Weekly coronavirus-related chat, questions, and minor updates - week of November 23

(Un)usual personal update:

I got tested on Sunday after losing smell and taste almost completely. I've been in full quarantine since, awaiting test results, and I'm happy to report that they came in and I'm negative!

I'm a little baffled because I don't know what else would cause me to lose smell and taste to the degree that I did -- they were operating at maybe 10-20% of normal at most. Searches turn up allergies/cold, but I'm adequately familiar with both of those, and it's never been like this. Furthermore, I wasn't stuffy or congested at all. On the other hand, my taste started returning later that evening: by the end of the day Sunday I had maybe close to 50%, and it's now back to 100%.

For a bit I wondered if my anxiety was overblowing things, but I can point to two anchor points that make me realize it wasn't all in my head. My amazing in-laws dropped off (contactless) some Indian food from one of my favorite restaurants on the day of my test as a quarantine comfort. I had some of it the first day and was taken aback at just how much I couldn't taste it. In my mouth it was mostly a texture and some of the heat of the dish came through, but the actual flavor of it, which should have been a wonderful symphony of strong spices, was nonexistent. When I had the remaining leftovers the next day, I was able to experience what I had missed out on the day prior -- it was almost as delicious as it should have been (I think the second day I was running at maybe 70-80%).

The second indicator was some leftover Halloween candy we still had on hand. I ate one in the middle of the first day, and it didn't taste sweet at all. It was like I had one they'd accidentally made without sugar. Later that night I tried another one, and it was actually what clued me in that my taste was returning, because it tasted partially sweet.

While the negative result is confusing to me, I'm nonetheless happy to have it confirmed. During these three days I developed no other symptoms and otherwise felt fine, so I was thinking maybe I got away with having a very mild, mostly asymptomatic case, but given how quickly smell and taste returned I think it's more likely something else was the culprit -- especially because I do have pretty numerous and somewhat severe allergies.

A big thanks to all of you who follow my updates and to those who wished me well. These past three days have been pretty nervewracking, so your kindness and support were very much appreciated. Much love to all. Stay safe out there, everyone.

The Logic of Pandemic Restrictions Is Falling Apart

As more and more New Yorkers have become sick, officials have urged people to skip Thanksgiving, because of the danger of eating indoors with people you don’t live with. Rather than closing indoor dining, however, Cuomo has ordered all restaurants and bars simply to close by 10 p.m. This curfew also applies to gyms, which are not exactly hotbeds of late-night activity even in normal times. Meanwhile, case counts have risen enough to trigger the closure of New York City public schools, but businesses still have full discretion to require employees to come into work. (Cuomo’s office did not respond to a request for comment.)

It isn’t just New York; in states across the country, local officials have urged caution and fastidiousness. But those words can seem tenuously connected, at best, to the types of safety measures they’ve put in place. In Rhode Island, for example, residents are prohibited from gathering with even one person outside their household, even in the open air of a public park. But inside a restaurant? Well, 25 people is fine. Hire a caterer? You’re legally cleared to have up to 75 outdoors. The governor’s executive order merely notes: “The lower attendance at such events, the lower the risk.” (The Rhode Island governor’s office did not respond to a request for comment.)

Daily COVID-19 Data Is About to Get Weird

Based on what we’ve seen over the last eight months of state-reported COVID-19 data, we think two big, potentially misleading things are about to happen to the testing, case, and death numbers that allow us to track the pandemic in the United States.

First, by Thanksgiving Day and perhaps as early as Wednesday, all three metrics will flatten out or drop, probably for several days. This decrease will make it look like things are getting better at the national level. Then, in the week following the holiday, our test, case, and death numbers will spike, which will look like a confirmation that Thanksgiving is causing outbreaks to worsen. But neither of these expected movements in the data will necessarily mean anything about the state of the pandemic itself. Holidays, like weekends, cause testing and reporting to go down and then, a few days later, to "catch up." So the data we see early next week will reflect not only actual increases in cases, test, and deaths, but also the potentially very large backlog from the holiday.

[...]

On weekends, fewer doctors’ offices and other testing sites are open, so fewer people get tested, which means that fewer tests make it to labs. The reporting systems, too, are affected: Fewer results are reported to health departments, and fewer health department staff are at their desks to turn those results into the data points we eventually see under tests and cases.

[...]

Death reporting, too, is affected, much more noticeably. Reporting for deaths already takes more than a week on average—and can take much longer in some states. On weekends, we see death reporting drop by an average of 44 percent from the seven-day average on Sundays, and 48 percent from the seven-day average on Mondays, with the highest reporting on Wednesday.

[...]

There are, however, a few metrics that we expect to remain relatively stable through the holiday. Current hospitalizations reported by states and territories have not shown as much volatility as tests, cases, and deaths, which makes sense—these numbers are reported by hospitals or hospital associations, and hospitals don’t get weekends off.

[...]

The actual case increases from Thanksgiving exposures—people who got COVID-19 during the holiday weekend—probably won’t start showing up in the data until the second week of December. Succeeding waves of infections from holiday gatherings will roll in for weeks.

The CDC regularly updates their provisional death data, by county, for at least all US counties with at least 10 reported COVID deaths. It is located here:
https://data.cdc.gov/NCHS/Provisional-COVID-19-Death-Counts-in-the-United-St/kn79-hsxy

I wanted to compare this to the regular number of deaths we see each year in the county I live in, Knox county. Previous years death data is available on the Tennessee Dept of Health site:
https://www.tn.gov/health/health-program-areas/statistics/health-data/death-statistics.html

Total number of deaths in Knox County (in parenthesis is the change from the previous year):

2014: 4474
2015: 4330 (-144)
2016: 4411 (+81)
2017: 4582 (+171)
2018: 4775 (+193)

If we look at 2020 from the CDC provisional data...
2020: 5767 (+992)

But Knox county is only officially reporting 256 COVID related deaths. That's quite the increase from previous years, not attributable to anything but COVID.

I imagine other areas are hiding their real COVID related deaths also. Feel free to find your state's historical death data and compare it to the CDC provisional death table, along with reported COVID deaths.

New York swingers club shut down for breaking coronavirus restrictions

When deputy sheriffs arrived, they found 80 people in the venue, including three couples having sex in a small room, according to NBC4 New York.

The club was based in a part of the city where indoor gatherings are currently limited to just 25 people.

Remember to limit your orgies to no more than 25 people in order to control the spread of covid.

How We Can Stop the Spread of COVID-19 By Christmas

Widespread and frequent rapid antigen testing (public health screening to suppress outbreaks) is the best possible tool we have at our disposal today—and we are not using it.

It would significantly reduce the spread of the virus without having to shut down the country again—and if we act today, could allow us to see our loved ones, go back to school and work, and travel—all before Christmas.

Antigen tests are “contagiousness” tests. They are extremely effective (>98% sensitive compared to the typically used PCR test) in detecting COVID-19 when individuals are most contagious. Paper-strip antigen tests are inexpensive, simple to manufacture, give results within minutes, and can be used within the privacy of our own home—the latter is immensely important for many people across the U.S.

[...]

The antigen test technology exists and some companies overseas have already produced exactly what would work for this program. However, in the U.S., the FDA hasn’t figured out a way to authorize the at-home rapid antigen tests because the FDA is used to regulating medical devices, not public health screening tools. Thus, every test that is authorized, regardless of whether it is designed for medicine or public health, is authorized as a clinical medical device. Requiring public health tools to meet medical device specifications has caused company after company to delay their FDA submissions in a never ending attempt to meet the FDA’s guidelines—for example the need to separately qualify a rapid antigen test for symptomatic versus asymptomatic use. This slows development and authorization because it is hard to find asymptomatic people when they are contagious (i.e. when the antigen test is meant to be positive) in order to gain an asymptomatic medical claim. Requiring public health tools to get funneled through a medical diagnostic authorization process also runs the risk of diluting down the test metrics that medical diagnostics demand—which again, are distinct from the public health tests we need today.

This blog post has more examples of other countries using antigen tests.

New York Governor Cuomo cancels Thanksgiving plans with family after backlash

Midwest Outbreaks Pause, Hospitalizations and Deaths Keep Rising: This Week in COVID-19 Data, Nov 25

After three months of seeing a consistent rise in the seven-day average of new daily cases, North Dakota's cases began to fall. The state's current hospitalizations, too, are declining, which means that more COVID-19 patients are leaving North Dakota's hospitals than are entering them. We’re also seeing convincing case drops, backed by clear decreases in hospitalized patients, in Iowa, Montana, South Dakota, and Wisconsin.

(They also warn again about expected problems with the data over Thanksgiving.)

Evidence Builds That an Early Mutation Made the Pandemic Harder to Stop

As the coronavirus swept across the world, it picked up random alterations to its genetic sequence. Like meaningless typos in a script, most of those mutations made no difference in how the virus behaved.

But one mutation near the beginning of the pandemic did make a difference [...] The mutation, known as 614G, was first spotted in eastern China in January and then spread quickly throughout Europe and New York City. Within months, the variant took over much of the world, displacing other variants. [...]

[Many scientists were skeptical, but] a host of new research — including close genetic analysis of outbreaks and lab work with hamsters and human lung tissue — has supported the view that the mutated virus did in fact have a distinct advantage, infecting people more easily than the original variant detected in Wuhan, China.

[...]

One study found that outbreaks in communities in the United Kingdom grew faster when seeded by the 614G variant than when seeded by its Wuhan ancestor. Another reported that hamsters infected each other more quickly when exposed to the variant. And in a third, the variant infected human bronchial and nasal tissue in a cell-culture dish far more efficiently than its ancestor.

El Paso was still grieving when the coronavirus arrived. Now, death has overwhelmed it

Inmates were paid to move hundreds of bodies into mobile morgues; the National Guard is now in charge of the grim task. Funeral homes have turned storage closets into freezers to hold the dead. A crematorium broke down from overuse. The city’s convention center has been transformed into a field hospital. The county judge wonders whether the community has enough gravesites.

[...]

Lujan understood how bad things had gotten when he realized he was seeing the same families coming back every week in smaller numbers. He recently sat across the table from a newly single mother and two young children discussing arrangements for their father. They attended funerals for three other relatives in recent weeks.

[...]

In a matter of weeks, more than 200 patients were in the ICU in El Paso. The sick were airlifted hundreds of miles to hospitals in Austin and Tucson. The field hospital opened at the convention center. More than 1,500 nurses, therapists and doctors arrived to staff the additional beds. State officials brought in nine mobile morgues and several dozen ventilators. The city recorded a sixfold increase in patients in a matter of weeks.

“We added somewhere around 600 new beds to our hospitals in total across the community. That’s like building two whole new hospitals,” said Ed Michelson, chief of emergency medicine at University Medical Center, the city’s public hospital. “We’ve kept up with the demand but barely.”

Twitter thread (and Threadreader link) that drew a parallel between Covid and the 1918 flu that I hadn't considered or heard discussed before:

Today's covid denialists are tomorrow's openly eugenicist "these disabled people are a drain on society"

Literally. 13 years after the Spanish flu, the very first people the nazis targeted were disabled people.

What caused a lot of those disabilities, you think?

Mall Santas brave the pandemic with plexiglass barriers, sanitation elves and snow-globe bubbles

Although some retailers, such as Macy’s, have suspended Santa visits or moved them online, many others are forging ahead with extra precautions and backup plans, in hopes of getting customers into stores during a particularly fraught holiday season.

[...]

The stakes are especially high. The pandemic has sent a number of prominent retailers into bankruptcy and disrupted every part of the industry, from supply chains to consumer behavior. Many retailers are still struggling to make up for lost sales from coronavirus-related closures in the spring. Another round of shutdowns just as the holiday season is kicking off, they say, could be devastating.

[...]

But at least a dozen Santas, he said, will continue to work because they need the money. “A lot of these guys are living on Social Security checks alone, so it’s a tough decision for them to make — their health or extra income,” he said.

A Santa gig, he said, can easily bring in hundreds of dollars a day. Brenneman charges $200 an hour early in the season and as much as $600 an hour on Christmas Eve. Overall bookings are down about 40 percent this year, but the company still has at least 300 events on its calendar.

Interesting look at how the best ("90% effective") result of the AstraZeneca / Oxford vaccine was basically the result of a mistake: AstraZeneca’s best COVID vaccine result was a fluke. Experts have questions

The WHO is stressing that it needs a better trial.

Mask defiance remains strong in Montana, even as the pandemic rages

Mask defiance is not contained to the northeastern corner of Big Sky Country. A group called the Freedom Protection Project has toured the state campaigning against the mask mandate and raising money to fight it in court. In an email, the group framed its mission in language similar to vaccine skeptics’ talking points. “The media has grossly mischaracterized our group,” its statement said. “We are not an anti-mask group. We are a pro civil liberties organization. We have not had any anti-mask events.”