"but what normal looks like varies dramatically."
August 4, 2020 8:09 PM   Subscribe

As the global death toll nears 700,000, the Guardian reports that six months on, coronavirus victories remain fragile, as public health authorities say the number of infections is accelerating and the peak still lies ahead. And yet, according to Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, areas that observed tight shelter-in-place constraints, like New York and some countries in Asia and Europe, showed that we can bring the deadly numbers down and bring back the economy in a safer public environment. posted by katra (211 comments total) 63 users marked this as a favorite
 
What Lockdown 2.0 Looks Like: Harsher Rules, Deeper Confusion (NYT / MSN reprint)
Melbourne, Australia’s second-largest city, is becoming a case study in handling a second wave of infections. There are lots of unanswered questions.
A breakdown in the quarantine program for hotels, which was contracted out to private security, meant that returning travelers passed the virus to hotel security guards, who carried the contagion into their neighborhoods. The spread continued even after Melbourne started a so-called Stage 3 lockdown in early July — until recently, the highest level of restrictions — with no large gatherings and most people working from home. Officials grew increasingly angry as they discovered that the perception of a problem solved had produced complacency. As officials cast about for ways to break the chain of infections, the city has developed a confounding matrix of hefty fines for disobedience to the lockdown, with minor exceptions for everything from romantic partners to home building, and endless versions of the question: So, wait, can I ____?
People need support to follow local lockdowns, not orders from above (Stephen Reicher, Guardian Opinion)
If communities feel singled out, discriminated against, left behind and ignored, blame the messenger not them
As psychologists who study disasters and emergencies predicted, the public showed remarkable resilience through the lockdown. Compliance was high from the start, and remained so throughout. People stayed home to protect their communities even though many suffered personally from doing so. And when Dominic Cummings broke the lockdown rules, displaying the weaknesses that the government had earlier projected onto the population, people continued to comply with them despite – not because of – Westminster. Perhaps the clearest psychological lesson to come out of the pandemic so far is that it’s wrong to think people are mentally fragile. When a common challenge leads us to come together and support each other, we can show remarkable psychological resilience. Put simply: people will accept some suffering for a bigger cause.

[...] Lockdowns make you think only of restrictions. But areas of high infection are generally areas of high deprivation. Those affected are often marginalised and vulnerable people in need of support – such as more and clearer information, accessible testing facilities, assistance for those needing to isolate and help for local businesses required to close. Language is always revealing, and never more so than in this case: we need local support packages, not local lockdowns.
posted by katra at 8:24 PM on August 4, 2020 [19 favorites]




SOME ARE WINNING - SOME ARE NOT : Which Countries Do Best At Beating COVID-19? - Endcoronavirus.org Global Incidence Charts
posted by benzenedream at 9:30 PM on August 4, 2020 [4 favorites]


As always, great links katra.

You should be everyone's editor.
posted by Windopaene at 9:37 PM on August 4, 2020 [15 favorites]


Countries tighten measures as global virus death toll nears 700,000 (AFP / Yahoo)
France and the Netherlands are gearing up for stricter mask-wearing rules to fight the coronavirus as the global death toll from the pandemic neared 700,000. Paris, Toulouse and other cities announced that the wearing of masks would be compulsory in particularly busy streets and squares. People already have to wear them inside most private businesses and all public buildings. A scientific committee advising the French government warned that the country could lose control of its spread "at any time."

[...] And Ireland postponed the reopening of pubs and other nightspots on the advice of scientists, concerned about rising infections. In other developments, the Philippines placed millions of people back under lockdown. [...] But with only 24 hours' notice of the shutdown, many people were stranded in Manila, unable to get back to their hometowns after public transport and domestic flights were halted.

[...] The worst hit country, the United States, had added 1,300 new deaths as of Tuesday evening, bringing its toll to nearly 156,000, according to Johns Hopkins University. The caseload grew by 53,847 to nearly 4.8 million, it said. [...] Brazil is driving a surge in Latin America and the Caribbean, where infections passed five million on Monday. South America's largest country has recorded more than 2.75 million cases, and nearly 95,000 deaths, nearly half the region's 203,800 deaths.
Closing schools around the world could cause a ‘generational catastrophe,’ U.N. secretary-general warns (WaPo / MSN reprint)
Allowing students to safely return to classrooms must be a “top priority” as countries get local transmission under control, [U.N. Secretary-General António] Guterres said in a video message released early Tuesday morning. A policy brief published alongside Guterres’s message emphasized that suppressing transmission of the virus is “the single most significant step” leaders can take toward reopening schools.

As of Aug. 2, more than 1 billion students in more than 160 countries were affected by school closures, according to data collected by the U.N. Educational, Scientific and Cultural Organization, and more than 40 million children had missed out on the “critical preschool year,” Guterres said. Countrywide closures remain in place in 106 countries.
posted by katra at 10:26 PM on August 4, 2020 [2 favorites]


There is a rise in cases here in Denmark, as people begin to return from their holidays into jobs that are not all safe. At this point, about 20% of the population have been tested, some more than once.
Mask-wearing in public transportation and crowded spaces has been encouraged, but not mandated, from August 1st.
Denmark is very dependent on international trade, so there has been a fear that the economy would tank in spite of a relatively succesfull reopening. At this point, the government is fairly optimistic that we will see an economic recovery during the fall, though everyone looks at America and the UK with a lot of apprehension. In both cases, it's not just about COVID-19. There are Trump's tariffs and Brexit to deal with too.
If you visit here, a lot of things will look normal. People are sitting at cafés and restaurants, we have never had any shortages of anything more than a week, and even then they were superficial, you could always go to another area and find yeast or toilet paper, or now masks.
posted by mumimor at 12:44 AM on August 5, 2020 [14 favorites]


Germany debates curbing freedom of assembly after coronavirus rallies
Saturday's huge demo in Berlin against Germany's coronavirus measures has raked up a new debate about the boundaries between the right to assemble and the protection of public health.

Inevitably, given that the organizers of the "Day of Freedom" were arguing that the German government was wilfully overestimating the threat of the coronavirus, most of the 17,000 – 20,000 protesters made no attempt to wear face masks or stick to social distancing guidelines.
posted by dmh at 1:17 AM on August 5, 2020 [6 favorites]


Overall Italy has been seeing roundabout 200 new cases per day for the last two weeks or so, so that kind of stability of a comparatively low rate of active contagion (mostly taking place in localised flare-ups, unrelated amongst each other, that are rapidly identified and contained) is very comforting. Having been at the global forefront of the hard early hit of the pandemic, to have managed as a country to weather a long, rigid national lockdown with pretty generalised compliance and very little protest, seeing the current low contagion last (provincial rankings here), there's a general sense of vindication, and pride at having discovered itself as a responsible global actor, especially given the opposite extremes we're seeing take place elsewhere.

A national study published a couple of days ago (based on 65K antibody tests done between end of May and mid-July) estimates 2.5% of the population (so about 1.5 million people) to have been exposed to the virus - though there a huge regional and province-level differences: Lombardy is at 7.5%, Lazio at 1%; Bergamo is the hardest-hit province, with nearly 25% sieropositivity - meaning that the probability of encountering someone positive in Italy is 2.5, which sounds low, but as the head of ISTAT puts it: "if I encounter 20 people, there's a 50 percent chance I'll come into contact with someone positive". Oh and: more than a quarter (27.3 %) of people found to have antibodies never developed any symptoms - so those are the unwitting untori to still be wary of...

Yeast's been back in shops since June, even rubbing alcohol has returned to shelves since early July. With the state of emergency having been extended til mid-October, there's concern about imported cases now, plus the question of under-resourced school reopening on the horizon (in six weeks), and a creeping sense of dread of the looming September jobs/rent/economic crunch up ahead, as details of a further €25B "August decree" are still being discussed (sounds like it'll take the shape of a restaurant bonus, and an extension of the cassa integrazione furlough scheme).

We've noticed our own don't-go-out-without-mask instinct sometimes fail, which is a concern, but generally folks are pretty serious about collective masking in public interiors. There was a brief travel regulation misstep the other day regarding long-distance trains: both main rail companies had been banking on being allowed to return to full-capacity seating as per rules that expired on July 31st, and so accepted all bookings - only to have the health minister walk that back a day later, on expert advice and after much public questioning, forcing multiple cancellations and travel-woes, much as is happening with many of the smaller European airlines. So if you're among the very few tourists coming here this year (Rome is truly spectral without the usual throngs...), do plan for some logistical entropy.

Mostly, wherever you are, please just wear masks, y'all, and think about your hands? (And do whatever you can from letting your solidarity instincts be shot - grazie.)
posted by progosk at 2:11 AM on August 5, 2020 [22 favorites]


If you visit here, a lot of things will look normal. People are sitting at cafés and restaurants, we have never had any shortages of anything more than a week, and even then they were superficial, you could always go to another area and find yeast or toilet paper, or now masks.

That describes the Netherlands too. But the number of cases has been steadily rising and the government may actually have to do something. Masks are required on public transport but that's all. This week it looks like they will start requiring them in certain busy areas, like the historic center of Amsterdam.

All our Dutch friends went off on August holidays - to France, to Spain. And whereas most summers I hear Americans all over town this time the city is crowded with German and French tourists. When everyone goes back/returns home in a few weeks, who knows what will happen.
posted by vacapinta at 2:32 AM on August 5, 2020 [8 favorites]


vacapinta: This week it looks like they will start requiring them in certain busy areas, like the historic center of Amsterdam.

Yes, masks are mandatory in certain streets as of today (Wednesday).
posted by Too-Ticky at 2:45 AM on August 5, 2020 [4 favorites]


Allowing students to safely return to classrooms must be a “top priority” as countries get local transmission under control, [U.N. Secretary-General António] Guterres said in a video message released early Tuesday morning. A policy brief published alongside Guterres’s message emphasized that suppressing transmission of the virus is “the single most significant step” leaders can take toward reopening schools.

Back in late May / early June SAGE, a scientific committee that provides advice to the British government, released a series of modelling papers on school re-opening that essentially showed that there was no scenario in which all schools could be opened as normal before the summer holidays. Even closing many other things back down and only opening schools was not enough.

Against the backdrop of a lot of unhappy parents who had hoped that their children might go back to school before then, a commitment was then made that they would certainly all be opened, in-person, in September when the new school year began.

The problem with that is nothing has changed that would invalidate the models, unless they've been re-run with new parameters which are more favourable. Whether school opening leads to Rt > 1 does not depend on the level of circulating virus, unless there is no virus at all opening schools will lead to increased transmission.

We can see from the FT coronavirus tracker that cases are slowly ticking up in countries that had previously controlled the virus. Germany now has a comparable number of new cases to the UK and almost every country is seeing an uptick. None of these countries currently have their schools opened.

A modelling paper in the Lancet last week looked at what we would need to do to prevent another runaway outbreak. They found that a combination of:
-68% of contacts of people referred for contact tracing need to be notified
-75% of symptomatic people need to be referred for contact tracing
Would be enough to relax essentially all other restrictions.

Based on the latest weekly report (to 22nd July, these reports come out every Wednesday), 61% of contacts are currently being contacted (81% people reached and 75% of their contacts reached) which needs to be improved somewhat. Notably, those numbers are much lower in some communities and PHE is now finally integrating local public health teams into the contact tracing system to improve that.

But... we are nowhere near testing 75% of symptomatic people. The latest ONS population survey data found about 4,200 new cases / day in the week 20 to 26 July in the community. That's about 29,400 / week. If we assume the same percentage asymptomatic (30%) as in the Lancet paper we have:
-8,820 asymptomatic cases. There is currently nothing we can do about these, although after a successful pilot they are now rolling out 100k / day or so tests of asymptomatic people in high risk occupations but that is a drop in the bucket.
-20,580 symptomatic cases

Since 4,128 people actually tested positive over that period that's only 20% of the symptomatic people that we know are out there. How to solve that problem? We have more than enough tests for those people, the capacity is currently at 500k a day so catching another 16k a week who already have symptoms shouldn't be so hard.

Now The Lancet paper makes a few pretty pessimistic assumptions. For one thing, they assume that symptomatic but untested people are as likely to transmit as symptomatic and tested which I do not think is true. Even so, what this shows is that even if the tracing scheme worked perfectly and reached 100% of all contacts, it wouldn't be enough.

The only way out for countries where the virus is now so widespread is to double, treble, quadruple down on fast testing.

Currently 91% of tests carried out in hospitals get results back within 24 hours of the lab receiving the sample and 77% of tests carried out at home and posted back come back within 48 hours which is probably as good as can be done with PCR testing. We'll see if the newly introduced LAMPore test leads to more point of care testing with very fast turnaround but given that they're scaling from nothing it will take a while to see any results from this. They've said they'll soon be producing 1m tests a month, which sounds great until you realise that's just 30k / day.
posted by atrazine at 2:47 AM on August 5, 2020 [11 favorites]


On testing, here's Italy's numbers - from steady highs of over 70K tests per day (on a population of 60M), it's currently down to about half that. (Here's a regional breakdown.)
Oh and the (AppleGoogle decentralised) Immuni tracing app? Since its launch a couple of months ago, only about 8% of Italians have downloaded it (Germany's at about double that with theirs, and France at about half), and so far it's sent possible contagion alerts to a total of... 23 people.
posted by progosk at 3:12 AM on August 5, 2020 [5 favorites]


only about 8% of Italians have downloaded it (Germany's at about double that with theirs, and France at about half), and so far it's sent possible contagion alerts to a total of... 23 people.

By contrast, the Irish app has been downloaded by about 30% of the population and had 137 alerts since July 7th, when it was launched. A similar app is now being used in Northern Ireland as well, and the two apps are linked so that they both work on a cross-border basis.
posted by scorbet at 3:39 AM on August 5, 2020 [11 favorites]


Nobody’s been talking much about Sweden lately, where schools, youth sports, and restaurants never closed. After a steady pace of infections and a brief uptick (increased testing?), positive numbers have dwindled and ICU admittance almost nil in the last weeks. Good news!

This could be explained by summer holidays, people going to their cottages and staying put. We’ll see. At least it’s a data point that a recommendation-based public health agency-led approach can manage OK. And it no doubt leans on the strong unemployment benefits and welfare system.
posted by anthill at 3:45 AM on August 5, 2020 [6 favorites]


Anthill, I'm sure that those things help... and having a small population, with a relatively introverted culture, may have a positive impact as well.
posted by Too-Ticky at 4:00 AM on August 5, 2020


This picture shows masks being handed out in the Kalverstraat, central Amsterdam... and people wearing them. Well, sort of. Okay, not really.
posted by Too-Ticky at 4:30 AM on August 5, 2020 [3 favorites]


A colleague who is deeply involved in executing testing and tracing says that the reason that trace is going to fail in the UK is as follows

As well as the "libertarian", "don't want to download","don't believe this is real" "govt spying on our lives", "anti-snitch mentality" as well as " deep (justified!) distrust from BAME populations of governmental intentions", that we've all heard about, there are 2 more big failure points for trace

i) people work off-the book jobs, get cash-in-hand payments,pay no taxes and thus don't want the govt. to know who they've been associating with
ii) people are screwing around on their partners

these last two points are responsible for double-digit percentage fails in tracing efficacy!

---
The UK will probably move to rapid, frequent, localized testing and bubble/lockdown formation in organizations/towns for the future, because trace is set up to fail with the cultural issues above.
posted by lalochezia at 5:01 AM on August 5, 2020 [2 favorites]


It's tricky to frame Sweden's strategy and outcomes, because although we're all highly Covid-numerate now, it's still rare to see their "success story" contrasted to their relative numbers: with a population similar to Lombardy's, their overall infection rate (cases per million population) was higher, and their mortality rate (deaths per million population) is still higher than the US and Brazil's, and as much as ten times that of neighboring Finland and Norway. Yes their restrictions were quite different from most other European countries', but a month ago their economy was projected to take a similar (if not worse) hit as neighboring Denmark's, with any early laissez-faire benefits cancelled out by the global nature of the economic contraction. As per a comment in the NYT article: "Sweden is exposed to the vagaries of global trade. Once the pandemic was unleashed, it was certain to suffer the economic consequences. [...] What remained in the government’s sphere of influence was how many people would die."
In the end, though, perhaps more than their character, their political infrastructure might yet soften the blow, as per another quote: "Collectively, Scandinavian consumers are expected to continue spending far more robustly than in the United States, said Thomas Harr, global head of research at Danske Bank, emphasizing those nations’ generous social safety nets, including national health care systems. Americans, by contrast, tend to rely on their jobs for health care, making them more cautious about their health and their spending during the pandemic, knowing that hospitalization can be a gateway to financial calamity. “It’s very much about the welfare state,” Mr. Harr said of Scandinavian countries. “You’re not as concerned about catching the virus, because you know that, if you do, the state is paying for health care.”
posted by progosk at 5:11 AM on August 5, 2020 [12 favorites]


Airlines Get Pushed to Brink Again With Virus Decimating Demand — Early signs of recovery have been stalled by Covid flareups during carriers’ prime season., Bloomberg Businessweek, Christopher Jasper, 8/5/2020: ...Summer represents the only profitable period for many carriers even in normal times. But with the prospect fading for a traffic rebound before the vacation season ends, a spate of collapses and bankruptcy filings is inevitable...
posted by cenoxo at 5:30 AM on August 5, 2020 [1 favorite]


Killing half of the airlines would be great for reducing high atmosphere carbon emissions. I'm for it.
posted by seanmpuckett at 5:36 AM on August 5, 2020 [13 favorites]


Modify that to "kill half of each airline" and you've got yourself a second. We don't need even more monopoly effects.
posted by notsnot at 5:39 AM on August 5, 2020 [12 favorites]


The UK will probably move to rapid, frequent, localized testing and bubble/lockdown formation in organizations/towns for the future, because trace is set up to fail with the cultural issues above.

But isn't that true in many other places too? Mind you, based on the current trends in infections it does not appear that test, trace, isolate is working in Spain or France either so maybe the exact same thing is happening there. Do you know if they're at least advising index patients to personally contact people that they may not be willing to disclose? That would still work, just be messier.
posted by atrazine at 5:40 AM on August 5, 2020


Killing half of the airlines would be great for reducing high atmosphere carbon emissions.

If you're referring to carbon dioxide as a greenhouse gas, it doesn't matter where in the atmosphere it's emitted, the effects are exactly the same. High atmosphere particulate emissions and their effect on stratospheric cloud formation are a different matter.
posted by heatherlogan at 6:43 AM on August 5, 2020 [2 favorites]


Malaysia just started mandatory masking this month, though we're still in our relaxed lockdown phase (which is scheduled to end this month). Whether that needs to be extended, will depend on our performance -- numbers started ticking up again once the govt relaxed quarantine requirements for inbound international travellers to home quarantine, and too many didn't follow protocol and i do think it's now back in the wild. Eid-ul-Adha was barely a week ago, so we'll have to see if there's going to be any explosion in numbers, in another week or so. I do think we're not going to see relaxed civilian international travel any time soon, definitely not as the world is much too unsafe yet.

the big problem is unlike Scandinavian countries, our social welfare net isn't too great, and the backdoor government that we have hasn't been keen to spend more resources on that front, unless their hand is forced (eg the quarantine -- and now, unlike before, the quality of care has markedly gone down). the mandatory masking for example has been accompanied with coverage of police arresting and fining civilians and no news whatsoever of free mask supply for the poor for example (something we've been assured of, and yet many hasn't received). our six-month housing/term loan moratorium is also winding down, and the next three-month extension is only available if you can prove you're still financially constrained such as losing your income (to be expected when the new finance minister is only recently a banker). we're really depending a lot on our healthcare system, which has been truly gone above and beyond in this crisis (even as longstanding issues with our contract-labour doctors and nurses aren't yet resolved, and we don't have a govt that will resolve this if the answer cannot involve privatization of some kind). this disease will hit us hard in our wallets, but at least we have our lives. let's hope we can stay alive long enough.
posted by cendawanita at 7:05 AM on August 5, 2020 [9 favorites]


Canada's COVID Alert has been praised by the great and good in computer privacy, but it won't run on older phones, thereby excluding the most at-risk in society.
posted by scruss at 7:26 AM on August 5, 2020 [3 favorites]


we must look to the example of countries such as South Korea and Singapore and certain EU nations, as well as states like New York, which recognized the challenge earlier; provided honest, effective leadership; and quickly undertook mitigation, testing and contract tracing...

New York is not a good model.
posted by doctornemo at 7:32 AM on August 5, 2020 [1 favorite]


Sweden's economy hit less hard by pandemic (BBC, August 5)
Sweden, which avoided a lockdown during the height of the Covid-19 pandemic, saw its economy shrink 8.6% in the April-to-June period from the previous three months. [...]

The European Union saw a contraction of 11.9% for the same period.

Individual nations did even worse, with Spain seeing an 18.5% contraction, while the French and Italian economies shrank by 13.8% and 12.4% respectively.
posted by dmh at 7:49 AM on August 5, 2020


While I was out, I heard on the radio that Sweden has ten times the deaths compared to Denmark, with an only slightly larger population. The news speaker gave out a deep sigh and added that he nearly couldn't take more now. The South of Sweden and East of Denmark are closely intertwined, economically and socially, with many people pendling across Øresund. For the most part there is no Schadenfreude, just a longing for normality.
posted by mumimor at 8:04 AM on August 5, 2020 [17 favorites]


Denmark has a pop of 5.8M with ~620 deaths, Sweden has a pop of 10.1M with ~5200 deaths as of this morning. That's a pretty stern indictment of Sweden's approach.
posted by seanmpuckett at 8:34 AM on August 5, 2020 [17 favorites]


Sweden did either well or horrendously, depending on who you compare it to. Compared to all its neighbors, the death rate there has been terrible (and I don't have time to look it up now but I saw an article claiming their economy has not fared any better than that of the other Scandinavian countries). I'm not sure it makes any sense to compare it to Italy and Spain, which were among the earliest and hardest-hit before they implemented lockdowns.
posted by trig at 8:37 AM on August 5, 2020 [3 favorites]


John from Scotland has produced a site that provides a great summation of Covid-19 information at a Scottish and at at UK level. If you are looking for plentiful, up to date and informative data sources in one place - then I have found nothing better.

Meanwhile - Physics Girl has published a video talking about bio-aerosols and ventilation with respect to covid-19 and other diseases. If you wanted to know what the "perfect sneeze" is - or where to not sit on a plane if you want to avoid catching bugs - then this is for you.
posted by rongorongo at 9:01 AM on August 5, 2020 [12 favorites]


I think there is no question that the Swedish approach was terrible from a mortality perspective. Sweden's mortality per million is among the worst in the world, only marginally better than Italy, somewhat better than Spain, and somewhat worse than the US. To some extent that was to be expected. The question now is whether Sweden's strategy succeeded in its aims of reducing economic harm (which, perhaps) and building some measure of immunity (remains unclear). Tegnell said it might take one or two years to know whose strategy had worked best and at what cost (FT, May 8).
posted by dmh at 9:07 AM on August 5, 2020


Tegnell said it might take one or two years to know whose strategy had worked best and at what cost (FT, May 8).

That is probably true.

Still since I don't like leaving the vague "I saw some article somewhere" in my previous comment, here are a few concrete links:
BBC July 24: Research from Scandinavian bank SEB in April suggested Swedes were spending at a higher rate than consumers in neighbouring Nordic nations.

Despite this, various forecasts predict the Swedish economy will still shrink by about 5% this year. That's less than other countries hit hard by Covid-19 such as Italy, Spain and the UK, but still similar to the rest of Scandinavia. Sweden's unemployment rate of 9% remains the highest in the Nordics, up from 7.1% in March.

"Sweden, like the other Nordic countries, is a small, open economy, very dependent on trade. So the Swedish economy tends to do poorly when the rest of the world is doing poorly," explains Prof Karolina Ekholm, a former Deputy Governor of Sweden's central bank.
NYT July 7-15: Sweden’s central bank expects its economy to contract by 4.5 percent this year, a revision from a previously expected gain of 1.3 percent. The unemployment rate jumped to 9 percent in May from 7.1 percent in March. “The overall damage to the economy means the recovery will be protracted, with unemployment remaining elevated,” Oxford Economics concluded in a recent research note.

This is more or less how damage caused by the pandemic has played out in Denmark, where the central bank expects that the economy will shrink 4.1 percent this year, and where joblessness has edged up to 5.6 percent in May from 4.1 percent in March.

In short, Sweden suffered a vastly higher death rate while failing to collect on the expected economic gains.
BBC Aug 5 (mostly compares Sweden to EU as a whole, but this bit at the end compares it to its neighbors): Various forecasts predict the Swedish economy will still shrink by about 5% this year.

That is less than other countries hit hard by Covid-19, such as Italy, Spain and the UK, but still similar to the rest of Scandinavia.

Sweden's unemployment rate of 9% remains the highest in the Nordics, up from 7.1% in March.
It's been interesting to see how the global coverage on Sweden seems to go through waves: there've been one or two weeks where articles on "Sweden's brilliant strategy" seemed to pop up everywhere, and then response waves of "Actually no, Sweden's a terrible model to follow" all over the place. I wonder how much of it is organic and how much is people actively trying to push the Swedish approach.
posted by trig at 9:37 AM on August 5, 2020 [10 favorites]


The problem with this "well we'll all get it at some point so might as well get it over with" attitude which is built into the Swedish model is that it ignores how quickly treatment has been changing.

If you had been treated for this a few months ago you might well have received pointless hydroxychloroquine, not received steroids, been intubated early, not been anticoagulated, may not have been proned if intubated. Certainly wouldn't have received any of the ILF-6 modulators or any of the very promising new drugs now been trialled. On the other hand, if you get it three months from now you'll probably receive all that plus a potent cocktail of monoclonal antibodies and who knows what else. That's if we ignore the fact that there may well be a vaccine in some limited deployment for high risk people by the end of this year.
posted by atrazine at 9:49 AM on August 5, 2020 [43 favorites]


there is no question that the Swedish approach was terrible from a mortality perspective

Exactly.

interesting to see how the global coverage on Sweden seems to go through waves

It's come to feel like it's being used as a litmus test/trial balloon for gauging how much cruelty citizens will abide by in the name of GDP, and the floating of the one or the other narrative about this recognised "outlier" in various contexts/outlets are making it into a weird kind of global parameter, which feels undeserved, given the relatively awful current numbers.

Tegnell's truism about timeframe, in asking for judgement to be deferred, would have us subscribe to a utilitarian fatalism that just feels off. "Worked" for whom? "Cost" for whom? The exceptionalism at work is just so out of kilter in the face of a global pandemic...
posted by progosk at 10:02 AM on August 5, 2020 [12 favorites]


I thought it turned out that COVID was devastating immigrant communities in Sweden?

On preview: anem0ne beat me to it.
posted by Glegrinof the Pig-Man at 10:43 AM on August 5, 2020 [1 favorite]


It's come to feel like it's being used as a litmus test/trial balloon for gauging how much cruelty citizens will abide by in the name of GDP

Looking back at the reporting on Sweden I ran across an interview with Tegnell in Nature from April 21 where he says something I don't recall having seen earlier: "The Swedish laws on communicable diseases are mostly based on voluntary measures — on individual responsibility [...] Quarantine can be contemplated for people or small areas, such as a school or a hotel. But [legally] we cannot lock down a geographical area."

I wonder to what extent Swedish law did indeed present a substantial hurdle to enacting lockdown, and/or to what extent that was just an excuse for experimentation.
posted by dmh at 10:47 AM on August 5, 2020 [1 favorite]


There was another possible factor to the Swedish solution that hasn't been brought up yet in this thread yet, and that's not sending some of the people most at risk (nursing home patients) to the hospital or doing anything but palliative treatment for them.
posted by foxfirefey at 11:20 AM on August 5, 2020 [3 favorites]


I wonder to what extent Swedish law did indeed present a substantial hurdle to enacting lockdown, and/or to what extent that was just an excuse for experimentation.
Isn't that something the lawmakers decide? Here, a lot of emergency laws were enacted, with a sundown clause.
posted by mumimor at 11:33 AM on August 5, 2020 [2 favorites]


Indeed, the UK enacted substantial additional laws when they thought it was required, I'm sure Sweden could have done likewise.
posted by atrazine at 11:42 AM on August 5, 2020


I posted a link to this video interview with a Swedish epidemiologist at the time. Amongst other things he said:
The other thing is that when you start the ‘exit strategy'… you’ll have some deaths that we had already.
All countries will have exit strategies where they will loosen one restriction, look at the numbers and say: “Ooo… the numbers are going up, so we’ll have to try another strategy and then say: “Ooo! That worked!”
Their theory was that everywhere else would just have multiple waves bringing the death toll up to Swedish levels.

So if you're confident that the Swedes were wrong, you should also be optimistic that there won't be very bad second waves elsewhere.

However in another part of the interview he said:
Interviewer: So you think millions and millions in Britain already have it?
Giesecke: Yes. I’m rather certain of that actually. In both Sweden and the U.K. at least half the population has had the virus.
That doesn't seem to be anywhere close to what the antibody tests say. It might be that they just over-estimated the infectiousness and underestimated the lethality of the virus, which led them to the wrong strategy.
posted by TheophileEscargot at 1:01 PM on August 5, 2020 [7 favorites]


Giesecke: Yes. I’m rather certain of that actually. In both Sweden and the U.K. at least half the population has had the virus.

My fantasy hope is that this is true in lots of places. Like low level exposures of masked people with incidental contact with infecteds led to an informal variolation program. I don't believe it because their seems to be no evidence for it in sero testing but I do think it is a nice fantasy for when I am daydreaming of a better world.
posted by srboisvert at 1:15 PM on August 5, 2020 [5 favorites]


It might be that they just over-estimated the infectiousness

Yeah, way over-estimated it: in this Dagens Nyheter article three months later (17 July), the head of the Public Health Agency says the official "proportion of people with antibodies in Stockholm can be between 17.5 and 20 percent", and in the rest of the country about half that. (How exactly they derive from this that "40% could be immune", the level they are shooting for so as to wear the herd immunity crown, remains somewhat unclear - something to do with T-cells - due to the googletranslation...)
posted by progosk at 1:26 PM on August 5, 2020


Here's a pretty detailled look (ForeignPolicy, June 23) at some of the reasoning behind the Swedish thinking:

"Critics should focus on the scientific argument behind Sweden’s light-touch strategy, namely that there is no satisfying evidence that draconian lockdowns reduce long-term mortality rates. This was summed up by Johan Giesecke, Sweden’s former state epidemiologist and a current advisor to the Public Health Agency, in a recent article published in The Lancet.
“There is very little we can do to prevent this spread: a lockdown might delay severe cases for a while, but once restrictions are eased, cases will reappear,” he wrote. “I expect that when we count the number of deaths from COVID-19 in each country in 1 year from now, the figures will be similar, regardless of measures taken. [...] The Swedish argument is that if a country can maintain adequate health care capacity throughout the crisis, the only benefit of a lockdown would be to delay deaths as the curve equals out across countries over time—assuming that governments that flattened the curve through lockdowns will inevitably face a second wave. On April 29, a modeling study from the Public Health Agency estimated that more than half a million people in Stockholm County, which is about 20 to 25 percent of its population, had been infected. But the results from the first antibody tests, published May 20, show that only 7.3 percent have developed antibodies in Stockholm."

and

"Sweden’s 5,161 fatalities from COVID-19, as of June 23, represent a death toll of 511 per million inhabitants, compared to 46 in Norway, 104 in Denmark, and 59 in Finland. Swedes, and the rest of the world, are now wondering why Sweden failed where its neighbors did not. And, indeed, the partial explanations and overall sense of confusion are far from satisfying. Tegnell says nursing home residents in Sweden are older than in Norway, Giesecke says nursing homes are larger than in Norway, Prime Minister Stefan Löfven says assuring adequate emergency resources are the responsibility of the regions, and when confronted with evidence of the elderly care sector’s lack of preparedness, the Public Health Agency’s general director, Johan Carlson, said he was surprised.
It’s probably all true. And while it’s frustrating that everyone admits failure but no one admits fault, looking for a scapegoat is futile. This isn’t the mistake of one person or a failure of the Swedish strategy as a whole. The Löfven administration did right by granting experts power free from political interference. But even the best leaders can’t repair a larger systemic failure in a matter of months.
The crisis Sweden is seeing today is the consequence of a government that has handed over responsibility to regions and counties at the expense of central oversight and, more importantly, a social democracy that has progressively abandoned its chief mission: protecting the most vulnerable."
posted by progosk at 1:57 PM on August 5, 2020 [7 favorites]


The Löfven administration did right by granting experts power free from political interference.
Actually, I think the last months have proved that isn't necessarily true. At the outset of the Corona-19 pandemic, no one knew what it was, we still don't really. It seems that many experts saw it as a bad flu or cold and treated it accordingly. It had to be a political, not a medical decision to impose those draconian measures, because the experts had no evidence for them, and experts must rely on evidence to make decisions.

The problem with this "well we'll all get it at some point so might as well get it over with" attitude which is built into the Swedish model is that it ignores how quickly treatment has been changing.
This. So much this. And to be honest I am a bit confused by the Swedish approach because already in March officials here were saying, we need a lockdown and a time-out as we try to figure out what this is and how to treat it.

Anyway, the reason the Swedish model is getting a lot of international press is that in the beginning, both the UK and the US followed a similar theory, and there are still Anglo hold-overs who believe it is a good idea. After all, most of the people dying in Sweden are either old or brown or both.
posted by mumimor at 2:33 PM on August 5, 2020 [2 favorites]


Cruise Lines Halt October Sailings from U.S. Ports, Cruise Industry News, 8/5/2020:
The Cruise Lines International Association (CLIA) [website, About] announced today that its ocean-going cruise line members have agreed to "voluntarily suspend" U.S. cruise operations until at least October 31, 2020. The Association issued the following statement on behalf of its members [list of member lines]:

Despite the valuable alignment between CLIA’s previous voluntary suspension to 15 September and the CDC’s current No-Sail Order date of 30 September [CDC Cruise Ship Guidance], we believe it is prudent at this time to voluntarily extend the suspension of U.S. ocean-going cruise operations to 31 October. This is a difficult decision as we recognize the crushing impact that this pandemic has had on our community and every other industry.

However, we believe this proactive action further demonstrates the cruise industry’s commitment to public health and willingness to voluntarily suspend operations in the interest of public health and safety, as has occurred twice prior. CLIA cruise line members will continue to monitor the situation with the understanding that we will revisit a possible further extension on or before 30 September 2020. At the same time, should conditions in the U.S. change and it becomes possible to consider short, modified sailings, we would consider an earlier restart.
More at Cruise industry extends sailing suspension past CDC 'no-sail' order until Oct. 31, USA TODAY, Morgan Hines, 8/5/2020.

Princess Cruises previously suspended cruises worldwide until at least 12/15/2020 (International Business Times, 7/23/2020).

Anchors await...
posted by cenoxo at 2:54 PM on August 5, 2020 [3 favorites]


Re Cruiseships I wish Norway would have been as sensible.
posted by adamvasco at 3:25 PM on August 5, 2020 [3 favorites]


Here in Germany things are almost back to normal. I was personally worried that since Germans are allowed to travel pretty extensively, that there would be a spike/2nd wave after the summer holidays. But so far, things are still ok.

Germany staggers their school holidays by state so that everyone is not out at the same time. Some states have had the summer break already since June and it is now coming to an end, while for others the summer break is just starting and will be over in September. According to RKI, cases were about 400-500 per day in June to early July. They're now at 800-900 per day. So not terrible, and not unmanageable at this point.

I'm really hoping numbers stay low as this is a great year to go to all those places that are so overcrowded with tourists! Once the final Germans are back from their summer holidays, that would be the last of the summer tourists and everywhere should be pretty empty. I'm hoping travel is still allowed in September/October so I can see Rome and Venice without millions of people in my way.
posted by LizBoBiz at 12:16 AM on August 6, 2020 [4 favorites]


Here in Germany things are almost back to normal.

It's interesting that you put it that way, since what is making the news rounds frames things quite differently, namely that Germany is actually in its second wave of Covid-19 - of course, the crucial question being how the community and health system are able to deal with it...
posted by progosk at 12:33 AM on August 6, 2020 [3 favorites]


I was personally worried that since Germans are allowed to travel pretty extensively, that there would be a spike/2nd wave after the summer holidays.

I'm still a bit worried about that, and even more so by the schools going back. I will be watching carefully what happens in the states where the schools are already back. It's another 10 days of holidays here in Hessen. Der Spiegel had an article on the subject last week which didn't lend me too much confidence.

I'm hoping travel is still allowed in September/October so I can see Rome and Venice without millions of people in my way.
I must admit I was half-thinking about doing something similar myself, particularly since I had originally planned to go to Rome in mid-March. So I'm not sure if there won't still be lots of "German" tourists, just ones without kids.
posted by scorbet at 12:34 AM on August 6, 2020 [1 favorite]


Btw, rest assured: Rome and Venice tourist figures are down officially by 60%, but according more localised figures by 99.7% (which is closer to what I would have guessed, living in the middle of it)...
posted by progosk at 12:43 AM on August 6, 2020 [1 favorite]


It's interesting that you put it that way, since what is making the news rounds frames things quite differently, namely that Germany is actually in its second wave of Covid-19

It's hard to know, to be honest if this is really the second wave, or whether the level of new cases has just stabilised again at a higher level. (The RKI reporting this morning that there were over a thousand new cases yesterday is a little bit more unsettling.) As I said above, I'm more concerned at the combined impact of people coming back from holidays and schools restarting. Particularly as the restart of the schools will also probably mean more people being able to go back to the office (even if not full time.)

On the other hand, it does feel fairly "back to normal" here, with the addition of masks and some social distancing (when people remember). At least where I am, basically everything is open once more, and I'm even back in the office most of the week (I can walk to work). The busyness of Frankfurt city centre is also pretty much the same as before any time I've been in to get something, but it's not really a tourist driven city.
posted by scorbet at 1:08 AM on August 6, 2020



Here in Germany things are almost back to normal.

It's interesting that you put it that way, since what is making the news rounds frames things quite differently, namely that Germany is actually in its second wave of Covid-19 - of course, the crucial question being how the community and health system are able to deal with it...


I was thinking about that when I posted the link above about Denmark's new "spike". In reality, it consists of two extremely local but relatively big spreading events, one in a meat processing plant, and one in the Somali community in Aarhus. But of course the media love presenting it as a second spike, and I suspect the politicians don't mind a bit of drama if it can get people to remember the rules better.
posted by mumimor at 1:17 AM on August 6, 2020


W.r.t. Germany what I find quite baffling/disturbing is the surge of anti-corona demonstrations, like the one I linked upthread. Earlier in Berlin, Stuttgart (DW, April 25), Munchen, Stuttgart, Frankfurt (DW, May 9) as well as others. Just today DW published another piece on Germany's growing anti-lockdown movement:
Protester were seen waving Germany's Imperial War Flag, a favorite with far-right extremists and members of the Reichsbürger, or Reich Citizens' Movement, both of whom reject Germany's present-day political order. Yet among the crowd were also people waving peace and rainbow flags, as well those with placards reading "Jesus Lives!"
NYT did a piece on the phenomenon back in May: Germany’s Coronavirus Protests: Anti-Vaxxers, Anticapitalists, Neo-Nazis.
posted by dmh at 1:22 AM on August 6, 2020 [4 favorites]


what I find quite baffling/disturbing is the surge of anti-corona demonstrations

As with QAnon in the US, there's an underbelly in every too-comfortable (= founded on structural inequality) society, ripe for fomenting. Italy's so far been curiously resistant to this kind of social theatre with regard to the pandemic, maybe because it elevated some of these theatrics to actual government a lot earlier than others (vis. Berlusconi, Grillo/MS5, Salvini), which may have served as a kind of booster shot to the immune response you'd have thought it acquired once and for all after it's full-blown case/history of fascism - something we've come to see was a naïve illusion, and it feels like something similar's the case in Germany too.
posted by progosk at 1:39 AM on August 6, 2020 [1 favorite]


It's interesting that you put it that way, since what is making the news rounds frames things quite differently, namely that Germany is actually in its second wave of Covid-19 - of course, the crucial question being how the community and health system are able to deal with it...

This is the site I've been using to track Germany's COVID numbers

I do prefer to look at the numbers rather than the news media. I personally think it's too soon to tell whether the 2nd wave is here. So far, I see only a small sustained increase from 400-500 cases per day to 800-900. No where near what it was in March/April when we locked down and we had between 3000-6000 cases per day. This is considerably different than the 2nd wave spikes we've seen in Spain (June had about 1000 cases per week, now they're at more than 10,000 per week) and Belgium (which had increases of 600-700% as compared to June).

The first of the states that had their summer holidays are finishing them this week, so it will be interesting to see if there is a spike. However, the two worst hit of the German states have only just started their holidays, so we will see what happens in the next couple of weeks.


W.r.t. Germany what I find quite baffling/disturbing is the surge of anti-corona demonstrations, like the one I linked upthread. Earlier in Berlin, Stuttgart (DW, April 25), Munchen, Stuttgart, Frankfurt (DW, May 9) as well as others. Just today DW published another piece on Germany's growing anti-lockdown movement:

I just took some holiday in Berlin last week and happened to catch this protest by surprise, though my friend and I tried to stay as far away from the protest as we could as we just wanted to enjoy the park. While the main theme of the protest was the coronavirus restrictions, there was soooo many different people just protesting whatever they want: there were vegans protesting against animal abuse, Germans protesting that they want to be able to be proud of their country again, people just angry that the German parliament is on holiday at the moment, etc. It was very diverse, though not something I wanted to be involved in.

I live in Munich and our restrictions have been stricter than the rest of the country (we were also one of the worst hit states, so it makes sense) and also the people here are 100% compliant. Going on holiday in east Germany I was shocked at how cavalier everyone was about masks and distancing. Even in the Berlin central station, only about half of the people were wearing masks.

I was surprised to learn from your links that the Munich protest had 3,000 people! The last time they tried this in May or June I think, they wanted to register for 10,000 people to protest and only 700 showed up.
posted by LizBoBiz at 2:08 AM on August 6, 2020 [4 favorites]


I do prefer to look at the numbers rather than the news media.

I'm with you about numbers being the thing, but, just to understand, why would you discount as just "news media" the estimation of the head of a doctor's union? Would she not be looking at the same numbers? Or are they to be considered as a special-interest group, so less than objective in their opinion?
posted by progosk at 2:33 AM on August 6, 2020


I think the doctor herself would also agree with what I'm saying.

"We are already in a second, flat surge"

A flat surge is not a spike, the surge is not large enough to overwhelm our hospitals in general, though local outbreaks could causes local resource constraints, and as long as we continue to wear masks, social distance, and wash our hands, things should be fine.

I also think, that talking to these doctors in private, you probably get a more nuanced view than they portray to the media because the news and normal people don't do nuance well. You need to be consistent and emphasize that the risks are still present and this is not over.

By the way, here is the RKI daily update. (my only complaint is that they dont provide the R numbers over time, that would be super helpful)

Page 10 shows the testing statistics. You can see that the last two weeks have seen an increase in positivity rate to put us back to the levels we saw in June, which was about the time that (in Bavaria at least) things were starting to reopen. So my conclusion from that is that the severity of the corona virus in June was low enough that reopening plans continued and even after that, levels continued to drop in July.

Two weeks of increased positivity rate, what has changed since June? More holiday travelling, especially as the summer school holidays started, probably a bit of people not being so compliant themselves, and (in Bavaria at least, not sure about the other states) just about 2-3 weeks ago, it began that anyone can get a test for any reason and there are testing centers set up in various locations so you dont even need to go to the doctor to get one (I think there's even one at the hauptbahnhof).

So, after reading and considering all the facts I have at my disposal, I dont think there's cause for concern yet, but that doesn't mean we can stop being vigilant. As more data comes in we will learn more about how this flat increase will progress, but at this point, I'd say yeah things are mostly back to normal. But I'm not a doctor, just a rando on the internet.

(Except for the clubs and oh how I never thought I would say this but I miss so much the crushing sweaty mass of drunk/high people just dancing together...)
posted by LizBoBiz at 3:34 AM on August 6, 2020 [5 favorites]


Commenting from New Zealand. I'm a traveler here and this is what I've picked up in conversation with locals. Actual KiwiFis may have other comments.

In New Zealand we still haven't had community transmission, but it feels like they're preparing us for an announcement that it exists. (Which would not be a surprise after all the people who have broken out of managed isolation over the past month!) We've been told to make sure we have masks and get ready to start wearing them at some point, and to have a prep pack in case we have to go back into lockdown.

Meanwhile, the New Zealand economy is being described as "perky." How much of this will end once the wage subsidy goes away is unclear. As people we've chatted with have pointed out, one of New Zealand's primary industries is international tourism, and domestic tourism can't make up for that. But dang if Kiwis aren't giving it a go! We're in Queenstown right now and, while it is definitely not as busy as it was when we were here in 2016, it is still steady. We waited in a line at Fergburger, albeit a 10-minute rather than 2-hour line. Another factor affecting tourism here (right here) is the extremely mild winter. International tourists can't rebook their ski holiday at the last minute like locals can.

On the other hand, there's other industries that are going full tilt. We talked to someone in the home building industry. Kiwis are applying those funds meant for international trips to buying and renovating homes like all get-out. The big issue in this instance: the supply chain. Many models of faucets are sold out, for example, and appliances aren't coming in, because even if the factory in China is running they get some parts from Malaysia, which is not.

My friends from yarn and sewing business also report that sales are very high. And hey, lots of local wool!

Another supply chain issue that has shocked us quite a bit: vegetables. Prices are very high for certain vegetables, like tomatoes, which we guess were imported from Australia in the winter. They're high enough that even locals we've talked to are commenting on how shockingly high they've gone.

I suspect the supply issues New Zealand is seeing will hit everywhere else in a bit. Due to its unique position in the world economy (small island off to the side), NZ sees things first.
posted by rednikki at 4:09 AM on August 6, 2020 [14 favorites]


You can see that the last two weeks have seen an increase in positivity rate to put us back to the levels we saw in June

...already back at May levels. We gallop into the past at an exponentially increasing pace.
posted by dmh at 4:44 AM on August 6, 2020


For the week ending 22nd July, the English combined test and trace figure of merit can be calculated as I did above as: (% symptomatic caught by tests x % reached by test and trace x % contacts reached)

20% x 81% x 75% = 12.2%

In other words, 12.2% of all possible exposures to symptomatic people are being contacted. The % of all possible contacts is lower because of asymptomatic people.

For the week ending 29th of July:

4,200 a day infections from ONS x 7 x 70% symptomatic = 20,580 symptomatic people (this is from the data ending 31st July, I will recalculate when the next tranche of data comes out tomorrow).

4,966 positive tests, 24% symptomatic infections picked up [n.b. likely overcount because using older prevalence]

79% reached x 72% contacts

24% x 79% x 72% = 13.7% [but note that first 24% is likely too high]

Every week there is a great deal of focus on those latter two numbers but note that you get a lot more bang for your buck adding a few % to that first number, also because people who test positive but who are not "officially" contact traced can still notify their contacts and reduce their contacts with others.

The modelling in the Lancet article seems to point to about 50% being needed to fully suppress the epidemic absent any other measures so the contact tracing scheme. What's currently being done is probably having some effect on reducing transmission which is good but unless we are able to substantially increase testing of non-symptomatic people I doubt that tracing alone will get us out of this.

[Note that it's not strictly correct to multiply these numbers like this, especially as they increase. That's because contacts who later test positive get counted as index patients in later time-steps but it's basically right]
posted by atrazine at 4:58 AM on August 6, 2020 [2 favorites]


A comment on the Swedish approach - I live here, in a little town in the north, and the consensus seems to be that the strategy itself was sound but that decades of defunding of elderly care led to the high death rate, and that a lockdown wouldn't have avoided that.

I agree in general with the approach (long term recommendations over short term lockdowns) but think a lockdown at the start to get a handle on treatment, protect nursing homes, etc. would have been very valuable.
posted by twirlypen at 5:13 AM on August 6, 2020 [11 favorites]


I have to issue a correction: the outbreak in Aarhus, Denmark, is not limited to Somalis, that was an unfortunate (perhaps racist) rumor. The situation seems to be quite serious and there will be some local restrictions in the city from today on.
Aarhus is Denmark's second largest city, and has a big university with a hospital and many other educational institutions.
posted by mumimor at 7:39 AM on August 6, 2020 [2 favorites]


'A matter of when not if': New Zealand begins battle against 'Covid fatigue' (Guardian, Aug. 5, 2020)
Spooked by outbreaks in Australia and Hong Kong, authorities are urging ‘constant vigilance’
New Zealand has attained the status of one of the world’s safest countries when it comes to the coronavirus; there is no known community transmission in the country and life has largely returned to normal. But with one eye on nations where the virus was once quashed before spiralling out of control again, officials and the government have changed their language in recent days in order to fight a new battle – this time against complacency. “We have to be absolutely on our toes,” Ashley Bloomfield, New Zealand’s top health official, said in a Radio New Zealand interview on Wednesday. “That’s not just the health system … it’s everybody.” [...] But it was inevitable, Bloomfield said on Wednesday, that New Zealand would have an outbreak beyond the isolation facilities.

“It’s a matter of when, not if,” he said. “We’re working on the basis that it could be any time.”
Closed for vacation: France faces new virus testing troubles (AP)
With virus cases rising anew, France is struggling to administer enough tests to keep up with demand. One reason: Many testing labs are closed so that their staff can take summer vacation, just as signs of a second wave are building. Doctors and experts say the vacation crunch is just part of a larger web of failures in France’s testing strategy – a strategy that even the government’s own virus advisory panel this week called disorganized and “insufficient.”

[...] France is in better shape than last time to keep ahead of new infections — but testing is key. “The virus didn’t disappear at all. ... The contamination is continuing, and amplifying in some regions,” said François Blanchecotte, president of the Union of Medical Biologists, who has been in the forefront of French testing efforts. “We have to adapt the testing strategy to this evolution.”
posted by katra at 9:37 AM on August 6, 2020 [3 favorites]


"Fifty million face masks bought by the UK government as part of a £252m (€280m; $330m) contract at the height of the covid-19 crisis will not be used in the NHS because of safety concerns, the government has admitted." (BMJ, August 6, 2020)
posted by Iris Gambol at 2:32 PM on August 6, 2020 [2 favorites]


Global report: WHO warns against dangers of 'vaccine nationalism' (Guardian)
The World Health Organization has warned against “vaccine nationalism”, cautioning richer countries that if they keep treatments to themselves they cannot expect to remain safe if poor nations remain exposed. As global cases of Covid-19 passed 19 million on Friday, WHO chief Tedros Adhanom Ghebreyesus said it would be in the interest of wealthier nations to help every country protect itself against the disease.

“Vaccine nationalism is not good, it will not help us,” Tedros told the Aspen Security Forum in the United States, via video-link from the WHO’s headquarters in Geneva. “For the world to recover faster, it has to recover together, because it’s a globalised world: the economies are intertwined. Part of the world or a few countries cannot be a safe haven and recover. The damage from Covid-19 could be less when those countries who... have the funding commit to this.”
posted by katra at 9:55 PM on August 6, 2020 [1 favorite]


"Fifty million face masks bought by the UK government as part of a £252m (€280m; $330m) contract at the height of the covid-19 crisis will not be used in the NHS because of safety concerns, the government has admitted." (BMJ, August 6, 2020)

Oh dear. Apparently they're currently in a legal dispute with the manufacturer, they claim that they offered to produce them to this spec, with the ear loops, and that this offer was accepted.

The government's position is that since they were specified as FFP2s, if they don't meet the technical tests for actually preventing air from the outside coming in at the mask seal, they're non-compliant.

I guess they can always just give them away to the public since a non-perfectly fitting FFP2 is still going to be better than a cloth mask but it does show the danger of frantically buying everything that looks remotely applicable in a panic, which is definitely where they were with PPE procurement in April - July.
posted by atrazine at 12:49 AM on August 7, 2020


Oh, the faulty masks is not the story.
It's the how of the thing that's the story.

Liz Truss continues to out-Grayling Chris Grayling.
A Ferry company without ferries? Pffft. A mask company which is barely even a company.
posted by fullerine at 1:45 AM on August 7, 2020 [3 favorites]


I'm not a huge fan of Jolyon Maugham, to be honest, despite broadly agreeing with him on many points of politics but that's for another thread.

The reality is that a huge amount of PPE here in the UK has been procured in more or less exactly this way - through weird intermediary companies and odd financial routing which would never have been allowed in normal circumstances. Remember, for instance, that weird pest control company that sold the NHS loads of PPE? That was in the news about a month ago. They have apparently delivered quite a substantial amount of standards compliant material, so despite the weird routing that doesn't massively bother me.

If they had delivered masks that worked at a reasonable price, procedural abnormalities would have been less of a concern. I will be curious to see the inevitable internal documents which will come out of this dispute.

Obviously the involvement of government advisers in this procurement in these roles raises questions. I'm sure that in some cases they're just trying to be helpful but the reason we have procedures in government procurement is that sometimes their idea of helpful doesn't quite accord with value for money for the public and sometimes of course they're actively attempting to have a little snuffle in the public purse.

(and while I abhor the preposterous Grayling, I was actually in favour of the no-ferry, ferry deal which must make me the only one. I have a long-standing position that governments in practice do much more damage by not pursuing optionality then they do by accidentally buying the wrong thing but that is not a position popular with the public. In this case of course, preparations should have started much earlier so as to prevent having to buy this kind of option but given the position they put themselves in I don't think it was a mistake.)
posted by atrazine at 4:10 AM on August 7, 2020


I have now recalculated this using ONS's most recent (7th August to cover week ending 2nd August) data

3,700 a day infections from ONS x 7 x 70% symptomatic = 18,130 symptomatic people

4,966 positive tests, 27% symptomatic infections picked up

79% reached x 72% contacts

27% x 79% x 72% = 15.5%

So I was too pessimistic yesterday and test coverage seems to be increasing. Still a long way to go to reach an overall effectiveness of 50%.
posted by atrazine at 4:44 AM on August 7, 2020


...already back at May levels.

In Italy too, today we're back to end of May figures, with 552 new cases confirmed this evening (we'd been hovering around half that daily for the past three weeks), though almost a third of the new batch found in a refugee shelter in one northern city. Some are reporting that a number of new cases are also returning vacationers...
posted by progosk at 1:11 PM on August 7, 2020 [1 favorite]


Some are reporting that a number of new cases are also returning vacationers...

Germany was above a thousand today again - I had been hoping that yesterday was a blip. The RKI is also blaming returning travellers for some of the high rates they’re seeing in particular areas, but there are other causes, including meat processing plants.

Meanwhile, Ireland is putting a regional lockdown in place in 3 counties (Kildare, Laois and Offaly) because of a high rate of cases. The new cases mostly associated with food processing plants, but the entire counties are being put on restricted movements to stop the spread, for at least the next two weeks.
posted by scorbet at 2:08 PM on August 7, 2020 [4 favorites]


New Zealander here, appreciate rednikki's comments that add a perspective that I haven't had (I hadn't noticed the tomato prices as I haven't been doing our shopping recently; yikes!).

Anyway: I don't think we have community transmission now, but the government is probably right to flag it as a possibility: we have people transiting our airports from COVID-19 hotspots, we have people arriving from overseas and staying in quarantine. We know that in places like Melbourne, quarantine hotels were the source of outbreaks, and it could happen here. I'm hopeful that the government has been using the time to plan a swift response to any outbreak.

The economy is doing better than we feared, but the loss of international students will be a big one. To some extent, I think we can substitute NZ tourists for international ones, as NZers won't be going overseas: my friends who had planned a family trip to New York will be spending that money here, somewhere. But we can't substitute the international students, who also contribute far more to the economy (being here longer) than tourists.

Politically, things are interesting (I might do an election FPP) - in February it was probably 55-45 that the government would lose the September election, and after a successful response to COVID-19 it looks almost certain that it will instead be re-elected with a big majority.

If anyone's interested, thoughts about why we've succeeded so far - a combination of a number of things, IMO:

- being an island means that we could close our borders
- we actually did close them, early
- good and clear communications from government (a daily press conference from PM and head of Ministry of Health, really good messaging around being kind, caring for each other, "team of five million")
- a very quick ramping up of our response, which was built around four 'levels' that were generally easy to understand (we spent a lot of time arguing over edge cases, but in the main they made sense). Apparently put together by officials in three days
- relatively high levels of social trust and cohesion, and obedience, meaning people followed instructions (not always a good thing, but in this situation it was)
- financial support for companies and workers who were forced to close during lockdown (I know people who absolutely hate our government, but were happy to go along with the lockdown, mainly because of this)
- a strict lockdown - all businesses closed except for supermarkets, grocery stores, pharmacies, and essential transport, supply chain and manufacturing. Only associate with those in your household 'bubble'. Only leave home to buy food, for medical reasons, or for limited exercise. High compliance with this.
- reasonably quick scaling up of testing and tracing. When I got tested it took two hours from ringing the helpline to confirm that I should be tested, to being home having been tested. Tested Friday afternoon, got results on Sunday.
- one national government, mostly able to direct things from the centre (regions/cities can't over-rule the lockdown rules).
posted by Pink Frost at 5:57 PM on August 7, 2020 [17 favorites]


India's biggest slum has so far nailed coronavirus. Here's how they did it -

With a million residents crammed within 2.4 square kilometres, local government assistant commissioner Kiran Dighavkar said relying on home quarantine was not an option.

"In one apartment of 10 feet by 15 feet, you'll find at least 10 to 12 people," he said.

"It is very difficult to do contact tracing because one person who used the community toilet, or toilet seat, is used by another 500 people.

"Once it starts, it can spread like anything."

Anything from sports centres, schools, nursing homes and hotels were converted into coronavirus treatment and isolation centres.

Hundreds of community toilets were sanitised multiple times a day.

Instead of waiting for symptomatic patients to come forward, authorities would doorknock homes to test temperatures and oxygen levels.

Anyone considered at risk or showing depleting oxygen levels was taken into care.

"Slowly, slowly, the cases were appearing in all the slum pockets," said Dr Virendra Mohite, a chief medical officer for one of Dharavi's coronavirus hospital wards.

"So, our biggest challenge was to isolate the high-risk contacts from the slum to the institutional quarantine.

"If we diagnose suspects early, it is easy to cut the chain of transmission, to start the treatment early and reduce further mortality."

Most temporary treatment centres have been closed due to the decline in cases, but authorities say they remain vigilant for a second wave.


The article also mentioned the theory that maybe large parts of India may already have reached herd immunity, but the science of it is still unclear.
posted by cendawanita at 1:11 AM on August 8, 2020 [10 favorites]


Coronavirus: India hits 2 million cases as health volunteers go on strike (NBC News / AP, Aug. 7, 2020)
Even as India, the world's second-most populous country, has maintained comparatively low mortality rates, the disease trajectory varies widely across the country, with the burden shifting from cities to rural areas, where healthcare resources are scarce. The Health Ministry reported 62,538 cases in the past 24 hours, raising the nation's total to 2,027,074 — with more than 41,000 people dead due to COVID-19 so far. [...] Cases in India have quickly risen since the government began lifting a social lockdown, hoping to jump-start a moribund economy. India is projecting negative economic growth in 2020. Although life has cautiously begun to return to the streets of the capital, New Delhi, and financial hub Mumbai, which appear to have passed their peaks, authorities elsewhere in India were reimposing lockdowns after sharp spikes in cases. Including in Uttar Pradesh, a state of 220 million where infections in every district are weighing heavily on the fragile health system.

[...] Around 900,000 members of an all-female community health force began a two-day strike on Friday, protesting that they were being roped in to help with contact tracing and in quarantine centers, but weren't given adequate personal protective equipment or additional pay, according to organizer A.R. Sindhu. The health workers, known as Accredited Social Health Activists, or ASHA, which means "hope" in several Indian languages, have been deployed in villages on behalf of the Health Ministry. "ASHA workers don't have masks or PPEs or even sanitizers," said Sindhu.
posted by katra at 9:52 AM on August 8, 2020 [5 favorites]


Brazil exceeds 100,000 deaths.
If It Were a Country, Rio de Janeiro would Have the World’s Second-Highest Mortality Rate.
The virus took three months to kill 50,000 people, and just 50 days to kill the next 50,000.
posted by adamvasco at 1:30 PM on August 8, 2020 [9 favorites]


I've been wondering lately whether any countries have laws against a Holodomor 2.0.
posted by srboisvert at 5:30 AM on August 9, 2020


Two Brazilian groups have filed case (ABJD vs Bolsonaro, details; UNISaúde vs Bolsonaro, details) with the International Criminal Court, so far...
posted by progosk at 7:30 AM on August 9, 2020 [4 favorites]


'We failed': one scientist's despair as Brazil Covid-19 deaths hit 100,000 (Guardian)
For months Natalia Pasternak has implored Brazilians to take science and coronavirus seriously, in a marathon of TV appearances, newspaper columns, live streams and podcasts. “I’ve given interviews at 2am,” said the microbiologist and broadcaster who runs a civil society group called the Question of Science Institute. As the epidemic has raged, Pasternak has condemned President Jair Bolsonaro’s chaotic, anti-scientific response; denounced fake news and unproven treatments such as chloroquine and ozone therapy; and urged her country’s 210 million citizens to respect quarantine measures aimed at controlling coronavirus. “Reopening … is a recipe for disaster,” the 43-year-old scientist warned on a recent talkshow, as lockdown efforts withered despite the soaring number of infections and deaths. [...] Like many Brazilians, Pasternak blames Bolsonaro – a Trump-smitten populist who calls Covid-19 “a bit of a cold”, has lost two health ministers during the crisis and has sabotaged containment measures he claims are too damaging to the economy. “As president, he bears personal responsibility. His behaviour has been deplorable,” the pro-science campaigner said. “It really disgusts me to see my country go through this. To have the worst possible leadership at the worst moment possible … As a scientist and a citizen, I find it so sad to think how this government has wrecked my country,” she added, her voice breaking.

[...] “The danger is that we normalize this – that we reach a point where people say: ‘Oh, it’s stabilized. Everything’s OK. It’s over!’” Pasternak warned. “No – it’s not over. It’s not normal for 1,000 people to die each day because of an infectious disease. “Our role as science communicators … is to keep showing the facts and in a way that engages people, moves people and makes them realize that this is still happening.” Pasternak’s institute is one of several groups trying to raise awareness. Since April, an online memorial called Inumeráveis (Countless) has celebrated victims’ lives as a way of emphasizing the epidemic’s human cost. “We are trying to fight this [trivialisation] with love,” said Rayane Urani, the project’s 31-year-old moderator. [...] “It could have been avoided,” [Pasternak] said. “Not completely, of course. But 100,000 people could have been avoided.” A vast network of national health service community health workers could have been mobilized to educate Brazilians, isolate people based on their symptoms and trace their contacts. A proper quarantine could have been implemented, like in Germany and New Zealand, “and we would now be in the same place as these countries – reopening safely, with a near-normal life.”
posted by katra at 10:59 AM on August 9, 2020 [5 favorites]


So there's been some preliminary research on what works and there's an essentially linear relationship between the number of days between number of days from first recorded domestic infection to some kind of lockdown and total deaths. In other words, other stuff doesn't matter.

Strictness of lockdown?
Strictness of enforcement?
Mask / no-mask?
Effective PPE stocking / procurement
Number of ventilators

All basically noise compared to the stage in the pandemic that some kind of broad restrictions aka lockdown were imposed.

Mathematically, it's not hard to see why. Getting Rt from 3 to <1 four days faster reduces the peak number of infected by 2/3s, compare the effect of going to Rt = 0.5 (where the UK got to) to something like 0.3 which you might achieve with a much stricter lockdown which is a much smaller effect.

I think it's easy to get locked into your own domestic news cycle or some kind of doomscrolling filter bubble and get really into minutia but the numbers are what they are.
posted by atrazine at 12:48 AM on August 10, 2020 [7 favorites]


Australian Bureau of Statistics finds “People born overseas were more than twice as likely to have worn a facemask" (NB: Survey conducted before masks mandated in some areas and before masks were even encouraged)

Another Australian study found Men and people aged 18-25 are more likely to believe COVID-19 myths.
posted by daybeforetheday at 2:35 AM on August 10, 2020 [1 favorite]


Earlier coronavirus lockdown could have saved 54,000 lives: study (NY Daily News, May 20, 2020)
Slow reaction to the coronavirus pandemic may have cost as many as 54,000 American lives, according to estimates released Wednesday by Columbia University researchers. [...] “Our findings underscore the importance of early intervention and aggressive response in controlling the COVID-19 pandemic,” read the paper authored by Sen Pei, Sasikiran Kandula and Jeffrey Shaman. [...] The article has not yet been peer-reviewed.
See also Newsweek, May 21, 2020 (The study [...] is based on "idealized hypothetical assumptions") and BBC, May 22, 2020, for additional reporting.

Thursday briefing: Earlier lockdown could have 'saved 20,000 lives' (Guardian, Jun. 11, 2020)
The UK could have saved 20,000 lives if it introduced the lockdown a week earlier, according to damning testimony from Prof Neil Ferguson, who was one of the government’s key advisers in the early stages of the pandemic. His comments will intensify pressure further on Boris Johnson and his team to explain why they waited to introduce tougher restrictions. Ferguson told the Commons science committee: “Had we introduced lockdown a week earlier we’d have reduced the final death toll by at least half.”
Earlier lockdown could have saved lives of London bus drivers, study suggests (Worchester News, Jul. 27, 2020)
Transport for London (TfL) commissioned the review after 29 of its bus drivers were reported to have died with Covid-19.
'Price of life' lowest in UK during COVID-19 pandemic, study finds (Science Daily, Aug. 4, 2020)
Modelling mortality across the countries before simulating changes in the date of lockdown, the researchers calculated that 20,000 lives in the UK would have been saved by imposing lockdown three days earlier. Even further delays would have cost yet more lives: 32,000 extra people would have died had lockdown come in three days later than it did; while a delay of 12 days would have cost more than 200,000 extra lives.
posted by katra at 9:10 AM on August 10, 2020 [3 favorites]


What countries did right and wrong in responding to the pandemic (CBC, Jun. 22, 2020)
CBC News compared countries' daily COVID-19 numbers with how strict their containment policies were, as measured by the Oxford COVID-19 Government Response Tracker, which rates countries on a host of factors such as workplace closures, travel controls, restrictions on gatherings, and testing regimens. With the help of experts, CBC News found that successful countries were not only swift to respond, but also applied the three Ts of disease control: testing, tracing and trust.
Lessons from Italy’s Response to Coronavirus (Harvard Business Review, Mar. 27, 2020)
Avoid partial solutions. A second lesson that can be drawn from the Italian experience is the importance of systematic approaches and the perils of partial solutions. [...] This illustrates is what is now clear to many observers: An effective response to the virus needs to be orchestrated as a coherent system of actions taken simultaneously. The results of the approaches taken in China and South Korea underscore this point. While the public discussion of the policies followed in these countries often focuses on single elements of their models (such as extensive testing), what truly characterizes their effective responses is the multitude of actions that were taken at once. Testing is effective when it’s combined with rigorously contact tracing, and tracing is effective as long as it is combined with an effective communication system that collects and disseminates information on the movements of potentially infected people, and so forth.
posted by katra at 9:29 AM on August 10, 2020 [3 favorites]


CBC News compared countries' daily COVID-19 numbers with how strict their containment policies were, as measured by the Oxford COVID-19 Government Response Tracker, which rates countries on a host of factors such as workplace closures, travel controls, restrictions on gatherings, and testing regimens. With the help of experts, CBC News found that successful countries were not only swift to respond, but also applied the three Ts of disease control: testing, tracing and trust.

Interesting. I've been following the Blavatnik tracker stuff and while it's good it's missing something pretty big which is compliance. For instance, I've seen data that shows that throughout the almost two months that the UK had its strictest level of lockdown, compliance dropped off gradually. I imagine it was the same everywhere. I don't blame them for not including that since there's no standardised dataset but it is worth considering.
posted by atrazine at 11:36 AM on August 10, 2020 [1 favorite]


EU governments roll back wage support despite corona uncertainty (Politico.eu, Aug. 10, 2020)
EU governments are curtailing their emergency wage-support schemes, aimed at preserving jobs in the coronavirus crisis, even as the pandemic continues to cloud the near-term economic outlook — and against pleas from trade unions.

The European social welfare model has been effective in supporting jobs through the coronavirus crisis, as governments stepped in to help cover the wages of unprecedented numbers of workers. According to the European Trade Union Confederation, 45 million Europeans are currently furloughed and receiving at least part of their salaries through government support schemes.

But these emergency measures are costly for state coffers, and governments are feeling the pressure.
Belgium headed toward lockdown unless coronavirus cases stop rising, experts warn (Politico.eu, Aug. 10, 2020)
This week will be important in determining whether Belgium has to introduce stricter measures to fight the coronavirus, including a potential second lockdown, experts told national media on Monday.

Belgium's number of new coronavirus cases has been rising for several weeks now, a development that has already prompted the government to tighten rules again after relaxing them earlier in the summer.
posted by roolya_boolya at 12:53 PM on August 10, 2020 [1 favorite]


Guardian: EU health agency calls for new lockdowns
The European Union’s health agency has called on member states that are seeing an increase in cases of coronavirus to reinstate control measures, as it warned of a “true resurgence” in several countries. In a “rapid risk assessment” published on Monday, the European Centre for Disease Prevention and Control (ECDC) warned of a “risk of further escalation of Covid-19” across the continent. [...] The Stockholm-based agency said that the Covid-19 pandemic continued to “pose a major public health threat”, in spite of a recent decline in cases. Since the relaxation of movement restrictions and other measures, the spread of the virus had resumed, it said. “Further increases in the incidence of Covid-19, and associated hospitalisations and deaths, can be mitigated if sufficient control measures are reinstalled or reinforced in a timely manner,” the agency said. [...] For those countries seeing an increase “the risk of further escalation of COVID-19 is high.” If those countries fail to implement or reinforce restrictions, the risk was “very high,” it warned.
posted by katra at 4:07 PM on August 10, 2020 [1 favorite]


Never too late to turn COVID pandemic around, but huge shortfall in funds to fight it: WHO chief (IBT)
There is a huge gap between funds needed to fight the coronavirus and funds committed worldwide, World Health Organization chief Tedros Adhanom Ghebreyesus said on Monday. But he said he saw "green shoots of hope".

"It is never too late to turn the pandemic around," Tedros told a news briefing. The message is to "suppress, suppress, suppress". More than 19.92 million people have been reported to be infected by the coronavirus globally and 729,883 have died. [...] "For the world to recover faster, it has to recover together, because it's a globalised world: the economies are intertwined. Part of the world or a few countries cannot be a safe haven and recover," Ghebreyesus told the Aspen Security Forum in the US, via video-link from the WHO's headquarters in Geneva.
Coronavirus in Europe: France extends mask use as Greece says it is in second wave (Guardian)
Face masks have become compulsory in more than 100 Paris streets and tourist areas, Greece is “formally” in a second wave and new outbreaks are causing alarm in Italy and Spain as coronavirus infections continue to pick up again across Europe. [...] Dr Mike Ryan, the head of the World Health Organization’s emergencies programme, also said the virus had shown no seasonal pattern and governments in western Europe needed to react fast to new flare-ups to prevent it bouncing back.
posted by katra at 10:47 PM on August 10, 2020 [1 favorite]


New Zealand has announced four cases of community transmission in one family, which we can't link to either the border or any isolation/quarantine facilities.

We've put Auckland back into a short-term lockdown and reintroduced distancing requirements around the rest of the country. Scary, but the response seems to be rapid and reasonably strong so hopefully we can stamp it out.
posted by Pink Frost at 2:57 AM on August 11, 2020 [7 favorites]


Neck gaiters are worse than not wearing a mask at all. [Washington Post]
The high droplet count could be linked to the neck gaiter’s porous fabric breaking up bigger particles into many little ones that are more likely to hang around in the air longer, Fischer said in the video. This effect makes wearing them possibly “counterproductive,” he added.

“It’s not the case that any mask is better than nothing,” he said. “There are some masks that actually hurt rather than do good.”
posted by Margalo Epps at 8:28 AM on August 11, 2020 [3 favorites]


If only someone had planned to make millions of proven N95 respirators available in a pandemic. Oh, wait, they did, in 2015:
Through the new BARDA-supported project, Halyard Health will research and test manufacturing processes, core manufacturing components, and design a new manufacturing line capable of functioning at high speeds to allow for greater surge capacity and rapid availability during a pandemic. If successful, the technology could be available to replace outdated and slow machines with high-speed machines that can produce between one and two million N95 respirators in one day.
posted by benzenedream at 8:48 AM on August 11, 2020 [2 favorites]


Scientists uneasy as Russia approves 1st coronavirus vaccine (AP)
Russia on Tuesday became the first country to approve a coronavirus vaccine, a move that was met with international skepticism and unease because the shots have only been studied in dozens of people. President Vladimir Putin announced the Health Ministry’s approval and said one of his two adult daughters already was inoculated. He said the vaccine underwent the necessary tests and was shown to provide lasting immunity to the coronavirus, although Russian authorities have offered no proof to back up claims of safety or effectiveness. [...] scientists in Russia and other countries sounded an alarm, saying that rushing to offer the vaccine before final-stage testing could backfire. What’s called a Phase 3 trial — which involves tens of thousands of people and can take months — is the only way to prove if an experimental vaccine is safe and really works.

[...] “Fast-tracked approval will not make Russia the leader in the race, it will just expose consumers of the vaccine to unnecessary danger,” said Russia’s Association of Clinical Trials Organizations, in urging government officials to postpone approving the vaccine without completed advanced trials. [...] The World Health Organization said all vaccine candidates should go through full stages of testing before being rolled out. Experts have warned that vaccines that are not properly tested can cause harm in many ways — from harming health to creating a false sense of security or undermining trust in vaccinations.
posted by katra at 10:01 AM on August 11, 2020 [2 favorites]


Pink Frost — thanks for your news link to New Zealand Stuff.

For those of us (including myself in the USA) woefully uninformed, could you briefly explain how NZ’s national elections and the associated dissolution of Parliament normally work? What on-the street effect(s) might a Covid-19 postponement of dissolution/elections have?
posted by cenoxo at 1:59 PM on August 11, 2020 [1 favorite]


I too, read a report about how the lasers showed that neck gaiters are worse than nothing, and since I'm not planning to wear a neck gaiter, I moved on with my day.

Later, I saw this in my news feed: No, Neck Gaiters Weren't Proven to be Worse Than No Face Mask, which concludes that maybe neck gaiters are worse than nothing, maybe they aren't, but this study is a flimsy basis for saying either way.

Whereas the WP article says that researcher Martin Fischer says in his video "“It’s not the case that any mask is better than nothing. There are some masks that actually hurt rather than do good,” the LifeHacker article points out that he wrote in his paper: "Again, we want to note that the mask tests performed here (one speaker for all masks and four speakers for selected masks) should serve only as a demonstration."
posted by polecat at 4:26 PM on August 11, 2020 [1 favorite]


Oh goodie, another goddamned confusing medical study that ends up not helping and only confusing the fuck out of everyone.
posted by jenfullmoon at 5:21 PM on August 11, 2020


But this one is different! How many other studies rely on the recording capabilities of a single camera? (Quaintly, it's the camera in the Samsung Galaxy 9 mobile phone.) Which other team filed a patent for its device on the same day they submitted their paper for publication? [Competing interests: A US provisional patent application has been filed by Duke University on 6/12/20. The authors of the current manuscript are identical to the inventors on the patent application. The patent information is as follows. Title: “Optical Method to Test Efficacy of Face Masks”; Inventors: Martin Fischer, Emma Fischer, David Grass, Warren Warren, Isaac Henrion, and Eric Westman; Application number: 63/038331. The authors declare no other competing interests.]

I'm a big fan of science on a shoestring, but the WaPo headline cheesed me off, too.

The Trump Administration has agreed to buy 100 million doses of Moderna's experimental coronavirus vaccine for $1.5 billion, or $15 per dose. (Axios, August 11, 2020) The federal government may own some of the patent rights associated with this vaccine.
posted by Iris Gambol at 5:50 PM on August 11, 2020 [1 favorite]


For those of us (including myself in the USA) woefully uninformed, could you briefly explain how NZ’s national elections and the associated dissolution of Parliament normally work? What on-the street effect(s) might a Covid-19 postponement of dissolution/elections have?


This is totally catnip to me, given that I used to work somewhere where my colleagues advised on exactly this sort of thing.

OK so as I understand it, we broadly have a three-year term of government. Elections are not held on a fixed date, as in the US, but in practice tend to be around September-November. Parliament can only sit for a certain length of time and then has to be dissolved; once dissolved, the election has to occur within a certain time.

We've had the election date planned since around February, but by coincidence Parliament was due to be dissolved today. That's bad, because it means Parliament has no means to scrutinise the government (which would obviously be especially useful now). [In lockdown, Parliament didn't meet, but a special committee chaired by the opposition leader did meet. It worked quite well].

The PM just suspended the dissolution of Parliament until Monday, meaning we have a few days to work out what's going on. The latest they can delay the election is apparently December. To delay until next year, we would need to pass a new law, with 75% approval. (I'm taking some of this from this Twitter thread by a lawyer who's an expert in this area).

Where it gets interesting is the politics:
Before COVID, I figured the opposition had a slight advantage (maybe 55-45) in the election. It would be close, but they looked good. After we exited lockdown, support for the government was at unheard of levels. They would have won a landslide victory if we'd voted last month. So they would really have wanted to get the election over with. Naturally the opposition would prefer to delay. But they do have a fair point that it's difficult to campaign during a lockdown, even a partial one. They're supported by a junior support party in the governing coalition, who look like being wiped out (but who historically always improve in the polls during the election campaign). Further complication that no-one (either government or opposition) really wants this party in their coalition, but has often been unable to form a government without them.

Meanwhile there are claims by the weirder fringe that this is a setup by the government - though how they think locking people down, scaring them and damaging the economy will help the government I don't know.
posted by Pink Frost at 6:37 PM on August 11, 2020 [6 favorites]


How The Pandemic Revealed Britain’s National Illness (Tom McTague, Atlantic)
Britain did not save as many lives as others. It had the money, the tools, and the wherewithal to respond as well as any, yet more of its people died than anywhere else in Europe. Britain has not been alone in its failure to prevent mass casualties—almost every country on the Continent suffered appalling losses—but one cannot avoid the grim reality spelled out in the numbers: If almost all countries failed, then Britain failed more than most. [...] When the pandemic hit, then, Britain was not the strong, successful, resilient country it imagined, but a poorly governed and fragile one. The truth is, Britain was sick before it caught the coronavirus. [...] “People will look back and say, ‘Could we have done it earlier?’ and with the power of retrospectroscope, which is an infinitely powerful instrument, the answer to that is, probably,” Mark Walport, who like Boyd sits on SAGE, told me. But Walport said this was not the fundamental issue of the crisis. “Many of the challenges that we’ve had are not, as it were, about policy advice or the science advice; they are questions about resilience.”

[...] The government’s job, as its leaders saw it, was to ensure that the most vulnerable members of society were protected and that the spread slowed to ensure that hospitals could cope. This was not the response among Asian countries, which experienced outbreaks before Britain but nevertheless sought to permanently defeat the virus. South Korea, for example, instituted widespread testing, alongside a contact-tracing regime to keep the disease at bay until a vaccine could be found. Many others in the region adopted masks en masse. Travel restrictions were put in place. Lockdowns, large and small, were implemented.
posted by katra at 11:23 PM on August 11, 2020 [4 favorites]


Thanks, PF, that was just right. I found more about New Zealand’s current parliamentary parties , the 2020 general election, and related COVID-19 processes.
posted by cenoxo at 6:29 AM on August 12, 2020 [1 favorite]


Here i in Denmark, it now seems clear we are having a second wave. It is not a lot of cases, more like a clear reminder that the pandemic isn't over yet. But the interesting thing is that hospitalizations and deaths are not rising equivalently. This is what they said all the time: level the curve so we can learn how to handle it, and it seems like they have achieved that. (Knocks on wood).
But here, at this point in time, the politicians are competing about who is the most responsible. Even the racism isn't what it used to be. While driving today, I heard a debate show about the outbreak among Somalis in Aarhus that I mentioned above, and spent 45 minutes shouting at the radio, but to be fair, even the most racist racist had to admit that it is important for everyone that immigrants and refugees are treated fairly and excellently by our national health system under these circumstances.
Another racist made a long ad hominem attack on a doctor on the show, and I almost stopped the car to call in, but then I realized that it flopped completely, he seemed flippant in a context where people die if you don't care.
posted by mumimor at 9:16 AM on August 12, 2020 [4 favorites]


Re neck gaiters, Figure 3 in the paper makes it clear that neck gaiters ("fleece") is statistically indistinguishable from nothing, and probably indistinguishable from a bandana. Their speculation about it being worse or breaking up particles or whatever is irresponsible, since the statistical result is just that it's no different, presumably because the gaps in a single layer of stretched fabric make it no different from just exhaling normally.
posted by chortly at 10:54 AM on August 12, 2020 [2 favorites]


Smaller particles hang in the air longer, so a fleece that breaks droplets into smaller droplets could, indeed, be worse than no face covering at all, since it's droplets in the air that are a danger.
posted by OHenryPacey at 11:41 AM on August 12, 2020 [2 favorites]


Smaller particles hang in the air longer, so a fleece that breaks droplets into smaller droplets could, indeed, be worse than no face covering at all, since it's droplets in the air that are a danger.

That is how it sounded like it was reported by CNN (US/Covid FPP link) ""We were extremely surprised to find that the number of particles measured with the fleece actually exceeded the number of particles measured without wearing any mask," [Martin Fischer, one of the authors of the study,] said."
posted by katra at 1:05 PM on August 12, 2020


"This study in no way proves that face gaiters are a menace, or even unhelpful, in the age of coronavirus. [...] It’s worth noting that another experiment, from a researcher at the University of Wisconsin–Madison, actually found that gaiters were the most effective mask in containing a cough, though those gaiters were slightly different, containing elastic. We are in the middle of a pandemic that has been grossly mismanaged by our government, and we’re all stressed out and desperate for information about how to stay safe. But to interpret this study as proof that neck gaiters are worse than wearing nothing is a wild misrepresentation of what it actually found." (Slate, For All We Know, Gaiter Masks Are Fine, Aug. 11, 2020)

"At least 800 people died around the world because of coronavirus-related misinformation in the first three months of this year, researchers say. [...] A study published in the American Journal of Tropical Medicine and Hygiene says about 5,800 people were admitted to hospital as a result of false information on social media. Many died from drinking methanol or alcohol-based cleaning products. They wrongly believed the products to be a cure for the virus.[...] Many of the victims had followed advice resembling credible medical information - such as eating large amounts of garlic or ingesting large quantities of vitamins - as a way of preventing infection, the study's authors say. Others drank substances such as cow urine. These actions all had "potentially serious implications" on their health, the researchers say." (BBC, 'Hundreds dead' because of Covid-19 misinformation, Aug. 12, 2020)

"Russia has dismissed mounting international concern over the safety of its locally developed Covid-19 vaccine as "absolutely groundless". [...] Russian officials have said they plan to start mass vaccination in October. [...] Meanwhile the Moscow-based Association of Clinical Trials Organizations (Acto), which represents the world's top drug companies in Russia, urged the health ministry to postpone approval until after phase-three trials. The Russian vaccine uses adapted strains of the adenovirus, a virus that usually causes the common cold, to trigger an immune response." (BBC, Russia calls international concern over vaccine 'groundless', Aug. 12, 2020)
posted by Iris Gambol at 2:08 PM on August 12, 2020 [1 favorite]


in what way do recommended consumption of cow urine or megadoses of vitamins or garlic resemble credible medical information?
posted by 20 year lurk at 2:36 PM on August 12, 2020


The COVID-19 pandemic has revived a decades-old debate about how respiratory diseases travel—which affects the safety practices experts recommend. National Geographic

"I'd add is that overdispersion plus short-range aerosols do modify some recommendations (masks indoors no matter distance) and adds a few new ones (ventilate; speaker should remain masked etc.). These are not currently in guidelines. I wrote about it here: We Need to Talk About Ventilation, Zeynep Tufekci, The Altantic."

"If SARS-CoV-2 transmission involves superspreading, then majority of secondary transmission comes from a small proportion of infections. This means that if a new case appears, it's likely to have come from a (potentially quite big) cluster. Whereas standard 'forward tracing' would be expected to detect up to R secondary infections per case (where R is the reproduction number), this clustering quirk means 'backward tracing' can identify R(1+1/k) additional infections linked to cluster, who can then be traced too." - @AdamJKucharski

"Article about the study (not peer-reviewed yet) documenting infectious virus in aerosols." "*If* the concentrations in air reported here are correct, then you would breathe in 1000 virions (infectious virus particles) in about 5 minutes in this room. Not all will stick. Need to know carrier aerosol size to predict how many deposit and where in the respiratory tract." - @linseymarr
posted by sourcejedi at 2:50 PM on August 12, 2020 [1 favorite]


in what way do recommended consumption of cow urine or megadoses of vitamins or garlic resemble credible medical information?

We haven't come that far in 350 years from Isaac Newton's cure for the plague:

The first step in the cure is hanging a toad upside down in a chimney for three days. You’ll know your toad is ready when it pukes and dies; be careful to collect all the vomit, which Newton describes as containing “earth with various insects in it.”

Next, grind the toad into a powder and mix it with the vomit until you’ve formed several lozenges. Finally, place your toad vomit lozenges “about the affected area.”

posted by JackFlash at 3:04 PM on August 12, 2020 [5 favorites]


‘A Smoking Gun’: Infectious Coronavirus Retrieved From Hospital Air (NYT / MSN reprint)
Skeptics of the notion that the coronavirus spreads through the air — including many expert advisers to the World Health Organization — have held out for one missing piece of evidence: proof that floating respiratory droplets called aerosols contain live virus, and not just fragments of genetic material. Now a team of virologists and aerosol scientists has produced exactly that: confirmation of infectious virus in the air. “This is what people have been clamoring for,” said Linsey Marr, an expert in airborne spread of viruses who was not involved in the work. “It’s unambiguous evidence that there is infectious virus in aerosols.” [...] The findings, posted online last week, have not yet been vetted by peer review, but have already caused something of a stir among scientists. “If this isn’t a smoking gun, then I don’t know what is,” Dr. Marr tweeted last week. But some experts said it still was not clear that the amount of virus recovered was sufficient to cause infection.

[...] Several experts noted that the distance at which the team found virus is much farther than the six feet recommended for physical distancing. “We know that indoors, those distance rules don’t matter anymore,” [Dr. Robyn Schofield, an atmospheric chemist at Melbourne University in Australia,] said. It takes about five minutes for small aerosols to traverse the room even in still air, she added. The six-foot minimum is “misleading, because people think they are protected indoors and they’re really not,” she said. That recommendation was based on the notion that “large ballistic cannonball-type droplets” were the only vehicles for the virus, Dr. Marr said. The more distance people can maintain, the better, she added. The findings should also push people to heed precautions for airborne transmission like improved ventilation, said Seema Lakdawala, a respiratory virus expert at the University of Pittsburgh.
posted by katra at 3:21 PM on August 12, 2020 [2 favorites]


Smaller particles hang in the air longer, so a fleece that breaks droplets into smaller droplets could, indeed, be worse than no face covering at all, since it's droplets in the air that are a danger.

Part of the issue with fleece is its stretchy open weave knit. But the other factor is that it is made of polyester yarn. Polyester is hydrophobic, it repels droplets, so they don't stick to the material. One of the appeals of fleece for activewear is that your sweat isn't absorbed. It passes right through to the outside air. This is great for exercising but not so great for filtering.
posted by JackFlash at 3:24 PM on August 12, 2020 [3 favorites]


But the other factor is that it is made of polyester yarn.

via CNET: "Dr. Martin Fischer, one of the authors of the study, told CNET, "Our work focused on developing a technique that can be replicated at other labs, rather than a comprehensive mask test. As we stated in the paper, our work was a preliminary study that included one fleece mask (also called gaiter mask, or neck gaiter) only -- we did not do a systematic study involving many masks, speakers and wear conditions. More studies are needed to make specific use recommendations." [...] "The fleece mask we demonstrated was a polyester/spandex mask. Typically, these masks are pretty thin to provide breathability, which is likely the reason for lots of particles getting though, broken into smaller pieces," he said."
posted by katra at 3:42 PM on August 12, 2020 [2 favorites]


Most modern sports fabrics are sweat-wicking. I find cotton masks seem to get soaking wet after a while, while the gaiter/fleece/buff masks seem to diffuse the moisture. Don't know if that's better or worse though.

Would be good to have a proper study that's designed to compare different mask types.

Also if a big chunk of the world's population is going to be wearing masks for a big chunk of the time, is it possible to develop a better mask that's designed for this use case? Can something be developed that is better by some combination of effectiveness, comfort, ease of use by non-professionals, and environmental impact than what we have at the moment?
posted by TheophileEscargot at 3:42 AM on August 13, 2020 [1 favorite]


New Zealand PM says Covid-19 outbreak will 'get worse' as Auckland cluster grows (Guardian, Aug. 12, 2020)
Covid-19 may have been circulating in New Zealand’s biggest city for weeks, the country’s top health official has said, as 13 new community cases were confirmed – all linked to the four cases announced on Tuesday. The prime minister, Jacinda Ardern, said the growing cluster in Auckland, now totalling 17, “would get worse before it gets better” in the city of more than 1.4 million people. [...] “Once again we are reminded of how tricky this virus is and how easily it can spread,” Ardern said. “Going hard and early is still the best course of action.”

[...] Dr Ashley Bloomfield, the director-general of health, said all active cases would now be required to enter government-managed quarantine, in a departure from a previous policy which had allowed infected people to self-isolate at home, or be admitted to hospital if they were severely ill. Bloomfield said despite people’s best intentions many were visited by friends and family when they fell ill, and placing infected people in mandatory quarantine was the country’s best bet at containing the spread. He admitted some Covid-19 patients had resisted the new measure. [...] The contact tracing, isolation and testing process has been identified as crucial in New Zealand which, unlike other countries, has pursued an elimination strategy of the virus.
Experts warn Spain is losing the 2nd round in virus fight (AP)
While an enhanced testing effort is revealing that a majority of the infected are asymptomatic and younger, making them less likely to need medical treatment, concern is increasing as hospitals begin to see more patients. [...] “The data don’t lie,” Rafael Bengoa, the former health chief of Spain’s Basque Country region and international consultant on public health, told The Associated Press.

“The numbers are saying that where we had good local epidemiological tracking, like (in the rural northwest), things have gone well,” Bengoa said. “But in other parts of the country where obviously we did not have the sufficient local capacity to deal with outbreaks, we have community transmission again, and once you community transmission, things get out of hand.” Bengoa is one of 20 Spanish epidemiologists and public health experts who recently called for an independent investigation in a letter published in the medical journal The Lancet to identify the weaknesses that have made Spain among the worst affected countries by the pandemic in Europe despite its robust universal health care system.
posted by katra at 11:53 AM on August 13, 2020 [4 favorites]


Also if a big chunk of the world's population is going to be wearing masks for a big chunk of the time, is it possible to develop a better mask that's designed for this use case? Can something be developed that is better by some combination of effectiveness, comfort, ease of use by non-professionals, and environmental impact than what we have at the moment?

Yes, that's exactly what an N95 is. They are cheap to make and quite reusable. China is pumping out about 20 billion such mask a month, about as much as the entire world used to make in a year, thanks in large part to massive government subsidies for building new factories. The main reason the US doesn't have enough is because "American companies have been reluctant to make big investments in fabric manufacturing because they worry that mask demand will be temporary." 3M, the main manufacturer in the US, has raised its production from 30 million per month to 50, with hopes to hit 100 million by late fall, while the US needs billions of them. This isn't just Trump's fault: the entire US system depends on companies to do the work, and if they worry they might not make a profit, then we just stumble along using vacuum cleaner bags, neck gaiters, and $300 million worth of Etsy masks. But the better solution is clear: cheap melt-blown masks by the billion.
posted by chortly at 10:54 PM on August 13, 2020 [4 favorites]


Europe’s Summer Unravels With Covid Spikes and Travel Chaos (BloombergQuint)
From France down to Ukraine, the number of positive tests for Covid-19 is rising sharply as more people seek vacations and after lockdown measures were eased to allow citizens to congregate. Germany reported the most new cases since May, while France said the situation is worsening, particularly in the cities of Paris and Marseille. [...] In Eastern Europe, which had been hit less hard by the pandemic, some countries approached near record number of daily cases. French Health Agency chief Jerome Salomon said large family reunions, such as weddings, and work places are prevalent places of infection. “One can only be worried as hundreds of new people are hospitalized,” Salomon told France Inter. He urged people to socially distance to avoid the crisis of March and April that “no one wants to go through again.”
Forced Isolation May Be the Only Way to Stop Resurgence of Virus (Bloomberg / MSN)
Flare-ups from Australia to Japan show the world hasn’t learned an early lesson from the coronavirus crisis: to stop the spread, those with mild or symptom-free coronavirus infections must be forced to isolate, both from their communities and family. In Australia, where Victoria state has been reporting record deaths, some 3,000 checks last month on people who should have been isolating at home found 800 were out and about. In Japan, where the virus has roared back, people are staying home but aren’t in isolation: 40% of elderly patients are getting sick from family members in the same apartments. The failure to effectively manage contagious people with mild or no symptoms is a driving factor behind some of the world’s worst resurgences. But lessons from Italy, South Korea and others that have successfully contained large-scale outbreaks show that there’s a tried-and-tested approach to cutting off transmission: move them out of their homes into centralized facilities while they get over their infections, which usually doesn’t require longer than a few weeks.

“A laissez-faire approach naively trusting everyone to be responsible has been shown to be ineffective, as there will always be a proportion who will breach the terms of the isolation,” said Jeremy Lim, adjunct professor at the National University of Singapore’s Saw Swee Hock School of Public Health. [...] Beyond household spread, the strategy is necessitated by a facet of human nature that’s been seen time and again across countries and cultures: left to their own devices, some people just won’t follow the rules. [...] Some people might lose their jobs if they disappear for two weeks, or have caretaking responsibilities for young children or older parents where it’s unfeasible to be separated. [...] Rather than forcing isolation on mild cases, authorities have locked down 5 million residents in Melbourne and are tightening restrictions until new cases come under control. [...] “The classic practice in public health is to identify, trace and quarantine,” said Yang Gonghuan, former deputy director of the Chinese Center for Disease Control and Prevention. “But how that is carried out depends on popular sentiment and the country’s resources.”
posted by katra at 7:00 AM on August 14, 2020 [4 favorites]


It's Friday which means time for me to calculate UK overall contact tracing effectiveness:

ONS most recent incidence: 3,800 new infections a day (slightly up from 3,700 actually pretty good compared to rest of Europe's trend, we'll see how long that continues)

18,620 symptomatic cases a week that could have been caught.

Positive tests 5,212 which is 28% of symptomatic cases (last week was 4,966 & 27%)

Contacts: 80% reached x 74% (last week 79% reached x 72% contacts)

Total: 28% x 80% x 74% = 16.6% (last week 27% x 79% x 72% = 15.5%)

Still a long way to go to reach an overall effectiveness of 50% which was calculated as being needed to relax all restrictions by some of the modellers in The Lancet recently.

Series to date:
22nd July 12.2%
29th July 15.5%
5th August 16.6%

So overall the system may be becoming more effective, mainly by catching a higher % of cases with tests as the %s reached by contact tracing have remained about the same.


(If someone has these numbers for other countries, would love to see them!)
posted by atrazine at 8:37 AM on August 14, 2020 [2 favorites]


they worry that mask demand will be temporary."

HAHAHAHAHAHAHAHAHAHHHHHHHHHHHHAAAAAAAAAAAAAAAAAAAA
posted by jenfullmoon at 5:13 PM on August 14, 2020 [6 favorites]


So today the Danish government has made masks mandatory in public transportation. At the press conference, they said that there were actually fewer deaths than in a normal year in the second quarter of 2020, but that they were now preparing for an extraordinary flu season, with more free vaccinations available. (Here, retired people get a free flu shot every year, now they are planning to give more people a shot with a broader spectrum than usual).
posted by mumimor at 3:25 AM on August 15, 2020 [2 favorites]


This isn't just Trump's fault: the entire US system depends on companies to do the work

Trump has the power to force companies to build new facilities and make more masks, he refuses to use it. And in any case, if the govt covers the capital expenditure then it's a free factory for 3M that they can do whatever they want with in 2 years. Hard to see the downside from a corporate perspective
posted by dis_integration at 6:51 AM on August 15, 2020 [10 favorites]


New Zealand coronavirus: seven new cases confirmed — Auckland’s lockdown extended for two weeks; start of provincial women’s rugby season delayed, The Guardian, 8/14/2020:
PHOTO: [*] Mannequins around the table of a cafe in Auckland that has been required to close. Photograph: David Rowland/AFP/Getty Images.

New Zealand reported seven new cases of coronavirus up to Saturday morning after a lockdown in Auckland was extended. Six of the seven new cases were linked to the cluster at the centre of all the previous community cases, said Ashley Bloomfield, the director-general of health.

Up to Saturday, the authorities in New Zealand have reported 37 cases connected to the outbreak with 19 other people in quarantine. The lockdown in Auckland, home to 1.7 million people, was extended for nearly two weeks after New Zealand reported 12 confirmed cases of Covid-19 on Friday....
Updated news and details at NZ’s Stuff > Coronavirus.

(*Like a scene from I Am Legend (2007) come to life.)
posted by cenoxo at 8:00 AM on August 15, 2020 [2 favorites]


I'm feeling slightly better about New Zealand. In our first outbreak, we went from 10 cases/day up to 80-100 pretty quickly. So far in this outbreak, we've gone 4, 13, 13, 7. We've confirmed all cases but one are linked to the same outbreak, and people affected seem to be self-isolating.

We processed nearly 24,000 tests yesterday - that's almost 1 in 200 of the entire population. A friend of mine was seconded to contact tracing in the first outbreak, and did a lot of training of new staff even after we'd eliminated Covid the first time. It seems to have worked so far; we're contacting 86% of close contacts within 48 hours.
One individual had visited a retirement home; everyone there has been tested and come back clear.
There's been a big uptake in downloads of the contact tracing app (although strangely I have a very tech-aware friend and another doctor friend who haven't downloaded it yet...). Masks are becoming more common, and bars adapted very quickly to the new distancing rules.

So there's a lot of good news.

Less good is reports that some people are being abused for having contracted Covid: "Covid 19 virus is the problem, the people are the solution", says Dr Bloomfield. Conspiracy theories are spreading about martial law, claims the government is hiding the truth about the number of cases, and there's a stronger undercurrent of Bill Gates/NWO/MAGA/Q conspiracies emerging, with a strong undercurrent now among Maori communities as well after a prominent musician got red-pilled in the first lockdown and formed a political party.

We've been slack around testing at the border, everyone, including Ministers, thought our border staff were being constantly tested. They weren't. And there are new rules requiring people who catch Covid into the community to go into managed isolation, rather than isolate at home: these have been criticised as racist because the current outbreak is predominantly among Maori and Pacific Islanders; when most cases were Pakeha (European NZers) returning from overseas, we didn't have those rules.
posted by Pink Frost at 2:14 PM on August 15, 2020 [8 favorites]


Island nations have the edge in keeping Covid away – or most do (Guardian)
Island nations have an advantage when it comes to stopping travellers importing disease, be it Covid or other infections. Seas are usually harder to cross than land, and beaches are easier to police. There are no cross-border towns, and fewer ways to sneak over frontiers. These advantages, combined with strict quarantine policies, have made island nations some of the most successful at containing Covid. But the ones that did best had shut themselves off from the world to varying degrees. And a fresh outbreak of cases in New Zealand last week suggests coronavirus can evade even tight controls. Experts say the lack of special border measures in the UK ahead of lockdown was a “serious mistake” that significantly increased the pace and scale of the epidemic. Even now, the UK’s quarantine measures – for selected countries and with limited enforcement – appear to be nowhere near as comprehensive or effective as those used by other island nations.
Toronto: strip club employee may have exposed about 550 people to Covid-19 (Guardian)
Health officials said they had reached out to the clients that had left their details in the establishment’s contact tracing log, urging them to monitor for any symptoms of Covid-19. Public health experts, however, questioned how many patrons would have handed over legitimate contact information. [...] Toronto health officials suggested their initial investigation found the club to be lacking when it came to following the required protocols, which include distancing between staff and customers and the use of a plexiglass shield when this is not possible. [...] Others questioned the decision to allow such establishments to open as the province grapples with a pandemic that has seen more than 40,000 people test positive to-date. “Why are strip clubs open before schools can safely open? Are these the right priorities?” Ontario doctor Jennifer Kwan wrote on Twitter.
posted by katra at 2:22 PM on August 16, 2020 [3 favorites]


Nope. Those are not the right priorities.
posted by Windopaene at 4:28 PM on August 16, 2020 [1 favorite]


Re: Island nations.

I think it's not just about "islands" vs non-islands, I think you really have to think about how closely interlinked places are. NZ for instance is about 100x farther from Australia than the UK is from Europe and that flows through into the volume of travel flows. The flight time to Sydney is almost four hours from NZ, that will take you to Istanbul or Moscow from London.

When the pandemic hit Northern Italy and alpine France, there were hundreds of thousands of people from the UK already there. Not a simple exercise to quarantine them all on return, although it is in retrospect obvious that it should have been done.

South Korea of course is not an island but practically it is because there are no crossings allowed at its only land border.

I do think that NZ has made the best of its geographical advantages here and is rightly being applauded for effective management but I also think that we can't just forget about geography when we do international comparisons.
posted by atrazine at 12:54 AM on August 17, 2020 [5 favorites]


“Why are strip clubs open before schools can safely open? Are these the right priorities?” Ontario doctor Jennifer Kwan wrote on Twitter.

Nope. Those are not the right priorities.


What do we have to wait around and not open anything until schools can open because they are the most important? That's not logical. You should be opening up what you safely can.

Schools: hundreds of people, including children who by nature are not going to be a vigilant about masks and handwashing and keeping distance, staffed by people who are majority 50+ years old

Strip clubs: can limit number of patrons but during regular times most clubs have only maybe 100 people probably, excluding lap dances and the workers can socially distance pretty easily, adults who in theory can be trusted to follow rules

Like it sounds bad, I get it. But in theory, a strip club has a better chance of safely opening than a school. When deciding what to open and what not to open, you can't place the priority on what is most valuable to society. The value is whether they can be opened safely. Obviously this strip club did not (maybe others did?), and schools will not be able to either.
posted by LizBoBiz at 2:13 AM on August 17, 2020


When deciding what to open and what not to open, you can't place the priority on what is most valuable to society. The value is whether they can be opened safely.

I disagree. You can't really look at opening things in isolation. What they are normally aiming to do is to reduce the overall risk, and not the risk to an individual. So yes, schools are arguably riskier than strip clubs, or offices, but what's important is the overall risk.

One strategy is to keep as much closed as possible, and open schools instead. This reduces the risk of transmission outside of schools and makes schools a bit safer. (Less transmission from families to kids to kids to families.) You still need to consider if the remaining risk in that case would be "acceptable", and I'd be inclined to still say no, but you can and should prioritise based on value to society.
posted by scorbet at 2:39 AM on August 17, 2020 [1 favorite]


When looking at what to open you have to:

-Assess the benefits of what you're opening: economic, educational, cultural, social, etc.
-Assess what it does to your overall "transmission budget", itself a two step process
a) assess how much transmission there will be per unit of the thing (how much transmission will there be per strip club)
b) assess how much of the thing will actually happen (how many strip clubs are there?)

That gets you a big list of things that you could open and the benefit / unit of additional transmission.

Now you have to put them together into packages of measures. Those packages have to be:
-Explainable: everyone gets that a restaurant and a pub are similar things so you can package them together. What you shouldn't do is to mix wildly different things together in such a way that it is no longer explainable in a single sentence. This also applies to local measures. Even if you have the data to do so, hyper targeted measures can make compliance and enforcement difficult because no-one can keep all the details straight in their heads.

-Equitable: In addition to aggregate benefits, you need to consider if you are spreading the benefits of re-opening fairly to different groups.
Essentially the package as a whole needs to scan with the rider of the proverbial Clapham Omnibus as much as possible. If they don't make sense, people will not follow them, whatever your modelling says.

Opening strip clubs before school works fine from the first step: Transmission risks can probably be managed down to be less per strip club than per school and there aren't that many of them (compared to schools). It doesn't work so well when you get to the second step, putting a package of reopening measures to the public. It seems instinctively wrong that we would "prioritise" opening strip clubs over schools, even if the model says that schools cannot open without bringing transmission up too much but strip clubs can.
posted by atrazine at 3:01 AM on August 17, 2020 [1 favorite]


Fair, atrazine, although you also have to consider that NZ gets a lot of overseas arrivals between January-March, for summer tourism and study - two major parts of our economy. And China is one of our biggest sources of tourists and students. Certainly we don't have the same tourism or business travelers as the UK (although per capita our tourist numbers seem to be higher).

Sure, being on an island helps, but you have to use that advantage: we closed borders to anyone who'd been in China in early Feb, by mid-March we'd required all overseas travelers to self-isolate; not long after closed borders to everyone except citizens/residents, and even now require all arrivals to enter managed quarantine. Our international arrivals are at about 1% of usual. Agreed, the UK couldn't have quarantined everyone coming back from Europe, but if I understand right there wasn't any real effort to get people to self-isolate, let alone a requirement to do so. And likewise, no real effort to shut down travel from overseas.
posted by Pink Frost at 3:05 AM on August 17, 2020


by mid-March we'd required all overseas travelers to self-isolate

I think this was key. The UK made the same mistake as Italy which was to do that for travellers from China and then not pay attention to others. Italy was infected from Germany and the UK was infected mostly from Spain and France.
posted by atrazine at 4:18 AM on August 17, 2020 [1 favorite]


It doesn't work so well when you get to the second step, putting a package of reopening measures to the public.

Why? Strips clubs could be lumped together with either restaurants/bars or live performances. Yeah it would be incongruous to make a special exception for strip clubs, but they can be lumped in with other similar businesses for ease of communication with the public.

It seems instinctively wrong that we would "prioritise" opening strip clubs over schools, even if the model says that schools cannot open without bringing transmission up too much but strip clubs can.

Maybe instincts and gut feelings aren't the best tools for fighting this. Your own comment lays out what should be considered and I don't see feelings anywhere on that list. Sticking to science is probably best.

Opening up is a balance between very many competing priorities that have to be considered. If schools were the only priority, we could shut down all other activity completely because we feel it is more important that children go to school than anything else anyone needs. Or we could take things piecemeal and open up what can be opened safely and delaying that which cannot.

And I don't mean this as an issue with you specifically, but I see this hand-wringing about "prioritation" alot and that more superfluous activities should be stopped. But I think that is the wrong way of looking at it. In my opinion, we should prioritize what is easiest to make safe, then gradually work our way up from there. Assuming everyone can and will follow the rules and guidances (big assumption there but stay with me), anything that involves large numbers of people indoors (schools, concerts, rallies, sports, some churches) or with a significant population of at-risk people (hospitals, nursing homes, bingo halls) are going to be last because they are the hardest. Let's get the low-hanging fruit and make sure that's working before we get into something more complicated.

(Of course, all this assumes that the country has their shit together: lockdown when necessary, re-open by actually following their own criteria for infection/hospitalization rates, etc. It doesn't matter about was to prioritize during re-opening if the virus is still raging.)
posted by LizBoBiz at 5:26 AM on August 17, 2020 [1 favorite]


Maybe instincts and gut feelings aren't the best tools for fighting this. Your own comment lays out what should be considered and I don't see feelings anywhere on that list. Sticking to science is probably best.

You misunderstand me, I think.

*I* don't care about either schools or strip clubs personally and I think the concerns about "priorities" are usually either ginned up to advance a political agenda or busybox filler produced by the media to fill space.

I personally believe that we should get the most economic and other "bang" for our transmission "buck". Get the most valuable things open, consistent with staying within our cumulative transmission budget. If that means we can open pubs but not schools, then so be it.

However the nature of public health is that if the public doesn't buy in to the package of measures, then compliance with not just those specific measures but all other distancing rules will go down. People simply will not follow rules they consider arbitrary as assiduously as they do ones they understand.

So yes, if the public at large doesn't understand or think they understand the logic of what is being closed and what isn't, that does matter. Even though I think the public are mostly morons, what people think of the rules matters to me because if they don't respect them then they will stop following them

Personally I doubt that schools can be opened even if almost everything else is shut down. There was extensive modelling to that effect carried out by the SAGE group that advises the UK government back in June - I don't see any reason why that modelling would no longer be valid in September when English schools are currently scheduled to reopen. Schools in Scotland are reopening this week I think. So we'll see.
posted by atrazine at 6:01 AM on August 17, 2020 [5 favorites]


COVID-19 Policy Brief: UN Secretary-General warns of education catastrophe (UNESCO, Aug. 4, 2020)
UNESCO led the drafting of the Secretary-General’s Policy Brief which contains inputs from 15 sister organizations. [...] The Brief calls for national authorities and the international community to come together to place education at the forefront of recovery agendas and protect investment in education. [...] Preventing the learning crisis from becoming a generational catastrophe must become a top priority for world leaders and for stakeholders across the education community, says the brief, emphasizing education’s role in driving economic progress, sustainable development and lasting peace.
COVID-19 Educational Disruption and Response (UNESCO, Jul. 30, 2020)
During the COVID-19 outbreak, IIEP is dedicated to providing educational planners, policy-makers, and all education actors with relevant material and resources to address this crisis.
Reopening schools: How to get education back on track after COVID-19 (UNESCO, May 13, 2020)
‘The absolute priority is to safeguard people’s lives and well-being,’ said [IIEP Director Suzanne] Grant Lewis. ‘Parents, teachers, and school communities need to have confidence that the school system can protect the physical and mental health of students, teachers, and other education personnel.’ This means asking, for example, whether reopening schools risks spreading the virus, whether schools have the necessary hygiene facilities, how to reduce class sizes to take into account physical distancing measures, and what psychological support the school community needs. The situation is different in, and even within, each country, and measures for reopening will need to be context specific.
posted by katra at 6:50 AM on August 17, 2020


In my opinion, we should prioritize what is easiest to make safe, then gradually work our way up from there.

That is the same as saying when you have a limited budget you should pay all of your smallest bills first. So you would pay your cable and gym bills before you pay your rent.

The opposite argument is that you prioritize what is most important. So essential services like food and groceries and schools takes priority over barbers and hair salons, even though the later might be easier to make safe. Just like your household budget, you have a safety budget and you should spend on the most important things first, not the easiest.
posted by JackFlash at 9:16 AM on August 17, 2020 [6 favorites]


Coronavirus: Will schools fully reopen for the new term? (BBC, Aug. 11, 2020)
Rising coronavirus infections suggest England is "near the limit" of opening up, the chief medical officer has warned. This means there may be trade-offs, such as closing pubs, to ensure children can safely return to school. Prof Graham Medley told the BBC that reopening schools would ''reconnect lots of households', so closing other networks may be required, and that was ''a matter of prioritising''. He asked: ''Do we think pubs are more important than schools?"
Schools 'must come before pubs and restaurants in future' (BBC, Aug. 5, 2020)
Schools should be the last places to shut in future lockdowns, after non-essential shops, pubs and restaurants, England's children's commissioner says. Anne Longfield says children have a right to education and, must not be an "afterthought", and that schools should be "first to open, last to close". [...] Ms Longfield has published a briefing setting out key actions needed to ensure children are "at the heart of planning for the future".
posted by katra at 9:58 AM on August 17, 2020


New Zealand delays general election by a month amid Auckland Covid-19 outbreak — The prime minister, Jacinda Ardern, announces vote will move from 19 September to 17 October., The Guardian, Eleanor Ainge Roy, 8/16/2020:
...Calls had been growing from opposition parties for the election to be moved, with opposition leaders saying it wasn’t “just and fair” to hold an election while an outbreak was underway and level 3 restrictions were in place in the country’s largest city, prohibiting campaigning.

Ardern said after consulting with every political party in parliament, as well as the electoral commission, she had decided to move the general election from 19 September to 17 October. “The Electoral Commission, via the Ministry of Justice, has advised me that a safe and accessible election is achievable on this date,” Ardern said. “Moving the date by four weeks also gives all parties a fair shot to campaign and delivers New Zealanders certainty without unnecessarily long delays.”
...
Ardern said Covid-19 would be with the world “for some time to come” and repeatedly pushing the election date would not lessen the risk of disruption to voters and parties. “This is why the Electoral Commission has planned for the possibility of holding an election where the country is at level 2, and with some parts at level 3. I will not change the election date again.”...
More at NZ StuffElection 2020: How the Government is delaying the election, and why, 8/17/2020.
posted by cenoxo at 11:01 AM on August 17, 2020


What We’ve Stolen From Our Kids (Chavi Eve Karkowsky, Atlantic)
We could fix it, you know. We could shut things down, and wear masks, and get enough tests to contact trace and isolate people—if we all worked together, the whole country, united in our goal of giving children what they need. If we did that, we could probably open schools in a few months, in person, safely. We would have to choose schools over bars; we’d have to think big. But if we had the appropriate federal resources and national leadership and shared priorities, we could make things right again.
Sweden's Covid-19 strategist under fire over herd immunity emails (Guardian)
Swedish schoolchildren of all age groups return to class this week, prompting alarm among some parents and a call from experts and academics for a “more responsible” policy, including making masks compulsory in schools – which [Anders Tegnell, the architect of the country’s no-lockdown strategy] does not support – and enforcing physical distancing rules. Scientific studies from countries including South Korea, the US, Israel and Sweden itself suggest that while scientists do not yet fully understand how exactly children contribute to the pandemic, it is clear school-age children can and do spread the virus to wider society, 26 academics argued in an open letter.
posted by katra at 11:06 AM on August 17, 2020 [2 favorites]


In my opinion, we should prioritize what is easiest to make safe, then gradually work our way up from there.

There is no “safe” apart from complete isolation - it’s possible to use masks and social distancing etc. to reduce risk, but not eliminate it completely. If someone asymptomatic goes to a restaurant for example, then it’s not unlikely that they will pass it on to at least one person. Ideally, contact tracing will mean that person will self-isolate before they in turn pass it on, but that’s not a given. Instead, depending on how long things take, they may already have been at a different restaurant, a pub, a gym and their office in an infectious state, each time potentially infecting people.

So doing it the way you suggest prioritizes lots of openings each with a relatively small added risk / transmission rate until a “max acceptable” rate is hit. But the more difficult stuff like schools opening etc. won’t happen, because the added risk is too high.
posted by scorbet at 11:43 AM on August 17, 2020 [1 favorite]


Italy's hovering between three and six hundred new cases per day this week (meaning we're now back to double the weekly total from our end-of-July low of around 1200 new cases), and so the hammer's been brought down on dance bars and discotheques (with masks now obligatory also in open public spaces "likely to host crowds").

Some Italian holiday-makers will need to get tested (or self-quarantine) upon their return home, and refugee centers continue to be in the eye of the storm; nursing staff in Rome has some frank thoughts to share (sadly neither Google nor DeepL do Roman dialect well, yet...), and the Church is still steering clear of unnecessary fray, while the going's "good" - though accusations of state negligence, as well as of dirigisme/statism, are starting to accrue...
posted by progosk at 2:28 PM on August 17, 2020 [1 favorite]


So essential services like food and groceries and schools takes priority over barbers and hair salons, even though the later might be easier to make safe. Just like your household budget, you have a safety budget and you should spend on the most important things first, not the easiest.
______

So doing it the way you suggest prioritizes lots of openings each with a relatively small added risk / transmission rate until a “max acceptable” rate is hit. But the more difficult stuff like schools opening etc. won’t happen, because the added risk is too high.


I guess maybe we disagree on two things:

1) I dont think community transmission will ever get low enough that schools could reopen back to normal levels without causing a significant increase in community transmission. That's too many households mixing every day.

2) I personally disagree that schools are the highest of high priorities to reopen. I don't think it makes sense nor is it best for everyone to go into complete lockdown so that children can go to school. And when someone says that only essential businesses can open so we can open schools that's what they're suggesting. There are people other than children that live in our society and I don't believe that the educational needs of children should weigh so much more than the needs of everyone else in society. There has to be a balance.

Let's keep in mind that this is the non-US thread, and where alot of us live, infections are currently at mostly steady levels and significantly less than March/April levels. (I'm sure things will get worse as the summer holidays go on, but I'm talking about how things are at the moment). So we are already at a point where we don't need the full lockdown to contain the virus itself.
posted by LizBoBiz at 12:22 AM on August 18, 2020


I guess maybe we disagree on two things:

We don't actually disagree particularly on either of them. I already said above that I don't think that opening schools would be a good idea, even if everything is shut down. What I'm trying (possibly failing) to say is that you do have to prioritise according to what is the best value for society, whatever that happens to be. That may be opening schools, or it may be opening restaurants and pubs (or strip clubs) or it may be a mixture of several. (Partial opening of schools for example.) It would be a bit easier if if were a purely economical decision, but unfortunately there are a lot of intangibles, that different people lay different worth on.

Where I possibly would disagree with you a little, is that I would see schools as more than just the educational needs of children, but also the ability for parents to work (they act as basically a form of childcare). Which leads to my other worry - where are the kids if they are not at school? If they are staying at home most of the time that's one thing, but if they end up being in everchanging groups of friends that's a bit different.

infections are currently at mostly steady levels and significantly less than March/April levels.

I'm in Frankfurt, where the school holidays have just ended. Our number of cases is not staying steady, but increasing, and looking at the number of new cases per week per 100 000, we're already at over half of our worst number from March/April in Frankfurt, whereas in Hessen it's almost half. You can quibble whether that's significantly less or not, but I certainly find it worrying.

However, the whole open schools or not debate is a little academic for me, anyway, as they are already open here. Possibly there will be enough experience from here, and the states that opened even earlier to allow particularly Baden-Württemberg and Bavaria to reanalyse the situation.
posted by scorbet at 2:31 AM on August 18, 2020 [1 favorite]


Ah I see. I'm in Bavaria and so yes our cases have increased in the past couple of weeks but we are still at just slightly above 1/10th the number of daily cases we had at our worst. I'm in Munich which is at about 1/4th our worst rate.

But we are right in the middle of the school holidays here. It will be interesting to what kind of spike we get when they're done in a few weeks (its only taken 2 weeks of school holidays to double our daily case rate from 75-100 per day to 150-200 per day).
posted by LizBoBiz at 5:20 AM on August 18, 2020


Global report: alarm over Covid case rates in 19 European countries (Guardian, Aug. 17, 2020)
Nineteen European countries have crossed a key threshold of new coronavirus infections, with Spain’s figures particularly worrying. According to data from the European Centre for Disease Prevention and Control, the countries have recorded cumulative 14-day infection totals higher than 20 per 100,000 inhabitants, considered an early alarm level by many health experts.
Guardian: Infection being spread by 'unaware' younger people, WHO warns
The World Health Organization has warned that Covid-19 is now being spread mainly by people in their 20s, 30s and 40s who may be unaware they are infected, potentially transmitting the disease to more vulnerable groups.

[...] Surges have been reported in countries that appeared to have the virus under control, including Vietnam, which until recently went three months without domestic transmission due to its aggressive mitigation efforts, Reuters reported. “What we are observing is not simply a resurgence. We believe it’s a signal that we have entered a new phase of pandemic in the Asia-Pacific,” Kasai said.
Guardian: Lebanon must shut down to stop coronavirus spread
Lebanon must shut down for two weeks after a surge in coronavirus infections, the caretaker health minister said on Monday, as the country reels from the massive Beirut port blast. The country’s health ministry registered a record 456 new infections, with two deaths, taking the cumulative number of cases to 9,337 since February, with 105 fatalities. “We declare today a state of general alert and we need a brave decision to close (the country) for two weeks,” Hamad Hassan told Voice of Lebanon radio.
posted by katra at 7:58 AM on August 18, 2020


The RKI daily report (German version only for some reason) has a graph on p6 showing how the new cases per week per 100 000 in the different states have changed over the past month. Bavaria (and Baden-Württemberg) does look pretty steady, but most of the rest have a more or less upward trend, which at least partially matches the school holiday dates.
posted by scorbet at 8:00 AM on August 18, 2020 [1 favorite]


Science: The pandemic appears to have spared Africa so far. Scientists are struggling to explain why
Although Africa reported its millionth official COVID-19 case last week, it seems to have weathered the pandemic relatively well so far, with fewer than one confirmed case for every thousand people and just 23,000 deaths so far. Yet several antibody surveys suggest far more Africans have been infected with the coronavirus—a discrepancy that is puzzling scientists around the continent.
...
Marina Pollán of the Carlos III Health Institute in Madrid, who led Spain’s antibody survey, says Africa’s youthfulness may protect it. Spain’s median age is 45; in Kenya and Malawi, it’s 20 and 18, respectively. Young people around the world are far less likely to get severely ill or die from the virus. And the population in Kenya’s cities, where the pandemic first took hold, skews even younger than the country as a whole, says Thumbi Mwangi, an epidemiologist at the University of Nairobi.
Also mentions speculation about exposure to other types of coronavirus, malaria, or other diseases
posted by polecat at 12:13 PM on August 18, 2020 [3 favorites]


I posted a thing on Facebook. It was brusque. My UK friend was threatening protest if schools don't open in September. She has 4 kids,

I have none, and in addition, I have no ties in the UK except for randoms I've met being an expat and traveler for a decade-plus of years. In her comments under the post, which most of her friends disagreed with, she was posting about a 99% survivability rate. My comment was, paraphrased, "Imagine you have 500 Facebook friends. Now imagine you've condemned 5 of them to death and 20 of them to lifelong chronic diseases. Now imagine your options are protest for their deaths or protest against their deaths. This is not a thought experiment. With this post, you are choosing to condemn these others. Choose."

I wasn't wrong, per se, but I've had moments in the past with this person where it's like, hi, that Tory/Trumpy/regressive talking point comes across savage to some. But I've never been that blunt, until now.

And since I posted it, I've been thinking about the cost of education. She said "we can't afford to tear down society over this." I've gained a lot of sympathy for the viewpoint that ceasing education is equivalent to tearing down society.

I've also gained more sympathy than that for the view that we never adequately funded education in the first place. My original view was "whatever, spend a year at home with your kids, we pick up school where we left off when the vaccine comes, you lost a year at school and you gained a year of family time, that's probably a net positive". I don't believe that anymore.

Republicans continue to demand gutting education budgets. Tories continue to demand the same. Conservatives in all countries continue to wage culture wars rather than addressing actual education inequalities. "Move online" they said, without any respectable attempt to improve online access. "Go back to school" they said, without any PPE investment.

My opinion now, radical though it is, is that school should stay closed and that parents can eat it until they all vote for 90 gajillion times more money for school, and basically, "school" has to mean all the online things too. From textbooks to class sizes to teacher wages to the cost and social importance of off-school childcare (if that's not a social good what is?), we fucked up.

The thing we once called school is like the fast fashion industry. It was broken long ago, and there's no point it bringing it back until we fix it. Do I sympathize with parents who need a solution? Yes. Do I think just going back to what we did before is an answer? NO!!!
posted by saysthis at 7:00 PM on August 18, 2020 [9 favorites]


And so I'm sorry to keep ranting on this one, I'm sorry because I'm child-free and it's by choice and I have the resources and the time to handle kids but I just never did because I had the space to imagine, but the pandemic and the school reopening debates made me think a LOT about this and I'm open for correction, tell me if I'm wrong, BUT: the world got put on pause for a minute, and no, I don't hate kids, I'd handle some of my own if the world treated them right, but they don't.

In the UK, in this Facebook friend's eyes, it's "they opened pubs so why not schools, it's not that deadly". She's not a news-literate person, never was. Doesn't know what RSS is. I do. Premium Feedly over here and I read most of the feeds.

I can't. She did. If you have children, how in the middle of a pandemic do you send them into a world where they open bars before schools, and then just send them back to school, with obvious case increases and shutdowns where that happens, before making a plan beyond "we'll all go home if cases increase"? Like they won't increase?

I don't know how to defend sending children back to school like that. I know it's not easy for parents, I've done some babysitting, I will again if asked. But how do you just send your kids back in? How do you go out and protest and argue for it? It's barbaric to take those little people and put them in that meat grinder, no matter what the cost. She wants to protest for THAT. What should a parent think? I don't know right now, and I'm not a parent, so I'm not even qualified to have an opinion, but I'd hope they fix it all before I'll argue for a return to school.
posted by saysthis at 7:22 PM on August 18, 2020 [3 favorites]


I think it's a bit melodramatic to talk about "take those little people and put them in that meat grinder". Children are at very low risk from COVID. School was open for key workers' children in the UK throughout the first wave, lots of other countries have reopened schools. It's not zero risk but it's certainly not been a meat grinder. (This applies to Europe, not countries where the first wave is still going strong).

What happens in a year? Maybe there will be a vaccine which is safe and highly effective and long-lasting. Maybe it will be like the flu vaccine and halve the risk but not eliminate it. Maybe it won't work or the virus will mutate. Once you've got the first wave crushed, the two timeframes to think about are "right now" and "forever".

(My son's in Year One and was back already. There was lots of apocalyptic talk on the parents forums and the Coronavirus subreddits but it was fine. Doesn't mean it always will be, but we've been here before.)
posted by TheophileEscargot at 1:54 AM on August 19, 2020


Tories continue to demand the same.

Do they? They demand that? All through the home counties their plaintive wails can be heard, "Please master Boris, spend less on these dreaded schools. We hates them!"

"whatever, spend a year at home with your kids, we pick up school where we left off when the vaccine comes, you lost a year at school and you gained a year of family time, that's probably a net positive"

Ok, sure. If you're a middle class, educated person with a nice comfortable house full of books, all your kids are behaviourally normal, everyone is neurotypical, then sure. If both parents are present in the same house and both can work from home and both have secure jobs with understanding employers, that's great.

When I was a kid, I probably would have loved it and I doubt I would have suffered any educational setbacks as a result.

The reality is that for many people, it's otherwise. Every person who is professionally accountable for the welfare of children, in particular the Children's Commissioners for all four home nations have argued that schools need to re-open. That the harm being done to children by not sending them to school is greater than the potential harm to them of being exposed to SARS-CoV-2. I'm sure they've done the maths.

I have friends who meet all those criteria here in England and in Scotland, they all have or are sending their children back to school and they worry about what their kids have missed. I've seen plenty of stories of kids having serious behaviour regressions as well. Keeping kids at home comes with substantial costs.

That doesn't mean that we necessarily have the space in our transmission budget to do that without blowing up the numbers again but from the point of view of the children, the consensus seems to be that in communities with low infection rates they will be better off at school.

My opinion now, radical though it is, is that school should stay closed and that parents can eat it until they all vote for 90 gajillion times more money for school, and basically, "school" has to mean all the online things too. From textbooks to class sizes to teacher wages to the cost and social importance of off-school childcare (if that's not a social good what is?), we fucked up.

UK state spending on primary and secondary schools is 3.8% of GDP which is comparatively quite high. It's more than France, Korea, The Netherlands, Germany, of course it's more than the US. Finland is 4%, Norway is 4.6%, Costa Rica (highest in the world) is 4.7%.

So while my instinct is that we don't spend enough on education, I don't think there is any evidence that under-spending is the problem.

Even if you did increase spending right now, none of that is quick, it's not a magic bucket that you just pour money into and more "school" comes out. If the decision was made to double the per pupil spending in primary schools from about £5000 to £10000, that would have no effect until at least the following academic year. Really much longer to change much.

So what you're saying is, don't open schools unless this fictional thing I want to happen - which I know will not happen - happens.
posted by atrazine at 2:09 AM on August 19, 2020 [3 favorites]


A Torrent of Good News - John Campbell summarizes various recent paper investigating Covid-19 antibodies. He starts off by saying "it would be good if..."
- Antibodies provide "real world protection"
- Cellular immunity is long lasting
- Antibody protection also arises for mild or asymptomatic cases
Research is now indicating that all of these assertions look to be true.
(Posting also because any Covid-19 thread needs a post entitled "A Torrent of Good News")
posted by rongorongo at 3:42 AM on August 19, 2020 [3 favorites]


I think it's a bit melodramatic to talk about "take those little people and put them in that meat grinder". Children are at very low risk from COVID.

Everyone keeps saying that but it's not like these cases aren't going up. And it's not like kids haven't died. It's amazing to me people keep saying kids are low risk. Not a risk I want for any child.
posted by tiny frying pan at 5:26 AM on August 19, 2020 [7 favorites]


Apologies, I meant to put up a different link since that is US based.
posted by tiny frying pan at 5:28 AM on August 19, 2020


Children are at very low risk from COVID. School was open for key workers' children in the UK throughout the first wave, lots of other countries have reopened schools.

The argument is not about kids dying from covid, it's about teachers dying from covid when an outbreak occurs.

In a perfect world we would triage the most disadvantaged and harmed kids (early grades, special needs), assign younger teachers to them, and allow older teachers to reallocate to distance learning for older grades.
posted by benzenedream at 9:06 AM on August 19, 2020 [3 favorites]


Schools reopened here (Hessen in Germany) on Monday morning, and by Monday afternoon, we already had least 2 classes full of students and teachers sent home to quarantine. Both were the result of students coming back from abroad, and their parents sending them to school before the test results were back. (German article from the Frankfurter Allgemeine Zeitung/FAZ on Hessen).

(They also extinguished my remaining hope that the high number of cases in Frankfurt were thanks to testing at the airport being registered as being in Frankfurt - but no, it's the home address that is used instead.)

The FAZ is also reporting that almost 40% of the new German cases are imported ones as travellers return from holidays abroad. Part of that is more testing at the airports, train stations etc. (obligatory if you are coming from a "high-risk area) so that more asymptomatic cases are being caught, but that isn't all of it. (FAZ article again in German)
posted by scorbet at 9:42 AM on August 19, 2020 [2 favorites]


Classes are being sent home here in Denmark, too. It's a big issue, because their whole families are quarantined until the test results arrive, and somehow there is a hole in the pandemic laws so the parents aren't compensated for their leave under these circumstances (technically, no-one is "sick", so normal sick leave doesn't apply). I'm guessing this will be solved soon, since the PM is busy making all the political hay she can out of being the most popular Social Democratic leader for generations. She's not going to let a few hundred worried families stand in the way of her making history.
posted by mumimor at 10:03 AM on August 19, 2020


Study: False health information viewed nearly 4B times on Facebook (UPI)
Billions of Facebook users in several countries came across some type of false health information on the social media platform over the past year, according to a new analysis published Wednesday. Advocacy group Avaaz said in a 33-page report [pdf] [html] that it found health misinformation on the platform that generated at least 3.8 billion page views in at least five nations. Websites spreading the inaccurate information peaked at about 460 million views in April in the early weeks of the COVID-19 pandemic, it noted.

[...] The report covered Facebook users in the United States, Britain, France, Germany and Italy and said anti-vaccine propaganda was also found on the popular platform. "Factually inaccurate or misleading content doesn't spread in isolation," it said. "It's often shared by actors who are spreading other types of content, in a bid to build followers and help make misinformation go viral." Campaign director Fadi Quran said the algorithm that Facebook uses to gather information is a "major threat to public health." [...] The report called on Facebook to provide all users with independently fact-checked corrections and downgrade erroneous posts by adjusting its algorithms.
posted by katra at 10:23 AM on August 19, 2020


Children are at very low risk from COVID.
In the immediate term.

Maybe they'll be fine a few months from now and a few years from now, too.

Do we know that children who contract COVID-19 and recover or show no symptoms will be fine down the line?

No.
No.
NO.
posted by Don Pepino at 10:37 AM on August 19, 2020 [5 favorites]


https://elemental.medium.com/new-survey-identifies-98-long-lasting-covid-symptoms-87935b258a3e
Given the current pandemic is only months old, nobody can say for sure if any of the post-Covid complications will become life-long problems. “It’s going to take months to a year or more to determine if there are any long-lasting, deleterious consequences of the infection,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, said last month in an interview on Facebook. “We just don’t know that now. We haven’t had enough time.”
posted by Don Pepino at 11:17 AM on August 19, 2020


Long-Haulers Are Redefining COVID-19 (Ed Yong, Atlantic [free access])
Our understanding of COVID-19 has accreted around the idea that it kills a few and is “mild” for the rest. That caricature was sketched before the new coronavirus even had a name; instead of shifting in the light of fresh data, it calcified. It affected the questions scientists sought to ask, the stories journalists sought to tell, and the patients doctors sought to treat. It excluded long-haulers from help and answers. [...] Long-haulers had to set up their own support groups. They had to start running their own research projects. They formed alliances with people who have similar illnesses, such as dysautonomia and myalgic encephalomyelitis, also known as chronic fatigue syndrome. A British group—LongCovidSOS—launched a campaign to push the government for recognition, research, and support. [...] All of this effort started to have an effect. More journalists wrote stories about them. Some doctors began taking their illness seriously. Some researchers are developing treatment and rehabilitation programs.

[...] It’s not enough, argues Nisreen Alwan, a public-health professor at the University of Southampton who has had COVID-19 since March 20. She says that experts and officials should stop referring to all nonhospitalized cases as “mild.” They should agree on a definition of recovery that goes beyond being discharged from the hospital or testing negative for the virus, and accounts for a patient’s quality of life. “We cannot fight what we do not measure,” Alwan says. “Death is not the only thing that counts. We must also count lives changed.” [...] A few formal studies have hinted at the lingering damage that COVID-19 can inflict. In an Italian study, 87 percent of hospitalized patients still had symptoms after two months; a British study found similar trends. A German study that included many patients who recovered at home found that 78 percent had heart abnormalities after two or three months. [...] These findings, though limited, are galling. They suggest that in the United States alone, which has more than 5 million confirmed COVID-19 cases, there are probably hundreds of thousands of long-haulers.

[...] Organizations and governments have been slow to recognize what long-haulers call “long COVID.” In July, the U.K. allocated $11 million (£8.4 million) for research into the long-term consequences of COVID-19, but “to be eligible, you have to have been admitted into hospital,” says Trisha Greenhalgh, a primary-health-care professor at the University of Oxford. “That makes no sense.” [...] “You have to get away from this idea that you can do more each day, or that you can push through,” says Caroline Dalton of Sheffield Hallam University in England, who works for a COVID-19 rehabilitation program. Many long-haulers push themselves because they miss their lives, or need to return to work. [...] The uncertainty that long-haulers are experiencing results from [the] long-standing neglect. But so does the help they’re getting from people with chronic illnesses, who have already walked the same path. [...] Likewise, the long-haulers have taken matters into their own hands, pushing for respect, research, and support when none were offered.
posted by katra at 11:29 AM on August 19, 2020 [6 favorites]


What are the actual criteria for opening schools though?

Flu deaths per year in the UK are usually about 10,000.
Coronavirus killed about 40,000.

Even if there is a vaccine developed quickly, the flu vaccine only reduces death rates by about 50%. You can still expect a lot of deaths even in an ideal world with a vaccine... and we don't know that there will be a vaccine.

Keeping schools closed until nobody dies of COVID anymore means keeping them closed forever.

To open schools, I'd say we need two things.

First, we have to make sure that the reproduction rate r stays pretty low, enough that the virus doesn't spiral out of control again.

Second, we need to make sure that the COVID death rate is an acceptable level. I would say going by what we tolerate for the flu, about 200 deaths per week would be a reasonable maximum for the UK, if that can be maintained at a steady level.

So maybe that makes me an evil, ruthless, murderous bastard. But if it's so intolerable to have an open society at the cost of that number of deaths, how come we tolerated it up to now?
posted by TheophileEscargot at 12:43 PM on August 19, 2020 [1 favorite]


But if it's so intolerable to have an open society at the cost of that number of deaths, how come we tolerated it up to now?

The same reason places like the US let COVID get so bad: because money is more important than people, especially when most of the people dying are already seen as disposable.
posted by Glegrinof the Pig-Man at 12:55 PM on August 19, 2020 [3 favorites]


So keeping the schools closed isn't actually about COVID, it's about rebuilding a radically more risk-averse society?
posted by TheophileEscargot at 1:07 PM on August 19, 2020


So maybe that makes me an evil, ruthless, murderous bastard. But if it's so intolerable to have an open society at the cost of that number of deaths, how come we tolerated it up to now?

Or maybe you are just not recognizing the full scale of the impact of the novel nature of this coronavirus by only focusing on death, and ignoring how much more evidence has been emerging about long-term effects, including as described recently by Ed Yong. The risk is not just death, but also long-term disabilities, which are still being studied and calculated, because it is so new. It may well be a matter of building a radically more equitable society that ensures health care for all, subsidizes income, vastly improves internet access, etc, and follows the guidance of public health experts for how to eliminate the pandemic.
posted by katra at 1:23 PM on August 19, 2020 [9 favorites]


Flu also has a load of long-term complications though.
posted by TheophileEscargot at 1:29 PM on August 19, 2020


At least flu complications are known! Studied! I am tired of people calling most covid infections mild. We have no idea how long some people may suffer from complications. Peoplw with mild infections who "recovered" have heart damage, lung damage, brain fog, chronic fatigue, and more. We don't know enough yet to call any of this mild or non worrying.
posted by tiny frying pan at 1:33 PM on August 19, 2020 [10 favorites]


And COVID-19 is not the flu, and research is ongoing, e.g. Trail of bubbles leads scientists to new coronavirus clue (AP)
A doctor checking comatose COVID-19 patients for signs of a stroke instead stumbled onto a new clue about how the virus may harm the lungs -- thanks to a test that used tiny air bubbles and a robot. [...] The tale illustrates how months into the pandemic, scientists still are struggling to unravel the myriad ways the coronavirus attacks -- and finding hints in surprising places. [...] Doctors know the coronavirus attacks the lining of blood vessels, causing dangerous clots. The bubble study suggests maybe blood is being detoured from clogged vessels to unusually widened ones — and thus flowing through too fast to properly absorb oxygen. [...] The findings are preliminary, not proof that dilated blood vessels are a problem. Still, some autopsies have linked COVID-19 to deformed lung capillaries. Next up is a larger study that aims to see if measuring bubbles could help doctors monitor whether patients are improving or worsening.

The report “I think is really going to generate a lot of talk” among lung specialists, because it’s “more evidence that the blood vessel is really where the action is,” said Dr. Corey Kershaw of the University of Texas Southwestern Medical Center, who wasn’t involved in the pilot study. He cautioned that researchers need to definitively prove a heart defect isn’t playing a role. But, “it’s an example of, there are so many things we still don’t know,” Kershaw added, praising the creativity used to find this latest clue.
posted by katra at 1:34 PM on August 19, 2020 [3 favorites]


I’m not trying to downplay the risks of COVID-19 to children, I would assume that children are just at risk of long term effects as adults, if not more. However, can I also remind everyone that the discussion in *this* thread is not about the situation in the US, and that a lot of us are coming from a European or Australia/New Zealand perspective. The number of new cases being identified and therefore the chances of transmission within schools are significantly lower.

It’s also easy to forget that not opening schools doesn’t mean that the risk of children getting COVID drops to zero. There is of course significantly less risk in the type of middle class home that atrazine described above, but I don’t know what single parents, or people living in cramped accommodation are expected to do, that doesn’t involve children mixing in groups, often with less oversight as to who and when.

I’m not sure myself if the benefits outweigh the risks, but all of the countries in Europe that I’ve been watching (Germany, Ireland and the UK) have decided to prioritise schools. The Irish Acting Chief Medical Officer went as far as saying that it would be inevitable to have clusters in schools: “There is no zero risk so it is likely unfortunately. But we have to balance the risk of infection versus their needs as children to educational attainment."
posted by scorbet at 2:20 PM on August 19, 2020 [1 favorite]


I would assume that children are just at risk of long term effects as adults, if not more. However, can I also remind everyone that the discussion in *this* thread is not about the situation in the US, and that a lot of us are coming from a European or Australia/New Zealand perspective. The number of new cases being identified and therefore the chances of transmission within schools are significantly lower.

This is true but keep in mind that one thing that Covid-19 has demonstrated to us over and over again, unfortunately including most recently - New Zealand who had been a shining exemplar up til now, what is "over there" will inevitably end up "over here" and that it silently spreads explosively fast.
posted by srboisvert at 3:13 PM on August 19, 2020 [1 favorite]


> The contact tracing, isolation and testing process has been identified as crucial in New Zealand which, unlike other countries, has pursued an elimination strategy of the virus.

fwiw, I created this FPP with a worldwide audience and perspectives in mind, and when it comes to the issue of responding to the pandemic, I appreciate the perspective described by Ed Yong in the recent article I linked above:
Throughout the pandemic, systemic failures have been portrayed as personal ones. Many people ignored catastrophic governmental choices that allowed the coronavirus to spread unchecked, and instead castigated individuals for going to beaches or wearing masks incorrectly. So, too, with recovery. The act of getting better is frequently framed as a battle between person and pathogen, ignoring everything else that sways the outcome of that conflict—the disregard from doctors and the sympathy from strangers, the choices of policy makers and the narratives of journalists. Nothing about COVID-19 exists in a social vacuum. If people are to recover, “you have to create the conditions in which they can recover,” Copeland, the sport psychologist from Sheffield Hallam, says.
Viral video of crowded pub in Dublin causes outrage as coronavirus cases rise and restrictions are tightened in parts of Europe (WaPo live blog)
With the number of cases of the novel coronavirus continuing to rise across the European Union, governments are moving to tighten health and safety measures. “We are at a tipping point,” Irish Health Minister Stephen Donnelly said as the country looked to bring back some of the rules it had previously relaxed. A limit of 15 people at outdoor events is set to be imposed, down from 200 at the moment. The move came after a video of people dancing and drinking at a pub in Dublin on Saturday went viral. [...] Irish Prime Minister Micheál Martin called the scene, in which a masked bartender was filmed pouring alcohol into customers’ mouths while others danced around them, “appalling,” Bloomberg News reported.
posted by katra at 5:09 PM on August 19, 2020 [3 favorites]


It's really horrible how most of the lessons learned from HIV in the 1990s have all been set on fire and forgotten. Shaming and blaming didn't work then to compensate for systemic failures and it won't work now.

A public health system that assumes all good actors is doomed to fail.
posted by benzenedream at 5:35 PM on August 19, 2020 [6 favorites]


I witnessed the horror of HIV 30 years ago. Here's how we can conquer a pandemic (Cleve Jones, Guardian Opinion, Aug. 18, 2020)
In the United States, largely because we initially perceived HIV as a gay disease, we failed to act with the speed and urgency required. This homophobia-driven indifference, compounded by racism, contributed to the deaths of tens of millions of heterosexual men, women and their children worldwide because the one nation supremely positioned to stop it in its tracks failed miserably. [...] Today, the Ryan White Care Act represents a national framework for responding to a viral pandemic. It ensures not only access to healthcare and medications for people with HIV, but also access to food, housing, dental care and mental health services to address as many barriers to health as possible. It is an unquestionable success and demonstrates the power of federal leadership in addressing public health challenges. While our national response to HIV still leaves much work to be done, programs and clinics funded by the Ryan White program save lives that would be otherwise lost. [...] There are differences, of course, between HIV and the coronavirus, modes of transmission chief among them. But it is remarkable how many parallels exist: [...] Traditional and social media are alive with nasty chatter from all sides of the debates about masks and economic reopening. It is easy to mock people with whom we disagree, but snarky memes and tweets do not move us forward. [...]

A compassionate and equitable response must replace anger and politically driven division. Access to testing, treatment and healthcare should not be determined by income, skin color, language, gender, sexual orientation or geography. Real economic support for struggling families and businesses as well as local governments must not be further delayed. We must also accept education and trust public health officials. When political and opinion leaders mock scientists and question their recommendations without basis, they undermine our best efforts to slow transmission of the virus. [...] Worldwide, 35 million people have lost their lives to HIV, and the pandemic is not over. We have no cure and no vaccine. But we have learned that when we set aside our differences, when communities work together, when the federal government leads – with decisions based on science, compassion and common sense – we can save lives.
posted by katra at 6:39 PM on August 19, 2020 [4 favorites]


I think given what we are seeing right now in Europe it is worth comparing the increase now with what happened in March and April.

Yes, cases are increasing almost everywhere and that is not good. However the speed with which those cases are increasing is much slower than last time, the visibility that countries have as to where cases are increasing is also much better.

Certainly in March, many countries had only quite vague senses of where the cluster were, that is not true now. Every country on that chart now has comprehensive national surveillance programmes, some kind of large scale contact tracing (effectiveness may vary), and a framework for rapidly imposing local restrictions when called for.

As the original thread title goes, this is the new normal, we will plod through with local restrictions and controls coming on and off particular areas, probably until well into next year. That means coming up with some kind of way of living that isn't just hunkering down as we did during the height of the crisis. I hope that we can find space in our transmission budget for opening schools. Since schools are now open in large parts of Europe, I suspect that we will see very quickly.
posted by atrazine at 5:19 AM on August 20, 2020 [3 favorites]


The spread of coronavirus in Australia is not the fault of individuals but a result of neoliberalism (Richard Denniss, Guardian Opinion)
Neoliberalism is spreading coronavirus faster than any “reckless teenager” ever could. Privatised guards at quarantine hotels, private aged care centres that put profits ahead of staffing levels, and the fact that those in charge neglected to have their health professionals appropriately evaluate the risk of the Ruby Princess, are the major causes of Covid-19 transmissions and deaths in Australia. Put simply, if Australia relied on a well-paid, well-trained and well-resourced public sector to protect us then there might have been no shutdown in Victoria, no restrictions on interstate travel and no forecast of double-digit unemployment. [...] For decades, advocates of the outsourcing and privatisation of public services have boasted of the cost savings of doing so. Today, we are counting the cost. We will be counting it for years to come. When you don’t care about the future, cost-cutting is easy. [...] Of course, the private sector hasn’t just done a poor job of keeping Covid-19 out of aged care homes, it’s done a poor job of keeping people infected with the virus contained in their quarantine hotels too. Victoria’s reliance on a poorly trained and poorly paid pool of private security providers seems likely to be a major cause of Australia’s largest Covid-19 outbreak and it’s now been revealed that a private guard at a Sydney quarantine hotel not only contracted the virus, but worked shifts at a court house and food market after he was infected.

[...] It’s not the fault of individual security guards, aged care nurses or Border Force officers if their employers haven’t given them the training they need to do their important work well. It’s the fault of their employers, and ultimately, of governments that are willing to contract out some of the most important, sensitive and intimate work in Australia to whatever private company offers the lowest price or the largest donations. It’s not the market’s fault that there are no minimum staffing numbers or minimum training standards in commonwealth-funded and privately run aged care homes. It’s the Morrison government’s. And it’s not the market’s fault if the private security guards protecting us from Covid-19 are poorly trained. As individuals we have a responsibility to wash our hands, respect social distancing rules and wear masks when appropriate. But if we really want to protect ourselves from this pandemic, and future threats, we need to ensure we hold government ministers responsible for the outcomes they deliver.
posted by katra at 6:25 PM on August 20, 2020 [6 favorites]


PM says Australia aiming for ‘no community transmission’ of coronavirus (News.com.au, Jul. 24, 2020)
After a National Cabinet meeting today Mr Morrison said there had been an “affirmation of the suppression strategy” among federal, state and territory leaders. But it was the next line that caught the ear of experts. “The goal of that is, obviously, and has always been no community transmission,” Mr Morrison said. [...]

However, Melbourne University epidemiologist Professor Tony Blakely said aiming for “no community transmission” was actually the goal of an elimination strategy and would be a “game-changer” for Victoria. “That is what is defined as elimination – no cases of community transmission where the source for the case is unknown, for 28 days,” Prof Blakely told news.com.au. “It is great to receive this clarity from the PM that indeed our national goal is elimination.”
Experts call for Australia to replace coronavirus suppression strategy with elimination plan (ABC News, Jul. 14, 2020)
Australia should change its COVID-19 strategy to a more ambitious "elimination" plan to stop the "endless game of groundhog day" of fighting ongoing outbreaks, some top public health experts say. The current national suppression strategy is aimed at "flattening the curve" to keep case numbers within the capacity of the health system, rather than eliminating the virus completely. An elimination strategy would likely involve tougher lockdowns, and has proved successful in New Zealand. Prominent public health experts who now believe Australia should adopt the strategy include Bill Bowtell and Gregory Dore, from UNSW's Kirby Institute, and Melbourne University epidemiologist Tony Blakely.

[...] The institute's Dr Dore, an infectious diseases doctor at Sydney's St Vincent's Hospital, has written an opinion piece for Nine Newspapers arguing for Australia to switch strategies. He said he once believed eliminating COVID-19 was not possible — but he had changed his mind after data from states outside of Victoria proved it was. "Having watched the COVID-19 elimination bus do its rounds with a few rowdy passengers, I have decided to flag it down and climb aboard," he wrote.
posted by katra at 6:45 PM on August 20, 2020


ONS infection survey of the UK is out

Estimated 2,400 a day new infections. 16,800 for the week. (down from 3,800 last week but within error bars so ONS position is infection rate is level)

11,760 symptomatic cases that could have been caught.

Positive tests: 6,616 or 56% of symptomatic cases (last week 5,212 & 28%)

Contacts 78.8% reached x 71.3% (last week 80%, 74%)

Total: 56% x 78.8% x 74.4% = 32.8% (last week 28% x 80% x 74% = 16.6%)

I'm not 100% clear if this is measuring what I think it's measuring, the increase in +ve tests has been driven by pillar 1 hospital testing.

Series to date:
22nd July 12.2%
29th July 15.5%
5th August 16.6%
13th August 32.8%
posted by atrazine at 6:03 AM on August 21, 2020 [1 favorite]


Meanwhile in Ireland, the Oireachtas (Houses of Parliament) Golf Society Dinner took place on Wednesday evening, whereby about 80 people, including a Minister,a couple of TDs (members of parliament) and senators, a Supreme Court Justice, and the Irish EU Commissioner. As of Tuesday, the limits on indoor events was 6 people from 3 households, but even previously events were limited to 50. They apparently trying to use a loophole by claiming that there was a partition separating the room, and it should be regarded as two events.

Understandably the general public is extremely angry, particularly as there are also questions regarding quarantining of some of the attendees who were abroad, breach of lockdown by some who live in Kildare, lack of social distancing, not to mention the fact that the location was actually under an Orange Weather warning. There are naturally concerns as to the impact that this will have on compliance going forward.

The minister in question, Dara Calleary, has already resigned and the Tánaiste (Deputy Prime Minister) Leo Varadkar has removed the whip from several senators. The Gardaí (police) are also investigating, and the organisers could be fined and or face a 6 month jail sentence.

Fianna Fáil often seem to have a penchant for messing up things on themselves (the minister is actually the 2nd Minister for Agriculture since Micheál Martin became Taoiseach (Prime Minister) at the end of June - the first was sacked), but this time they seem to be trying to bring Fine Gael down with them.
posted by scorbet at 7:06 AM on August 21, 2020 [4 favorites]


From the final link in scorbet's comment:
A person staying at the hotel with his family told the Irish Times he saw no evidence of social distancing when he witnessed the attendees arriving.

“No masks. No distancing,” said the the witness who asked that his name not be used.

He said he had to push his kids through two Oireachtas members whom he recognised to try to get to the lift.

“My 11 year old who is Covid anxious was hugely upset. The hotel has been brilliant all week on all Covid aspects. This was a really strange event with all that in mind.

“At the reception people were being introduced to each other and shaking hands. No distancing and no masks. We were flabbergasted.”
This is going to be shocking bad for the government. Near total loss of credibility just as they head towards schools opening in September and the budget in October. It's hard to believe elected officials could be so out of touch.

Irish twitter has been a mix of outrage and hilarity all day.
posted by roolya_boolya at 4:45 PM on August 21, 2020 [3 favorites]


Yesterday evening, a journalist put together a (long) twitter thread with a timeline of the previous 24ish hours. It features lots of “apologies” from people with excuses of the "I was told it was okay” variety. I’m not sure this is quite the defense they think it is.

Irish twitter has been a mix of outrage and hilarity all day.

Significantly more outrage and hilarity than usual, with even Bosco was commenting on it. (A mixture of outrage and hilarity is pretty much Irish twitter’s normal state.)
posted by scorbet at 10:50 PM on August 21, 2020 [1 favorite]


Italy's back to 850 new daily cases, which is almost where it was at in mid-May, when the national lockdown in place since the beginning of March was about to be lifted for shops, bars, restaurants and public offices. The difference between then (May 16th) and now in the other numbers help to contextualise this seeming similarity: daily deaths were 153 then, and are now 6; cases in ICU then were 775, and are 68 today; overall hospitalised cases were 10,400, and are now just 883; cases in isolation were 59,000, whereas currently they are 15,000. Also: daily tests then were about 30K, and are now 50K. So it's definitely a different picture (mainly showing the health system coping where in May it was dysfunctional). The cases now being caught have a much lower median age (30), which fits with an overall reduction in clinical severity of cases.

This is not to say the second wave that seems to be slowly swelling (it's the fifth consecutive week of growth in number of new cases) isn't extremely concerning, but it does seem that the response capacity has definitly evolved.
posted by progosk at 3:57 AM on August 22, 2020 [6 favorites]


This is not to say the second wave that seems to be slowly swelling (it's the fifth consecutive week of growth in number of new cases) isn't extremely concerning

Germany’s seeing something similar, though possibly faster, or at least earlier. There were over 2000 cases reported yesterday morning, which was last seen in April. My state is currently the worst affected, whereas before we were relatively less badly hit. This makes comparing numbers particularly worrying. The RKI uses the 7day/100k as its measure and Frankfurt’s at 30.5, according to my calculations at least, the highest it got here was about 39. There doesn’t seem to be a major localised outbreak driving the increase either, instead the RKI reports are talking about returning travelers, and parties being the main causes.

Meanwhile in Ireland, #golfgate is still ongoing, with the main issue now being with Phil Hogan, the EU Trade Commissioner. Who, it turns out, not only apparently broke the localized lockdown in Kildare, but the reason that the Taoiseach and Tánaiste became aware of this was because he was stopped by a Garda for using a mobile phone while driving.
posted by scorbet at 2:29 PM on August 23, 2020 [3 favorites]


COVID Is Making Younger, Healthy People Debilitatingly Sick For Months. Now They’re Fighting For Recognition.
Across the globe, scores of COVID “long-haulers” have been fighting for doctors to believe and help them. On Friday, they finally got a meeting with the World Health Organization.
posted by adamvasco at 3:17 PM on August 23, 2020 [5 favorites]


Regarding #golfgate, I usually take great pleasure is seeing politicians squirm under scrutiny, but I really wish those 80 fucking idiots had stayed at home. I don't like the term 'treason' but that is what those people committed.
posted by night_train at 1:22 AM on August 24, 2020


Does anyone have good links for SARS-CoV-2 population prevalence/incidence surveys for countries other than the UK? This great tracker from the FT has a 7-day average of reported cases but for the UK we know that this only represents about half of the cases as estimated from the weekly PCR sample survey carried out by the ONS.

If you look at the cases Germany had more at its peak than the UK and consistently about as many as France, Italy, and Spain which given the much lower deaths in Germany must mean that a much higher fraction of infections in Germany were being detected and recorded as cases. Especially now that surveillance testing is being stepped up in areas with known high prevalence, it can be hard to know whether there is a real increase or whether this is due to going looking for infections.

I know many places have done antibody prevalence but maybe I'm just not using the right search term to find the PCR data.
posted by atrazine at 5:21 AM on August 24, 2020


Does anyone have good links for SARS-CoV-2 population prevalence/incidence surveys for countries other than the UK?

I had a look through the German RKI website and from what I can see, they don't seem to be doing any. There are antibody surveys (among others of people who donated blood), but nothing seems to indicate (to me at least) a PCR based survey.

However, the ECDC has a summary from the whole of EU+UK. (But I'm not sure how accurate it is, as it seems to say that the UK results are not available.)
posted by scorbet at 8:29 AM on August 24, 2020


It's just a modeling approach, but covid19-projections.com has per-country estimates of current and newly infected, including unmeasured cases. For the UK, they estimate about 3,700 daily new cases, which seems fairly consistent with 1000 measured cases as in FT. On the one hand it's just a model; on the other hand, the parameters are tuned for good forward in time predictions, so they are hopefully fairly decent estimates of all cases. And it's not just multiplying measured by 4 or whatever -- eg, Brazil and US are closer to a 10x ratio of unmeasured to measured cases.
posted by chortly at 10:15 AM on August 24, 2020


First covid-19 reinfection documented in Hong Kong, researchers say (WaPo)
Kwok-Yung Hyuen and other study authors suggested in their paper that their “results suggest SARS-CoV-2 may continue to circulate among humans despite herd immunity," using a scientific name to refer to the novel coronavirus. They conclude that herd immunity is unlikely to eliminate covid-19 on its own and that a potential covid-19 vaccine may not provide lifelong immunity to the disease. They also recommend that even those who have recovered from the coronavirus continue to comply with social distancing protocols and other measures, such as wearing a mask.
Hong Kong reports first coronavirus reinfection (The Japan Times), Hong Kong scientists report 1st case of COVID-19 reinfection (UPI)
Earlier studies suggested immunity may not last longer than several months, which would mean any vaccine might have to be given repeatedly. "Since the immunity can be short-lasting after natural infection, vaccination should also be considered for those with one episode of infection," the Hong Kong researchers said. Maria van Kerkhove, the World Health Organization's lead COVID-19 researcher, said more studies are needed to better understand the strength and durability of the antibody response in recovered patients.
posted by katra at 12:09 PM on August 24, 2020


China says it began public use of covid-19 vaccine a month ago, bypassing clinical trials (WaPo / MSN reprint)
China is claiming the dubious honor of the first nation to roll out an experimental coronavirus vaccine for public use, saying it began inoculating high-risk groups in late July. [...] Officials around the world have been debating how far they should suspend ordinary drug-development protocols to get covid-19 vaccines and treatments to market. Many governments declared early on that they would not cut corners in developing a vaccine, but they are proving amenable in practice to corner-cutting as the pandemic’s human and economic tolls mount. [...] The standard approval process for a new vaccine takes years and requires the observation of large numbers of patients over time to ensure safety and efficacy. The United States and China have both pledged to bring vaccines to market by the end of this year or early 2021, an unprecedented speed that requires gargantuan factory investments before the vaccines have passed safety tests. Now Beijing and Moscow have pushed the timeline up further, with large numbers of citizens essentially being asked to serve as test subjects as an act of patriotism.

[...] One point that remains unexplained is why China chose to delay its announcement of the public rollout of a trial vaccine for a full month. It could reflect caution among authorities, as a quiet rollout would be easier to end if those inoculated reported severe side effects. On Saturday, Chinese health officials said few people who were given the experimental vaccine so far had reported adverse effects, and none reported fevers. They did not give a number of how many have received the trial vaccines.
posted by katra at 12:40 PM on August 24, 2020 [1 favorite]


The language about reinfection could be clarified to note that this is a different strain of coronavirus, and that the patient was asymptomatic, i.e. appeared to gain some partial protection from the previous infection, which stopped reinfection from progressing to the disease state. This is a small bit of good news, perhaps.

There's a useful summary from research immunobiologist Dr. Akiko Iwasaki over here.
posted by They sucked his brains out! at 3:35 PM on August 24, 2020 [2 favorites]


If I vaguely recall correctly, wasn't there a false alarm reinfection a couple months ago? Are we sure this isn't another one of those?
posted by lazaruslong at 6:04 PM on August 24, 2020


If I vaguely recall correctly, wasn't there a false alarm reinfection a couple months ago? Are we sure this isn't another one of those?

From UPI:
The researchers said they ruled out the possibility that the man may have been a "persistent carrier" from his earlier infection by sequencing the virus. They said the two strains were "clearly different."
WaPo offers a little more background:
The Hong Kong man whose case was studied, an unnamed 33-year-old IT worker with a reported history of good health, had first tested positive for the coronavirus in late March. His symptoms included a fever and a cough and he was sent to the hospital in keeping with city guidance. The man was released in mid-April after testing negative for the virus and having no further symptoms. But after visiting Spain via Britain in August, he tested positive again upon returning to Hong Kong, despite appearing asymptomatic.
posted by katra at 6:13 PM on August 24, 2020 [1 favorite]


I'd be shocked if, out of millions of cases, there aren't at least a few instances of reinfection. As I posted in the other thread, to me it seems likely that sans vaccination the disease would pass through the population until everyone had some degree of immunity and all reinfections were mild or even asymptomatic, as it appears was the case for the Hong Kong individual. He wouldn't have even known he got reinfected had he not gone through a screening due to his travel activities.

As I also posted in the other thread, after researchers began taking Coronaviruses more seriously after the first SARS outbreak, it was suggested that the 1890 Russian flu was actually a coronavirus that crossed over to humans and now circulates as a virus that causes the common cold; although, from what I've read, like SARS-COV-2 it still can be particularly deadly if an outbreak occurs in nursing homes.

Luckily, everything I've read so far seems to suggest that vaccination, even if it isn't 100 successful at preventing infection for everyone, will at least offer the protection of making otherwise severe infections milder or even asymptomatic that would otherwise have been severe without the vaccine. Hopefully that will be enough to dramatically reduce the fatality rate. The fact that his individual's reinfection was asymptomatic seems to support that.
posted by eagles123 at 8:47 PM on August 24, 2020 [1 favorite]


"Death Rates Plummet" - Dr John Campbell reviews various sources that are showing flat or falling case fatality rates even as infection rates rise again. For example France and Spain have seen cases rise recently to be nearly at levels seen in early lockdown - but with a death rate that looks little changed from the lull of early summer. He looks why this might be.
posted by rongorongo at 11:20 PM on August 24, 2020


Dr John Campbell reviews various sources...

Thanks. It is a good, sane summary of things. We are seeing a similar trend here in the Netherlands. Cases are back where they were at the start of all this and yet hospitals are relatively empty and deaths are minimal.

I believe it is because the kids are all out partying and giving it to each other. The 20-something age group in particular doesn't seem to care. As for older and vulnerable people, they were caught off-guard in the first wave but now are being extremely cautious, staying at home, wearing masks when out, jumping to the other sidewalk when they see people coming...

What happens next, I don't know. Will all this infection wave among the more outgoing population eventually create a more safer environment for everybody? Or is is the fate of the old and vulnerable (and cautious!) to stay locked up indefinitely?

Among businesses, cafes and terraces that cater to the younger crowd are booming, for now. But museums, theatres, cinemas, concert halls seem to be undergoing a slow death.
posted by vacapinta at 2:24 AM on August 25, 2020 [4 favorites]


In Pakistan we had a bad spike and a feeling of imminent doom like a tsunami wave rearing overhead, and then... nothing. Lots of possible factors, and it may well be termporary, but for now at least, the country is weathering the pandemic: Pakistan wins rare, fragile success against novel coronavirus.
posted by tavegyl at 2:34 AM on August 25, 2020 [2 favorites]


Death rates have plummeted dramatically from the peak but watching the trends for the four different regions of the United States the Case Fatality Rate looks like it is starting to very slowly edge back up.

The big drop from the peaks can be due to lots of things - age of cases, improved treatment, masks reducing infection severity, testing including more asymptomatic cases, hospitals under manageable loads and so on. What I am more interested in right now is why the the CFR looks like it is very slowly going back up in all four regions because that suggests something is starting to go wrong.
posted by srboisvert at 2:43 AM on August 25, 2020 [2 favorites]


I wish I could find where I read it, but I think the average age of new cases is starting to creep back up after dropping considerably in the spring and summer.

Edit: I should mention I am talking about the in the US.
posted by eagles123 at 6:04 AM on August 25, 2020


More about the implications of the report of the reinfection:

Some people can get the pandemic virus twice, a study suggests. That is no reason to panic.

Exactly what that finding means is unclear, however. To and his colleagues make some sweeping statements in their paper, parts of which Science has seen. “It is unlikely that herd immunity can eliminate SARS-CoV-2,” the authors write, referring to the idea that the epidemic will peter out once enough people have been infected and become immune. “Second, vaccines may not be able to provide life-long protection against COVID-19.”

But it’s too early to draw those conclusions, says Columbia University virologist Angela Rasmussen. “I disagree that this has huge implications across the board for vaccines and immunity,” she wrote in an email, because the patient described in the study may be a rare example of people not mounting a good immune response to the first infection.

Mark Slifka, a viral immunologist at Oregon Health & Science University, says his takeaway from the paper is the opposite of what the authors write: “Even though [the patient] got infected with a very different strain that’s distinct from the first time around, they were protected from disease,” he says. “That is good news.”

Fueling the debate over the importance of the case is that the paper on it isn’t public yet, which means scientists can’t scrutinize its data in full. HKU put out a press release about the study today and said the paper had been accepted for publication by the journal Clinical Infectious Diseases. To confirmed that a few pages of the manuscript circulating online were from the paper but said he could not make the full text available. “This is why I loathe data disclosure by press release,” Rasmussen wrote. “It seems designed to stoke sensationalism by leaving all these provocative questions unanswered, some of which could probably be answered by just reading the paper and examining the figures.”


Also, an interesting article about how past events of coronaviruses crossing animals to humans likely caused pandemics similar to the current one:

An Uncommon Cold

IN 1889, a disease outbreak in central Asia went global, igniting a pandemic that burned into the following year. It caused fever and fatigue, and killed an estimated 1 million people. The disease is generally blamed on influenza, and was dubbed “Russian flu“. But with no tissue samples to check for the flu virus, there is no conclusive proof.

Another possibility is that this “flu” was actually a coronavirus pandemic. The finger has been pointed at a virus first isolated in the 1960s, though today it causes nothing more serious than a common cold. In fact, there are four coronaviruses responsible for an estimated 20 to 30 per cent of colds. Only recently have virologists begun to dig into these seemingly humdrum pathogens and what they have found suggests the viruses have a far more deadly past. Researchers now believe that all four of these viruses began to infect humans in the past few centuries and, when they did, they probably sparked pandemics.

posted by eagles123 at 7:02 AM on August 25, 2020 [2 favorites]


For an idea of “what normal looked like” in early 2020 in Wuhan, I’ve added Ai Weiwei’s surprise documentary Coronation to Fanfare.
posted by progosk at 5:37 AM on August 27, 2020 [3 favorites]


Six feet may not be enough to protect against coronavirus, experts warn (WaPo / Philly Inquirer reprint)
Public health experts are reevaluating guidelines for safe social distancing amid growing evidence that the novel coronavirus can travel farther than six feet under certain conditions. A team of infectious-disease experts argues in a new analysis, published this week in the BMJ, that six-feet protocols are too rigid and are based on outmoded science and observations of different viruses. Other researchers say six feet is a start — but only a start, warning that more space is almost always better, especially in poorly ventilated areas indoors. Factors such air circulation, ventilation, exposure time, crowd density, whether people are wearing face masks and whether they are silent, speaking, shouting or singing should all be part of assessing whether six feet is sufficient, experts say.

[...] The World Health Organization has recommended at least one meter, or three feet. Some countries in Europe set social distances at 1.5 meters, almost five feet; others at two meters, or six-and-a-half feet. Great Britain earlier in the pandemic implemented a two-meter mandate for diners and drinkers. But — under pressure from pubs that feared this rule would limit patrons to unprofitably low numbers — in July Prime Minister Boris Johnson compressed that to a “one-meter-plus” separation.
Non-woven masks better to stop Covid-19, says Japanese supercomputer (Guardian, Aug. 26, 2020)
Makoto Tsubokura, team leader at Riken’s centre for computational science, encouraged people to cover up despite the heatwave gripping large parts of Japan. “What is most dangerous is not wearing a mask,” Tsubokura said, according to the Nikkei. “It’s important to wear a mask, even a less effective cloth one.” Fugaku, which was named the world’s fastest supercomputer last month, has also run simulations on how respiratory droplets spread in partitioned office spaces and on packed trains when the carriage windows are open.
posted by katra at 2:35 PM on August 27, 2020 [1 favorite]


COVID-19 was initially identified as a respiratory disease, but scientists now appreciate that it also affects several other organs in the body, including the heart.
posted by adamvasco at 5:59 PM on August 28, 2020


Guardian: "Police in Berlin have started to dissolve a protest in the German capital against coronavirus restrictions, according to police social media and German news outlets. The official account of Berlin police tweeted that they had “no other option” after demonstrators did not comply with requirements which German news outlets report were to social distance or wear masks. [...] City authorities had banned the planned protest, citing the flouting of social distancing by participants in a similar march that drew at least 17,000 people a few weeks ago, but a court overturned the ban."

Guardian: As in Berlin, more than 1,000 demonstrators have congregated in London’s Trafalgar Square to protest against lockdown restrictions.
Jason Rodrigues (@RodriguesJasonL) At least a thousand anti-lockdown protestors have filled London’s Trafalgar Square pic.twitter.com/b1PuSPX87A August 29, 2020
Guardian: "German police Saturday halted a march by some 18,000 coronavirus sceptics in Berlin because many were not respecting social distancing measures. [...] “The minimum distancing is not being respected by most (of the demonstrators) despite repeated requests,” the police said. “There is no other option than to break up the gathering.” After the announcement, the demonstrators shouted “Resistance” and “We are the people,” a slogan often used by the far-right, and sang the German national anthem. Police had vowed to turn out in force and strictly monitor compliance with mask-wearing and social distancing at the protest."

Guardian: "Until now Germany has managed the coronavirus crisis better than many of its European counterparts, with rigorous testing helping to hold down infections and deaths. But new daily infections have accelerated in recent weeks, as in much of the world. On Friday, the chancellor, Angela Merkel, urged citizens to keep up their guard against the virus. “This is a serious matter, as serious as it’s ever been, and you need to carry on taking it seriously,” she said. Protesters had gathered before the Brandenburg Gate in central Berlin ahead of the march with signs reading: “Stop the corona lies” and “Merkel must go”. About 200 anti-mask activists held a rally in Paris to protest against sanitary measures with slogans such as: “No to the health dictatorship” and “Let our children breathe”."
posted by katra at 8:46 AM on August 29, 2020


Coronavirus cases in some European countries are rising again, but with fewer deaths. For now. (WaPo / SFGate reprint, Aug. 28, 2020)
Many countries, including Italy, endured grinding lockdowns this spring. Now citizens are exhausted, and economies are still flagging. “I don’t think the country can survive another lockdown. And to be frank, there is no reason to,” said Ranieri Guerra, a World Health Organization assistant director general who is advising the Italian Health Ministry. “It’s very unlikely we’ll see anything like it was in the past. The likely scenario is that we’ll have some clusters here and there, even heavier than now, but very localized.” [...] But Guerra said that containment depends on contact tracing and testing. “If you don’t have a system to track, trace and quarantine localized clusters, it’s really difficult. This virus is very contagious,” he said. “Moving from 100 cases to 200 may take a few days, but moving from 2,000 to 4,000 may take hours.”

[...] In France, meanwhile, the government on Friday recorded a spike of 7,379 new cases in the past 24 hours — the second-largest ­single-day caseload since the pandemic began and the latest data point in an upward swing that began last month. [...] “We’re doing everything to avoid another lockdown and in particular a nationwide lockdown,” President Emmanuel Macron told journalists Friday. But he added: “Nothing can be ruled out.” [...] Leaders implored citizens to remain vigilant, especially as students return to class on Tuesday, masks in hand. “Washing your hands, keeping your distance and wearing masks will be our daily life for several months,” said French Health Minister Olivier Véran. “I’m not saying it’s easy — I’m saying we have no choice.”
WaPo live blog: First presumed U.S. case of coronavirus reinfection reported in Nevada (Aug. 28, 2020)
A 25-year-old Reno man is the first reported coronavirus patient to be reinfected in the United States, scientists say. Unlike the world’s first presumed case of reinfection in Hong Kong, this patient developed more severe symptoms when he got sick in late May after a mild case in April, according to the newly released study, which has not yet been peer-reviewed. Scientists with the medical school at the University of Nevada at Reno and the Nevada State Public Health Laboratory used advanced testing that sequenced the genetic strains, finding they were distinct between the infections.
posted by katra at 9:13 AM on August 29, 2020 [1 favorite]


John Campbell (again) cites infection rates from places like Mumbai and New York where there has been substantial community spread. Under standard herd immunity models we would expect the rate of acceleration of cases to remain pretty much constant until we get to a point where about 75% of the population has been infected. But in these places we have seen a market decrease in new cases from a point where a mere 20-25% of the population has been exposed. Why is this? Campbell speculates that there could be quite a high level of underlying immunity to Covid-19 in society caused by earlier exposure of people to other coronavirus antigens, for example.

This reminds me of the story of the small Italian town of Ferrera Erbognon -which had zero infections among its inhabitants while the pandemic was all around it.
posted by rongorongo at 5:14 AM on August 30, 2020


Can someone explain to me what it means when they say (for example) that infections rise to 1000 on U of Alabama campus? Does that mean that 1000 people are sick and got tested to confirm that their symptoms were Covid19? Or does that mean that some people are actually sick, and by some loose sort of contract tracing the people exposed to them also got tested and found themselves positive but with no or only minor symptoms? Or whether the explosion in numbers isn't that big a deal in terms of sickness, only as a huge deal because of possible vectors to harm or kill others?

I'm just having a hard time understanding how so many people are not taking this seriously if that many people are getting really sick (especially since my friends who have had it really suffered, even without needing hospitalization).
posted by Mchelly at 8:26 AM on August 30, 2020


It sounds like tests that came up positive for the virus, regardless of whatever symptoms they may or may not have had at the time.

As for not taking it seriously: enough people are asymptomatic and you have no idea if you're going to be anything from asymptomatic to on a ventilator when you catch it. Also, people are assuming that they're young and healthy and will recover fine. Also people want to be around other people and have fun and not spend more time in quarantine jail.

Sigh.
posted by jenfullmoon at 10:17 AM on August 30, 2020 [2 favorites]


John Campbell (again) cites infection rates from places like Mumbai and New York where there has been substantial community spread yt . Under standard herd immunity models we would expect the rate of acceleration of cases to remain pretty much constant until we get to a point where about 75% of the population has been infected. But in these places we have seen a market decrease in new cases from a point where a mere 20-25% of the population has been exposed. Why is this? Campbell speculates that there could be quite a high level of underlying immunity to Covid-19 in society caused by earlier exposure of people to other coronavirus antigens, for example.

Standard SEIR models also assume both perfect mixing which we know is not correct (more sophisticated models like the Imperial College one used as one of the UK SAGE models do have more realistic mixing models) but they also assume constant contacts and I don't know of any models being used that adjust for the fact that contacts are not constant.

People are not zombies. As people start getting sick and the population realises what's going on, they cut way back on contacts even without official intervention. Public panic is a heavily lagging measure, by the time people are sufficiently scared a very bad few weeks are already stacked up with nothing to be done to prevent them. Meanwhile, the public in many places (including the UK) is currently more frightened than the *current* level of infection warrants.

This means that without control measures, the real pattern is not an exponential rise up to herd immunity but a series of waves, each wave driving enough fear to cut off its own fuel supply until the reduction in deaths reduces public wariness enough to kick off the next wave. Each wave is progressively slower and lower as the percentage of the population immune rises until the final wave reaches herd immunity.

Of course if you're managing based on less lagging indicators like surveillance testing then you can achieve much more fine grained control and apply/disapply control measures as required to prevent the virus growing out of control. Maintaining public compliance is hard once the refrigerated morgues go away.
posted by atrazine at 12:45 PM on August 31, 2020 [7 favorites]


Standard SEIR models also assume both perfect mixing which we know is not correct (more sophisticated models like the Imperial College one used as one of the UK SAGE models do have more realistic mixing models) but they also assume constant contacts and I don't know of any models being used that adjust for the fact that contacts are not constant.

This recent paper in PNAS, "A network-based explanation of why most COVID-19 infection curves are linear", had some interesting tweaks to the standard SIR models of Covid, including how social networks and public interventions change the curves and equilibria in outbreaks like this one. It's still pretty idealized, but it does get at some aspects of how "herd immunity" can vary, and it (possibly) explains an aspect of the daily case curves I'd been puzzling over, how they tend to be so linear for such long stretches.
posted by chortly at 7:08 PM on August 31, 2020 [2 favorites]


the story of the small Italian town of Ferrera Erbognon

What happened there was that the local mayor is a doctor, and his idea of making their seeming exception into a test-study (involving a local medical foundation) got some media play, even internationally. It was, however rapidly given the kibosh by the regional health authority (who were coordinating all aspects of emergency Covid initiatives); also, the town lost their Covid-free status just a week later, with two, then three, then 17 cases...

So ultimately: one of many "Covid stories" that are really just symptomatic of the state of news media (it took quite an effort to chase up the "what happened next" items).
posted by progosk at 4:51 AM on September 1, 2020 [6 favorites]


thank you for that digging, progosk. It's telling that all of those links (but one) are not in English.

More and more (and I'm not really surprised), I'm coming to view optimism as a particularly dangerous mindset with regard to covid-19. Certainly that aspect of an optimistic mindset that gets us sincerely invested in the situation being better than it seems. It's not. The enemy is virulent and invisible and resilient ... and patient, silently lurking, ready for us to let our guard down ...
posted by philip-random at 8:22 AM on September 1, 2020 [1 favorite]




That's a hopeful bit of Science right there.
posted by Windopaene at 4:32 PM on September 1, 2020 [4 favorites]


Unbeknownst to Jacobson, Frank van de Veerdonk, an infectious disease specialist at the Radboud University Medical Center in the Netherlands, was heading down the same molecular pathway in mid-March. He had noticed two features in COVID-19 patients in his clinic—fluid in the lungs and inflammation. Because other labs had pegged angiotensin-converting enzyme-2 (ACE2), a key enzyme in the RAS, as being the SARS-CoV-2 receptor, and because he knew that ACE2 regulates the kinin system, van de Veerdonk began connecting the dots. In April, he and his group hypothesized that a dysregulated bradykinin system was leading to leaky blood vessels in the lungs and perhaps causing excess fluid to build up.

Targeting the bradykinin pathway in COVID: Currently, there are two approved drugs that target the kinin system: icatibant (a B2R blocker) and the monoclonal antibody lanadelumab, which inhibits plasma kallikrein (there are no drugs yet approved that inhibit tissue kallikrein). van de Veerdonk contends that targeting the kinin system early in the disease, soon after a patient is hospitalized, and is hypoxic, but hasn’t yet developed ARDS, might be helpful. That is what his group found in a small exploratory study published this month. COVID-19 patients taking icatibant showed marked improvement in oxygenation as evidenced by a substantial decrease in need for supplemental oxygen, compared to control patients. - Is a Bradykinin Storm Brewing in COVID-19? Excess of the inflammatory molecule bradykinin may explain the fluid build-up in the lungs of patients with coronavirus infections. Clinical trials of inhibitors are putting this hypothesis to the test, The Scientist, Aug. 26, 2020
posted by Iris Gambol at 7:12 PM on September 1, 2020 [9 favorites]


Minister Ferdinand Grapperhaus of Justice and Security regrets that social distancing wasn't maintained at his wedding in Bloemendaal last Saturday. State Secretary Ankie Broerkers-Knol, who performed the ceremony, also said that she regrets how things went.

Photos and video from the wedding, published by SBS Shownieuws, showed wedding guests gathering close together on the stairs of the Bloemendaal town hall.

New photos have surfaced of the wedding of Minister Ferdinand Grapperhaus, showing that he violates more corona rules than just the one-and-a-half meter measure,

The photos show how the Minister of Justice and Security shakes hands and hugs his mother-in-law.

42 percent of the Dutch believe that Minister Ferd Grapperhaus (Justice and Security) has lost his credibility when he warns people to adhere to the corona measures. A quarter of the participants in Maurice de Hond’s weekly opinion poll think that the minister should resign.
posted by Too-Ticky at 11:14 PM on September 1, 2020 [3 favorites]


New Zealand's outbreak is coming under control, following a few weeks with Auckland mostly locked down and other centres following social distancing. New daily cases are down to 2 or 3. Sadly we've had further deaths, including the former Prime Minister of the Cook Islands, Dr Joe Williams, who lived in Auckland.
posted by Pink Frost at 7:22 PM on September 4, 2020 [1 favorite]


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