Coronavirus (COVID-19) Pandemic

[Jezza]

Deaths per million (Countries with the top 32 most confirmed cases + Australia)

Belgium = 793
Spain = 598
Italy = 537
UK = 531
France = 432
Sweden = 384
Netherlands = 337
Ireland = 321
USA = 291
Switzerland = 219
Ecuador = 167
Canada = 163
Portugal = 125
Germany = 99
Peru = 96
Brazil = 95
Iran = 86
Mexico = 51
Turkey = 50
Chile = 31
Poland = 26
UAE = 24
Russia = 21
Belarus = 20
Saudi Arabia = 10
Qatar = 6
Pakistan = 5
Indonesia = 5
Australia = 4
Singapore = 4
India = 3
China = 3
Bangladesh = 2

Deaths per million in the last 7 days (Countries with the top 32 most confirmed cases + Australia)

UK = 36
Sweden = 35
Ecuador = 34
Brazil = 29
USA = 28
Peru = 27
Belgium = 25
Italy = 18
Canada = 18
Mexico = 16
Ireland = 16
Spain = 14
France = 12
Chile = 12
Netherlands = 11
Portugal = 9
Russia = 5
Germany = 4
Iran = 4
Belarus = 4
Switzerland = 3
UAE = 3
Poland = 3
Turkey = 2
Saudi Arabia = 2
Pakistan = 2
India = 1
Qatar = 1
Indonesia = 1
China = 0
Singapore = 0
Bangladesh = 0
Australia = 0

[Pies4shaw]

101: An 80 year old woman died from COVID-19 last night in Sydney’s Concord Hospital. That’s the 50th death in NSW.

[Pies4shaw]

Looking at the opinion poll results K refers to on the previous page suggests that many people in the US don’t actually appreciate how poor their national response to COVID-19 has been.

There have been 50,818 new deaths in the US in the last month. And, of course, the total number of deaths in that country have more than doubled in that month. The number of deaths per 1,000,000 there is now nearing 300 (and will, I think, reach that mark by Saturday, their time). Already, the US death rate is more than 70 times as high as Australia’s.

Against that background, statistics indicating that even significant minorities of the population there think that the pandemic has been handled by the Trump administration at any standard better than “shambolic incompetency” suggest to me that the US is reaching a political breaking point.

[Jezza]

Latest numbers

Confirmed (Deaths) - Recoveries

USA = 1,623,273 (96,432) - 382,944
Russia = 326,448 (3,249) - 99,825
Brazil = 312,074 (20,112) - 125,960
UK = 254,195 (36,393) - Unknown
Spain = 233,037 (27,888) - 150,376
Italy = 228,006 (32,486) - 134,560
France = 181,826 (28,215) - 63,858
Germany = 179,020 (8,318) - 156,661
Turkey = 153,548 (4,249) - 114,990
Iran = 131,652 (7,300) - 102,276
...........................................................
Australia = 7,095 (101) - 6,479

5,184,216 confirmed cases
335,508 deaths
2,061,674 recoveries

Australia:
- Confirmed cases = 7,095
---- New South Wales = 3,084
---- Victoria = 1,593
---- Queensland = 1,058
---- Western Australia = 557
---- South Australia = 439
---- Tasmania = 228
---- ACT = 107
---- NT = 29
- Deaths = 101
- Recoveries = 6,479
- Case fatality rate = 1.42%

Active Cases = 2,787,034
- USA = 1,143,897
- Russia = 223,374
- UK = 217,802 (maximum)
- Brazil = 166,002
- France = 89,753
- India = 67,017
- Peru = 62,034
- Italy = 60,960
- Spain = 54,773
- Netherlands = 39,100 (maximum)
............................................
- Australia = 515

**(Maximum) = Recovery numbers are not counted, so only subtracts the number of deaths from the total number of confirmed cases.

[Jezza]

AUSTRALIA

Date = Confirmed Cases (New Cases) = Percentage of new cases

15/05/2020 = 7,020 (31) = 0.4%
16/05/2020 = 7,036 (16) = 0.2%
17/05/2020 = 7,045 (9) = 0.1%
18/05/2020 = 7,060 (15) = 0.2%
19/05/2020 = 7,068 (8] = 0.1%
20/05/2020 = 7,079 (11) = 0.2%
21/05/2020 = 7,081 (2) = 0.03%
22/05/2020 = 7,095 (14) = 0.2%

6,479 recovered, 101 deaths.

Cases doubling every 55 days.

608 cases of community transmission nationwide.

515 active cases.

South Australia, ACT and NT have no active cases.

VICTORIA

Date = Confirmed Cases (New Cases) = Percentage of new cases

15/05/2020 = 1,540 (20) = 1.3%
16/05/2020 = 1,551 (11) = 0.7%
17/05/2020 = 1,558 (7) = 0.5%
18/05/2020 = 1,567 (9) = 0.6%
19/05/2020 = 1,573 (6) = 0.4%
20/05/2020 = 1,580 (7) = 0.4%
21/05/2020 = 1,581 (1) = 0.1%
22/05/2020 = 1,593 (12) = 0.8%

1,479 recovered, 18 deaths.

Cases doubling every 53 days in Victoria.

171 cases of community transmission in Victoria.

96 active cases.

No deaths in Victoria since April 29.

[K]

Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext

"The registry comprised data from 671 hospitals in six continents. We included patients hospitalised between Dec 20, 2019, and April 14, 2020, with a positive laboratory finding for SARS-CoV-2. ...

96 032 patients (mean age 53·8 years, 46·3% women) with COVID-19 were hospitalised during the study period and met the inclusion criteria. ... After controlling for multiple confounding factors (age, sex, race or ethnicity, body-mass index, underlying cardiovascular disease and its risk factors, diabetes, underlying lung disease, smoking, immunosuppressed condition, and baseline disease severity), when compared with mortality in the control group (9·3%), hydroxychloroquine (18·0%; hazard ratio 1·335, 95% CI 1·223–1·457), hydroxychloroquine with a macrolide (23·8%; 1·447, 1·368–1·531), chloroquine (16·4%; 1·365, 1·218–1·531), and chloroquine with a macrolide (22·2%; 1·368, 1·273–1·469) were each independently associated with an increased risk of in-hospital mortality. Compared with the control group (0·3%), hydroxychloroquine (6·1%; 2·369, 1·935–2·900), hydroxychloroquine with a macrolide (8·1%; 5·106, 4·106–5·983), chloroquine (4·3%; 3·561, 2·760–4·596), and chloroquine with a macrolide (6·5%; 4·011, 3·344–4·812) were independently associated with an increased risk of de-novo ventricular arrhythmia during hospitalisation."

[K]

^ WaPo's take:

"The study, published Friday in the medical journal the Lancet, is the largest analysis to date of the risks and benefits of treating covid-19 patients with antimalarial drugs. Like earlier smaller studies, it delivered disappointing news to a world eager for promising treatments for the novel coronavirus ... While doctors have refined how they treat the disease, they have yet to discover a magic bullet against a virus for which humans have no known immunity.

The Lancet analysis is based on a retrospective analysis of medical records, not a controlled study in which patients are divided randomly into treatment groups — the method considered the gold standard of medicine. But the sheer size of the study was convincing to some scientists.

“It’s one thing not to have benefit, but this shows distinct harm,” said Eric Topol, a cardiologist and director of the Scripps Research Translational Institute. “If there was ever hope for this drug, this is the death of it.”

David Maron, director of preventive cardiology at the Stanford University School of Medicine, said that “these findings provide absolutely no reason for optimism that these drugs might be useful in the prevention or treatment of covid-19.”
...

Those who were on mechanical ventilators or who received remdesivir, an antiviral drug made by Gilead Sciences that has shown promise in decreasing recovery times, were excluded.

Mehra said in an interview that the widespread use of antimalarials for covid-19 patients was based on the idea of “a desperate disease demands desperate measures,” but that we have learned a hard lesson from the experience about the importance of first doing no harm.

In retrospect, Mehra said, using the drugs without systematic testing was “unwise.”
...

Cardiologist Steven Nissen of the Cleveland Clinic said the new data, combined with data from smaller previous studies, suggests that the drug “is maybe harmful and that no one should be taking it outside of a clinical trial.”
...

Peter Lurie, a former top FDA official who now heads the Center for Science in the Public Interest, called the report “another nail in the coffin for hydroxychloroquine — this time from the largest study ever.”
...

There have been at least 13 studies in recent months on hydroxychloroquine or chloroquine as a treatment for covid-19 patients. They have included randomized controlled studies and observational analyses encompassing patients on the continuum from mild illness to those near death. Evidence of any benefit, such as viral clearance or improved symptoms, has been almost nonexistent. But many found an increased risk in adverse cardiac reactions — especially when combined with the antibiotic azithromycin.
...

Topol, of the Scripps Research Translational Institute, suggested that the researchers should reconsider the ethics of those trials, given the increasing evidence of potential harm. “It’s very hard to ignore that signal, and it’s worrisome to continue giving it,” he said."

https://www.washingtonpost.com/health/2020/05/22/hydroxychloroquine-coronavirus-study/

[K]

[think positive]

[Pies4shaw]

I think the two things are just symptoms of a larger political dysfunction. I don’t know that the US can be moved by the sort of advertising you’re referring to - the implied message of the recent “open up the economy” protests was “my inconvenience is more important than the risk of your death” and I have no idea what could turn around stupidity at that level.

[K]

[K]

"When the Spanish flu hit the rest of the world in 1918, Australia had the advantage of its island isolation ... Anticipating that it would inevitably arrive on Australian soil, the federal and state governments got together and forged a 13-point agreement in November 1918. Among other things, they promised that any state which detected a case of Spanish flu would immediately notify the others.

The coronavirus of its time first penetrated the quarantine wall in Victoria. The first case turned up in January 1919. But did Victoria observe its obligation to report? ... Melbourne knew yet remained silent for two weeks.

The first known disease bearer was a returned soldier who took the train from Melbourne to Sydney. NSW identified the problem, declared a health emergency and closed its border with Victoria. Victoria protested, and the federal government supported it. Melbourne wanted to keep the border open. The NSW acting premier George Fuller slammed Victoria for claiming the right "to send any number of her widely infected population into this state, in which, so far, we have been successful in keeping the disease within small bounds".

NSW defied an order from the acting prime minister to reopen its border. If the federal government would not interdict and inspect all shipping from Victoria to NSW, then the Sydney government would take control of the quarantine function itself.

... "We will protect our people," headlined The Sydney Morning Herald in February 1919. Victoria was furious at what it considered unfriendly economic vandalism.

The Age newspaper fumed at NSW's "parochial stupidity bordering on insanity". It headed its editorial aimed at the Sydney government: "The crime of egotism." Economic collapse would follow. "Suddenly, on the eve of winter," explained The Age, "comes the startling news that Australia is near the brink of an industrial and domestic calamity", as coal and gas supplies ran low, industries shut down and unemployment soared.

The Melbourne newspaper drove hard at Sydney's culpability in April 1919: "It will be interesting for the workman who is thrown out of work and cannot meet his Easter bills to learn that he and his family are paying for the sport of politicians who contend about what they are pleased to call 'state rights.' The magnitude and cost of the NSW administration make it an imposture."

It quickly became every state for itself. Victoria imposed no restrictions whatsoever. Other states took a harder line. ...

In most states face masks were compulsory, schools were shut. The WA government seized interstate trains. The federal government tried to exert its authority to keep economic activity alive, but it was exposed as feeble when Queensland refused to allow entry to Commonwealth troops to enforce quarantine.

Tasmania ignored the federal government order to shorten its quarantine period on incoming ships. Tasmanians took satisfaction from enjoying ultimately the lowest death rate anywhere on earth, according to a 1976 paper by Humphrey McQueen.
...

The outcome of this failure of cooperation was unhappy. ... the Spanish flu killed somewhere between 12,000 and 13,000, in waves of increasing severity. It was estimated that about one-third of the entire population was infected at some point."

https://www.theage.com.au/national/a-chance-for-the-states-to-do-something-really-unprecedented-20200522-p54vne.html

[Pies4shaw]

102: A man in his 60s has died in hospital in Victoria.

[K]

More mindboggling stupidity in the US:

C.D.C. Test Counting Error Leaves Epidemiologists ‘Really Baffled’

https://www.nytimes.com/2020/05/22/us/politics/coronavirus-tests-cdc.html

"WASHINGTON — As it tracks the coronavirus’s spread, the Centers for Disease Control and Prevention is combining tests that detect active infection with those that detect recovery from Covid-19 — a system that muddies the picture of the pandemic but raises the percentage of Americans tested...

Now that serology tests, which look for antibodies in the blood of people who have recovered, are more widespread, C.D.C. officials said Friday they would work to separate them from the results of diagnostic tests, which detect active infection. One of the agency’s data tracker websites has been lumping them together.

Stunned epidemiologists say data from antibody tests and active virus tests should never be mixed because diagnostic testing seeks to quantify the amount of active disease in the population. Serological testing can also be unreliable. And patients who have had both diagnostic and serology tests would be counted twice in the totals.

“It just doesn’t make any sense; all of us are really baffled,” said Natalie Dean, a biostatistician at the University of Florida.

Epidemiologists, state health officials and a spokeswoman for the C.D.C. said there was no ill intent; they attributed the flawed reporting system to confusion and fatigue in overworked state and local health departments that typically track infections — not tests — during outbreaks. The C.D.C. relies on states to report their data.
...

Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health, said mixing the two numbers would distort the picture of the coronavirus outbreak in various parts of the country. In most places outside of New York City, the center of the outbreak in the United States, the proportion of people who have been exposed to the virus, and who would produce a positive result on an antibody test, is likely to be lower than 10 percent.

“What that means is that those tests are more likely to come back negative, which means that you could end up with a misleading picture overall,” he said. “You’ll think there is less disease there than there actually is. That is not something that is not going to be helpful, to say the least.”"

[K]

^ This was first reported by The Atlantic:

‘How Could the CDC Make That Mistake?’

The government’s disease-fighting agency is conflating viral and antibody tests, compromising a few crucial metrics that governors depend on to reopen their economies. Pennsylvania, Georgia, Texas, and other states are doing the same.

https://www.theatlantic.com/health/archive/2020/05/cdc-and-states-are-misreporting-covid-19-test-data-pennsylvania-georgia-texas/611935/

"We’ve learned that the CDC is making, at best, a debilitating mistake: combining test results that diagnose current coronavirus infections with test results that measure whether someone has ever had the virus. The upshot is that the government’s disease-fighting agency is overstating the country’s ability to test people who are sick with COVID-19. The agency confirmed to The Atlantic on Wednesday that it is mixing the results of viral and antibody tests, even though the two tests reveal different information and are used for different reasons.

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

“You’ve got to be kidding me,” Ashish Jha, the K. T. Li Professor of Global Health at Harvard and the director of the Harvard Global Health Institute, told us when we described what the CDC was doing. “How could the CDC make that mistake? This is a mess.”
...

A negative test result means something different for each test. If somebody tests negative on a viral test, a doctor can be relatively confident that they are not sick right now; if somebody tests negative on an antibody test, they have probably never been infected with or exposed to the coronavirus. (Or they may have been given a false result—antibody tests are notoriously less accurate on an individual level than viral tests.)"
...

This is what concerns Jha. Because antibody tests are meant to be used on the general population, not just symptomatic people, they will, in most cases, have a lower percent-positive rate than viral tests. So blending viral and antibody tests “will drive down your positive rate in a very dramatic way,” he said.