H5N1

China’s zero-Covid policy is a pandemic waiting to happen

An op-ed in The New York Times: China’s Zero-Covid Policy Is a Pandemic Waiting to Happen. Much as I respect Drs. Emanuel and Osterholm, I'm nervous about their use of terms like "have to live with it" and "endemic." They sound at this point like acceptance of high mortality and morbidity rates, which will be endured much more by working-class people and people of colour. Excerpt:

As the Winter Olympics approach and some 3,000 athletes, their retinues and the media converge in and around Beijing, the Chinese government has gone to extraordinary lengths to prevent the 24th version of the games from becoming a Covid super spreading event. 

Though athletes and coaches will be required to be vaccinated, they will face severe restrictions. Those who receive a medical exemption from vaccination are being required to quarantine for 21 days after entering the country. Even the vaccinated will have to present two negative tests. Olympic participants must submit to daily Covid tests and will be restricted to an Olympic bubble where they will be confined to prevent spread to the local population.  

These extreme measures are in line with China’s zero-Covid policy. President Xi Jinping and his government seem to believe that the country can be sealed off until the virus is eradicated around the world.  

But that goal is unattainable with the highly transmissible Omicron variant and has set the nation up for disaster. The coronavirus is not going to disappear — the world will have to live with it. Making matters worse, China’s vaccines are much less effective against Omicron. And the Chinese health care system simply is not equipped to care for millions of people sickened by the virus.  

Yes, China has weathered the pandemic well so far. Even with about four times the population of the United States, China has had fewer than 140,000 confirmed Covid cases and fewer than 6,000 deaths since January 2020, according to the World Health Organization. A vast majority of factories continued to operate. Early in the pandemic, China added thousands of hospital beds to its health care system in days.  

All of this seems like an enormous success when compared with the messy and often chaotic response to the virus in the United States, where more than 860,000 people have died and some 2,000 more die each day. Many hospitals are under siege. The economy has been disrupted.  

But this may very well be the future China is facing. Its pursuit of zero Covid will prove to be a huge mistake. The policy has left it wholly unprepared for what will become endemic Covid.

Brazil's unvaccinated president misses soccer match

Via Reuters: Brazil's unvaccinated president misses soccer match.

SAO PAULO, Oct 10 (Reuters) - Brazilian President Jair Bolsonaro said on Sunday he was not allowed to attend a league match between Santos and Gremio because the home club did not allow unvaccinated supporters into their stadium.  

The soccer match was Santos' first with supporters present since the start of the COVID-19 pandemic, but the club insisted it would only permit entry of vaccinated people or those who had a negative PCR test.  

"I wanted to watch the Santos game now and they told me you have to be vaccinated," Bolsonaro said in a video posted on the website of the Metropoles news portal. "Why?"  

Bolsonaro, who has refused to get vaccinated and encouraged others to follow his lead, claimed he had antibodies because he had already contracted COVID-19.  

It was unclear whether Bolsonaro, a keen football fan who spent the weekend near Santos, tried to go to the game or whether his complaint was a general one about the need for what he called "vaccine passports."  

A spokesman for Santos said the club had not been approached by the president's team and that all fans must follow the country's sanitary regulations.  

More than 600,000 people have died from COVID-19 in Brazil.

Indonesia deploys ships as floating covid-19 wards

Via the Jakarta Globe: Indonesia Deploys Ships as Floating Covid-19 Wards. Excerpt:

Jakarta. The Indonesian government has deployed five ferries to be used as makeshift isolation facilities for Covid-19 patients with mild symptoms in several cities with a combined capacity of more than 3,000 beds. 

The five ferries have dropped anchors off Jayapura in Papua, Sorong in West Papua, Belawan in North Sumatra, Makassar in South Sulawesi, and Bitung in North Sulawesi. 

“The aim of those floating isolation facilities is to move self-isolating patients from their homes, thus reducing the risk of family clusters,” Coordinating Minister for the Economy Airlangga Hartarto said when inspecting the facility at Jayapura Port in Papua. 

All the five ships are owned and operated by state-run sea transport company Pelni. 

MV Tidar is the biggest among the five and able to accommodate 929 beds. It’s now being stationed off Jayapura, where multi-sport event the National Games will take place later this month. 

Airlangga said the number of Covid-19 patients being treated at the facility has dropped sharply to a mere 17 as of Saturday. 

The ferry has six doctors, 12 nurses, a nutritionist, two pharmacists, four volunteers and four medical analysts, he said. 

MV Tidar arrived in Jayapura on August 14 at the request of the city’s health department. It will continue the service until the conclusion of the National Games in mid-October. 

The government is ramping up vaccination in Papua, especially in the cities of Jayapura, Merauke and Mimika that will become the venues of the sporting event. 

Airlangga said the entire adult population in the three cities are expected to have received at least a dose of the Covid-19 vaccine by the time the event begins. 

“Only vaccinated persons can watch the games on site so hopefully more and more people will come to get the jabs,” he said.

Sturgis Motorcycle Rally revs back, despite Delta variant

They're baaack... Via The Los Angeles Times, an Associated Press report: Sturgis Motorcycle Rally revs back, despite Delta variant. Excerpt:

SIOUX FALLS, S.D. — Crowds of bikers are rumbling their way toward South Dakota’s Black Hills this week for the Sturgis Motorcycle Rally, raising fears that COVID-19 infections will be unleashed among the 700,000 people expected to show up at the event. 

The rally, which starts Friday, has become a haven for those eager to escape coronavirus precautions. Last year, the rally hardly slowed down, with roughly 460,000 people attending. Masks were mostly ditched as bikers crowded into bars, tattoo parlors and rock shows — which afterward offered a lesson in how massive gatherings could spread the coronavirus across the country. 

This year, the 81st iteration of the rally is expected to be even bigger, drawing people from around the U.S. and beyond, despite concerns about the highly contagious Delta variant. 

“It’s great to see a party of hundreds of thousands of people,” said Zoltan Vari, a rally-goer who was settling into his campsite Tuesday after making the trek from Hungary. 

He was eager to return to riding a Harley-Davidson through the Black Hills after missing last year. Vari evaded U.S. tourism travel restrictions on Europe by spending two weeks in Costa Rica before making his way to South Dakota. He hopes 1 million people will show up. Typical attendance is around half a million. 

The city of Sturgis, usually a sleepy community of fewer than 7,000 people, tried to tamp things down last year, canceling most city-sponsored events and promotion, but hordes of bikers showed up anyway. 

“The rally is a behemoth, and you cannot stop it,” said Carol Fellner, a local resident who worried that this year’s event would cause a fresh outbreak of cases. “I feel absolutely powerless.” 

This year, the city is embracing the crowds. Republican Gov. Kristi Noem has given the rally her blessing and will appear in a charity ride. The event is a boon for tourism, powering over $800 million in sales, according to the state Department of Tourism. 

The rally is happening as other giant summer events — including state fairs and music festivals like Lollapalooza — are returning around the U.S. In Wisconsin, health officials say nearly 500 coronavirus cases may be linked to the crowds that attended Milwaukee Bucks games or gathered outside the team’s arena — estimated as high as 100,000 one night — during their push to the NBA championship. 

The Sturgis Motorcycle Rally’s defenders argue that open air is plentiful on the meandering highways and in the campgrounds where many bikers stay. But contact tracers last year reported 649 virus cases from every corner of the country linked to the rally, including one death. 

A team from the Centers for Disease Control and Prevention concluded in a published study that the 2020 rally “ had many characteristics of a superspreading event.”

‘Devastating’: WHO scientist condemns Euro 2020 final

Watching the game on TV, I could almost see a haze of SARS-CoV-2 drifting over the crowds. Via The Guardian: ‘Devastating’: WHO scientist condemns Euro 2020 final. Excerpt:

A WHO scientist has said watching unmasked crowds singing and shouting at the Euro 2020 football final in London on Sunday was “devastating”, and expressed concerns that it would spur Covid-19 transmission, including of the Delta variant. 

Covid infections in England have been surging, driven by the highly transmissible Delta variant and the lifting of restrictions, even as vaccination rates remain high. On 19 July, almost all remaining restrictions are set to be lifted, including mask-wearing and social distancing mandates. 

In the closing stages of the match against Italy, the World Health Organization’s Covid-19 technical lead, Maria Van Kerkhove, tweeted: “Am I supposed to be enjoying watching transmission happening in front of my eyes?” 

“The #COVID19 pandemic is not taking a break tonight… #SARSCoV2 #DeltaVariant will take advantage of unvaccinated people, in crowded settings, unmasked, screaming/shouting/singing. Devastating.” 

In June, the UK struck a deal with Uefa to allow Wembley to open up to 75% of its 90,000 capacity for three July games, including the final, despite pausing the final stage of its proposed reopening due to a resurgence of Covid-19, as part of its “events research programme” (ERP). 

The ERP – a pilot scheme designed assess the safety of mass gatherings during the pandemic and the effect on transmission – relies on event attendees to provide a negative rapid test as the condition of entry. However, the Innova lateral flow tests used in the UK are not very reliable at spotting positive cases when the infected person has low levels of the virus (usually in the first few days after being infected), and when administered by non-healthcare staff. 

The WHO has issued warnings that tournament crowds would fuel coronavirus cases. “We know that in a context of increasing transmission, large mass gatherings can act as amplifiers,” Katie Smallwood, WHO’s senior emergency officer, said earlier in July. 

The European parliament’s committee on public health described the decision to allow 60,000 fans into Wembley as “a recipe for disaster”. Hundreds of cases have already been linked to the tournament, including nearly 1,300 Scotland fans who travelled to London for their team’s fixture against England on 18 June, 300 Finns returning from St Petersburg, and multiple infections in Copenhagen.

Rallies, religious gatherings aggravate India's worst COVID-19 surge

Via Reuters: Rallies, religious gatherings aggravate India's worst COVID-19 surge. Excerpt:

NEW DELHI (Reuters) - India’s COVID-19 cases have soared 13-fold in barely two months, a vicious second wave propelled by open disregard for safety protocols in much of the vast country.

Election rallies led by Prime Minister Narendra Modi and other major figures, as well as crowded festivals and religious gatherings, have characterised the record resurgence of the new coronavirus. 

After quelling the first surge late last year, India’s leaders let down their guard. Allowing or even encouraging dangerous behaviour, they underestimated the virus, reopening the economy too fast and too broadly, experts say. 

With daily infections hitting a record 127,000 on Thursday, the most in the world and the third day this week over 100,000, the third-hardest hit country is soaring past its mid-September peak of around 98,000 cases a day. 

Days after the health minister declared India’s COVID-19 outbreak contained in late January, Mumbai reopened its massive suburban train network and authorities let tens of thousands of visitors into stadiums for international cricket matches. 

Many of the South Asian nation’s 1.35 billion people ignored masks and social distancing, while politicians including Modi and Interior Minister Amit Shah greeted hundreds of thousands of mostly mask-less supporters at election rallies. 

When daily infections fell below 10,000 in early February, some experts predicted India would see only a modest second wave at most. 

“We were really premature to celebrate,” said University of Michigan epidemiologist Bhramar Mukherjee. 

“This is a lesson,” said Mukherjee, who leads a team of researchers modelling the trajectory of India’s outbreak. “The really treacherous thing about this virus is how silently it casts its footsteps. By the time you see the cases and deaths, the damage is done.” 

Health Minister Harsh Vardhan told officials of 11 of the worst-hit states this week that “people largely gave up on COVID-appropriate behaviour, became very careless” as activity resumed. 

“There have been elections, religious gatherings, reopening of offices, lots of people travelling, attending social functions, not following rules, little mask-wearing in functions like weddings, even on crowded buses and trains,” he told a video conference.

A year on from lockdown, India reports worst day for COVID-19 in months

Via Reuters: A year on from lockdown, India reports worst day for COVID-19 in months. Excerpt:

NEW DELHI (Reuters) - India reported its most COVID-19 cases and deaths in months on Monday, on the first anniversary of the start of a chaotic nationwide lockdown that left many people jobless and shrank the economy. 

Authorities reintroduced some curbs to slow the spread of the virus, especially in the western state of Maharashtra, which accounted for nearly two-thirds of the 46,951 new infections and the majority of the 212 deaths. 

Some hospitals in the country’s worst-affected districts have begun to run short of beds, and there is a rising clamour for the immunisation campaign to be widened to cover more people, instead of just the elderly and those suffering from other health conditions. 

With the biggest rise in cases since early November, India’s total has surpassed 11.65 million, the highest in the world after the United States and Brazil. The increase in deaths was the largest since early January, and took the total to 159,967. 

In some parts of India, most people still go out without masks and flout advice on social distancing, including politicians campaigning in four states where elections will begin later this month. 

The health ministry has also warned that a huge gathering of devotees for a Hindu festival could lead to a spike in cases as people from all over the country flock to the banks of the Ganges river in the holy northern town of Haridwar. 

Local authorities have said they expect 150 million visitors at the weeks-long Mahakumbh that began this month and peaks in April. The festival is held only once every 12 years, and many Hindus believe bathing in the river during this period absolves people of sins.

COVID-19 outbreak associated with a 10-day motorcycle rally in a neighboring state — Minnesota, August–September 2020

MMWR has published COVID-19 Outbreak Associated with a 10-Day Motorcycle Rally in a Neighboring State — Minnesota, August–September 2020. The summary:

What is already known about this topic?  

Gatherings present an opportunity for rapid spread of COVID-19. 

What is added by this report?  

Following a 10-day motorcycle rally in South Dakota attended by approximately 460,000 persons, 51 confirmed primary event-associated cases, 21 secondary cases, and five tertiary cases were identified in Minnesota residents. An additional nine likely rally-associated secondary or tertiary cases occurred. Four patients were hospitalized, and one died. Genomic sequencing supported the associations with the motorcycle rally. 

What are the implications for public health practice? 

The impact of gatherings as a source of virus transmission underscores the importance of reducing the number of attendees at gatherings, using face masks, and encouraging physical distancing to prevent ongoing transmission of SARS-CoV-2. Furthermore, these findings demonstrate the rationale for consistent mitigation measures across states.

The contagion externality of a superspreading event: The Sturgis motorcycle rally and COVID-19

Via the National Bureau of Economic Research: The Contagion Externality of a Superspreading Event: The Sturgis Motorcycle Rally and COVID-19. The abstract:

Large in-person gatherings without social distancing and with individuals who have traveled outside the local area are classified as the “highest risk” for COVID-19 spread by the Centers for Disease Control and Prevention (CDC). Between August 7 and August 16, 2020, nearly 500,000 motorcycle enthusiasts converged on Sturgis, South Dakota for its annual motorcycle rally. Large crowds, coupled with minimal mask-wearing and social distancing by attendees, raised concerns that this event could serve as a COVID-19 “super-spreader.” 

This study is the first to explore the impact of this event on social distancing and the spread of COVID-19. First, using anonymized cell phone data from SafeGraph, Inc. we document that (i) smartphone pings from non-residents, and (ii) foot traffic at restaurants and bars, retail establishments, entertainment venues, hotels and campgrounds each rose substantially in the census block groups hosting Sturgis rally events. Stay-at-home behavior among local residents, as measured by median hours spent at home, fell. 

Second, using data from the Centers for Disease Control and Prevention (CDC) and a synthetic control approach, we show that by September 2, a month following the onset of the Rally, COVID-19 cases increased by approximately 6 to 7 cases per 1,000 population in its home county of Meade. 

Finally, difference-in-differences (dose response) estimates show that following the Sturgis event, counties that contributed the highest inflows of rally attendees experienced a 7.0 to 12.5 percent increase in COVID-19 cases relative to counties that did not contribute inflows. Descriptive evidence suggests these effects may be muted in states with stricter mitigation policies (i.e., restrictions on bar/restaurant openings, mask-wearing mandates). 

We conclude that the Sturgis Motorcycle Rally generated public health costs of as much as $12.2 billion.

University of Alabama, other colleges struggle with COVID-19 outbreaks

Via The Washington Post: University of Alabama, other colleges struggle with coronavirus outbreaks. Excerpt:

More than 500 cases at the University of Alabama in Tuscaloosa. Nearly 160 at the University of Missouri in Columbia. Dozens at the University of Southern California.  

Colleges and universities that brought students back to campus are expressing alarm about coronavirus infections emerging with classes having barely started, raising the possibility that everyone could be sent home.  

“The rise we’ve seen in recent days is unacceptable, and if unchecked, threatens our ability to complete the rest of the semester on campus,” University of Alabama President Stuart Bell said at a news conference Monday, five days after classes resumed, as the mayor of Tuscaloosa temporarily closed bars and warned that the local health system could become overwhelmed. 

While a growing number of schools have backed off reopening, opting instead for online classes, others are hoping a host of new rules and adaptations can keep the coronavirus at bay. They are requiring masks, mandating testing and threatening students and campus groups with penalties for partying. Ohio State University alone said this week that it has suspended 228 students over virus-related violations.  

Despite the precautions, schools are quickly discovering large outbreaks that have prompted new soul-searching about their students’ commitment to social distancing and universities’ ability to deliver even a dramatically transformed on-campus experience. Speaking Monday, Bell declined to blame young people’s lack of caution and emphasized that it is on the university to work with everyone to minimize infections.  

“Our challenge is not the students,” Bell said, though he acknowledged that multiple students are facing discipline for breaking coronavirus rules. “Our challenge is the virus.” 

Tuscaloosa Mayor Walt Maddox, who joined Bell at the Monday news conference, said the university had requested his executive order closing bars for two weeks and eliminating bar service at restaurants. He said that “the ever-increasing number of coronavirus cases on campus will create two major disruptions for Tuscaloosa if left unabated” — stretching the city’s health system and threatening its economy, which includes thousands of university jobs.  

Among students, faculty and staff tested across the University of Alabama system, 566 have had positive results for the virus since Aug. 19, according to a dashboard that is being updated. Those numbers do not include “entry testing” conducted to make sure students leave home coronavirus-free.  

The overwhelming majority of the new cases, 531, are at the flagship campus in Tuscaloosa.