A Head Full of Coronavirus Research, Part 70

One quick note regarding the actual number of infections in Minnesota.  Both the seroprevalence data published in JAMA and the recent CDC publication would have us at around 1,500,000  to 2,000,000 infections.  Even at the low end that is about a .2% infection fatality rate, down at flu level, and considering the age spread of deaths, a completely miniscule cause of death in the non-LTC and under 70 population.

Ok, let us start with a paper on the obvious.  Researchers have discovered that the media likes to spread hysteria and panic and never gives people rational, calm, balanced information.  (NBER Paper).   I won’t spend much time on the details, but 91% of major US media stories about CV-19 were negative, compared to  54% of non-US media.  It is overwhelmingly negative even when the developments are generally good.  WE NEED A NEW SET OF MEDIA COMPANIES.

Readers know that a subject near and dear to me is the role advance directives play in the number of deaths in the epidemic attributed to CV-19.  An advance directive generally forbids any kind of intensive care and they are especially common among the frail elderly and patients with dementia.  You would expect that there are many CV-19 patients with advance directives, give the age concentration of serious disease and that these people basically chose to die rather than be treated.  As I have suggested, deaths with advanced directive involvement should be categorized separately.  Here is a study on the issue.  (CID Article)   The authors looked at 640 patients who died of CV-19 (supposedly) in two New Jersey health systems.  Out of these, an astounding 89% had an advance directive with at least a do not resuscitate component.  Patients who died in the hospital were far more likely to have a do not resuscitate order than those who did not die.  It is pretty clear that the deaths attributable to CV-19 are artificially boosted by the presence of advance directives and do not resuscitate orders.

A hospital in Michigan did a contact tracing study of all its child CV-19 cases and determined that there was not one instance of child to adult transmission.  (JPIDS Article) 

I don’t know quite what to make of this, but some researchers have published an extensive critique of the use of PCR testing for CV-19.  Some of it is similar to what I have seen in other studies but some seems less firm.  Worth a look.  (PCR Critique)

Here is yet another paper clearly finding that voluntary behavior changes, not stay-at-home orders or lockdowns were the cause of any slowing of case growth.  (Medrxiv Paper)  The authors studied county level mortality in counties with significant mortality and compared it to mobility reductions and the timing of lockdown orders.  They found that mobility reductions had largely occurred prior to issuance of orders and that the largest impact of mobility restrictions was in urban counties, which you would expect since there are many more contacts in urban areas.  The authors conclude that stay-at-home and lockdown orders had little impact on cases or mortality.

Another adaptive immunity paper, this one focusing on the response in airway tissues.  (Medrxiv Paper)  The systemic and airway tissue response was assessed in patients with disease, or non-disease, across the spectrum.  Even in severe patients, airway antibodies tended to wane over time.  But once again, this is becoming a what difference does it make problem, the thing that should be studied is the memory B and T cell response.  And in this study, memory B cells were found to be similar across disease severities.

And continuing the adaptive immunity theme, this study covered T cell responses.  (Medrxiv Paper)   The authors sought to identify T cell responses to infection, but also to determine any effect of T cells developed due to seasonal coronavirus infection.  Using a technique to minimize random appearance of cross-reactivity, they found that there appeared to be little effect of prior seasonal CV T cells upon CV-19.