Covid19mathblog.com

“A lie can travel half way around the world while the truth is putting on its shoes” Mark Twain

Questioning even the obvious allows one to understand the core issues. History books are evolving do they real paint the reality or more how the author wants the history painted. Feel good stories are great but do they represent the truth so one can learn from the past. Here is a real good feel story in USA Today about the vaccine development – all participants are painted like heroes with no selfish intentions (e.g. no desire for fame) other than perhaps the Trump group – I am sure many are great people in the story as they suggest but I am skeptical on how things just coincidentally happens – https://amp.usatoday.com/amp/6555783002

Enjoy the read….

Being a numbers guy lets pull out the numbers from the article and leave the emotions behind –

“the Department of Health and Human Services pledged to spend $483 million on the Moderna vaccine. Later, it would add another $472 million to pay for the trial.”

“Goldman Sachs estimates that Moderna will make $13.2 billion in revenue this year from the vaccine.”

The reason regulated utilities existed is the fact to build “affordable” power generation it required significant scale and significant upfront capital which COULD potentially be worthless IF some other technology or market structure change was to occur. In order to have progress monopoly were constructed and regulated with fixed rate of returns which in theory was balance with the de-risk supplied by the monopoly power. IF vaccine development doesn’t seem like a regulated worthwhile market I don’t know what is. In this case the US govt. spent almost $1 billion – and company can make 13.2Billion in revenue – how much is that profit – how much did they invest – is the rate of return proportional to the risk undertaken particularly if the government is de-risking the deal?

“African Americans die of COVID-19 at nearly three times the rate of white Americans.”

Is this a genetic race thing or an economic issue or lifestyle? IF another race was in the same situation (which many are just perhaps not on the same scale) would they also succumb to that statistic?

IF this was a direct issue then shouldn’t the counties with the highest rates of black observe the highest confirmation per capita ….but its more clearly seen when graphing poverty level. Likely renting therefore older HVAC, smaller housing, perhaps healthy food availability limited – but then again climate probably is also a factor. This is why Dewey SD so high in confirmed per capita yet essentially 0% black. Interesting Macon AL the same poverty level but 3X less confirmed per capita than Dewey with 84% Black rate – so this multifaceted issue just cannot be explained or noted by race or even poverty. The death rate is also worse in Dewey SD than Macon AL by 3X.

US death below 4K – but it’s a weekend.

CA leads states as usual

LA leads with an interesting reporting from NC – unassigned county deaths

LA is on a downward trajectory for confirmation

Covid19mathblog.com

Do you want to know how thorough phase 3 is – take a look at J&J – in addition its important to note the 65% vs 95% is not clear its apple to apple. If you read the document there is a definition of serious covid which gets to the 85% – in the end its not the calculation of death. There was no death from what I gather so one COULD say the vaccine helped either way….. https://www.jnj.com/coronavirus/covid-19-phase-3-study-clinical-protocol

“Case Definition for Severe/Critical COVID-19

 A SARS-CoV-2 positive RT-PCR or molecular test result from any available respiratory tract sample

(eg, nasal swab sample, sputum sample, throat swab sample, saliva sample) or other sample

AND any 1 of the following at any time during the course of observationa

:

 Clinical signs at rest indicative of severe systemic illness (respiratory rate ≥30 breaths/minute, heart

rate ≥125 beats/minute, oxygen saturation (SpO2) ≤93% on room air at sea level*, or partial pressure

of oxygen/fraction of inspired oxygen (PaO2/FiO2) <300 mmHg)

* SpO2 criteria will be adjusted according to altitude per the investigator judgement.

 Respiratory failure (defined as needing high-flow oxygen, non-invasive ventilation, mechanical

ventilation, or extracorporeal membrane oxygenation [ECMO])

 Evidence of shock (defined as systolic blood pressure <90 mmHg, diastolic blood pressure <60 mmHg,

or requiring vasopressors)

 Significant acute renal, hepatic, or neurologic dysfunction

 Admission to the ICU

 Death”

For some reason this study didn’t make much news – HCQ with Zinc and Azithromycin works to reduce covid-19 when treated early – perhaps with Biden people can admit to what is there – risk/reward is asymmetric – https://www.sciencedirect.com/science/article/pii/S0924857920304258?via%3Dihub

“chloroquine and probably HCQ have characteristics of a zinc ionophore resulting in increasing intracellular zinc concentrations [20]. The dose of elementary zinc in this study was similar to doses previously studied to successfully prevent infections in the elderly [45]. The antiviral effects of zinc against a variety of viruses have been demonstrated during the last decades [46]. Zinc, in addition to its role as a general stimulant of antiviral immunity, is known to specifically inhibit coronavirus RNA-dependent RNA polymerase (RdRp) [21]. Based on the ionophore properties of HCQ, it has been hypothesised that zinc may enhance the efficacy of HCQ in treating COVID-19 patients [22]. In addition, zinc might inhibit the serine protease furin [47]. Furin is expressed on endothelial cells, monocytes/macrophages and smooth muscle cells in human atherosclerotic plaques [48] and therefore might play a critical role for the severe cardiovascular complications of COVID-19. As furin might be responsible to favour SARS-CoV-2 spread compared with other Betacoronaviruses [49,50] and as furin inhibition protects from certain viral-dependent infections [51], it may be important to evaluate the potential role of zinc in inhibiting this pathway.”

“Although there is a synergistic antiviral effect between zinc, HCQ and azithromycin, zinc supplementation may be instrumental for the outcome of patient populations with severe clinical courses. Zinc deficiency was confirmed in a large number of healthy elderly [53] and in diabetic patients [54]. In addition, it has been documented that the antihypertensive drugs hydrochlorothiazide, angiotensin-converting enzyme inhibitors and angiotensin 2 receptor antagonists can result in increased urinary excretion of zinc with subsequent systemic zinc deficiency [55]. Age, co-morbidities and relevant co-medications align well with the majority of described COVID-19 patients at high risk, including the risk-stratified population of this analysis. Zinc deficiency might explain why certain patient groups seem not to benefit from HCQ monotherapy. During the 5-day treatment with the triple therapy and during follow-up, no severe adverse events were observed and no cases of cardiac arrhythmia were reported in this general practice, which is in accordance with available safety data for more than 300 000 patients”

CA deaths are high regardless of Covid – almost shows other extra death the same level as covid – so our treatment plan is causing just as much death as covid!

US death back below 4K

CA still leads the US

LA county still leads all counties

LA county data is coming down for confirmation….death is still staying up

Covid19mathblog.com

Results from J&J not great but decent – one shot has a big advantage in this day in age – https://www.buzzfeednews.com/article/danvergano/johnson-and-johnson-janssen-covid-vaccine-results

“Officials from Janssen, a Johnson & Johnson company, said they planned to submit the clinical trial results — a 66% overall reduction in COVID-19 cases after vaccination — to the FDA for possible authorization as a third US coronavirus vaccine in February. While still effective, the reductions are less than the results for the US’s already-authorized COVID-19 vaccines, about a 95% for Pfizer-BioNTech’s and around 94% for Moderna’s.

The vaccine was 72% effective in its US testing, and 85% effective overall in preventing severe disease, as well as completely protective against death and hospitalization.”

“…vaccine relies on a harmless cold virus, called an adenovirus, that has been given the genes for the spike protein used by the coronavirus to infect people’s cells. The vaccine familiarizes the immune system against the spike protein, readying it against the actual virus when it attacks.

Already used for a successful Ebola vaccine, adenovirus vaccines require less care than the two already-authorized mRNA vaccines, easing their administration in pharmacies and smaller clinics. They can be stored in normal refrigerators for up to three months.”

J&J volume is already at 2million – https://www.bloomberg.com/news/articles/2021-01-28/j-j-covid-vaccine-supply-to-start-at-2-million-doses-gao-says?sref=qS0Eg2QL

“Johnson & Johnson will deliver about 2 million doses of its Covid-19 vaccine when it receives an emergency use authorization in the U.S., according to a Government Accountability Office report published Thursday.”

“A spokesman for J&J said in an email that it expected to supply 100 million doses to the U.S. government in the first half of the year. He didn’t comment further on the GAO report.”

Already noted that a decent risk/reward relationship with melatonin and covid exist (https://covid19mathblog.com/2020/07/covid-7-20-20/ – study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211589/) another reason to take it – https://scitechdaily.com/finally-a-supplement-that-actually-boosts-memory-many-already-take-it-for-better-sleep/

“Researchers at Tokyo Medical and Dental University (TMDU) showed that melatonin’s metabolite AMK can enhance the formation of long-term memories in mice. Memory of objects were tested after treatment with melatonin or two of its metabolites. Older mice that normally performed poorly on the memory task showed improvements as dosage increased. The metabolite AMK was found to be the most important as melatonin failed to improve memory if it was blocked from metabolizing into AMK.”

There is a lot of refrigeration occurring as we can subtract the Distributed – Administered by state….over 22 Million Vaccine sit refrigerated….

US death 4K…Mexico, Brazil, Germany, and UK all above 1K

Worldwide confirmation coming down but death is not yet.

CA still leader in both categories

LA county still leading all other counties

NW seeing some confirmation now

Miami-Dade leading in confirmation per capita at almost 15%. LA is still coming down.

Covid19mathblog.com

Variant concerns growing – how the article is written – it leaves the reader with a perpetual income for vaccine makers as they play the cat and mouse game – vs. getting healthy – https://www.npr.org/sections/goatsandsoda/2021/01/27/961108577/why-scientists-are-very-worried-about-the-variant-from-brazil

“A variant called P.1, which emerged in early December in Manaus, Brazil, and by mid-January had already caused a massive resurgence in cases across the city of 2 million people.

On Monday, officials detected the first confirmed case of P.1 in the U.S., specifically in Minnesota. The state Department of Health picked up the case by randomly sequencing 50 nasal swabs from positive patients each week. The person infected with P.1. had previously traveled to Brazil.”

“virus expert Jeremy Luban at the University of Massachusetts told NPR two weeks ago before the variant arrived in the United States. "Manaus already had 75% of people infected [in the spring of last year]."

The concern with P.1 is twofold: Scientists don’t understand why the variant has spread so explosively in Brazil, and the variant carries a particularly dangerous set of mutations.”

“. In addition, Manaus had already been hit extremely hard by the virus in April. One study estimated that the population should have reached herd immunity and the virus shouldn’t be able to spread easily in the community. So why would the city see an even bigger surge 10 months later? Could P.1 be evading the antibodies made against the previous version of the virus, making reinfections easier? Could it just be significantly more contagious? Could both be true?

"While we don’t *know* exactly why this variant has been so apparently successful in Brazil, none of the explanations on the table are good," epidemiologist Bill Hanage at Harvard University wrote on Twitter.”

“the mutations are helping the virus evade antibodies or escape recognition by them. In essence, the mutations are providing the virus with a type of invisibility cloak.

To test out this hypothesis, Moore and her colleagues took blood serum from 44 people infected with the previous version of the virus and checked to see if the antibodies in that serum still worked against the new variant from South Africa. Or did the antibodies lose their sensitivity?

"Indeed that’s what we saw," she said. "In fact, it was really quite a dramatic drop-off in sensitivity. We saw that in half of the serum, the antibodies were significantly less effective against the new variant [from South Africa]." So far, scientists haven’t tested out P.1 in similar neutralization experiments, but P.1 has two mutations that scientists have already shown reduce antibody binding.”

“This process is going to cost the world a great deal of money — and take time, Gupta added. "I don’t think there’s going to be a single solution that just comes along in 2021 that says, ‘That’s it, we’re done.’

"The coronavirus is going to cause a long-term disruption."”

US deaths barely under 4K

TX leads in confirmation whereas CA leads in Death

LA county is leading in both categories again – but slowly coming back into line with other counties

Deaths for LA still resisting in coming down as confirmation fall dramatically for LA

It is interesting to note how well the NW US has done even though it was one of the beginning states plus they are generally colder up there.

Covid19mathblog.com

Pfizer is making some very impressive media coverage – more vaccine coming than expected – https://www.bloomberg.com/news/articles/2021-01-26/pfizer-to-deliver-u-s-vaccine-doses-faster-than-expected-ceo?sref=qS0Eg2QL

“Pfizer Inc. will be able to supply the U.S. with 200 million Covid-19 vaccine doses by the end of May, two months sooner than previously expected, according to its top executive.”

Vaccine looks to be working – https://www.timesofisrael.com/week-after-2nd-pfizer-vaccine-shot-only-20-of-128000-israelis-get-covid/

“The world’s first analysis of fully vaccinated patients has indicated that the Pfizer vaccine is at least as effective as suggested by clinical trials.

Israel’s Maccabi Healthcare Services revealed Monday that only 0.015 percent of people are getting infected in the week after receiving their second shot. Maccabi said it has 128,600 members who have seen seven days pass since full vaccine protection kicked in — and only 20 have caught the coronavirus after they were considered immunized. Leading immunologist Cyrille Cohen told The Times of Israel that among the general population, around 0.65% are infected in a given week.”

““These are very good results, and if it continues this way it could even be that the vaccine is more effective than Pfizer thought it would be based on clinical trials,” Anat Ekka Zohar, the Maccabi analyst behind the research, told The Times of Israel.”

Another promising treatment – https://news.sky.com/story/covid-19-breakthrough-treatment-claims-to-stop-100-of-symptomatic-infections-12200072

“The makers of an experimental drug, now being trialled by the NHS, say it is 100 per cent effective in protecting against symptomatic cases of the virus.

US-based Regeneron Pharmaceuticals says its two-antibody cocktail called REGEN-COV also reduces overall coronavirus infection rates by about 50 per cent.”

“The claims are based on interim results and the "confirmatory stage" of the trial will not be complete until the second quarter of this year, but the company has said it is hopeful it may "break the chain" of rising infections.”

“REGEN-COV works by combining two antibodies which bind to a protein on the surface of the virus and blocks infections of SARS-CoV-2, the virus that causes COVID-19.

Former US president Donald Trump claimed the drug "cured" him after he contracted COVID-19 last year.”

A better late than never claim from CDC about school openings….yes there are ways to make schools safer….https://www.nytimes.com/2021/01/26/world/cdc-schools-reopening.html

“On Tuesday, federal health officials weighed in with a call for returning children to the nation’s classrooms as soon as possible, saying the “preponderance of available evidence” indicates that in-person instruction can be carried out safely as long as mask-wearing and social distancing are maintained.

But local officials also must be willing to impose limits on other settings — like indoor dining, bars or poorly ventilated gyms — in order to keep infection rates low in the community at large, researchers at the Centers for Disease Control and Prevention said in the journal JAMA and in a follow-up interview.”

There are very successful counties that implemented school openings. I am sure most adjusted their HVAC and open doors and windows. The should come up with guidelines on CO2 readings to know what are proper ventilation levels.

Back to the high numbers…US over 4K – Mexico, UK, Brazil over 1K

CA leading in both for US

LA county leading in both

Confirmation is going down for LA – unfortunately not for deaths

Limited dispersion outside CA AZ, NY, and TX

Covid19mathblog.com

Another existing drug for treatment for covid-19 – 30X more effective than remdesivir – https://sfist.com/2021/01/25/ucsf-team-finds-cancer-drug-that-is-30-times-more-effective-at-fighting-covid-19-than-remdesivir/

“A research team at UCSF has landed on a potential game-changing treatment for COVID-19, though it is a cancer drug made by a Spanish firm that is not yet approved for any uses in the United States.

The drug is called Aplidin (generic name: plitidepsin), and it’s a compound that was originally derived from one found in a bizarre marine creature found near Ibiza called Aplidium albicans. As the team explains in a new report in the journal Science, plitidepsin was shown to dramatically inhibit the replication of SARS CoV-2, a.k.a. the coronavirus, and may in fact be 30 times more effective as an antiviral treatment than remdesivir, which has been used on an emergency basis in patients in clinical settings since last winter.

The team that discovered the new treatment was led by UCSF systems biologist Nevan Krogan, and it appears to potentially be the biggest success to arrive from a project that began last February to isolate existing drugs and compounds that might work as antiviral treatments.”

“Scientists both in San Francisco and on other teams around the globe participating in the same effort found two human proteins that appeared to be key in the fight to shut down the coronavirus’ ability to replicate inside people, Sigma R1 and Sigma R2, and their drug search initially focused on these. Aplidin works on the human protein known as eEF1A, and because it focuses on the human part of the equation and not the virus, it should hopefully remain effective as the virus mutates.

And the project is highlighting something scientists have long stressed about the importance of maintaining biodiversity in the world’s oceans and elsewhere. The marine invertebrate from which this compound is derived is an ascidian or sea squirt that looks "a bit like a disembodied brain," as the Chronicle explains. The drug is actually owned by a Spanish company founded by a scuba diver, Pharma Mar, and it’s been approved in Australia for treating the blood cancer known as multiple myeloma. It’s also been used in the EU as a treatment for lymphoblastic leukemia. The drug is in Phase 2 clinical trials in Spain, during which it has been tested on 45 severely ill COVID patients. Based on data on the first 27 of those patients, the drug significantly reduced the amount of time people spent in the hospital, with 81 percent going home after 15 days, compared to a typical rate of under 50 percent. And according to a separate paper, Aplidin appears to be effective against the UK variant of the virus as well.”

“Aplidin still has to undergo more broad-based Phase 3 clinical trials, which will reportedly take place in both Spain and the U.S. And it remains to be seen how long it could be — should it prove as effective as the early trials suggest — before the drug becomes widely available here.”

The US is blocking international travel now whereas CA is opening up even though LA county is still the worse in the country in confirmation and deaths – https://www.traveloffpath.com/new-u-s-travel-restrictions-could-devastate-mexico-tourism/

“After a new testing requirement mandates all Americans to present proof of a negative Covid-19 antigen test, many travelers were left scrambling on where and how to get testing. Just when Americans thought it couldn’t get any harder to travel abroad, Joe Biden announced a new presidential proclamation stating all travelers entering the U.S. from abroad would need to self-quarantine following the CDC’s recommended guidelines of 7-10 days.”

https://apnews.com/article/california-lifts-stay-home-order-virus-1c298c67338a5914f7c3857cd167edcc

“Gov. Gavin Newsom lifted stay-at-home orders across the state Monday in response to improving coronavirus conditions, a surprising move hailed by beleaguered businesses but that prompted caution from local health officials concerned the public may let down its guard.

“We’re seeing a flattening of the curve — everything that should be up is up, everything that should be down is down — case rates, positivity rates, hospitalizations, ICUs,” Newsom said at a virtual news conference.

The turnaround puts California in a starkly different place than it was last month, when some Southern California hospitals overwhelmed by virus patients were crafting emergency plans for rationing care.”

Complaining about Nasal Swab? How about an anal swab? https://www.newsweek.com/covid-anal-swabs-beijing-residents-more-accurate-says-chinese-expert-1564381?

“"In some asymptomatic cases or in individuals with mild symptoms, they tend to recover from the illness very quickly. It’s possible that there will be no trace of the virus in their throat after three to five days.

"What we’ve found is that in some infected patients, the coronavirus survives for a longer period of time in their digestive tract or excrement than in their respiratory tract."

Li said rectal swabs increase the rate of detectability and lower the chances of a missed diagnosis.

"Of course, anal swabs aren’t as convenient as throat swabs, so they’re only being used on individuals in key quarantine areas. This will reduce the return of false positives," he added.

According to guidelines published by China’s National Health Commission, anal swabs are to be administered 3 to 5 centimeters (1.2 to 2 inches) inside the rectum. The swab is to be rotated and removed before being securely placed inside a sample container.

On Friday, a resident of Tangshan in Hebei province, about 120 miles east of Beijing, told CCTV that she was given double rectal swabs as part of citywide testing in her area. She said each swab took just under 10 seconds.

A few medical papers release since the start of the outbreak last year have suggested anal swabs as a more accurate way of testing for COVID-19, but its merits have yet to be widely accepted by the Chinese medical community.”

Still a good reporting day – US under 2K deaths

CA leading the states in both death and confirmation

First time in awhile LA county not leading death. Tarrant County (near Dallas TX) leading deaths at 81 – LA at 52 but next 5 counties all S. California

Middle of the country seems to not have much covid issue

Good news LA is coming down.

Covid19mathblog.com

Good news on vaccine front – https://fortune.com/2021/01/24/israel-covid-vaccine-cases-hospitalizations-decline/

“Israel’s world-leading campaign to vaccinate its citizens is beginning to rein in the disease, according to the country’s second-largest health network.

Maccabi Health Services studied a sample group of 50,777 people over the age of 60 inoculated in late December and then again in mid-January. Raw data showed that two days after the second shot, the number of new infections and hospitalizations were both down about 60% from their peak, researchers reported.

Trends began to shift around two weeks from the first dose, according to the analysis Maccabi’s KSM Research and Innovation Center did in collaboration with Israeli computational health researchers KI Institute.”

“A separate Israeli study of health workers who received two doses of the Pfizer Inc. shot found elevated levels of antibodies in nearly every participant that matched or exceeded clinical results. Israel has been largely using Pfizer’s vaccine since it began its immunization drive in late December, with Prime Minister Benjamin Netanyahu offering data on the campaign to expedite and expand shipments. The country has been adhering to Pfizer’s guidance of a second shot about three weeks after the first, reserving second doses.

So far about 2.5 million people, or more than a quarter of the population, have received a first dose, with almost a million more getting the second. Children under 16, who have not been approved to take the vaccine, account for about 30% of the country’s 9.3 million people.

The country is currently in the midst of a third lockdown that began in late December to control a resurgence of the outbreak. In total, Israel has had nearly 600,000 cases and more than 4,360 deaths.”

More testing and more awareness of any little symptom required testing probably the largest driver on why younger are testing positive for covid-19 – https://www.forbes.com/sites/robertglatter/2021/01/24/why-are-so-many-more-young-adults–testing-positive-for-covid-19/?sh=3a5ae98b745f

“New findings from a CDC study (conducted from March through December) indicate that young adults, 24 and younger, were more likely to test positive (RT-PCR) for Covid-19, and drive transmission, compared to the summer of 2020. But the study’s findings come with a caveat, as explained by one expert.”

“Data from the study revealed that close to 3 million confirmed cases of Covid-19 were reported in those 24 and younger. The study also found that close to 60 percent of newly diagnosed cases were seen in those 18-24 years of age. This suggests that the virus is striking younger age groups at an increased rate; in fact, the greatest incidence of new cases was seen during the final week of the study in December.”

“Anotther recent CDC study, conducted July through Sept 2020, and published in earlier this month found that U.S. counties with university in-person instruction had a 56% increase in incidence of Covid-19, by comparing the 21-day periods before and after classes began. Meanwhile, U.S counties with large colleges or universities with remote instruction had close to an 18% decrease in incidence of Covid-19. Another study published last month in Science also found that closing schools and universities reduced transmission R(t) by 38%. Limiting gatherings to less than 10 people also led to an impressive 42% reduction of transmission. This data clearly argues for instituting remote learning as a way to reduce the elevated risk for transmission with in-person college instruction, as eloquently presented on Twitter by Dr. Eric Feigl-Ding, an epidemiologist, health economist and Adjunct Senior Fellow at the Federation of American Scientists in Washington, DC.”

““However, despite young children being susceptible [to infection], epidemiology does not show in-person PreK-12 to be a driver of infection,” emphasized Adalja. “Colleges with in-person learning are different and require significant testing protocols and guidance for off-campus activities to minimize the impact of COVID.”

The bottom line is that clear and explicit messaging to younger persons promoting mask wearing, physical distancing and avoiding crowded spaces as the primary strategy to contain Covid-19 is imperative until vaccines become more readily available, especially in light of the uneven rollout of the Pfizer and Moderna vaccines over the past 6 weeks. The arrival of additional vaccines (Johnson and Johnson, AstraZeneca) is forthcoming in the next several weeks to months, and will be welcome as the Biden administration ramps up vaccine production using the Defense Production Act (DPA).”

I think this message from Dr. Eric Feigl-Ding is weak – it’s a total cop out. The data also shows there are more successful schools and perhaps we should learn from the successful openings and applied those to others vs. close it all down. We can see it our county school data – certain counties are much more effective in managing covid transmission – what are they doing – modify ventilation? – mask wearing? Parent support? Etc….

CDC vaccine data pulled in….and what does it tell us….distribution of vaccine is not by need….if it was by need there distribution should be a function of confirmation by state…. Why Alaska the highest per capita? South Carolina at bottom?

Vaccine should be distributed by need? South Carolina top 3 confirmation per capita.

We also can learn how well states are doing disseminating the vaccine….Prisons did a great job!…..States like CA and AZ who have huge issues are doing an awful job!

Great Sunday report – US under 2K deaths no other country above 1K

CA still in the lead

No surprise LA county the leader

Good news LA is still on decline for confirmation.

Covid19mathblog.com

As noted very early – May 28 2020 https://covid19mathblog.com/2020/05/covid-5-28-20/– the data suggested what this article is now discussing – this is endemic. What is sad this article focus on highlighting medicine to save us vs. letting us save ourselves by having a healthier lifestyle – https://api.nationalgeographic.com/distribution/public/amp/science/2021/01/covid-19-will-likely-be-with-us-forever-heres-how-well-live-with-it

“the likeliest long-term outcome is that the virus SARS-CoV-2 becomes endemic in large swaths of the world, constantly circulating among the human population but causing fewer cases of severe disease. Eventually—years or even decades in the future—COVID-19 could transition into a mild childhood illness, like the four endemic human coronaviruses that contribute to the common cold.”

““People have got to realize, this is not going to go away,” says Roy Anderson, an infectious disease epidemiologist at Imperial College London. “We’re going to be able to manage it because of modern medicine and vaccines, but it’s not something that will just vanish out of the window.””

“A 2013 study in BMC Infectious Diseases shows that on average, humans are first exposed to all four of these coronaviruses between the ages of three and five—part of the first wave of infections that young children experience.

These initial infections lay the foundation for the body’s future immune response. As new variants of the endemic coronaviruses naturally evolve, the immune system has a head start in fighting them off—not enough to eradicate the virus instantly, but enough to ensure that symptoms don’t progress much beyond the sniffles.

“The virus is also its own enemy. Every time it infects you, it tops up your immunity,” says Marc Veldhoen, an immunologist at Portugal’s University of Lisbon.”

“Past studies make clear that partial immunity can keep people from getting seriously ill, even as coronaviruses successfully enter their systems. Long-term, the same is likely to be true for the new coronavirus. Emory University postdoctoral fellow Jennie Lavine modeled SARS-CoV-2’s post-pandemic trajectory based on the 2013 study’s data, and her results—published in Science on January 12—suggest that if SARS-CoV-2 behaves like other coronaviruses, it will likely morph into a mild nuisance years to decades from now.

This transition from pandemic to minor ailment, however, depends on how the immune response to SARS-CoV-2 holds up over time. Researchers are actively examining the body’s “immunological memory” to the virus. A study published in Science on January 6 tracked the immune response of 188 COVID-19 patients for five to eight months post-infection, and while individuals varied, about 95 percent of patients had measurable levels of immunity.

“Immunity is waning, but certainly not gone, and I think this is key,” says Lavine, who wasn’t involved with the study.”

“Current vaccines should still work well enough against emerging variants, such as the B.1.1.7 lineage first found in the United Kingdom, to prevent many cases of serious illness. Vaccines and natural infections create diverse swarms of antibodies that glom onto many different parts of SARS-CoV-2’s spike protein, which means that a single mutation can’t make the virus invisible to the human immune system.”

“Other labs have found that mutations in 501Y.V2, the variant first found in South Africa, are especially effective at helping the virus elude antibodies. Out of 44 recovered COVID-19 patients in South Africa, blood extracts from 21 of the patients didn’t effectively neutralize the 501Y.V2 variant, according to another preprint published on January 19. Those 21 people had mild to moderate cases of COVID-19, however, so their antibody levels were lower to begin with, perhaps explaining why their blood did not neutralize the 501Y.V2 variant.”

“Experts agree that transitioning beyond a pandemic depends on the prevalence of immunity, especially among older and more vulnerable populations. Younger people, especially children, will build up immunity to SARS-CoV-2 over a lifetime of exposure to the virus. Today’s adults have had no such luxury, leaving their immune systems naive and exposed.

The exact threshold for achieving population-wide immunity that slows down the virus’s spread will depend on how contagious future variants become. But so far, research of early variants of SARS-CoV-2 suggest at least 60 to 70 percent of the human population will need to become immune to end the pandemic phase.”

Lets do some review of stats

Perhaps this is due to more testing but very interesting to see Asia not even showing up

Last 30 days death – though the US leads – on a per capita basis UK is higher

Regionally US does not fare too bad when calculated on per capita. The super star is South and Central Asia- whereas the worse region is Central and Southern Europe.

US county death per capita last 30 days – NY counties actually lead. LA does show up even though the large population base in 14th.

On a confirmation basis LA and surrounding areas lead for the last 30 days

High deaths for a weekend 3.3K in US

CA leads again

LA county leads by a long shot to other counties

LA is out there on the map

However for LA it is much better than last few weeks. Magically the 7 day confirmation has 7k/day since Jan 13th! Death hasn’t fallen as dramatically but should start following.

Covid19mathblog.com

Confusing message for vaccine – particular those requiring two shots – personally I would lean towards to one shot vaccine just due to implementation issue and how busy peoples lives can get – https://www.post-gazette.com/news/covid-19/2021/01/23/CDC-2nd-shot-can-be-other-vaccine/stories/202101240114

“The Centers for Disease Control and Prevention has quietly changed its recommendations for coronavirus immunizations to allow patients to switch the authorized vaccines between the first and second doses in “exceptional situations,” and to extend the interval between doses to six weeks, even though such changes have not been studied in large clinical trials.”

“With respect to dosing, the guidance says the second dose should be administered as close as possible to the recommended interval — three weeks for the Pfizer-BioNTech vaccine and four weeks for Moderna. But if that is “not feasible,” the agency wrote, the interval between doses may be extended to six weeks.”

Not the most optimistic article on our vaccine approach which is very systematic – https://theprint.in/opinion/why-a-mucosal-covid-vaccine-has-a-better-shot-at-ending-the-pandemic/589821/

“A systemic vaccine against a mucosal pathogen may reduce disease severity, but may not impact the infectivity and spreading of the pathogen. The systemic Covid-19 vaccines available or undergoing evaluation will be able to induce IgG antibodies and other protective immune cells in the blood, but are unlikely to induce mucosal IgA antibody production, as demonstrated in the monkey immunisations.

This is because the nature of antibodies generated in these two compartments — in case of natural infection or by a vaccine — is different. A systemic vaccine injected into the muscles induces the production of IgG antibodies, not IgA antibodies that can block a respiratory virus from attaching to a host cell there. Only a mucosal vaccine can stimulate the production of IgA antibodies.

The IgG antibodies present in the blood can reach the mucosal layers, but this process is inefficient. So even if a high concentration of IgG antibodies is present in the blood after a successful systemic vaccination, sufficient quantities of these antibodies may not reach the upper respiratory tract to prevent viral infection or stop the spread of the viruses to other subjects. For nearly all mucosal infections, the real sign of protection is the presence of elevated IgA levels in the respiratory compartment.

Although mucosal vaccines can elicit IgA antibodies, these vaccines suffer from a limitation — that mucosal responses induced by them usually are not long-lasting.”

“A good Covid vaccine must protect at three different levels. First, the vaccine must induce IgA antibodies in the upper respiratory tract where the coronavirus attaches initially and prevent viral infection. The virus subsequently spreads to the lower respiratory tract and the lungs. We need a combination of IgA and IgG antibodies to stop the viral expansion to the lungs, which only a mucosal, but not a systemic, vaccine can do.

Second, in a minority of subjects, the virus can disseminate to systemic body organelles, such as the brain, gut, liver, heart, etc. A systemic vaccine can minimise disease severity by preventing viral dissemination. Lastly, the virus will spread to other subjects through aerosol droplets generated in the upper respiratory tract. Only IgA antibodies can prevent the shedding of viral particles by this route.”

Policy makers make rules but there is little evidence either way certain rules will be effective. Challenges arise particularly when culture and human behavior is not accounted for. Article here questions curfews effectiveness and uses China as evidence of effectiveness. US society and policing of the rules cannot be farther from China. IF curfews and quarantine would be followed by all and have strict enforcement it would work. HOWEVER the reality is the people in charge of policing in general don’t support that lifestyle either. Therefore cheating occurs with individuals going out and then gathering INDOORS in secrecy which is probably the worse one can do without a change in ventilation systems. CO2 readings should be standard now. We should all carry CO2 sensors and realize if an area is not well ventilated. Public places should be measuring this and reducing this metric. But yet we are focus on RULES/POLICING vs solving the issue – https://www.nytimes.com/2021/01/23/health/coronavirus-curfews.html

“One study, published recently in Science, analyzed data from Hunan Province, in China, at the start of the outbreak. Curfews and lockdown measures, the researchers concluded, had a paradoxical effect: These restrictions reduced the spread within the community, but raised the risk of infection within households, reported Kaiyuan Sun, a postdoctoral fellow at the National Institutes of Health, and his colleagues.

Dr. Longini and his colleagues incorporated lockdowns and curfews into models of the pandemic in the United States, and concluded that they can be an effective way to reduce transmission.”

Bright side still under 4K daily deaths in US

Confirmation trend downward is happening hopefully death will follow

CA is the top state for both confirmation and death

As expected LA is the top county however they are getting back down to earth relative to the other counties

Dispersion across the US is limited with the area of concerned is SouthWest region

Amazing big dive in confirmation in LA – its like a miracle right….

Covid19mathblog.com

Good news on vaccine front from Johnson & Johnson – https://www.cnbc.com/2021/01/21/jj-plans-to-have-100-million-vaccines-for-americans-by-spring-board-member-says.html

“Johnson & Johnson board member Dr. Mark McClellan told CNBC that “if the clinical trial works out,” the company could significantly increase the nation’s Covid vaccine supply availability within the coming weeks.

“I do know that J&J is making a very large supply, going all out with its production, both here in the U.S. and elsewhere around the world, with the goal of having perhaps enough vaccines for 100 million Americans by spring, by this April or so,” said the former FDA Commissioner in a Thursday evening interview on “The News with Shepard Smith.””

China wont like this statement and worse yet from Taiwan – https://www.aljazeera.com/news/2021/1/22/prompt-action-in-wuhan-who-involvement-could-have-stopped-covid

“The coronavirus pandemic could have been contained if the authorities in Wuhan had notified the World Health Organization earlier and allowed an expert team to investigate in December 2019, according to Dr Chen Chien-jen, Taiwan’s former vice-president and health minister who made his name during the SARS [Severe Acute Respiratory Syndrome] outbreak nearly 20 years ago.

“Transparency and openness is very important for the containment of infectious diseases,” Dr Chen told Al Jazeera in an interview. “If the situation in Wuhan was very well reported to the World Health Organisation and the WHO organised a team and went to Wuhan in mid-December 2019, I think the disease could have been contained and no other countries would have suffered.”

As noted given the variant and potentially less effectiveness of vaccine and even getting infected to produce immunity – a strong focus has to be on your health. Another study indicating eating less meat could lead to longer life. Of course if you eat less meat but replace it with process food that will do more harm. https://www.realclearscience.com/articles/2021/01/22/a_surprising_reason_eating_less_meat_is_linked_to_a_longer_life_657516.html

“High-protein diets are having a moment. In any grocery store you can now buy a protein bowl, pick up a protein box of eggs and nuts for lunch, or snack on a protein bar.

But there’s evidence that restricting which proteins you eat — particularly cutting back on meat — could be important for healthy aging. The surprising reason: it forces the tissues to make hydrogen sulphide (H2S), a gas that’s poisonous if inhaled and smells like rotten eggs, but promotes health inside the body.”

“Less can be more when it comes to food. When scientists have put organisms on carefully balanced but restricted diets, these organisms have substantially increased healthy lifespans.

This holds true for yeasts, fruit flies, worms and monkeys. In mice, such diets reduce cancer risk, strengthen the immune system and improve cognitive function.”

“Earlier this year, a study using data from the 11,576 adults in NHANES III, the U.S. national nutrition survey, delivered evidence that they do. It found that reduced dietary intake of these sulphur amino acids is linked to lower cardiometabolic risk factors, including lower levels of cholesterol and glucose in the blood. Cardiometabolic risk factors are those linked to heart disease, stroke and diabetes.”

“Red meat is particularly high in sulphur amino acids, but fish and poultry white meat also contain a lot (the dark meat has less). Switching to plant-based proteins would help reduce this intake.

Beans, lentils and legumes are good sources of protein that are also low in sulphur amino acids. But beware: soy protein, which is the basis of foods like tofu, is surprisingly high in sulphur amino acids. Meanwhile, vegetables like broccoli contain lots of sulphur but not in amino acid form.”

“It might seem odd that a toxic gas can help maintain health, but it may reflect the origins of life on early Earth when the atmosphere was much richer in sulphur gas than it is today. Indeed, we are starting to appreciate how fundamental H2S signalling may be. For example, it has also been shown to reduce inflammation, opening the door to potential new treatments for arthritis or potential use as a painkiller.”

US below 4K but not by much

TX is leading confirmation with CA leading deaths

LA county still the lead but the extent of the lead is dropping.

Still a lot of dispersion in TX for confirmation

LA peak seems to be behind the rear view mirror.