COVID-19

[gerontocrat]

... it's not the amount of sunlight or supplements that matter; it's the microbiome ...

Study Reveals Connection Between Gut Bacteria and Vitamin D Levels
https://medicalxpress.com/news/2020-11-reveals-gut-bacteria-vitamin-d.html

Robert L. Thomas et al. Vitamin D metabolites and the gut microbiome in older men, Nature Communications (2020).
https://www.nature.com/articles/s41467-020-19793-8

This article is pretty good to explain the basics of how vitamin d becomes active in the body

https://www.dummies.com/health/nutrition/vitamins/what-is-vitamin-d-and-how-does-it-work/

[Rodius]

Government model suggests U.S. COVID-19 cases could be approaching 100 Million

https://www.mprnews.org/story/2020/11/26/npr-government-model-suggests-u-s-covid-19-cases-could-be-approaching-100-million

The mass murder to reach a temporary relief from herd immunity would be a breath of fresh air until the immunity wears off or a mutated form begins the process again.

I don't understand why people think herd immunity means this ends.... it doesn't stop the virus, it just changes and it begins again.

I also am not understanding why people think Covid will cease to be a problem within five years, even with a vaccine. The mutation rate via other species is, to me anyway, frighteningly fast.
We found the mink variety already, unless that is just really terrible luck, this virus is not going to leave us to the old normal ever again.

We will end up with Covid only hospitals eventually and the training of nurses and doctors will still take years to catch up with the patient numbers.

Yes, like Spanish Flu kept mutating.... or, wait, did it?

Are you a hysterical secular fundamentalist? Your posts would argue, "YES". Secular fundamentalism is the general populace's newfound love for science in place of religion,

<Deleted a part for the usual reason. kassy>

The Flu responsible for the 1918 flu pandemic did mutate, actually, and is still with us today.
So, yes, it did mutate.

In fact, the flu pandemics of 1957, 1968, 2009 all came from the 1918 flu.

https://www.washingtonpost.com/history/2020/09/01/1918-flu-pandemic-end

I am not sure why you think I am a secular fundamentalist... I try hard to base what I know on what the evidence says.
For example, rather than spout on about the Spanish Flu not mutating without even looking, I find evidence to show that it did mutate and is still around today causing its own brand of disruption. That is the evidence, so if you think you follow the evidence, feel free to admit your fault and learn something then move on from there.

Also, feel free to look at the situation in New York City and explain how your non-evidence based belief that New York has herd immunity when the main reason NYC isn't having a second large wave (so far) has to do with the protocols that have been put in place to keep the numbers down.

https://www.npr.org/sections/coronavirus-live-updates/2020/11/29/939902582/new-york-city-schools-will-reopen-with-new-covid-19-testing-protocol

And when you understand that virus' mutate to stay alive, it isn't a big leap to understand that Covid will do the same thing and already has via mink.... so much so that any vaccine we get for the current version may not work for the mink covid version and even if it does, the mutation rate is rapid enough to be a cause of concern.

https://www.nature.com/articles/d41586-020-03218-z

So, I stand by my thinking until I see a reason to change it.
Feel free to post evidence that the Spanish Flu didn't mutate..... I will wait for your counter information.

[vox_mundi]

NY Unveils 5-Strategy Winter COVID Plan; Includes Emergency Hospital Protocols
https://www.nbcnewyork.com/news/coronavirus/ny-unveils-5-strategy-winter-covid-plan-includes-emergency-hospital-protocols/2751915/?amp

During his Monday coronavirus press briefing, the governor introduced the 5-strategy plan that will focus on hospital capacity, testing, schools, a safety campaign and a thorough vaccination plan.

"We are now worried about overwhelming the hospital system. And if those numbers continue to increase, which we expect they will, you will see serious stress [within the hospital]," Cuomo said Monday.

... "Literally every region is dealing with a hospital issue now," Cuomo said. Hospitalizations surged past 3,500 over the weekend, an alarming volume not seen in New York since May.

The governor announced the state will initiate emergency hospital measures immediately. The measures are:

Every hospital has to identify retired nurses and doctors now. "We’re already experiencing staff shortages.  Staff just get exhausted after a while. They’ve had a horrendous year.

Stop elective surgery in Erie County starting Friday. "Erie County has the most critical situation in the state. So Erie County must stop elective surgery; Catholic hospitals in Erie County voluntarily stopped elective surgery just to be responsible. I thank them. It’s now mandatory….Let's start to free up those hospital beds. If things continue to get worst. We’ll stop elective surgery in other parts of the state also," the governor said;

Individual hospital network load balancing is mandated as of Monday. "There are hospital systems in the state that have a number of hospitals in their system – and they can be private or they can be public….it is mandatory as of today that they balance the load within their system... So you distribute the patients among your hospitals in your system. The nightmare we went through last time was a hospital would be overwhelmed, but that system had other hospitals that had capacity," Cuomo said. "If a hospital gets overwhelmed there will be a state investigation and if the result of that investigation is that they did not distribute the patients, that will be malpractice on their part. This was a serious issue last time."

Prepare emergency field hospital plans region-wide;

Add 50 percent capacity to each hospital. "We did this last time. It was highly effective," the governor said;

Prepare to implement statewide “surge and flex," which would move patients among [different hospital] systems;

Prepare to staff emergency field hospitals;

Confirm PPE stockpiles.

https://www.cnbc.com/2020/11/30/new-york-implements-emergency-hospital-measures-as-covid-cases-surge-gov-cuomo-says.html

----------------------------------------------------

Dr. Scott Atlas Resigns from Trump Administration
https://amp.cnn.com/cnn/2020/11/30/politics/scott-atlas-resigns-trump-administration-coronavirus-task-force/index.html

Dr. Scott Atlas, a highly controversial member of the White House's coronavirus task force, has resigned from his post in the Trump administration.

A source familiar with what happened told CNN that Atlas turned in his resignation letter to President Donald Trump on Monday. As a special government employee, Atlas had a 130-day window in which he could serve and that window was technically coming to a close this week.

A source close to the task force told CNN on Monday that Atlas' departure comes as welcome news, as his discredited theories will no longer have a seat at the table. A separate official said the task force remains intact following Atlas' departure.

... In one extraordinary episode in October, Twitter removed a tweet from Atlas that sought to undermine the importance of face masks because it was in violation of the platform's Covid-19 Misleading Information Policy, according to a spokesman for the company.

He also promoted the idea that the US should aim to achieve “herd immunity”, a so-called strategy that would probably result in millions of deaths, and was repeatedly rebuked by public health and infectious disease experts, in addition to Stanford University and the Stanford faculty senate.


Lord of the Rings: Wormtongue is shown the door

[Richard Rathbone]

MRI scanning patients inhaling xenon shows up long term COVID injury to lungs not caught by other scanning techniques.

https://www.bbc.co.uk/news/health-55017301

Just proof of technique so far, but opens up a way to characterise long COVID and to research treatments for it.

[Tom_Mazanec]

Just found out Ben Bova, one of my favorite authors, has died of this virus.

[Shared Humanity]

MRI scanning patients inhaling xenon shows up long term COVID injury to lungs not caught by other scanning techniques.

https://www.bbc.co.uk/news/health-55017301

Just proof of technique so far, but opens up a way to characterise long COVID and to research treatments for it.

Great. Significant lung damage in patients who did not have severe cases of COVID. Haven't posted much lately but I have maintained and will continue to maintain that the most serious impact of COVID is not the IFR but the long term health effects on those who have recovered. Research is confirming damage to many organs.

[vox_mundi]

Coronavirus Was In U.S. Weeks Earlier Than Previously Known, CDC Study
https://www.npr.org/sections/coronavirus-live-updates/2020/12/01/940395651/coronavirus-was-in-u-s-weeks-earlier-than-previously-known-study-says

The coronavirus was present in the U.S. weeks earlier than scientists and public health officials previously thought, and before cases in China were publicly identified, according to a new government study published Monday.

New findings published in the journal Clinical Infectious Diseases suggest that the coronavirus, known officially as SARS-CoV-2, had infected people in the U.S. even earlier.

"SARS-CoV-2 infections may have been present in the U.S. in December 2019, earlier than previously recognized," the authors said.

This discovery adds to evidence that the virus was quietly spreading around the world before health officials and the public were aware, disrupting previous thinking of how the illness first emerged and how it has since evolved. It also shows the virus's presence in U.S. communities likely didn't start with the first case identified case in January.

Researchers came to this conclusion after the U.S. Centers for Disease Control and Prevention analyzed blood donations collected by the American Red Cross from residents in nine states. They found evidence of coronavirus antibodies in 106 out of 7,389 blood donations. The CDC analyzed the blood collected between Dec. 13 and Jan. 17.

Researchers found coronavirus antibodies in 39 samples from California, Oregon, and Washington as early as Dec. 13 to Dec. 16. They also discovered antibodies in 67 samples from Connecticut, Iowa, Massachusetts, Michigan, Rhode Island, and Wisconsin in early January — before widespread outbreaks in those states.

Sridhar V Basavaraju, MD, et.al, Serologic testing of U.S. blood donations to identify SARS-CoV-2-reactive antibodies: December 2019-January 2020, Clinical Infectious Diseases, (2020)
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1785/6012472

https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciaa1785/34598046/ciaa1785.pdf

[pietkuip]

Great. Significant lung damage in patients who did not have severe cases of COVID. Haven't posted much lately but I have maintained and will continue to maintain that the most serious impact of COVID is not the IFR but the long term health effects on those who have recovered. Research is confirming damage to many organs.

Here a study that shows that it is really very common:
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1792/6012625

Long COVID in the Faroe Islands - a longitudinal study among non-hospitalized patients

Results
Of the 180 participants (96.3% of the 187 eligible COVID-19 patients), 53.1% reported persistence of at least one symptom after a mean of 125 days after symptoms onset, 33.3% reported one or two symptoms and 19.4% three or more symptoms. At the last follow-up, 46.7% were asymptomatic compared with 4.4 % during the acute phase. The most prevalent persistent symptoms were fatigue, loss of smell and taste, and arthralgias.

Conclusions
Our results show that it might take months for symptoms to resolve, even among non-hospitalized persons with mild illness course in the acute phase. Continued monitoring for long COVID is needed.

[El Cid]

... it's not the amount of sunlight or supplements that matter; it's the microbiome ...

Study Reveals Connection Between Gut Bacteria and Vitamin D Levels
But the team unexpectedly found no correlations between where men lived and their levels of active vitamin D hormone. ... "So in this case, maybe it's not how much vitamin D you supplement with, but how you encourage your body to use it."

Robert L. Thomas et al. Vitamin D metabolites and the gut microbiome in older men, Nature Communications (2020).
https://www.nature.com/articles/s41467-020-19793-8

There 's more and more evidence that our microbiome is extremely important for our health. And your microbiome depends very much on what you eat.

[harpy]

Great. Significant lung damage in patients who did not have severe cases of COVID. Haven't posted much lately but I have maintained and will continue to maintain that the most serious impact of COVID is not the IFR but the long term health effects on those who have recovered. Research is confirming damage to many organs.

Here a study that shows that it is really very common:
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1792/6012625

Long COVID in the Faroe Islands - a longitudinal study among non-hospitalized patients

Results
Of the 180 participants (96.3% of the 187 eligible COVID-19 patients), 53.1% reported persistence of at least one symptom after a mean of 125 days after symptoms onset, 33.3% reported one or two symptoms and 19.4% three or more symptoms. At the last follow-up, 46.7% were asymptomatic compared with 4.4 % during the acute phase. The most prevalent persistent symptoms were fatigue, loss of smell and taste, and arthralgias.

Conclusions
Our results show that it might take months for symptoms to resolve, even among non-hospitalized persons with mild illness course in the acute phase. Continued monitoring for long COVID is needed.

Absolutely.

Lungs are just one of the organs damaged by the coronavirus.

We have previously posted studies demonstrating brain damage, heart damage, kidney damage etc.

[Tom_Mazanec]

“first case identified case”
Love those little glitches in proofreading.

[Richard Rathbone]

Coronavirus Was In U.S. Weeks Earlier Than Previously Known, CDC Study
https://www.npr.org/sections/coronavirus-live-updates/2020/12/01/940395651/coronavirus-was-in-u-s-weeks-earlier-than-previously-known-study-says

The coronavirus was present in the U.S. weeks earlier than scientists and public health officials previously thought, and before cases in China were publicly identified, according to a new government study published Monday.

New findings published in the journal Clinical Infectious Diseases suggest that the coronavirus, known officially as SARS-CoV-2, had infected people in the U.S. even earlier.

"SARS-CoV-2 infections may have been present in the U.S. in December 2019, earlier than previously recognized," the authors said.

This discovery adds to evidence that the virus was quietly spreading around the world before health officials and the public were aware, disrupting previous thinking of how the illness first emerged and how it has since evolved. It also shows the virus's presence in U.S. communities likely didn't start with the first case identified case in January.

Researchers came to this conclusion after the U.S. Centers for Disease Control and Prevention analyzed blood donations collected by the American Red Cross from residents in nine states. They found evidence of coronavirus antibodies in 106 out of 7,389 blood donations. The CDC analyzed the blood collected between Dec. 13 and Jan. 17.

Researchers found coronavirus antibodies in 39 samples from California, Oregon, and Washington as early as Dec. 13 to Dec. 16. They also discovered antibodies in 67 samples from Connecticut, Iowa, Massachusetts, Michigan, Rhode Island, and Wisconsin in early January — before widespread outbreaks in those states.

Sridhar V Basavaraju, MD, et.al, Serologic testing of U.S. blood donations to identify SARS-CoV-2-reactive antibodies: December 2019-January 2020, Clinical Infectious Diseases, (2020)
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1785/6012472

https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciaa1785/34598046/ciaa1785.pdf

If you read the paper, there's only 1 sample (taken on Jan 10th) that probably was COVID rather than cross immunity from other coronaviruses. Its a decent piece of work thats doesn't say anything new about when COVID appeared in the US and its been sensationalised for clickbait.

There's some pretty careless work getting published on blood donor antibodies at the moment. If COVID really was as widespread as early as these studies are claiming, where are the bodies? There'd have been around 60,000 deaths in the US before anyone realised what was happening if you take this report at face value. A few unusual deaths will go unexplained, but not 60k.

The virus can be analysed at miniscule false positive rates. COVID is lethal, tissue samples get kept when people die in unusual ways. Analysing them for the virus is the way to spot the earliest inroads, not antibody surveillance.

[pietkuip]

If you read the paper, there's only 1 sample (taken on Jan 10th) that probably was COVID rather than cross immunity from other coronaviruses. Its a decent piece of work thats doesn't say anything new about when COVID appeared in the US and its been sensationalised for clickbait.

There's some pretty careless work getting published on blood donor antibodies at the moment. If COVID really was as widespread as early as these studies are claiming, where are the bodies? There'd have been around 60,000 deaths in the US before anyone realised what was happening if you take this report at face value. A few unusual deaths will go unexplained, but not 60k.

The virus can be analysed at miniscule false positive rates. COVID is lethal, tissue samples get kept when people die in unusual ways. Analysing them for the virus is the way to spot the earliest inroads, not antibody surveillance.

There are many more suspected cases where no samples were kept. Many cases were not sick enough to go to a hospital. And some old patients died an unremarkable death.

There is a published case from Sweden from December. Not from Stockholm but from the somewhat remote region of Dalarna. https://lakartidningen.se/aktuellt/nyheter/2020/06/viruset-kan-ha-funnits-i-dalarna-redan-i-december/

Similar reports indicate that the virus was in Italy, Spain and France in 2019. It was in Italy as early as September.

[gerontocrat]

https://www.worldometers.info/coronavirus/#countries

It will be some time before vaccination is so widespread that new cases will sharply reduce.

World Data

New cases seem to be stabilising at just under 600k per day, with daily deaths also stabiliing at just over 10,000 per day. But a sustained reduction not yet apparent.

US Data
New cases seem to be possibly slowly reducing, currently at just ovder 160k per day, with daily deaths also abit lower at just over 1,500 per day. But a sustained reduction not yet apparent.
Of course, Fauci is worried that socialising during Thanksgiving might screw things up, ditto Xmas & New Year.

[Richard Rathbone]

If you read the paper, there's only 1 sample (taken on Jan 10th) that probably was COVID rather than cross immunity from other coronaviruses. Its a decent piece of work thats doesn't say anything new about when COVID appeared in the US and its been sensationalised for clickbait.

There's some pretty careless work getting published on blood donor antibodies at the moment. If COVID really was as widespread as early as these studies are claiming, where are the bodies? There'd have been around 60,000 deaths in the US before anyone realised what was happening if you take this report at face value. A few unusual deaths will go unexplained, but not 60k.

The virus can be analysed at miniscule false positive rates. COVID is lethal, tissue samples get kept when people die in unusual ways. Analysing them for the virus is the way to spot the earliest inroads, not antibody surveillance.

There are many more suspected cases where no samples were kept. Many cases were not sick enough to go to a hospital. And some old patients died an unremarkable death.

There is a published case from Sweden from December. Not from Stockholm but from the somewhat remote region of Dalarna. https://lakartidningen.se/aktuellt/nyheter/2020/06/viruset-kan-ha-funnits-i-dalarna-redan-i-december/

Similar reports indicate that the virus was in Italy, Spain and France in 2019. It was in Italy as early as September.

The Italy paper is another load of false positives. They claimed 20% of Italians had had it by Sept 2019. Unlike the CDC they didn't even bother to do any detailed work just took a crap test at face value.

You can miss a death or two, but not 100,000.

[gerontocrat]

https://www.worldometers.info/coronavirus/#countries

It will be some time before vaccination is so widespread that new cases will sharply reduce.

UK data

New cases are reducing, currently 15k per day, with daily deaths perhaps stabilising at around 460 per day, But a sustained reduction in deaths is not yet apparent.

But perhaps there will be a lot of people assuming that as vaccimation commences, all worries are over. (Yes, there are people dumb enogh to believe vaccination is a cure, not just a preventative).

ITALY Data
New cases seem are reducing, currently at just under 26k per day. But daily deaths are still at a high level of over 700 per day - a sustained reduction in deaths not yet apparent.

[crandles]

US Data
New cases seem to be possibly slowly reducing, currently at just ovder 160k per day, with daily deaths also abit lower at just over 1,500 per day. But a sustained reduction not yet apparent.
Of course, Fauci is worried that socialising during Thanksgiving might screw things up, ditto Xmas & New Year.

Thanksgiving holiday plus weekend could still be messing with reporting of cases and deaths - a 4th day with over 2k deaths and this may not be complete yet. "Only" 143k cases so far....

[pietkuip]

The Italy paper is another load of false positives. They claimed 20% of Italians had had it by Sept 2019. Unlike the CDC they didn't even bother to do any detailed work just took a crap test at face value.

You can miss a death or two, but not 100,000.

"20 % had it by September" is not what the paper said.
For the people who are interested, here is the paper:
https://journals.sagepub.com/doi/full/10.1177/0300891620974755

"The first positive sample (IgM-positive) was recorded on September 3 in the Veneto region, followed by a case in Emilia Romagna (September 4), a case in Liguria (September 5), two cases in Lombardy (Milano Province; September 9), and one in Lazio (Roma; September 11)."

The Apolone paper may have deficiencies, there are some doubts here:
https://pubpeer.com/publications/6C851502E101527028A6D5CD371F8D

But if it would really be due to false positives, it is surprising that those would occur primarily in Lombardy.

Anyway, the paper has references to other finds in 2019.

[vox_mundi]

COVID-19 Can Damage Lungs So Badly,  'Only Hope' Is Transplant
https://medicalxpress.com/news/2020-12-covid-lungs-badly-transplant.html

Case studies and autopsy results are confirming that, in some cases, COVID-19 can cause such severe lung damage that patients require a lung transplant to survive.

In a new study, researchers in Chicago analyzed discarded tissue from COVID-19 patients who had lung transplants and from patients who died of the disease. They found that COVID-19 can destroy the "fundamental framework" of the lungs, meaning the organs simply cannot recover.

And that means a patient's treatment choices become very limited.

... "The progenitor cells in the lungs necessary for healing can repopulate wounds of the lung by moving along the basic underlying framework of the lung matrix," Bharat explained. "But when the framework is destroyed, the progenitor cells have no place to go and lungs develop large holes that serve to harbor infections, an observation we also made during the tough transplant surgeries in these patients," Bharat said.

His team also discovered unique cells—called KRT17 epithelial cells—in the lung tissue of COVID-19 patients with irreversible damage. These cells have also been found in patients with end-stage pulmonary fibrosis, a deadly progressive lung disease.

The findings, the first of their kind on the issue, were published Nov. 30 in Science Translational Medicine. To date, eight COVID-19 patients have received double-lung transplants at Northwestern Medicine, the most performed at any health system in the world.

... The team also found that in COVID-19 patients whose lungs are so damaged that they won't survive without a lung transplant, it's safe to place them on ECMO (extracorporeal membrane oxygenation)—a life support machine that does the work of the heart and lungs. ECMO can be used for an extended period of time and still leave the door open for a successful lung transplant, the team said.

The most recent transplant at Northwestern took place on Thanksgiving Day and involved a patient who spent 130 days on ECMO. That's the longest known amount of time a patient has spent on ECMO in the world before receiving a transplant.

... Lung transplant comes with its own dangers, Horovitz added.

"Complications of transplants include infection (possibly even with COVID-19 again), bacterial infection and possible rejection of the transplanted lungs," he said.

Ankit Bharat et al. Lung transplantation for patients with severe COVID-19, Science Translational Medicine (2020).
https://stm.sciencemag.org/content/early/2020/11/25/scitranslmed.abe4282

[longwalks1]

Yes, the US study on semi-random blood donors was somewhat of a dog.   I was working hard to filter out viewing it as pre-print versus the lovely layout of the Italian study, https://journals.sagepub.com/doi/full/10.1177/0300891620974755    Being an order of magnitude less in samples for the Italian study was not a flaw, they had a well selected previous study and the ability to fine tune of locations that were known to have been early to appear.   The graphics are quite nice. 

The nuts and bolts of how to select for and identify the right antigens is way beyond me.  Identification of the amounts of false positives is as far as I am concerned is one crucial item for world wide study.   Also finding out percentages of aysmptomatiic indidviduals are out there. 

I should not extrapolate myself, but transmission via person A to person B to myself appears to be 3 asymptomatic cases in a row.    I was doing 30 miles a day on bike  2 days in a row prior to being tested positive.   (Provided that I am not a false positive for PCR).   

I do believe the Italian study however  strongly suggests that Covid-19 had gotten a foothold  into the boot that is Italy before October.   The propaganda laden paen to the Red Cross that is the u.s.  study not so stellar.  It looks like it was written via a committee of plodders.   I wrote this some more being written.  More studies should be out soon. 

[El Cid]

I agree with Richard. If COVID was around so much earlier, where are the bodies? Where is the excess mortality? It's nowhere. Use Occam's Razor!
I believe that there might have been some SPORADIC cases in Dec (maybe, maybe Nov) 2019, but definitely not more than very few and not much earlier.

[vox_mundi]

Young Adults Experience Lingering COVID Symptoms, Too
https://udayton.edu/news/articles/2020/12/messinger_covid.php

A new preliminary study contradicts the perception that lingering COVID-19 symptoms mostly affect middle-aged adults, with evidence that a majority of young adults also experience chest pain, breathing difficulty, headaches, diarrhea, loss of smell or taste and other complications for weeks after diagnosis, according to new research at University of Dayton.

The study, which included more than 40 university students who tested positive or were diagnosed with mild or moderate COVID-19, found a majority (51%) continued to experience symptoms and complications more than 28 days later and 30% experienced these symptoms for 50 days or longer.

"The common belief in the U.S. is that COVID-19 is benign or short-lived in young adults," Walsh-Messinger said. "Our study, which we believe is the first to report on post-COVID syndrome in college students, almost exclusively between 18 and 21 years of age, suggests otherwise. More research needs to be done to confirm these findings, but until then, we urge the medical and scientific community to consider young adults vulnerable to post-COVID syndrome and to closely monitor those who contracted the disease for lingering viral effects."

Walsh-Messinger said the study also "is consistent with the sex differences in COVID mortality and morbidity noted in other studies. Males are more likely to succumb to the virus, but women appear to be more vulnerable to post-COVID syndrome."

The Pulmonary Wellness Foundation https://pulmonarywellness.org offers free resources and support for people experiencing lingering COVID in addition to remote and in-person consultation and rehabilitation.

Julie Walsh-Messinger, et.al, The Kids Are Not Alright: A Preliminary Report of Post-COVID Syndrome in University Students, medrxiv, (2020)
https://www.medrxiv.org/content/10.1101/2020.11.24.20238261v1

[dnem]

As for the US Red Cross paper, I found the highly equivocal language in the conclusion to be interesting (my bolding):

Conclusions
These findings suggest that SARS-CoV-2 may have been introduced into the United States prior to January 19, 2020.

As for lasting impacts, I had a relatively minor case with symptoms starting on November 4.  I really didn't have much lung involvement during the acute phase. I had a minor, productive cough (somewhat atypical) and a little bit of generalized chest pain.  I've been slowly returning to exercise and doing pretty well. I'm a strong tennis player and played yesterday for the first time.  I was quite breathless and my lungs felt sort of raw and raspy like you might feel after heavy exercise outside in very cold, dry weather.  I'm confident this will resolve over time but I'm a month out from a minor case and I'm certainly still feeling some impacts.

[Tor Bejnar]

Get well soon, Dnem.

Your story and others leads me to be almost a hermit [I food shop] (and my wife to be one).  Fortunately, I can work from home.

[TeaPotty]

Why Pfizer's or Moderna's CoViD-19 vaccine cannot be 95% effective
https://www.bmj.com/content/371/bmj.m4471/rr-3?fbclid=IwAR2Kz2J8AnMvX4OjrTdJViFKvD6SconUxs0DApyQZLPJ9LMYBXz3lESl0Mc

"Pfizer and Moderna has claimed ~95% efficacy in their interim analysis. There are many reasons why such efficacy claims are premature and are likely to be proven incorrect in the long term."

"the trial subjects are living a new normal (social distancing, wearing masks, hand hygiene etc), which means that their chances of contracting the virus are already low (currently 4 in 100 in the USA). This would mean that we do not know if the subjects in the vaccine group were protected due to the vaccine or it is just because they have not had a contact yet. The definitive approach could involve deliberately challenging the trial subjects with the virus, like in preclinical trials, however, it is unlikely due to ethical and safety implications. In the absence of any definitive challenge test, it becomes imperative to not rush to conclude efficacy just within weeks of vaccination."

[Archimid]

Given the cost in life and money of a disease like covid 19, I believe it to be completely ethical to carry out a controlled exposure trial for these vaccines. I find it downright anti-ethical that it has not to been done (publicly) yet.

What is the ethical argument for the hold-up?

[kassy]

FWIW i think the challenge trials with small groups are always done before the big trials.

[El Cid]

Given the cost in life and money of a disease like covid 19, I believe it to be completely ethical to carry out a controlled exposure trial for these vaccines. I find it downright anti-ethical that it has not to been done (publicly) yet.

What is the ethical argument for the hold-up?

OMG, I once again totally agree with Archimid.

This is terrible

[vox_mundi]

FWIW i think the challenge trials with small groups are always done before the big trials.

Challenge trails are rarely to almost never run with a disease like this. The ethical and regulatory hurdles are significant. I'm speaking as someone who has worked in the pharmaceutical industry on clinical trails. Animal models - yes; humans - not so much.

Unless you have no other choice ...

--------------------------------------------

... if you're in a rush to catch it, there's still time to sign up ...

Dutch Researchers Preparing for 'Human Challenge' COVID-19 Vaccine Trial
https://www.reuters.com/article/health-coronavirus-challenge-virus-idUSKBN2852VM

(Reuters) - Researchers at the Leiden University Medical Center in the Netherlands are preparing for a potential “human challenge” trial in which volunteers are deliberately infected with the new coronavirus to test the effectiveness of vaccine candidates, advocacy group 1Day Sooner said on Wednesday.

The plan has already attracted 240 volunteers, the U.S.-based group said.

https://www.1daysooner.org/press-releases

This is the latest in 1Day Sooner’s efforts to get such a trial off the ground. In September, the group said such trials are expected to begin in January at a quarantine facility in London.

Researchers in the Netherlands have not yet decided to conduct the trial, which would still need regulatory approval, 1Day Sooner said.

A British biotech firm said last month it was in advanced talks with the UK government to create and provide strains of the coronavirus for such a challenge study.

-----------------------------------------

... from over a month ago ...

U.K. to Infect Healthy Volunteers In Covid-19 Vaccine Research Trial
https://www.statnews.com/2020/10/20/uk-to-infect-healthy-volunteers-in-covid-19-vaccine-research-trial/

(London) U.K. researchers are preparing to infect healthy young volunteers with the virus that causes Covid-19, becoming the first to announce plans to use the controversial technique to study the disease and potentially speed up development of a vaccine that could help end the pandemic.

Imperial College London said Tuesday that the study, involving volunteers aged 18 to 30, would be conducted in partnership with the government’s Department for Business, Energy, and Industrial Strategy, the Royal Free London NHS Foundation Trust, and hVIVO, a company that has experience conducting challenge studies. The government plans to invest 33.6 million pounds ($43.4 million) in the research.

The Imperial College partnership expects to begin work in January, with results expected by May. Before any research begins, the study must be approved by ethics committees and regulators.

In the first phase of the U.K. challenge study, researchers will expose 90 paid volunteers to the virus using nasal drops in an effort to determine the smallest level of exposure needed to cause Covid-19. Ultimately, the same model will be used to test the effectiveness of potential vaccines by exposing volunteers to the virus after they’ve received one of the candidate vaccines.

The research will be conducted at the Royal Free Hospital in London, which has a specially designed area to contain the disease. Volunteers will be monitored for at least a year to ensure they don’t suffer any long-term effects.

Challenge studies are typically used to test vaccines against mild infections to avoid exposing volunteers to a serious illness if the vaccine doesn’t work. While the coronavirus causes only mild or moderate symptoms in most people and seems to be especially mild in young, healthy individuals, the long-term effects of the disease aren’t well understood, and there have been reports of lingering problems in the heart and other organs even in those who don’t ever feel sick.

In the U.S., the National Institutes of Health has downplayed the need for challenge studies given the speed with which vaccines are being developed, but it has taken preliminary steps to prepare for such research in case the approach eventually is required. Those steps include examining the ethics of a challenge study, and funding research to create lab-grown virus strains that potentially could be used.

-----------------------------------------

[gandul]

Why Pfizer's or Moderna's CoViD-19 vaccine cannot be 95% effective
https://www.bmj.com/content/371/bmj.m4471/rr-3?fbclid=IwAR2Kz2J8AnMvX4OjrTdJViFKvD6SconUxs0DApyQZLPJ9LMYBXz3lESl0Mc

"Pfizer and Moderna has claimed ~95% efficacy in their interim analysis. There are many reasons why such efficacy claims are premature and are likely to be proven incorrect in the long term."

"the trial subjects are living a new normal (social distancing, wearing masks, hand hygiene etc), which means that their chances of contracting the virus are already low (currently 4 in 100 in the USA). This would mean that we do not know if the subjects in the vaccine group were protected due to the vaccine or it is just because they have not had a contact yet. The definitive approach could involve deliberately challenging the trial subjects with the virus, like in preclinical trials, however, it is unlikely due to ethical and safety implications. In the absence of any definitive challenge test, it becomes imperative to not rush to conclude efficacy just within weeks of vaccination."

In this crisis, don’t let the perfect be an obstacle of the good.
In other words: Who cares? ? ? They’ve been selling the placebo remdesivir at 1000’s $ per bolus and we’re gonna be concerned by a +/- 5% in efficacy of the vaccines? ? ?

[wili]

That seems kind of insane, given ample availability of already infected people, a supply that is not likely to dwindle greatly any time soon

[Grubbegrabben]

Why Pfizer's or Moderna's CoViD-19 vaccine cannot be 95% effective
https://www.bmj.com/content/371/bmj.m4471/rr-3?fbclid=IwAR2Kz2J8AnMvX4OjrTdJViFKvD6SconUxs0DApyQZLPJ9LMYBXz3lESl0Mc

"Pfizer and Moderna has claimed ~95% efficacy in their interim analysis. There are many reasons why such efficacy claims are premature and are likely to be proven incorrect in the long term."

"the trial subjects are living a new normal (social distancing, wearing masks, hand hygiene etc), which means that their chances of contracting the virus are already low (currently 4 in 100 in the USA). This would mean that we do not know if the subjects in the vaccine group were protected due to the vaccine or it is just because they have not had a contact yet. The definitive approach could involve deliberately challenging the trial subjects with the virus, like in preclinical trials, however, it is unlikely due to ethical and safety implications. In the absence of any definitive challenge test, it becomes imperative to not rush to conclude efficacy just within weeks of vaccination."

If they run the trial until 100 subjects are infected it doesn't really matter what the chance of contracting the virus is. As long as it's roughly equal between the vaccinated test subjects and those that got the placebo. I'm not sure what CI they have for the 95% statement but I doubt it will change that much if they continue the trial until 300 or 500 have been infected.

Also, the level of antibodies is monitored in the earliest test subjects. Vaccines also generate much higher initial level of antibody responses. If the antibody concentration drops very steeply I think if would show in the trials.

Most vaccines target the part of the virus that is active to enter the cells. Most mutations in that part of the virus renders it ineffective or less effective.

This is absolutely not my field, but I think this "response" is full of questionable conclusions and statements.

[vox_mundi]

‘Very Dark Couple of Weeks’: Morgues and Hospitals Overflow
https://apnews.com/article/pandemics-coronavirus-pandemic-2d8758a7bac85cd136248d5ce85533ed

Nearly 37,000 Americans died of COVID-19 in November, the most in any month since the dark early days of the pandemic, engulfing families in grief, filling newspaper obituary pages and testing the capacity of morgues, funeral homes and hospitals.

Amid the resurgence, states have begun reopening field hospitals to handle an influx of patients that is pushing health care systems — and their workers — to the breaking point. Hospitals are bringing in mobile morgues. And funerals are being livestreamed or performed as drive-by affairs.

... At Mercy Hospital Springfield in Missouri, a mobile morgue that was acquired in 2011 after a tornado ripped through nearby Joplin and killed about 160 people has been put into use again. On Sunday it held two bodies until funeral home workers could arrive.

At the Bellefontaine Cemetery in St. Louis, burials are up by about one-third this year compared with last year, and the cremated remains of about 20 people are sitting in storage while their families wait for a safer time to hold memorial services. The dead include a husband and wife in their 80s who succumbed to COVID-19 five days apart.

The Star Tribune in Minneapolis-St. Paul saw a 40% increase in the number of pages dedicated to paid obituaries in November, largely because of COVID-19, a spokesman said. By Nov. 29, the newspaper had 11 pages of obituaries, compared with about half that many on a typical Sunday.

In Worcester, Massachusetts, the National Guard trucked in cots, medical supplies, tables and other items needed to operate a 250-bed field hospital in the event the state’s medical centers become overwhelmed.

Rhode Island opened two field hospitals with more than 900 beds combined. The state’s regular hospitals reached their coronavirus capacity on Monday. New York City, the epicenter of the U.S. outbreak earlier in the year, reopened a field hospital last week on Staten Island. Wisconsin has a field hospital in West Allis ready to take overflow patients. A Nevada hospital has added hospital bed capacity in an adjacent parking garage.

“Hospitals all around the country are worried on a day-to-day basis about their capacity ... and we’re not really even into winter season and we haven’t seen the impact of Thanksgiving travel and Thanksgiving gatherings,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.

California officials said the state could see a tripling of hospitalizations by Christmas and is considering stay-home orders for areas with the highest case rates. Los Angeles County already has told its 10 million residents to stay home.

The number of hospital beds is just one concern. Many hospitals are scrambling to find enough staff to care for patients as the virus surges almost everywhere at once, Adalja said.

In Oklahoma, Republican Gov. Kevin Stitt declared Thursday a day of prayer and fasting as the state’s confirmed coronavirus infections neared 200,000. State health authorities Tuesday reported a one-day high of over 1,700 hospitalizations.



Although the White House task force has repeatedly recommended a mask mandate to curb the spread in Oklahoma, Gov. Kevin Stitt has refused to enact such a policy, saying mask wearing should be a personal responsibility.

More Oklahomans have been hospitalized with the virus in the past two weeks than ever before. The state broke its previous records for single-day increases of cases and daily infections.

Many metro schools scrapped plans for in-person classes once Oklahoma County and the surrounding area soared past Red Level, the highest alert of community spread from the Oklahoma State Department of Education.

https://oklahoman.com/article/5677007/school-districts-pleading-for-oklahoma-to-curb-covid-19

------------------------------------------

As COVID-19 Hospitalizations Near 100,000 in USA, Experts Fear Facilities Lacking Staff Will Be 'Overrun' By Patients
https://www.usatoday.com/story/news/health/2020/12/02/covid-19-hospitalizations-near-100-000-doctors-nurses-beds-needed/3780809001/

The number of hospitalized COVID-19 patients nationwide stood on the brink of 100,000 Wednesday, an alarming statistic fueling enormous strain on the health care system and its brave but beleaguered workers.

Some experts say the total, compiled by the COVID Tracking Project, could soon double.

https://covidtracking.com/data/national

[crandles]

8 of the top 10 countries for deaths per population are now European also 7 of top 8. Has previously been European dominated then South American countries started to make inroads into top 10 before autumn weather and waves returning to Europe. The two other countries in the list are Peru and Argentina. USA is 11th.

2727 US deaths is second highest number of deaths after 2744 on April 21. Cases only recently levelling off so US might get back into top 10 by overtaking Argentina or maybe somewhere else Montenegro? will get there first.

Uk was very high in list, 3rd at one point I think. Fell to 13th place now up to 7th but will start falling again imminently.

[crandles]

Almost at 1.5m deaths worldwide.

Another 29 days at 12.5k deaths per days would take us to 1.86m by end of the year, looking much nearer to 2m than I had hoped and expected a couple of months ago. A more optimistic view might be that deaths have levelled off at around 10260 per day but even that is close to 1.8m deaths.

[Rodius]

Almost at 1.5m deaths worldwide.

Another 29 days at 12.5k deaths per days would take us to 1.86m by end of the year, looking much nearer to 2m than I had hoped and expected a couple of months ago. A more optimistic view might be that deaths have levelled off at around 10260 per day but even that is close to 1.8m deaths.

I could see the potential for 2 million this year, although I thought the odds were against it happening.
Now, I am beginning to think it is becoming more likely.
All it takes is for the US to not cope with the sickest patients and begin turning people away. Should that happen, the death rates will leap upward because the only real reason death rates have dropped so much is because of better treatment in hospitals. Without treatment, Covid will kill many more people.

WorldoMeter is showing an average of 10K per day for the last week but has leveled off there. Lets hope that remains the case. But looking at the unfolding events and refusal to do what needs to be done on a wide scale, I suspect we will get closer to 2.0 million than 1.8 million.

The mind boggles at that thought.

[vox_mundi]

US Reports 3,100 Coronavirus Deaths In One Day -- 20% Over Previous Record
https://amp.cnn.com/cnn/2020/12/03/health/us-coronavirus-thursday/index.html
https://www.nytimes.com/live/2020/12/02/world/covid-19-coronavirus

There were 3,157 Covid-19 deaths reported Wednesday -- an all-time high for the pandemic -- and health care systems are struggling to support the weight of worsening impacts.

The more recent death toll is an increase of about 20% from the previous record of 2,603 set on April 15. Over the course of the pandemic, 273,799 people in the US have died of the virus and more than 13.9 million have been infected, according to data from Johns Hopkins University.

The surge has pushed records set one day to be broken the next. The spike in coronavirus deaths came on the same day the number of people hospitalized broke 100,000, according to the Covid Tracking Project.

The 911 emergency call system is "at a breaking point," the American Ambulance Association, which represents all of the nation's ambulance services, said in a letter Wednesday.

"Without additional relief, it seems likely to break, even as we enter the third surge of the virus in the Mid-West and West," the letter said.

http://www.cnn.com/2020/12/03/health/911-emergency-breaking-point-covid/index.html

---------------------------------

“During the pandemic thus far, 99 of the 498 fire departments reporting across Minnesota have had COVID-19 outbreaks,” the head of the two firefighting groups wrote. “This number is rapidly increasing and the ability for many departments to respond to emergencies is on the verge of collapsing.”

-----------------------------------------

... According to officials at both Methodist LeBonheur and Baptist hospitals, the time it takes to get a patient off an ambulance and get that person processed is taking much longer.

A paramedic told us in some cases patients have been forced to wait some three to 10 hours just to be offloaded.

A spokesperson for Baptist told us the longest wait time is at Baptist East, where it can take up to 45 minutes to offload a patient.

----------------------------------

Calif. County Stops Sending Ambulances to All 911 Calls Due to COVID-19 Surge

San Bernardino County emergency dispatchers have stopped sending an ambulance to all 911 calls, a strategy that's lightening their load as coronavirus-related calls surge.

Instead, people whose symptoms appear consistent with COVID-19 or the flu but who do not appear to need hospitalization are being visited by paramedics without an ambulance, said Steve Tracy, a spokesman for the San Bernardino County Fire Department.

Before San Bernardino County's new policy began, some ambulances were waiting four to six hours at a hospital before they could release a patient, Tracy said.

"That ambulance is tied up," he said. "It can't respond to other emergencies."

------------------------------------------

World Trade Center 2,753 deaths

... over 1 a day

------------------------------------------

U.S. Hits 100,000 COVID-19 Hospitalizations; More Than 3,100 Deaths
https://www.npr.org/sections/coronavirus-live-updates/2020/12/02/941902471/u-s-hits-100-000-covid-19-hospitalizations

Data from the COVID Tracking Project show 100,226 people were hospitalized on Wednesday with the disease caused by the coronavirus — a figure that has been steadily rising for weeks. Meanwhile, 3,157 new deaths were recorded on Wednesday, surpassing the previous peak of 2,607 deaths on April 15, according to Johns Hopkins University.

The Centers for Disease Control and Prevention Director Robert R. Redfield warned Wednesday that things are likely to get worse over the winter months. He predicted deaths could reach "close to 450,000" by February if Americans fail to take more health precautions, such as wearing a mask.

[SteveMDFP]

Given the cost in life and money of a disease like covid 19, I believe it to be completely ethical to carry out a controlled exposure trial for these vaccines. I find it downright anti-ethical that it has not to been done (publicly) yet.

What is the ethical argument for the hold-up?

Researchers generally consider it unethical to kill volunteers.

WMA DECLARATION OF HELSINKI – ETHICAL PRINCIPLES FOR MEDICAL RESEARCH INVOLVING HUMAN SUBJECTS
https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/

[vox_mundi]

https://www.defense.gov/observe/photo-gallery/igphoto/2002539583/

The Department of Defense released the first images of a COVID-19 vaccination record card and vaccination kits Wednesday.

The cards will be sent out as part of vaccination kits from Operation Warp Speed.

“Everyone will be issued a written card that they can put in their wallet that will tell them what they had and when their next dose is due,” according to Dr. Kelly Moore, associate director of the Immunization Action Coalition



The CDC issued a COVID-19 Vaccination Program Interim Playbook which states “For most COVID-19 vaccine products, two doses of vaccine, separated by 21 or 28 days, will be needed. Because different COVID-19 vaccine products will not be interchangeable, a vaccine recipient’s second dose must be from the same manufacturer as their first dose.”

https://www.cdc.gov/vaccines/imz-managers/downloads/COVID-19-Vaccination-Program-Interim_Playbook.pdf

[Richard Rathbone]

UK headline deaths surpass 60,000 today. https://coronavirus.data.gov.uk/details/deaths

The latest death certificate number for England is 61389, but that is lagged compared to the headline as well as just being England, the comparable headline figure being 47842. Wales and Scotland tend to be even worse at keeping deaths out of the headline figure than England, so the actual toll is probably about 80k now and we'll be lucky to hold it under 100k before vaccines start to have an impact. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/weekending20november2020

[vox_mundi]

Comparison of Coronavirus Antibody Tests Revealed Too Optimistic Claims
https://medicalxpress.com/news/2020-12-comparison-coronavirus-antibody-revealed-optimistic.html

A study by University of Tartu researchers indicates that the sensitivity of tests used to detect viral antibodies in a blood sample may differ significantly. The combination of several tests may give the best result.

... The study was conducted in cooperation between the University of Tartu, Synlab and Kuressaare Hospital in Saaremaa (Saaremaa is the island in Estonia with the biggest corona outbreak during the first virus wave—editor remark). In the study nine coronavirus antibody tests that were most widely used during the outbreak in spring were analyzed. Seven of them were by major producers and two were laboratory tests developed at the University of Tartu by the research group led by Professor Pärt Peterson.

The study involved 97 patients from Saaremaa with a confirmed case of COVID-19. The IgG antibodies to coronavirus were determined by nine tests and the test results were compared based on the patients' symptoms (cough, headache, tiredness, difficulty breathing, diarrhea, etc.) and the time between the onset of the disease and the antibody test. The majority of studied patients had COVID-19 symptoms, except for about one fifth of them.

The study revealed that in general, the sensitivity of the tests was lower than the producers had stated. As was expected, the rapid test included in the study at the request of the Health Board had the lowest sensitivity.

In half of the patients, all nine antibody tests gave a positive result. In two patients, none of the tests detected coronavirus antibodies. This implies that antiviral antibodies might not even emerge in some COVID-19 patients. For the rest of the patients, the test results varied. Analysis of the correlation of the results indicated that in some patients, the prevailing antibodies were those against the nucleocapsid while in others antibodies against the spike protein prevailed.

"In the everyday work of Synlab, we are using the Abbott test that is sensitive to antibodies to the nucleocapsid. If that gives a borderline negative result in a patient, we will analyze this sample again using another test sensitive to antibodies to the spike protein. If the result is positive, we will trust that. My experience has shown that antibodies to the nucleocapsid disappear faster and antibodies to the spike protein last for longer," explained the lead author of the study Paul Naaber, Senior Research Fellow in Medical Microbiology at the University of Tartu.

Paul Naaber et al. Evaluation of SARS-CoV-2 IgG antibody response in PCR positive patients: Comparison of nine tests in relation to clinical data, PLOS ONE (2020).
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237548

... We here compared the sensitivity and specificity of seven commercial (SNIBE, Epitope, Euroimmun, Roche, Abbott, DiaSorin, Biosensor) and two in-house LIPS assays (LIPS N and LIPS S-RBD) IgG/total Ab tests in serum samples from 97 COVID-19 patients and 100 controls, and correlated the results with the patients’ clinical data and the time-point the test was performed.

We found a remarkable variation in the sensitivity of antibody tests with the following performance: LIPS N (91.8%), Epitope (85.6%), Abbott and in-house LIPS S-RBD (both 84.5%), Roche (83.5%), Euroimmun (82.5%), DiaSorin (81.4%), SNIBE (70.1%), and Biosensor (64.9%). The overall agreement between the tests was between 71–95%, whereas the specificity of all tests was within 98–100%. The correlation with patients’ clinical symptoms score ranged from strongest in LIPS N (ρ = 0.41; p<0.001) to nonsignificant in LIPS S-RBD.

Furthermore, the time of testing since symptom onset had an impact on the sensitivity of some tests. Our study highlights the importance to consider clinical symptoms, time of testing, and using more than one viral antigen in SARS-CoV-2 antibody testing. Our results suggest that some antibody tests are more sensitive for the detection of antibodies in early stage and asymptomatic patients, which may explain the contradictory results of previous studies and should be taken into consideration in clinical practice and epidemiological studies.

[vox_mundi]

WHO Trial Finds No Benefit of 4 Drugs for Hospital COVID Patients
https://www.cidrap.umn.edu/news-perspective/2020/12/who-trial-finds-no-benefit-4-drugs-hospital-covid-patients

None of the four once-promising drugs evaluated for the treatment of COVID-19 in the ongoing World Health Organization (WHO) Solidarity Trial—remdesivir, hydroxychloroquine, lopinavir, or interferon-beta-1a—prevented in-hospital death, reduced the need for ventilation, or shortened the duration of hospitalization.

The interim results of the open-label study, published yesterday in the New England Journal of Medicine, involved randomly assigning hospitalized COVID-19 patients equally to whichever trial drugs were available locally or to a control group from Mar 22 to Oct 4.

The study involved 11,226 patients in 405 hospitals in 30 countries in all six WHO regions assigned to receive one of the four drugs or to be part of a control group. Some patients assigned to interferon also received the HIV antiviral drug lopinavir. The control group received hospital-specific standard care. Adherence to the regimens was 94% to 96% halfway through the treatment period.

A total of 1,253 patients (11.2%) died after a median of 8 days. The Kaplan-Meier 28-day death rate was 11.8% but rose to 20.4% in patients older than 70 years and 39.0% in patients already receiving ventilation at study arm assignment.

Of the 2,743 patients who received remdesivir, 301 died, as did 303 of the 2,708 patients in its control group (rate ratio, 0.95). Of the 947 patients in the hydroxychloroquine group, 104 died, as did 84 of the 906 in its control group (rate ratio, 1.19).

Of the 1,399 patients in the lopinavir group, 148 died, while 146 of 1,372 in its control group did so (rate ratio, 1.00). Among the 2,050 patients receiving interferon, 243 died, as did 216 of the 2,050 in its control group (rate ratio, 1.16).

"No drug definitely reduced mortality, overall or in any subgroup, or reduced initiation of ventilation or hospitalization duration," the authors wrote.

The vast majority (81%) of patients were younger than 70 years, 62% were male, and 25% had diabetes. ...

WHO Solidarity Trial Consortium, Repurposed Antiviral Drugs for Covid-19 — Interim WHO Solidarity Trial Results, NEJM, (2020)
https://www.nejm.org/doi/full/10.1056/NEJMoa2023184

[vox_mundi]

CDC: US Could See Nearly 20,000 Covid-19 Deaths Week of Christmas
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/forecasting-us.html

The Centers for Disease Control and Prevention released a grim forecast of an estimated 9,500 to 19,500 deaths the week of Christmas alone, contributing to a projection of tens of thousands of new Covid-19 deaths over the next four weeks.

... This week’s national ensemble forecast predicts that the number of newly reported COVID-19 deaths will likely increase over the next 4 weeks, with 9,500 to 19,500 new deaths likely to be reported in the week ending December 26, 2020. The national ensemble predicts that a total of 303,000 to 329,000 COVID-19 deaths will be reported by this date.



-------------------------------------

Global Coronavirus Death Toll Passes 1.5 Million
https://www.cnbc.com/2020/12/03/coronavirus-live-updates.html

More than 1.5 million people have lost their lives due to Covid-19 with one death reported every nine seconds on a weekly average, as vaccinations are set to begin in December in a handful of developed nations.

Reuters reports that half a million deaths occurred in just the last two months, indicating that the severity of the pandemic is far from over. Nearly 65 million people globally have been infected by the disease and the worst affected country, United States, is currently battling a third wave of coronavirus infections.

In the last week alone, more than 10,000 people in the world died on average every single day, which has been steadily rising each passing week. Many countries across the world are now fighting second and third waves even greater than the first, forcing new restrictions on everyday life.

The U.S. alone has recorded 275,000 deaths, the highest in the world, followed by Brazil and India with 174,000 and 138,000 recorded deaths, respectively.

[glennbuck]

https://www.theguardian.com/world/2020/dec/01/uk-coronavirus-death-toll-passes-75000

The UK’s total Covid death toll has passed 75,000, according to a tally of all fatalities that mention the disease on death certificates.

The grim milestone comes just over a month after the UK surpassed 60,000 deaths in late October, showing how the Covid death toll accelerated since September, having slowed during the summer.

The figure is higher than the government’s Covid death toll of 59,051. The latter figure only covers people who have died within 28 days of testing positive for the virus.

[Tom_Mazanec]

Just got a call from the City of Twinsburg.
Summit County has gone from level 3 (Red) to level 4 (Purple)...the highest level.
We have been asked to limit travel.

[sidd]

We see that 911 systems and firefighters/first responders are being affected by the pandemic. Should non COVID related deaths due to 911/emergency response/firefighting failure be counted in COVID death toll ? I incline to that view, if one bleeds out from a farm accident because of 911 failure or delay caused by COVID swamping hospitals and first responders, that death was caused by the COVID pandemic.

sidd

[Rodius]

We see that 911 systems and firefighters/first responders are being affected by the pandemic. Should non COVID related deaths due to 911/emergency response/firefighting failure be counted in COVID death toll ? I incline to that view, if one bleeds out from a farm accident because of 911 failure or delay caused by COVID swamping hospitals and first responders, that death was caused by the COVID pandemic.

sidd

This reasoning is why I tend to look at excess deaths as well.

[wili]

Good points, sidd.

vox, thanks for the WHO study. It seems to confirm most of the studies I've been seeing lately about these drugs. As I noted earlier, a large part of the improvement in hospital survival rates is simply giving up on these 'miracle' drugs, not wasting time and endangering lives with treatments like this that don't work, and focus mostly on the fundamentals.

As for the CDC study, I would call it...optimistic, given that we just had one-day death total of over 3100.

https://www.aljazeera.com/news/2020/12/3/covid-19-deaths-in-the-us-set-new-record-exceeding-2600-in-a-day

So if my maths are right, and we see NO increases in daily death totals from now on, we'll have ~ 21,700 deaths in the coming week, let alone Christmas week.

[Rodius]

A quick update on Australia.
Normally it would seem pointless to talk about how things are not bad, but for me, it matters that even though it is going badly in the Northern Hemisphere, it helps to know that this thing can be brought into line with good processes.

What will be interesting is what will happen next SH winter.....  hopefully, a vaccine will be here to ruin the direct comparison.

Melbourne - zero covid for 35 days in a row. 8500 tests were done.

Adelaide - zero cases for 5 days in a row. 8 active cases all in isolation. 4000 to 8000 tests done per day.

Sydney - 1 case from 11,000 tests... although this one case was a cleaner from an isolation hotel who traveled on the train for 50km a few days ago. This explains the extra testing being done as they testing those who were near her and doing contact tracing. This is another attempt from Covid to start a new outbreak.

In total, there were 16 new cases around Australia (not just in cities but the rural areas as well).

The weather is warming up (heat wave last week) and more to come. Australia should remain about the same for the next four months due to the warm weather and high degree of containment and testing.

[pileus]

Good points, sidd.

vox, thanks for the WHO study. It seems to confirm most of the studies I've been seeing lately about these drugs. As I noted earlier, a large part of the improvement in hospital survival rates is simply giving up on these 'miracle' drugs, not wasting time and endangering lives with treatments like this that don't work, and focus mostly on the fundamentals.

As for the CDC study, I would call it...optimistic, given that we just had one-day death total of over 3100.

https://www.aljazeera.com/news/2020/12/3/covid-19-deaths-in-the-us-set-new-record-exceeding-2600-in-a-day

So if my maths are right, and we see NO increases in daily death totals from now on, we'll have ~ 21,700 deaths in the coming week, let alone Christmas week.

A good rule of thumb has been daily cases x 1.8%, out 21 days.  So ~3800 on Dec 24.  But I tend to agree that systemic care failures will assert more, so we may see numbers closer to 5k at some point.

Retrospective excess mortality will really be the best measure of the toll when this is done.