My observation on Minnesota government incompetence for the day is based on an editorial in the Wall Street Journal yesterday which demonstrated that Minnesota is a leader in one thing–we are third in the number of jobs lost in the recent stages of the epidemic. We are not a high population state but we had the third largest number of jobs lost among all states. Congratulations Governor. And I am sure that tax increase will really help improve the employment picture. And I wonder if you will be making those comparisons to the Dakotas and Iowa for this statistic.
And my federal government observation is that the new administration is from the party of the rich, just go look at the publicly available contribution data and you will see that, and they clearly are going to help the rich. A number of the executive orders (gee, didn’t the president say those should never be used during the campaign?) are designed to help wealthy people and large shareholders of big companies. The only group benefiting more is the Chinese government and oil-exporting countries.
Although I said something nice about Dr. Osterholm yesterday, I have to take it back today. He claims the next 6 to 14 weeks will be the darkest period of the epidemic yet. I believe he made the same prediction last March, last April, May, June, July, August, September, October, November, but in December it was hospitals will be literally be collapsing. He might want to look at some actual data and apply his supposedly phenomenal epidemiologic skills to explain for all of the us the geographic and seasonal pattern we see to cases, and then forecast forward. Might be a little more accurate than just repeating the same doomsday predictions.
A slightly updated version of my video presentation is available on youtube (Link)
Scary, boys and girls, very scary, new CV-19 variants. This paper looks at the effect of one such beast. (Medrxiv Paper) This was the England strain. The researchers found no difference in symptoms, disease severity or disease duration, although they did find that the variant may be slightly more transmissible. But don’t let that stop you from following along with the media hysteria.
Rhode Island started requiring the reporting of PCR cycle numbers and this research used that data to establish that the PCR number is correlated with outcomes. (Medrxiv Paper) Lower numbers were clearly correlated with and higher viral load and therefore a higher mortality. In addition, as cases ebb, cycle numbers tend to increase on average, indicating that more low or non-positives are actually being picked up. (thanks to a readers sharp eye, I corrected this, what I should have said was, lower cycle number, higher viral load, more serious disease. Higher cycle number, lower viral load, less serious disease.)
Respiratory viruses are generally inhaled so the first line of defense is in the upper respiratory tract, which has mucus linings. This paper looks at immune processes in that nasal region. (Medrxiv Paper) The authors were focused on potential differences between adults and children. Production of interferons is a primary antiviral defense, so that was specifically examined. In addition to the response to CV-19, RSV and influenza virus was also studied. The local interferon response was not different between children and adults and was similar across viruses. It did vary with viral load, as you would expect. There was not a significant difference in viral loads between children and adults. Some other aspects of the immune response to CV-19 did vary in children versus adults, primarily among inflammatory molecules.
One thing we should be concerned about is how often people contract CV-19 in a health care setting. This study looked at that issue. (BMC Article) The research was a meta-review and the the authors first examined transmission to health care workers. The found generally poor quality studies which made it hard to assess the frequency of health care worker transmission in the workplace. While more data is available on transmission among patients, there were similar methodological issues and reporting issues. But there have been large numbers of outbreaks in health care facilities, particularly nursing homes, which clearly reflect transmission within the facility. Semi-trustworthy research would suggest that 5% to 15% of infections reported in hospitalizations were actually contracted in the hospital, with some studies finding an even higher number.
Okay, here is a good example of why you should never, ever, accept people saying you just believe whatever a scientist tells you. Science is not absolute. Scientists’ research often disagrees. Science is an iterative process by which successive rounds of research gradually get closer to truth. This was another paper on meteorological and geographic factors. (Medrxiv Paper) You may recall a summary a day or so ago about research finding that latitude but not temperature or humidity correlated with case levels. Guess what? This paper finds the opposite. Covering April through August, a number of European countries were used as the test bed. Cloudiness was found to be highly correlated with mortality levels. There was some negative correlation with solar intensity. Latitude was not found to be correlated. The explanation could be that fewer clouds means greater solar intensity, or that people are indoors more when it is cloudy.
How about vitamin D deficiency, for which there is also conflicting research. Another paper is out on that topic. (Medrxiv Paper) Europe once again was used and comparisons of population vitamin D deficiency levels were made to cases and deaths. There was wide variation in deficiency levels across the countries. Higher levels of deficiency were correlated with more cases and deaths. But what makes little sense is that higher latitude countries supposedly had lower levels of vitamin D deficiency, although they also would have lower levels of total solar insolation. The correlations also seem pretty weak.
How is mental health holding up during the pandemic. This paper looked at depression symptoms among adults at Duke University, where little economic disruption occurred and there was low infection risk. (Medrxiv Paper) 40% had signs of moderate depression and 25% of severe depression, according to a standardized test. The levels of depression were strongly age-related, with the youngest adults showing the highest rates. Students had the highest levels of severe depression.
Another study of infection risks related to schools, this one from Berlin. (Medrxiv Paper) The authors found very low rates of infections among students or staff and low risk of transmission.