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Covid19 11/29 weekly update

drmikecmd

4-Year Starter
Gold Member
Jan 7, 2016
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Symptom Surveillance
Flat for two weeks now, have to see what revisions are made later this week:




Testing Data
~1.7 million
tests is the 7 day average. 1 week ago it was 1.7 million.
~160k positives is the 7 day moving average with % positive at ~9.4%. 1 week ago this was 167k/9.8%. Cases at exactly the same level as the prior week. I don’t know what effect the holiday had on numbers and wont even attempt to make any conclusions on this data. The % positive falling is good to see and that seems like a variable that would be unaffected by the holiday. I will say this, we would be falling now if it was not for California numbers. As it is, we are level.



States that have seen a >10% drop in cases over the last 2 weeks: CO, ND, SD, UT, IL, KS, NE, MT, MI, IA, KY, CT, MO, RI, VT, WI, WY
I'll add here that it will not be a surprise if cases fall through the floor in December. I say that because college students have been driving numbers in several states. We'll see.

Hospitalization Data
Hosp. 83870--> 93328 (+11% week to week)
ICU....16219--> 18200 (+12%)
Vent... 5233---> 6249 (+19%)
New admissions have plateaued as per graphic below. Ignore the squared off peaks in that graphic, those are changes in reporting and not reality. Focus on the 3 Gaussian type curves the last of which is in a plateau. I’d also add that Arizona discharges began ramping up last week which means the peak in hospitalizations for any state that is on the same timeline as AZ is incoming (most of the south). Of the 24 states that hit a high in hospitalizations this week, 19 have mask mandates. Weird, I know.





Fatality Data
Total deaths at 257,909 per CTP.
Week to week: 10289--> 9968 (-3%)
Certainly some holiday effect in those numbers. I fully expect them to rise in a big way this week. If this is the peak of syndromic surveillance, add 3 weeks to the peak for deaths.


State Data
Mississippi. Deaths 133--> 120 (-10%)
Cases: 8871--> 8605 (-3%)
Hosp 897--> 971 (+8%)
ICU... 222--> 245 (+10%)
Vent.. 106--> 130 (+22%)

Cases flat as is syndromic surveillance. We can glean a lot of information from the curve posted on the MSDH website. I mentioned last week it looked like we were beginning to peak and that still appears to be the case and we probably have entered the plateau phase where we bounce around for 7-14 more days before the big decline begins. Look at this graphic:





The purple arrow is where I believe we were last week. The red arrow is where I think we are now with the blue line being where ICU peak occurs and that appears to be late this upcoming week, likely around December 5th give or take a few days. Also, look at the months on the x-axis. You can practically superimpose Nov/Dec/Jan over July/Aug/Sept in my opinion. We are exactly 4 months removed from the summer with a very similar curve. If we follow that, and there is no reason to think otherwise currently, by Christmas hospitalizations should have fallen to the 700’s. Unlike many others, I do not expect December or January to be particularly bad. The most likely scenario is another small wave in Feb/March if there is one. It all depends on influenza and whether it decides to return as well as continued lockdowns which only cause more cases/deaths.

Looking at this on the more local level, it’s clear this is a northern and central MS issue. Tupelo and the coast seem to be just fine. We closed an ICU at SRHS recently. Even Hattiesburg looks good currently. Someone did inform me that Baptist Oxford serves a pretty big surrounding area that I was unaware of and would explain their high numbers to some degree. DeSoto looks better with falling numbers… might be able to declare a peak there if trend continues. Baptist in Jackson still with around 20% of patients being CV19. However, St. D is the story this week with 35% of their patients being CV19 as of yesterday. Big number and now higher than Baptist DeSoto which held the title last week. I do think some of that is a staffing issue as this is the lowest number of beds I’ve ever seen available at St. D since the live tracker was started. That also tells me they are comfortable with where they are in dealing with the patients.


Texas. Deaths, 988--> 801 (-19%).
Hosp: 8174--> 8634 (+6%)
Not much change here. El Paso still heading down albeit slowly. Some areas along the border are up like Laredo, less so in other border counties. Harder hit areas early like Houston and SA are slightly up but only about 6% of hospitalizations in those areas are from CV19. I'd consider anything under 10-15% an endemic level. I didn't do a big look into Texas this week so I could have missed something.

Florida. Deaths, 480--> 522 (+8%)
Hosp: 3613--> 4059 (+12%)
I keep reading that DeSantis is killing the human population in Florida. Let’s review:
*Over the last 14 days, Florida’s cases are up 41%. New York’s cases are up 41%.
*New York’s hospitalizations are up 83%. Florida’s are up 24%.
*Florida has been nearly wide open since 9/25. NY in perpetual lockdown of some sort.
*To date, New York has had far higher covid deaths than Florida.

I’ve seen no one report it this way. Not a single media outlet. Propaganda.

Alabama. Deaths, 209--> 120 (-35%)
Hosp: 1332--> 1609 (+20%)

California. Deaths, 290--> 423 (+46%)
Hosp 5918--> 8198 (+39%)
The big numbers from here are really pushing the hospitalizations nationally as well.

Since the south and midwest have started to peak, plateau, or decline I've removed most of the individual states. Keeping TX, CA, FL, AL and MS for now. Probably gonna go by regions in the future since we are clearly now in a seasonal pattern everywhere.

Comments:

1. I’m about done with the mask stuff. Pretty clear they either have little or no effect on transmission but I want to touch on the CDC study from Kansas that was published. The CDC is now publishing propaganda. Seriously, this garbage of a “study” is complete nonsense and a contemptuous attempt to deceive the public. The study can be found here: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947e2-H.pdf
This is the graph they published:



Looks legit, at least a correlation, right? Well, no there isn’t. Look what they did. They took a 6 week timeframe that fit their narrative:



So let’s forget about what happens after the study period? That’s how this works? Please note when they published on the graphic. They knew. They absolutely knew it was garbage. Remember the study I linked to recently that was retracted for this same reason? Because cases then went up after the study was published? At least those authors had the balls to withdraw it and say oops. The CDC doesn’t even care, they published it anyway.

I’ll say it again, the CDC is a joke. It is an innumerate bureaucracy gone wild that does nothing but spin a narrative. Want to see how cases in KS really went with and without masks with no arbitrary cutoff dates? Here you go by percent change to negate differences in testing levels:



Seems important. I’ll pose the question again, is it possible masks actually make it worse?

2. Lesson here:



The lower the initial wave, the higher the next.

3. Fauci now says this about schools: “Look at the data, the spread from children and among children is not very big at all, not like one would have suspected” Wait, wut? You mean the Asian and European data on children was valid? The data we've had since April? You mean the NY Times and WaPo were wrong? The US doesn't have some super revved up version of the virus that kids spread like mad? This guy is an immunologist people. This is the guy who attacked Rand Paul when confronted with school data and mentioned the fabled Kawasaki's like disease fear porn... I have nothing but contempt for Anthony Fauci and zero respect. I'll ask again, has he been right about anything? I feel like he's the guy in Couple's Retreat saying "please, regard me." Instead he says, "please, disregard me."

4. Segway into more Fauci who thinks we can have a "surge within the surge." He is concerned about Thanksgiving creating another surge within the current one. First, this is no surge. If we can handle 100-140k hospitalizations in one month from influenza, we can handle what is currently happening with no issues whatsoever. Second, he is wrong... again... for about the 50th time. This is a seasonal virus on its way down in most of the country and Thanksgiving will have no significant effect. Just like Memorial Day, 4th of July and Labor Day. Always bet against Fauci. Maybe we could get the casinos down here to start giving odds on his statements... that'd be fun.

5. Well, well, well. Speaking of schools, I guess since Fauci said it they can reopen in NY? You cannot make this stuff up people. https://www.nytimes.com/2020/11/29/...g-partially.html?referringSource=articleShare

6. Another point here I want to make regarding "not knowing." It's a lie. We knew. This is from March. Posted before but worth a re-read: https://math.cmu.edu/~wes/covid.html
"...strategies which focus on minimizing transmission rates to every extent possible in the entire population could increase deaths among all age groups."

7. This is certainly possible, if not extremely likely. https://www.wsj.com/articles/covid-...9e2ldf8j5ncqbmv&reflink=article_copyURL_share
"An American adult typically suffers two colds a year, while school-age children may suffer 10 or more, and 20 million of us get the flu. A conservative estimate, then, is that 13 million Americans every day suffer from something not readily distinguishable from mild Covid (never mind asymptomatic Covid).

This perhaps explains why, despite conducting 186 million tests since the plague arrived, we’ve found only 12.7 million cases. Most who have Covid aren’t getting tested; among those seeking tests the large majority are suffering from something that isn’t Covid."

The best statement in the whole article: "The new virus was always more widespread and invisible than we wanted to realize."

8. After reading that article, do you get the sense that much of the narrative for asymptomatic spread is to lessen the responsibility/failure of the government to "control" it? I hadn't thought about it that way before. Seems likely. I thought it was the mask BS but probably both.

9. You want to see what's going on behind the scenes at our wonderful amazing CDC? Came across this recently. https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/shielding-approach-humanitarian.html
"The shielding approach aims to reduce the number of severe COVID-19 cases by limiting contact between individuals at higher risk of developing severe disease (“high-risk”) and the general population (“low-risk”). High-risk individuals would be temporarily relocated to safe or “green zones” established at the household, neighborhood, camp/sector or community level depending on the context and setting. They would have minimal contact with family members and other low-risk residents."

My first thought on that is... sounds like a Japanese internment camp to me. Right? Second, this is probably the most idiotic thing you could possibly do. It might work for a non-airborne pathogen but otherwise it sounds like it would work about as well as placing a bunch of vulnerable people in... say, a nursing home? The CDC was a once highly respected institution. It's a joke and needs a complete overhaul from top to bottom.

10. Study from New Jersey. In a sample of 1380 admissions with COVID19, of the 640 who died of it, 570 (or 89%) had DNR (“do not resuscitate”) orders PRIOR to admission.
In other words, 90% of these “COVID deaths“ were already deathly sick before getting COVID. There is going to be a large "pull-forward" effect on all cause deaths next year. We will be well under normals (with exception of possibly higher cancer deaths). https://t.co/nHBbsVtRy3

11. A study of Sweden, written by a who's who of epidemiology. https://www.sciencedirect.com/science/article/pii/S1047279720304130
"The overarching goal of the Swedish mitigation strategy has been to implement a response that could be sustained over a longer time horizon while minimizing the associated morbidity and mortality of COVID-19. Moreover, the mitigation strategy was intended to avoid amplifying the potential and realized inequities associated with suppression strategies combined with adverse consequences on competing health, education, and developmental risks in the short, medium, and long term.

12. Where is the flu?



13. The CDC's recent press conference on 11/19, they said masks CAN provide protection. OK. I can walk on the moon but that doesn't mean its going to happen. They also mention "exponential growth" on multiple occasions. That is one phrase I hope to never see again after this is done. Again, they are innumerate, babbling fools. https://www.cdc.gov/media/releases/2020/t1118-covid-19-update.html

14. This paper garnered a ton of attention this week. https://www.jhunewsletter.com/article/2020/11/a-closer-look-at-u-s-deaths-due-to-covid-19
In it, the author incorrectly made the claim that deaths were not above normal this year. However, he correctly pointed out that many of the CV19 deaths are being "pulled" from other categories. John's Hopkin's removed the article which gave it even more attention and the crazies went nuts. Look, CV19 is real, it kills people and making dumb claims to the contrary isn't useful. But this paper makes an important point I've made on many occasions, that many CV19 deaths were just early. Many, if not most, of these deaths had under a year to live. Example from the paper here:



As you can see, a fall in deaths from normal causes has occurred. The so called "pull-forward" effect is what we are seeing here. But there is an increase in excess deaths and the paper gets that very wrong.

15. Hospitalization time for a CV19 patient has fallen by over 50%. https://www.statnews.com/2020/11/23...higher-rates-but-surge-could-roll-back-gains/



16. I blame the lockdowners. This is awful. https://www.usatoday.com/story/news...ing-food-banks-hunger-covid-worse/6424137002/
"In Arizona, a 2-mile line of cars waited to receive food from St. Mary’s Food Bank when holiday distribution started at 8 a.m. in Phoenix on Monday."

17. Say it with me, sEaSoNaLiTy. Nothing else matters:



18. Austria and Switzerland are neighbors. This go round the Swiss had nothing to do with lockdowns nor school closures. They used a Swedish type approach, in 2019 this was also known as a normal pandemic response. Austria with a very hard lockdown and virtual schooling only. See the difference? Yeah, me either.

https://drive.google.com/file/d/1Qk4rsOoNXTnpm54pZ4iD8_9-QbckKHVK/view?usp=sharing

19. A few of my favorite mask charts. You know, the ones the CDC doesn't want you to see nor will it ever publish.

https://drive.google.com/file/d/1RI2v4W7BkzJ3YHAq_D10nNgLvkkkRSja/view?usp=sharing

But the models that assumed masks worked showed they worked! And the hair dressers! SMH...

20. Guys and gals... we are in an abusive relationship... with the government:

https://drive.google.com/file/d/13tE6yX0a_P30GwjBgRUU86A5RRk2fp-k/view?usp=sharing

21. Highly touted paper here on contact tracing. https://science.sciencemag.org/content/early/2020/11/23/science.abe2424.full
Highlights:
* Analyze detailed epidemiological records for 1,178 SARS-CoV-2 infected individuals and their 15,648 close contacts, representing 19,227 separate exposure events
*Individuals who were close contacts of the primary cases were followed for at least 2 weeks after the last exposure
*Cases PCR confirmed
*80% of secondary infections traced back to 15% of SARS-CoV-2 primary infections
*Transmission risk scales positively with the duration of exposure and the closeness of social interactions
*Significant heterogeneity exists in transmission events
*The lockdown period increases transmission risk in the family and households
*isolation and quarantine reduce risks across all types of contacts.
*The reconstructed infectiousness profile of a typical SARS-CoV-2 patient peaks just before symptom presentation.
-- That last point is modeled and an estimate. "...we stochastically reconstruct transmission chains and estimate the timing of infection..." Also, it is just before symptom onset they say, 0.1 days... that's 2.4 hours before. Still consistent with only a small amount of presymptomatic spread but they say 50% of it is asymptomatic. What? But you have to read the paper. Buried deep in the musty masked basement is this gem: “Our study is likely underpowered to assess transmission potential of asymptomatic individuals given the relatively small fraction of these infections in our data” No, not likely... it IS underpowered which means you can make no definitive statement about it whatsoever.

The better study is here, posted last week: https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(20)30172-5/fulltext
“Although modeling studies estimated potential viral load peak before symptom onset—we did not identify any study that confirms pre-symptomatic viral load peak”
You see, it's only the models that give you these garbage conclusions. Real life data says the opposite. I'd go with real life.

22. Imperial college, for what their work is worth, estimates 3.5% asymp/presymp spread. https://t.co/YAz39S7Uxd

23. Probably much ado about nothing in SK but found this interesting given how "successful" they have been. https://www.reuters.com/article/us-health-coronavirus-southkorea-idUSKBN28706Q

24. This would give an IFR of 0.26%. https://www.npr.org/sections/corona...vid-19-cases-could-be-approaching-100-million

25. Can someone sue Newsom into oblivion. Doesn't he own Plumpjack winery? https://variety.com/2020/tv/news/covid-19-impact-walt-disney-business-1234840497/
28k layoffs in Disney Parks, mostly at Disneyland which remains closed despite Disneyworld having been open for months now with no issues. Why is that you think peeps? Could it possibly be because the people in those parks are around children all day and are probably overexposed to coronaviruses compared with the population at large? Kind of like teachers, assistants and day care workers? Yeah, that'd be my guess. That and a ton of it is outdoors.

26. https://www.thecut.com/2020/11/covid-19-pandemic-kids-mental-health.html
"The kids who are suffering most in this pandemic are the kids who were already suffering most."

27. More duh from the NY Times: https://www.nytimes.com/2020/11/25/opinion/sunday/covid-quarantine-children-immune-systems.html
"Keeping children masked and separated is necessary. It could also undermine their bodies’ ability to learn how to fight pathogens."
Read that sentence again and let me know in what world of logic it makes sense in... not mine. Clueless. My opinion of humanity's intelligence gets lower every day I read the NY Times.

28. https://www.wsj.com/articles/too-mu...u454h4xmuxa9ux6&reflink=article_copyURL_share
"As Covid-19 cases and hospitalizations rise around the country, creating an atmosphere of crisis, political leaders are reaching for last spring’s lockdown playbooks. Their grave tone conveys an air of inevitability, as if politicians have no choice but again to restrict civil liberties, limit social gatherings, and cripple businesses that survived the initial lockdowns. But there’s a better way: following the evidence for early treatment of Covid-19."

29. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30555-5/fulltext
"Lockdowns now present the greatest threat to population health .. plummeting vaccination rates .. not getting diabetes treatment .. not attending for cancer screening, cardiovascular disease outcomes are worsening, and .. a huge strain on mental health.”

30. None of the mutations of the virus appear to increase transmissibility as feared. https://scitechdaily.com/good-covid...utations-appear-to-increase-transmissibility/

31. I can't leave tonight without bashing the Mayo Clinic. A favorite pastime of mine over the last 15 years. Long story. This study is a clown show. https://newsnetwork.mayoclinic.org/...le-of-masks-in-preventing-covid-19-infection/
"The most common mechanism for COVID-19 transmission is through respiratory droplets which are larger than aerosols and are more easily blocked with masks," says Dr. Callstrom.
Well, that's false. Premise number 1 is wrong. Ok, I'm done. Seriously, you could be finished at this point. There is no further need to read anything more from Dr. Callstrom or his study.
Let's review why we know this is false:
*Outdoor spread is very, very rare. If droplets were the main pathway, that would not be the case.
*Close contact, but not face to face, for a prolonged period of time is required. If droplets were the main pathway, that would not be the case
*All superspreader events are consistent with aerosol spread, not droplets. All of them show persons infected after being in the same room with a superspreader despite never being face to face with him/her. Many infected from over 20 feet away.
*Prisons, meat packing plants, dorms, ships are perfect places if aerosols are the primary mode. What do we see? >90% infection rates in many of those and most over 20%.
*If droplets were a major factor, airplanes would have to be banned as a form of travel because the infection would spread catastrophically on them. Flight attendants would have the highest rate of infection in the world.
*If Dr. Callstrom is correct, masks should have shown some measurable benefit somewhere on the planet by now, yet they haven't. Because I agree with him... if droplets were the issue, masks would probably help some. Personally, I think droplet spread is <3% of cases.
*In every single study of hand washing to prevent influenza it was shown to be ineffective. Why? Aerosols don't give a crap about you washing your hands.
*No well ventilated, open air space has ever hosted a super spreader event. Not one. Think Lowes, Home Depot, gyms, arenas, etc.

All of these studies have one thing in common. Presumption X (X = majority of transmission is in droplets or 25% transmission is from asymptomatic tor whatever their presumption is) which is fed into the model followed by “Eureka moment” X being confirmed.

Ladies and gents, that is called circular reasoning with a large dose of confirmation bias.

32. Finally, immunity develops even after mild infection. https://www.cell.com/cell/fulltext/S0092-8674(20)31565-8?rss=yes
"Recovered individuals developed SARS-CoV-2-specific IgG antibodies, neutralizing plasma, memory B and memory T cells that persisted for at least three months. Our data further reveal that SARS-CoV-2-specific IgG memory B cells increased over time."

33. One last thing. For the vegans out there. https://www.telegraph.co.uk/news/20...Echobox&utm_source=Twitter#Echobox=1606124567
"Vegans are 40 per cent more likely to suffer from a bone fracture due to a lack of calcium and protein than meat eaters"

34. Last one and I meant to put this first. I've been asked about the vaccine off board by a few. I'll share part of my response to one on what I think of the data.
"There is no documented mortality benefit yet and while the relative risk reduction was 90%, the absolute risk reduction was only 0.4% giving us a NNT (number needed to treat, 100/0.4) of 250. That is 250 people need to get vaccinated to prevent one infection. Since the iFR is ~0.2% or 2 of 1000 infections and we prevent 4 infections out of 1000... seeing the problem? That means we have to vaccinate 250,000 people to prevent 2 deaths. That means we can prevent 2,640 deaths out of 330,000,000 persons in the US. That number is high because an estimated 80-100 million people in the US have already had it."

There you go, that's my beef with the vaccine. It seems to be a very long run for a very short slide.


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