March 26, 2020

More Bits On The Corona Crisis

Donald Trump's MAGA is successful.

The U.S. is providing the world with another example of its great exceptionalism. In a few days it will have the greatest number of Covid-19 cases and the greatest number of casualties of the disease. It will also have spent the greatest amount of money on the crisis with the smallest part of it going to the people who need it.

It is not a nice picture and it makes me sad.

The more than two trillion dollar the lobbyists told Congress to put into their 800+ pages relief bill will mostly go to very rich people. It is corporate socialism - a bail out for investors and managers.

Contrast that with the Russian president Vladimir Putin who, in an address to the Russian people, allocated most of the money for the unemployed, the retired and for families:

Then, with special flourish, Mr. Putin used the impending crisis to fix several unpopular tax loopholes favoring the very rich, so that the proceeds of the new taxes may be used to offset some of the costs of the social protection measures now being introduced for the great majority of the working population, for families, etc. To name one such abuse, he is calling for all remittances of dividends and the like by physical persons to offshore ‘tax havens’ where they go untaxed, now to be subjected to a 15% income tax in Russia. The double taxation treaties with those tax haven countries allowing this abuse will be amended accordingly.

The U.S. as well as other countries is still not doing enough to slow down or even stop the outbreak.

The Wall Street Journal today reports (paywalled but quoted here) what we emphasized in our earlier pieces. The lockdown in Wuhan on January 23 was not enough to end the growth of the number of cases.

It was only after February 2, when Wuhan introduced the isolation of suspected cases and of people who had close contact with confirmed cases, that it gained a grip on the crisis:

What really turned the tide in Wuhan was a shift after Feb. 2 to a more aggressive and systematic quarantine regime whereby suspected or mild cases—and even healthy close contacts of confirmed cases—were sent to makeshift hospitals and temporary quarantine centers. The tactics required turning hundreds of hotels, schools and other places into quarantine centers, as well as building two new hospitals and creating 14 temporary ones in public buildings. It also underscored the importance of coronavirus testing capacity, which local authorities say was expanded from 200 tests a day in late January to 7,000 daily by mid-February.

To send anyone who has mild symptoms home to be cared for by family only increases the speed of the epidemic as all family members are then likely to get catch the virus.

Tests and care for Covid-19 must be for free. We need hospitals to care for only the critical cases. We need quarantine centers to isolate the milder cases from the wider population. Many hotels, sport arenas and exhibition halls are currently empty. They can be converted into quarantine stations within a day or two. People will have to stay for only two weeks. They would be fed and would have medical attention. That is a small restriction of the freedom of a few for a large benefit for our societies.

We must also introduce the wearing of a mask in public as a new social norm:

A number of studies have reported that a significant portion of people are even spreading the virus while presymptomatic — in the day or two before they start to feel ill. Presymptomatic spreaders are, well, gonna spread. It’s not their fault. How much this type of transmission is driving the pandemic is unclear but it could be significant. Gabriel Leung, dean of medicine at the University of Hong Kong, has estimated about 40% of cases transmit before symptoms develop. A recent preprint — a study that has not yet been peer-reviewed — from China pooled data from seven countries and estimated a very similar 43%.

The novel coronavirus is spread to a great extent by people who stay asymptomatic and by people who do not yet feel sick but will later show symptoms. When they talk, sneeze or cough they release small droplets that carry viruses. The droplets can stay in the air for some time. If a person coming along inhales those droplets the viruses will likely infect that person.

Those who have have the virus or might spread it should wear a mask because it prevents their droplets from flying out. Those who do not have the virus should wear a mask to prevent droplets from entering their body.

We were told that 'masks don't work' because they are not a 100% protection. The very tiny viruses can pass behind the mask at its sides or they can slip through its webbing. But the virus is not traveling alone but as part of a droplet. Even a relatively wide webbing may hold it up. If it is doubled with a sheet of cosmetic paper towel in between the protection will be even better. Microfilter bags for vacuum cleaners and so called HEPA filters are also effective materials that are readily available and easy to turn into masks.

The development of the epidemic will depend on how many people will start to regularly wear masks when they are not at home. Even if the protection masks prevent only 50% of new infections the speed with which the epidemic will unfold will be significantly lower.

Consider that the societies in the blue circle are all ones where people regularly wear masks while the other countries (except China which was surprised by the outbreak) are societies were wearing a mask is seen as unusual. These 'blue' countries, which also gained experience during the SARS and MERS epidemics, show significant flatter trajectories.

Graphs similar to the above for all U.S. states and territories can be found here.

Meanwhile U.S. media continue to spread anti-China propaganda:

Two European Countries Report High Error Rate For Chinese Supplied Coronavirus Tests

Medical personnel in Spain and the Czech Republic have reported that the coronavirus rapid tests their respective countries have received from China are faulty and have a high error rate. Several labs in Spanish hospitals have reported that the test kits they purchased, manufactured by Chinese company Bioeasy and based in Shenzhen, have a sensitivity of 30% when the sensitivity should be above 80%, Spanish newspaper El País reported Thursday. Due to the test’s lack of reliability, medical personnel in Spain have switched back to the PCR test, which takes up to four hours for a diagnosis, while rapid tests take between 10 to 15 minutes The Spanish government purchased 340,000 tests from the Chinese company, a similar quantity to the tests ordered by the Czech Republic, where medical personnel also report an 80% failure rate.

When one checks the original reports from Spain and from the Czech Republic one learns that these countries bought anti-body tests which only react when a person has had the virus for some time and developed anti-bodies against it. These tests can obviously not be used to find persons who are infected but have not yet developed anti-bodies.

China's ambassador in Spain also pointed out that these tests have yet to be verified by the regulator and were imported without the help or knowledge of the Chinese government.

The anti-body tests are valuable to identify people who have developed current immunity against the virus. These people can then care for those who are most endangered by the disease. Anti-body tests are quick. They can be used anywhere.

The polymerase chain reaction (PCR) tests which are currently necessary to find if someone has the virus take at least four hours and specialized laboratories to process them. We will need a much quicker reliable test if we want to put our economies back to work. Luckily several companies and academic groups are already working on these and a 45 minute test is now ready to be marketed.

When we have a quick test for the virus and a quick test for anti-bodies available in mass we can restart the economy by 'filtering' through the population on a large scale. Movement restrictions would then only be needed for those who show virus-positive and anti-body negative results. All others could go back to work.

There would certainly still be outbreaks from people who escaped the 'filtering' process but with easy testing and care in place those clusters can be locally contained.

It may take another two month or so to get to that point. Until then there is little we can do but to stay apart as much as possible and to wear our masks.

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Previous Moon of Alabama posts on the issue:

Posted by b on March 26, 2020 at 18:20 UTC | Permalink

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