H5N1

COVID-19 on November 30: 17,368,575 new cases and 273,814 deaths since October 31

A screenshot from the Johns Hopkins Coronavirus COVID-19 (2019-nCoV) dashboard:

And here, by way of comparison, is what the Johns Hopkins dashboard looked like on October 31, one month ago:

So we have seen 17,368,575 cases in a month, and 273,814 people who were alive on October 31 are now dead from COVID-19.

Serologic testing of US blood donations to identify SARS-CoV-2-reactive antibodies: December 2019-January 2020

Via Clinical Infectious Diseases: Serologic testing of U.S. blood donations to identify SARS-CoV-2-reactive antibodies: December 2019-January 2020. The abstract:

Background 

SARS-CoV-2, the virus that causes COVID-19 disease, was first identified in Wuhan, China in December 2019, with subsequent worldwide spread. The first U.S. cases were identified in January 2020. 

Methods 

To determine if SARS-CoV-2 reactive antibodies were present in sera prior to the first identified case in the U.S. on January 19, 2020, residual archived samples from 7,389 routine blood donations collected by the American Red Cross from December 13, 2019 to January 17, 2020, from donors resident in nine states (California, Connecticut, Iowa, Massachusetts, Michigan, Oregon, Rhode Island, Washington, and Wisconsin) were tested at CDC for anti-SARS-CoV-2 antibodies. Specimens reactive by pan-immunoglobulin (pan Ig) enzyme linked immunosorbent assay (ELISA) against the full spike protein were tested by IgG and IgM ELISAs, microneutralization test, Ortho total Ig S1 ELISA, and receptor binding domain / Ace2 blocking activity assay.  

Results 

Of the 7,389 samples, 106 were reactive by pan Ig. Of these 106 specimens, 90 were available for further testing. Eighty four of 90 had neutralizing activity, 1 had S1 binding activity, and 1 had receptor binding domain / Ace2 blocking activity >50%, suggesting the presence of anti-SARS-CoV-2-reactive antibodies. Donations with reactivity occurred in all nine states.  

Conclusions 

These findings suggest that SARS-CoV-2 may have been introduced into the United States prior to January 19, 2020.

Canada on track for 4,000 COVID-19 patients in hospital by Christmas, eclipsing first wave

Via The Globe and Mail: Canada on track for 4,000 coronavirus patients in hospital by Christmas, eclipsing first wave. Excerpt:

Canada is on track to have 4,000 coronavirus patients in hospital by Christmas, a figure that would eclipse the peak of the first wave and put tremendous pressure on a health-care system already pushed to the brink by nine months of battling the pandemic.  

A new analysis conducted for The Globe and Mail by researchers at British Columbia’s Simon Fraser University projects that the number of Canadians admitted to hospital for treatment of COVID-19 will continue to grow, with the steepest increases in the West, particularly in Alberta. 

If Alberta stays on its current trajectory, the province’s physicians and nurses will be caring for more COVID-19 patients – as many as 1,300 in the worst-case scenario – than Ontario, which has three times the population. There were 425 COVID-19 patients in Alberta hospitals on Sunday.  

By contrast, Ontario and Quebec, the twin epicentres of Canada’s spring wave, are expected to see slower growth in the number of COVID-19 hospital admissions over the next four weeks, but growth nonetheless. 

Meanwhile, the number of new cases reported daily across the country has increased by more than 2,000 since the beginning of November and is closing in on 6,000 a day.  

Jens von Bergmann, the mathematical modeller who produced the hospitalization forecasts for The Globe, stressed that his projections offer a glimpse of what could be, not what has to be, even though the lag between infections and admissions mean part of the trend is already baked in. COVID-19 hospitalization projections   

Recently imposed government restrictions and individual choices could turn the tide, he said. “The key is that in all of these models, we are actually still in control of what’s going to happen at the end of December.”  

Over the past week, there has been an average of just over 2,000 COVID-19 patients being treated in Canadian hospitals, 420 of them in critical-care units, according to a Globe and Mail tally of provincial data. Both figures have nearly doubled since the end of October. 

The national totals aren’t as high as the peak of the first wave, when the seven-day average of cases in hospital topped 3,000 in mid-April. But the geography of the second wave is different. 

Gone are the days when COVID-19 was primarily a Central Canadian scourge. Hospitals in Manitoba, Alberta and B.C. have long blown past their spring peaks. Manitoba hospitals were treating an average of 285 coronavirus patients a day last week. They averaged 11 at the height of the first wave. While Quebec and Ontario are generally in better shape, hospitals in their hot zones are struggling.   

Canada’s hospitals held up well during the first wave, thanks to the staff and space freed up by halting elective procedures and a collective effort to bend the curve. This time, hospitals are caring for COVID-19 patients and trying to keep scheduled surgeries running at the same time, all while staff are experiencing existential levels of exhaustion and the public has grown weary of physical distancing. 

Doctors, nurses and other hospital workers will be all the more burned out – and less able to provide the best care for patients – if the SFU team’s worst-case projections for coronavirus hospital admissions come to pass. 

“[People] talk about front-line workers as if there’s somebody waiting in the wings to step in if we fall,” said Meighan Jones, an emergency nurse in Edmonton. “But there is nobody waiting in the wings. We’re all that there is.”

Evictions have led to hundreds of thousands of extra Covid-19 cases

Via CNBC: Evictions have led to hundreds of thousands of extra Covid cases.

Expiring state eviction bans have led to hundreds of thousands of additional coronavirus cases, new research finds, raising alarm about what will happen when the national eviction moratorium lapses next month. 

During the pandemic, which at one point was estimated it would displace as many as 40 million people, 43 states, plus Washington, D.C., temporarily barred evictions. Many of the moratoriums lasted just 10 weeks, while some states continue to ban the proceedings. 

The researchers, from the University of California, Los Angeles, University of California, San Francisco, Johns Hopkins University, Boston University and Wake Forest University School of Law, found that lifting state moratoriums and allowing eviction proceedings to continue caused as many as 433,700 excess cases of Covid-19 and 10,700 additional deaths in the U.S. between March and September.

The findings are not yet published in a journal but will be available online Monday.  

“When people are evicted, they often move in with friends and family, and that increases your number of contacts,” said Kathryn Leifheit, one of the authors on the research and a postdoctoral fellow at the UCLA Fielding School of Public Health. “If people have to enter a homeless shelter, these are indoor places that can be quite crowded.”  

To best understand the direct impact that evictions continuing in a state has on the spread of the coronavirus, the researchers controlled for stay-at-home orders, mask orders, school closures, testing rates and other factors. The study period was from March to early September, before the most recent spike in cases. 

It was also in September that the Centers for Disease Control and Prevention ordered a nationwide halt to most evictions through the end of the year to curb the outbreak that, in the U.S., has sickened more than 12.9 million people and left over 263,000 dead. 

If the CDC’s eviction ban isn’t extended until 2021, experts say, many new cases are likely to emerge from people being forced out of their houses and apartments. 

“This is a time where it’s not an overstatement to say that for many people, eviction can lead to death,” said Helen Matthews, communications manager at City Life Vita Urbana, a nonprofit in Boston.

COVID-19: Inside the communications battle to reach pandemic-weary Canadians

Via The Globe and Mail: Inside the communications battle to reach pandemic-weary Canadians. Excerpt:

With his goatee and designer glasses, Quebec’s director of public health, Horacio Arruda, cuts a striking figure behind a podium. His name and distinctive image were everywhere in the province this spring: T-shirts, cans of hipster beer, Facebook groups dedicated to his worship. During the first wave of the pandemic, the bureaucrat became a star.  

So it was perhaps a sign of the times when it emerged, earlier this month, that Dr. Arruda had hired a communications coach. If Quebeckers were less than shocked at the news, it was because the doctor’s star has waned. His rambling answers, once valued for their sincerity, were now accused of sowing confusion. His bubbly personality fell out of step with the public mood.  

Leaders of the country’s COVID-19 response, from coast to coast, can no doubt relate. The grace period that greeted them in the pandemic’s fearful early months is gone, as fatigue and frustration set in, more than nine months after the virus took hold in Canada. During the first phase of a crisis, people tend to seek clear direction. “We want to know there’s someone telling us what to do, and they tend to be well-received,” said Alexandre Coutant, assistant professor of social and public communications at the University of Quebec at Montreal. “Things get a little rougher after that.”  

Experts in public-health communication warn that this long second wave demands a new approach to levelling with citizens, as more of them tune out health advice. Heidi Tworek, an associate professor of history and public policy at the University of British Columbia, said leaders need to find ways of keeping the public on board over the long term by communicating in a way that is transparent, empathetic and not overly reliant on one voice. A message that’s sustainable for months or a year will need to look different from the early blitz of press conferences in March and April, she said. 

“We’re in a phase of habit formation, which is a different challenge from the spring, when you were getting people to do things for the first time.”  

Examples abound of the whiplash caused by this shift. Deena Hinshaw once inspired memes about her calm demeanour and nerdy-chic wardrobe, but Alberta’s Chief Medical Officer of Health is now battling leaked recordings of meetings with other bureaucrats and a health network on the brink. B.C.’s Provincial Health Officer, Bonnie Henry, had songs composed and a mural painted in her honour in the spring but now faces heightened criticism for the province’s lax policy on mask-wearing. 

Some of the shift can be attributed to earlier communications failures “coming home to roost,” said Prof. Tworek, who co-authored a recent report from UBC on “Democratic Health Communications during COVID-19.” The study looks at how nine countries and two Canadian provinces have delivered public-health messages since March and contains harsh criticism of the Ontario government in particular. 

Premier Doug Ford’s government emphasized protecting one’s self and family from the virus early in the pandemic, rather than protecting others, which may have led to a weaker sense of social solidarity, the report says.  

The Ford government also handed down relatively “granular” advice and regulations, Prof. Tworek argues, such as 10-person social “bubbles,” rather than emphasizing broad principles of safe conduct such as limiting the size of gatherings. That has left Ontarians primed to expect specific and evolving guidance on how to behave, she said, evidenced by “this weird desire to know what to do for Halloween.”

Second wave of COVID-19 could jeopardize 4 decades of work on HIV/AIDS, expert warns

Via CBC News: 2nd wave of virus could jeopardize 4 decades of work on HIV/AIDS, expert warns. Excerpt:

New HIV infections are at their lowest rate since the disease first hit British Columbia, according to top researcher Dr. Julio Montaner. 

Last year, on Dec. 1, World AIDS Day, Montaner declared the epidemic of HIV/AIDS over in B.C. because infection rates had fallen so low.  This year, despite concerns that COVID-19 restrictions would get in the way, the spread of HIV has declined even further.  

Montaner is the executive director and chief physician at the B.C. Centre for Excellence in HIV/AIDS and the head of the HIV/AIDS Program at St. Paul's Hospital. 

He was instrumental in turning HIV infections from a death sentence to a manageable condition. Now, he is concerned the success he has helped create in B.C. is not happening elsewhere.  

"The rest of the country and the rest of the world are falling behind," said Montaner. 

In April, after pandemic restrictions came into place, Montaner and others were concerned. HIV testing rates fell and people struggled to access health care.  

After four decades of hard work on the AIDS pandemic, to Montaner, it was "unthinkable."  

Now, he worries, we squandered the opportunity to prepare for the second wave of COVID this past summer, when new COVID infections were low.   

"We wasted the summer celebrating our success without taking responsibility collectively that we need to be cautious," he said. "I am very concerned that the way things are going with shutdowns and lockdowns and competition for health-care resources." 

Montaner worries B.C. is not up to speed on contact tracing, hasn't managed to expand testing and implement rapid testing, approaches he calls "game-changers" in controlling HIV. 

"We don't seem to learn from the past," he said. "It's very frustrating."

Rapid response decisive to Vietnam’s success over COVID-19: German newspaper

Via VietnamPlus: Rapid response decisive to Vietnam’s success over COVID-19: German newspaper.

Berlin (VNA) – German newspaper Neues Deutschland (New Germany) published an article on November 28 by Julia Behrens highlighting Vietnam's rapid response to the COVID-19 pandemic as well as the fact that the Vietnamese government has put the health of the people ahead economic benefits. 

Vietnam has had no community infection cases of COVID-19 to report over the past three months, and that all new cases were imported. Clubs are open, major events are taking place, conferences are held face to face, market activity is unbroken, everyday life is almost the same as ever, the newspaper said.  

It quoted Thirumalaisamy P. Velavan, Professor at the University Hospital Tübingen and Director of the Vietnamese-German Center for Medical Research (VG-CARE) in Hanoi, as saying that the rapid response to the novel coronavirus was decisive to the success of Vietnam.  

Vietnam responded comprehensively and quickly to the pandemic, he said. From the beginning of the outbreak, the government has traced people in contact with infected persons, ordered compulsory quarantine and efficiently mobilized state institutions into the response efforts. 

There was an immediate order for people to wear face masks, along with guidelines for hygiene measures, safe distancing and four-tier quarantine, he added. 

According to Velavan, the Vietnamese government has prioritised people over economic benefits. The Vietnamese economy had also been severely affected by the pandemic, especially the tourism sector. Economic growth has declined, but remains positive. 

The article also quoted Dong Huy Cuong from the Vietnam Union of Friendship Organisations, as saying that the government's clear strategy and the willingness of the people to stick to the strategy are crucial to Vietnam’s fight against COVID-19.  

Cuong also emphasised the government's success in communications, which was transparent and understandable for everyone, so that the people have realised that the measures were carried out for their own protection.

China beat COVID-19 with science and strong public health measures, not just with authoritarianism

Via The Conversation, an article by Elanah Uretsky, an associate professor of international and global studies at Brandeis: China beat the coronavirus with science and strong public health measures, not just with authoritarianism. Excerpt:

I live in a democracy. But as Thanksgiving approached, I found myself longing for the type of freedom I am seeing in China.  

People in China are able to move around freely right now. Many Americans may believe that the Chinese are able to enjoy this freedom because of China’s authoritarian regime. As a scholar of public health in China, I think the answers go beyond that.  

My research suggests that the control of the virus in China is not the result of authoritarian policy, but of a national prioritization of health. China learned a tough lesson with SARS, the first coronavirus pandemic of the 21st century. 

How China flattened its curve 

Barely less than a year ago, a novel coronavirus emerged in Wuhan, China, with 80,000 cases identified within three months, killing 3,000 people. 

In late January 2020, the Chinese government decided to lock down this city of 11 million people. All transportation to and from the city was stopped. Officials further locked down several other cities in Hubei Province, eventually quarantining over 50 million people. 

By the beginning of April, the Chinese government limited the spread of the virus to the point where they felt comfortable opening up Wuhan once again. 

Seven months later, China has confirmed 9,100 additional cases and recorded 1,407 more deaths due to the coronavirus. People in China travel, eat in restaurants and go into theaters, and kids go to school without much concern for their health. Juxtapose that to what we are experiencing in the U.S. To date, we have confirmed over 11 million cases, with the last 1 million recorded in just the last one week alone. 

In September and October, friends from China sent me pictures of food from all over the country as they traveled around to visit friends and family for the mid-autumn festival and then the seven-day National Day vacation week. I envied them then and envy them even more now as Americans prepare and wonder how we will celebrate the holidays this year. 

What China learned from SARS 

We Americans are told that the freedoms Chinese now enjoy come at the expense of being subject to a set of draconian public health policies that can be instituted only by an authoritarian government. But they also have the experience of living through a similar epidemic. 

SARS broke out in November of 2002 and ended in May of 2003, and China was anything but prepared for its emergence. It didn’t have the public health infrastructure in place to detect or control such a disease, and initially decided to prioritize politics and economy over health by covering up the epidemic. This didn’t work with such a virulent disease that started spreading around the world. 

After being forced to come to terms with SARS, China’s leaders eventually did enforce quarantine in Beijing and canceled the week-long May Day holiday of 2003. This helped to end the pandemic within a few short months, with minimal impact. SARS infected approximately 8,000 worldwide and killed about 800, 65% of which occurred in China and Hong Kong. 

The Chinese government learned from SARS the important role public health plays in protecting the nation. Following SARS, the government improved training of public health professionals and developed one of the most sophisticated disease surveillance systems in the world. While caught off guard for this next big coronavirus outbreak in December 2019, the country quickly mobilized its resources to bring the epidemic almost to a halt inside its borders within three months.

US passes 4 million cases for November alone

Via The New York Times: Covid-19 Live Updates: U.S. Passes 4 Million Cases for November Alone. Excerpt:

The total number of coronavirus cases in the United States for November surpassed four million on Saturday, more than double the record set in October of 1.9 million cases. And the sharp escalation is likely to continue — or grow even steeper.  

“We are on track to continue this accelerated pace of the epidemic and see even more speed of rise of cases because of the movement indoors, of activities around the country and because large numbers of people have moved around the country for the holidays,” said Tom Inglesby, the director of the Center for Health Security at Johns Hopkins University.  

The milestone came as Americans traveled by the millions for the long Thanksgiving weekend and amid a Black Friday that saw some store crowding, even as merchants guided customers to online sales and limit in-person shopping. In the end, retail trackers reported.  

More than 170,000 people in the United States are now testing positive on an average day. More than 1.1 million people tested positive in the past week alone. The country’s overall total, from the start of the pandemic, is over 13 million infections — by far the world’s largest outbreak. 

The Thanksgiving holiday, however, caused skews in reporting at the end of the week, with a steep drop-off in new cases reported on Thursday, and then a huge jump on Friday. Many states did not report data on the Thanksgiving holiday, when the national tally rose more than 103,000 cases and more than 1,100 deaths — far lower levels than on the previous Thursday, Nov. 19, when 187,000 cases and 1,962 deaths were recorded. 

For that very reason, the numbers were artificially high on Friday, when many states reported two days’ worth of data. That pushed the country past 200,000 cases in a single day for the first time, with more than 205,000 reported as of late Friday night, along with more than 1,400 deaths. The preceding Friday, Nov. 20, the reports were more than 198,600 infections and more than 1,950 deaths. 

The blurry data could persist. Access to testing around the country was likely to have decreased for a few days, meaning more infections could go uncounted. In Louisiana, testing sites run by the National Guard were slated to be closed both Thursday and Friday. In Wisconsin, some National Guard testing sites closed all week. 

Many hospitals across the country are already overcrowded and struggling to keep up with rising numbers of patients seeking care, and the pressure on the health care system is likely to only increase. Hospitalizations on Saturday reached a daily record of 91,635, according to the Covid Tracking Project.  

The country’s monthly case numbers have varied considerably, but have exploded over the past two months. Officials announced more than 188,000 cases for the month of March, followed by a significantly higher 887,000 cases for April. From there, the monthly total dropped to more than 723,500 for May, and then, after the Memorial Day holiday, rose to more than 854,000 for June. That skyrocketed to more than 1,918,000 for July, dropped to more than 1,473,000 for August and more than 1,216,000 for September, and then shot back up past 1,946,000 for October. 

The number for this month, as of midday Saturday, was 4,006,548, with more than two days left for the tally to grow. 

Monthly deaths have been rising more slowly, but they are already higher than at any point since the spring surge, when New York, New Jersey and Louisiana became global hot spots.

COVID-19 on Saturday afternoon: 62,084,566 cases, 1,449,642 deaths

A screenshot from the Johns Hopkins Coronavirus COVID-19 (2019-nCoV) dashboard:

It's also worth noting that the Johns Hopkins Daily Cases graph in the lower right corner indicates that yesterday, November 27, had the highest case count so far in the pandemic: 671,885.