"As scarce as truth is, the supply has always been in excess of demand." — Josh Billings

Coronavirus Vaccine & Herd Immunity Digest #1 by Bruce Brown

News & Commentary for People Planning to Survive the Coronavirus Pandemic

New and interesting Updated July 14, 2020

Past Digests

Good NewsBad News

Index of Articles in chronological order

Plague Doctor
A 1665 etching by Paul Fürst, entitled “Der Doctor Schnabel von Rom (“Doctor Nose of Rome), which depicts a plague doctor who treated victims of the medieval Bubonic plague, or Black Death. To ward off infection, the plague doctor wore a costume which cloaked and otherwise covered him from head to foot. The long, bird-like beak on the doctor’s face mask contained aromatic medicinals such as Thieves Oil, also called Venetian Treacle, which enabled the plague doctor to constantly breathe anti-infective vapors while treating the sick, an approach that might benefit modern plague doctors and nurses as well. A delightful detail is the little device at the end of the plague doctor’s wand: an hour glass with wings, signifying “time flies” (tempus fugat in Latin).

good news

March 17, 2020 – What exactly is herd immunity?, MIT Technology Review (Commentary)

According to the MIT Technology Review, when enough of the population is resistant to a germ, its spread stops naturally because not enough people are able to transmit it. Thus, the “herd” is immune, even though many individuals within it still are not.

Consider the Zika virus, a mosquito-borne illness that caused a epidemic panic in 2015 because of a link to birth abnormalities.

Two years later, in 2017, there was no longer nearly so much to worry about. A Brazilian study found by checking blood samples that 63% of the population in the northeastern beach city of Salvador had already had exposure to Zika; the researchers speculated that herd immunity had broken that outbreak.

Vaccines create herd immunity too, either when given widely or sometimes when administered in a “ring” around a new case of a rare infection. That’s how diseases like smallpox were eradicated and why polio is close to being erased. Various vaccine efforts are under way for this coronavirus, but they may not be ready for more than a year.

Even then, vaccine makers can find themselves in a losing race with nature to see which protects the herd first. That’s in part what happened in 2017, when drug maker Sanofi quietly abandoned a Zika vaccine in development after funding dried up: there simply wasn’t much of a market any longer.

For herd immunity to take hold, people must become resistant after they are infected. That occurs with many germs: people who are infected and recover become resistant to getting that disease again, because their immune system is charged with antibodies able to defeat it.

About 80,000 people have recovered from the coronavirus already, and it’s likely they are now resistant, although the degree of immunity remains unknown.

The point at which we reach herd immunity is mathematically related to the germ’s propensity to spread, expressed as its reproduction number, or R0. The R0 for the coronavirus is between 2 and 2.5, scientists estimate, meaning each infected person passes it to about two other people, absent measures to contain the contagion.

The current germ’s rate of spread is higher than that of the ordinary flu, but similar to that of novel emergent influenzas that have occasionally swept the globe before. “That is similar to pandemic flu of 1918, and it implies that the end of this epidemic is going to require nearly 50% of the population to be immune, either from a vaccine, which is not on the immediate horizon, or from natural infection,” according to Harvard University epidemiologist Marc Lipsitch.

The current epidemiological policies in most of the Western World now call for aggressive “suppression” of the virus by wearing face masks to limits the coronavirus’s spread, isolating sick people, and tracing their contacts.

However, there is an intrinsic downside to this approach.

“Suppressing transmission means that we won’t build up herd immunity,” says Azra Ghani, the lead epidemiologist on the new model of the outbreak from Imperial College London.

Ghani said the trade-off of success is “that we are driving it [herd immunity] down to such a low level that we have to keep those control [measures] in place.”

Commentary — the important take-away here is contained in the last two paragraphs, where Azra Ghani, epidemiologist at the Imperial College London, observes that the current “weak herd” approach being followed in the U.S. and much of the rest of the world is actually suppressing the very thing we desperately need right now, namely herd immunity to the coronavirus pandemic!

The “weak herd” approach also requires that economically devastating policies and totalitarian political controls be kept in place, permanently perhaps.

bad news

April 1, 2020 – The Coronavirus Patients Betrayed by Their Own Immune Systems, New York Times

The New York Times reports that a 42-year-old man arrived at a hospital in Paris on March 17 with a fever, cough and the “ground glass opacities” in both lungs that are a trademark of infection with the new coronavirus.

Two days later, his condition suddenly worsened and his oxygen levels dropped. His body, doctors suspected, was in the grip of a cytokine storm, a dangerous overreaction of the immune system. The phenomenon has become all too common in the coronavirus pandemic, but it is also pointing to potentially helpful drug treatments.

When the body first encounters a virus or a bacterium, the immune system ramps up and begins to fight the invader. The foot soldiers in this fight are molecules called cytokines that set off a cascade of signals to cells to marshal a response. Usually, the stronger this immune response, the stronger the chance of vanquishing the infection, which is partly why children and younger people are less vulnerable over all to coronavirus. And once the enemy is defeated, the immune system is hard-wired to shut itself off.

“For most people and most infections, that’s what happens,” said Dr. Randy Cron, an expert on cytokine storms at the University of Alabama at Birmingham.

But in some cases — as much as 15 percent of people battling any serious infection, according to Dr. Cron’s team — the immune system keeps raging long after the virus is no longer a threat. It continues to release cytokines that keep the body on an exhausting full alert. In their misguided bid to keep the body safe, these cytokines attack multiple organs including the lungs and liver, and may eventually lead to death.

In these people, it’s their body’s response, rather than the virus, that ultimately causes harm.

Cytokine storms can overtake people of any age, but some scientists believe that they may explain why healthy young people died during the 1918 pandemic and more recently during the SARS, MERS and H1N1 epidemics. They are also a complication of various autoimmune diseases like lupus and Still’s disease, a form of arthritis. And they may offer clues as to why otherwise healthy young people with coronavirus infection are succumbing to acute respiratory distress syndrome, a common consequence of a cytokine storm.

Reports from China and Italy have described young patients with clinical outcomes that seem consistent with this phenomenon. It’s very likely that some of these patients developed a cytokine storm, Dr. Cron said.

In the case of the 42-year-old patient, the suspected cytokine storm led his doctors to eventually try tocilizumab, a drug they have sometimes used to soothe an immune system in distress.

After just two doses of the drug, spaced eight hours apart, the patient’s fever rapidly disappeared, his oxygen levels rose and a chest scan showed his lungs clearing. The case report, described in an upcoming paper in Annals of Oncology, joins dozens of accounts from Italy and China, all indicating that tocilizumab might be an effective antidote to the coronavirus in some people.

On March 5, China approved the drug to treat serious cases of Covid-19, the disease caused by the coronavirus, and authorized clinical trials. On March 23, the U.S. Food and Drug Administration granted approval to the pharmaceutical company Roche to test the drug in hundreds of people with coronavirus infection.

Tocilizumab is approved to quieten the chatter of immune molecules in rheumatoid arthritis and in some types of cancer. It mutes the activity of a specific cytokine called interleukin-6 that is associated with an over-exuberant immune response.

“That’s the rationale for using the drug,” said Dr. Laurence Albiges, who cared for the patient at the Gustave Roussy Cancer Center in Paris.

bad news

April 4, 2020 — Coronavirus in Washington state: A timeline of the outbreak through March 2020, KIRO-TV

According to KIRO-TV in Seattle, WA,

Here is a timeline of the coronavirus outbreak in Washington state, from the day the first U.S. case was confirmed in Snohomish County through the end of March 2020, courtesy of KIRO-TV, Seattle.

On April 1, State Department of Health staff said there were 247 deaths from 5,984 cases through the end of March. Nationwide the U.S. death toll topped 5,000.

March 31

President Donald Trump said there could be between 100,000 and 240,000 deaths nationwide from the coronavirus. A quarantine site opened at Angel of the Winds Arena in Everett. Pierce County reported 26 new cases and no new deaths. Snohomish County reported 102 new cases, including two new deaths. The State Department of Health again did not have updated numbers and cited technical issues.

March 30

The Tokyo Olympics were rescheduled for July 23-August 8, 2021. Snohomish County updated their counts to 31 total deaths among 1,127 coronavirus cases. The Washington State Department of Health did not release an updated coronavirus case and death count. The State Attorney General warmed about scams related to the coronavirus.

March 29

Dr. Anthony Fauci said the U.S. could have millions of cases and more than 100,000 deaths from the coronavirus pandemic. King County issued a new order that threatened involuntary detention for those who refused to isolate after testing positive for the coronavirus. Public Health – Seattle and King County reported five new deaths and 82 new coronavirus cases. The Tacoma-Pierce County Health Department reported one new death and 36 new coronavirus cases. President Trump extended federal social distancing guidelines through April 30. Gov. Jay Inslee said Washington still needed more help from the federal government. Local animal shelters were closed. The Spokane Regional Health District reported two new deaths and seven new coronavirus cases in Spokane County. Michigan State Rep. Isaac Robinson, who represented a part of Detroit, died of a suspected coronavirus infection. The Washington State Department of Health increased their county to at least 195 deaths among 4,896 coronavirus cases.

March 28

Everett’s Angel of the Winds Arena was being converted to a coronavirus quarantine site. It was announced a King County Metro driver tested positive for the coronavirus. Gov. Jay Inslee and Seattle Mayor Jenny Durkan talked about the deployment of a new field hospital at the CenturyLink Field Event Center. The Tacoma-Pierce County Health Department reported 55 new cases there. One resident and five staff members at a long-term care facility in Skagit County tested positive for the coronavirus. Public Health – Seattle and King County reported 11 new deaths and 249 new coronavirus cases. The State Department of Health increased its counts to 189 deaths from 4,300 cases. The United States reached 2,000 deaths nationwide. Three of the largest homeless shelters in the Seattle area were closed. Three Seattle-area shelters closed after resident tests positive for the coronavirus.

March 27

President Trump issued an order allowing the Pentagon to reactivate former troops for the coronavirus response. The Department of Health updated its statewide count to 175 deaths from 3,700 cases. British Prime Minister Boris Johnson tested positive for coronavirus. The Army scouted CenturyLink Field as a possible field hospital.

March 26

Gov. Jay Inslee signed a proclamation effective immediately to provide payment for doctor’s appointments handled over the phone the same way that a claim for an in-person appointment would be handled. That prevented telemedicine claims from being denied by insurance companies. (Senate Bill 5385, passed by the State Legislature this year, would do the same thing, but wouldn’t take affect until January 2021.) More than 133,000 people in Washington filed for unemployment benefits in the previous week, The Associated Press reported. It was announced a record 3.3 million Americans filed new unemployment claims nationwide. State Department of Health numbers rose to 147 deaths from 3,207 cases. Of those cases, 15 deaths were reported as new. Whatcom County and Pierce County each reported two new coronavirus deaths. King County reported nine new deaths and 218 new cases. The United States overtook all other counties for the number of confirmed coronavirus cases. New York had the highest number of cases in a state with 519 deaths from 44,635 reported cases.

March 25

The State Department of Health’s numbers increased to 132 deaths from 2,580 cases. All non-essential businesses closed. The DOH also said 34,292 people were tested in Washington, and the 2,580 positive tests are 7% of those. Washington State University postponed its spring commencement. Federal officials reached a deal on a $2 trillion aid package. Public Health – Seattle and King County reported six new deaths, bringing the county total to 100. Home test kits also were launched in King County. Pierce County reported a second death. Snohomish County reported 20 new cases, but no new deaths. Prince Charles tested positive for the coronavirus.

March 24

The State Department of Health reported a new total of 123 deaths from 2,469 cases. The Tacoma-Pierce County Health Department reports 12 new cases, no new deaths. The Snohomish Health District reported five new deaths among 95 new cases. Public Health – Seattle and King County reported seven new “estimated” deaths among 107 new “estimated” cases. It was announced that a TSA officer at Seattle-Tacoma International Airport tested positive for the coronavirus. A Northwest group raised $27 million in 72 hours for local businesses and people impacted by the coronavirus. The Summer Olympics in Tokyo were postponed.

March 23

Boeing announced a temporary suspension of production at its Puget Sound facilities. In their daily update, the State Department of Health reported 110 deaths among 2,221 cases. In a 5:30 p.m. statewide address, Gov. Jay Inslee directed Washington residents to stay home by executive order. Inslee’s executive order had exceptions for essential critical infrastructure workers, including first responders. Grocery stores, pharmacies, convenience stores, liquor stores that sell food, food banks and farmers’ markets were among businesses that could stay open. People also could go outside for exercise, but Inslee also said people should not make a run on the grocery store to overstock. Supplies to grocery stores would continue, he said. The Snohomish Health District reported one new death among 39 new cases. The Skagit County Public Health reported the first coronavirus death there. The Tacoma-Pierce County Health District reported 19 new cases, no new deaths.

March 22

President Trump approved the state’s disaster declaration. Washington campgrounds were closed through the end of April. The mayor of Edmonds issued a stay-at-home order that started at 11:59 p.m. Rand Paul was the first U.S. Senator to test positive for the coronavirus. The Navy ship Mercy was sent to California instead of Washington. Elton Washington, 58, is the first Boeing worker known to die from the coronavirus. Gov. Jay Inslee named retired Navy Vice Admiral Raquel C. Bono as the director for the state’s COVID-19 Health System Response Management.

March 21

Pierce County reported 12 new coronavirus cases. The Department of Health updated its statewide count to 94 deaths from 1,793 cases. Of those, 74 deaths were in King County deaths from 934 cases. King County converted Harborview Hall into a recovery center for up to 45 people. That became the fourth King County recovery center. Gov. Jay Inslee diverted masks being sold on shelves at local Target stores to Washington health care workers in need of safety equipment. Target apologized, saying the N95 masks were available for purchase in error. Local grocery stores started special hours for seniors. The State Department of Corrections announced plans to produce protective hospital gowns to help with the nationwide shortage. Seattle temporarily eased some parking restrictions. Everett’s mayor issued a directive instructing all residents to stay home starting Monday.

March 20

The Department of Health updated their statewide count to 81 deaths from 1,512 cases. King County announced 100 new cases and seven new deaths. Pierce County had eight new cases; Thurston County had two new cases; Snohomish County had 37 new cases and one new death Friday. Inslee sent a letter to President Trump requesting a federal major disaster declaration. The U.S. deadline to file taxes was pushed back to July 15. Non-essential travel was restricted between US and Mexico border. President Trump said people with student loans can suspend payments for 60 days without interest. A member of Vice President Mike Pence’s staff tested positive for the coronavirus, but other staff said the positive person did not come in contact with Pence or President Donald Trump. Gov. Jay Inslee did not issue a shelter-in-place order during his Friday afternoon news briefing, but said he could take legally binding action if people did not take proper steps for social distancing. Inslee said Washington state needed powerful volunteers and social pressure to make proper distancing decisions that would avoid additional measures. Inslee also said 1.6 million N95 masks – the kind used by health professionals to block spread of the coronavirus – would be arriving in Washington as early as March 22. Playgrounds and sport courts across King County were closed. Fields were open for non-team activities. The mayor of Everett issued a directive Friday instructing all residents to stay home, with exceptions for essential activities. The order, which takes effect at noon Monday, tells everyone to stay home except for necessary errands, walks and caring for friends and relatives. Essential businesses, such as grocery stores, pharmacies, child care and banks, can remain open. Nonessential business owners were directed to stay home.

March 19

The Department of Health reported at least 74 deaths from 1,376 coronavirus cases. The first death in Lewis County was announced. Pierce County announced 19 new coronavirus cases, but no new deaths Thursday. Snohomish County announced one more death, moving its total to seven. President Trump said the Food and Drug Administration was fast-tracking approval of antiviral treatments for coronavirus. A Shoreline soccer field was being converted to a site to treat future coronavirus patients. All clam digs in Pacific County were canceled indefinitely by the deputy health officer there. The Whatcom County Health Department reported the first death in that county, a man in his 60s. A Kitsap County sheriff’s corrections officers tested positive for the coronavirus. The Washington State Department of Commerce made $30 million in funding available to every county under a new grant in response to the coronavirus pandemic. The Washington Distillers Guild announced several small, family-owned distilleries have banded together, converting their operations to make thousands of gallons of hand sanitizer for nurses and doctors taking care of patients. King County Metro announced it will temporarily reduce transit services starting Monday in response to the coronavirus pandemic. The city of Sammamish announced it will begin closing all park playgrounds and the Sammamish Commons Skate Park until further notice. WorkForce Central announced it will temporarily close its doors until further notice. The Fairmont Olympic Hotel announced it will temporarily close starting Sunday in response to limit the spread of the coronavirus.

March 18

Johns Hopkins University confirmed coronavirus cases topped 200,000 worldwide. Seattle restaurants that initially tried to continue with take-out announced closures. Grocery stores limited the number of people allowed in at a time. President Trump said the U.S. would close the border with Canada for non-essential traffic. Canlis, which started a drive-thru option on March 16, had an overwhelming response of people wanting $14 burgers and the $12 Canlis salad. The U.S. Census Bureau suspended all field operations until April 1. President Trump announced he’d invoke the 1950 Defense Production Act to ensure medical professionals had essential supplies. The Tacoma-Pierce County Health Department reported the county’s first coronavirus death. The state Department of Health numbers increased to 66 deaths from 1,187 cases, not including the Pierce County death. Inslee announced a 30-day statewide moratorium on evictions. The Seattle International Film Festival was cancelled. The Washington Department of Social and Health Services confirmed a patient at Western State Hospital in Lakewood tested positive for COVID-19. The Thurston County Board of Commissioners announced county facilities will close from March 19 through April 3. The University of Washington announced Wednesday that it has extended its remote instruction through the spring quarter. Clallam County announced its first confirmed case of COVID-19. Some residents called for a shelter-in-place order.

March 17

The Department of Health’s updated numbers had at least 1,009 cases statewide with 54 deaths. Inslee signed multiple coronavirus relief bills. A University of Washington faculty member tested positive for the coronavirus, bringing the number of cases in the campus community to nine. A new coronavirus site was setup in Burien. Coronavirus cases were confirmed in all 50 states.

March 16

The total number of coronavirus cases in Washington state was 904 with at least 48 deaths, according to the Department of Health. A Seattle woman became the first person in the country to receive an experimental coronavirus vaccine through Kaiser Permanente. Canadian Prime Minister Justin Trudeau closed the border to non-citizens amid the pandemic. It was announced an Evergreen Health emergency room doctor tested positive, and that doc in his 40s was in critical but stable condition.

March 15

The death toll in the state reached 42, with 772 confirmed cases. Public Health – Seattle & King County reported 37 deaths and 420 confirmed cases in the county, with 29 of the deaths linked to Life Care Center of Kirkland. Gov. Inslee announced that all entertainment and recreational facilities, including gyms, will close, as well as bars and restaurants; however, restaurants will be allowed to do take out and delivery. King County health officials warned the blood supply could collapse due to the emergency. Starbucks announced it is temporarily closing some stores nationwide for at least two weeks and will shift others to a to-go model. A Pike Place community member tested positive for the coronavirus, as well as a Sounders FC support staffer. An EvergeenHealth physician was diagnosed with COVID-19. Seattle temporarily suspended farmers markets to reduce the coronavirus spread. Gov. Jay Inslee’s statewide school closure will take effect Monday. A second Washington State Department of Corrections employee tested positive for the coronavirus. UW Medicine announced it plans to expand its ability test for the coronavirus starting Monday. Royal Caribbean suspended services through April 10. QFC announced it is hiring and will hold a hiring event Monday in downtown Bellevue. Washington’s ban on crowds will not apply to the state’s ferry system. The Federal Reserve cut short-term interest rates to zero. Washington Rep. Derek Kilmer will push for more help for people affected by the economic fallout from the pandemic and has introduced the Coronavirus Worker Relief Act.

March 14

The Washington State Department of Health reported 40 deaths and 642 confirmed cases of coronavirus. Public Health – Seattle & King County reported 60 new cases, bringing the case count in the county to 388. Three new deaths were reported, bringing the county total to 35. Seven new COVID-19 cases were announced in Pierce County. Laboratory tests have been made more broadly available. King County health officials said anyone with a fever and cough should assume their illness could be COVID-19. Forty-Seven Life Care workers tested positive for the coronavirus. King County added more temporary housing for people exposed to the virus. UW reached its testing capacity with 2,360 people tested. The U.K. and Ireland were added to the travel ban for passengers flying from Europe to the U.S. Seattle Municipal Court confirmed a staff member tested positive for coronavirus. A Seattle City Attorney’s Office employee was diagnosed with the coronavirus, forcing the closure of the office for at least one week. Fire Station 21 in Kirkland is back in service after undergoing an eight-hour deep clean Friday. Spokane health officials announced three confirmed cases of COVID-19. Comcast offered free access to Wi-Fi hotspots in response to the coronavirus emergency. Summit at Snoqualmie closed ticket sales until further notice. Crystal Mountain and Steven Pass resorts announced they would temporarily shut down. Shoreline Community College said it would shift to remote operations Sunday. University of Washington Medicine postponed elective surgeries as it is faced with an unprecedented need to respond to the coronavirus pandemic. A Seattle Dragons XFL player tested positive for the coronavirus, the team confirmed. The Pac-12 Conference canceled all spring sports and championships amid coronavirus concerns.

March 13

Evergreen Health Hospital announced it is canceling elective surgeries per CDC guidelines. Critical and necessary surgeries will still take place. The hospital said the elective surgeries are being suspended to conserve resources, people and supplies. A coronavirus patient in Kent left the quarantine facility unauthorized. The person later tested negative. President Trump declared a national emergency. Inslee said all Washington schools would be closed until April 24, so the first day back would be April 27. The Washington death count went up to 37 from 570 cases. The Washington State Office of the Secretary of State announced it will suspend public access to critical in-person services until further notice but will remain fully operational. Dr. Jeff Duchin, public health officer in Seattle and King County, tweeted Friday evening that, “All hospitals need to urgently prepare for a surge in critically ill patients.” Officials with Seattle Children’s Hospital said it is limiting visitors to a maximum of two primary caregivers for each patient to help protect against possible exposure to the coronavirus. King County Metro ridership declines as the public heed the guidance of health officials. Seattle Mayor Jenny Durkan prepares to sign an emergency order, ensuring renters are not evicted during the coronavirus emergency. A second University of Washington student in as many days has tested positive for the coronavirus. An employee at the Monroe Correctional Facility tested positive this week for COVID-19.

March 12

The statewide death count increased to 31 from 457 total cases. King County had 27 of those deaths from 270 cases. Gov. Jay Inslee said all schools in King, Pierce and Snohomish counties would close through April 24. Some Seattle hospitals banned visitors. The NHL suspended its season. Stock futures were halted for the second time this week. Princess Cruises halted sailing for 60 days. The Pac-12 men’s basketball tournament was canceled, and the NCAA championships also were canceled. President Trump said restricting domestic travel to Washington state is a possibility, though it’s not been discussed, The New York Times reported. The Washington Department of Corrections stopped visits and limited events in prisons. Seattle Mayor Jenny Durkan said all library locations and community centers would be closed starting March 14 until at least April 13. Some casinos will stay open. Canadian Prime Minister Justin Trudeau’s wife, Sophie Trudeau, has tested positive for the new coronavirus. A University of Washington graduate student tested positive for the coronavirus, according to the UW Advisory Committee on Communicable Diseases. The Space Needle temporarily suspended its operations until March 31. King County Metro temporarily ceases its fare enforcement inspections in response to the coronavirus outbreak. Antioch University announced that all of its classes will move to remote learning. Boeing said it was going on a hiring freeze amid the coronavirus crisis. The Seattle Art Museum announced it would temporarily close its three sites effective Friday until March 31.

March 11

The World Health Organization declared the coronavirus outbreak a pandemic. Inslee banned gatherings of more than 250 people in King, Pierce and Snohomish counties, including weddings. The NCAA announced March Madness games would be played without fans. Seattle Public Schools announced a closure through the end of March. The Shoreline and Lake Washington school districts also closed through the end of March. Everett and Bellevue public schools announced a closure for the month starting March 13. Schools in the Archdiocese of Seattle announced closures from March 16 until the end of the month. The Monroe School District announced all schools would close for six weeks, starting Friday. The Sounders postponed their March 21 match, and the Mariners were working with Major League Baseball on how to handle games. The Woodland Park Zoo closed for the month. The death toll rose to 31 deaths from 374 confirmed cases statewide. That included 27 deaths from 235 cases in King County. Of those deaths, at least 23 were linked to Life Care Center in Kirkland. The Snohomish County toll increased to three deaths from 75 cases. The coronavirus was known to have spread to 13 Washington counties. State health officials also said 36 confirmed coronavirus cases were not yet assigned to a specific county. Luise Weatherill, 85, is the first person officially announced as a coronavirus victim by the King County medical examiner, though her death is not the first from the coronavirus in King County. Weatherill was first identified by her son, Mike, outside Life Care Center during the March 5 family briefing with reporters. Tom Hanks and his wife, Rita Wilson, announced they had the coronavirus. President Trump announced Wednesday a 30-day travel ban on all incoming travel from Europe, except for the U.K. The ban begins Friday and applies to foreign nationals who have been in 26 European countries with open border agreements and have been in the countries in the last 14 days. U.S. citizens are exempt and will be directed to airports where screening can take place. The NBA suspended games. On Wednesday, Sen. Maria Cantwell closed her D.C. office after a staff member tested positive for the coronavirus. The person has been in isolation since symptoms started. That person has not had any known contact with the senator or other members of Congress.

March 10

The new statewide coronavirus case number, as reported by health officials, reached at least 269. There were two new deaths reported in King County and 74 new cases there. The Snohomish Health District reported 17 new coronavirus cases, bringing its total to 54. It also announced a presumptive positive case at a Stanwood caregiving facility. There were reports that Inslee would ban gatherings of 250 people or more. Amazon announced a $5 million grant to help businesses impacted by the coronavirus. Trevor Bedford, a computational biologist at Fred Hutchinson Cancer Research Center, and collaborators at the University of Washington and the Institute for Disease Modeling were looking at the genome sequencing of 18 cases and the infection rate in the recent Seattle Flu Study. Based on that data, they believed there could be 1,100 active infections, Bedford told The Associated Press.

March 9

The statewide death toll increased to 22 deaths. Jefferson County confirmed its first coronavirus case, which was a man who visited Life Care Center in Kirkland and traveled back to Jefferson County. The State Department warned about cruise ship travel. The number of deaths linked to Life Care Center in Kirkland increased to 19. University of Washington Medicine explained plans to let some people be tested in their cars. Stocks plunged 7% on Wall Street, triggering a 15-minute trading halt. It was the Dow’s worst day since the 2008 recession.

March 8

A U.S. Department of Health and Human Services strike team started work at Life Care Center, the epicenter of the coronavirus outbreak in King County. Clark County confirmed its first case of the coronavirus after a man in his 70s tested positive for the virus. Inslee said Washington officials were considering mandatory social distancing measures to combat the coronavirus. The statewide totals increased to 123 people in eight Washington state counties. Grant County reported its first coronavirus death. King County announced two more coronavirus deaths.

March 7

For the first time since its start in 1972, the St. Patrick’s Day parade in Seattle and Irish Week events were canceled. The Washington coronavirus death total increased to 16, and there were at least 102 confirmed cases statewide. Starbucks closed a downtown Seattle store after learning an employee was diagnosed with the coronavirus.

March 6

Emerald City Comicon, which brings tens of thousands of visitors to Seattle and tens of millions of dollars to the local economy, was postponed. The University of Washington announced classes would no longer meet in person beginning the following Monday. That was the plan through the end of winter quarter. Seattle University, Seattle Pacific University and Bellevue College also announced classes would no longer meet in person. Pierce County health officials announced the first confirmed coronavirus case there. The SXSW festival was canceled in Austin, Texas. Other large events locally and nationally were canceled. Kent’s mayor announced a plan to file a restraining order to stop the county from turning the former EconoLodge into a quarantine shelter. A King County Superior Court judge sided with King County, and plans moved forward. Winter graduation at Western Washington University was canceled. The Ida Culver House, at 2315 N.E. 65th St. in Seattle, also reported a positive coronavirus case. That man, Kenneth Robert Hunt, 86, had underlying health issues and died March 9.

March 5

The death toll increased to 11. A CenturyLink Field employee who worked the Feb. 2 Seattle Dragons game tested positive for the coronavirus. The total case number increased to 70 statewide. That included 10 deaths from 51 cases in King County; 18 cases and one death in Snohomish County; and one death in Grant County. Snohomish County and Everett officials declared a state of emergency. Copays and deductibles for coronavirus testing were waived by emergency order in Washington state. Monroe School District schools closed. Vice President Mike Pence landed in Washington and met with Gov. Jay Inslee. Families of Life Care Center patients in Kirkland talked about the deaths of their parents from the coronavirus and said staff members were overwhelmed. One said the report that people were quarantined there was false. Amazon employees in Seattle and Bellevue whose jobs can be done remotely were advised to work from home. Microsoft, Nordstrom and Starbucks corporate offices and Boeing also gave the same advice to workers.

March 4

The coronavirus death toll in Washington state increased to 10. King County bought the EconoLodge in Kent to quarantine coronavirus patients. Kent’s mayor objected. Most employees at Fred Hutch Cancer Research Center in Seattle were told to stay home all month for nonessential work. King County Executive Dow Constantine recommended that pregnant people and people over 60 with underlying health conditions avoid crowds.

March 3

The Washington state death toll increased to nine. Life Care in Kirkland, at 10101 N.E. 120th St., was the epicenter of the outbreak. A new coronavirus case in North Carolina was linked to King County after the person visited Life Care. Seattle’s Homeland Security/immigration building closed after concerns an employee was exposed to the coronavirus. That case was later confirmed. Additional schools announced closures, including the Northshore School District, for up to 14 days. Seattle Mayor Jenny Durkan declared a state of emergency.

March 2

The coronavirus-related death count increased to six in Washington state. Public Health – Seattle and King County reported 14 new coronavirus cases, including five deaths. A student petition to close the University of Washington drew thousands of signatures. The Puyallup School District closed two schools for deep cleaning, and two North Sound schools closed. The F5 tower in downtown Seattle announced a Monday closure because of coronavirus concerns. Two Kent schools announced Monday closures.

March 1

A local postal service employee tested positive for the coronavirus. A man in his 70s with ties to Life Care Center of Kirkland was the second person to die from the coronavirus in King County. More schools announced closures, including Hazen High in Renton. Local Costcos were packed with people stocking up on toilet paper and supplies, and some locations sold out.

Feb. 29

At 9:38 a.m., Public Health – Seattle and King County confirmed the first coronavirus-related death in Washington, which also was the first in the United States. Word of the death was initially emailed to staff at EvergreenHealth in Kirkland, where the first patient died. Dozens of residents reported symptoms at Life Care Center in Kirkland, roughly 20 miles from downtown Seattle, and the first death was linked there. Jackson High School announced a Monday closure after a student had a presumptive positive test. Two people treated for the coronavirus at Sacred Heart Medical Center in Spokane were released Jan. 21. Health officials said Feb. 29 that what we’re seeing is the tip of the iceberg.

Jan. 21

The first coronavirus case in the United States was confirmed in Washington state. The patient recently returned from Wuhan, China, where a pneumonia outbreak caused by the coronavirus started in December 2019. The person who returned to the United States did so Jan. 15. “While originally thought to be spreading from animal-to-person, there are growing indications that limited person-to-person spread is happening,” a news release from the Centers for Disease Control and Prevention said. “It’s unclear how easily this virus is spreading between people.”

bad news

What Disease Are We Treating?’ Why Coronavirus Is Stumping Many Doctors, New York Times, 4/14/2020

According to this New York Times video news production by Robin Stein and Ainara Tiefenthaler, doctors say the coronavirus is challenging core tenets of medicine, leading some to abandon long-established ventilator protocols for certain patients. But other doctors warn this could be dangerous.

Commentary: This New York Times video is one of the very best, most powerful, and NEWSWORTHY reports that have appeared in the entire coronavirus saga.

The surface narrative here is driven by a series of cinéma vérité interviews with off duty doctors who admit, over and over, that they don’t know how to treat COVID-19, or even what disease they are treating (hence the video’s title).

“This thing is different than anything we’ve seen before,” said Dr. Salim R. Reasie, a San Antonio, TX, ER physician. “The paradign for ARDS is just not matching what we’re seeing [with COVID-19]. So it’s like trying to fit a square peg into a round hole.”

Said Dr. David A. Farci, presient American Academy of Emergency Medicine, “this thing challenges everything we believed was right six weeks ago.”

“I mean, this is strange. It’s like out of some horror movie,” mused Dr. Cameron Kyle-Sidell, a Brookyn, NY, ER doctor.

The doctors, several of whom appeared exhausted, freely acknowledged that what they have been trained to do — the protocols established by modern medicine — are not working with COVID-19, e.g., the use of ventillators for patients with low blood oxygen, as was widely prescribed at the outset of the pandemic.

Farci, Reasie, Kyle-Sidell and the others in this video were among the first physicians to speak in the popular press of coronavirus’s frightening capacity to produce hemantic derrangement, or the cytopic storm phenomenon, where a “storm of the blood” creates thousands of tiny clots that can cripple and/or damage virtually any organ, especially the lungs.

“Today, we do not rush to intibation (ventilate),” said Farci. “Intubation has become the last resort.”

“So, within the last two weeks what was unacceptible has become very acceptible,” said Dr. Richart Harper, ER physician in Davis, CA.

Dramatic on-screen interviews. Conflicting ideas at play against the backdrop of high human drama. And an important breaking turn in the story of the century.

This New York Times video news piece by Robin Stein and Ainara Tiefenthaler has just about got it all!

Princess of the Universe, a novel by Hale FellowMountain in the Clouds by Brucve BrownSaga In Itself - The Filming of Never Cry Wolf by Bruce Brown100 Voices from the Little Bighorn by Bruce Brown
Some books from BF Communications, Amazon Kindle editions

bad news

May 8, 2020 – COVID-19 is like three different diseases, says New York doctor, from flu-like illness to severe reactions and rare children’s syndrome, ABC Net of Australia (Commentary)

ABC Net of Australia writes that almost 10 weeks into the pandemic, COVID-19 is continuing to surprise and baffle health experts.

In fact, experts’ picture of exactly how COVID-19 might play out in the body is now quite different to what was thought as little as a few weeks ago, with some experts saying it could be better described as three different diseases.

We have known for a while that the mild to moderate form of the disease — a flu-like illness with fever, muscle aches and respiratory symptoms, or often no symptoms at all — is almost like “child’s play” compared to the major damage to organs like the the lungs, heart, brain, and kidneys seen when COVID-19 becomes severe.

Umesh Gidwani, head of cardiac intensive care at New York’s Mount Sinai Hospital, says that trying to treat the severe form of the disease is like facing a terrifying fire, burning out of control.

“The patients we take care of [in intensive care] are those in whom the fire has already destroyed the house. But there continues to be embers and small fires. I can’t enter the house because it’s too hot and things are falling on me,” he says.

“[Severe disease] is almost a completely different animal [compared] to someone who is recovering at home with some chicken soup and paracetamol”.

And now it seems there is evidence of a third variation in illness that can occur following exposure to the virus — a mysterious new disease given the name paediatric multisystem inflammatory syndrome, with an entirely different set of symptoms again.

The syndrome seems to only affect children, unlike both mild and severe COVID-19, which mostly affect adults. However the link between the inflammatory syndrome and the virus that causes COVID-19 is not yet 100 per cent confirmed.

The bottom line, says Dr Gidwani, is what we have been calling a single disease — COVID-19 — is really looking more like three separate diseases.

He and others draw this conclusion based on how the virus affects the immune system.

“The key disaster is the extent and severity of the immune response,” he says.

It is now clear the symptoms experienced by people with severe COVID-19 are largely caused by the body’s disordered immune response to the virus rather than the virus itself, Dr Gidwani says.

In fact, the disordered immune response in severe COVID-19 is the disease; they are one and the same thing.

In contrast, with mild to moderate COVID, the immune response is more measured, with symptoms largely confined to the upper respiratory tract.

But with severe COVID-19, the body’s response to the infection goes into overdrive. In particular, substances called cytokines, which tell other parts of the immune system there is a problem that needs fixing in the body, and which coordinate the immune response, are released in excessive amounts.

This creates what’s known as a “cytokine storm”, which ends up causing damage to healthy tissue.

Doctors have seen similar cytokine storms in people with different kinds of infections or with certain cancers. But the cytokine storm with COVID-19 is wildly different.

As a result, therapies that work for the other cytokine storms don’t control the problem, Dr Gidwani says.

“My brain is thinking ‘what is going on? Is there a way to fix this?’ I don’t know what to do,” he says.

“It is very challenging, very frustrating, very upsetting.”

‘This is a brand new disease’

Understanding what makes the cytokine storm unique in severe COVID-19 is important as it means there may need to be a different approach to helping patients get better.

“This is a brand new disease. We are seeing more and more that the therapies we are used to working with don’t necessarily produce the same results with COVID,” Dr Gidwani says.

One important difference is that the cytokine storm in severe COVID-19 results in widespread blood clotting, which can in turn trigger heart attacks, strokes, deep vein thrombosis (DVT), pulmonary embolisms (clots in veins in the lungs) and limbs so damaged they may need to be amputated.

What’s more, Dr Gidwani says the surge in cytokines can last up to 45 days and can wax and wane. Patients may show an improvement, then a worsening — a pattern that can be repeated several times, often for weeks on end.

This can lead doctors to misjudge how sick a patient is and withdraw supportive measures such as a ventilator before they should.

“It is important to realise this is a distinct [immune] syndrome and that you can therefore avoid certain pitfalls,” says Dr Gidwani.

“This is not what we expected at the outset.

“But we never knew what to expect. I don’t know what will happen next either.”

Over-activation of the immune system could be a major “unifying element” that explains a large part of why the disease can play out in such different ways in severe COVID-19 and in PMIS, says Australian cardiologist and blood vessel researcher Jason Kovacic.

An immune attack on blood vessels potentially explains many of the key dangerous features of both conditions, says Dr Kovacic, who is Professor of Medicine and Cardiology both at New York’s Icahn School of Medicine and the Victor Chang Cardiac Research Institute at the University of NSW.

Rare mysterious illness in children

Paediatric multisystem inflammatory syndrome is an entirely different set of symptoms but it is nonetheless a “post-COVID-19” disease, Dr Gidwani says.

Symptoms may include fever, swollen hands and feet, a red rash that can occur on the skin around the lips and eyes, abdominal pain, diarrhoea and vomiting, resembling a rare condition called Kawasaki disease, thought to be triggered by infections.

But it is inflammation of the heart and blood vessels supplying it that make the condition potentially deadly.

Australian health authorities have pointed out the link between the syndrome and COVID-19 is unclear because not all affected children were positive in tests for current or past infection with the virus.

But it’s known “false negatives” — where no signs of current or past virus exposure are detected when that is not actually the case — can occur with these tests.

In all likelihood, the minority of cases who did not show a link with COVID-19 were in fact just undiagnosed cases because of inaccuracies with the tests, says Dr Gidwani.

Further investigation is underway to explore this idea.

The illness has appeared in 102 children from newborns to teenagers in the US in past two months, killing at least three.

Two of those died at Mount Sinai Hospital. Additional cases have been reported in the UK, Spain, France, Netherlands and Italy.

“All of these kids [with paediatric multisystem inflammatory syndrome] have some sort of inflammation of the blood vessels,” Dr Gidwani says.

“It is not due to the COVID itself but to an overblown immune reaction following COVID exposure.”

Immune attack may explain both conditions

In this sense, paediatric multisystem inflammatory syndrome seems similar to severe COVID-19, in that it is the result of a disordered immune response, triggered by the virus.

But the timing and nature of the immune response is different in the two conditions (with different outcomes in terms of symptoms).

In severe COVID-19, which occurs in about 10 per cent of patients, the immune over-activation usually occurs eight to 10 days after symptoms begin.

In the children’s syndrome, it seems the immune over-activation occurs either late in the course of infection, or after the virus has been cleared from the body.

“These kids have escaped the symptoms of the acute infection but they may not have escaped the post-infectious reaction to the virus.”

The condition is much rare than severe COVID, and it is thought that children who develop it may have unusual genetic vulnerabilities.

“Only a very small number of kids who get COVID exposure will get this,” Dr Giwani says.

“We do not have a good handle on what the number is but it’s pretty clear it is extremely rare.”

While treatments for the unique cytokine storm in COVID-19 are currently limited, recognising that it is new and different is nonetheless a vital first step towards tackling the problem and saving lives, Dr Kovacic says.

“It is a very, very, scary virus.”

Dr Gidwani agrees.

Australians should “thank God” they have not seen the devastation he has witnessed in New York.

“I do not wish it on anyone,” he says.

Commentary — This excellent story by ABC Net of Australia was one of the first to describe the many faces of COVID-19, which was initially thought to merely be “the flu on steroids.”

good news

June 7, 2020 — Are we underestimating how many people are resistant to Covid-19?, The Guardian writes that during the first wave of the Covid-19 pandemic, cities were in general affected worse than smaller conurbations or rural areas. Yet in Italy, Rome was relatively spared while the villages of Lombardy experienced very high rates of sickness and death. Then again, one Lombard village – Ferrara Erbognone – stood out for not recording a single case of Covid-19 at the height of the wave. Nobody knows why.

The puzzle is not just Italian. From the beginning, Covid-19 struck unevenly across the globe, and scientists have been trying to understand the reasons. Why are some populations or sectors of a population more vulnerable than others? Or to turn the question around, why are some groups relatively protected?

In the Observer last weekend, neuroscientist and Covid-19 modeller Karl Friston of University College London suggested – on the basis of his comparison of German and British data – that the relatively low fatality rates recorded in Germany were due to unknown protective factors at play. “This is like dark matter in the universe: we can’t see it, but we know it must be there to account for what we can see,” he said.

While this is a novel view – most experts praise Germany’s lockdown and systematic testing regime – others are working hard to identify factors which are modulating the spread of Covid-19 and in doing so could explain other puzzles – such as why Japan seems to have avoided a lethal first wave despite its relatively old population and lacklustre public health response, or why Denmark, Austria and the Czech Republic have reported no surge in cases despite their early easing of lockdown measures. That could shape how governments manage the risks of a second wave.

One thing seems clear: there are many reasons why one population is more protected than another. Theoretical epidemiologist Sunetra Gupta of the University of Oxford thinks that a key one is immunity that was built up prior to this pandemic. “It’s been my hunch for a very long time that there is a lot of cross-protection from severe disease and death conferred by other circulating, related bugs,” she says. Though that cross-protection may not protect a person from infection in the first place, it could ensure they only experience relatively mild symptoms.

Gupta’s hunch has remained just that, because of the lack of data on immunity to Covid-19. Antibody testing, as we know, was slow to get going and unreliable to begin with, and the results to date suggest that the percentages of populations carrying antibodies to the Covid-19 virus are often in single or low-double digits. New, more sensitive antibody tests that have become available in recent weeks could soon provide a much more accurate picture if deployed widely enough, but there are already hints that the results to date may be underestimates.

First there was evidence based on diagnostic testing of postmortem samples from patients who died in December that the virus was circulating in western countries – notably France and the US – about a month earlier than was initially thought. New research shows that another component of the human immune response – T cells, which help orchestrate the antibody response – show memory for coronavirus infection when exposed to Sars-CoV-2, the virus that causes Covid-19.

In a paper published in Cell on 14 May, researchers at the La Jolla Institute for Immunology in California reported that T cells in blood drawn from people between 2015 and 2018 recognised and reacted to fragments of the Sars-CoV-2 virus. “These people could not have possibly seen Sars-CoV-2,” says one of the paper’s senior authors, Alessandro Sette. “The most reasonable hypothesis is that this reactivity is really cross-reactivity with the cousins of Sars-CoV-2 – the common cold coronaviruses which circulate very broadly and generally give rather mild disease.”

The finding supported an earlier one from a group at the Charité hospital in Berlin, detecting T cell reactivity to proteins in the Sars-CoV-2 virus in 83% of Covid-19 patients but also in 34% of healthy volunteers who had tested negative for the virus itself.

David Heymann, an epidemiologist at the London School of Hygiene and Tropical Medicine who advises the World Health Organization on Covid-19, says these results are important, but cautions that cross-reactivity doesn’t necessarily translate into immunity. To determine whether it does would involve following a large number of people who show such cross-reactivity to see if they are protected, if not from infection with Covid-19, then at least from severe forms of the disease.

It is, however, a reasonable hypothesis that exposure to other coronaviruses could confer protection, Sette says. “We’ve seen it before, for example with the 2009 H1N1 flu.” Older people fared well compared to other age groups in that pandemic, he says, probably because their immune systems had been primed by exposure to similar flu strains from decades before. That could be the reason the 2009 pandemic was less lethal than other flu pandemics in history, killing an estimated 200,000 people globally.

If exposure to other coronaviruses does protect against Covid-19, Gupta says, then variability in that exposure could explain much of the difference in fatality rates between countries or regions. Exposure to the related virus that caused the epidemic of severe acute respiratory syndrome (Sars) in 2002-4 might have afforded some protection to east Asians against Covid-19, for example.

In late March, Gupta’s group published a paper that drew attention because it generated very different forecasts from those of epidemiologist Neil Ferguson of Imperial College London and his colleagues – to whom the UK government was listening most closely. The Oxford group suggested that up to half of the UK population could already have been infected by Sars-CoV-2, meaning the infection fatality rate (IFR) – the proportion of infected people who went on to die – was much lower than Ferguson’s group was indicating, and the disease was therefore less dangerous. Neither group had much data at that point, and Gupta says that her intention was to highlight that, in the absence of data, a wide range of scenarios should be considered.

Two months on, she stands by her model, but wishes that she had made its implications clearer. “The truth is that the IFR is not a hardwired property of the virus or of our interaction with the virus,” she says. “It’s the vulnerable fraction [of the population] that is determining the average overall risk of dying.” Once an elderly care home is infiltrated by the virus, for example, the virus spreads rapidly through it and is often lethal, pushing up the IFR. This means it is critical to understand why some people are resistant and others are not, so that those who are vulnerable can be protected.

We know some of those vulnerability factors. Age is the most obvious one. Unlike with the 2009 flu, elderly people are particularly vulnerable to Covid-19 – a fact that might reflect the history of exposure to coronaviruses of different age cohorts. Comorbidity is another, and a third is being male. According to Garima Sharma of Johns Hopkins University School of Medicine in Baltimore, who with colleagues recently published a paper on sex differences in Covid-19 mortality, women are protected by virtue of having a “backup” X chromosome. “X chromosomes contain a high density of immune-related genes, so women generally mount stronger immune responses,” she says.

Socioeconomic status, climate, culture and genetic makeup could also shape vulnerability, as could certain childhood vaccines and vitamin D levels. And all of these factors can vary between countries. The Japanese might have been afforded some protection, for example, by their custom of bowing rather than shaking hands. And though most of the disparity between the sexes is down to biology, Sharma says some of it is due to social and behavioural factors, with women being more likely to wash their hands and seek preventive care.

It is also becoming clear that protecting the vulnerable has made a big difference to outcomes so far. Italy and Germany, for example, have similar proportions of over-65-year-olds – just over 20% of the population in both cases – and yet the two have reported strikingly different fatality rates. The case fatality rate (CFR) – the proportion of the sick who go on to die – is less informative but easier to measure than the IFR, because sick people are more visible than merely infected ones, and as at 26 May the CFR in Italy was about 14%, compared to 5% in Germany.

Italy is more densely populated than Germany, and Italian homes tend to be smaller than German ones. Many Italians in their 20s and 30s live at home with their extended families, which meant that transmission to the elderly was high and, when critical care units were overwhelmed, so were deaths. This is rarer in Germany, where many elderly care homes also enacted a strict isolation regime. In Germany, says Heymann, “they did a better job in keeping the elderly protected”. Some estimates suggest that only 20% of German Covid-19 cases were over 60, as compared to more than 90% in Italy.

The UK, which has recorded the second highest death rate from Covid-19 after Spain, has not looked after its elderly so well – deciding at one point to discharge patients from hospitals back to care homes without testing them for the disease. The government’s advice to 1.5 million UK citizens with underlying health conditions to self-isolate for three months from late March may have helped protect those people, but for Gupta the UK’s high death rate reflects a deeper problem – years of erosion of community support services that provided pastoral care. “There is just not enough investment in the NHS and in that GP or other frontline individual who advises the vulnerable person,” she says.

Holding to her hunch, she believes that lockdown was an overreaction and that frontline care and protection of the vulnerable – which should have been a priority from the beginning – should be prioritised now. She also thinks that the worst is behind us, and that while subsequent waves can’t be ruled out, they will probably be less bad than what we have experienced so far. The disease will settle into an endemic equilibrium, in her view, perhaps returning each winter like a seasonal flu.

Friston’s models also suggest that immunity in the population is higher than data indicates, but for him it’s not clear how long that immunity will last – and he argues that test-and-trace protocols should be put in place now, ahead of any possible second wave that might erupt once that immunity drops off. Heymann remains wary of models, which he says have too often been mistaken for reality in this pandemic, and he awaits more data: “I don’t think anybody can predict the destiny of this virus at this point in time,” he says.

bad news

June 8, 2020 – Your blood type could affect your risk from Covid-19, Advisory.com

Advisory.com reports that researchers already have determined that a person’s age and whether they have certain underlying health conditions can affect their risk of developing a severe case of Covid-19, the disease caused by the new coronavirus. But now, some research suggests a person’s blood type may be another factor in whether they have a higher risk of developing a severe case of the disease.

For example, a preprint study published Tuesday that has not been peer-reviewed examined blood samples from 1,610 Covid-19 patients who developed severe cases of Covid-19, which the researchers classified as needing oxygen or a ventilator as part of their treatment. The researchers sequenced part of each those patients’ genomes, and then performed the same analysis on samples from 2,205 blood donors who did not have Covid-19 and compared the results.

The researchers found that many of the patients who had severe cases of Covid-19 possessed the same variant on a gene that determines a person’s blood type. Specifically, the researchers found that having blood type A was linked with a 50% increase in the likelihood a patient would develop a severe case of Covid-19.

According to the New York Times, a separate preprint study conducted by researchers in China that hasn’t yet been peer-reviewed found similar results. The study found that, out of 2,173 Covid-19 patients with different blood types, blood type A was associated with a higher risk of death from Covid-19 when compared with other blood types. The study also found that people with blood type A appeared more likely to contract the new coronavirus, whereas those with blood type O appeared to be the least likely to contract the virus.

Andre Franke, a molecular geneticist at the University of Kiel in Germany, who led the first study said he and his colleagues also identified another locus on Chromosome 3 that appeared to be linked with Covid-19. However, the researchers noted that locus hosts six different genes, and they’ve yet to determine which of those genes influences how Covid-19 develops.

Despite the findings, Franke said researchers are still unsure exactly how a person’s blood type plays a part in how Covid-19 affects them. “That is haunting me, quite honestly,” he said.

good news

June 9, 2020 — Coronavirus: Tests show half of people in Italy’s Bergamo have antibodies, DW.com (Commentary)

An antibody test in Italy’s former coronavirus epicenter has shown more than half of blood samples contain coronavirus antibodies. Researchers said the sample size is large enough to represent all of Bergamo province.

More than half of Bergamo residents who submitted a blood sample tested positive for SARS-CoV-2 antibodies, health authorities in the northern Italian city reported Monday.

Out of nearly 10,000 Bergamo residents who had their blood tested between April 23 and June 3, 57% had antibodies, indicating they had come into contact with the virus and developed an immune response.

Health authorities said the sample size was “sufficiently broad” to be a reliable indicator of the presence of SARS-CoV-2 among Bergamo province’s population.

Bergamo was the Italian city worst hit by COVID-19, with images of overflowing hospitals and bodies being carried away by trucks illustrating the horrifying impact of the pandemic.

According to Italy’s National Institute of Statistics (ISTAT), at the height of the outbreak in March, 568% more people died in Bergamo compared with the 2015-2019 average. The city and the surrounding province have reported 13,600 total COVID-19 cases.

Nationwide testing campaign

ISTAT, along with the Ministry of Health, has launched a nationwide blood testing campaign to map out the severity of Italy’s epidemic region by region. The goal is to obtain a representative sample of around 150,000 people.

An antibody test does not check for the virus itself, rather it detects whether the immune system has responded to the presence of a viral pathogen in the body.

Scientists around the world are exploring antibody therapy to treat COVID-19 patients. One method is using the blood plasma of recovered.

Commentary — More good news for herd immunity and humanity. The more people who become infected with COVID-19 and then get over it, the better — because this increases our species’ (the herd’s) immunity to COVID-19.

bad news

June 11, 2020 – How the Coronavirus Short-Circuits the Immune System, New York Times

The New York Times reports that at the beginning of the pandemic, the coronavirus looked to be another respiratory illness. But the virus has turned out to affect not just the lungs, but the kidneys, the heart and the circulatory system — even, somehow, our senses of smell and taste.

Now researchers have discovered yet another unpleasant surprise. In many patients hospitalized with the coronavirus, the immune system is threatened by a depletion of certain essential cells, suggesting eerie parallels with H.I.V.

The findings suggest that a popular treatment to tamp down the immune system in severely ill patients may help a few, but could harm many others. The research offers clues about why very few children get sick when they are infected, and hints that a cocktail of drugs may be needed to bring the coronavirus under control, as is the case with H.I.V.

Growing research points to “very complex immunological signatures of the virus,” said Dr. John Wherry, an immunologist at the University of Pennsylvania whose lab is taking a detailed look at the immune systems of Covid-19 patients.

In May, Dr. Wherry and his colleagues posted online a paper showing a range of immune system defects in severely ill patients, including a loss of virus-fighting T cells in parts of the body.

In a separate study, the investigators identified three patterns of immune defects, and concluded that T cells and B cells, which help orchestrate the immune response, were inactive in roughly 30 percent of the 71 Covid-19 patients they examined. None of the papers have yet been published or peer reviewed.

Researchers in China have reported a similar depletion of T cells in critically ill patients, Dr. Wherry noted. But the emerging data could be difficult to interpret, he said — “like a Rorschach test.”

Research with severely ill Covid-19 patients is fraught with difficulties, noted Dr. Carl June, an immunologist at the University of Pennsylvania who was not involved with the work.

“It is hard to separate the effects of simply being critically ill and in an I.C.U., which can cause havoc on your immune system,” he said. “What is missing is a control population infected with another severe virus, like influenza.”

That may create chaotic signaling in the body: “It’s like Usain Bolt hearing the starting gun and starting to run,” Dr. Hayday said, referring to the Olympic sprinter. “Then someone keeps firing the starting gun over and over. What would he do? He’d stop, confused and disoriented.”

The result is that the body may be signaling T cells almost at random, confusing the immune response. Some T cells are prepared to destroy the viruses but seem undermined, behaving aberrantly. Many T cells apparently die, and so the body’s reserves are depleted — particularly in those over age 40, in whom the thymus gland, the organ that generates new T cells, has become less efficient.

Some patients are severely affected by coronavirus infections because their immune systems respond too vigorously to the virus. The result, a so-called cytokine storm, also has been seen in cancer patients treated with drugs that supercharge T cells to attack tumors.

These overreactions can be quelled with medications that block a molecule called IL-6, another organizer of immune cells. But these drugs have not been markedly effective in most Covid-19 patients, and for good reason, Dr. Hayday said.

“There clearly are some patients where IL-6 is elevated, and so suppressing it may help,” he explained. But “the core goal should be to restore and resurrect the immune system, not suppress it.”

The new research may help answer another pressing question: Why is it so rare for a child to get sick from the coronavirus?

Children have highly active thymus glands, the source of new T cells. That may allow them to stay ahead of the virus, making new T cells faster than the virus can destroy them. In older adults, the thymus does not function as well.

The emerging picture indicates that the model for H.I.V. treatment, a cocktail of antiviral drugs, may be a good bet both for those with mild illnesses and those who are severely ill.

Some experts have wondered if antiviral treatment makes sense for severely ill Covid-19 patients, if their main affliction is an immune system overreaction.

But if the virus directly causes the immune system to malfunction, Dr. Hayday said, then an antiviral makes sense — and perhaps even more than one, since it’s important to stop the infection before it depletes T cells and harms other parts of the immune system.

“I have not lost one ounce of my optimism,” Dr. Hayday said. Even without a vaccine, he foresees Covid-19 becoming a manageable disease, controlled by drugs that act directly against the virus.

“A vaccine would be great,” he said. “But with the logistics of its global rollout being so challenging, it’s comforting to think we may not depend on one.”

good news

June 12, 2020 — Up to 96% of COVID-19 Infections May Be Asymptomatic, Science Daily (Commentary)

Science Daily reports that many — if not most — people who are infected with the coronavirus don’t feel bad or get sick. In fact, they feel completely normal and don’t even know they have the supposedly dread virus!

The headline on the June 12 Science Daily story actually reads “Up to 45 percent of SARS-CoV-2 infections may be asymptomatic,” but when you read the story you find that asymptomatic COVID-19 infections may actually be as high as 96 percent of total COVID-19 infections.

“Among more than 3,000 prison inmates in four states who tested positive for the coronavirus, the figure was astronomical: 96 percent asymptomatic.”

In other words, most and maybe nearly all of the people infected with the COVID-19 virus don’t get sick!

The Science Daily story was based on data from the Scripps Research Institute published in Annals of Internal Medicine.

Commentary — It is undeniably excellent news that most people who are infected with COVID-19 don’t get sick, but like so much COVID-19 press coverage, Science Daily sees this very good news casting a horrific shadow because asymptomatic COVID-19 carriers may infect others.

But if the death rate from COVID-19 is 1/2 of 1 percent — or even far less than that — and if infection imparts at least some immunity, what’s the terrifying problem here?

bad news

June 15, 2020 – Seattle Man Gets a $1.1 Million Bill After Spending 62 Days in the Hospital with Coronavirus, People Magazine (Commentary)

People Magazine writes that a Seattle man who spent 62 days in the hospital with a near-deadly case of COVID-19 had a “heart-stopping” moment when he received the bill, for $1.1 million.

Michael Flor, 70, had a severe case of COVID-19, the Seattle Times reported. He spent most of those 62 days at Swedish Medical Center in Issaquah, Washington in a sealed room in the intensive care unit to protect others at the hospital, and 29 days on a ventilator. His heart, kidneys and liver were all failing at points during his stay, and at one point he was so close to dying that a nurse held a phone up to his ear so his wife and kids could say their last goodbyes.

But Flor recovered, and finally went home at the beginning of May. Seeing his hospital bill, though, was a shock.

“I opened it and said ‘holy [bleep]!’ ” he told the Times.

The 181-page hospital bill includes a day fee of $9,736 — $408,912 total — for his ICU room, around a quarter of a million for the various drugs doctors tried on him and $82,215 for the ventilator he used for 29 days. In all, the bill was for $1,122,501.04, and includes almost 3,000 itemized charges.

Flor also thinks more bills are on the way for the two weeks he spent in a rehabilitation center, his dialysis treatments and for the doctors’ labor.

Thankfully, Flor most likely will not have to pay any of it. He has Medicare and Medicare Advantage insurance through Kaiser Permanente, which would cover the bulk of the bill. The company has said that they will waive most out-of-pocket costs for COVID-19 treatment in 2020 thanks to the $100 billion emergency funding bill from Congress, meaning he likely won’t have to pull together his estimated $6,000 co-pay.

Flor also feels guilty that he has good health insurance when other Americans do not, and he also recognizes that thanks to the funding bill, his hospital stay is paid for from taxpayer money and insurance money from people with non-COVID-19 bills.

“It was a million bucks to save my life, and of course I’d say that’s money well-spent,” he says. “But I also know I might be the only one saying that.”

Commentary — Based on the press coverage of this incident, I would say that Michael Flor appears to be an intelligent and caring man. But just as clearly, I would say he should NOT have been saved. This is a ludicrous waste of public and private health care resources!

Coronovirus is a wolf come to cleanse our sad and sick species of the weak and the elderly, and make humanity strong again. If we persist in this insane course of action, humanity will perish. It’s sad when a good man has to die, but it’s more important that a strong and resilient human species live on!

bad news

June 17, 2020 – Breaking down ‘miracle’ coronavirus survivor’s $1.1M hospital bill, New York Post (Commentary)

The New York Post writes that a Seattle COVID-19 survivor knew that he must have run up a pretty huge medical tab after spending March and April in the hospital, including more than a month in the intensive care unit. But Michael Flor, 70, told the Seattle Times that the 181-page, $1.1 million hospital bill nearly gave him a heart attack.

“I opened it and said ‘Holy [bleep]!’” he said.

Flor was dubbed “the miracle child” by nurses at Swedish Medical Center in Issaquah, Wash., for his incredible turnaround after spending four weeks on a ventilator. He was so close to death at one point that a night-shift nurse held a phone to his ear so that his wife and children could say their final goodbyes from quarantine. He was “as sick as you can get, with basically every organ system shutting down,” according to one of his doctors.

The good news is that Flor recovered and is back at home. And he’s probably off the hook for that $1.1 million, because his insurance is footing the bill for most of his medical costs. And his remaining $6,000 out-of-pocket expenses will probably be picked up by the more than $100 billion that Congress has earmarked to help hospitals and insurance companies cover the costs of the COVID-19 pandemic. But Flor’s hospital bill still offers a fascinating look at the cost of treating a life-threatening illness such as COVID-19.

Here’s how the $1,122,501.04 bill breaks down:

The 181-page book — sorry, bill — includes almost 3,000 itemized charges, averaging about 50 a day. The greatest expense by far was his 42-day stay in the ICU, totaling $408,912. His room had to be sealed, and was accessed only by medical staff wearing plastic suits and headgear, which cost $9,736 a day.

Flor also was hooked to a mechanical ventilator for 29 days, which at $2,835 a day ran up to $82,215.

There were two days when his heart, kidneys and lungs were all failing. And the bill for that touch-and-go period spans 20 pages and runs almost $100,000 in costs as doctors “were throwing everything at me they could think of,” Flor said.

Almost a quarter of the bill includes various drug costs, and this accounting doesn’t even factor in Flor’s two weeks of recovery in a rehabilitation facility.

Flor said that the bill has given him survivor’s guilt. “There’s a sense of ‘why me?’ Why did I deserve all this?” he told the Seattle Times. “Looking at the incredible cost of it all definitely adds to that survivor’s guilt.”

But he should know that he’s not the only COVID-19 survivor to be shocked with a surprise medical bill following a bout with the deadly disease that’s killed 116,250 Americans and counting. Lawyer turned writer David Lat recently wrote about his own $320,000 COVID-19 bill in Slate. He spent 16 nights in the hospital in March, including a week in the ICU and six days on a ventilator.

And while he was bracing to pay $6,000 or $7,000 in out-of-pocket costs, he also didn’t end up on the hook for any of it because his hospital, NYU Langone, was in-network for his insurance company, UnitedHealthcare. And UHC is among the insurance companies that have waived patient cost-sharing for COVID-19 treatment.

But this doesn’t mean that everyone can expect “free” coronavirus treatment. While the nation’s largest insurers, including Aetna CVS, Anthem, Blue Cross Blue Shield, Cigna, Humana and United Healthcare, did announce that they are not making patients pay deductibles, copays, coinsurance and other charges if they are hospitalized with COVID-19, the people who get health insurance through their jobs may still end up having to pay for treatment. And that’s because employers with “self-funded” or “self-insured” health plans are allowed to opt out of waiving cost-sharing for their employees. What’s more, insurers are only waiving this cost-sharing for a limited time.

The City University of New York (CUNY) Graduate School of Public Health and Health Policy recently ran a computer simulation to gauge what the nation’s COVID-19-related health care costs could be. They determined that the median cost of a coronavirus hospitalization is $14,366. And that doesn’t include the long-term health care costs for patients with severe illness who suffer significant lung damage, for example. Other estimates have pushed COVID-19 hospitalization costs closer to $20,000.

Even COVID-19 testing, which is supposed to be free, has resulted in some eye-watering bills. Earlier in the pandemic, a Miami man reportedly racked up $3,270 in hospital charges when he went in for a COVID-19 test after a work trip to China. And a Pennsylvania man had to set up a GoFundMe page to help pay for $3,918 in surprise bills after he was evacuated from China and quarantined with his 3-year-old daughter.

Indeed, Flor’s bill and these other COVID-19 hospital costs are a stark reminder that: one in six Americans get hit with a “surprise” medical bill after a trip to the emergency room; one in five Americans get hit with a surprise medical bill after elective surgery; and one in five patients hospitalized with a severe case of pneumonia get stuck with a surprise medical bill from an out-of-network provider. What’s more, the American Cancer Society estimates that 137 million Americans are burdened by medical debt — and cancer treatment is a huge part of that, of course, with one in four cancer survivors struggling to pay medical bills.

Flor added that while he feels that a million bucks to save his life is “money well-spent,” he also appreciates that “I might be the only one saying that.”

Commentary — Can you handle a little blunt truth? We can not afford this sort of counter-productive folly. It is important that COVID-19 kill the weak, both to contain the spread of the disease, and to strengthen the human species, or “herd.” Saving the weak at immense expense is lunacy. As the country western song says, “the secret to a long life is knowing when it’s time to go.”

good news

June 26, 2020 – Coronavirus death rate falling in hospitals, BBC

University of Oxford researchers found the proportion of coronavirus patients dying each day in England fell from 6% to 1.5% between April and June.

Improvements in treatments, changes in the patient population and seasonal effects could all play a role.

The data emerged as the government prepares to ease lockdown restrictions.

Around the height of the outbreak, on 8 April, there were 15,468 people in hospital in England with coronavirus of whom 899 died (6%).

By 21 June there were 2,698 hospitalized coronavirus patients, 30 of whom died (1%), according to the most recent data compiled University of Oxford’s Centre for Evidence-Based Medicine.

Hospital case fatality is a measure used since the beginning of the outbreak, providing consistent figures and enabling researchers to look for trends.

Commentary — this is dramatic and excellent news on the direst part of the coronavirus pandemic! And it has been followed by similar declines in coronavirus-caused deaths in the United States as well.

100 Voices from the Little Bighorn by Bruce BrownThe History of the Corporation by Bruce BrownSaga In Itself - The Filming of Never Cry Wolf by Bruce BrownMountain in the Clouds by Brucve Brown
Some books by Bruce Brown.

bad news

July 4, 2020 – Revealed: Seven year coronavirus trail from mine deaths to a Wuhan lab, Times of London (Commentary)

The Times of London writes that in the monsoon season of August 2012 a small team of scientists travelled to southwest China to investigate a new and mysteriously lethal illness. After driving through terraced tea plantations, they reached their destination: an abandoned copper mine where — in white hazmat suits and respirator masks — they ventured into the darkness.

Instantly, they were struck by the stench. Overhead, bats roosted. Underfoot, rats and shrews scurried through thick layers of their droppings. It was a breeding ground for mutated micro-organisms and pathogens deadly to human beings. There was a reason to take extra care. Weeks earlier, six men who had entered the mine had been struck down by an illness that caused an uncontrollable pneumonia. Three of them died.

Today, as deaths from the Covid-19 pandemic exceed half a million and economies totter, the bats’ repellent lair has taken on global significance.

Evidence seen by The Sunday Times suggests that a virus found in its depths — part of a faecal sample that was frozen and sent to a Chinese laboratory for analysis and storage — is the closest known match to the virus that causes Covid-19.

It came from one of the last droppings collected in the year-long quest, during which the six researchers sent hundreds of samples back to their home city of Wuhan. There, experts on bat viruses were trying to identify the source of the Sars — severe acute respiratory syndrome — pandemic 10 years earlier.

The virus was a huge discovery. It was a “new strain” of a Sars-type coronavirus that, surprisingly, received only a passing mention in an academic paper. The six sick men were not referred to at all.

What happened to the virus in the years between its discovery and the eruption of Covid-19? Why was its existence tucked away in obscure records, and its link to three deaths not mentioned?

Nobody can deny the bravery of the scientists who risked their lives by harvesting the highly infectious virus. But did their courageous detective work lead inadvertently to a global disaster?

Where flowers bloom all yearThe first victims of a new virus

Kunming, the capital of Yunnan province in southwest China, is known as “the city of eternal spring” because its unique climate encourages flowers to bloom all year. The sprawling high-rise buildings of the First Affiliated Hospital tower over the ancient city.

On Tuesday April 24, 2012, a 45-year-old man with the surname of Guo was admitted to the hospital’s intensive care unit suffering from severe pneumonia.

The next day a 42-year-old man with the surname Lv was taken to the hospital with the same life-threatening symptoms, and by Thursday three more cases — Zhou, 63, Liu, 46, and Li, 32 — had joined him in intensive care. A sixth man called Wu, 30, was taken into intensive care the following Wednesday.

All the men were linked. They had been given the task of clearing out piles of bat faeces in an abandoned copper mine in the hills south of the town of Tongguan in the Mojiang region. Some had worked for two weeks before falling ill, and others just a few days.

The illness confounded the doctors. The men had raging fevers of above 39C, coughs and aching limbs. All but one had severe difficulty in breathing.

After the first two men died, the remaining four underwent a barrage of tests for haemorrhagic fever, dengue fever, Japanese encephalitis and influenza, but they all came back negative. They were also tested for Sars, the outbreak that had erupted in southern China in 2002, but that also proved negative.

The doctors sought the opinion of Professor Zhong Nanshan, a British-educated respiratory specialist and a former president of China’s medical association who had spearheaded his country’s efforts to combat Sars. Aware the men might be suffering from another Sars-related coronavirus, he advised the doctors to test them for antibodies.

The Wuhan Institute of Virology (WIV), a renowned centre of coronavirus expertise, was called in to test the four survivors. These produced a remarkable finding: while none had tested positive for Sars, all four had antibodies against another, unknown Sars-like coronavirus.

Furthermore, two patients who recovered and went home showed greater levels of antibodies than two still in hospital, one of whom later died.

Researchers in China have been unable to find any news reports of this new Sars-like coronavirus and the three deaths. There appears to have been a media blackout. It is, however, possible to piece together what happened in the Kunming hospital from a master’s thesis by a young medic called Li Xu. His supervisor was Professor Qian Chuanyun, who worked in the emergency department that treated the men. Other vital details, including the results of the antibody tests, were found in a PhD paper by a student of the director of the Chinese Centre for Disease Control and Prevention.

Li’s thesis was unable to say what exactly killed the three miners, but indicated that the most likely cause was a Sars-like coronavirus from a bat.

“This makes the research of the bats in the mine where the six miners worked and later suffered from severe pneumonia caused by unknown virus a significant research topic,” Li concluded.

That research was already under way — led by the Wuhan virologist who became known as “Bat Woman” — and it adds to the mystery.

The Bat Heroine – The Bat Woman heralded as a hero in China

For historians of the Chinese Communist Party, Wuhan is where the 72-year-old Mao Tse-tung took a symbolic swim in the Yangtze River in 1966 before launching the Cultural Revolution. For generations born since that disastrous era, the modern industrial city is the crossroads of China’s high-speed rail network and was the centre of the Covid-19 pandemic.

For science, however, Wuhan is the centre for research into the coronavirus in bats. Shi Zhengli, nicknamed “Bat Woman” by her colleagues, is heralded as a hero in China and in scientific communities across the world.

But the bats in Yunnan are 1,000 miles from her laboratory, and one of the most extraordinary coincidences of the Covid-19 pandemic is that ground zero happened to be in Wuhan, the world centre for the study and storage of the types of coronavirus the city’s own scientists believe caused the outbreak.

Coronaviruses are a group of pathogens that sometimes have the potential to leap species from animals to humans and appear to have a crown — or corona — of spikes when viewed under a microscope.

Before Covid-19, six types of coronavirus were known to infect humans but mostly they caused mild respiratory symptoms such as the common cold.

The first outbreak of Sars — now known as Sars-Cov-1 to distinguish it from Sars-Cov-2, the virus that causes Covid-19 — is one of the deadly exceptions. It emerged in Guangdong, southern China, in November 2002 and infected 8,096 people in 29 countries. It caused severe pneumonia in some and killed 774 people before petering out eight months later.

A race began to find out how a coronavirus had mutated into something so deadly and jumped from animals to humans. The initial prime suspects were masked palm civet cats, a delicacy in some parts of China. But suspicion shifted to bats, which had also been linked to other deadly viruses such as rabies. Perhaps they were the primary source and civets were just intermediaries that they infected.

7 year trail of COVID-19 revealed
Illustration by the Times of London. Click to enlarge.

Shi and her team from the WIV began hunting among bat colonies in caves in southern China in 2004. In 2012 they were in the midst of a five-year research project centred on caves in remote mountains southwest of Kunming when the call came to investigate the incident in the copper mine about 200 miles away.

They were joined by local disease control experts when they descended into the mine that August with protective equipment and bat-catching nets.

Over the next year, the scientists took faecal samples from 276 bats. The samples were stored at minus 80C in a special solution and dispatched to the Wuhan institute, where molecular studies and analysis were conducted.

These showed that exactly half the bats carried coronaviruses and several were carrying more than one virus at a time — with the potential to cause a dangerous new mix of pathogens.

The results were reported in a scientific paper entitled “Coexistence of multiple coronaviruses in several bat colonies in an abandoned mineshaft” co-authored by Shi and her fellow scientists in 2016.

Notably, the paper makes no mention of why the study had been carried out: the miners, their pneumonia and the deaths of three of them.

The paper does state, however, that of the 152 genetic sequences of coronavirus found in the six species of bats in the mineshaft, two were of the type that had caused Sars. One is classified as a “new strain” of Sars and labelled RaBtCoV/4991. It was found in a Rhinolophus affinis, commonly known as a horseshoe bat. The towering significance of RaBtCov/4991 would not be fully understood for seven years.

An ordinary coronavirus – The top security lab at the centre of Wuhan

A new facility was taking shape on the virology institute campus on the west side of the Yangtze in Wuhan. Built by a contractor for the People’s Liberation Army under strict secrecy, a top-security laboratory for handling deadly human pathogens was unveiled in 2017.

There were 31 such laboratories in the world at the time but this was China’s first. The new lab had been certified by the Chinese authorities as “biosafety level 4”, or BSL-4, the highest. But it was raising eyebrows internationally.

Scientists and biosafety experts were concerned that the closed nature of the Chinese state and the emphasis on hierarchy would prove incompatible with running such a dangerous facility.

“Diversity of viewpoint, flat structures where everyone feels free to speak up and openness of information are important,” Tim Trevan, a consultant in biosecurity, told the science magazine Nature when it opened.

Laboratory leaks are not uncommon. In the past, ebola and the fatal bat disease Marburg, which kills nine out of 10 people infected, have escaped from BSL-4 laboratories in the US. American health authorities recorded 749 laboratory safety breaches in the six years to 2015. Indeed, several people were infected by Sars in 2004 after an accident at China’s National Institute of Virology in Beijing.

The need for a secure facility in Wuhan was obvious, however. Shi and her team had already collected hundreds of samples of the coronavirus — including RaBtCov/4991 — from their work on bats across Yunnan province, and they were running controversial experiments to find out how they might mutate to become more infectious to humans.

This “gain-of-function” work is described in papers released by the WIV between 2015 and 2017, scientists say. Shi’s team combined snippets of different coronaviruses to see if they could be made more transmissible in what they called “virus infectivity experiments”.

It was controversial because it had the potential to turn bat coronaviruses into human pathogens capable of causing a pandemic. In 2014 the US government issued a ban on funding any endeavour to make a virus more contagious.

Shi’s team argued that gain-of-function work increased its understanding of how an ordinary coronavirus might one day transform into a killer such as Sars.

Others disagreed. “The debate is whether in fact you learn more by helping to develop vaccines or even drugs by replicating a more virulent virus than currently exists, versus not doing that,” explained Deenan Pillay, professor of virology at University College London. “And I think the consensus became that the risk was too much.”

In January 2018 the US embassy in Beijing took the unusual step of sending scientists with diplomatic status to Wuhan to find out what was going on in the institute’s new biosafety laboratories. They met Shi and members of her team.

Details of the diplomats’ findings have been found in US diplomatic cables that were leaked to the Washington Post and others. “Most importantly,” states a cable from January 19, 2018, “the researchers also showed that various Sars-like coronaviruses can interact with ACE2, the human receptor identified for Sars-coronavirus. This finding strongly suggests that Sars-like coronaviruses from bats can be transmitted to humans to cause Sars-like diseases.”

The Americans were evidently worried about safety. “During interactions with scientists at the WIV laboratory, they noted the new lab has a serious shortage of appropriately trained technicians and investigators needed to safely operate this high-containment laboratory,” the cable added.

Shi was in a conference in Shanghai on Monday December 30, 2019, when she received a call to say there was a new coronavirus on the loose — and it had surfaced in Wuhan, of all places. Since her work had established that such viruses were most likely to originate in south China, she found the news puzzling and extremely worrying. “I wondered if [the local health authority] got it wrong,” she told the Scientific American magazine in a rare interview this year. “I had never expected this kind of thing to happen in Wuhan, in central China.”

One of her initial thoughts, as she prepared to return immediately to analyse the virus, was “Could they [the new coronaviruses] have come from our lab?”. It was a natural anxiety, although she said she was later able to dismiss it after examining the lab’s records.

Patient Zero – When did Covid-19 really start?

The precise point at which Covid-19 erupted in Wuhan may never be known. Various theories have been discredited.

A study by Harvard University claimed the virus may have started last August. It relied on satellite images in which the car parks of selected Wuhan hospitals looked busier. However, the study’s detractors have pointed to discrepancies in the evidence.

There is also a theory — propagated by the Chinese media — that the virus may have been introduced into the country by foreign athletes competing in the Military World Games in Wuhan last October. They included the French former world champion pentathlete Élodie Clouvel and the Italian Olympic gold medallist fencer Matteo Tagliariol, who were laid low by fever during the Games.

Few of the athletes have been tested to find out whether they carry antibodies to Covid-19, apart from the Swedish team. Melina Westerberg, a Swedish pentathlete, has revealed that while many of her teammates were sick during the Games, they tested negative. “It was just a coincidence,” she said.

It is possible that the virus did start patchily at around the time of the Military World Games. Yu Chuanhua, an epidemiology professor at Wuhan University, has told Chinese media that one man was admitted to hospital on September 29 with Covid-19-like symptoms but it is impossible now to show whether he had the virus because he died. There were two more suspected early carriers of the virus from November 14 and 21 in the city’s 47,000-strong database of cases, but they are unconfirmed.

Probably the first confirmed case was a 70-year-old man with Alzheimer’s disease, whose family had told researchers from Wuhan Jinyintan Hospital that his symptoms had begun on December 1.

From that point it accelerated to about 60 identifiable cases by December 20, according to government research data reported in the South China Morning Post. However, it would not be until a week later that Dr Zhang Jixian, of the Hospital of Integrated Traditional Chinese and Western Medicine in Hubei province, became the first person to report a suspected outbreak to the provincial government.

By then it had already spread as far as Europe, probably via regular flights from Wuhan. The virus may have been in Italy as early as December 18. The country’s National Institute of Health reported finding traces of Covid-19 in sewage water collected in Milan and Turin on that date.

It was certainly in France, as a man called Amirouche Hammar was admitted to Jean-Verdier hospital in Paris on December 27. He had unknown respiratory pneumonia and was coughing blood. His samples later revealed Covid-19. His wife, who had a slight cough, worked at a supermarket used by shoppers leaving Charles de Gaulle airport, where there were direct flights from Wuhan.

In Wuhan itself, the first cluster of cases included traders and shoppers at the Huanan seafood market, a maze of small trading stores opening on to crowded alleys in the centre of the city. Despite its name, the market also sold meat and vegetables, and there was an exotic wildlife section in the west of the market.

On January 1 the Huanan market was closed and scientists found 33 coronavirus samples, nearly all in the area of the market where wild animals were sold.

It seemed like an open and shut case. When the results were released later that month, the Chinese state news agency Xinhua reported: “The results suggest that the novel coronavirus outbreak is highly relevant to the trading of wild animals.”

However, an early study published in The Lancet made clear that of the 41 patients who contracted Covid-19 in Wuhan only 27 had been “exposed” to the market. A third had no connection to the market, including the study’s “patient zero”, who fell ill on December 1.

Months later George Gao, the director of the Chinese Centre for Disease Control and Prevention, revealed that all the samples taken from animals at the market had tested negative for the virus and that those found had been from sewage or other environmental sources. The Chinese health authorities are now working on the theory that the market helped spread the disease but was not where it originated.

Mapping the virus – China warns world of deadly new strain

On December 31, the day Shi returned to the WIV to begin work identifying the new coronavirus, the Chinese authorities decided it was time to tell the world there was potentially a problem.

The World Health Organisation (WHO) was notified that a number of people had been struck down with pneumonia but the cause was not stated. On the same day, the Wuhan health authority put out a bland public statement reporting 27 cases of flu-like infection and urged people to seek medical attention if they fell ill. Neither statement indicated that the new illness could be transmitted between humans or that the likely source was already known: a coronavirus.

By the second week in January, desperate scenes were unfolding at Wuhan hospitals. Hopelessly ill-prepared and ill-equipped staff were forced to make life-and-death calls about who they could treat. Within a few days, the lack of beds, equipment and staff made the decisions for them.

Shi’s team managed to identify five cases of the coronavirus from samples taken from patients at Wuhan Jinyintan Hospital using a technique to amplify the virus’s genetic material. The samples were sent to another lab, which completed the whole genomic sequence.

However, the sequence would not be passed to the WHO until January 12 and China would not admit there had been human-to-human transmission until January 20, despite sitting on evidence the virus had been passed to medics.

One of Shi’s other urgent tasks was to check through her laboratory’s records to see if any errors, particularly with disposal of hazardous materials, could have caused a leak from the premises.

She spoke of her relief to discover that the sequences for the new virus were not an exact match with the samples her team had brought back from the bat caves. “That really took a load off my mind,” she told Scientific American, “I had not slept a wink for days.”

RaTG13 – From bat cave to lab

She then set about writing a paper describing the new coronavirus to the world for the first time. Published in Nature on February 3 and entitled “A pneumonia outbreak associated with a new coronavirus of probable bat origin”, the document was groundbreaking.

It set out a full genomic description of the Covid-19 virus and revealed that the WIV had in storage the closest known relative of the virus, which it had taken from a bat. The sample was named RaTG13. According to the paper, it is a 96.2% match to the Covid-19 virus and they share a common lineage distinct from other Sars-type coronaviruses. The paper concludes that this close likeness “provides evidence” that Covid-19 “may have originated in bats”.

In other words, RaTG13 was the biggest lead available as to the origin of Covid-19. It was therefore surprising that the paper gave only scant detail about the history of the virus sample, stating merely that it was taken from a Rhinolophus affinis bat in Yunnan province in 2013 — hence the “Ra” and the 13.

Inquiries have established, however, that RaTG13 is almost certainly the coronavirus discovered in the abandoned mine in 2013, which had been named RaBtCoV/4991 in the institute’s earlier scientific paper. For some reason, Shi and her team appear to have renamed it.

The clearest evidence is in a database of bat viruses published by the Chinese Academy of Sciences — the parent body of the WIV — which lists RaTG13 and the mine sample as the same entity. It says it was discovered on July 24, 2013, as part of a collection of coronaviruses that were described in the 2016 paper on the abandoned mine.

In fact, researchers in India and Austria have compared the partial genome of the mine sample that was published in the 2016 paper and found it is a 100% match with the same sequence for RaTG13. The same partial sequence for the mine sample is a 98.7% match with the Covid-19 virus.

Peter Daszak, a close collaborator with the Wuhan institute, who has worked with Shi’s team hunting down viruses for 15 years, has confirmed to The Sunday Times that RaTG13 was the sample found in the mine. He said there was no significance in the renaming. “The conspiracy folks are saying there’s something suspicious about the change in name, but the world has changed in six years — the coding system has changed,” he said.

He recalled: “It was just one of the 16,000 bats we sampled. It was a faecal sample, we put it in a tube, put it in liquid nitrogen, took it back to the lab. We sequenced a short fragment.”

In 2013 the Wuhan team had run the sample through a polymerase chain reaction process to amplify the amount of genetic material so it could be studied, Daszak said. But it did no more work on it until the Covid-19 outbreak because it had not been a close match to Sars.

Other scientists find the initial indifference about a new strain of the coronavirus hard to understand. Nikolai Petrovsky, professor of medicine at Flinders University in Adelaide, South Australia, said it was “simply not credible” that the WIV would have failed to carry out any further analysis on RaBtCoV/4991, especially as it had been linked to the deaths of three miners.

“If you really thought you had a novel virus that had caused an outbreak that killed humans then there is nothing you wouldn’t do — given that was their whole reason for being [there] — to get to the bottom of that, even if that meant exhausting the sample and then going back to get more,” he said.

“I would expect people to be as clear as they can be about the history of the isolates of their sequencing,” said Professor Wendy Barclay, head of Imperial College London’s infectious disease department and a member of the UK government’s Sage advisory committee. “Most of us would have reported the entire history of the isolate, [back] to where all that came from, at the time.”

According to Daszak, the mine sample had been stored in Wuhan for six years. Its scientists “went back to that sample in 2020, in early January or maybe even at the end of last year, I don’t know. They tried to get full genome sequencing, which is important to find out the whole diversity of the viral genome.”

However, after sequencing the full genome for RaTG13 the lab’s sample of the virus disintegrated, he said. “I think they tried to culture it but they were unable to, so that sample, I think, has gone.”

In recent weeks, academics are said to have written to Nature asking for the WIV to write an erratum clarifying the sample’s provenance, but the Chinese lab has maintained a stony silence. A spokesman for Nature said: “Concerns relating to this paper have been brought to Nature’s attention and are being considered at the moment. We cannot comment further at this time.”

Ski holiday – The contagion spread through Europe

The director of the WIV, Wang Yanyi, gave an interview in May in which she described suggestions that Covid-19 might have leaked from the lab as “pure fabrication”. She said that the institute managed to sequence the genome of RaTG13 but had not been able to return it to a live virus. “Thus, there is no possibility of us leaking RaTG13,” she said.

Shi’s interview with the Scientific American mentions the discovery of a coronavirus that 96% matches the Covid-19 virus, and has a reference to the miners dying in a cave she investigated. However, the two things are not linked and Shi downplays the significance of the miners’ deaths by claiming they succumbed to a fungus.

Experts consulted by this newspaper thought it was significant the men had tested positive for antibodies against Sars. Professor Martin Hibberd, a professor of emerging infectious diseases at the London School of Hygiene & Tropical Medicine, said the antibodies provided “a good clue” that the cause of death was “a proper coronavirus”, which “most likely” was Sars-related.

“[RaTG13] is so similar to all the other Sars coronaviruses and so I’d imagine all of that family can cause similar disease, so it makes good sense to me that if the miners caught it they would end up with something that looks similar.”

On January 23 Wuhan became the first city in the world to go into lockdown and it would later suffer nearly 4,000 deaths, according to official figures that some people believe are too low.

Britain’s first official cases — a Chinese student studying in York and a relative — would not emerge for another week, but it is highly likely the virus was already in the country. There were 901 flights from China to the UK between December 1, when the first known patient fell ill, and January 24. Of those, 23 flights brought thousands of passengers directly from Wuhan to Heathrow.

There is also evidence that Britons were bringing back the virus from Europe. Professor Tim Spector, an epidemiologist at King’s College London, who runs the Covid Symptom Study app, says he was contacted by up to 500 people who had returned to the UK between Christmas and January with symptoms.

Many were returning from ski resorts, notably in Austria. In April, 42% of residents in the town of Ischgl were found to have antibodies. “I was interested in the Austrian surveys done in Tyrol because I was quite struck by the stories of all the people that came back from Austrian ski holidays in January, predominantly, feeling ill. It was very convincing because a lot of the stories were the same from different people,” he said.

The investigation – How did this happen?

The origin of Covid-19 is one of the most pressing questions facing humanity. Scientists worldwide are trying to understand how it evolved, which could help stop such a crisis happening again.

The suggestion that well-intentioned scientists may have introduced Covid-19 to their own city is vehemently denied by the WIV, and its work on the origin of the virus has become an x-rated topic in China. Its leadership has taken strict control of new studies and information about where the virus may have come from.

A directive from the education ministry’s science and technology department in the spring stipulated that such work had to be read by a taskforce directly under the state council — comprising China’s president, Xi Jinping, and top ministers — before it can be published.

The secrecy has only increased as the origin of Covid-19 has become politicised as a weapon of aggressive foreign policy. President Donald Trump has described the virus as a “kung flu” and has delighted in claiming it is a Chinese disease. Scientists are dismayed and fear China will retreat further into its shell.

Professor Richard Ebright, of Rutgers University’s Waksman Institute of Microbiology in New Jersey, believes there is now less than a 50:50 chance China will allow a transparent investigation into the origin of the pandemic. “That’s unfortunate,” he said. “And that largely reflects the poor handling of the matter by the US president, who chose to push this in a way that made it unlikely that there could be an open investigation.”

Over the next few days, WHO scientists will be allowed to fly into China to begin an investigation into the origins of the virus after two months of negotiations. Many experts such as Daszak believe the source of the virus will be found in a bat in the south of China.

“It didn’t emerge in the market, it emerged somewhere else,” said Daszak. He said the “best guess right now” is that the virus started within a “cluster” on the Chinese border that includes the area where RaTG13 was found and an area just south of the mineshaft, where another bat pathogen with a 93% likeness to Covid-19 was discovered recently.

As for how the virus travelled to Wuhan, Daszak said: “Fair assumption is that it spilt into animals in southern China and was then shipped in, via infected people, or animals associated with trade, to Wuhan.”

But how could such an infectious virus avoid causing a single noticeable outbreak during the 1,000-mile journey from Yunnan to the city?

Hibberd said it was feasible the virus could have travelled in an animal such as a pangolin, which passed it to a human wildlife trader when it was being transported for sale in the market. “Maybe a young guy moves a pangolin and sold it on and may have had a mild infection but didn’t have any disease,” he said. “It’s not impossible for that scenario to happen.”

On the other hand, Hibberd believes it is possible the virus could have been brought back by one of the scientists, who were frequent travellers between the caves and Wuhan. “If you imagine these researchers who probably did this are students — who are probably quite young — it’s entirely possible that a researcher might become infected through the study of bats.”

The WIV was not the only body of scientists from the city delving into virus-laden caves. On December 10 last year a Chinese state media outlet published an extraordinary video lionising the bravery of a researcher called Tian Junhua, who is said to have caught 10,000 bats in studies for Wuhan’s disease control centre.

Tian admitted that he knew little about bats when he first started visiting the caves eight years ago, and once had to isolate himself for 14 days after being showered with bat urine while wearing inadequate protection. On occasions bat blood spilt onto his hands but he says he has never been infected.

The young researcher aroused suspicion because one of the offices of the disease control centre is about 300 yards from the Huanan seafood market. He has refused to talk to reporters, but his friends have firmly denied that he was “patient zero”.

The final and trickiest question for the WHO inspectors is whether the virus might have escaped from a laboratory in Wuhan. Is it possible, for example, that RaTG13 or a similar virus turned into Covid-19 and then leaked into the population after infecting one of the scientists at the Wuhan institute?

This seriously divides the experts. The Australian virologist Edward Holmes has estimated that RaTG13 would take up to 50 years to evolve the extra 4% that would make it a 100% match with the Covid-19 virus. Hibberd is slightly less conservative and believes it might take less than 20 years to morph naturally into the virus driving the current pandemic.

But others say such arguments are based on the assumption the virus develops at a constant rate, along lines that have been monitored over the past six months. “That is not a valid assumption,” said Ebright. “When a virus changes hosts and adapts to a new host the rate of evolutionary change is much higher. And so it is possible that RaTG13, particularly if it entered humans prior to November 2019, may have undergone adaptation in humans at a rate that would allow it to give rise to Sars-Cov-2. I think that is a distinct possibility.”

Ebright believes an even more controversial theory should not be ruled out. “It also, of course, is a distinct possibility that work done in the laboratory on RaTG13 may have resulted in artificial in-laboratory adaptation that erased those three to five decades of evolutionary distance.”

It is a view Hibberd does not believe is possible. “Sars-Cov-2 and RaTG13 are not the same virus and I don’t think you can easily manipulate one into the other. It seems exceptionally difficult,” he said.

Ebright alleges, however, that the type of work required to create Covid-19 from RaTG13 was “identical” to work the laboratory had done in the past. “The very same techniques, the very same experimental strategies using RaTG13 as the starting point, would yield a virus essentially identical to Sars-Cov-2.”

The Sunday Times put a series of questions to the WIV. They included why it had failed for months to acknowledge the closest match to the Covid-19 virus was found in a mine where people had died from a coronavirus-like illness. The questions were met with silence.

Commentary — although ultimately inconclusive, this is one of the most important — and best written — articles on the origins of the coronavirus pandemic that has appeared. Cudos to the Times of London for publising Revealed: Seven year coronavirus trail from mine deaths to a Wuhan lab!

good news

July 4, 2020 — Actual COVID-19 Death Rate Is About 1/2 of 1%, The New York Times (Commentary)

The New York Times reports that the actual death rate of people infected by coronavirus is surprisingly low — “about 0.6 percent — which means that the risk of death is less than 1 percent.” Actually, the Times figures indicates that COVID-19 death rate is about 1/2 of 1 percent.

Stated another way, it now appears that less than one person out of every 100 who become infected with coronavirus may be expected to die. By comparison, the Bubonic plague is believed to have killed “an estimated 30–50 percent of the European population, between 1347–1351,” according to the U.S. National Library of Medicine National Institutes of Health. Thus the mortality rate from the Bubonic plague was as much as 100 times greater than the mortality rate from COVID-19.

Similarly, the mortality rate from the Spanish influenza was as much as 5 times greater than the mortality rate from COVID-19, and the Spanish influenza was simply a bad flu. According to the Center for Disease Control, the mortality rate from the 1919 Spanish influenza was about 2.5 percent, compared to about 1/2 of 1 percent for COVID-19.

Commentary — Despite hysterical and misleading headlines like “Covid-19 Deaths Soar in Florida…” in yesterday’s USA Today, the death rate from COVID-19 is actually quite low. And if the data from a recent Annals of Internal Medicine article reported in Science Daily is correct — that more than 90 percent of all COVID-19 infections are asymptomatic — then the actual COVID-19 death rate may be truly microscopic.

In fact, the novel coronavirus could be called a “minor league pandemic” because of the extremely low percentage of infected people it kills. The simple fact of the matter is that nearly everyone who contracts coronavirus survives.

Not everyone survives, of course, but better than 99 percent do in fact survive!

good news

July 6, 2020 – Coronavirus death rate keeps dropping even as alarm grows over summer surge, Washington Times

The Washington Times reports that the number of Americans dying from COVID-19 has been falling for weeks, a case the White House is making as it points out that the U.S. fatality rate is well below that of Europe’s biggest countries.

White House press secretary Kayleigh McEnany told reporters Monday that the fatality rate — the ratio between confirmed deaths and confirmed cases — is well below that of France, the United Kingdom and Germany, as she defended President Trump’s comment during his Fourth of July address that 99% of novel coronavirus cases are “totally harmless.”

“The president is not downplaying the severity of the virus,” Ms. McEnany said at a press briefing. “What the president is noting is that at the height of this pandemic we were at 2,500 deaths per day. We are now at a place where on July 4 there were 254. That’s a tenfold decrease in mortality.”

She said the number of deaths from COVID-19 on Sunday was 209, which was down 23% from the previous week.

“What the president was pointing to, and I’m glad you brought it up, was a factual statement, one that is rooted in science and one that was pointing out the fact that mortality in the country is very low,” Ms. McEnany said.

Indeed, the Centers for Disease Control and Prevention issued an update Friday noting that the death rates from pneumonia, influenza and COVID-19 have dropped for 10 straight weeks, from 9.0% in week 25 to 5.9% in week 26 and almost reaching the point at which the outbreak would no longer be considered an epidemic.

“The percentage is currently at the epidemic threshold but will likely change as more death certificates are processed, particularly for recent weeks,” the CDC said in its July 3 update.

After daily death rates peaked at 3,000 in March and April, they fell Sunday to 251, in large part because younger people who are better able to survive COVID-19 make up a larger percentage of patients.

Alex Berenson, author of “Unreported Truths About Covid-19 and Lockdowns,” said the “news is significantly better on all fronts” when it comes to SARS-CoV-2, the official name of the virus.

“Despite fact that the number of positive SARS-COV-2 tests (what the media calls cases) in the Sun Belt has been rising for the last few weeks, hospitalizations and especially patients in intensive care and on ventilators are rising much more slowly,” Mr. Berenson said.

In addition, “deaths actually continue to drop to their lowest levels since the epidemic began in March.”

Mr. Trump said in a Twitter post that COVID-19 deaths in the U.S. have fallen by more than a third and asked why the “Lamestream Fake News Media REFUSE to say that China Virus deaths are down 39%, and that we now have the lowest Fatality (Mortality) Rate in the World.

“They just can’t stand that we are doing so well for our Country!” the president tweeted.

bad news

July 9, 2020 – Broadway Star Loses COVID-19 Battle, MedPage Today (Commentary)

MedPage Today writes that Broadway star Nick Cordero has lost his over-three-month battle with COVID-19 at the age of 41. Cordero’s Broadway credits include “Waitress,” “Rock of Ages,” “A Bronx Tale,” and “Bullets Over Broadway.”

Many have been following the roller coaster ride that has been Cordero’s medical course through the frequent Instagram posts of his wife Amanda Kloots. A previously healthy Cordero fell ill on March 20, with an initial diagnosis of pneumonia. After two negative tests, a third was positive for COVID-19. He was admitted from the emergency department on March 30 and was intubated on a ventilator on April 1.

“Since then has [sic] he has suffered an infection that caused his heart to stop, he needed resuscitation, he had two mini strokes, went on ECMO, went on dialysis, needed surgery to remove an ECMO cannula that was restricting blood flow to his leg, a fasciotomy to relieve pressure on the leg, an amputation of his right leg, an MRI to further investigate brain damage, several bronchial sweeps to clear out his lungs, a septic infection causing septic shock, a fungus in his lungs, holes in his lungs, a tracheostomy, blood clots, low blood count and platelet levels, and a temporary pacemaker to assist his heart.”

On May 1, he was taken off sedation but did not regain consciousness until May 13. Although he was able to respond slightly with his eyes, he remained immobile. His lung damage was so severe that Kloots told CBS This Morning that it was likely that Nick would need a double lung transplant, “in order to live the kind of life that I know my husband would want to live.”

Commentary — The supposedly “humanitarian” effort to save people who are very sick with COVID-199 is frequently not an act of kindness, as the case of Broadway star Nick Cordero shows. The true kindness is to let them die, for as the country song says, “the secret to a long life is knowing when it’s time to go.”

good news

July 9, 2020 – 68% of a New York clinic’s patients test positive for coronavirus antibodies, New York Times (Commentary)

The New York Times reports that people living in some of the areas of New York City hit hardest by COVID-19 also have the highest incidence of COVID-19 resisting antibodies.

The data, first reported by The New York Times Thursday, shows that more than 68% of people tested positive for antibodies at a clinic in Corona, Queens, while 56% tested positive at another clinic in Jackson Heights, Queens.

While these two working-class neighborhoods saw high numbers for their antibody tests, only 13% of people tested positive for antibodies at a clinic in Cobble Hill, a mostly white and wealthy neighborhood in Brooklyn. The data suggest that while minority and working-class communities were hit hard by the virus, they may be first to build immunity.

“When you’re looking at a large population of people and a large percentage of those people are technically immune to a virus, you could start thinking it’ll be almost impossible for the virus to penetrate and for people to get sick,” said Dr. Daniel Frogel, senior vice president of medical operations at CityMD.

Commentary — This data suggests that attempting to limit COVID-19 exposure and infections may be completely wrong-headed and counter-productive. To achieve herd immunity, a high rate of coronavirus infection may necessary.

In other words, it may be that face masks should be prohibited, not made mandatory.

And the most exciting thing about this New York study is that the COVID-19 antibody rates of 60 percent or better seen in hard hit New York neighborhoods would appear to be enough to grant the population herd immunity!

In fact, if two recent articles in Atlantic Monthly and The Conversation / Umeå University are correct, 60 percent coronavirus antibodes may be THREE TIMES more than are needed to achieve herd immunity against the coronavirus pandemic.

bad news

July 10, 2020 – How coronavirus affects the entire body; Health (Commentary)

Health reports that in the very small minority of COVID-19 infections where the individuals show symptoms from the infection, the damage wrought by the virus can be widespread and severe.

Coronavirus can damage not only the lungs, but the kidneys, liver, heart, brain and nervous system, skin and gastrointestinal tract, according to doctors from Columbia University Irving Medical Center in New York City.

Their comprehensive picture shows the coronavirus attacks virtually every major system in the human body, directly damaging organs and causing the blood to clot, the heart to lose its healthy rhythm, the kidneys to shed blood and protein and the skin to erupt in rashes. It causes headaches, dizziness, muscle aches, stomach pain and other symptoms along with classic respiratory symptoms like coughing and fever.

Much of the damage wrought by the virus appears to come because of its affinity for a receptor — a kind of molecular doorway into cells — called ACE2. Cells lining the blood vessels, in the kidneys, the liver ducts, the pancreas, in the intestinal tract and lining the respiratory tract all are covered with ACE2 receptors, which the virus can use to grapple and infect cells, the Columbia team wrote in their review, published in the journal, Nature Medicine.

Blood clotting effects appear to be caused by several different mechanisms: direct damage of the cells lining the blood vessels and interference with the various clotting mechanisms in the blood itself. Low blood oxygen caused by pneumonia can make the blood more likely to clot, the researchers said.

These clots can cause strokes and heart attacks or can lodge in the lungs or legs. They clog the kidneys and interfere with dialysis treatments needed for the sickest patients.

Damage to the pancreas can worsen diabetes, and patients with diabetes have been shown to be at the highest risk of severe illness and death from coronavirus.

The virus can directly damage the brain, but some of the neurological effects likely come from the treatment.

“COVID-19 patients can be intubated for two to three weeks; a quarter require ventilators for 30 or more days,” according to the study. “These are very prolonged intubations, and patients need a lot of sedation. ‘ICU delirium’ was a well-known condition before COVID, and the hallucinations may be less an effect of the virus and more an effect of the prolonged sedation.”

The virus also affects the immune system, depleting the T-cells the body usually deploys to fight off viral infections. “Lymphopenia, a marker of impaired cellular immunity, is a cardinal laboratory finding reported in 67-90% of patients with [symptomatic] COVID-19” infections, the researchers wrote.

Commentary — As many as 96 percent of people infected with the coronavirus are asymptomatic and don’t even know they are infected, but a small minority of those infected may suffer a wide range of harmful bodily effects, including damage to the lungs, heart, kidneys, pancreas, immune system and brain.

However, some of this damage — such as dementia — may be the result of ill-advised hospital “treatments,” such as prolonged intubation on ventilators.

good news

July 10, 2020 – Covid-19 Immunity May Rely on a Microscopic Helper: T Cells, Wired (Commentary)

Wired reports that researchers have been looking beyond antibodies to understand how immunity to the new virus might work—and how to design a vaccine.

If you want to know if you’ve ever been infected with SARS-CoV-2 (COVID-19), the natural thing to do is to get a blood test. These look for antibodies—proteins that signal your body has encountered a virus, and could perhaps be protected from catching it again. But recently, a study published in Nature Medicine introduced a worrying complication. Researchers in Chongqing, China, followed 37 people who had tested positive for the virus but didn’t show symptoms during their illness—in other words, who were asymptomatic—and tested their blood regularly. They found those antibodies didn’t always last for long: In some cases, after two to three months, they were barely detectable. Thought a positive antibody test was your ticket out of this thing? It’s not so simpleSimple, after all, is not a word immunologists would ever use to describe their field.

Marcus Buggert, an immunologist at the Karolinska Institute in Sweden, had noticed a similar pattern among patients there: cases where people who tested positive for the virus quickly lost their antibodies or never appeared to muster those forces at all. That wasn’t a big surprise—antibodies had also waned in patients who recovered from SARS. But to Buggert, who studies T cells—part of an orchestra of cells that perform in the body’s immune response—the symphony appeared incomplete. Research from SARS offered hints that, even if antibodies faded, some people retained immune cells that recognized the virus. Sometimes, those responses could last for years. For SARS-CoV-2, similar dimensions of the immune response could have bearing on how immunity works and how to design a vaccine. “Just because you can’t detect antibodies in their blood doesn’t mean there’s no immune response,” Buggert says.

Antibodies are a critical component of immunity—especially the ones that “neutralize” the virus by homing in on the proteins that comprise it. They glom onto their target and prevent the virus from infecting cells. A good vaccine will try to replicate that kind of natural protection. “Neutralizing antibodies are the holy grail,” says Sallie Permar, a vaccine researcher at Duke University. “There are few to no viral vaccines where we’re not shooting for that as an end point.”

But antibody levels are only part of the immunity story. While antibodies may wane past the limit of detection, that doesn’t mean they go away entirely. And even a very low level could be protective. “What‘s important when you’ve been exposed to the virus is how quickly you can ramp up those antibodies,” Permar says. That involves a whole army of cells, which store knowledge of each new pathogen they encounter. There are B cells, which help coax those virus-specific antibodies into existence, plus killer T cells, which can learn to obliterate infected cells. Helper T cells help orchestrate the whole process. “You have multiple arms of the immune response,” says Donna Farber, an immunologist at Columbia University who studies respiratory viruses. “It’s like the Army, the Navy, and the Air Force.” If one branch stands down, the body hasn’t necessarily lost its germ-fighting capacity.

For vaccine researchers, those helper T cells are of particular interest. They’re the ones that rally the troops, kicking off the process that leads to antibody production. But so far, there hasn’t been evidence that that’s how the body is actually primed to fight SARS-CoV-2, says John Wherry, an immunologist at the University of Pennsylvania. That’s because T cell responses are much harder to measure than antibody levels, requiring a lot of blood and fine-tuned instrumentation to wrangle the right kinds of immune cells. “We’ve lacked data on which cells—especially B and T cells—are truly recognizing the virus,” Wherry says. “There’s a lot of noise.”

That makes it difficult to know if vaccine developers are really on the right track. Their hunch is based, primarily, on how the immune system responds to other pathogens. But some viruses evade the typical patterns. They short-circuit the immune response. The most infamous example of that is HIV, Wherry says, which attacks the very T cells that would coordinate the immune response to the virus. SARS-CoV-2 has already offered its own twists and turns, like its propensity to prompt runaway immune responses. For Covid-19, “there’s no prototypical immune response, especially in severe cases,” Wherry says.

Lately, though, systematic studies of T and B cell responses to SARS-CoV-2 have begun to elicit some patterns. Recently, researchers at the La Jolla Institute for Immunology looked at T cell responses in what they considered “average” cases of the disease—people who got sick but didn’t need to be hospitalized. In a study published in Cell in May, they found that all of their subjects developed helper T cells, and 70 percent had killer T cells. The level of the T cell response, they found, roughly corresponded with levels of neutralizing antibodies. Other studies, including a recent preprint from a team at Oxford, have come to similar conclusions.

Simply having T cells—or even antibodies—that recognize the virus doesn’t mean you’re protected. There’s much more to learn about that. But on the vaccine front, the findings looked like good news. “It’s confirming that [helper] T cells are going to be an important factor in generating a robust antibody response,” Permar says. That’s a relief for pharma companies trying to replicate that process with a vaccine.

But immunology is never straightforward, remember? The La Jolla group’s findings came with a wrinkle: In a control group of blood donors who had never been exposed to SARS-CoV-2, the researchers also found T cells that recognized the virus. They speculate that those T cells might be “cross-reactive” with other viruses. Say you’ve had a lot of colds—especially colds caused by other coronaviruses. Then perhaps your immune system is primed to recognize this new virus based on its experience with other viral proteins, the researchers suggested.

It’s too soon to tell if those particular T cells offer any useful protection against SARS-CoV-2, the researchers caution. (In fact, let’s just make that the blanket caveat, for now.) But cross-reactive cells could have implications for vaccines too, Permar says. Those T cells could be a good thing, if they give their bearers a head start in producing antibodies after vaccination. Or they could backfire if a vaccine stimulates them to generate the wrong kind of antibodies, elbowing out a more fine-tuned response to SARS-CoV-2.

And what about when those antibodies wane in exposed people, or if they don’t show up at all? To address that question, Buggert’s team in Sweden took a slightly different approach. In addition to Covid-19 patients and two control groups—blood donors who gave samples before and after the pandemic began—they added members from the households of people with known cases. Those people, they reasoned, were at a greater likelihood of having been exposed to the virus than the general population, even if they had never shown symptoms or got tested.

Like other researchers, Buggert’s team saw cross-reactive T cells in unexposed people. But they also looked for responses that were specific to this virus by identifying a unique array of viral proteins those T cells recognized—a response not seen in the pre-pandemic blood donors. “People who have really been infected [with SARS-CoV-2] tend to respond against multiple different regions of the virus,” Buggert explains. “They have a broader response.” In a few blood donations taken during the pandemic, and in the household members of Covid-19 patients, they found that unique T cell response, but no antibodies.

That research hasn’t been peer-reviewed yet. And it’s a small study, Farber notes, with plenty of uncertainty; ruling out cross-reactivity entirely is a difficult task. “I think you need really big cohort studies to assess that this is possible,” she says. And in any case, back to that original caveat: Nothing about the results says that a T cell response alone confers immunity to Covid-19. But to Buggert, it demonstrates the importance of looking beyond antibodies alone when investigating potential immunity.

Commentary — This is an interesting and thoughtful piece that takes the herd immunity discussion in America beyond the hysterical, dumb-think coverage seen in sources like CNN (“We’re wasting our time talking about herd immunity”).

Here’s an absolute, unequivocal fact of the matter — herd immunity is what has gotten the human species through every pandemic we have ever faced, and it is what will get us through this one. The only question here is really how many people will have to die to achieve herd immunity protection.

With a vaccine, herd immunity can be achieved without great loss of human life. Without a vaccine, it will take mass graves. But either way, herd immunity is humanity’s ONLY way out of the COVID-19 pandemic.

bad news

July 10, 2020 – Chinese virologist accuses Beijing of coronavirus cover-up, flees Hong Kong: ‘I know how they treat whistleblowers’, Fox News

Dr. Li-Meng Yan told Fox News that she believes China knew about the coronavirus well before it claimed it did. She says her supervisors also ignored research she was doing that she believes could have saved lives.

Yan’s story weaves an extraordinary claim about cover-ups at the highest levels of government and seemingly exposes the obsessive compulsion of President Xi Jinping and his Communist Party to control the coronavirus narrative: what China knew, when it knew it and what edited information it peddled to the rest of the world.

Yan said a scientist at the Center for Disease Control and Prevention in China who had first-hand knowledge of the cases told her on Dec. 31, 2019 about human-to-human transmission well before China or the WHO admitted such spread was possible.

She reported some of these early findings back to her boss, Yan said.

“He just nodded,” she recalled, and told her to keep working.

A few days later, on Jan. 9, 2020, the WHO put out a statement: “According to Chinese authorities, the virus in question can cause severe illness in some patients and does not transmit readily between people… There is limited information to determine the overall risk of this reported cluster.”

She also claims the co-director of a WHO-affiliated lab, Professor Malik Peiris, knew but didn’t do anything about it.

The WHO and China have vehemently denied claims of a coronavirus cover-up.

bad news

July 11, 2020 – 80% Of People Hospitalized With Coronavirus Still Had Symptoms Two Months Later, Says New Study, Forbes (Commentary)

Forbes reports that a new study looking at people discharged from hospital after treatment for COVID-19 has found that 80 percent of them were still reporting symptoms two months later.

The research published in the Journal of the American Medical Association looked at 143 patients from Italy who had been hospitalized with Covid-19 and survived.

At the time of the assessment, none of the patients reported fever, or any symptoms of acute COVID-19 but over half reported fatigue and 43% reported shortness of breath. Almost a third of the survivors reported joint pain and 22% had chest pain.

Only 13% of patients were free of any COVID-19-related symptoms after two months, whereas more than 50 percent of the people reported three or more symptoms. People profiled in this study were between 19-84 years old, with an average age of 57.

In some people, COVID-19 can cause persistent and long-lasting symptoms, even long after the virus itself can no longer be detected.

Commentary — while COVID-19 does not make most people sick, and more than 99 percent of those infected survive, it does cause serious, persistent health issues for a small minority of those people who become infected with the disease.

good news

July 12, 2020 – Florida’s 15,300 new COVID-19 cases sets a new U.S. pandemic record, South Florida Sun-Sentinel (Commentary)

The South Florida Sun-Sentinel reports that Florida hit an alarming one-day high on Sunday with 15,300 new coronavirus cases, shattering both the state and national record for new cases reported since the start of the pandemic.

With Sunday’s staggering surge in new cases, Florida eclipsed New York’s coronavirus peak of 12,274 cases on April 4.

Researchers say they expect deaths to rise nationwide in the coming weeks, but some aren’t expecting the numbers to spike as dramatically as they did in the spring partly due to increased testing.

Adm. Brett Giroir, a member of the White House coronavirus task force, says mask-wearing is key to curbing the spread of the potentially fatal virus.

“If we don’t have that, we will not get control of the virus,” Giroir, assistant secretary at the Health and Human Services Department, told ABC’s “This Week” on Sunday.

Florida reported 45 new deaths Sunday morning. That’s a lower tally than in the past several days.

On Thursday, Florida reported 120 deaths in one day, setting a state record for daily deaths during the pandemic. On Saturday, two days later, Florida tallied its second-most deaths in a day, with 98. Friday’s death toll was also high, at 93.

Commentary — Despite the heavy breathing note of terror in this story, it is actually very good news that Florida is experiencing record numbers of new coronavirus cases!

We as a nation and a species need as many people as possible to get the coronavirus so that the “herd” can achieve immunity.

As a recent article in the Atlantic notes, places like New York City that were hammered by the first wave of the coronavirus pandemic “have now achieved “a version of herd immunity, or at least safe equilibrium,” with low numbers of new infections, BECAUSE THEY WERE HAMMERED.

In fact, recent studies show that the hardest hit New York neighborhoods have coronavirus antibodies in as high as 60 percent of the population, while less hard hit neighborhoods only have antibodies in less than 20 percent of the population.

Herd immunity is what has gotten the human species through every pandemic we have ever faced, and it is what will get us through this one. The only question here is really how many people will have to die to achieve herd immunity protection.

With a vaccine, herd immunity can be achieved without great loss of human life. Without a vaccine, it will take mass graves. But either way, herd immunity is humanity’s ONLY way out of the COVID-19 pandemic.

But you can’t ride on the herd immunity bus unless you pay the fare, and the cost here is that many people must get infected (the majority of whom will be asymptomatic and not even know they are sick) , and a few (about 1/2 of 1 percent of those infected) must die so the majority may live.

Them’s the hard facts of the matter. We’re not dealing with a stroll in the park here; we’re dealing with a pandemic!

good news

July 12, 2020 – Russia first nation to finish human trials of Coronavirus vaccine, Tass News Agency

Russian news agency TASS reports that Russia has become the first country to complete human trials of the COVID-19 vaccine on Sunday, July 12. The Russian news agency added that the results have proven the effectiveness of the medication.

Human trials have been completed at the Sechenov University, and the subjects of the study will soon be discharged, said chief researcher Elena Smolyarchuk who heads the Center for Clinical Research on Medications at the university.

“The research has been completed and it proved that the vaccine is safe. The volunteers will be discharged on July 15 and July 20,” said Smolyarchuk in an interview with TASS.

However, there was no further information yet on when their vaccine would be commercially reproduced. On June 18, Russia had allowed clinical trials of two forms of a potential COVID-19 vaccine developed by the Gamaleya National Research Center for Epidemiology and Microbiology.

Moreover, Burdenko Military Hospital received the first vaccine in the form of a solution for intramuscular administration. Then another vaccine in the form of a powder for preparing the solution for an intramuscular administration was carried out at the Sechenov First Moscow State Medical University.

The first stage of the Sechenov University vaccine research involved 18 volunteers in one group and a second group with 20 volunteers. After the vaccination, the volunteers were expected to remain isolated in a hospital for 28 days.

Early results of the vaccine tests on a group of volunteers showed that they were developing antibodies to the coronavirus.

good news

July 12, 2020 – Coronavirus: Could It Be Burning Out After 20 Percent of a Population Is Infected?, The Conversation (Commentary)

More than half a million people have died from COVID-19 globally. It is a major tragedy, but perhaps not on the scale some initially feared. And there are finally signs that the pandemic is shuddering in places as if its engine is running out of fuel.

On the Diamond Princess cruise ship, for example, where the virus is likely to have spread relatively freely through the air-conditioning system linking cabins, only 20 percent of passengers and crew were infected. Data from military ships and cities such as StockholmNew York, and London also suggest that infections have been around 20 percent – much lower than earlier mathematical models suggested.

This has led to speculation about whether a population can achieve some sort of immunity to the virus with as little as 20 percent infected – a proportion well below the widely accepted herd immunity threshold (60-70 percent).

The Swedish public health authority announced in late April that the capital city, Stockholm, was “showing signs of herd immunity” – estimating that about half its population had been infected. The authority had to backtrack two weeks later, however, when the results of their own antibody study revealed just 7.3 percent had been infected. But the number of deaths and infections in Stockholm is falling rather than increasing – despite the fact that Sweden hasn’t enforced a lockdown.

Hopes that the COVID-19 pandemic may end sooner than initially feared have been fuelled by speculation about “immunological dark matter”, a type of pre-existing immunity that can’t be detected with coronavirus antibody tests.

Antibodies are produced by the body’s B-cells in response to a specific virus. Dark matter, however, involves a feature of the innate immune system termed “T-cell mediated immunity”. T-cells are produced by the thymus and when they encounter the molecules that combat viruses, known as antigens, they become programmed to fight the same or similar viruses in the future.

Studies show that people infected with COVID-19 indeed have T-cells that are programmed to fight this virus. Surprisingly, people never infected also harbor protective T-cells, probably because they have been exposed to other coronaviruses. This may lead to some level of protection against the virus – potentially explaining why some outbreaks seem to burn out well below the anticipated herd immunity threshold.

Young people and those with mild infections are more likely to have a T-cell response than old people – we know that the reservoir of programmable T-cells declines with age.

In older and immunocompromised populations like the Italian COVID-19 epicenter in Bergamo, a town where one in four residents are pensioners, 60 percent of the population had antibodies by early June.

Commentary — this article offers a glimmer of real hope that herd immunity may be achieved against the coronavirus pandemic without the introduction of an effective vaccine, which may never actually happen. It also echoes the recent story in Atlantic Monthly which suggests that if 20 percent of the population has coronavirus antibodies, it may be enough to achieve herd immunity.

good news

July 13, 2020 – A New Understanding of Herd Immunity, Atlantic Monthly (Commentary)

The Atlantic Monthly writes that the herd immunity threshold in the United States might be achieved with “less than 20 percent” of the population infected by COVID-19 and therefore possessing coronavirus antibodies, compared to the 65 percent that many scientists have though would be required to obtain herd immunity.

Here’s why — there is enormous variation even within the U.S. in terms of the impact of the coronavirus pandemic. Some places took limited measures and were barely hit; others locked down but suffered greatly. New York City has been slowly reopening since early June, but despite that—and despite mass outdoor gatherings in the throes of civil unrest over the past six weeks—the city has not seen even a small increase in daily reported cases. By contrast, other cities that have attempted to reopen have seen incapacitating surges.

In a pandemic, the differences the infectious process for different locales and different groups of people make forecasting difficult. When you flip a coin, the outcome is not affected by the flips prior. But in dynamic systems, the outcomes are more like those in chess: The next play is influenced by the previous one. Differences in outcome can grow exponentially, reinforcing one another until the situation becomes, through a series of individually predictable moves, radically different from other possible scenarios. You have some chance of being able to predict the first move in a game of chess, but good luck predicting the last.

That’s exactly what Gabriella Gomes, a professor at the University of Strathclyde, in Glasgow, Scotland, attempts to do. She describes a model in which everyone is equally susceptible to coronavirus infection (a homogeneous model), and a model in which some people are more susceptible than others (a heterogeneous model). Even if the two populations start out with the same average susceptibility to infection, you don’t get the same epidemics. “The outbreaks look similar at the beginning. But in the heterogeneous population, individuals are not infected at random,” she told me. “The highly susceptible people are more likely to get infected first. As a result, the average susceptibility gets lower and lower over time.”

Effects like this—“selective depletion” of people who are more susceptible—can quickly decelerate a virus’s spread. When Gomes uses this sort of pattern to model the coronavirus’s spread, the compounding effects of heterogeneity seem to show that the onslaught of cases and deaths seen in initial spikes around the world are unlikely to happen a second time. Based on data from several countries in Europe, she said, her results show a herd-immunity threshold much lower than that of other models.

“We just keep running the models, and it keeps coming back at less than 20 percent” to achieve herd immunity, Gomes said. “It’s very striking.”

If that proves correct, it would be life-altering news. It wouldn’t mean that the virus is gone. But by Gomes’s estimates, if roughly one out of every five people in a given population is immune to the virus, that seems to be enough to slow its spread to a level where each infectious person is infecting an average of less than one other person. The number of infections would steadily decline. That’s the classic definition of herd immunity. It would mean, for instance, that at 25 percent antibody prevalence, New York City could continue its careful reopening without fear of another major surge in cases.

At Stockholm University, Tom Britton, the dean of mathematics and physics, thinks that a 20 percent threshold is unlikely, but not impossible. His lab has also been building epidemiological models based on data from around the globe. He believes that variation in susceptibility and exposure to the virus clearly seems to be reducing estimates for herd immunity. Britton and his colleagues recently published their model, demonstrating the effect, in Science.

“If there is a large variability of susceptibility among humans, then herd immunity could be as low as 20 percent,” Britton told me. But there’s reason to suspect that people do not have such dramatically disparate susceptibility to the coronavirus. High degrees of variability are more common in things such as sexually transmitted infections, where a person with 100 partners a year is far more susceptible than someone celibate. Respiratory viruses tend to be more equal-opportunity invaders. “I don’t think it will happen at 20 percent,” Britton said. “Between 35 and 45 percent—I think that would be a level where spreading drops drastically.”

“During the last few months, we’ve started talking about ‘natural herd immunity’ and what would be used to block future waves,” says Shweta Bansal, an associate professor at Georgetown University who studies how social interactions influence infectious diseases. She worries that many people conflate academic projections about reaching herd immunity with a “let it run wild” fatalism. “My view is that trying to take that route would lead to mass death and devastation,” she says.

But some areas have had no choice but to let the virus “run wild,” and they are now experiencing the benefits. Essentially, at present, New York City — which was hit very hard by the first coronavirus wave — might be said to be at a version of herd immunity, or at least safe equilibrium. Our case counts are very low. They have been low for weeks. Our antibody counts mean that a not-insignificant number of people are effectively removed from the chain of transmission. Many more can be effectively excluded because they’re staying isolated and distanced, wearing masks, and being hygienically vigilant. If we keep living just as we are, another big wave of disease seems unlikely.

Commentary — This is a rambling and hard to understand story that is nonetheless important, partly for what it says and partly for what it doesn’t want to say for fear of being “politically incorrect.”

The point of the story is that it may be possible to achieve herd immunity against the coronavirus pandemic with only 20 percent immunity in the broad population, or less than one third the percentage many scientists have thought up until now. This is very good news!

The second, implicit point of the story is that places like New York City, which was hammered by the first wave of the coronavirus pandemic, have now achieved “a version of herd immunity, or at least safe equilibrium,” with low numbers of new infections, BECAUSE THEY WERE HAMMERED.

In fact, recent studies show that the hardest hit New York neighborhoods have coronavirus antibodies in as high as 60 percent of the population, while less hard hit neighborhoods only have antibodies in less than 20 percent of the population.

You can’t ride on the herd immunity bus unless you pay the fare, and the cost here is that many people must get infected (the majority of whom will be asymptomatic and not even know they are sick) , and a few (about 1/2 of 1 percent of those infected) must die, or experience what the story euphemistically calls “selective depletion.” Them’s the hard facts of the matter. We’re not dealing with a stroll in the park here; we’re dealing with a pandemic!

bad news

July 13, 2020 – Coronavirus warning from Italy: Effects of COVID-19 could be worse than first thought, Sky News (Commentary)

According to Sky News, the long-term effects of COVID-19, even on people who suffered a mild infection, could be far worse than was originally anticipated, according to researchers and doctors in northern Italy.

Psychosis, insomnia, kidney disease, spinal infections, strokes, chronic tiredness and mobility issues are being identified in former coronavirus patients in Lombardy, the worst-affected region in the country.

The doctors warn that some victims may never recover from the illness and that all age groups are vulnerable.

The virus is a systemic infection that affects all the organs of the body, not, as was previously thought, just a respiratory disease, they say.

Some people may find that their ability to properly work, to concentrate, and even to take part in physical activities will be severely impaired.

“At first, initially, we thought it was a bad flu, then we thought it was a bad flu with a very bad pneumonia, but subsequently we discovered that it is a systemic illness with vessel damage in the whole body with renal involvement, cerebral involvement,” Dr. Roberto Cosentini, head of emergencies at Papa Giovanni XXIII Hospital in Bergamo, Italy, said.

Italian researchers identified serious neurological complications arising from COVID-19 including delirium, brain inflammation, stroke and nerve damage in 43 people aged 16 to 85.

Some of the patients had experienced no severe breathing problems at all, with the neurological disorder being the first and only sign that they had coronavirus.

Commentary — The supposedly “humanitarian” effort to save people who are very sick with COVID-199 is frequently not an act of kindness, as the case of Broadway star Nick Cordero shows. The true kindness is to let them die, for as the country song says, “the secret to a long life is knowing when it’s time to go.”

But as the New York Times has calculated, more 99 percent of the people who become infected with the coronavirus do NOT die. They survive, and the majority do not even know they were “sick.”

And to beat the coronavirus, this is exactly what must happen. We need as many people as possible to get sick and survive. As a recent article in the Atlantic notes, places like New York City that were hammered by the first wave of the coronavirus pandemic “have now achieved “a version of herd immunity, or at least safe equilibrium,” with low numbers of new infections, BECAUSE THEY WERE HAMMERED.

And this is also true of the Italian town that is the scene of this story. Bergamo, Italy, has an elderly population, and was especially hard hit by the first wave of the coronavirum pandemic. However, tests show that more than 60 percent of Bergamo’s population now has coronavirus antibodies which impart at least some immunity to the disease.

A reflection of this is the fact that Dr. Roberto Cosentini was interviewed for this story in a silent hospital emergency room, a stark contrast to the busy emergency room scene at Papa Giovanni XXIII Hospital a few months ago.

good news

July 13, 2020 – Drugmakers will start coronavirus vaccine production by end of summer, Trump health officials say, CNBC

CNBC writes that U.S. health officials and drugmakers expect to start producing potential coronavirus vaccine doses by the end of the summer, a senior administration official said Monday.

The U.S. is aiming to deliver 300 million doses of a vaccine for Covid-19 by early 2021. The manufacturing process is already underway even though they aren’t sure which vaccine, if any, will work, a senior Trump administration official told reporters on a conference call Monday. He said they are already buying equipment, securing the manufacturing sites and, in some cases, acquiring the raw materials.

“Exactly when the vaccine materials will be in production and manufacturing? It’s probably four to six weeks away,” the official said on the call, which was hosted by the Department of Health and Human Services. “But we will be actively manufacturing by the end of the summer.”

Because of the pandemic, U.S. health officials and researchers have been accelerating the development of vaccine candidates by investing in multiple stages of research even though doing so could be for naught if the vaccine ends up not being effective or safe.

U.S. health officials have previously said they are ramping up the manufacturing process to ensure they can immediately get a vaccine to market once they identify one that works.

The Trump administration has selected four potential vaccines as the most likely candidates, but the senior official said Monday that that list could grow. On the list are vaccines from biotech firm Moderna and Johnson & Johnson. The two companies are expected to begin late-stage human trials for potential vaccines by the end of this month. It’s a record-breaking time frameto produce a vaccine — even as scientists say there is no guarantee the vaccines will be effective. 

President Donald Trump has repeatedly touted the “tremendous progress” of vaccine development, calling the project Operation Warp Speed, as coronavirus cases across the U.S. continue to surge. 

good news

July 13, 2020 – Why a coronavirus vaccine won’t end the pandemic by itself, San Francisco Chronicle

The San Francisco Chronicle writes that a vaccine may not be enough to end the coronavirus pandemic and restore society to some semblance of normalcy, according to doctors and researchers who say effective treatments for COVID-19 are equally important.

While many parts of public life, from crowded stadiums to San Francisco’s beloved cable cars, are on hold until the threat posed by the virus abates, a vaccine alone will likely not allow those functions to resume. And even if scientists find a vaccine that works and is safe, it may take a long time to reach everyone who needs it.

In the meantime, millions of people will continue to become ill with the coronavirus. So researchers across the globe are racing to find drugs that can keep more people alive and out of the hospital — and any one of those treatments may ultimately work just as well as a vaccine.

“I’d much rather put my money on the drugs rather than the vaccine for now,” said Dr. Lee Riley, an infectious-disease expert at UC Berkeley’s School of Public Health.

A drug could function similarly to a vaccine if it can prevent people from transmitting the virus in addition to improving their symptoms, Riley said. For example, people can protect themselves from being infected with HIV by regularly taking a pre-exposure prophylaxis, or PrEP, a pill sold under the brand-name Truvada and made by Foster City’s Gilead Sciences.

To accomplish something similar for the coronavirus, drug makers would need to develop a pill that people could take as soon as they begin having symptoms or even as a preventative measure akin to Truvada, Riley said. If a drug along those lines works to prevent people from falling ill with COVID-19, people can start going back to work and school much more easily, he said.

So far, the highest-profile and most advanced drug used to treat COVID-19 is remdesivir, an antiviral medicine that is also made by Gilead. Clinical trials have shown that hospitalized patients who received the drug through intravenous injections recovered faster than those who did not get the treatment, and Gilead revealed data on Friday indicating that remdesivir can help people survive, too. In a recent study of hundreds of coronavirus patients, remdesivir reduced mortality risk by 62%, the company said.

Gilead now is studying an inhalable form of remdesivir. If proved safe, the inhalable version of the drug could be given to patients who are not hospitalized, potentially slowing the spread of the virus.

bad news

July 13, 2020 – WHO: We won’t immediately have a ‘perfect vaccine’, Business Insider

Business Insider writes that a coronavirus vaccine is still many months away, but leading infectious disease experts are already warning that any eventual inoculation won’t be a one-and-done fix for this pandemic, and that we’ll instead have to learn to live with the looming threat of more coronavirus infections for months, if not years to come. 

“Expecting that we will eradicate or eliminate this virus in the coming months is not realistic,” the World Health Organization’s Mike Ryan, executive director of health emergencies, said during a press briefing streamed from Geneva on Monday.

“And also, believing that magically we will get a perfect vaccine that everyone will have access to, is also not realistic.”

Ryan’s notes of caution about eradicating the novel coronavirus, and the disease it causes — COVID-19 — come as the respiratory virus continues rapidly circling the globe, while infecting tens of thousands of new people across the US every day. On Sunday, Florida reported more than 15,000 new COVID-19 cases in a single day, a new record for any US state.

good news

July 13, 2020 – CDC Director Pleads for Mask Compliance: If Everybody Wears One for Six Weeks, We Could Drive Covid ‘Into the Ground’, Mediate.com (Commentary)

Mediaite.com reports that CDC Director Robert Redfield pleaded with people to wear masks in a press conference Monday afternoon, declaring that Americans could drive Covid-19 “into the ground” if everybody wore facial coverings for six weeks.

“If everyone could wear a face covering over the next six weeks we could drive this [coronavirus] into the ground,” Redfield said in Mecklenburg County, NC. Mecklenburg County, which includes Charlotte, has more than seven times the number of Covid-19 positive cases than any other county the state.

Redfield’s comments come as the United States has seen three-straight days of 60,000-plus new coronavirus cases.

The CDC recommends but does not require “people wear cloth face coverings in public settings and when around people who don’t live in your household, especially when other social distancing measures are difficult to maintain,” according to its website.

Commentary — if that’s all it takes, count me in!

— Bruce Brown
Editor, Coronavirus Vaccine & Herd Immunity Digest

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