Covid 10/8/20 | COVID 19 Information Page

Good news – riding the coat tails of Trump regenron monoclonal antibody – this is Eli Lilly version – https://investor.lilly.com/news-releases/news-release-details/lilly-provides-comprehensive-update-progress-sars-cov-2

“An exploratory analysis showed that the proportion of patients with persistent high viral load at day 7 for combination therapy was lower (3.0 percent) versus placebo (20.8 percent), corresponding to a nominal p value of p<0.0001 without multiplicity adjustment”

“The rate of COVID-related hospitalization and ER visits was lower for patients treated with combination therapy (0.9 percent) versus placebo (5.8 percent), a relative risk reduction of 84.5 percent (p=0.049)”

No discussion of cost….

Media discussion – election timing one hopes not playing with peoples emotions but not so sure – Headlines CNN “Only two US states report a decline of new cases and nationwide hospitalizations are increasing” https://www.cnn.com/2020/10/08/health/us-coronavirus-thursday/

Axios “Coronavirus infections rise in 23 states and D.C.” https://www.axios.com/coronavirus-23-states-dc-e11cfce1-6c0b-4dd0-a118-8978f74ce303.html

Both are factually correct. The only piece is the perspective of deaths and how things have improved. Very similar to the case in TX in July with increase hospitalization many said we would see large deaths – which never occurred in Harris County. Below is Wisconsin which clearly shows increase in confirmations and also continued testing. Hospitalization is rising – but correspondingly the fatality rates are still dropping. IF the hospitals are overwhelming one should see the fatality rate increase else they are just over hospitalizing. As seen in the Houston/Harris county case the hospital modified its criteria for hospitalization with only a slight variation of fatality rate. When scarcity occurs its human nature to maximize better.

Hospital revenue is very dependent on elective procedures they don’t have much choice of additional revenue as they are hemorrhaging as a business. Operating room accounts for up to 65% of hospital profit margin. Their inclination to over hospitalized to balance out revenue is very high. This doesn’t make it wrong it just out of more caution than usual – then as bed fills they will likely become more strict with criteria but not to the point beyond reasonable. IF the deaths rise then you know they went beyond that point AND IF you become more strict and fatality don’t rise you know you over hospitalized. Note as beds got full in early July in Houston the amount of hospitalized starting going down even though confirmation rose. Fatality rates stayed the same if not slightly down.

Overall US certainly shows confirmations rising – but no indication of death yet. Even the second surge of confirmation (FL,TX,CA) did not lead to the level of deaths as observed in the first surge. Fatality rates continue to fall. Testing is around 1/3 of the US population now.

I am not saying this is nothing and we should do nothing. No – we should realize the confirmations are rising in the North as a function of people going back inside and heating their homes and not leaving windows open. We need to focus on improving ventilation – getting healthy as comorbidities are direct function of deaths with covid – but realize certain actions would not lead to a different result – massive lockdowns will likely cause more deaths in the long run and not prevent the mass spreading events (people getting together with people they know – church, weddings, bday, graduation, just missing each other, etc…- perhaps the Chinese and other more restrictive society can lockdown but this is not going to happen here) – knowledge and innovation to reduce viral load is the key for the US.

Great news on non-covid research – https://www.usnews.com/news/health-news/articles/2020-10-07/treatment-reverses-young-mans-type-1-diabetes-will-it-last

“After starting a drug that’s officially approved to treat a type of blood cancer, a young man with type 1 diabetes was able to stop using insulin.”

We don’t want to crowd out this type of research due to covid.

Even though confirmations have been rising in younger ages – deaths are not changing in age group.