(big sigh) More data nonsense today from the Health Department, probably actually not their fault, but a lab they work with hasn’t been timely in providing results. A jump in reported cases to over 1000 for the day, but a press release explained that this lab had been sitting on results for about 2 weeks and delivered 19000 to the state, I assume within the last couple of days. About 4600 were included in today’s testing and case counts, with 265 positive results added. At that ratio, there will be about 1000 new cases added when all the test results are processed by the state. The specimen dates are from the last two weeks. That is a shame. Because it was almost looking like cases might have dipped after the mask mandate (I still wouldn’t have attributed the drop to that) but add 1000 cases to the last couple of weeks and I don’t think so. Almost makes you wonder if there are other labs holding out as well. This is why it is taking me so long to feel comfortable delivering an analysis; it seems to take at least two weeks for a day’s case number to be stable. For several weeks I have every day printed the table of cases by specimen collection date. Even back a long time ago, a day’s numbers will change. And in recent weeks, they can change pretty significantly. So there is a big lag to completeness. And it makes the daily case reports as worthless as the daily death report, but at least they give us the date of specimen collection data in a table. And I am sure the Department is holding out hope that some of those positive cases were at Sturgis.
Brazil, like Sweden, and the US to some extent, was getting bashed for its failure to lockdown and for supposedly having a disastrous epidemic. When you look on a population-adjusted basis it doesn’t look so bad, not nearly as bad as Peru, which has one of the longest, strictest lockdowns anywhere. It looks like the epidemic is ending in Brazil, again with less economic damage than other places. This article tells a more accurate story. (Brazil Article) I still believe every country is going to end up at roughly the same place, adjusting for population characteristics and other factors, and it is apparent that the ones like Sweden and Brazil, and even to some extent the US, that were a looser and more balanced in their approach to the epidemic, are going to pay a lower non-coronavirus toll to get to that similar destination.
That 6 feet social distance metric? Undoubtedly backed by firm scientific evidence? The British Medical Journal publishes an article that suggests maybe not so much. (BMJ Article) The origin of 6 feet or two meters is apparently based on studies 70 years ago which found that most droplets fell before traveling that far. Some more recent imaging studies purport to find droplet spread further away, but what actually appears to happen is that large droplets do fall within one to 2 meters and smaller ones are aerosolized and evaporate. The force of the exhaled airflow and any airflow in the environment may determine how far various sized droplets do or don’t go. Of course it would be good if people actually looked at what happened to the infectious agents in the droplets as they are expelled. Do they remain viable and if so, for how long. Studies which purport to study dispersion of the current CV strain are wildly inconsistent. And there are only a couple that look at actual infectiousness. None found viable virus. That, ladies and gentlemen, is what should be referred to as absence of scientific evidence. This is pathetic, given that one of the most important questions about this virus, or any pathogen, is how is it actually transmitted–what viral loads are shed, how do they travel, how long are they in the air at a level where humans might inhale them, what happens when they come to rest with their carrier particles, how long do they exist in infectious doses. The fact that we aren’t close to a definitive answer leads to poor public policy, often based on worst case assumptions, like asymptomatic people shed viable virus in infectious amounts, the virus can be blocked by masks, and our precious 6 foot rule. These authors put together a recommended gradient of risk graph, under which distances can be adjusted. Outdoors, for example, is generally safer. Take a look at the chart at the end of the paper. I can imagine printing it on a mask so you always have it handy. It seems to me it would be best if we mandate that people carry the chart at all times, including at home, and that they must always obey the distancing requirement attached to the settings in the chart. No more eating dinner at the same table with your family, or sharing car rides. Makes as much sense as any other stupid policy that has been ordered by our always benevolent dictators.
This study is another in the line attempting to identify how many infections there actually have been in the US. (PNAS Study) I am leery of these only because testing has changed so much and the antibody studies many people rely on may not be highly accurate. In any event, like everyone else, these authors find that a large percent, as high as 90%, of infections were not detected early on. I tend to agree with these and higher estimates early in the epidemic. Now, with much greater testing and a significant part of the population having been infected, I doubt detection is that low. The authors believe that if we had realized how many infections were occurring we might have taken earlier action that would contain the epidemic. That is absurd in light of actual events, i.e., the recent surge in southern state cases and the return of cases to places that believed they had suppressed the virus. And it ignores the very fact it finds, if all those undetected cases were undetected, they were non-events. Why would we try to suppress, at enormous economic, social and health cost, something that affects so few people with serious illness? We got ourselves into this mess by ignoring that question.
Here is a discussion of superspreading events in Georgia. (PNAS Study) The authors studied cases in five urban and rural counties. They believe they ascertained that 2% of cases led to 20% of all infections. I was not too impressed, because using mobility data and the daily case numbers in the counties, they found a high transmission rate initially that declined after a statewide stay-at-home order. Except that their own information was that the case rates began declining before the order was issued. They also found that superspreading was more common in those under age 60 than among the elderly. This is apparently based on the model and not on any actual study to identify various persons’ role in transmission.
Finally, a recent study, thanks to Scott Johnson for bringing it to my attention, that confirms that obesity is a major risk factor for serious coronavirus illness. (Obesity Study) This was a meta-analysis, meaning the authors took results from various studies and pooled that data. Using 75 studies, they found that persons who were obese had a 46% greater risk of being infected, 113% higher risk of being hospitalized, 74% greater risk of being in an ICU, and a 48% higher risk of death than did non-obese persons. The likely cause is the association of obesity with heart disease, hypertension, diabetes and a weakened immune system. The authors worried that being obese could lessen the effectiveness of a vaccine.