Interesting kind of slowdown in research, but that seems to happen periodically. It is pretty apparent that CV-19 does indeed have a geographic seasonal pattern. It definitely likes cooler weather with short, low intensity sunshine days. We will see how long it takes this surge to roll over. I am somewhat encouraged by the fact that at least in Minnesota the metro area case growth appears lower than the outstate, suggesting that there was a substantial incidence in the spring. In any event, if we have a new president he should be very grateful to the current one, because the overall prevalence level across the country will likely be sufficient to substantially slow transmission by Inauguration Day. The panic level now, however, is starting to rise and lockdown fever is overtaking our gutless political leaders. You would think they would have learned from how little the first one accomplished.
Henceforth, extreme lockdowns shall be known as the Osterheimlich Maneuver, in which the fists are clenched together and placed around the victim’s, er, patient’s, throat very tightly for five minutes, which will prevent the virus from sliding down into the lungs and has the added benefit of leading to lack of respirations, which might otherwise cause exhalation and inhalation of the virus. It is well known that dead people do not contract CV-19 and do not pass it to others. If the Osterheimlich Maneuver were applied to 80% to 90% of Americans, the epidemic would be over. I would suggest applying it to the eponym first.
Here is a comment on the IMHE projections of a ridiculous number of deaths if we didn’t all have masks glued on 24 by 7. IMHE has done a horrible job of modeling and has contributed substantially to hysteria and panic. They are funded by Bill Gates, gee, wonder if his desire to see billions spent on vaccines has anything to do with the Institute’s work. (SSRN Paper) There are a ton of flaws in IMHE’s work, but this observer noted that they used very outdated data on mask wearing and that if they used accurate data the impact of further masking would have been negligible. But then they couldn’t spread hysteria. Same observation I made about why Minnesota’s mask mandate was unlikely to have much impact–there was already a high rate of mask-wearing so it wasn’t going to make much difference.
And speaking of that, can anyone seriously believe any longer that mask mandates and mask wearing substantially slow case growth. I will post one chart later, but there are a million now that will show stratospheric case growth following mask mandates. That macro perspective that I keep talking about clearing is in play, over large numbers of encounters in virus-friendly environmental conditions, mask are not going to stop substantial transmission.
And here is a little more evidence to that point, from a study of Marine recruits. (NEJM Paper) The recruits were quarantined for 14 days twice and regularly tested. They had to wear masks, maintain a social distance, and undergo regular temperature and symptom checks. Study volunteers had regular, frequent PCR testing, including before quarantine. Another group which was tested only at the end of the second 14 day quarantine period was used as a comparator. The study group actually had higher rates of positive tests, despite more frequent testing to detect cases early. Almost every case in both groups was asymptomatic. And please note that despite the rigorous and monitored mitigation measures, including mask wearing at all times, cases occurred. Also of interest was that 6% were positive for antibodies. 1% were PCR positive on arrival at the camp despite having quarantined for two weeks and having no history of activities that might be related to transmission. The few symptomatic positives had viral loads far higher than the asymptomatic positives. And here is another little tidbit that reveals how worthless PCR tests are in low threshold results; complete viral genomes could not be obtained in a significant number of samples, meaning the presence of viable virus was unlikely. Extensive testing obviously did no better at preventing cases than not testing frequently. Virus gonna virus.
More good news for the proponents of test everyone, everyday with PCR testing. A study in Rome found that positive results after a person had recovered and after they had a negative test were likely due to detection of non-replicating (i.e., non-viable) virus. Only one patient had replicating virus. (JAMA Paper) If you look at the table, you will note a stark difference in cycle numbers for results deemed positive during the active infection period and in the testing after recovery, with numbers in the 20s when the infection was active, and in the 30s when the positives, except for one, had no replicating virus. But we need to call tests with cycle numbers up to 40 positive.
This is another study on data around children’s role in transmission. (Medrxiv Paper) This was a meta-review of 22 studies. The authors found that while children may have some effect as transmitters and transmittees in the community, they were almost never an index case in a school.
An interesting study from Italy, which had one of the first bad waves and is having another one now. So it became an interesting test case for whether the hardest hit parts of the country showed lower incidence this time around, which might reflect some population immunity. (SSRN Study) The researchers found that towns that were harder hit in terms of mortality in the first wave had about a 30% lower rate of cases in this second wave. That could reflect behavioral changes but is more likely slower transmission from population immunity.
And even the CDC is noticing the increasing non-CV-19 health damage caused by the responses to the epidemic. (CDC Report) Emergency room visits from children for mental health issues rose dramatically. The absolute number and proportion of such visits rose by over 20% after the initial lockdown period.