we did.

Q. How does that affect public perceptions?

A. We're setting the precedents for making decisions by press conference or by tweet. And this is where the American public is getting confused and more angry, because all they want is the truth. Just tell us what it is and why we're gonna do it. The first step is basically saying there are no easy answers here. There aren't any. … People are going to die. Don't deny that. People are going to die no matter what we do.
posted by Sublimity at 4:18 PM on May 25, 2020 [20 favorites]


[Federal] NDP Leader Jagmeet Singh secured two weeks of paid sick leave for every worker in Canada by pushing the federal government to act.

[...]

We will keep pushing the government to make sure they deliver on this commitment and that they work with provinces to make sick leave for workers permanent going forward
Canada currently has a minority Federal government and the governing centre left Liberal party requires cooperation of at least one opposition party to pass legislation. The socialist left NDP party have quite a bit of power to advance it's policies (really to hold the Liberals to policies that Liberal voters generally agree with). Canada currently doesn't mandate or provide short term sick benefits and many workers have no accessible short term sickness benefits.
posted by Mitheral at 7:04 PM on May 25, 2020 [2 favorites]


This is an amazing read. Straight talk in USA Today, a long interview with Dr. Michael Olsterholm, director of Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota:

Though he claims to know a lot about what is going on in other countries, he has a very American perspective.
For instance:
Q. Why are some areas, even within the same country such as Italy, hit so much harder than others?

A. We don't know, and it can't be explained by any sociologic, population density, transportation issue. We don't know. That's the random nature of these viruses, and that's what makes it so tough.
I'm not an epidemiologist, but I think European epidemiologists know quite a lot about what happened in Italy, and they are successfully following the example of Italy in how they are dealing with the virus. I'm not at all saying Europe is home-free, contrariwise, I think everyone is very worried about a potential second wave and the health and economic consequences of that. But the notion that "We don't know, and it can't be explained by any sociologic, population density, transportation issue", appears to be plain wrong.
I can see a lot of reasons why you can't reproduce the European experience/solutions in the US (or the UK), but that doesn't mean "we don't know".

One thing I've noticed is that the hospitals here are getting better at helping patients through the critical periods of the disease. In the beginning of this, you had these terrible stories of hospital staff having to decide who to treat. Now, when I read the daily numbers, it's very clear that most people who enter hospital are getting treated and recover, while less people are on ventilators. So while we don't have a vaccine, or a simple treatment, the hospitals are getting people back on their feet. That is a huge win, achieved through the lockdown which has let the hospitals catch up and learn. That knowledge won't disappear even if there is a second wave (or more waves).
There is a huge difference between COVID-19 is a terrible disease and you will die in a tent all alone, and COVID-19 is a terrible disease and you will spend weeks in a hospital and then weeks getting back in shape.
posted by mumimor at 2:18 AM on May 26, 2020 [11 favorites]


So this is what I mean about it being fact specific.

When we go after him on the facts, we are faced with the issue that because he was there he has all the facts and we have between none and whatever turns up (who knows, maybe something will turn up from CCTV as you said1) he can control the narrative.

Certainly he could drive all the way up on a single tank if it was anywhere near full. Certainly he couldn't have gone all the way up, on his bluebell jaunt, and all the way back down without refilling but of course he could have safely filled up on the way down. I guess with little traffic you would get decent mileage even with that brick-like Land Rover.

But we don't need to look up fuel efficiency models for particular models of cars or any other thing because we know that the trip was fundamentally not allowed!

I hope your friend and their cousin are as well as they can be under the circumstances.

(1) It's unlikely because most (maybe all?) UK petrol stations are directly owned so not franchised, so it would have to be someone from a major chain who leaked it, that would be illegal, and they usually only keep images for a set period anyway which usually a month.
posted by atrazine at 2:41 AM on May 26, 2020 [1 favorite]


If this is correct it explains why we seem to be still getting low (1-2 people daily) levels of community transmission in my state; it also implies that a lack of social distancing will inevitably lead to a fresh epidemic: A passenger of the Ruby Princess who tested positive to coronavirus is suspected to have carried the “dormant” virus for almost 10 weeks before falling ill.
posted by Joe in Australia at 3:33 AM on May 26, 2020 [3 favorites]


Stockholm won't reach herd immunity in May, Sweden's chief epidemiologist saysMinnesota Public Radio News; H.J. Mai; May 26, 2020
Sweden's controversial approach to fighting the coronavirus pandemic has so far failed to produce the expected results, and there are calls within the country for the government to change its strategy.
posted by ZeusHumms at 7:48 AM on May 26, 2020 [5 favorites]


The piece in Science magazine linked above is very useful. That infections appear to be heavily clustering, with a small number of infected people responsible for the vast majority of the spread, almost all occurring indoors, has ramifications for how I'm thinking about risk.

Stay out of bars and restaurants for the next 6 months, is what I'm saying.
posted by mediareport at 7:57 AM on May 26, 2020 [21 favorites]


A Lesson from Sweden on How Not to Respond to COVID-19Washington Monthly; Blake Fleetwood; May 26, 2020 • 'The Swedish government didn’t enforce social distancing. It’s now paying the price—in lives and in GDP.'
So, you might logically ask, should we really be reopening? ... [Don't] be convinced that it will help the economy much. Sweden has shown us that we can’t let everyone do what they want and be convinced that they will do the right thing—or that our healthcare system can handle the consequences. The stake in human lives is too great.

During a pandemic, society’s safety should not be decided by its people on a voluntary basis. A standard of what’s best for the greater good must prevail. More often than not, the right thing is not always the easiest. Let’s learn the right lesson from Sweden’s human sacrifice of thousands of its elderly people and set some boundaries for our cities to follow.
posted by ZeusHumms at 8:05 AM on May 26, 2020 [7 favorites]


From Katelyn Burns, one of the sharpest trans journalists around: LGBTQ people need queer spaces. The coronavirus has locked them out.

During an extended Thanksgiving break, Emma’s parents dangled her tuition in front of her like a “carrot on a string,” so she lied and agreed to go back to school as a male student — an agreement she quickly went back on once she had returned to school.

However, the coronavirus pandemic threw a wrench into her plan once Carleton decided to move to online classes on March 18. The college freshman is now back home — and back in the closet — because of Covid-19, cut off from the school LGBTQ center where she had met many of her friends and received emotional support.

posted by mediareport at 9:13 AM on May 26, 2020 [15 favorites]


WHO warns of "second peak" in areas where Covid-19 declining (Guardian live blog)
The world is still in the middle of the first wave of the coronavirus outbreak, WHO emergencies head Dr Mike Ryan told an online briefing, noting that while cases are declining in many countries they are still increasing in Central and South America, South Asia and Africa, Reuters reports. [...] “When we speak about a second wave classically what we often mean is there will be a first wave of the disease by itself, and then it recurs months later. And that may be a reality for many countries in a number of months’ time,” Ryan said.

“But we need also to be cognisant of the fact that the disease can jump up at any time. We cannot make assumptions that just because the disease is on the way down now it is going to keep going down and we are get a number of months to get ready for a second wave. We may get a second peak in this wave.” He said countries in Europe and North America should “continue to put in place the public health and social measures, the surveillance measures, the testing measures and a comprehensive strategy to ensure that we continue on a downwards trajectory and we don’t have an immediate second peak.”
Tory revolt grows as minister resigns over Dominic Cummings' lockdown trip (Guardian)
Douglas Ross, the MP for Moray, stepped down as a Scotland Office minister, saying he accepted Cummings felt he had acted in the best interests of his family when fearing he had coronavirus but these were “decisions others felt were not available to them”.

“While the intentions may have been well meaning, the reaction to this news shows that Mr Cummings’ interpretation of the government advice was not shared by the vast majority of people who have done as the government asked,” he said on Tuesday. “I have constituents who didn’t get to say goodbye to loved ones; families who could not mourn together; people who didn’t visit sick relatives because they followed the guidance of the government. I cannot in good faith tell them they were all wrong and one senior adviser to the government was right.”
posted by katra at 9:17 AM on May 26, 2020 [6 favorites]


Very much agree, winterhill.

Retail in the UK has been in steady structural decline for years now, online shopping has just taken much too large a chunk out of it. Is anyone going to go to the shops when there are constant, unpleasant reminders that you are in danger? A few weeks ago a commentator described many of the currently furloughed retail workers as being "already unemployed, they just don't know it yet". I think that's unfortunately true. Retail margins are low, many shops were barely hanging on and even a small decrease in footfall will finish them.

It would be one thing if we all woke up tomorrow and the virus had just disappeared. I reckon the mad outburst of joy would indeed save retail but that's not going to happen is it? We're going to gradually crawl our way back to normality and suffer economically. Shops are screwed.
posted by atrazine at 9:22 AM on May 26, 2020 [3 favorites]


"Who the hell is buying a new car right now?"

I have been hearing of multiple friends who live in cities without cars planning to buy cars because they don't feel comfortable with public transit.

I can't even imagine the nightmare that traffic will be if/when significant numbers of people start commuting to work/school again.
posted by Salamandrous at 12:13 PM on May 26, 2020 [10 favorites]


This breakdown of retail sales data shows why Amazon is leading the stock market, CNBC Markets, Pippa Stevens, 5/15/2020:
  • Consumer spending plunged by a record 16.4% in April, but one category saw a bounce: nonstore retailers.
  • Included in this category, which saw an 8.4% month-over-month increase, is online shopping.
  • Amid the pandemic, online retailers like Amazon have seen a jump in sales. Shares of the Seattle-based company have gained nearly 30% this year.
CHART: Retail Store Sales by Category - Percent change from March to April 2020. Total retail sales dropped by 16.4 percent [clothing sales dropped by nearly 79%].
posted by cenoxo at 12:34 PM on May 26, 2020


I'm considering buying a new car--well, a new-to-me car, like a 2017/18/19. My current car is a 2009 Toyota with 100K miles on it. I've been saving money to buy my next car. Do I head into the coming Depression with a 10 year old car? Or do I use some of my savings on something much newer? Given the news about Hertz's bankruptcy, there may be a lot of bargains out there.
posted by Sublimity at 3:00 PM on May 26, 2020 [4 favorites]


Kaiser Health News has a Bill of the Month feature that dissects a hospital bill and tries to help resolve it in the patient's favor. This month it's a father with COVID-like symptoms whose insurer refused to pay for his ER visit after a nurse at an urgent care facility directed him there, even though "UnitedHealthcare is one of many insurers that announced it will waive cost sharing for COVID-19 testing-related visits and treatment." Of course, hospitals weren't offering the actual test to any but the most serious cases at that point. Last month's Bill of the Month featured a similar "we'll only pay if there's a test but you weren't allowed to get tested so we won't pay" situation. Both links have suggestions for making sure your testing is indeed free of charge.
posted by mediareport at 6:40 PM on May 26, 2020


In New Zealand, the last person in hospital with coronavirus has been discharged. It is the 5th day in a row with no new cases. When and how to move from Alert Level 2 to Level 1 is now an open debate. At this stage it seems that a third of households are in financial difficulty and many more "on the edge".
posted by i_am_joe's_spleen at 6:50 PM on May 26, 2020 [16 favorites]


Oh and also, while international tourism has cratered leaving a terrible hole in the NZ economy, there is a silver lining. We have housed all our homeless in the empty motels and hotels. It is believed that at least temporarily, there are no homeless people in New Zealand.
posted by i_am_joe's_spleen at 7:26 PM on May 26, 2020 [40 favorites]


That's amazing about having everyone housed, even if just temporarily.

Meanwhile, here in Miami, the police decided to roll up at least one camp during the worst of the pandemic with no warning.

Some have been made homeless by shitbag landlords flouting the emergency order that temporarily forbids evictions statewide, or using quasi-legal bullying tactics to force tenants out. A lot more people are probably going to be out of a home in a couple of weeks given that there are at least 100,000 people in the state who have yet to receive any unemployment benefits despite being out of work for months. It will be impossible for them to pay what they owe before the eviction moratorium expires June 2nd even though they are owed more than enough by the state.

To be fair, the Homeless Trust and others have been working hard to test and house people, including in currently vacant hotel rooms, but between their own bureaucracy, people with difficult to accommodate needs and those who outright refuse to take the offered assistance, many people have remained unhoused throughout and it's about to get worse..
posted by wierdo at 10:18 PM on May 26, 2020 [3 favorites]


COVID-19 is raging through Quebec prisons

Prisoners, Laberge says, were taking the pandemic more seriously than guards. “When we had the ability to leave our cells for two or three hours a day, we were able to organize so a few of the guys from the cleaning team would be at the phones cleaning them,” Laberge says. “Same for things like the handrails. We were the ones doing it.”

...“Even after the deadlock, with every inmate in his cell and can’t come out, there was still cross contamination happening from unit to unit. And it was the guards that were doing it. They continued the practice of making guards go from one unit to the next. So they were doing a cross contamination, they weren’t observing anything, even social distancing – the guards, they didn’t practice it.”


It's a detailed report with evidence from a number of prisons in the province.
posted by mediareport at 6:00 AM on May 27, 2020 [3 favorites]


Madeline Barron's amazing podcast In The Dark refocussed on Coronavirus in the Delta in April, and their second episode features the inmates' perspective, as the pandemic neared, from inside Parchman prison. (Where there've been more cases since, all while they're sewing masks.)
posted by progosk at 6:46 AM on May 27, 2020 [2 favorites]


In a new Associated Press poll, 49% of U.S. citizens say they plan to get vaccinated aginst COVID-19 once a vaccine becomes available. 31% aren't sure, and 20% say they would refuse.

“I am not an anti-vaxxer,” said Melanie Dries, 56, of Colorado Springs, Colorado. But, “to get a COVID-19 vaccine within a year or two ... causes me to fear that it won’t be widely tested as to side effects.”

Dr. Francis Collins, who directs the National Institutes of Health, insists safety is the top priority...“I would not want people to think that we’re cutting corners because that would be a big mistake. I think this is an effort to try to achieve efficiencies, but not to sacrifice rigor,” Collins told the AP earlier this month.

“Definitely the worst thing that could happen is if we rush through a vaccine that turns out to have significant side effects,” Collins added.

posted by mediareport at 7:27 AM on May 27, 2020 [2 favorites]


We cannot keep ignoring the possibility of airborne transmission. Here’s how to address it. (Joseph Allen, WaPo Opinion, May 26, 2020)
Joseph Allen is director of the Healthy Buildings program at Harvard T.H. Chan School of Public Health and co-author of “Healthy Buildings: How Indoor Spaces Drive Performance and Productivity.”
If you’ve been following advice about covid-19 from the Centers for Disease Control and Prevention or the World Health Organization, chances are you’ve heard a lot about how the coronavirus can travel through large droplets via coughing and sneezes. You’ve also probably heard about the virus being transmitted through surfaces. But you probably haven’t heard anything about airborne transmission, which many organizations have largely ignored. [...] I’ve been warning about airborne transmission of covid-19 since early February. The explosive transmission on the Diamond Princess cruise ship, as well as other coronavirus outbreaks, constituted telltale signs that airborne transmission was happening. Close contact transmission was likely happening on that cruise ship, but the disease had spread far more quickly than non-airborne diseases typically spread. Since then, evidence has continuously pointed to airborne transmission of covid-19, as my colleague Linsey Marr and I outline in a recent paper. [...] The evidence suggests that mitigating airborne transmission should be at the front of our disease-control strategies for covid-19. In some ways, that only bolsters public health measures already in place, such as avoiding groups and wearing masks in public. But it also requires that we minimize exposure to airborne pathogens, especially indoors.

To do that, we need to do two things. First, maintain physical distancing. Six feet is good, but 10 feet is better. Second, we must deploy healthy building strategies, such as refreshing stale indoor air.
Social Distancing Is Not Enough (Derek Thompson, Atlantic, May 22, 2020)
COVID-19 has mounted a sustained attack on public life, especially indoor life. Many of the largest super-spreader events took place inside—at a church in South Korea, an auditorium in France, a conference in Massachusetts. The danger of the indoors is more than anecdotal. A Hong Kong paper awaiting peer review found that of 7,324 documented cases in China, only one outbreak occurred outside—during a conversation among several men in a small village. The risk of infection indoors is almost 19 times higher than in open-air environments, according to another study from researchers in Japan.

[...] Before we review the relevant studies and draw out lessons for the future of the great indoors, a brief word of humility. Our understanding of this disease is dynamic. Today’s conventional wisdom could be tomorrow’s busted myth. Think of these studies not as gospels, but as clues in a gradually unraveling mystery.
posted by katra at 7:40 AM on May 27, 2020 [6 favorites]


The Atlantic posted a striking photo gallery of the ways folks are interacting through plastic - ranging from grocery store shields to schools to plastic-mediated hugs - across the world.
posted by mosst at 9:13 AM on May 27, 2020 [5 favorites]


Mod note: One deleted; let's not make this thread about Trump admin response, there's multiple other threads to talk about that.
posted by LobsterMitten (staff) at 9:14 AM on May 27, 2020 [6 favorites]


Coronavirus may never go away, even with a vaccine (WaPo / MSN reprint)
With so much else uncertain, the persistence of the novel virus is one of the few things we can count on about the future. That doesn’t mean the situation will always be as dire. There are already four endemic coronaviruses that circulate continuously, causing the common cold. And many experts think this virus will become the fifth — its effects growing milder as immunity spreads and our bodies adapt to it over time. [...] Combating endemic diseases requires long-range thinking, sustained effort and international coordination. Stamping out the virus could take decades — if it happens at all. Such efforts take time, money and, most of all, political will.

[...] People also keep talking of returning to normal, said Natalie Dean, a disease biostatistician at the University of Florida. But a future with an enduring coronavirus means that normal no longer exists. “As we find different ways to adapt and discover what works, that’s how we’re going to start reclaiming parts of our society and life,” she said. [...] Leaders desperately need to shift their response from short-term crisis management to long-term solutions, [Irwin Redlener, director of Columbia University’s National Center for Disaster Preparedness] and other experts say.
posted by katra at 11:24 PM on May 27, 2020 [1 favorite]


This type of reporting in the press is totally unhelpful.

I don't know if you read the full article or just the quoted part. The actual article was great and was more about the need for longer term and more comprehensive planning. It definitely wasn't tossed off sensationalism. I agree that we don't need more articles about COVID-19 magically disappearing, but that's not a mainstream view amongst experts, it's more akin to climate change denial or creationism.
posted by snofoam at 4:03 AM on May 28, 2020 [8 favorites]


South Korea's coronavirus fight 'in trouble' amid surge in cases

69 of the new cases come from a single cluster at an online shopping warehouse west of Seoul, which "appears linked to an outbreak that emerged in several Seoul nightclubs and bars in early May...Health officials said on Thursday they would be conducting on-site inspections of logistics centres across the country, to develop better policies for preventing outbreaks at such facilities."

More: 6-Year-Old Tests Positive For Coronavirus, Complicating South Korea's School Reopening Plans
posted by mediareport at 5:47 AM on May 28, 2020 [1 favorite]


Coronavirus may never go away, even with a vaccine

I will probably talk about this more in a related thread, where I have been saying things like "if we all recognized a broadly-applied 'disabling' condition, then we could develop policies, such as UBI and universal health care, and other structural supports that disabled people and others have been long been advocating for, but now also to promote community health and safety in the midst of an unprecedented public health emergency."

This type of reporting in the press is totally unhelpful.

After my health crisis nearly two years ago, it was alarming to grapple with increasing evidence that "normal no longer exists," and I resisted, and it sometimes didn't work out well for me. It's still hard, and even harder now during the pandemic, but in some ways, I feel like I've had more time to figure out how to 'reclaim parts of society and life.' So I thought the article struck a hopeful tone, including because it pushes back on the rushed reopening narratives, and because it seems to bolster the idea that Ed Yong reported on recently, that “It’s a question of political will, not scientific discovery.

In my personal analogy, it was unhelpful to have it suggested that I could relatively quickly return to work and go back to "normal," as if I only had a short-term health issue to push through. It took months for it to become clear that there would be no return to "normal" for me and that instead, I would have to adapt. American society is roughly and imperfectly configured for adaptations to disabling conditions with policies and laws that theoretically could be expanded, such as the ADA, SSDI, and Medicare. The ADA has meant buildings had to change, and workplace practices have had to change, and SSDI is essentially a UBI program. In America, we also have powerful mechanisms that can protect civil rights, and we have a crisis of institutional racism that demands action right now.

More broadly, I am reminded of what Matthew Lopez wrote recently in the Guardian about Larry Kramer:
In revisiting Larry Kramer’s life, I cannot help but think about the world he exited. It is sadly fitting that the United States slouched to 100,000 deaths from the coronavirus on the very day that he died. One has to but look at the statistics to see that this has become a black disease, a Latinx disease and a disease of poverty. As states begin reopening earlier than medical experts advise, as middle-class white Americans insist it is their constitutional right to go clothes shopping, to go to parties and to hair salons – all without wearing masks – I look back at Kramer’s words to Jane Pauley: “There’s no question in my mind, if this were happening to you and the white, straight middle-class community it would have been attended to a long time ago.”
posted by katra at 9:20 AM on May 28, 2020 [14 favorites]


Useful round-up of the types of spikes Europe's various "re-opened" countries are seeing.
posted by progosk at 9:59 AM on May 28, 2020 [1 favorite]


Unfortunately, that article uses the same word 'lockdown' to describe very different things. It is something we have complained about here. France's lockdown exit is equivalent in many ways to Netherlands under lockdown. And no mention is made of what Denmark is actually allowing now. So very much apples to oranges.

Netherlands in any case is opening restaurants next week. Let's see how that goes in a couple weeks. Also, travel operators in Europe are beginning to assure everyone that they can plan their July vacation. Again, lets see how that goes...
posted by vacapinta at 11:43 AM on May 28, 2020 [1 favorite]


Maybe tangerines to oranges, more like, but yes, some of the devil is definitely in the details. It does seem interesting to identify new spike/cluster location types all the same, given we've now learned there's the k number to consider, too...

"what Denmark is actually allowing now"

An update from Denmark, published this morning.
posted by progosk at 11:49 AM on May 28, 2020 [4 favorites]


if this were happening to you and the white, straight middle-class community it would have been attended to a long time ago.”

Yeah, a friend of mine said as much the other day. If it affects rich white men, it WILL be taken care of, so don't worry about them not coming up with a vaccine!

That of course remains to be seen if it is scientifically possible, and I admit every time I read "there may never be a vaccine," I lose it even harder.
posted by jenfullmoon at 12:03 PM on May 28, 2020 [2 favorites]


My county's moving to a 'modified Phase 1 reopening' on Monday, but retail will only be for curbside pickup. So my shop will be staying closed at least another couple of weeks, and tbh I'm more relieved than anything else.
posted by nonasuch at 2:51 PM on May 28, 2020 [1 favorite]


There does not seem to be a spike in Denmark at this point. I woke up to an alarmist headline in my newsfeed, about a spike in Copenhagen, but it turned out to be two people who were hospitalized Wednesday, research is going on to track the infections. The more sober news are more about what we can learn from the whole thing, and how to remain safe. Nobody is claiming we can go back to the before times, but things are getting better.

Personally, I'm in Copenhagen for minor surgery, and it's quite shocking to see the lack of social distancing, compared to what I'm used to at this point. But after the initial shock, I feel safe enough.
posted by mumimor at 8:51 PM on May 28, 2020 [1 favorite]


China Rules Out Animal Market and Lab as Coronavirus Origin (Wall Street Journal, May 26, 2020)
--
The first case of SARS-CoV-2 didn't emerge from a Wuhan wet market, according to experts at the Wuhan Institute of Virology (WIV). (LiveScience, May 28, 2020) Instead, the live animal market may have been the site of a superspreader event, where one person spread the virus to many other people, one US-based expert told Live Science. [...] A number of early cases of the outbreak in Wuhan were tied to the Huanan Seafood Wholesale Market. Later, researchers took environmental samples that suggested the virus had landed on surfaces in the market. But in the period since, tissue samples from the market's animals have revealed no trace of the virus. For the virus to jump from animals to humans, the animals have to actually be carrying it.
--
The Chinese CDC now says the coronavirus didn't jump to people at the Wuhan wet market — instead, it was the site of a super-spreader event (Business Insider, May 28, 2020) A growing body of research supports the Chinese CDC's conclusion that the outbreak's origins were unrelated to the market. The virus seems to have been circulating in Wuhan before those 41 cases were reported: Research published in January showed that the first person to test positive for the coronavirus was likely exposed to it on December 1, then showed symptoms on December 8. The researchers behind the study also found that 13 of the 41 original cases showed no link to the wet market.

Similarly, an April study suggested that the coronavirus had already established itself and begun spreading in the Wuhan community by early January. The identity of "patient zero" hasn't been confirmed, but it may have been a 55-year-old man from China's Hubei province who was infected on November 17, according to the South China Morning Post (SCMP), which reviewed government documents.
--
China again reports no new coronavirus cases (Al Jazeera, May 28, 2020, 00:46 GMT) Health authorities in China have reported no new confirmed coronavirus cases in the mainland as of the end of May 28.
posted by Iris Gambol at 9:40 PM on May 28, 2020 [8 favorites]


I am going to stop giving these updates after this, unless things get worse again.

New Zealand has had seven days in a row of no new cases
. There is just one person still in hospital. There have been 22 deaths out of roughly 5 million people. From today, social gatherings of up to 100 people are allowed. "Normal" life is not quite here yet, but it feels like we're on the edge. Scare quotes because without tourism, and with most people who can preferring to work from home, and many businesses mortally wounded, we must wait and see what the "new normal" will be. There is a lot of anxiety out there and much of it highly justified. But fingers crossed, for now, we seem to have made it out the other side.
posted by i_am_joe's_spleen at 12:20 AM on May 29, 2020 [16 favorites]


I really like local immediate facts-as-we-know-them roundups, thank you. I think it’s the good side of the global conversation.
posted by clew at 10:07 AM on May 29, 2020 [10 favorites]




First documented coronavirus case in someone who was at that Lake of the Ozarks pool party last weekend. Let's hope the outdoor scenario dispersed the virus enough that we don't see a new cluster arising, but they probably were indoors for long periods as well.
posted by mediareport at 7:20 PM on May 29, 2020 [4 favorites]


Can't help but note this idiocy at the bottom of the article:

People who may have been in contact with the person are asked to monitor themselves for COVID-19 symptoms.

If a person develops symptoms, they are asked to self-isolate until they receive a negative COVID-19 test.


Asymptomatic transmission doesn't exist for these people, apparently.
posted by mediareport at 7:35 PM on May 29, 2020 [3 favorites]


Looks like an epic day/night of drinking though...

4 hours at one place, a 40 minute drive to the next place, for another 4 hours of drinking, then back to the first place for a nightcap. Then breakfast the next day, at 1pm for some Buffalo Wild Wings...
posted by Windopaene at 8:10 PM on May 29, 2020 [1 favorite]


Why was Lombardy hit harder than Italy's other regions?
This is quite interesting and a reminder that it wasn't "Italy" that was very hard hit, but mainly Lombardy.
posted by mumimor at 9:38 PM on May 29, 2020 [4 favorites]


The soccer game superspreader event didn't help.
posted by Windopaene at 11:00 PM on May 29, 2020 [3 favorites]


Is any state/county in the USA doing proactive testing of high risk people outside of healthcare (bus drivers, grocery clerks, delivery people) yet? Until that starts happening we will never stop the asymptomatic spreading events -- we'll just be moving slower towards another exponential increase.
posted by benzenedream at 12:17 AM on May 30, 2020 [4 favorites]


The anonymous article in the Guardian about the track and trace system is pretty grim reading in terms of anyone actually leading this thing.
posted by paduasoy at 1:35 AM on May 30, 2020 [2 favorites]


Sweden also starts opening up: sporting events (without audience) are now permitted, and secondary schools, continuing education, and universities open from 15 June. However, after careful consideration the 70-year limit for avoiding all social contact remains.

The school opening decision is based on a literature review, the low impact of covid19 on secondary school-age people, and register studies showing that primary and pre-school personnel have fallen ill in a slightly lower rate than the population mean.

It’s going to be interesting to see how university classes will be run in Autumn term.
posted by froghopper at 12:36 AM on June 1, 2020 [1 favorite]


How the libertarian right plans to profit from the pandemic.
Disaster capitalists dream of disassembling nation states for post-viral exploitation.
posted by adamvasco at 8:09 AM on June 1, 2020 [1 favorite]


US heads into a new week shaken by violence and frustration (AP)
The scale of the coast-to-coast protests has rivaled the historic demonstrations of the civil rights and Vietnam War eras. At least 4,400 people have been arrested for such offenses as stealing, blocking highways and breaking curfew, according to a count compiled by The Associated Press.
Crowded protests spark concerns about fresh outbreaks of the deadly coronavirus (WaPo, May 31, 2020)
Experts said it remains to be seen whether the protests will produce a surge in infections. Given the behavior on the street, they said, there is cause for concern. [...] “There are so many variables at play here: Extent of social distancing, ambient environmental conditions, number of people, extent of mask use, the effect of things like tear gas [and] pepper spray on susceptibility via different transmission routes,” Angela Rasmussen, a virologist at the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health, wrote in an email. “I don’t think there’s any way to know how bad it will be,” she added, “but there is likely to be increased cases in cities with large protests.”
Will Protests Set Off a Second Viral Wave? (NYT, May 31, 2020, updated Jun. 1, 2020)
The biggest concern is the one that has bedeviled infectious disease experts since the pandemic began, and it’s the coronavirus’s secret weapon: that it can be transmitted by people who don’t display any symptoms and feel healthy enough to participate in protests. [...] Dr. Ashish Jha, a professor and director of the Harvard Global Health Institute, said more than half of coronavirus infections are spread by people who are asymptomatic, including some who are infected but never go on to develop symptoms and others who don’t yet know they are sick. Arresting, transporting or jailing protesters increases the potential for spreading the virus. [...]

Dr. Scott Gottlieb, a former commissioner of the Food and Drug Administration, appearing on CBS’s “Face the Nation” on Sunday, also predicted the protests would lead to new “chains of transmission.” He said social and economic inequities, including poor access to health care, discrimination in health care settings, greater reliance on public transportation and differences in employment were all factors leading to a greater burden of Covid-19 disease among people of color.
posted by katra at 8:12 AM on June 1, 2020 [2 favorites]


The new coronavirus is losing its potency and has become much less lethal, a senior Italian doctor said on Sunday (Reuters, May 31, 2020) “In reality, the virus clinically no longer exists in Italy,” said Alberto Zangrillo, the head of the San Raffaele Hospital in Milan in the northern region of Lombardy, which has borne the brunt of Italy’s coronavirus contagion. “The swabs that were performed over the last 10 days showed a viral load in quantitative terms that was absolutely infinitesimal compared to the ones carried out a month or two months ago,” he told RAI television.

Italian Doctor's Claim Coronavirus Is Getting Weaker Questioned by Experts (Newsweek, June 1, 2020) Zangrillo, who is also professor in Anesthesiology and Intensive Care at Università Vita-Salute San Raffaele, said he and other researchers had signed an editorial to say there was no need to create additional intensive care places, as "our emergency rooms and our intensive care units are empty." He said MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome)—diseases also caused by coronaviruses—both "disappeared forever." [...]

Willem van Schaik, professor of Microbiology and Infection at the University of Birmingham, U.K., told Newsweek it is difficult to assess the validity of the claims being made by Zangrillo because no scientific evidence has been published to support it. "It is, in my opinion, unlikely that the virus itself is weakening but, if these observations from Italian hospitals are correct, I believe it is more likely caused by patients being infected with lower doses of the virus than any changed inherent property of the virus," he said.
--
Covid-19 expert Karl Friston: 'Germany may have more immunological “dark matter”' (The Guardian, May 31, 2020) "We’ve been comparing the UK and Germany to try to explain the comparatively low fatality rates in Germany. The answers are sometimes counterintuitive. For example, it looks as if the low German fatality rate is not due to their superior testing capacity, but rather to the fact that the average German is less likely to get infected and die than the average Brit. Why?

"There are various possible explanations, but one that looks increasingly likely is that Germany has more immunological “dark matter” – people who are impervious to infection, perhaps because they are geographically isolated or have some kind of natural resistance. This is like dark matter in the universe: we can’t see it, but we know it must be there to account for what we can see. Knowing it exists is useful for our preparations for any second wave, because it suggests that targeted testing of those at high risk of exposure to Covid-19 might be a better approach than non-selective testing of the whole population." - Neuroscientist Karl Friston, of University College London, builds mathematical models of human brain function. Lately, he’s been applying his modelling to Covid-19, and using what he learns to advise Independent Sage, the committee set up as an alternative to the UK government’s official pandemic advice body, the Scientific Advisory Group for Emergencies (Sage)
--
posted by Iris Gambol at 11:18 AM on June 1, 2020 [1 favorite]


Zangrillo, who is also professor in Anesthesiology and Intensive Care at Università Vita-Salute San Raffaele

Zangrillo is a spot-light seeking celebrity doc (he was Berlusconi's personal physician, and just a few years ago charged with vast fraud at his hospital...), not someone to keep on your expert pedestal...
posted by progosk at 12:03 PM on June 1, 2020 [18 favorites]


Thank you, progosk, I was composing an ask question about that! In the Guardian interview, he cites some 'correct' predictions his modeling team has made about the coronavirus, but an alternative Sage sounds so weird; and in several places Bizarro Sage is in agreement with/more conservative than regular Sage.
posted by Iris Gambol at 12:19 PM on June 1, 2020 [1 favorite]


Swimmers and sunbathers turned out in droves on Monday as Spain reopened nearly all its beaches as part of government steps to revive a devastated tourist industry. (Irish Times, June 1, 2020) Spain also reported no new coronavirus deaths for the first time in months on Monday.

Bilbao’s Guggenheim Museum reopened its doors, the first such institution to do so since the strict lockdown imposed on the country in mid-March began to be eased. Seeking to entice international visitors back for a planned reopening in July, the government said it aimed to guarantee health conditions. [...] Tourism accounts for one in eight jobs in Spain, the world’s second most visited country after France, and contributes more than 12 per cent of Spanish GDP.
posted by Iris Gambol at 1:37 PM on June 1, 2020 [1 favorite]


The epic battle against coronavirus misinformation and conspiracy theories (Nature, May 27, 2020)
Researchers have been monitoring the flow of information online for years, and have a good sense of how unreliable rumours start and spread. Over the past 15 years, technology and shifting societal norms have removed many of the filters that were once placed on information, says Amil Khan, director of the communications agency Valent Projects in London, who has worked on analysing misinformation for the UK government. Rumour-mongers who might once have been isolated in their local communities can connect with like-minded sceptics anywhere in the world. The social-media platforms they use are run to maximize user engagement, rather than to favour evidence-based information. As these platforms have exploded in popularity over the past decade and a half, so political partisanship and voices that distrust authority have grown too.

[...] [Joan Donovan, a sociologist at Harvard University in Cambridge, Massachusetts] is trying to teach others to spot the trail of misinformation: as with a viral outbreak, it’s easier to curb the spread of misinformation if it’s spotted close to its source, when fewer people have been exposed.
posted by katra at 1:38 PM on June 1, 2020 [5 favorites]


In single Brazilian state, some 2,400 meat plant workers catch coronavirus, officials say (Reuters, June 1, 2020) More than a quarter of the confirmed novel coronavirus cases in Brazil’s southernmost state of Rio Grande do Sul are among meat plant workers, the labor prosecutors’ office said on Monday. The prosecutors said in a statement that an estimated 2,399 employees from 24 slaughterhouses in 18 municipalities of the state have been infected. That equates to 25.7% of the 9,332 confirmed cases of coronavirus in Rio Grande do Sul as of Sunday, according to health ministry statistics.

The findings corroborate evidence that meatpackers have become hotspots in Brazil for the coronavirus, which causes the COVID-19 respiratory disease. Overall, Brazil has more than 500,000 cases and nearly 30,000 deaths, according to a Reuters tally. Brazil is the world’s biggest beef and chicken exporter and the fourth largest pork exporter.
posted by Iris Gambol at 1:45 PM on June 1, 2020 [1 favorite]


The WHO launched a voluntary Covid-19 product pool. What happens next? (STAT News, May 29, 2020) After weeks of planning, the World Health Organization formally launched a voluntary pool to collect patent rights, regulatory test data, and other information that could be shared for developing drugs, vaccines, and diagnostics to combat Covid-19. The effort reflects rising concern that some Covid-19 medical products may not be accessible for poorer populations – in any country. By establishing a voluntary mechanism under the auspices of the WHO, the goal is to create a pathway to attract numerous governments, as well as industry, universities and nonprofit organizations.

Nonetheless, the initiative, which the WHO has called a “Solidarity Call to Action,” is getting off to a rocky start. So far, only three dozen countries have committed to joining. And notably, the pharmaceutical industry has dismissed the notion, which underlies concerns that such a project is unlikely to succeed without widespread involvement.
--

Solidarity Call To Action: Making the response to COVID-19 a public common good (World Health Organization)
--

[Jeez-o-pete. progosk, thanks for adding context for Zangrillo, absent from the Newsweek link, and kindly ignore the rest of my comment. I'm putting myself down for a nap.]
posted by Iris Gambol at 2:05 PM on June 1, 2020 [4 favorites]


Is any state/county in the USA doing proactive testing of high risk people outside of healthcare (bus drivers, grocery clerks, delivery people) yet?

In New Mexico, testing is open to all workers.

I don't remember the details, but I think there is also targeted testing. That is, I think they are trying to test a co-workers of anyone who tests positive.
posted by NotLost at 3:10 PM on June 1, 2020


From the Andes to Tibet, the coronavirus seems to be sparing populations at high altitudes (Washington Post, May 31, 2020) ... Scientists warn that the apparent pattern might not last, but the as-yet-unexplained phenomenon has them intrigued. Researchers are starting to investigate a possible relationship between the coronavirus and altitude. In one peer-reviewed study, published in the journal Respiratory Physiology & Neurobiology, researchers from Australia, Bolivia, Canada and Switzerland looking at epidemiological data from Bolivia, Ecuador and Tibet found that populations living above 3,000 meters (9,842 feet) reported significantly lower levels of confirmed infections than their lowland counterparts. They found that Tibet’s infection rate was “drastically” lower than that of lowland China, the rate in the Bolivian Andes was one-third that of the rest of Bolivia, and the rate in the Ecuadoran Andes was one-fourth that of the rest of Ecuador.
posted by Iris Gambol at 9:48 PM on June 1, 2020 [4 favorites]


New coronavirus laws in England have made it illegal for couples who live in different homes to have sex indoors and stay overnight. (The Independent, May 31, 2020) The Health Protection Regulations previously banned people leaving home without “reasonable excuse”, but the provision has been replaced by stringent curbs on where people can sleep and gather together. The law, which will be laid in parliament on Monday, says: “There is a gathering when two or more people are present together in the same place in order to engage in any form of social interaction with each other, or to undertake any other activity with each other.”

A separate provision makes it illegal to stay overnight outside your home “without reasonable excuse”, which can include moving home, work, attending funerals, providing care and escaping harm. An exception has not been made for couples who do not live together, meaning that they can spend time together outdoors but not inside. People who have sex outside can be punished under pre-existing laws on outraging public decency and indecent exposure. Police can arrest or fine people for breaking the law, with the default penalty standing at £100 in England, but do not have the power to check for violations inside properties.
--
^This was a less shriek-y, non-paywalled headline about these new provisions, but I still don't understand how any of it can be reasonably enforced, esp. in the wake of the Dominic Cummings scandal. The Independent notes, "The new law contains a long list of exemptions, including for 'elite athletes' and their teams who need to train elsewhere and for children whose parents are separated," and that previous pandemic-related laws were not applied equally: "Almost 17,000 fines had been handed out by police in England and Wales by 25 May. Provisional statistics show the penalties have been racially disproportionate and suggest a “postcode lottery” of enforcement between different police force areas."
posted by Iris Gambol at 10:09 PM on June 1, 2020 [5 favorites]


To be clear, the previous round of regulations also made that illegal. It's kind of weird framing because it is equally illegal to be in someone else's house for *any* reason other than the defined ones, there's nothing explicitly in there about sex. In the previous regulations it was also illegal to be outside of your house without good excuse so it's not like this is newly against the rules.

People started breaking some of these rules in some areas about 3 weeks ago after the Stay Alert messaging replaced the Stay Home messaging and despite worries that it might do so, the Cummings thing doesn't seem to have made much difference. We'll see if that holds.

So far the rule breaking that I've seen in the press seems to be mostly outdoors groups larger than the allowable 6, hopefully that will be low risk.

Does anyone know if other heavily infected European countries (Spain, Italy, France) have got contact tracing running at this point? I know that the Italians are soft launching their app and that the French have just approved it for release but no idea if they're doing large scale contact tracing the old fashioned way as well. The UK is trying but our system won't be fully operational until end of next week or so at the earliest. I'm curious if that is out of step, my sense is that on the one hand it's not but on the other hand, Spain, Italy, the UK, & France have all been a bit shit in our collective response so its not really something to benchmark against.
posted by atrazine at 1:19 AM on June 2, 2020 [2 favorites]


The Correspondent has a roundup of contact tracing technology around the world. It can be found here.
posted by Too-Ticky at 1:59 AM on June 2, 2020 [1 favorite]


Thanks, that's an excellent roundup (and De Correspondent is always excellent so no surprise there).

What's fascinating to me is that a month ago there were there intense debates going on about narrow technical differences between protocols and finding the balance between privacy and efficacy and it turns out that actually the reason the apps don't seem to work is that people don't like taking instructions from an app!
posted by atrazine at 2:31 AM on June 2, 2020


Journal retracts study claiming masks ineffective in preventing Covid-19 spread. Lower limit of detection issues, and PCR is already super sensitive to begin with.
posted by Comrade_robot at 3:23 AM on June 2, 2020 [10 favorites]


Is any state/county in the USA doing proactive testing of high risk people outside of healthcare (bus drivers, grocery clerks, delivery people) yet?

San Francisco is also offering testing "for any person living in San Francisco who has 1 symptom, or has been in close contact with a positive COVID-19 person. Any essential or frontline worker can also get tested, regardless of symptoms or exposure." In the Bay Area, "essential" has a specific definition, and it pretty much includes anyone who has to go out and about for work, so it should not be limited to healthcare workers.

Now, how "proactive" they're being is another story. I think they just publicize the service generally and then take walk-ins. I read somewhere (sorry, no clue where at this point) that the county has bandwidth for something like 4K tests per day, but when I check the stats they are averaging well under 2K / day actual tests. The positive rate is comfortably under 5% - trending between 2-3% in the last 10 days, in fact - so maybe that's enough. But it sure would be nice to do more sentinel testing among at risk populations.
posted by Joey Buttafoucault at 7:22 AM on June 2, 2020 [1 favorite]


Similarly, there have been testing sites in South Florida where anyone (who has a car..) can get a test by appointment, regardless of symptoms, since mid-April. There has also been an ongoing effort to do random antibody tests, rather than hoping people show up to the regular testing sites.
posted by wierdo at 1:12 PM on June 2, 2020 [2 favorites]


Update from Denmark. I was reading an article about Sweden and that made me look at the local statistics. Just to say I don't check the official corona site every day anymore. We now have close to 10% of the population tested, and the known number of infected is 11.734. The minister of health was out to say that people with weak symptoms should get tested so the government can have the best possible data for decision-making. Everyone can get tested, but I think the antibody test is still a bit iffy. 99 people are hospitalized, and deaths have been consistently below five a day for two weeks. We can all exhale now.
I think I mentioned before that the borders to Germany, Norway and Iceland are open, and yesterday, I already saw tourists in the streets, and not only from those three countries, though they must have entered that way.
Social distancing is still upheld rigorously at workplaces and in public transportation, and the police locks down beaches and parks if they get too rowdy, but cafés in my neighborhood are almost back to the old times outdoors. Indoors they are social distancing.

The headlines are that some individuals are super-spreaders, and that big events are super-spreading, so right now the government is keeping a lockdown on big events indeterminately and trying to find super-spreading individuals to figure out why they have this.
posted by mumimor at 11:45 PM on June 2, 2020 [3 favorites]


Being from the Netherlands, I'm still not allowed into Denmark. Not a problem for me now, but I do hope it changes before August, because the hacker event I wanted to go to is on. They have halved the number of tickets, so there will be max. 150 people present, and there will be lots of little changes to make things as safe as possible.
posted by Too-Ticky at 1:33 AM on June 3, 2020 [2 favorites]


What's fascinating to me is that a month ago there were there intense debates going on about narrow technical differences between protocols and finding the balance between privacy and efficacy and it turns out that actually the reason the apps don't seem to work is that people don't like taking instructions from an app!

I think the fundamental problem is with the degree to which people will trust the advice of an app when it tells them to quarantine and/or get tested. Following such advice has big implications for most people: they have to isolate themselves from others in their household, they have to go and get tested, they have to stay home from their work, they have to divulge the names of others they have been close to.

For a moment, let's imagine that we have a video feed of a bus journey where an infected passenger is aboard. Which other passengers should we send a warning to? That will depend on where they were sitting with respect to the spreader, whether the spreader sneezed, coughed or talked a lot, what the spreader (and the other passengers) touched, whether there were barriers (like a glass partition) between the spreader and a particular other passenger, how the air was being circulated on the bus - and how long the spreader and passenger were in the same space. Only by considering all of this would we be able to determine whether it would be wise to sound the alarm for a particular passenger and put them - and those close to them - through all the worry and pain.

The ideal app would automatically as assimilate all of this information to give a decision which is reasonably reliable. But the technology is only really capable, in the best circumstances, of detecting a set of other passenger IDs with a time stamp for when they were collected and a location stamp accurate only to 10 metres or so. It is unaware of barriers, it is unaware of individual behaviours and it is unaware of exposure time.
posted by rongorongo at 1:59 AM on June 3, 2020 [1 favorite]


The ideal app would automatically as assimilate all of this information to give a decision which is reasonably reliable. But the technology is only really capable, in the best circumstances, of detecting a set of other passenger IDs with a time stamp for when they were collected and a location stamp accurate only to 10 metres or so. It is unaware of barriers, it is unaware of individual behaviours and it is unaware of exposure time.

Exposure time is the one thing in that list that it does know.

Really things like this will probably work best when combined with human contact tracing which is why I think that the UK design (which may still not work) is superior to the Google/Apple one. Feeding the list of people you were in prolonged contact with to a human contact tracing team is going to be much better than just blanket notifying people that they were near a person without really being able to quantify how near.

I do agree that we need to be better at managing the consequences of isolation. Why not pay anyone who has to isolate and cannot work from home 150% of their normal earnings? Yes it's an incentive for fraud but a little fraud is an acceptable price to pay for very high adherence, right?
posted by atrazine at 4:01 AM on June 3, 2020 [2 favorites]


I really wish there was some kind of pie chart of "How people contracted COVID-19" with slices for "member of household", "workplace", "social event", "public transport", "care home" etc.
posted by TheophileEscargot at 5:09 AM on June 3, 2020 [5 favorites]


Exposure time is the one thing in that list that it does know.
This Sciencemag article talks a little about how Bluetooth based Covid trackers could work. They quote one expert from the Swiss Institute of technology who mentions that they would really like the trigger criteria to be something like "you were within 2 metres of an infected person for at least 15 minutes". But that seems to be expecting a magical level of tracking capability from a smartphone that is only able to use a Bluetooth detected signal of another. Bluetooth devices have a radio range of up to 400 metres - depending on type. Just saying that somebody may have been infected because they were detected is not enough - so we probably need to measure signal strength and use it as a proxy for distance. But that will depend on details such as whether or not people have their phones in their pockets; transmission occurs over a sphere and can be limited in size by many sorts of objects. I can't see how this would be able to give people (either app owners or professional contract tracers) sufficient information to make meaningful decisions.

Human contact tracing can do an amazing job - finding exactly which diners were infected by an infected person in a restaurant for example - I just don't see how these kinds of apps are going to be the best use of their time.
posted by rongorongo at 7:54 AM on June 3, 2020 [2 favorites]


‘This is what happens to us.’ : How U.S. cities lost precious time to protect black residents from the coronavirusWashington Post; Robert Samuels, Aaron Williams, Tracy Jan and Jose A. Del Real; June 3, 2020
Interviews with nearly 60 public health experts, lawmakers and community leaders show that many of the first coronavirus testing sites went up in areas that happened to be whiter and more affluent, despite the requests of black leaders. Local governments — sometimes ignoring the pleas of community activists — targeted few of their education campaigns about prevention and social distancing specifically to African Americans, even as conspiracy theories spread that black people were immune to the disease.

Poor reporting of data, which initially masked the fact that the disease was disproportionately affecting black communities, remains a problem even as states move to reopen their economies.

Today, Americans living in counties with above-average black populations are three times as likely to die of the coronavirus as those in above-average white counties, according to an analysis of census and other data by The Washington Post.
posted by ZeusHumms at 8:24 AM on June 3, 2020 [6 favorites]


How Germany Saved Its Workforce From Unemployment While Spending Less Per Person Than the U.S. • 'The pandemic has cost jobs around the world. Comparing people who lost the same position in the two countries reveals that the U.S. government is spending more on unemployment — but its citizens are getting less.' (ProPublica; Alec MacGillis; June 3, 2020)
Instead of leaving employers to lay off workers en masse during hard times, and then have the workers apply individually for unemployment benefits, the German government subsidizes employers’ payrolls directly. Workers at a given firm or business agree to all work fewer hours, to spread what work remains among the whole staff instead of having some people laid off. But through government subsidies, they continue to receive a sizable share of their usual pay, as high as 87%, even if circumstances have them working few hours for the time being. When the economic crisis passes, they return to work full time, without the upheaval of losing a job and filing for unemployment on their own.

Some 10 million Germans are currently benefiting from Kurzarbeit, as it’s called there — literally, short-work. It has been adopted in similar form during the pandemic crisis by several other countries, including France, Spain and the U.K.

But in the U.S., despite half-hearted efforts in some states, the workshare approach, as it’s typically referred to here, is barely a blip on the horizon. Americans have filed more than 40 million claims for unemployment benefits in the past 10 weeks. Meanwhile, there are fewer than 200,000 Americans benefiting from workshare payments while remaining employed, according to a tally by Susan Houseman, an economist with the nonpartisan W.E. Upjohn Institute for Employment Research in Michigan.
It takes a different mindset to enact and support this; one that's not shortsightedly focused on immediate gains or winning the next polling cycle.
posted by ZeusHumms at 9:41 AM on June 3, 2020 [10 favorites]


The Secret, Absurd World of Coronavirus Mask Traders and Middlemen Trying To Get Rich Off Government Money'The federal government and states have fueled an unregulated, chaotic market for masks ruled by oddballs, ganjapreneurs and a shadowy network of investors.' (ProPublica; J. David McSwane; June 1, 2020)
posted by ZeusHumms at 9:46 AM on June 3, 2020 [2 favorites]


'We were packed like sardines': evidence grows of mass-event dangers early in pandemic (Guardian)
Research appears to back up stories of people who believe they got coronavirus at events UK government allowed to go ahead
Nobody who has had Covid-19, or the families of almost 50,000 British people who have since died from the virus, can be certain when they caught it. But Renoldi is one of almost 200 people who have contacted the Guardian in recent weeks to say they believe they became infected during the course of a major event in those first two weeks of March. [...] Meanwhile, some scientists who do not sit on Sage have reached very different conclusions to the government’s experts.

Dr William Hanage, associate professor of epidemiology at Harvard, says that many contacts are made at a packed modern event, and that the large crowds increase the chance of superspreading. “Cancelling large events at the early stage of a pandemic is an essential part of reducing opportunities for transmission. Stopping Cheltenham on its own would not have preserved the UK from the pandemic, but delays in a coherent response made the initial surge more intense, and cost lives.” Sir David King, the chief scientific adviser from 2000-07, argues that major events are “ideal” spreading episodes. Told by the Guardian that Sage scientists had advised that large gatherings have minimal impact on the spread of the virus, King said: “I find it very difficult to believe scientists said that; I am absolutely astounded.” He pointed out that countries that responded well to Covid-19, and kept cases low, banned crowds at events early, including Greece, Hong Kong, South Korea, Australia and New Zealand. “You need to get in early, test, trace and isolate infectious people, take all action to stop the virus spreading. But here they allowed the virus to spread. There is nothing to be said for going down the herd immunity route; it involves so many deaths.”
posted by katra at 10:49 AM on June 3, 2020 [3 favorites]


Recent analysis: Coronavirus is a blood vessel disease, study says — and its mysteries finally make sense (Salon, June 1, 2020) "Covid Toe," pediatric multisystem inflammatory syndrome, and other odd manifestations are finally tied together
--

[R]esearchers have woven these findings into a new hypothesis explaining why some patients slip into a fatal “second phase” of COVID-19, 1 week or so after hospitalization. The key is direct and indirect damage to the endothelial cells that line the blood vessels, particularly in the lungs, explains Peter Carmeliet, a vascular biologist at the Belgian research institute VIB and co-author of a 21 May paper in Nature Reviews Immunology. By attacking those cells, COVID-19 infection causes vessels to leak and blood to clot. Those changes in turn spark inflammation throughout the body and fuel the acute respiratory distress syndrome (ARDS) responsible for most patient deaths. (Science Magazine, published by the American Association for the Advancement of Science, June 2, 2020)
--

Endothelial cell infection and endotheliitis in COVID-19 (The Lancet, April 20, 2020) Our findings show the presence of viral elements within endothelial cells and an accumulation of inflammatory cells, with evidence of endothelial and inflammatory cell death. These findings suggest that SARS-CoV-2 infection facilitates the induction of endotheliitis in several organs as a direct consequence of viral involvement (as noted with presence of viral bodies) and of the host inflammatory response.
posted by Iris Gambol at 11:10 AM on June 3, 2020 [16 favorites]


The "X million pieces of PPE have been supplied" stuff during previous press briefings turned out to be counting one glove as one "piece of PPE".

i knew it! (stsl)
posted by 20 year lurk at 12:54 PM on June 3, 2020 [2 favorites]


Texas to enter third phase of reopening, despite rise in cases (WaPo live blog)
On Wednesday, Texas remained in an upward trend as the state had more than 1,500 new confirmed cases. Other states also showed a rise in confirmed infections, with Utah reporting 295 new cases Wednesday for a 31 percent increase over Tuesday’s numbers, according to an analysis by The Washington Post. Also, days after experiencing its highest number of cases (27) since the start of the pandemic, Alaska had 18 new cases on Wednesday. [...]
While cases rise, Florida prepares to move into Phase 2 of reopening
Most of Florida is on track to move into the second phase of reopening on Friday, Gov. Ron DeSantis (R) said Wednesday — the same day that the state reported its second-highest daily jump in coronavirus infections, with 1,317 new cases. [...] DeSantis has pushed to reopen the state and argued that the economic benefits outweigh the health risks, a calculus many public health officials reject. [...]
Cases rise in Arizona weeks after stay-at-home order is lifted
The state health department reported 973 new confirmed coronavirus cases and 40 related deaths on Wednesday, a day after it registered a record rise in infections: 1,127 in 24 hours. In total, the state has confirmed 22,223 coronavirus cases and 981 deaths. [...] The return to economic and social activities, however, probably will come at a cost to public health, former Food and Drug Administration commissioner Scott Gottlieb told CNBC on Wednesday. “A state like Arizona is concerning,” he said. “The scope of the rise and the velocity of it is concerning. I think its going to be vary hard, though, for a lot of these governors to hear a suggestion to go backward and start implementing the mitigation again.” [...] “And that just sets up more risk — that a state like Arizona can have a very large outbreak and end up reseeding parts of the country,” he said.
posted by katra at 5:20 PM on June 3, 2020 [5 favorites]


Meanwhile, New Zealand’s government will consider a move to lift all Covid-19 restrictions except border controls after Jacinda Ardern, the prime minister, said an early lockdown of the country was on track to eliminate the virus “ahead of schedule.” (The Guardian, June 2, 2020)

Her comments came as health officials announced an 11th straight day of no new Covid-19 cases recorded in New Zealand. It also increases the likelihood that New Zealand could jettison physical distancing measures entirely as early as next week, while other nations struggle to contain the coronavirus. Only one person in New Zealand is still recovering from Covid-19 and they are not being treated in hospital, 22 people have died, [and] no additional deaths were reported on Tuesday.
posted by Iris Gambol at 7:54 PM on June 3, 2020 [6 favorites]


Brazil this month will start testing an experimental vaccine against the novel coronavirus being developed by researchers at the University of Oxford and AstraZeneca Plc, Brazil's health surveillance agency Anvisa and the Federal University of Sao Paulo (Unifesp) said.
posted by adamvasco at 7:58 PM on June 3, 2020


"Recent analysis: Coronavirus is a blood vessel disease, study says — and its mysteries finally make sense (Salon, June 1, 2020) 'Covid Toe,' pediatric multisystem inflammatory syndrome, and other odd manifestations are finally tied together"

This is not unexpected and involves the focus of much research about COVID-19's etiology.

In response, I just wrote a comprehensive, carefully researched, technical, and thoroughly cited draft comment regarding COVID-19 and endothelial cells, summarizing the comprehensive relationship between SARS-Cov-2, angiotensin, the ACE2 enzyme and receptors, the cytokine storm, the distinctive and imbalanced innate immune response triggered by SARS-Cov-2, and the most severe symptoms of COVID-19: actute respiratory distress syndrome (ARDS), disseminated intravascular coagulopathy, and gastrointestinal distress.

Unfortunately, while I'm moderately pleased with my draft comment's flow, completeness, and credibility; it needs a rewrite for more clarity and accessibility, a clear and easy-to-read summary, and the addition of those many supporting links and citations. So, I may not finish it tonight.

Those interested and impatient for a starting point and orientation can follow the google searches on the italicized terms from the previous paragraphs, as well as bat-CoV-RaTG1 and pangolin-CoV-2020; also secondary hemophagocytic lymphohistiocytosis (sHLH).
posted by Ivan Fyodorovich at 8:06 PM on June 3, 2020 [12 favorites]


Correction: "Pangolin-CoV-2020" in that last paragraph should have been pan_SL-CoV_GD.
posted by Ivan Fyodorovich at 10:06 PM on June 3, 2020 [2 favorites]


Netherlands opens up travel slightly on June 15, but not to Brits:

‘The message is, we do not want British people and Swedes here at the moment,’ he said. ‘If they do come, they will have to go into quarantine for two weeks.’ From June 15, people from the Netherlands will be able to visit 12 countries, including Germany, Belgium, Italy, Croatia and the Dutch Caribbean islands. ‘The health risks have to be the same as they are here,’ Rutte said.

posted by vacapinta at 1:46 AM on June 4, 2020 [2 favorites]


The Dutch don't want the Brits anyway. Their economy isn't reliant on tourism and vast numbers of British visitors to Amsterdam spend their time drinking to excess, abusing drugs and gawping at sex workers like they're in some kind of zoo.

Why do you British hate yourselves so much? I mean, I get why other people mightn't like you - god knows there's reason enough - but it seems cruel to inflict it on yourselves.
posted by atrazine at 4:17 AM on June 4, 2020 [3 favorites]


Brazil this month will start testing an experimental vaccine against the novel coronavirus being developed by researchers at the University of Oxford and AstraZeneca Plc, Brazil's health surveillance agency Anvisa and the Federal University of Sao Paulo (Unifesp) said.

Not surprising. In a weird way countries that have mismanaged their outbreaks have a resource to bargain with which is people to test on. There's a concern that the phase 2 trial in the UK will end up way underpowered as there's no longer much circulating virus - so it's possible that no one in the control arm gets Covid-19 either.
posted by atrazine at 4:19 AM on June 4, 2020 [1 favorite]


How do they do these trials? I know they have a vaccine group and a control group who don't get the vaccine, but how do they then expose them to Covid-19 to test whether it works? Is it as simple as telling them "hey, get the bus to the supermarket and then walk around a bit and try and catch it" or is there some controlled way that they expose them to a dose of the virus?

They just let them go about their daily business and hope that they get exposed. That's why everyone was desperate to get their trials started. In this case, one group got a meningitis vaccine (so they would have a local skin reaction and not know which vaccine they got) and one group got the trial vaccine.

So it only works if people are getting background infections in the community. There's now very few community acquired infections in the UK compared to the peak, so they may end up with literally no-one in either arm of the trial getting ill. In some ways, that's good news (effective lockdown intervention) but if you're trying to figure out how well your vaccine works it's not so great!

Deliberately exposing people to virus (challenge trials) has been discussed in this case since it's an emergency but is extremely controversial because:

-over a large group of people you might kill someone
-we don't really know the right doses that people get exposed to "in the wild". When they tested the vaccine in non human primates they infected them with massive doses in three sites simultaneously which is definitely not how humans are getting it. That makes it even more likely that you'll seriously kill someone.

Challenge trials do get done for diseases which are less dangerous (flu, rhinoviruses, etc.) and there was one done recently on typhoid which was allowed because it responds well to antibiotics. All those people were given antibiotics after a certain number of days which was before they would get ill.

I would expect that they are currently doing non-human-primate trials where they artificially infect one animal and let them spread it socially through a group to test vaccine response in a more natural environment but nothing is as good as the real world.

Sadly Brazil has failed so badly in their response that even now a trial could be effective there. I also think that it is morally cleaner to test a vaccine there now after it has been administered to people in a wealthy country. It is the nature of vaccine trials that they often have to be done in poor countries (can't test an Ebola vaccine in areas with no Ebola) but it always makes me feel a little icky and it needs to be done carefully. Doing it only after testing it on people who look and talk like the researchers makes me more comfortable with it.
posted by atrazine at 6:16 AM on June 4, 2020 [7 favorites]


Is the Oxford University/Zeneca vaccine notably further ahead than other trials around the world, or do we just hear more about it because we're in the UK and they're in the UK and it's a good "go UK!" story for them to print?

They're ahead because they were researching vaccines for Coronaviruses before the COVID-19 pandemic.
posted by PenDevil at 7:13 AM on June 4, 2020 [4 favorites]


Covidhagen is more fantasy than documentary, but it brings a smile to your face.
posted by mumimor at 7:28 AM on June 4, 2020


Oxford University/Zeneca vaccine is sponsored by Fundação Lemann founded by Jorge Paulo Lemann, Brazil's top billionaire.
posted by adamvasco at 7:29 AM on June 4, 2020 [1 favorite]


Is the Oxford University/Zeneca vaccine notably further ahead than other trials around the world, or do we just hear more about it because we're in the UK and they're in the UK and it's a good "go UK!" story for them to print?

So there's five basic stages in vaccine candidate testing,
Preclinical tests of various sorts including in non human primates
Phase I clinical trials - these are safety trials done in small numbers of healthy volunteers.
Phase II clinical trials - An efficacy trial done on a larger number of people
Phase III clinical trial - A much larger trial on a very large number of people to get approval from the regulator
Phase IV post market surveillance - monitoring of any side effects that come up in order to catch rare effects that may not have been picked up so far.

The principle is that we carefully increase the number of people that we expose to experimental treatments as we get more safety information over time.

There's a huge number of vaccines in development for SARS-CoV-2 but only eight that I know of in human clinical trials.

There's four that are quite far along.

The Oxford one, was called ChAdOx-ncov19 now renamed to AD1222. About to start Phase II/III.

This is a modified chimpanzee Adenovirus which will infect the patient's cells and produce some of they key SARS-Cov-2 proteins. The advantage of using a chimp virus is that you won't have an immune response to it (although apparently 5% of people in rural West Africa do) so it can get into the cells without being inactivated. It can't replicate in your cells.


The Moderna mRNA vaccine, which has gone into 500 people in a phase II as of late May. This contains mRNA which codes for viral proteins in a virus like particle envelope which gets the mRNA into your cells so that they produce viral proteins.

Ad5-nCoV from China. Also an Adenovirus but a human one. That has just started recruiting for a phase II trial following a successful Phase I.

An inactivated virus vaccine developed in Wuhan, hoping to start Phase I/II combined trial soon.

Fortunately/unfortunately there is now very little Sars-Cov-2 circulating in China so they are having trouble getting their trials off the ground. They would like to test it in the US but his orangeness isn't having that.

The Oxford team had a MERS coronavirus vaccine that they'd already tested on humans before, so they were able to do a combined phase I/II trial in April and May. They injected 1,090 people overall which was considered an acceptable risk because they'd shown safety of their MERS vaccine in the past.

They've now recruited about 10k people in the UK and are recruiting people for in the US (30k funded by BARDA and now apparently an unknown number in Brazil. These will be combined phase II/III trials. I know they've completed recruiting for the UK trial as when I tried to sign up they were already full, don't know exactly when they will start injecting people. There's a delicate balance here between getting the vaccine out while there's still disease and waiting long enough to be sure that it's safe.

The UK government has ordered 100m doses and the US has ordered 300m doses for delivery this year and I know that the Serum institute in India is also involved. One reason that AstraZeneca is racking up the orders now is that the Jenner institute and UK government have made it clear that the vaccine recipe for this will be shared, so if it works and AZ don't have the manufacturing capacity, they will license it to whoever else can make it in order to get it out there.

I would say it's fair to say that the Oxford/AstraZeneca vaccine is leading on the basis of having it in the most patients to date. The challenge with the Moderna vaccine which is closely behind is that I don't know if we can manufacture mRNA vaccines in large numbers, apparently they claim they will be able to do a billion doses a year but they didn't say by which year. We definitely can manufacture adenovirus vectored vaccines in large numbers and inactivated virus vaccines are the easiest of all to make (although it does have to be done in a BSL-3 facility. We may well end up with multiple vaccines that work to different degrees.
posted by atrazine at 12:04 PM on June 4, 2020 [23 favorites]


There's a concern that the phase 2 trial in the UK will end up way underpowered

I will be so pleased if this optimism is anything more than wishful thinking. Once lockdowns are completely done do we really think R will be less than 1?
posted by benzenedream at 12:20 PM on June 4, 2020


Brazil tests start in São Paulo later this month on 2,000 people.
All of the volunteers are health care workers and many of them were on the front lines and have been exposed to the virus.
Those chosen for the study must be seronegative, meaning they have not contracted the disease before.
As part of the Oxford trial’s design, participants will receive the vaccine and then continue being exposed to the virus normally in their day-to-day work.
posted by adamvasco at 12:34 PM on June 4, 2020 [2 favorites]


I will be so pleased if this optimism is anything more than wishful thinking. Once lockdowns are completely done do we really think R will be less than 1?

We don't know when lockdowns will be lifted completely, the measures taken so far in the UK are pretty modest and countries like Spain, France, and Italy which have lifted their lockdowns considerably further haven't seen any resurgence.

Italy started removing restrictions a month ago today and has had restaurants and bars open since the 18th of May. Spain opened bar terraces at reduce capacity on the 11th, the same day that the French opened primary schools and nurseries. If these measures take r > 1, the UK will know well in advance since apart from the schools, none of these things are planned here until July.

Nonetheless, even if R>1, the current infection baseline is pretty low. You need high absolute infection levels, not just infection growth to test a vaccine. So if R briefly goes above 1 again but is rapidly brought back under control (and since we now have a lot of covid surveillance in place, I'd guess that it would) we still might not get much signal on the vaccine trial.

The real nightmare scenario is that we don't get a vaccine readout over the summer (or of course we do and it doesn't work) and the epidemic picks back up in September.
posted by atrazine at 2:46 PM on June 4, 2020 [3 favorites]


Why does the UK need 100 million doses of vaccine when our population is just under 67 million? What are we doing with the other third of our supply, vaccinating everyone's dog?

The extras are for a prime + booster vaccine strategy (which they think they won't need but might) and if not they can be shared with other countries. It's pretty much impossible to have too much vaccine overall so they just went for a big round number I think.

In practice once we got beyond the 5m people who are either clinically extremely vulnerable, NHS or care home staff, or care home residents the UK would probably start sharing some doses as they came off the line. People who are healthy, young and can work from home and who do not routinely interact with vulnerable people are pretty low yield to vaccinate.
posted by atrazine at 3:43 AM on June 5, 2020 [4 favorites]


Don't worry, there will be plenty of people to test on in the US with states like Florida continuing to ease restrictions despite there being a clear upward trend in new cases. Unfortunately, even people who ought to know better are taking cues from governor head-in-the-sand.
posted by wierdo at 6:31 AM on June 5, 2020 [1 favorite]


There's a huge number of vaccines in development for SARS-CoV-2 but only eight that I know of in human clinical trials.

Btw, I probably first got this from this here or the slack, but for anyone who hasn't seen it and is interested in keeping abreast of vaccines and other therapeutics, this COVID-19 Vaccine & Therapeutics Tracker is a nice resource and is updated frequently. Even though there are no real results yet, I find the sheer number of things being explored reassuring to glance over every now and then.
posted by chortly at 6:42 PM on June 6, 2020 [3 favorites]


Monday, they are going to open fitness centres and swimming pools and stuff like that here in Denmark. The last opening hasn't led to any spike, nationally or locally, so it seems safe to go ahead. Large gatherings are still forbidden, and right now the universities are planning to keep on wfh for the rest of the year. But you can't really know anything.
posted by mumimor at 11:55 PM on June 6, 2020 [2 favorites]


An overview of how Cuba is coping with the Covid pandemic. The county appears to have its outbreak under control with a death per million figure of about 7 (versus 104 in Mexico or 164 in Brazil). The country seems to have been helped by a strictly imposed rules (14 day quarantine in specialist set up centres, mandatory mask wearing) - as well as by having the world's highest ratio of doctors per head of population: doctors who have been going door to door seeking out outbreaks.
posted by rongorongo at 3:11 AM on June 7, 2020 [4 favorites]


winterhill: "Sharma is due to talk to his Dutch and Danish counterparts about how they shifted to one metre"

I'm not entirely sure what this is about. Nothing, as far as I know, has been shifted to one metre in the Netherlands. We're expected to stay 1,5 metres away from each other, and since the beginning of Corona regulations here, 'twas ever thus.
posted by Too-Ticky at 5:27 AM on June 7, 2020 [3 favorites]


Minnesota: Health Department releases data detailing COVID-19 cases in Minnesota’s long-term care facilities • MinnPost; Walker Orenstein; 06/06/2020 •
The [Minnesota Department of Health, or MDH] had previously not disclosed such case information, citing legal guidance that it could violate patient privacy rules. But MDH reversed course Friday after Republican Sen. Karin Housley, who chairs the Minnesota Senate’s Family Care and Aging Committee, threatened to subpoena the agency for the data and responses to more than a dozen other questions. The top Democrat on Housley’s committee also said he supported a subpoena if MDH did not respond.
Could be precedent for undoing patient privacy in more and more scenarios.
posted by ZeusHumms at 9:38 AM on June 7, 2020


The 1m, 1.5m, 2m thing is a fascinating case study in how science gets translated into public health advice. There's not great science underpinning any of them apart from some pretty general research on respiratory droplets. Context is also very important. I walked past someone on a forest path today and we were briefly about 1m apart, I doubt that is a significant exposure. Would I sit 2m away from someone, face to face, for hours indoors where lots of other people were also about 2m away? Absolutely not.

The headline of that article practically gave me a heart palpitation but the actual stuff being proposed looks ok and in line with what other countries have done (so far, safely). As long as the pubs and restaurants are operating outdoors. Definitely do not support earlier opening of indoor pubs, that seems very dangerous.
posted by atrazine at 12:01 PM on June 7, 2020 [4 favorites]


New Zealand officially no longer has any coronavirus cases. No new cases in 17 days, and the last remaining active case has now recovered. Cabinet decision on moving to level 1 expected in next few hours - essentially no enforced rules internal to the country, although social distancing will be encouraged and testing will continue. Strict border controls, including quarantine, will remain.
posted by inflatablekiwi at 6:37 PM on June 7, 2020 [10 favorites]


I do wonder what price we put on defeating Covid-19, and whether it's worth it if we kill off our country's cultural, social and economic life in the process.

Or, you know, you could do test and trace like other sane nations like Taiwan and Mongolia. This is not some bullshit either-or of "forever lockdown" vs "reopen everything". Staged openings, mandatory testing for all high risk workers, and robust quarantine rules all work just fine, but if you cheap out on any aspect of it then it fails. By reopening without adequate testing leaders are forestalling the day when people can gather without fear.
posted by benzenedream at 7:11 PM on June 7, 2020 [14 favorites]


whether it's worth it if we kill off our country's cultural, social and economic life in the process.

Yeah, but the country's cultural/social/economic life will also die off if everybody dies because they went outside for sun and fun and to be with all their family and friends, and then in a few months or years we're down to a few stray survivors like it's a zombie apocalypse.

I was forced to do my 2 week "leave the house so the car won't die" trip today and I was actually reassured that the streets are just as barren and empty of people (well, hardly any, a few more on bikes, some cars) that they were two weeks ago. Other than seeing a group of seven people biking together (eek) and of course, nobody EVER has a mask in this town, I was reassured that the town wasn't suddenly full of people partying it up and socializing and picnicking and shopping.
posted by jenfullmoon at 7:54 PM on June 7, 2020


Washington Post: Coronavirus infections haven’t spiked since Europe loosened lockdowns. There are many theories about why.
Europeans, heeding warnings that the virus is more transmissible indoors, have adapted their lives accordingly — something easier to do in warmer months. In Rome, the parks and alfresco restaurant tables are full; the tables indoors are empty.

In Germany, confined indoor gatherings have led to small outbreaks, while outdoor mass demonstrations against the lockdown in several cities — some drawing thousands of people — have not led to obvious consequences.
Virus researcher Trevor Bedford on Twitter (in the latest of several threads about how to estimate the public health effects of protests during the pandemic):
A small improvement in epidemic control (through #TestTraceIsolate or otherwise) will pay dividends in mitigating infections acquired at protests, but also in reducing overall mortality. We can try to fix the things that are broken rather than playing off a false dichotomy.
posted by mbrubeck at 8:35 PM on June 7, 2020 [2 favorites]




Brazil stops releasing Covid-19 death toll and wipes data from official site — Government accused of totalitarianism and censorship after Bolsonaro orders end to publication of numbers, The Guardian, 6/7/2020:
The Brazilian government has been accused of totalitarianism and censorship after it stopped releasing its total numbers of Covid-19 cases and deaths and wiped an official site clean of swaths of data. Health ministry insiders told local media the move was ordered by far-right president, Jair Bolsonaro, himself – and was met with widespread outrage in Brazil, one of the world’s worst-hit Covid-19 hotspots, with more deaths than Italy and more cases than Russia and the UK.

“The authoritarian, insensitive, inhuman and unethical attempt to make those killed by Covid-19 invisible will not succeed. We and Brazilian society will not forget them, nor the tragedy that befalls the nation,” said Alberto Beltrame, president of Brazil’s national council of state health secretaries....
Brazil currently has the world’s second-highest number of cases, at 672,846, according to the John Hopkins university site...[current JHU COVID-19 Map].
posted by cenoxo at 12:12 AM on June 8, 2020 [2 favorites]


Here's why. On this trajectory Brazil is going to overtake the UK in cumulative deaths within a few days and that looks like it's not even slowing down much, they may well overtake soon.

Mexico also not looking great. Almost every other country on there is now in a plateau and is currently reporting relatively few new deaths.
posted by atrazine at 12:58 AM on June 8, 2020 [2 favorites]


Coronavirus infections haven’t spiked since Europe loosened lockdowns. There are many theories about why.

One other possible reason is that we might be underestimating how many people are resistant to Covid-19 (Guardian Article). For a while researchers have bee interested in places such as the village of Ferrara Erbognone in Lombardy - which recorded no cases at all even while all its neighbours were heavily hit. There is an idea that populations who have been exposed to other coronaviruses (such as those that cause some colds) may have acquired protective immunity to Covid-19 as a result. That may not stop them getting the Covid-19 virus altogether - but it could mean that they get much milder symptoms.

My understanding from the article is that the volume and sensitivity of Covid antibody tests is only now starting to get to the point where we can how many in a population might have this light level of immunity.

My guess, also, is that the virus exists in a world of super-spreaders and of the especially vulnerable (where that vulnerability can be because of medical or occupational factors). Lots of the particularly vulnerable will have already caught the disease or will now be more effectively shielded. Also most events that would allow super-spreading to take place are now forbidden.
posted by rongorongo at 1:01 AM on June 8, 2020 [2 favorites]


Mod note: One comment deleted; I want to remind folks to take a little care about the impact that hard-core doomsaying scenarios can have on readers and fellow MeFites. There's good cause to try and think through the serious ramifications of COVID and of changing safety measures around it, but painting bleak worst-case scenarios is hard on folks at a time when we're all already dealing with an unusual level of stress and worry. Please try to keep stuff more at the level of "here's things I'm concerned about" and less "here's my apocalyptic/catastrophic vignette of the near future".
posted by cortex (staff) at 8:46 AM on June 8, 2020 [5 favorites]


There is a clear difference between the Swedish and the Norwegian approach, far less people have become sick and died in Norway. There is no way we can know how this works out on the longer term, but the difference is there, and it matches experiences from the 1918 flu epidemic. What the UK and Sweden (maybe) did wrong was wait just a couple of days or a week more than the more succesfull countries to take action and they pay for it now as opening is not as safe as in countries that locked down right when the first infections were registered.

All the while, the lockdowns were about not overwhelming the healthcare system, and that had to be different from country to country. Here, it's been a surprising test of the five healthcare regions (not very surprising to me who has been observing healthcare for more than a decade, but certainly for the general public and some politicians). If you imagine you and your electorate are immortal, you are bound to fail in this crisis, because the very people you spend on are also the most vulnerable.
posted by mumimor at 11:45 AM on June 8, 2020 [2 favorites]


Putin Is Warping Russia’s Pandemic ResponseForeign Policy; Leonid Gozman; June 4, 2020
Doctors are being attacked and critics silenced as Moscow tries to control the narrative.

[...] the lives of the citizens—not to mention their health—hold no value for an authoritarian regime that does not answer to the people. The tradition of treating citizens like a renewable resource did not disappear with the collapse of the communist regime. And while authoritarian regimes aren’t immune to public opinion, the uncertainty and doubt generated by manipulating statistics and blaming outsiders helps keep things from reaching boiling point.
posted by ZeusHumms at 1:56 PM on June 8, 2020 [2 favorites]


Shutdowns prevented 60 million coronavirus infections in the U.S., study finds (WaPo / MSN reprint)
Shutdown orders prevented about 60 million novel coronavirus infections in the United States and 285 million in China, according to a research study published Monday that examined how stay-at-home orders and other restrictions limited the spread of the contagion. A separate study from epidemiologists at Imperial College London estimated the shutdowns saved about 3.1 million lives in 11 European countries, including 500,000 in the United Kingdom, and dropped infection rates by an average of 82 percent, sufficient to drive the contagion well below epidemic levels. The two reports, published simultaneously Monday in the journal Nature, used completely different methods to reach similar conclusions.

[...] The two reports on the effectiveness of the shutdowns come with a clear warning that the pandemic, even if in retreat in some of the places hardest hit, is far from over. [...] Timing is crucial, the Berkeley study found. Small delays in implementing shutdowns can lead to “dramatically different health outcomes.”
posted by katra at 4:34 PM on June 8, 2020 [3 favorites]


Omission of air pollution from report on Covid-19 and race ‘astonishing’ (The Guardian, June 7 2020) Failure to consider dirty air as a factor in higher death toll among ethnic minorities wholly irresponsible, say critics
posted by Iris Gambol at 6:08 PM on June 8, 2020 [2 favorites]


I think the disparities in death rates will turn out to involve so many factors that they'll take years to unravel. For instance, Jews in the UK, who probably do not experience major discrimination in receiving medical treatment, experienced an extraordinarily high death rate.

This may sound unlikely, but I think a significant cause in the Jewish community will turn out to be communal prayer and singing. Other relevant factors might include their relatively high population density, average age, and (mostly urban) places of residence. Also, it could totally just be bad luck, in that their community got infected early on, before social distancing was a thing. Unfortunately the UK's Jewish community is so small that it barely shows up in statistics, which means many of these lessons may be missed.
posted by Joe in Australia at 10:35 PM on June 8, 2020 [7 favorites]


I live on the Northwestern suburban edge of London and our community has indeed been hit very hard. I accept it wasn't in their remit but I was surprised to not see it addressed at all in the PHE report, even as something they were aware of but weren't looking at in this report.
posted by atrazine at 12:50 AM on June 9, 2020 [1 favorite]


> while outdoor mass demonstrations against the lockdown in several cities — some drawing thousands of people — have not led to obvious consequences.

> most events that would allow super-spreading to take place are now forbidden.

hopefully outdoor protests cut down on (presymptomatic or asymptomatic) superspreading: evidence that indoor crowding, NOT population density, is what spreads the virus

-Black Lives Matter protest in Los Angeles
-Images From a Worldwide Protest Movement
-demonstrations gaining momentum around the world
-14 states just hit their highest 7-day average of #COVID19 cases

also btw...
-Deaths jump in Brazil's indigenous tribes as virus spreads
-Fear stops Rohingya getting tested as virus hits refugee camps
posted by kliuless at 2:13 AM on June 9, 2020 [2 favorites]


winterhill, at this point we can see that some approaches are more succesful than others. In New Zealand they have done very well. In a lot of other countries they have done well. As a lay person it is now possible to compare the different approaches and see which are working. It seems locking down early and hard was a good thing. It seems contact tracing is a good thing. It seems many tests and isolation of people who test positive are a good thing.

Obviously, if you are in a country were the government have handled things badly and you are in a risk group, take all the precautions you can. I understand how frustrating that is.

Also, quit social media. If there is one thing in this modern world that can give anyone anxiety, it is social media.
posted by mumimor at 3:20 AM on June 9, 2020 [3 favorites]


... Failure to consider dirty air as a factor in higher death toll among ethnic minorities wholly irresponsible, say critics

Bizarrely, the study did take pains to control for age, sex, socio-economic deprivation, region and ethnicity (within the broad category of "BAME"). Yet they ignored not only air pollution but also vitamin D deficiency.

Elsewhere: a study (at pre-print) shows that dogs can be trained to detect covid-19 infection. The authors tested with 8 dogs - mostly Belgian Malinois - and found that half of them (*) performed with 100% accuracy on trial sizes of up to 68. I suspect that these animals would give most conventional antigen tests a good run for their money in terms of cost, speed and ease of administration.

* The slightly less good boys did no worse than 84%.
posted by rongorongo at 3:30 AM on June 9, 2020 [8 favorites]


23andMe Provides More Evidence That Blood Type Plays Role in Virus
Preliminary results from more than 750,000 participants suggests type O blood is especially protective against SARS-CoV-2, the virus that causes Covid-19, the company said on Monday. The findings echo other research that has indicated a link between variations in the ABO gene and Covid-19.

[Another study also suggested] 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 Covid-19...

The [23andMe] 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.
posted by kliuless at 3:45 AM on June 9, 2020 [6 favorites]


Given that 80% of people who get put on ventilators die, isn't that simply a slightly less panic inducing way of saying having blood type A is linked to a 40% increase in the likelihood a patient will die?
posted by Justinian at 4:25 AM on June 9, 2020 [1 favorite]


Given that 80% of people who get put on ventilators die
I'd thought that number was a result of some early and possibly flawed studies and that the real mortality rate was closer to the 30s? Though often with a long and painful road to recovery and often expected lifelong issues...

I can't find the story that I was looking at and I'm not 100% sure about this site but...

https://www.newswise.com/coronavirus/mortality-of-mechanically-ventilated-covid-19-patients-is-lower-than-previously-reported-reveals-study-in-critical-care-medicine/?article_id=732673
posted by cirhosis at 7:07 AM on June 9, 2020


Given that 80% of people who get put on ventilators die
I'd thought that number was a result of some early and possibly flawed studies and that the real mortality rate was closer to the 30s? Though often with a long and painful road to recovery and often expected lifelong issues...


I wonder if there is a change in this over time, as the doctors get better at treating people? When I look at the daily numbers here (which I don't do every day), I think that might be the case. I'm asking, not claiming any knowledge.
posted by mumimor at 8:08 AM on June 9, 2020


I despair, this is far from unusual. People really are this selfish and stupid. Coronavirus parties highlight Brazil's fractured approach to pandemic. The level of disconnect is beyond Surreal, thanks to the Evangelicals and Bolsonazi fuckwits.
I have no idea when I will leave my home again. I intend to do so walking and not on a stretcher.
This is all so sad and so avoidable. New vertical sections built at Inhauma cemetery, Rio de Janeiro. The city has over 4,500 official deaths from Covid-19 so far. The real number is probably nearly double. There has been no health Minister now for 3 weeks,; there is a military stand in, a general who is not a doctor and with no background in Health. The Bolsonazi stopped all up to date reporting of statistics and stated that he did not want daily national deaths to exceed 1,000 (they are ''oficially'' approching 40,000 Total.
In short it's a fucking mess and the way out is more than confused with a lot of avoidable death in the near future.
posted by adamvasco at 9:41 AM on June 9, 2020 [13 favorites]


WHO walks back comments on asymptomatic transmission of coronavirus

Van Kerkhove stressed that her comments on Monday were specific to particular studies and did not represent a new policy or direction. The WHO said it regrets saying that asymptomatic spread is "very rare."

...the entire transcript from Monday shows she was stressing that governments should focus on detecting and isolating those with symptoms because asymptomatic people can be difficult to trace.

posted by polecat at 10:47 AM on June 9, 2020 [3 favorites]


Good lord. Hairsplitting about "showing symptoms" or not doesn't matter. Ramp up testing to the point where we can do proactive testing of high risk individuals and it won't matter whether it's asymptomatic, mildly symptomatic, or indistinguishable from pollen making your nose run slightly.
posted by benzenedream at 3:59 PM on June 9, 2020 [2 favorites]


> polecat: "WHO walks back comments on asymptomatic transmission of coronavirus"

Oof. This whole thing was a spectacularly unnecessary own-goal. I remember reading some article about the Epidemic Intelligence Service and the training they provide. One point of emphasis was that epidemics, being public health emergencies, require very careful and consistent public messaging because keeping the public's trust was paramount if you wanted the public to do what you wanted them to do. This... was not that.
posted by mhum at 5:39 PM on June 9, 2020 [8 favorites]


Re Ventilator deaths. I really hope some of it is just the medical services getting better at it all, but I think some of it just seems to be over anxious reporting. Like looking at the people who had died vs recovered... and not properly taking into account the people who were still receiving the treatment. I guess the rush to be published first doesn't just infect the news media.
posted by cirhosis at 8:30 PM on June 9, 2020


Once again a newspaper campaign to put pressure on the government to open up faster has failed in the UK. There are no plans to open pubs before July, even for outdoor service.

They've now also given up on the ambition to get everyone back into primary schools for a month this academic year. Time will tell whether this was the right thing to do, but it was always reliant on being able to drop the physical distance requirement within schools and thus far the government's scientific and medical advisors have not agreed to do this.
posted by atrazine at 1:46 AM on June 10, 2020 [3 favorites]


One point of emphasis was that epidemics, being public health emergencies, require very careful and consistent public messaging because keeping the public's trust was paramount if you wanted the public to do what you wanted them to do.

The problem faced by people like the WHO, is that the messaging has to be both simple and mutable as scientific understanding about the virus builds. Messaging which does not encompass both of these elements is going to run into trouble. In terms of choosing a way of representing the best advice - I'm reminded of this infographic summarising the effectiveness of various health supplements. It shows the effectiveness of various supplements on the basis of rafts of clinical trials: we can see that ideas such as using coffee to reduce the risk of heart disease or folic acid to prevent birth defects, have great (meta-studies of controlled, randomised, double blind peer reviewed papers) evidence in their favour: if you want to achieve either goal then these look like good methods.

There is a "worth it" line of treatments that pass a particular standard of effectiveness - and the implication is that you should probably act on anything that lies above the line and disregard anything that falls below it. If I check back on the chart in the future, I can expect things to have moved as research has progressed.

So it should be with Covid-19 information. The ideas of preventing spread by wearing a mask would have gradually risen above the "worth it" line over the last or 4 months. "Hydroxychloroquine" would have risen and sunk. "Probability of asymptomatic infection" would have risen.
posted by rongorongo at 2:19 AM on June 10, 2020 [5 favorites]


I'm here for the good dogs using their noses and for Jacinda Ardern's happy dance.
posted by daybeforetheday at 2:41 AM on June 10, 2020 [2 favorites]


Are outdoor meeting not allowed in the UK? I realize that's not a solution for the whole year, but seems like it could be a solution for the next few months. Not perfect, but better than no meetings.
posted by Tehhund at 4:07 AM on June 10, 2020


Man, winterhill, every time I hear about the British lockdown rules, they sound like they were carefully designed to produce so much frustration and discomfort as to get everyone to agree to call the whole thing off and go back to Johnson's original strategy of "just let everyone catch it." I'm in a US state that had a really strong policy on shelter-at-home, and we could go out and walk around all we want, just not near other people.
posted by Harvey Kilobit at 3:31 AM on June 12, 2020 [4 favorites]


In case anyone still thinks asymptomatic transmission isn't a thing, I refer you to the results of Tyson testing one of its chicken processing facilities in Arkansas:
Of the 1,102 team members who work at the facility and were tested onsite between June 4 and June 6, 199 tested positive. Tyson says only one of the employees that tested positive showed symptoms. The other 198 individuals who tested positive did not show any symptoms and otherwise would not have been identified, according to Tyson.
One person with symptoms, 198 actually infected. It strains credulity to believe that only people experiencing symptoms of COVID-19 can spread the disease.
posted by wierdo at 5:55 AM on June 12, 2020 [12 favorites]


Man, winterhill, every time I hear about the British lockdown rules, they sound like they were carefully designed to produce so much frustration and discomfort as to get everyone to agree to call the whole thing off and go back to Johnson's original strategy of "just let everyone catch it." I'm in a US state that had a really strong policy on shelter-at-home, and we could go out and walk around all we want, just not near other people.

That has always sort of been the case in the UK as well. There was guidance for the first month that you should restrict exercise to once a day and not more than an hour but that wasn't actually in the regulations and was never something the police even tried to enforce.

There was always going to be a period between "everything but the most essential things closed" and "everything normal" where the rules are slightly strange in what they do and do not allow. So for instance, it is now allowed for two people who both live alone to see each other without distancing and be in each other's homes (merge their... errr… bubbles, so to speak). It is also allowed for one person living alone to socialise with another household. Two households of multiple people are not allowed to socialise.

That seems bonkers, except that there is actually a very good reason for it. First, restricting it controls the epidemiological consequences per bubble joining. Second, by putting qualifications on it, they control the number of times it happens in aggregate. Third, by setting the rules up that way they give the benefit of social contact to the people who need it most - people who are currently living alone.

It does create edge cases that seem odd - like technically having to leave when the seventh person shows up to a gathering - but the alternative is to either disallow gatherings entirely or to just let people do what they want and have many large gatherings and parties.
posted by atrazine at 7:59 AM on June 12, 2020 [8 favorites]


'The country is adrift': echoes of Spanish flu as Brazil's Covid-19 catastrophe deepens.
And from the Amazonian region of Manaus - Brilliant pictures, sad stories.
posted by adamvasco at 9:22 AM on June 14, 2020 [2 favorites]


It's now becoming clear why the UK made such a misjudgement.

In March, I came to the following conclusion:

Based on that, you would predict that UK cases will peak lower than Italy and Spain and about the same as France (but a few days later). The die for the next 2 weeks is cast already.

This was based on assessing each country's relative number of infections based on cumulative deaths at lockdown. Cumulative deaths is a good proxy for infections before control measures are put in place because it is much less sensitive to whether you are doing a good job testing.

The UK started locking down quite seriously with 177 cumulative deaths. I then looked at Italy, France, and Spain, and found how many days ahead and behind their lockdowns were relative to 177 deaths.

I found that:

Italy locked down 5-6 days later.
Spain locked down at the same time.
France started slightly earlier.

On that basis I made the above prediction, that the four countries would have similar pandemics but that the UK would come out of it with fewer deaths. That was wrong, as were the government's statements that we were "2 to 3 weeks behind Italy". Why though?

It was something that Neil Ferguson said at a committee session this week, reinforced by a phylogenetic analysis paper published last week on UK infections that gave me what I think is the answer. Using cumulative deaths as a proxy for number of infected only works if the epidemic is mostly spreading locally. If that's happening, then the infection curve and therefore the death curve will be very similar. What they found in the UK was that SARS-CoV-2 was introduced into the UK in upwards of a thousand different lineages.

All those fresh introductions mean that there was a bow-wave of people who were infected, able to transmit, but not yet showing up in the death numbers in the UK the way they would if they were infected as part of a slowly spreading epidemic. It would be like measuring the ash produced by a single fire vs a hundred sparks. You see little ash so you assume the fire has not yet spread far. I bet this also depressed hospital admissions in a similar if less lagged way. If that is so, then the main tools used by the government to estimate spread would all read low.

(Let's see if my prediction about why this happened is more accurate than the original prediction)
posted by atrazine at 2:16 PM on June 14, 2020 [5 favorites]


China's capital re-institutes virus measures (AP, June 14, 2020) China has reported 49 new confirmed coronavirus cases as the capital Beijing re-instituted measures to contain a new outbreak. Of the new cases, 36 were reported Monday in Beijing, traced to a wholesale market that supplies much of the city’s meat and vegetables. Ten of the other cases were brought from outside the country and three were found in Hebei province just outside Beijing. [...]

The new cases reported over the weekend mark China’s highest daily total of coronavirus cases in two months, prompting Beijing to suspend the restart of some classes and reverse the relaxation of some social isolation measures.
posted by Iris Gambol at 7:57 PM on June 14, 2020 [3 favorites]


The Center for Global Development has published a paper looking at predicted Covid-19 fatality rates around the world. They came up with adjusted Infection Fatality Rates for all countries around the world - adjusting for demographics, comorbidity rates among those demographics and health system capacity. Adjusted IFR rates vary from 0.43% in Western Sub-Saharan Africa (poor but very young and quite healthy) to 1.83% in Eastern Europe (richer but older, with many health problems). If we look at the adjusted IFR alongside the population of the region - and we assume whatever rate of infection that may have happened by the end of the pandemic - then we can get an idea of the overall number of likely mortalities. For example, an 80% infection rate in Tropical Latin America (population 219.69 million and adjusted IFR of 0.97) would be expected to leave about 1.70 million dead by my calculations.

If we perform the same arithmetic for all global regions then it leaves a predicted mortality rate that looks comparable to Spanish Flu in 1919.
posted by rongorongo at 2:28 AM on June 15, 2020 [2 favorites]


(Plugging the above data into a spreadsheet and playing about with what I feel might be likely final infections rates gives me a global mortality prediction of about 45 million - roughly just under 0.6 of the world's population)
posted by rongorongo at 4:54 AM on June 15, 2020 [1 favorite]




Steroid found to help prevent deaths of sickest coronavirus patients (The Guardian, June 15, 2020) A total of 2,104 patients were chosen at random to receive 6mg of dexamethasone once a day (either by mouth or by intravenous injection) for 10 days, and were compared with 4,321 patients chosen at random to continue with normal care alone. Among the latter group of patients, 28-day mortality was highest in those who required ventilation (41%), intermediate in those who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).

Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio 0.65 [95% confidence interval 0.48 to 0.88]; p=0.0003) and by one fifth in other patients receiving oxygen only (0.80 [0.67 to 0.96]; p=0.0021). There was no benefit among those patients who did not require respiratory support (1.22 [0.86 to 1.75; p=0.14). Based on these results, the use of dexamethasone would prevent one death of around eight ventilated patients, or one of about 25 patients requiring oxygen alone.
---
Two hours ago, @Atul_Gawande tweeted: It will be great news if dexamethasone, a cheap steroid, really does cut deaths by 1/3 in ventilated patients with COVID19, but after all the retractions and walk backs, it is unacceptable to tout study results by press release without releasing the paper. https://recoverytrial.net/files/recovery_dexamethasone_statement_160620_final.pdf
posted by Iris Gambol at 8:50 AM on June 16, 2020 [8 favorites]


Yeah, steroids? For the "sickest?" I'm going to wait for the announcement that it doesn't eat all the cartilage it can find.
posted by rhizome at 10:53 AM on June 16, 2020 [1 favorite]


Steroids have a long history of use for reduction of inflammatory responses, so it makes sense at the most basic level that a steroid could reduce the severity of the inflammatory response COVID-19 is associated with. My understanding is that they are risky mainly when used at high dosage or for extended periods and that the risk of exacerbating illness is mainly limited to bacterial, not viral, infections.

This is all from memory, though, so please do correct me if I'm wrong.
posted by wierdo at 11:06 AM on June 16, 2020 [1 favorite]


Since 106 new cases emerged around the Xinfadi wholesale food market in Beijing’s southwestern Fengtai district—following 56 days without any new infections—the Chinese capital has been plunged into what officials are calling “wartime mode.” Some 100,000 epidemic control workers have been deployed, at least 29 local communities placed under lockdown, schools and sports facilities shuttered, and various officials sacked. (Time, June 16, 2020)

The new outbreak—which first cropped up June 11—may already be waning. After peaking with 36 new cases reported on both June 13 and 14, that tally dropped to 27 on Monday. (Although four cases were reported in neighboring Hebei province with one more in Sichuan.) Still, China’s unease is understandable. Xinfadi market is the largest of its kind in Asia, sprawling over 112 hectares and supplying 80% of Beijing’s agricultural produce, as well as food to other populous northern provinces.
posted by Iris Gambol at 11:34 AM on June 16, 2020 [5 favorites]


Steroids have a long history of use for reduction of inflammatory responses, so it makes sense at the most basic level that a steroid could reduce the severity of the inflammatory response COVID-19 is associated with.

In my defense, I deleted an aside about it working better as a cortisone joke. I think we probably agree though: it remains to be seen whether "high" or "extended" doses are involved, hence my "wait and see" attitude. ;)
posted by rhizome at 12:38 PM on June 16, 2020


Cases rise in Arizona weeks after stay-at-home order is lifted

Remember when folks were saying the coronavirus might go away in the summer. It's been well over 100 degrees in Phoenix for almost a month.
posted by JackFlash at 9:45 PM on June 16, 2020 [2 favorites]


As dumb as the "gee maybe summer will save us" argument is, Arizona may be a bad example. In AZ people are more likely to stay inside during a scorcher in a nice air-conditioned COViD incubator;. It's the inverse of states with bad winters as regards outdoor/indoor time.
posted by benzenedream at 12:13 AM on June 17, 2020 [3 favorites]


Pandemics result from destruction of nature, say UN and WHO
High-level figures have issued a series of warnings since March, with the world’s leading biodiversity experts saying even more deadly disease outbreaks are likely in future unless the rampant destruction of the natural world is rapidly halted.
posted by mumimor at 12:37 AM on June 17, 2020 [8 favorites]


Re: dexamethasone --

According to my Director-General of MOH, Malaysia apparently has been using that same steroid from the very beginning (probably as an anti-inflammatory) , but strictly for Category 4 & 5 for a maximum of five days. There seems to be a one-third reduction in symptoms, if I understood his answer correctly (i kept trying to find a good writeup but our journalists covering this so far are generalists). So far, we only have 121 deaths out of a total 8,515 cases (and there's only about 521 active cases at the moment), so for what it's worth, our combination of steroids and other drugs to address the inflammation and hold off the cytokine storm seems to be working. Also, we managed to institute lockdown early enough we never had to change policy on admitting every known positive case.
posted by cendawanita at 9:08 AM on June 17, 2020 [13 favorites]


If anyone's interested, the Malaysia DG of Health also recently posted a situation brief on how Malaysia's handled it (strictly from a public health perspective. I venture we would do much much better if the Home Ministry didn't resort to xenophobia and basically caused a u-turn on detaining migrants, refugees, and foreign workers in close quarters that are the detention centres causing a fresh spike in cases --but I did say we're a trash fire too):

In summary, this situation brief finds:

1. Malaysia’s preparedness and planning began in December 2019, when they first heard from Chinese authorities that there were cases of acute respiratory illness;
2. Previous experience with MERS and the 2002-2003 severe acute respiratory syndrome (SARS) epidemic, including experienced contact tracing teams, was key in enabling a speedy response;
3. Malaysia drastically upgraded health facilities and diagnostics capacity in February 2020, including an 86% increment in diagnostics laboratory capacity, 89% increment in critical care bed capacity, and an 49% increase in the number of available ventilators (from 526 to 1034 units);
4. Malaysia hospitalised all individuals diagnosed as COVID-19 positive, whether symptomatic and asymptomatic;
5. Learning from other countries, including China was essential in identifying do’s and don’t’s in the COVID-19 response, including in terms of treatment;
6. While evidence on treatments was still murky, Malaysian physicians prioritised monitoring for negative side-effects of treatments and adjusted medication regimens

posted by cendawanita at 10:49 AM on June 17, 2020 [6 favorites]


Note that everyone knew that SARS-CoV-2 had an inflammatory component, but didn't know when to intervene. You have to strike a delicate balance between suppressing the immune system and suppressing the inflammation in a viral inflammatory syndrome; if you intervene too early and turn off the immune system too hard the virus will replicate like crazy and you may end up with a worse outcome. The new finding on dexamethasone is that it does not worsen the outcomes because of increased virus production at a late stage, and improves them in some cases.
posted by benzenedream at 1:57 PM on June 17, 2020 [7 favorites]


I wouldn't eliminate the possibility that SARS-Covid virus initiates inflammation and an autoimmune response which makes a corticosteroid a double benefit.
posted by dances_with_sneetches at 6:34 PM on June 17, 2020 [2 favorites]




The problem is that killing a substantial number of teachers isn't likely to be very good for children's mental health or educational attainment either. I don't claim to be in any position to have an informed opinion on how to balance all the considerations, though.
posted by wierdo at 3:33 AM on June 18, 2020 [3 favorites]


Unusually the New Statesman and the Spectator both seem to be behind reopening schools:
Today, instead of being able to do the part of my job I love, being in a real classroom with real children, I am sitting at home staring at some slides I’ve just made and talking to my computer. ‘Stop the video now’ — I’m saying — ‘and write down the definition of fiscal policy.’

I’m trying to make my voice sound light but my heart is heavy. There are 25 students in this particular class. Eight of them will listen carefully and follow my instructions to a T. A further eight will do the work more sloppily. The rest will not do it at all.

There has been much talk about how the closure of schools has widened the gap in educational achievement. The eight students who will watch my video and pause every time I say pause are the same eight I had no worries about before the virus struck. Some are middle-class children and most are girls, but all have a rock-solid work ethic and are well supported by their parents. The students doing nothing are the same students I was fretting about from the moment I started teaching them. Many are poor. Some have behavioural difficulties. Some have complicated special needs. For most, it is a Herculean job to get them to work at the best of times — even with the strict structure provided by the school. None of them has done a single sausage since this nightmare began...

Not only is the gap yawning between students in my class — it is widening between north and south, rich and poor, and between state and private schools. Research by UCL Institute of Education shows that in the south-east, 28 per cent of kids are working for more than four hours a day, compared with less than 10 per cent in the north-east. The children on free school meals are half as likely as richer ones to be working hard. And a third of private schools are offering four or more hours of lessons a day, five times as many as state schools...

I phone a teenage boy to find out why he has done no work. It’s 3 p.m. and he’s still in bed. His once-upon-a-time cheery voice is flat and he talks slowly in monosyllables. Adolescence is rubbish at the best of times. Try it in a tiny, impoverished flat with no outdoor space, nowhere to go, no one to see and nothing to do, with the guilt of the god-awful slides on Google Classroom hanging over you.
posted by TheophileEscargot at 3:34 AM on June 18, 2020 [3 favorites]


Nobody is yelling, thankfully. It's inarguable that there are competing interests at work here, all of which are valid. Nobody has the one right and true answer. Anyone who says otherwise is either a fool or a liar.

I don't know about the schools you've attended, but mine were staffed mostly by women over 50. At best a quarter of the faculty and staff were young enough that we wouldn't be explicitly asking them to accept a risk of death that would not be allowed under health and safety law to persist in any profession.

If our countries would get off their asses and implement a sufficient system of testing and contact tracing, this wouldn't be an issue. The reality is that it isn't getting done, though.
posted by wierdo at 3:47 AM on June 18, 2020 [4 favorites]


How does a "sufficient system of testing and contact tracing" apply to schools though?

My son's in Year 1 and back at school three days a week, thankfully. We've been told to check his temperature every day. His class has been split into two pods with different teachers in different classrooms.

We know which teachers are in contact with which children. If someone gets COVID-19, we know which pod is affected and school. I don't really see how the national system of contact tracing is relevant to protecting schoolteachers in particular.
posted by TheophileEscargot at 4:47 AM on June 18, 2020 [1 favorite]


Okay, you guys, this recent discussion about dexamethasone and inflammation compels me to just go ahead and post that comment I wrote a draft of two weeks ago. I didn't get around to polishing it up and providing the specific citations to my sources because enough time had passed that I felt I needed to follow-up on new developments, but the comment I did post with numerous reference links should be enough to get you started. Here's what I wrote on the 4th:

SARS-CoV-2 uses a protein on its spikes to target the ACE2 "receptor" on target cells, like a key unlocking an entry path. ACE2 stands for angiotensin converting enzyme II.1

Angiontensins are hormones which regulate blood pressure2 and the ACE2 enzyme is found widely in the body in arterial and venous endothelial cells, arterial smooth muscle cells, and, notably, ACE2 is abundantly present in humans in the epithelia of the lung and small intestine. These cells are prime targets for Sars-Cov-2 infection. Of great importance is that ACE2 also strongly mediates the inflammatory response of the immune system.

Most of the severe symptoms of COVID-19 involve damage from an over-activated innate immune system3, the so-called "cytokine storm": acute respiratory distress syndrome (ARDS), disseminated intravascular coagulopathy (widespread blood clots), and the related secondary hemophagocytic lymphohistiocytosis (sHLH).

The abundance of ACE2 receptors in the epithelia of the lung and small intestine make those organs prime targets for Sars-Cov-2 infection, and imply the commonly seen cytokine triggered ARDS and the less common gastrointestinal symptoms. The abundance of ACE2 receptors in the arterial and venous endothelial cells similarly make those prime targets and imply the disseminated intravascular coagulopathy and sHLH. Collectively, this implies direct damage from the virus to the lungs, the GI tract, and other organs with epithelial cells such as blood vessels (and also again blood vessels because the abundance of ACE2 in arterial smooth muscle cells), and then again these same areas indirectly via the cytokine storm. The damage is compounded.

Note that there are various etiologies for cytokine storms, some of which indicate distinct treatments: sHLH presents as "sepsis" but does not respond well to antibiotics/antivirals alone, but rather in combination with intravenous γ-immunoglobulin and intravenous steroids.

Suppressing the innate immune system is self-evidently counter-productive before or upon infection. It's necessary when a cytokine storm is occurring or imminent. Therefore, timing is everything.

1. The bat coronavirus most closely related to SARS-Cov-2, bat-CoV-RaTG13, doesn't have this protein and cannot infect humans, lacking this access to the ACE2 receptor. SARS-Cov-2 has been hypothesised to have aquired the gene to produce this protein via horizontal gene transfer from a coronavirus common in pangolins, pan_SL-CoV_GD, when both the bat coronavirus and that pangolin coronavirus were infecting the same pangolin. Then this new strain, SARS-Cov-2, was transmitted from an infected pangolin to a human.

2. Among other things, including the inflammatory response. See: renin–angiotensin system.

3. The mechanisms by which SARS-Cov-2 provokes a cytokine storm with some notably distinctive features is an area of intense research. Specifically, the provoked hypercytokinemia includes an impaired type-I interferon response and lymphopenia. This is hypothesised to do with the viral ACE2 cell bindings resulting in a deficit of angiotensin-2.

posted by Ivan Fyodorovich at 4:56 AM on June 18, 2020 [7 favorites]


How does a "sufficient system of testing and contact tracing" apply to schools though?

Rapid testing and tracing enables clusters to be contained before people have been infected long enough to transmit the disease. Daily temperature checks aren't nearly enough when dealing with a disease that is often transmissible before the immune response is strong enough to cause a fever.

Even if that weren't the case, testing and tracing would dramatically reduce the number of unknowingly infected people walking around, which reduces the risk of spread with any gathering of people since most of the infected people would be isolated.
posted by wierdo at 5:29 AM on June 18, 2020 [4 favorites]


I'm very sympathetic to the argument that if children can go to Primark, they can go to class. The pictures of the reopened shops earlier in the week surprised me - I never realised there were so many households with six teenage girls and no-one else. I don't understand why the government are putting the reopening of pubs and visitor attractions ahead of the reopening of schools.

There's a number of competing interests to be balanced here.

First, the two direct risks: to pupils and to staff

Then, the indirect risk: greater overall transmission

I think it is now pretty clear that the direct risk to pupils who are not in a shielding category is very low. The "Kawasaki" like syndrome seems to be really rare (and it's possible that classical Kawasaki syndrome was actually caused by the endemic Coronaviruses all along). I think we can fairly balance the small risk of this with the substantial learning deficits happening and say - the children would be much better off at school.

Staff is more complicated. We basically have enough-(ish) teachers to teach schools normally. That means, no smaller classes, no distancing within classrooms. We cannot safely bring retired teachers back to beef up the workforce. Although we probably could recruit additional temporary staff to assist teachers (from TeachFirst and things like that), that training takes time and the less trained people will not be as effective and will not be able to run classes by themselves. We also don't have the space, even if we requisition other buildings and make them suitable to teach all kids and distance them.

My understanding is that teachers in more vulnerable categories have in most cases been assigned non pupil-facing roles to protect them. The risk to a 30 year old may be acceptable, I do not know that I could say the same for a 60 year old. This depletes the supply of available teachers even more.

Indirect risk is fundamentally different because the indirect risks have to be balanced against all the other possible measures that can be taken whereas the direct ones stand on their own. The key is to determine a "package" of allowable interactions that cumulatively keep Rt below 1 while delivering the highest possible benefits.

It is in indirect risk where a balance has to be struck between re-opening Primark and re-opening schools. Part of the issue is that if you re-open schools, all kids will go five days a week. That is a much bigger increase in cumulative interactions then re-opening shops. You will have noticed that there were mad scenes on Monday morning much beloved of the tabloids. How busy were they today though? Pretty dead I would think. Anyone desperate to buy something particular will have been out already, most people who haven't gone by now won't be going for weeks. Compare that with schools where, once-open, many millions of kids go every day.

SAGE released modelling where they tested a number of school re-opening scenarios. Many of them drive Rt above 1 so the government was rather restricted in what they could do. I will note that France has re-opened some schools (and subsequently closed some again) while Spain and Italy are (last time I checked) not re-opening any school at all this academic year.

One of the things that they will look at in putting together "packages" of measures is what harm you avert from doing them. High priority will be things which they consider irreversible. Perhaps the judgement has been made that with additional tutoring, longer school days, and other measures, children can catch up on learning next year while if they don't re-open pubs they will all close permanently.

On testing and tracing, they seem to be getting contact disclosures from 75% of people with positive tests who are transferred to them and are then able to contact 90% of their contacts. That's an ok performance but the real concern is that in the week 4th of June to 10th of June they only transferred in 6k.

The ONS survey work found that there are about 4500 new community infections a day. The Kings College symptom survey is at about the same. The weeks don't quite overlap but the issue is then that:

31.5k were newly infected in that week (from ONS survey data)
1k to 2k a day are testing positive (Assume 1.5kx7 = 10.5k)
So about 33% of infections are being caught by testing.

Then 6k of those were sent on to test and trace (the others were probably hospital/care home/other institution acquired which can be handled internally).

Of those,
75% were reachable
90% of their contacts were reached
So that's 67.5% of the contacts.

We therefore have:
66% 21k new infections were not picked up anywhere: none of their contacts were traced
13% 4k new infections were picked up and handled by hospitals etc.: we can assume all their contacts were traced
21% 6k new infections were handled by test and trace: 67.5% of contacts were traced.

Total effect: 66%x0% + 13%x100% + 21%x67.5%
=27% reduction in un-notified contacts.

So if your Rt would be 1.3 before contact tracing, it's 0.95 after contact tracing. That's ok, it's a useful contribution but really you'd want that number to be much higher.

I expect the usual press noise to go hard on "only" 75% percent of people being reached. It's a much bigger deal that most people are never even tested. Presumably as you improve performance, you get more of those infections into the system. 75% is already quite good, the real focus needs to be on getting the completely missing cases into the system.
posted by atrazine at 6:45 AM on June 18, 2020 [5 favorites]


Wasn't there a question about children's ability to spread coronavirus?

Back when all this started and some people suggested that kids were not major spreaders of SARS-CoV-2, I (an ignorant layperson, mind) dismissed it as unlikely. But now that we know more about the virus it strikes me as a bit more likely, at least in the sense that the data we've gathered has shown my intuition to be wrong over and over.

I wonder if any more data has come out around that. The school reopening plans I've seen seem to mostly say "keep adults besides teachers the hell out of the schools and keep classes separate as much as possible," and if we have better data about kids' ability to spread coronavirus we might be better able to determine if that's enough.

As atrazine notes, there are risks beyond the classroom we have to consider too, so this wouldn't be a complete picture.
posted by Tehhund at 7:17 AM on June 18, 2020


Universities and high schools are readying high-tech ways to curb the spread of Covid-19 - "The methods range from trackable student IDs and 'exposure alert' apps to UV lights and thermal cameras that automatically perform temperature checks."
This type of surveillance is picking up in the corporate world to confront the health crisis, too. Car manufacturer Ford has given its employees Bluetooth wristbands that buzz when standing too close to someone else, and consulting firm PricewaterhouseCoopers is testing a phone tracking app at its Shanghai office that knows how far apart people are in the office. Some companies are even using thermal cameras that automatically check for elevated body temperatures. However, the World Health Organization states on its website thermal cameras may be effective in detecting if someone has a fever but they cannot screen for Covid-19... The fear is that these efforts can gradually shift away from their original use cases to other forms of monitoring, such as keeping an eye on employee productivity.
posted by kliuless at 8:22 AM on June 18, 2020 [1 favorite]


The schools here in the Netherlands have been open for over a month. There hasn't been any reports of transmission due to this.

Kids are kept with the same peers and teachers. I believe they did discover two kids in Leiden a couple days ago and immediately sent the entire class home to quarantine.

I'm sure its better for kids to be in school but kids are also resilient and a year of being out of school I don't think will strongly affect them. But it is probably driving the parents themselves mad and mental health is not something to be underestimated.
posted by vacapinta at 8:43 AM on June 18, 2020 [8 favorites]


There is quite a bit of research that points to even summer breaks leading to cumulative reduced schooling outcomes because of the amount of review that is required before new material can be introduced (half the impetus for year round schooling). There are going to be at least some kids who have greatly reduced performance if they are defacto off for half a year or more.

Of course falling ill or dying will also have a serious negative impact so I'm glad I don't have to make this decision.
posted by Mitheral at 8:58 AM on June 18, 2020 [2 favorites]


I'm sure its better for kids to be in school but kids are also resilient and a year of being out of school I don't think will strongly affect them. But it is probably driving the parents themselves mad and mental health is not something to be underestimated.

Maybe. It wouldn't have done me much harm (I probably would have learned more) - but I was not a typical child. Most people on MeFi probably weren't. Consider also that kids in state schools located in wealthy areas where all the kids have access to their own tablets and/or laptops and private schools are basically running full programmes while some state schools are basically mailing out some worksheets and hoping for the best. This is going to lead an absolutely enormous attainment gap.
posted by atrazine at 9:05 AM on June 18, 2020 [6 favorites]


I'm sure its better for kids to be in school but kids are also resilient and a year of being out of school I don't think will strongly affect them.

In South Africa one reason that schools are reopening, despite COVID-19 cases growing at an ever increasing pace, is that for poor and rural children (and in SA that's a significant %) the longer they stay out of school decreases the chance they will return into the educational system.
posted by PenDevil at 12:20 PM on June 18, 2020 [2 favorites]


[Canadian] Prime Minister announces new mobile app to help notify Canadians of COVID-19 exposure

The technology will be owned and operated by the Government of Canada, and published under an open source licence.
posted by Mitheral at 2:14 PM on June 18, 2020 [1 favorite]


About the schools: I maybe wrote this earlier, but we actually had a full scale test of this some years ago, when there was a universal teacher's lockout for a month. There was no measurable drop in levels of skills or competences anywhere or in any subjects. Obvious three months is longer than one, but I'd imagine there's a big leeway here.
More importantly, the kids were getting depressed and lonely, and yes, the families were very stressed as the parents were working from home as well as being teachers and short order cooks.

The schools have opened a while ago here, and there are outbreaks here and there (maybe three in the entire country? I'm not certain). The point is that they are very manageable. A class is a manageable bubble, and it is easy to isolate every individual after testing who is infected. Then because it is a small group, it is possible to care for them, wether or not hospitalization is necessary because the hospital is not overburdened. AFAIK none of the school outbreaks have till now led to hospitalizations, and the total number of cases is still falling steadily as the number of tested individuals is now way over 10% of the population.
Schools should open before pubs.
posted by mumimor at 2:58 PM on June 18, 2020 [3 favorites]


The UK has announced that they're not going to use their custom protocol and instead will use the app they developed based on the Apple/Google DP3T API. In a way it's too bad since the capabilities the NHSX app would have had were superior to the Apple/Google one, in particular allowing revocable notifications and therefore giving people a warning that a contact was symptomatic and then a message to isolate based on a positive test. Given the inherent difficulties of using Bluetooth signal strength to measure distance, the more capability the better.

Unfortunately despite a very clever ping-pong keepalive design that used the differing capabilities of Androids and iphones, they never got iphones to stay "alive" long enough in practice and Apple was not willing to budge on their API requirements. Essentially, as long as you switch the iphobe app on in a crowd, it will work since there will always be enough android phones around you hitting you with keepalive pings. The problem comes if you switch the app on in the morning, walk to the station (away from other phones for a few minutes) and then get on the train. By the time you're on the train, the iPhone app has backgrounded and is no longer receiving.

They have apparently collected a huge amount of data on turning Bluetooth signal strength data into distance measurements which is being shared with Apple and Google to improve the performance of their API. Not clear if that's genuinely useful or just face saving, I suspect a little of both.

It does show the wisdom of pursuing both technologies in parallel. I'm sure the usual halfwits will be out in force complaining about "wasted" money on the one that didn't work but the problem with government spending is that they don't spend enough on optionality, not that they spend too much.

The real irony is that we spent so much time talking and thinking about this, and it turns out that people don't really like being told to self-isolate by an app at all! So strike one for techno-utopianism I guess.
posted by atrazine at 12:18 AM on June 19, 2020 [2 favorites]


Small point: Nobody knows if the German app works. Nobody knows if any of these apps work beyond the app loading on phones. "work" in this context has to mean actually picking up high risk contacts correctly and motivating people to self isolate, not just loading on the phone and looking good.

Apparently NHSX already has an app based on the Google/Apple API working so no reason it would take months. My understanding is they could roll it out tomorrow if they thought it would help in its current form. I actually think Hancock is doing the right thing for once by waiting to see what happens elsewhere and trying to get it perfect before releasing it.

There is no information on when they are planning to release it, reports that it will be at the end of the summer are based on extrapolating out a remark Bethel made at a HoL committee meeting earlier in the week when he said that they didn't think they needed it before then. Obviously not the same as it only being read at that point.

Initial tests with both apps seem to show that:

1) Bluetooth ranging is hard to make work, that affects both the original NHSX design as well as the Google/Apple based apps. Apparently they have managed to make ranging work better using their own app. We shall see how true that is, if it is true then I would expect the phone OEMs to adopt the ranging calibration which will benefit everyone.

2) People don't like being told to stay at home for 14 days by an app. I am curious to see what the emerging German, French, and Italian experience is there. In the UK it seems that people prefer to be contacted by
posted by atrazine at 3:11 AM on June 19, 2020 [2 favorites]


winterhill: agreed. We don't need an app this week or next. I would really like them to get something working in July as people spend more time around people they don't know.


Some other developments in the UK:

The ONS released age standardised death rates by religion today:

Number for males:
No religion: 80.7
Christian: 92.6

Jewish 187.9
Muslim 198.9

Buddhists, Hindus, and Sikhs had death rates in between. Female death rates were dramatically lower and showed less spread.

The very high death rate in the Jewish community does rather challenge the idea that differential death rates are mostly due to deprivation or due to vitamin D deficiency. When adjusted for indices of multiple deprivation and other socioeconomic factors, the male Jewish excess death rate is staggeringly high compared to any others.

It could just be that death rates have been higher in urban areas, that Northwest London where the majority of the British Jewish community lives was particularly hard hit, or something else.
posted by atrazine at 3:37 AM on June 19, 2020 [3 favorites]


Fear of Infection Hurt the Economy More Than Lockdowns - "There is a middle way — lockdown lite — that allows most activity to continue without snuffing out business." thread:
...

"Lockdown lite" would mean something along the lines of:
  1. Work from home
  2. No indoor gatherings of more than a few people
  3. No indoor restaurant/bar seating
  4. Mandatory masks for anyone in an indoor public space
  5. AND, of course, lots of #TestAndTrace!!!
States and cities should consider "lockdown lite", combined with robust testing, tracing, and isolation, as a way to inflict minimal harm on the economy while saving the maximum number of lives in the event of a local coronavirus outbreak.
also btw, re: outdoor activities...
"The absence of surges in the cities with massive demonstrations has taken many officials and health analysts by surprise."
posted by kliuless at 5:49 AM on June 19, 2020 [5 favorites]


Re: 23andMe Provides More Evidence That Blood Type Plays Role in Virus... - posted by kliuless at 6:45 AM on June 9

Blood type, genes tied to risk of severe COVID-19: European study (Reuters, June 18, 2020) A person’s blood type and other genetic factors may be linked with severity of coronavirus infection, according to European researchers looking for further clues about why COVID-19 hits some so much harder than others. The findings, published in The New England Journal of Medicine on Wednesday, suggest people with type A blood have a higher risk of being infected with the coronavirus and developing worse symptoms.

Italy sewage study suggests COVID-19 was there in December 2019 (Reuters, June 19, 2020) Scientists in Italy have found traces of the new coronavirus in wastewater collected from Milan and Turin in December 2019 - suggesting COVID-19 was already circulating in northern Italy before China reported the first cases. The Italian National Institute of Health looked at 40 sewage samples collected from wastewater treatment plants in northern Italy between October 2019 and February 2020. An analysis released on Thursday said samples taken in Milan and Turin on Dec. 18 showed the presence of the SARS-Cov-2 virus.
posted by Iris Gambol at 9:32 AM on June 19, 2020 [2 favorites]


Coronavirus: Over 600 people test positive at German slaughterhouse - "Yet another German slaughterhouse has registered a massive outbreak of the coronavirus. Roughly two-thirds of the test results so far have come back positive."

Opinion: Coronavirus outbreak in German slaughterhouse was preventable - "A major coronavirus outbreak in Europe's biggest meat-processing plant was a disaster that was bound to happen and just as preventable."
Many locals who live near the Tönnies' headquarters have cared little for the company's controversial practices. Well paid jobs in this part of the country, after all, are hard to come by. In the past, the company has exerted considerable influence on regional and local lawmakers, who turned a blind eye to the mistreatment of foreign workers.

Now, public opinion is changing. Lawmakers are distancing themselves from company boss Clemens Tönnies, as are co-owners of the high-profile company. Locals, meanwhile, are enraged because the recent virus outbreak has led to the closure of schools, preschools and kindergartens in and around Rheda-Wiedenbrück and the nearby, bigger city of Gütersloh.
posted by kliuless at 3:11 AM on June 20, 2020 [6 favorites]


there is something about these outbreaks at meat processing/packing plants internationally (Germany, UK, US reported so far) that seems emblematic/symptomatic, ripe for a metaphor I can’t quite put my finger on...
posted by progosk at 5:57 AM on June 20, 2020 [5 favorites]


Schlachthof-sechs
posted by kliuless at 6:06 AM on June 20, 2020 [2 favorites]


The very high death rate in the Jewish community does rather challenge the idea that differential death rates are mostly due to deprivation or due to vitamin D deficiency. When adjusted for indices of multiple deprivation and other socioeconomic factors, the male Jewish excess death rate is staggeringly high compared to any other

A friend of mine pointed out that the reasons behind high death rate for a particular ethic, religious, etc. group might not be all bad. They might be indicative of strong community ties, higher level of social interaction between generations, etc. Of course, it is horrible that the virus would hit these communities harder.
posted by zeikka at 7:53 AM on June 20, 2020 [1 favorite]


« Older Cats and Friends Choir   |   Nick Cave and the Bad Seeds - Deanna (TNG edition) Newer »


This thread has been archived and is closed to new comments