Another high death day reporting – US on top at 1342

The leading state is FL 253 followed by TX 249

However the state picture can be misleading as noted….I suspect not many people in the US would know about Hidalgo County TX – with the total population of only 0.26% of US population – however on a ranking of ALL US county that county lead the way in deaths representing over 11% of US deaths

Hidalgo county is the red dot in the South part of Texas. As noted the healthcare system would not turn down anyone including non-US citizens. Not to ameliorate the numbers in anyway but to at least put the perspective on why the numbers could be high – potentially very tragic that people are traveling to the US for care – not in just a car ride sense traveling – Mexico fatality rates are one of the worse in the world.

The pesky covid is just not going to 0. Belgium UK China Italy Japan – all cannot take their confirmations to 0 – they are starting to rise again. The positive thing the death figures are in relatively low – but its not going to zero.

Where are all the testing devices that test quickly? Shouldn’t we fast track that as much as vaccines? https://nypost.com/2020/07/29/nyc-doctor-develops-rapid-noninvasive-covid-19-test/?

“A New York fertility doctor has developed a rapid, noninvasive coronavirus test that can deliver accurate results in 30 minutes or less, according to a preliminary study.

The test, developed by Dr. Zev Williams, a reproductive endocrinologist who runs the Columbia University Fertility Center, uses a person’s saliva to screen for COVID-19.”

“The study, which has not been peer-reviewed, also recorded sensitivity of 97 percent and specificity of 100 percent.

Sensitivity refers to the ability of a test to correctly identify infected patients, while specificity is the ability of a test to correctly identify those who are not ill. In this case, when the sample was negative, the saliva test didn’t deliver a false positive result, while when the sample was positive, 97 percent of the time it was correctly detected.”

Weds reporting seem to be the worse and weekends are the best when it comes to death reporting….Brazil 1595..India 1530

Similar to the rest of the world Brazil and India shows the disease is NOT super spreading but it is somewhat focused with the majority of the outbreak in a certain state

TX continues to lead the US in death 280

For TX 70/280 (25%) unassigned to a county… the next big county death from Dallas at 36 then Bexar (San Antonio) 24. Harris county still reporting very large confirmation 1468 but death continue to be minimal (15).

An alternative view of the county data for the 4 major counties seeing the most confirmation is that we have a very good handle on covid now and how to treat it. Even though confirmations continue to rise our fatality rate continues to be below 1.5%. Access to healthcare in these major counties seemed to be good.

Harris County View

Somber reporting day ….

Two experts agree this is here to stay now and even with vaccine …..

https://www.cnbc.com/2020/07/28/even-with-vaccine-we-will-be-dealing-with-this-forever-virus-experts.html

““Even with a vaccine, there is no going back to normal anytime soon,” said Thomas Frieden, former director of the Centers for Disease Control and Prevention, speaking at a CNBC Workforce Executive Council virtual event to human resources executives on July 23 about a safe return to the workplace. “Prepare for at least eight to 12 months of this situation,” said Frieden, who now runs the Resolve to Save Lives disease prevention organization.”

“Michael Osterholm, director of the Center for Infectious Disease Research & Policy at the University of Minnesota, said it is estimated that 7% to 9% of the total U.S. population has been infected with coronavirus, and that means the worst is yet to come. He said the best understanding in the medical field is that transmission will not slow down until 50% to 70% of the population is infected.

“The pain, suffering, death and economic pain we’ve had to date — that’s 7% to 9% of the U.S. population. We’ve got a long way to go,” Osterholm said.”

““We will be dealing with this forever,” Osterholm said.

“Covid is here to stay,” added Frieden.”

““We have great vaccines and still 100,000 deaths a year from measles,” Frieden said, speaking about Africa. “In the U.S. we still have hundreds of thousands of hospitalizations from flu each year with vaccines, and it looks more likely than not that this virus keeps circulating even with a vaccine.”

““Face-cloth covers are not surgical or N95, but wear ‘em, wear ’em,” Osterholm said, even though he added, “We don’t know how well they work.”

The virus expert said distance is the most important protective measure, especially in indoor-air environments, and everything else, including masks, needs to be layered on after that.

Osterholm chided current CDC director Robert Redfield for recently claiming that all we need is masks to drive Covid-19 into the ground in six weeks.

“I thought it was irresponsible,” Osterholm said of Redfield’s claim.”

“There has been a lot of discussion about the need for updated HVAC systems to provide ventilation never considered necessary before Covid-19, but the former CDC director said becoming infected by touching a doorknob or elevator in a building is more probable than contracting the virus due to an AC system, which was the case with SARS. “One thing we need to do is know there is no one thing we need to do,” Frieden said. “If anyone tells you they know this virus, don’t trust them,” he added.”

“Osterholm said anyone who does not know a person who has become infected or died from coronavirus should heed his personal warning about indoor air and large gatherings”

““There is no 100% safe other than everyone staying at home, which is too difficult,” Frieden said. “We will be living in a 24/7 Covid world eventually,” he said

The point of the HVAC discussion I will disagree with the “expert” IF this was the case there would have been multiple floors impacted in the S. Korean building structure. He then says there is no one thing – that’s right – just a bunch of low hanging fruits to reduce the probability to a manageable level…HVAC, Mask, distancing, washing hands, open windows, healthy diet, exercise….all reduce probability to a manageable level. Staying INDOORS by YOURSELF and not going anywhere is the only way to 100% proof – but it would seem with families and friends the BY YOURSELF is not feasible. We need to start with what we can now – there are multiple benefits with redoing the HVAC – fresh air reduces odor – reduces other contaminants beyond covid.

CDC studies show symptoms persist for 35% covid patients weeks later – https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm?s_cid=mm6930e1_w

“ Ninety-five (35%) reported that they had not returned to their usual state of health at the time of interview. The proportion who had not returned to their usual state of health differed across age groups: 26% of interviewees aged 18–34 years, 32% aged 35–49 years, and 47% aged ≥50 years reported not having returned to their usual state of health (p = 0.010) within 14–21 days after receiving a positive test result.”

Good news is you can reduce your odds by 2X in terms of longterm impact by getting healthy (physically and mentally)

“Obesity (body mass index ≥30 kg per m2) (aOR 2.31; 95% CI = 1.21–4.42) and reporting a psychiatric condition§ (aOR 2.32; 95% CI = 1.17–4.58) also were associated with more than twofold odds of not returning to the patient’s usual health after adjusting for age, sex, and race/ethnicity.”

US leads in death at 1244 – Brazil and Mexico next

TX leads in death at 200

What is happening in TX is not very apparent if you look at state level data. The county level shows a much different story. Below are bar chart of each county with % of Total Death of State (Blue), % of Total Population of State (Orange), and Fatality rate (death/confirmation – Red). Just the top 10 counties represent ~55% of total deaths and population in TX. We noticed that Harris county has more population per state capita but much less death per state capita. Hidalgo and Cameron county are the opposite – so this indicates the high level state data is not corresponding to reality. The issue of death numbers coming from the state of Texas is not directly a function of covid -but other factors in play and by a significant amount. The fatality rate in Cameron County is 3X to Harris. Top end state data is essentially useless in interpreting what is happening – good for warning signs but not much after that. Each county has their own issues and challenges – and some are a lot worse than others.

Statistically speaking the mortality rate (death/total county population) in TX is quite a range from essentially 0% to 0.13% – the areas of death are not in the areas observing the topline confirmations that are being noted. In Harris county you need to know 6666+ people in Harris county before you would statistically know of someone that has died from Covid compared to Cameron at 1515.

County daily change show the same counties causing most of the increases

Confirmations in Harris County are falling now. Still no major crisis noted from the data – as death rates are still within range and ICU beds for covid are still trending down….

China is creeping up in deaths and confirmation….indicating its just not going away….

Another reason why Asia fatality rate much lower – besides eating cabbage (kimchi – as noted https://covid19mathblog.com/2020/07/covid-7-21-20/) – Seaweed – https://www.nature.com/articles/s41421-020-00192-8

“when taken orally, the fucoidans, isolated from edible sulfated seaweed polysaccharides, are considered as “Generally Recognized as Safe” and heparin, an approved drug, is not orally bioavailable. Interestingly, a retrospective clinical study suggests that the administration of anticoagulants, such as heparin, may provide better outcomes for patients hospitalized with COVID-19, including a dramatic reduction in mortality of intubated patients17. It is unknown whether this is a result of heparin’s anticoagulation alone, or to some degree is an effect of its anti-SARS-CoV-2 activity. Inhaled heparin has additional benefits such as reducing pulmonary coagulopathy and inflammation without producing systemic bleeding18. To this end, we suggest that treatment of fucoidans, nebulized heparin, or possibly TriS-heparin in combination with or without current antiviral therapies, should be assessed first in human primary epithelial cells and then in human patients suffering from COVID-19.”

Summary article and comments – https://www.fastcompany.com/90532822/this-seaweed-extract-outperforms-covid-drug-remdesivir-in-the-lab

“The extract, called RPI-27—found in the same type of seaweed that you might eat in sushi—helps trap the virus before it can infect human cells. Researchers at Rensselaer Polytechnic Institute tested the extract in the cell studies, along with the blood thinner heparin, which has a similar effect.”

“In cell tests in the lab, RPI-27 was nearly 10 times as active as remdesivir at blocking infection, meaning a much smaller dose was needed to inhibit infection. Heparin was slightly less active than remdesivir but could also be used in treatment. Separate tests showed that the compounds worked without causing any damage to the cells. The researchers are now beginning the next step of animal trials.

But it should be generally safe: “Anytime you eat seaweed in something like sushi, you’re going to be taking in these compounds,” he says. Because only a small concentration is needed, and the compound is found in edible seaweed, a treatment could get FDA approval fairly quickly because the substance is considered GRAS, or generally recognized as safe.”

Diet for sure must play a part in covid deaths. In terms of death per capita – even though Japan oldest and one of the most populated density they fared well in covid – along with South Korea (both large cabbage and seaweed consumers). China did very well but suspect on data. Germany fared well in the European country (large cabbage eater). Norway did very well to and is known to focus on Vitamin D intake from cod liver oil to fortified foods. UK is known as the least healthiest European country and it shows in the stats. Mexico and Brazil difference potentially lies in the different approach – Brazil is dispensing HCQ and Mexico is not – time will tell…

US is back on top of death chart at 1076 – India second at 637

Texas leads the way at 637!

Once again not at the leading confirmation locations the deaths in Texas are coming from Bexar (San Antonio 158) and Cameron (South Texas 95)

Not much stress occurring in Houston as thought – fatality rate running at 1.2%

India is confirming at a rapid pace but fatality rates are still being kept low – 2.3%

Another report examining the HVAC as the key spreader in the south – https://news.yahoo.com/connection-between-coronavirus-air-conditioning-103000756.html

“At an online event hosted by the Massachusetts Consortium on Pathogen Readiness, Harvard Medical School professor Edward Nardell noted that states using high levels of air conditioning in June due to “high temperatures” have experienced “greater increases in spread of COVID-19, suggesting more time indoors as temperatures rise.” This mimics the increase in illness that occurs in the winter when we spend “more time indoors.””

“Hospitals deal with this regurgitation of air by using UV lights, high-quality HEPA filters, and routine cleaning to ensure their HVAC system is not spreading contagions. (Potential good news: A recent study at Columbia University Irving Medical Center found Far-UVC lights, safe for humans, have great efficacy in killing some forms of coronavirus; further testing on SARS-CoV-2 is ongoing). But the average home or business is extremely unlikely to have such technology, and the risk of contagious particles being recycled through the home increases as a result.”

“For those in the upper Midwest, Pacific Northwest, and New England, there are few more enjoyable things than letting the soft breeze of a summer morning waft through the home. Not so in the South, where daily temperatures reach high into the nineties routinely.”

“Taking a small poll of Texans in Houston, Dallas, and Lubbock, we found that the average thermostat is set to 75 degrees Fahrenheit. Matching that information to our data, we noticed the R0 — the viral reproduction rate — of infection tends to increase when the average outside temperature exceeds the average temperature of many Texans’ thermostats, likely meaning their houses are closed up and the air conditioning is running.”

“Yet a rise in average temperature — and its effect on personal cooling habits — is not a monocausal explanation for any of these states’ viral surges. Timing is a factor as well; the virus reached these places later than the North, its spread delayed into the summer months. While this means later peaks, it also means infections converging with hostile temperatures and rising rates of A/C use. And when you combine the reopening of private establishments, lack of mask-wearing, and mass migration to air conditioning, there is certainly ample opportunity for the spread of COVID-19.”

IF there is even half truth to this hypothesis – when it gets cold again in the North expect a resurgence of the virus unless we start doing something about it now. There are mechanical solutions out there to reduce the viral spread in the HVAC. It is not so outpriced it is not affordable for commercial/office buildings to employ. Creative engineers I am sure will come out with more solutions once it becomes mandated/guided to mechanically reduce viral load in public spaces. Here is a product being pushed – I still think best to put it into the ventilation system – https://safeology.com/uvc-tower/

UK came out with their health campaign against obesity in the name of covid – https://www.gov.uk/government/news/new-obesity-strategy-unveiled-as-country-urged-to-lose-weight-to-beat-coronavirus-covid-19-and-protect-the-nhs

“Ban on TV and online adverts for food high in fat, sugar and salt before 9pm

End of deals like ‘buy one get one free’ on unhealthy food high in salt, sugar and fat

Calories to be displayed on menus to help people make healthier choices when eating out – while alcoholic drinks could soon have to list hidden ‘liquid calories’

New campaign to help people lose weight, get active and eat better after COVID-19 ‘wake-up call’”

Interesting focus on calories and not much focused on process food reduction. A step in the right direction.

Mexico on top of deaths as the data yesterday was missing 1035. India second 711

TX leads in death at 86

Same counties driving the confirmation.

Miami-Dade is now 4% of the population confirmed. NYC was down at 2.7% – but fatality rate was also 10X more.

Even if we combined all the counties still nothing approaching NYC in terms of deaths. Confirmations certainly combined would overwhelm NYC.

As a country the US confirmation rate seems to be flattening out. The deaths are slightly rising.

The silver lining in all this covid mess – we will at some point take our lifestyle (food/exercise/mental) choices seriously. There are large externality cost due to poor lifestyle choice which as a cost on the world on a discounted basis (time value/impact is more near term) is larger than climate change and offer some co-benefits to climate change. UK looks to be stepping up action to reduce obesity in the country. Findings show obesity increases risk of death by 90%! – https://inews.co.uk/news/health/obesity-coronavirus-risk-death-public-health-england-report-562156

“Current evidence does not suggest that having excess weight increases people’s chances of contracting coronavirus, but people with the illness who are overweight are much more likely to be admitted into hospital and be critically ill in intensive care compared to those with a healthy body weight, with certain groups at higher risk.”

“For most adults, a BMI of 18.5 to 24.9 is a healthy weight, 25 to 29.9 is overweight, 30 to 39.9 is obese and above 40 is severely obese.

One study found that for people with a BMI of 35-40, risk of death from Covid-19 increases by 40 per cent and with a BMI over 40 by 90 per cent, compared to those who were a healthier weight. Other data found that in intensive care units 7.9 per cent of critically ill patients with Covid-19 had a BMI over 40 compared with 2.9 per cent of the general population.

The UK has some of the worst obesity rates in Europe: around two-thirds of adults are overweight or obese, with people aged 55-74, those living in deprived areas and certain Black, Asian and Minority Ethnic Groups more severely affected. Excess fat can affect the respiratory system and is likely to affect inflammatory and immune function. This can impact people’s response to infection and increase vulnerability to severe symptoms of Covid-19. People with obesity may be less likely to access health care and support and it is also thought that Covid-19 affects other diseases associated with obesity.”

“The report has been published ahead of next week’s anticipated announcement from Boris Johnson on the Government’s obesity policies, which could include a ban junk food adverts before the 9pm watershed and curbs on snack promotions.

“Dr Alison Tedstone, chief nutritionist at PHE: “The current evidence is clear that being overweight or obese puts you at greater risk of serious illness or death from Covid-19, as well as from many other life-threatening diseases.

“It can be hard to lose weight and even harder to sustain it, which is why people cannot easily do it on their own. Losing weight can bring huge benefits for health – and may also help protect against the health risks of Covid-19. The case for action on obesity has never been stronger.””

“…so many studies that point in the same direction is compelling and certainly suggests that now is an ideal time to combine Covid-19 responses with interventions to address overweight and obesity.”

Hopefully the US will follow suit and at least do what they can do reduce our consumption on process food and promote whole foods. It doesn’t have to be vegan to be whole – but a whole veganism should be considered a worthy option due to the multi-facet win it can create (health, ethics, climate). Though in general I don’t support prohibition of products one could tax process foods to represent some externality cost much like we do with cigarettes and alcohol – and much like cigarettes with continuous education and cost escalation we can make that change.

New comer into the top list South Africa 12.2K confirmation and 312 deaths – Looks like Mexico reporting was blank.

Texas leads the US death at 200

Unlike other states the population center is not leading the death count. We have the bordering counties of Texas to Mexico representing almost 50% of the death.

Unfortunately Harris County Hospital view does show deaths are rising. However the rate still hasn’t hit the previous high. ICU beds used for Covid has been declining. Certainly not an ideal place to be but at least not catastrophic as many projected.

South Africa has been climbing steadily in deaths…

I will start with the feel good stuff…

94% detection positive rate from dogs trained to detect covid-19 – https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05281-3

“These preliminary findings indicate that trained detection dogs can identify respiratory secretion samples from hospitalised and clinically diseased SARS-CoV-2 infected individuals by discriminating between samples from SARS-CoV-2 infected patients and negative controls. This data may form the basis for the reliable screening method of SARS-CoV-2 infected people.”

“The dogs were able to discriminate between samples of infected (positive) and non-infected (negative) individuals with average diagnostic sensitivity of 82.63% (95% confidence interval [CI]: 82.02–83.24%) and specificity of 96.35% (95% CI: 96.31–96.39%). During the presentation of 1012 randomised samples, the dogs achieved an overall average detection rate of 94% (±3.4%) with 157 correct indications of positive, 792 correct rejections of negative, 33 incorrect indications of negative or incorrect rejections of 30 positive sample presentations.”

This needs to be fast tracked – easy to station dogs in front of schools and public spaces – and who doesn’t love seeing a dog – Mans best friend! The speed and the volume that can be processed in little time allows the efficacy buffer to be drop – 94% is good for me for this purpose vs. $99 per person 2-7 day result and intrusive stick into your nasal cavity limited volume. Lets hope pharma doesn’t try to squash this as this will drop the testing demand – and lets hope someone isn’t in favor/mentions this or else media will crush it….

Another good news you will recover your sense of smell after you recover from covid as it does not directly attack the neurons buts the cells supporting the neurons – https://advances.sciencemag.org/content/early/2020/07/24/sciadv.abc5801.1

“primary infection of non-neuronal cell types — rather than sensory or bulb neurons — may be responsible for anosmia and related disturbances in odor perception in COVID-19 patients.”

I am sure this was censored greatly but the candid discussion seemed to be genuine from the lead scientist that studies bat coronavirus at the Wuhan Institute of Virology – Shi Zhengli – https://www.sciencemag.org/news/2020/07/trump-owes-us-apology-chinese-scientist-center-covid-19-origin-theories-speaks-out?

“She and her colleagues discovered the virus in late 2019, she says, in samples from patients who had a pneumonia of unknown origin. “Before that, we had never been in contact with or studied this virus, nor did we know of its existence,” Shi wrote.”

“Yet the possibility that her lab had played a role worried Shi, she revealed in a March Scientific American profile that briefly touched on origin questions. “She frantically went through her own laboratory’s records from the past few years to check for any mishandling of experimental materials, especially during disposal,” the story said. None of the sequences of bat viruses her lab had found closely matched SARS-CoV-2, the article noted. “That really took a load off my mind,” she told Scientific American. “I had not slept a wink for days.”

Interview pdf – https://www.sciencemag.org/sites/default/files/Shi%20Zhengli%20Q%26A.pdf

“When and where the earliest cross-species transmission of SARS-CoV-2 occurred from

the intermediate host to humans has not been scientifically uncovered yet. We know from

historical experience like HIV that the places where big emerging diseases first break out

usually are not their place of origin (where the spillover originally happened). Tracing the

origin of a virus is a very challenging scientific task. As for the origin and transmission routes

2

of SARS-CoV-2, it needs a pioneering vision, and the collective efforts of scientists all around

the world, and it needs time as well.

We have done bat virus surveillance in Hubei Province for many years, but have not

found that bats in Wuhan or even the wider Hubei Province carry any coronaviruses that are

closely related to SARS-CoV-2. I don’t think the spillover from bats to humans occurred in

Wuhan or in Hubei Province.

I guess you are referring to the bat cave in Tongguan town in Mojiang county of Yunnan

Province. To date, none of nearby residents is infected with coronaviruses. Thus the claim that

the so-called "patient zero" was living near the mining area and then went to Wuhan is false.”

“We detected SARS-CoV-2 nucleic acids in environmental samples from

sources such as rolling door handles, the ground and sewage in that market, but we did not

detect any SARS-CoV-2 nucleic acids in frozen animal samples. The Huanan seafood market

may just be a crowded location where a cluster of early novel coronavirus patients were

found.”

“The results of our tests of SARS-CoV-2 antibodies in cat sera, collected in Wuhan after

the COVID-19 outbreak, revealed that the infection rate and antibody titers of SARS-CoV-2 in

house cats was higher than in stray cats. So I think the SARS-CoV-2 infections in cats were very

likely to have been transmitted by humans.”

“: We first received the clinical samples of SARS-CoV-2 on December 30 2019, which

were called back then samples of “pneumonia with unknown etiology”. Subsequently, we

rapidly conducted research in parallel with other domestic institutions, and quickly identified

the pathogen. The complete genome sequence of SARS-CoV-2 was submitted and published

via WHO on January 12. Before that, we had never been in contact with or studied this virus,

nor did we know of its existence.”

“To date, no pathogen leaks or personnel

infection accidents have occurred.”

“We have only isolated three strains of live SARS-related coronaviruses (SARSr-CoV)

from bats, which shared 95-96% genome sequence similarity with SARS-CoV and less than 80%

similarity with SARS-CoV-2”

“We isolated viruses or extracted virus RNA from biological samples in the lab. The

sequencing was done mostly in Wuhan.”

“Recently we tested the sera from all staff and students

in the lab and nobody is infected by either bat SARSr-CoV or SARS-CoV-2. To date, there is

"zero infection" of all staff and students in our institute.”

“Ra4991 is the ID for a bat sample while RaTG13 is the ID for the coronavirus detected

in the sample. We changed the name as we wanted it to reflect the time and location for the

sample collection. 13 means it was collected in 2013, and TG is the abbreviation of Tongguan

town, the location where the sample was collected.”

“Over the past 20 years, coronaviruses have been disrupting and impacting human lives

and economies. Here, I would like to make an appeal to the international community to

strengthen international cooperation on research into the origins of emerging viruses. I hope

scientists around the world can stand together and work together. The purpose of the search

for the origin of a virus is to prevent the recurrence of similar outbreaks which will harm

human society, and in this way, we can respond more effectively when an outbreak happens.”

Oh crap its still 2020 – https://www.usatoday.com/story/news/health/2020/07/24/cdc-salmonella-outbreak-growing-rapidly-cases-23-states/5505593002/

“CDC: ‘Rapidly growing’ Salmonella outbreak has hit nearly 2 dozen states, source unknown”

What BS reporting and statements being made and perpetuated in press is just really amazingly incredulous – https://www.axios.com/birx-coronavirus-california-florida-texas-e68e3f75-3765-4fbd-b98f-3dad800d5753.html

“Dr. Deborah Birx, the coordinator of the White House coronavirus task force, told NBC’s "Today" on Friday that coronavirus surges in California, Florida and Texas have left the U.S. with "essentially three New Yorks."”

Really? SO What metric are we making that claim on? Thank God it’s a false statement – as NY data is really out there as a worldwide outlier – systematic screw up happened – or data issue – no doubt. In order to compare we had to pick a ramp up moment in time and graph it accordingly in time. The cutoff below is when the 7 day moving average daily death was greater than 75. For NY that began back in late March – For CA Mid April – For AZ FL and TX Early to Mid July…..Like I noted before after that point NY soared to over 200 deaths a day in less than a week (4/1/20) and then less than 2 weeks >500 deaths a day (4/7/20) AND that was with a SHELTER in place March 20th! ONE could easily argue – perhaps with wrong causation/correlation – the data shows that Shelter in place INCREASED deaths! As noted in the reports spread is most likely happening at the home front – shelter in place could exacerbate the situation if not airing out the home. Viral load reaches a point of infection and its game over in terms of staying not sick. Going in and out of home does cause some airing of the home and reduces your viral load activity throughout the day.

County view also shows the same picture as in the state view – NYC is an outlier – their policy/responses killed people in excess that should have happened AND/OR the data is wrong. No other region in world spiked over 1000 deaths a day! Easy to say treatment has improved but there were regions and countries that actually had the issue earlier and they never got that bad China, S. Korea, Japan, Italy, Spain, France….

Peru back down to only reporting 189 deaths – US leads death at 1242. Very important to note is Mexico and their high fatality rates. Note Mexico unlike Brazil is not dispersing HCQ under the guidance from WHO. Brazil fatality rate 3X lower.

Texas leads in death at 168

TX deaths you really need to figure out where because its not really occurring at the population or where the confirmations are occurring. Hidalgo county leads again at 33. I had a discussion with someone who came from a Funeral down south and she had spoken to the medical people down there and what is happening there are many coming from Mexico seeking help and they do not refuse them. The high fatality rates in Mexico one can see why you would want to come to the US. However these numbers are causing a skew in TX data. By the time they arrive in the US they are likely in a bad situation.

Mexico has the highest current fatality rate other than the data revision from Peru yesterday – running at 11.3%

Promising results from Oxford /AstraZeneca vaccine – decent sized amount of people – no major side effects – https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31604-4/fulltext

“Between April 23 and May 21, 2020, 1077 participants were enrolled into the study and assigned to vaccination with either ChAdOx1 nCoV-19 (n=543) or MenACWY (n=534; appendix p 3); ten of these participants were enrolled in group 3, the prime-boost group, and thus were not randomly assigned. 88 participants were included in group 1, 412 in group 2, and 567 in group 4 (appendix p 3). All randomised participants were vaccinated; one participant in the MenACWY group received the ChAdOx1 nCoV-19 vaccine (appendix p 3).”

“In conclusion, ChAdOx1 nCoV-19 was safe, tolerated, and immunogenic, while reactogenicity was reduced with paracetamol. A single dose elicited both humoral and cellular responses against SARS-CoV-2, with a booster immunisation augmenting neutralising antibody titres. The preliminary results of this first-in-human clinical trial supported clinical development progression into ongoing phase 2 and 3 trials. Older age groups with comorbidities, health-care workers, and those with higher risk for SARS-CoV-2 exposure are being recruited and assessed for efficacy, safety, and immunogenicity of ChAdOx1 nCoV-19 given as a single-dose or two-dose administration regimen in further trials conducted in the UK and overseas. We will also evaluate the vaccine in children, once sufficient safety data have been accumulated in adult studies. Phase 3 trials are now underway in Brazil, South Africa, and the UK and will evaluate vaccine efficacy in diverse populations.”

Some more promising existing drug options being used for covid – relatively small sample – https://theconversation.com/multiple-sclerosis-drug-may-help-treat-covid-19-and-lead-to-faster-recovery-143090

“In total, 101 patients in a hospital setting were enrolled in the SNG001 trial and were given the drug daily for 14 days. Compared with a placebo, those given SNG001 had a 79% lower risk of developing severe disease.

Patients given the drug were also twice as likely to recover from their infection and were discharged earlier from hospital than those given the placebo.”

“One of the most important side effects of the drugs is that it can induce depression.

As a result, interferon is used with caution in patients with pre-existing depression or who have suicidal thoughts. These conditions may already be heightened by the pandemic if a potential patient for the drug has lost their job or they are not dealing well with the isolation of social distancing.”

Interesting paper from one of the champions of HCQ – James Todaro MD – he has spent quite a bit of time on this matter and I see no monetary value for him to do so other than additional fame from supporters on social media and growing list of haters? Some interesting points in the paper.

https://omnij.org/Gilead:_Twenty-one_billion_reasons_to_discredit_hydroxychloroquine_(ORIGINAL_ARTICLE)

“Chloroquine was first shown to have strong antiviral effects on SARS-CoV infection in primate cells back in the 2005 publication Chloroquine is a potent inhibitor of SARS coronavirus infection.” Vincent, MJ; Bergeron, E; Benjannet, S et al. (22 Aug 2005). "Chloroquine is a potent inhibitor of SARS coronavirus infection and spread". Virology Journal. Retrieved 21 July 2020.

“Hydroxychloroquine was available without prescription in France for years. This came to an end on January 13, 2020, when hydroxychloroquine was classified “in all its forms” as a “list II poisonous substance.” After decades of widespread use, hydroxychloroquine quickly became a restricted substance in France in the earliest days of the COVID-19 pandemic. Just several weeks later, Dr. Didier Raoult in the South of France would report his landmark clinical trial demonstrating hydroxychloroquine’s efficacy against COVID-19”

“US pharmaceutical industry increased total spending on marketing from $17.7 billion in 1997 to nearly $30 billion in 2016. The strategy was successful with US spending on prescription drugs ballooning from $117 billion to $329 billion during this time. [11] Advertising and sponsorships are a substantial source of revenue for most medical journals comprising up to 80% of publishing revenue for some journals.”

“The Lancet may have chosen satisfying Gilead over scientific truths when it published a fraudulent study showing that hydroxychloroquine increased mortality and lethal arrythmias in COVID-19 patients.

On May 22, 2020, The Lancet published a peer-reviewed, observational study comparing hydroxychloroquine to standard therapy in 96,032 hospitalized COVID-19 patients. [14] Almost immediately afterwards, the WHO suspended all clinical trials on hydroxychloroquine because of safety concerns. [15] Dr. Fauci also commented on the dangers of hydroxychloroquine, telling CNN’s Jim Sciutto that it likely causes "adverse events with regard to cardiovascular."

“The connection between Gilead and the study authors is tenuous. What is known is that both Dr. Mehra and Dr. Sapan Desai (founder of Surgisphere) have openly praised remdesivir in various interviews and tweets. Of note though, Dr. Mehra was one of just a few experts selected to speak at a Gilead sponsored COVID-19 conference live-streamed by thousands of experts worldwide in early April. [21] Without a formal investigation into this affair, it is likely the motivation—be it attention seeking or the meddling of big pharma—will never be fully revealed.

The authors and Lancet were not the only involved parties though. The WHO suspended worldwide clinical trials on hydroxychloroquine based on this study.”

“Gilead helps fund the WHO. Gilead Sciences provided 0.12% of the WHO’s funding for the biennium of 2018-19—more than doubling its contribution from the prior biennium. [22] This may seem like an insignificant percentage, but it’s important to note that China contributed just 0.21%, Italy 0.48% and Spain 0.06% of the WHO’s funding. With the exception of Sanofi, Gilead gave more to the WHO than any other pharmaceutical company. With remdesivir approved as a standard therapy for COVID-19, I suspect Gilead will further increase its contributions to become the largest pharmaceutical donor in the 2020-2021 biennium. While Gilead may appear philanthropic, one must wonder how ethical it is for organizations making global recommendations on therapeutics to receive substantial funding from big pharma.”

“The pharmaceuticals and health products spent $295 million in lobbying efforts in the United States which places it in 1st place in money spent on lobbying. For comparison, the insurance industry and automotive industry only spent $155 million and $69 million in 2019, respectively. [27] In 2019, Gilead spent nearly $6 million in political lobbying efforts. This number is on track to reach record highs in 2020 as Gilead has spent already nearly $2.5 million on lobbying in just Q1 of 2020. [28] The money appears to be well spent. The exclusive NIH COVID-19 Treatment Guidelines Panel that informs US clinicians how to care for patients is occupied by 8-9 experts who have received financial support from Gilead.”

“it is peculiar that some of the most vehement critics of hydroxychloroquine have conflicts of interest with Gilead. Just for example, in the New York Times feature He Was a Science Star. Then He Promoted a Questionable Cure for Covid-19, [30] all three scientists (Karine Lacombe, Christine Rouzioux, and Jean-Michel Molina) criticizing Dr. Raoult and his study are either on Gilead’s advisory board and/or received funding from Gilead. [31] [32] [33] Notably, the New York Times article fails to mention these conflicts of interest.”

“Eric Topol, editor-in-chief of Medscape and prominent critic of hydroxychloroquine was formerly on the Scientific Advisory Board for Gilead; George P. Shultz, Stanford University was formerly on the Board of Directors for Gilead (notably also a prominent figure in the scandal of the biotech firm Theranos, continuing to support it as a board member even in the face mounting evidence of fraud.)”

This is has always been a big concern for me – the lasting impact of Covid for the children raised in this time. Lets hope it can be a positive outcome (healthy lifestyle) vs. a future of fear – we need covid/work/life balance – we need to push for healthier lifestyle along with mechanical engineering solutions to reduce viral load so we can get back to our lives…. https://nationalinterest.org/blog/reboot/beware-biological-effects-coronavirus-policy-children-165387

“We are concerned because some of the unintended consequences of the public health response to the pandemic are increased stressors for children and adolescents.

These stressors — reduced family income, food insecurity, parental stress and child abuse — can become biologically embedded and negatively impact children’s developing brains, immune systems and ability to thrive. While some effects will be immediate, many will surface decades from now.”

“For adolescents, who need peer interaction to support development, social deprivation and reduced opportunities for social learning are likely to have far-reaching consequences on their development and mental health.”

“Creative and safe plans are required for reopening schools and allowing safe social interactions. These measures will benefit all young people, but a specific focus is needed to support young people most affected by the amplification of social inequalities. In particular, as we emerge from this crisis, more support is required for those who may have experienced child abuse and domestic violence.”

Much like the mask argument – I cant fathom how one can argue not opening up schools – one can argue how to open schools – but to not push for opening up schools is giving up and not using our intellect and it will have significant social impact beyond the education piece. IF we can agree to open school then we can focus on how to open schools in an effective way. Open windows, change schedule to align with outdoor temp, rotation of school population, fans to push fresh air, wear mask, hire and promote healthy staff, assist staff to get healthy, retrain older vulnerable staff to other duties, tune the ventilation to pull more fresh air, install UV filtration system, temperature stations at entrances, so many practical options that do not cost astronomical figures. Ask our inventors and our technology team for their suggestions and help to build devices to reduce viral load….I am so confident Elon Musk, Dyson, Apple engineers, engineering schools etc…can easily tackle this issue – its not rocket science to reduce viral load.

Last few reports we clearly showed NY/NYC was a complete outlier in the US. Below they do get some company(UK, France, Italy, Spain) when comparing to some countries but still an outlier in death per capita. Also lets put it in context that NY declared stay at home orders March 20th – whereas Sweden never did. The first time NY went above 75 deaths as the criteria of the chart below was 3/27/20 – it would seem quarantine did not help NY.

Got a new leader for daily death today – PERU – looks to be a catch up 3887! – how will this data be any helpful in terms of timing with so many just entering block adjustments

US leader in death TX at 183 – FL leads in confirmation at 10.2K

Hidalgo county continues to lead TX in death at 33. The same counties leading the confirmation. A new player is Clark County Nevada at 1152.

The list of 500+ deaths are growing….

As discussed previously T cells is where its at for long-term immunity and that it explains why living in a clean bubble is likely not healthy in the long term if you ever leave that bubble. It is very possible the common cold could help those fight off covid-19. https://www.bbc.com/future/article/20200716-the-people-with-hidden-protection-from-covid-19?ocid=twfut

““Looking at Covid-19 patients – but also I’m happy to say, looking at individuals who have been infected but did not need hospitalisation – it’s absolutely clear that there are T cell responses,” says Hayday. “And almost certainly this is very good news for those who are interested in vaccines, because clearly we’re capable of making antibodies and making T cells that see the virus. That’s all good.””

“one vaccine – developed by the University of Oxford – has already been shown to trigger the production of these cells, in addition to antibodies. It’s still too early to know how protective the response will be, but one member of the research group told BBC News that the results were “extremely promising”.”

“Dwindling T cells might also be to blame for why the elderly are much more severely affected by Covid-19. “

“The fact that coronaviruses can lead to lasting T cells is what recently inspired scientists to check old blood samples taken from people between 2015 and 2018, to see if they would contain any that can recognise Covid-19. The fact that this was indeed the case has led to suggestions that their immune systems learnt to recognise it after being encountering cold viruses with the similar surface proteins in the past. “

“If old exposures to cold viruses really are leading to milder cases of Covid-19, however, this bodes well for the development of a vaccine – since it’s proof that lingering T cells can provide significant protection, even years after they were made.”

Data concerns – if someone gets tested positive then dies many weeks later from potentially something else is it still a covid death? https://www.bbc.com/news/amp/health-53443724?

“"Currently the daily deaths measure counts all people who have tested positive for coronavirus and since died, with no cut-off between time of testing and date of death.

"There have been claims that the lack of cut-off may distort the current daily deaths number."”

“"By this PHE definition, no one with Covid in England is allowed to ever recover from their illness," Prof Heneghan says .”

“"As we go into the winter, it will get incredibly confusing and concerning if you have an increase in deaths while you are still counting and combining deaths from within the first phase," Prof Heneghan said.

"This means we might be unable to detect early trends in rising deaths if we put them down to historical deaths due to the inadequacies of the current system."

The bottom line there needs to be at least consistency among the countries/states/counties in order to learn anything else we will draw wrong conclusions. Note the acceptance of the second wave is inevitable….its time to get healthy – it can be done – eliminate/reduce process foods – think about juicing your vegetables (Fat sick and nearly dead was a very inspirational documentary for me) – less meat products are win-win – reduce cholesterol (allow your body to naturally make the cholesterol you need) and reduce the unethical manufacturing of our food supply.

3 countries over 1K death Brazil, US, and India. US confirms 71.7K

Texas observed a surge in deaths 240 along with 12.5K confirmation. It was inevitable that Texas death had to climb as more and more are infected. Obviously no comfort for those who are part of the 1.2% – but a 1.2% fatality rate is one of the lowest in the country.

Compared to the NY debacle TX still so much better – Note California now has more confirmation than NY yet still ¼ of NY deaths. At this point of deaths starting at 75 per day on 7 day moving average – TX has confirmed 2X and deaths are 5X lower.

Shift of state from Eastern northern states to southern states can be seen in the area chart below. The only consistent state over this time period is California.

It would seem the deaths in TX are not really occurring in the regions seeing the largest confirmations. This is indicating an issue with healthcare not a direct issue due to the fatality of covid. Note Hidalgo county almost 3X fatality rate to Harris. Younger, less public transport, and lower population density in Hidalgo.

One could jump to social economics but comparing to the other counties that is not obvious – only when comparing to Harris and Dallas.

A review of care is certainly needed for Hidalgo county – something is not right.

So many horror stories on how long it takes to get a covid test to how intrusive it is to stick something through your nose….yet I have posted on so many advancements in testing from not just no name companies but big ones such as Roche….but yet here we are…. https://www.bloomberg.com/amp/opinion/articles/2020-07-22/coronavirus-testing-is-broken-and-there-s-no-plan-to-fix-it?

“Federal agencies such as the Centers for Disease Control and Prevention, state labs and hospitals all provide testing services, but commercial labs dominate the market. The clinical testing business, which generates annual revenue of about $80 billion, has a number of big players, including ARUP Laboratories, BioReference Laboratories, Mayo Clinic Laboratories, and Sonic Healthcare Ltd. But two aggressive competitors, Quest Diagnostics Inc. and Laboratory Corporation of America Holdings, dominate the field.

Quest earned $858 million on revenue of $7.7 billion in 2019. The company says its operations “touch the lives” of 30% of the U.S. adult population and it boasts of relationships with about half of all physicians and hospitals in the country. LabCorp earned $824 million on revenue of $11.5 billion last year. It says it interacts with 3 million patients weekly, controls proprietary data derived from 35 billion lab test results (which includes about 50% of the U.S. population), and has contributed to the development of all 50 of the country’s top-selling drugs.

Both companies were assembled through decades of mergers and acquisitions, diagnostic ingenuity and an unrelenting focus on expanding their market share. Quest and Labcorp are preferred or exclusive providers for many of the largest private health insurance companies in the U.S., and they process a large portion of tests covered by Medicare and Medicaid.”

“Smaller competitors have complained over the years that Quest and Labcorp’s tight relationships with insurers and the federal government make it hard for them to break into health care networks to offer alternatives. Some consumers have alleged that the companies charge exorbitant prices for tests administered to uninsured patients, and both companies have drawn scrutiny for possibly overbilling Medicare and Medicaid (charges that they’ve denied).”

“A three-to-five-day turnaround time for test results they announced at the end of June gave way to a four-to-five-day delay by the first week of July. After announcing the second delay, Quest said it didn’t expect to get any faster until the coronavirus stopped spreading nationally. Don’t expect that to happen anytime soon. In an interview with the Financial Times on Tuesday, a senior Quest executive said “it will be impossible” for his company “to increase coronavirus testing capacity to cope with demand during the autumn flu season.””

“New York’s Andrew Cuomo, a Democrat, has advised his state’s residents to patronize local labs rather than Quest or LabCorp to get timely test results. About 70% of New York’s tests are now processed by 200 local labs that return results in one to three days, the state said.”

“Smaller labs around the country have excess capacity they’re unable to deploy because they haven’t been able to break into the insurance networks dominated by the big guys. And labs of all sizes struggle to operate at full capacity because a balkanized supply chain forces them to compete against one another for frequently scarce resources.”

The author of the article argues for a lot of federal govt. interaction into the market place. I would agree but the govt. actions should involve breaking down the barriers of competition and removal of large lobbying interest not expanding their power and oversight. Who would lose if there was a test you can buy and do it yourself or even submit yourself to be checked? Labcorp and Quest are both at their 52 week high. They are proud of their connection to doctors/hospitals/ and drug manufacturers – who like their distribution network. How much money are the equipment manufacturer getting, the lab, etc…what is the money trail – is it worth the cost – can we do statistical sampling to get a better wholistic picture – similar to polling? We want to fast track vaccine but seem to not care to fast track testing that has shown quite effective.

Reported a few days ago: A new test – the all in one test – that can produce results in 20 minutes and tell if you are currently infected and if you had it! https://www.scmp.com/news/asia/australasia/article/3093608/australian-researchers-invent-20-minute-coronavirus-blood

“Their test, using 25 microlitres of plasma from blood samples, looks for agglutination, or a clustering of red blood cells, that the coronavirus causes.

While the current swab test is used to identify people who are infected with the coronavirus, the agglutination assay – or analysis to detect the presence and amount of a substance in blood – can also determine if someone had been recently infected, after the infection is resolved, they said. Hundreds of samples can be tested every hour, the researchers said, and they hope it can also be used to detect antibodies raised in response to vaccination to aid clinical trials. ”

I referenced the study noted in this report back in 6/2/20 (https://covid19mathblog.com/2020/06/covid-6-2-20/) – yet its taken this long to show up in media – nonetheless on FoxNews – pointing out his conclusion that its political drug not a medical drug – https://www.theblaze.com/news/yale-professor-hydroxychloroquine-100-000-lives

“Yale epidemiology professor Dr. Harvey Risch said Tuesday that he believes the President Trump-touted drug, hydroxychloroquine, could save up to 100,000 lives if used properly to treat the coronavirus.”

“Speaking with Fox News’ Laura Ingraham Monday night, Risch insisted that the controversial drug is proven to be effective against the disease and safe for people to use, but lamented that it has become the victim of a "propaganda war."

"It’s a political drug now, not a medical drug," Risch said. "I think we are basically fighting a propaganda war against the medical facts, and that colors not just population people, how they think about it, but doctors, as well.

"There are many doctors that I’ve gotten hostile remarks [from] saying that all the evidence is bad for it and, in fact, that is not true at all," he said. "All the evidence is actually good for it when it’s used in outpatient uses.”

“All in all, Risch asserted that "75,000 to 100,000 lives would be saved" if the drug was used widely and perhaps as a prophylactic, meaning in a preventative manner.”

“Since then, a new study conducted by the Henry Ford Health System found that "treatment with hydroxychloroquine cut the death rate significantly in sick patients hospitalized with COVID-19."”

Ugh where is the mass media retraction or at least an investigation of this. Lets put the politics aside and save some lives? Lets hope a vaccine that is shown to work – Trump doesn’t endorse it – else it’s going to be trashed.

Speaking of vaccine – https://www.reuters.com/article/us-health-coronavirus-usa-vaccines-price/moderna-merck-say-they-will-not-limit-price-of-coronavirus-vaccines-to-company-cost-idUSKCN24M2PP

“Moderna Inc and Merck & Co on Tuesday told a U.S. Congressional panel that they expect to profit from their coronavirus vaccines once approved, amid concerns the vaccines may not be accessible to all.”

“Executives from Johnson & Johnson and AstraZeneca Plc testified that they will price their respective potential vaccines at no profit while the pandemic rages on.”

“Pfizer Inc has said the company intends to make a profit from its potential coronavirus vaccine if approved. However, Pfizer Chief Business Officer John Young, testified: “We recognize that these are extraordinary times and our price will reflect that.””

“AstraZeneca said its vaccine would be provided at no profit under its agreement with the United States for allocation of some 300 million doses.”

No profit – doesn’t mean it doesn’t come with return on capital – technically a return on capital allocated one could argue is part of the “no cost”. ROC on pharma is quite high.

Back to 1K plus for Brazil and US – but averaging the past 2 days US would be under. India is accelerating their confirmations. Note they are using HCQ as preventive to their medical folks.

The leader in death is FL at 134. Confirmation leader CA

It’s the same counties

Fatality rates continue to fall for LA.

I keep seeing scare articles noting how ICU in Texas are like war zone etc… I am sure they are awful but to put things in perspective they are no way near what had happened in NYC. Yesterday I showed state view – lets dive into the county view and you cant even see Harris County in terms of death. I had to cut the criteria to 10 to just get Harris county to be plotted along these other regions. Even LA, Maricopa, Miami Dade is dwarfed by NYC. Can you imagine the hospitals in NYC when they were over 500 deaths a day (peak 1079 deaths a day 4/19) – and now these counties are complaining at less than 100 deaths a day (Harris county 16 deaths/day)? The extrapolation of what happened in NYC just cannot be used to represent other breakouts. No doubt error after error had to have occurred in NY. Other hotspots at that time did not get that bad. We are working on getting state data in foreign countries to compare with NY. LA is getting close to the level being confirmed in NY but the deaths are nowhere near NYC.

Without NYC in the chart – Harris County still much lower than LA, CA.

Speaking of Houston/Harris county – the miracle continues with ICU beds availability flat lining and improving in the face of growing confirmations. Fatality rate observing a slight rise but still the envy of the world at less than 1%.