Coronavirus in Decline

It is still frustratingly hard to get reliable information about what is going on with COVID-19. Official sources seem to so badly lag unofficial ones as to be useless or even harmful; bureaucracies are vast inert bodies, and perhaps also riddled with special interests pursuing their own agendas. In the media, political partisanship seems to be producing false information consistently. And experts in the field are all over the map, disagreeing on almost everything. You can find an expert to support any possible position.

One prominent expert now says the virus may be dying out naturally. As I noted here some time ago, this is actually the usual thing with epidemics. It does not necessarily have to do with vaccines or “herd immunity.”

I look at the graphs at Our World in Data, and it does look as though he may be right. Among the previously hard-hit countries, the death toll has been declining steadily for some time. Although none are anywhere near herd immunity.

Better treatments? Perhaps. But the number of new confirmed cases daily has also been declining at about the same rate. Despite the rapid “ramping up” of testing.

The result of lockdowns? I included Sweden in the mix last time, and the trend still held. I hear that Austria, Czechia, Norway, and Denmark have been out of lockdown for a few weeks, and this does not seem to have bent the curve upward for any. Denmark, Norway, and Austria are still going down in number of new cases. Perhaps more slowly than during the lockdown period in the case of Norway or Austria. Czechia is trending slightly up.

I hypothesized that this might have to do with the coming of summer and warmer, sunny weather. To test the hypothesis, I look at Argentina, Brazil, Chile, South Africa, and Australia, a selection of Southern Hemisphere countries. Presumably, they are now moving into the colder half of the year, so their reported cases should be going up, not down.

And they are—dramatically in the case of Chile or Brazil. Australia is an exception, but they have taken lockdown measures that may have prevented the virus from yet establishing a foothold. Mozambique, Angola, and Uruguay also have seen few cases overall.

Meanwhile, the WHO is announcing that, worldwide, numbers are still rising.

So it still looks to me as though a summer lull is the likeliest explanation, rather than viral suicide.

Either way, we should be able to safely come out of lockdown for the summer in the Northern part of the big blue marble.

Here Comes the Sun

Bad news has been unrelenting, so it seems, for some while. I think we may now finally be seeing some rays of sunshine.

Remdesavir seems to be somewhat helpful. A now concluded study showed a 31% faster recovery. It showed no change in death rate, but that may be because the study was ended early. Once it proved effective, the moral obligation was to offer it to all patients involved.

Contrary to many reports, it looks as though hydroxychloraquine is not dead. As noted yesterday in this space, a Ph.D. has compared total cases against active cases, state by state, and seems to show a difference for states in which hydroxychloroquine is more widely available. This suggests that it too shortens the course of the illness.

If hydroxychloraquine has not shown the same clear effect in clinical trials, it may be because the drug, being in limited supply, is generally given even in trials only to patients in very poor condition, already in hospital. And this may not be the stage of the illness for which it is effective.

Dr. Didier-Raoult, the French virologist who has strongly advocated hydroxychloroquine therapy, says viruses usually just burn themselves out; we do not understand why. He believes, accordingly, that Dr. Fauci in the US is probably wrong to think there will be a second wave of COVID-19 in the fall. I had said this before: SARS, Swine Flu, MERS, Ebola, seemed to burn themselves out. With any luck, COVID-19 will too. An Israeli mathematician thinks he recognizes a pattern of seven or eight weeks of virulence, after first community spread, beyond which it subsides. If the Chinese government figures are anything near accurate, this would seem to fit their evidence.

Plasma treatment also seems effective. The problem here seems only that quantities are inevitably limited.

After all the fears of lack of respirators, it seems the US has a great surplus. This surely had been our greatest fear: people being taken off respirators to die, or dying in the corridor because there were no respirators left. Moreover, it seems now as though less aggressive techniques may be more effective.

The news that the virus is sensitive to heat, temperature, light, and UV light, seems promising in two ways. For one thing, it suggests some relatively non-invasive new treatments. For example, just pumping warmer air into the lungs might make a difference.

For another, it makes it likely the virus will die back naturally for summer.

We had been worried that re-infection was possible; this would be devastating. Then vaccines would not work; herd immunity would not work. Sooner or later, we might simply all die of coronavirus. But it seems now confirmed that this does not happen. Prior results were testing failures.

Testing seems to have rapidly gotten better, and the US at least is concentrating on turning out test kits. Testing is almost a solution by itself. Until now, we have been quarantining upside down: locking everyone in. With efficient testing, we can quarantine right side up: locking in only the infected, and perhaps the most vulnerable, while business goes on for the rest of us.

There is an obvious and unexplained difference between the course of the virus in Korea, Japan, Taiwan, or Hong Kong, compared to Iran, Europe and America. The former, although they got the virus sooner, have lower rates of spread, and lower death rates.

The obvious explanation is that these are cultures that commonly use face masks in the street.

There is a second consideration: why do some able-bodied people of equivalent age suffer far more serious symptoms than others? There may be a genetic component; but there is a good chance it has to do with how strong the original exposure was: how many virus cells spread and bred before the body was able to muster its immune response.

Aside from reducing the spread, face masks combined with social distancing may more or less ensure that initial dosing is relatively mild. Almost, in a good number of cases, like a vaccination.

An Indonesian study shows vitamin D also matters. Those with low levels of vitamin D are more likely to catch the virus, and more likely to have a bad result.

Dr. John Campbell suggests that this may be behind the odd fact that meat packers seem to have become centres of spread, in the US and Canada. Why meat packers?

And why meat packers here, and not in Europe?

Campbell says that recent Somali immigrants tend to take these factory jobs. Aside from living communally, they are dark-skinned. Darker skin generates less vitamin D. They work inside. Sunlight generates vitamin D.

So the virus might claim fewer victims if we checked vitamin D levels, and took supplements.

Add all this together, and it seems as though we might have a program, even in the absence of anything more.

A Journal of the Plague Year

Out and about today because I needed to mail a couple of letters—one to the government with a time limit on it. I also needed change for laundry. Not being out and about, I have not accumulated any. In ordinary times, I could, in a pinch, have used a change machine at the laundromat across the street. But it is closed due to the virus.

There was not much foot traffic in my neighbourhood, but cars seemed to circulate at the usual level. There was a lineup at the supermarket, but not long.

The post office was not open yet. They were delaying opening by an hour due to coronavirus.

The day was sunny and cold. Daffodils and dandelions were in bloom. Saw one of our black squirrels, apparently not common in other parts of North America, and a big fat robin. Spring is here.

Back out an hour later to try again. Got the letters sent, but could not get change for laundry. The postal clerk said they could not get change for their float, because the bank is closed.

Banks closed? This seems to me sure to become a grave problem—businesses cannot get change for their floats? Shouldn’t banks be an essential service? Apart from practical matters, it seems to me important psychologically for banks to be open. It is unsettling if money is suddenly not available; shades of bank runs.

Trudeau yesterday said Canada must remain in lockdown for some time to come. Last week he said the restrictions would apply until sometime in the summer.

I think he is foolish to say this, and it is not going to happen.

You can see a lot of restlessness already in the US. The mood seems to be shifting quickly towards getting back to work. With or without an effective treatment, with or without widespread testing, I hear suggestions that the virus follows a natural curve, a surge and then abatement, and in most places we are on the downward slope of that surge. People are saying the shutdown was an overreaction.

That may not be objectively true, but it looks as though US governments cannot keep a lid on things much longer, and it looks as though they have no intention to do so. A consortium of states in the Northeast have declared their intent to reopen; a consortium of states in the West have done the same; and Trump says the feds will have a plan soon.

If the US starts reopening, there is no way Trudeau can keep Canada closed. He now risks being blamed for a panicked overreaction, or a grab for power.

Aside from this, it is bad psychology to say in advance that you plan to keep things closed for much longer. First of all, you do not really know if this is necessary; we are learning as we go. Secondly, you need to give people hope that things could get better soon. Hope is important.

I think the truth is that Trudeau is panicked. I think he has shown a tendency to panic before this. We are unlucky he is PM at such a time.

Some premiers are doing a far better job: Legault in Quebec, Ford in Ontario, Kenney in Alberta. They are essentially working around Trudeau, and Kenney is pretty open about it.

It is a pity none of them are running for the vacant Tory leadership. Kenney in particular.

I predict things are going to open up soon, in the US and around the world. I think the worst is over.

A Journal of the Plague Year

Steampunk coronavirus selfie.

It feels like a corner was turned today.

Dr. Fauci, who was the pessimist at Trump’s press conferences on the pandemic, is now quoted as saying "I know we'll be successful in putting this down now, but we really need to be prepared for another cycle."

This looks like a backhanded admission that the hydrochloroquine treatment works. It also looks like he has reason to believe the virus is seasonal, and will naturally begin to abate, as flu viruses often do, as summer approaches. Perhaps the thesis that the virus needs a narrow band of temperature and humidity to spread was at least partly right.

Although abating for summer is only temporary relief, it does buy us a bit of time to be better prepared in the autumn.

The Oxford study, suggesting that the virus is significantly less deadly than we thought, is also getting widely circulated. It does not sound right to me, but perhaps I am missing something. Others who presumably understand better than I do are impressed.

Perhaps the reason Fauci and others in government have been downplaying hydrochloroquine is because they did not have enough of the drug. Since it was already available on prescription, people could pressure their doctors, producing a possible run on the drug. And they felt they needed the limited supply to protect health care workers. Just like with face masks.

India has now banned exports of the drug.

They would not do this if it were not effective.

Same for Nevada suddenly banning the drug’s use for COVID-19.

They are worried about protecting limited supplies.

Unfortunately, India is a major world source for generic drugs. We have to hope there are sufficient production facilities closer to home.