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Friday, April 17, 2020

COVID-19: Are We Prematurely Relaxing Quarantining for the Sake of the Economy?


The coronavirus COVID-19 is affecting 210 countries and territories around the world and 2 international conveyances. The day is reset after midnight GMT+0. The list of countries and territories and their continental regional classification is based on the United Nations Geoscheme. Sources are provided under "Latest Updates". Learn more about Worldometer's COVID-19 data


New deaths:

DAY     China   Italy   USA   Spain   Germany   S. Korea  WORLD

Apr    1         7  727     589      463            83               3        3239
          2         6  760     522      709          158               4        4183
          3         4  766     716      587          123               5        3822
          4         4  681     769      546            55               3        4755
          5         3  525     909      471          106               6        3595
          6         2  636     874      528            78               3        4414
          7         ?  604   1371      556            95               6        6291
          8         2  542   1400      628          176               8        5431
          9         2  610   1286      446            82               4        3779
        10         1  570   1739      523          121               4        6506
        11         3  619   1476      399             ?                3        5358
        12         ?  431   1090      366            74               3        4533
        13         2  566   1147      280            21               3        4489
        14         ?  602   1754      300          100               5        5726
        15         1  578   1558      324            97               3        6351
        16         ?  525   1796      318          139               4        6239
        17   1290  575   1338      298          151               1        6857

Summary:
  • China did not suddenly jump to 1290 new deaths.  This was just adjusting their actual Wuhan deaths.  Similarly, the world new deaths total actually dropped for the second straight day.
  • The USA had a decline.
Is President Donald Trump's pressure on Republican governors to re-open their economy foolhardy?  Here is the story of Hokkaido, Japan from the BBC, published yesterday:
  • It was once seen as something of a success story - a region that worked to contain, trace and isolate the virus - leading to a huge drop in numbers. But Hokkaido is in the spotlight again as it struggles to deal with a second wave of infections.
  • In late February, Hokkaido became the first place in Japan to declare a state of emergency due to Covid-19.
  • Schools were closed, large-scale gatherings cancelled and people "encouraged" to stay at home. The local government pursued the virus with determination - aggressively tracing and isolating anyone who'd had contact with victims.
  • The policy worked and by mid-March the number of new cases had fallen back to one or two a day. On 19 March the state of emergency was lifted, and at the beginning of April, schools re-opened.
  • But now, just 26 days after the state of emergency was lifted, a new one has had to be imposed.
  • Hokkaido had acted independently of the central government, which placed Tokyo, Osaka and five other prefectures under a state of emergency last week. A nationwide state of emergency was declared on Thursday.
  • "It is relatively easy to tackle clusters, to contact trace and isolate," says Professor Kenji Shibuya of King's College London.
  • In this respect, Hokkaido has some similarity to what happened in the South Korean city of Daegu. There, a large outbreak in a religious cult was aggressively traced. Those infected were isolated and the outbreak was suppressed.
  • In the last week, Hokkaido has recorded 135 new confirmed cases of Covid-19. Unlike the first outbreak in February, there is no evidence the virus has been re-imported from outside Japan.
  • After the Daegu outbreak, the South Korean government began a massive testing program to try and track the epidemic. Japan has done the opposite.
  • Even now, more than three months after Japan recorded its first case, it is still only testing a tiny percentage of the population.
  • Firstly, Japan's health ministry feared that hospitals would be overwhelmed by people who test positive - but only have minor symptoms. And on a wider scale, the testing is the responsibility of local health centres and not on a national government level.
  • "The major lesson to take from Hokkaido is that even if you are successful in the containment the first time around, it's difficult to isolate and maintain the containment for a long period. Unless you expand the testing capacity, it's difficult to identify community transmission and hospital transmission."
  • The third lesson is that this "new reality" is going to go on a lot longer than most people expect.
  • "The key lesson" he says "is even if you are successful in containment locally but there is transmission going on in other parts of the country, as long as people are moving around, it's difficult to maintain a virus-free status".
Is anyone of leadership in the USA aware of the above?  Europe actually one-upped Trump about loosening restrictions, also without having adequate testing.  The Donald's ego might have actually been crushed by anyone beating him to prematurely restarting the economy.

I've long been mantra-ing the need for a lot more testing before returning to normality.  What President Donald Trump is doing is to insure that the cost of testing kits will zoom up as has been the price of facial masks.  Everyone will be competing for the same thing.  This is insane!!!   But I guess this is the American way so more companies can be induced to produce more test kits.

The following statistics are from yesterday:

Country    Total Cases     Cases/1M    Total Tests   Tests/1M

World         2,182,197             280
USA             677,570           2.047         3,398,140    10,266
Spain            145,521           3,956            930,230    19,896
Germany      137,698           1,643         1,728,357     20,629
China             82,367                 57
Russia            27,938               191         1,613,413     11,056
India              13,430                 10            302,956           220
South Korea  10,635                297           546,463      10,659
Luxembourg   3,444                  69              31,660      50,577
Finland            3,369                  75              49,700       8,970
Taiwan                395                 17              50,703       2,129

Dividing total cases by total tests for the USA gives me 19.9%.  I thought only about 1% of the population was supposed to be infected with COVID-19 (this percentage started at 3.4% and is speculated to drop to as low as 0.5% when all is said and done).  And South Korea is already at 1.9% today.

Why are we, then, so off the charts in this term called positivity?  Easy, there are not enough test kits to go around and only those who are looking really sick get the tests.  This availability will remain short for months to come.

Under these conditions, there are a lot of people milling about with family and friends who are asymptomatic and infecting them.  How large is this percentage?  Here is an article that shows a table indicating mostly anecdotal examples:  
  • 18% (Diamond Princess--this is probably the most credible percentage)
  • 50-75% (Italian village), 4%-80% (China), 94% of children (China)
  • 31% (Japanese nationals evacuated from Wuhan)
  • 57% (that nursing facility in the State of Washington)
  • 80% (WHO indicated that this percent have no or only mild symptoms--this is a scary figure, because they are all contagious
  • Iceland (50%)
  • CDC (25%)
  • blood donors in Italy (67%).
  • as an aside, 15% of pregnant women in New York City tested positive to COVID-19
If you look closely at these above bullets:
  • Data are all over the map.
  • However, the asymptomatic (those who are carriers, but show no symptoms) will be higher than 20%, and maybe more.
  • The most dangerous condition are those COVID-19 infectees who only have mild symptoms, and, therefore, won't be tested...but are seriously contagious.
  • This group of individuals, and they could represent up to 50% of people who have this novel coronavirus, will begin to join the public in the next phase of economic development recovery.
Based on the statistics of yesterday, I wondered how the lack of testing has misinformed authorities about what to do.  So I found a recent article from The Atlantic:
  • According to the Tracking Project’s figures, nearly one in five people who get tested for the coronavirus in the United States is found to have it. In other words, the country has what is called a “test-positivity rate” of nearly 20 percent.
  • Such a high test-positivity rate almost certainly means that the U.S. is not testing everyone who has been infected with the pathogen, because it implies that doctors are testing only people with a very high probability of having the infection.
  • South Korea—which discovered its first coronavirus case on the same day as the U.S.—has tested more than half a million people, or about 1 percent of its population, and discovered about 10,500 cases. The U.S. has now tested 3.2 million people, which is also about 1 percent of its population, but it has found more than 630,000 cases. So while the U.S. has a 20 percent positivity rate, South Korea’s is only about 2 percent—a full order of magnitude smaller.
  • Hawaii, meanwhile, has tested twice as many people per capita as Illinois, but its positivity rate is only one-tenth as high as the larger state’s. As the outbreak comes under control, more states should have positivity rates closer to Hawaii’s, Andrews, the Stanford professor, said. At the beginning of a pandemic, both the actual number of infections and the number of tests per day shoot up, and the positivity rate is controlled by whichever happens to grow faster, he said. In this case, the faster-growing number appears to have been infections. “As things stabilize, if the testing rate declines and the positivity rate declines, you have some good signal that the epidemic is declining,” he said.
  • .....if the United States were testing more people, we would probably still be seeing an increase in the number of COVID-19 cases. And combined with the high test-positivity rate, it suggests that the reservoir of unknown, uncounted cases of COVID-19 across the country is still very large.
A lot of words above.  What are they saying?
  • Mayors and governors need to be very careful about releasing their voters and immigrants into the general public until a lot more testing is made available.
  • When will sufficient test kits be available?  Yesterday I indicated that if the 50,000 15-minute kits daily production rate by Abbot Labs is maintained, it will take 20 years to test all 327 million Americans.
  • Then what about those antibody tests to safely clear people to return to work, schools and theaters/stadia?  There is no national plan, and most of the 70 methods available are currently inaccurate.
  • Clearly, there needs to be the full power of the Defense Production Act applied by the President to develop both pre- and post-testing. 
  • This is being totally ignored by President Donald Trump.

Ah, enough of that stuff.  This is a Friday and I don't need to go to work tomorrow.  Wait a minute, I'm quarantined, and retired.  Anyway, remember Sukiyaki by Kyu Sakamoto?  It was released nearly 60 years ago in Japan, and hit #1 on Billboard two years later in 1963, the first non-English song to do so, and more than 40 years later by Gangnam Style in 2012.  The title has nothing to do with that Japanese dish of vegetables and beef.  The equivalent would be to re-title Moon River in Japan as Beef Stew.  Few remember that Kyu reached #57 in 1963 with Shina No Yoru.

He died at the age of 43 when Japan Airlines 123 crashed killing all 524 passengers and crew, the deadliest single-craft air accident ever.  I very much remember this tragedy because a close friend of mine subsequently told me that he was just late for boarding that flight and was turned away even though the plane was still at the gate.  He sat down, he said, to write a scathing letter (this was 1985, no computers) about his rejection and the staff's incompetence, and showed me his crumpled note.

Never knew what Kyu was singing about in Sukiyaki, but it has been resurrected for COVID-19 recovery inspiration by the Sing for Hope Project as an uplifting theme, with the Japanese words translated into English.  This organization hails from Houston.

Another song of hope, this one from Iz:

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