3/18/20 PM UPDATE: More on the Coronavirus from CDC, WHO, medical researchers and the medical community
Author: Nick Lilja
|| Published: 3/18/2020 at 9:36pm
Reminder: My attempt here is to pass along scientifically-studied information about COVID-19. Not everything here will be “set in stone” because, sadly, that isn’t how science works most times. Especially in a very fluid situation like this. The guidance, any guidance, offered here will be directly from medical professionals based on peer-reviewed, trial-shown data. Guidance may also come directly from government sources. I may have to inject some personal opinions occasionally – usually by using analogies – to add context to an example or a situation.
But I am not a medical doctor. I know a few, and they are all awesome! But I am not one. Nor am I a healthcare professional of any kind.
These updates are my way of helping everyone sift through the riff-raff. There is a lot of misinformation floating around. My goal with these posts is to pass along relevant information from the medical community – direct from the source – with some translation into regular English.
I want to keep you informed as best as I can. Nothing here is a political stance. And I’m not here to “argue” with anyone, either.
Latest Numbers
Total United States cases: 7.038 (up from 3,487 yesterday)
— Travel-related: 269
— Close contact: 276
— Under investigation: 6,493
Total deaths: 97 (an increase of 29)
States reporting cases: 50 states, District of Columbia, Puerto Rico, Guam, and US Virgin Islands
(Numbers pulled from other reliable resources) Total United States cases reported by other medical sites:
Johns Hopkins:
Total cases: 9,077 (an increase of more than 4,000 since yesterday)
Total deaths: 145 (an increase of 51)
Total recovered: 106 (this number is growing, which is good news)
This chart of US numbers is from Brian McNoldy, a research scientist and meteorologist, at the University of Miami.
Higher totals may be reported by other news agencies. This information is pulled straight from official government / medical university websites only. The numbers may conflict. If I understand things correctly, the CDC site is pulled from reports they receive by noon while Johns Hopkins pulls in data continuously.
What’s new?
A lot. Testing increased in nearly every state. The Government kicked out a new campaign to “Slow the Spread” of COVID-19.
The World Health Organization reports 191,000 people are currently infected with COVID-19. A 12,000 case increase since yesterday.
Sadly, that means the decrease in acceleration of the spreading virus we saw yesterday, was not a trend.
Keep fighting the good fight, friends!
As this pandemic gets worse, you might think things you can do to protect yourself may have changed, but actually, things have not, really.
Right now, simply keep tabs on the news with Coronavirus. Continue to wash your hands – like you would do to combat the spread of the common cold or flu – and avoid touching your face. And continue to practice good social distancing and, if you are sick, avoid others completely while your body fights off the infection.
Because handwashing videos are still making the rounds, here is one from the CDC
Patients assigned to lopinavir–ritonavir did not have a time to clinical improvement different from that of patients assigned to standard care alone in the intention-to-treat population. In the modified intention-to-treat population, the median time to clinical improvement was 15 days in the lopinavir–ritonavir group, as compared with 16 days in the standard-care group
Graph from research // Courtesy:
… when the time to clinical deterioration (defined as a one-category increase on the seven-category scale) was compared between the two groups, no difference was observed
… no benefit was observed with lopinavir–ritonavir treatment beyond standard care. However, in the modified intention-to-treat analysis, which excluded three patients with early death, the between-group difference in the median time to clinical improvement (median, 15 days vs. 16 days) was significant, albeit modest. Future trials in patients with severe illness may help to confirm or exclude the possibility of a treatment benefit.
Of note, the overall mortality in this trial (22.1%) was substantially higher than the 11% to 14.5% mortality reported in initial descriptive studies of hospitalized patients with Covid-19,1,2 which indicates that we enrolled a severely ill population.
This treatment has been making its rounds on facebook recently as being a “new treatment that is working” but, per the current research, it is not helping that much.
NSAIDs and COVID-19
A lot of people are curious about NSAIDs and COVID-19. The limited information that is available does not offer any scientific evidence one way or the other.
The European Medicines Agency (EMA), a decentralised agency of the European Union (EU) which began operating in 1995, says there is no credible evidence to support any claim about Ibuprofen’s negative interaction with COVID-19 cases. The agency, on their website, claims it is responsible for the scientific evaluation, supervision and safety monitoring of medicines in the EU. They noted that they are monitoring the situation closely and will review any new information that becomes available on this issue in the context of the pandemic.
The EMA was busy today, too. From their website:
Today, the first global regulatory workshop on COVID-19, was convened under the umbrella of the International Coalition of Medicines Regulatory Authorities (ICMRA). The virtual meeting brought together delegates from 17 different countries, representing more than 20 medicines regulatory authorities globally, as well as experts from the World Health Organization and the European Commission, to discuss the development of vaccines against COVID-19.
Vaccine in the works, but don’t get excited
There have been a ton of headlines about vaccines and clinical trials. But, don’t get too excited. Even if a vaccine is developed today or tomorrow – or even yesterday – clinical trials take time. More than a year usually. And often there isn’t just one clinical trial before a vaccine is ready to go.
The report circulating Social Media like wildfire
In case you missed it…
That Imperial College projection floating around social media or on the national news, is pretty dark. I’ve been trying to figure out if it was peer-reviewed or not, but there seems to be conflicting information on that. And since it is conflicting information, that would lead me to believe it was not peer-reviewed.
If you don’t know what I’m talking about, That is probably for the better.
But let me give a quick overview: A research team out of the UK ran a ‘global pandemic model’ (a lot like our weather models) to predict the number of cases that would eventually develop and – sorry, there is no nice way to say this – how many people will die. They then plotted this on a graph (like spaghetti plots with hurricanes) to try to help explain where this COVID19 thing is going.
The outcome was rather depressing and the findings are still being discussed and disputed by other research teams, mathematicians and scientists.
The Imperial College research team said that we continue to live life as we normally live it that nearly 3/4 of America would get the virus and about 4-million people would die. Of those deaths, it would include about 10-percent of the population over 70.
When I tell you that reading that broke my heart. Words do not do that justice.
If we restrict movements, and wash hands, practice social distancing still leaves us with 2-million deaths.
If we do all of that, and go into lockdown like Italy and China: a few thousand deaths.
That is still heart-breaking.
— Now for the part that is under the greatest scrutiny —
The Imperial College team argued that if the restrictions were lifted – at any time – before a vaccine was found that we would be right back in the same boat that we are right now with a massively quick spread and potential deaths.
This is under such dispute that a researchers already published a rebuttal, “REVIEW OF FERGUSON ET AL “IMPACT OF NON-PHARMACEUTICAL INTERVENTIONS…”
They write:
[Imperial College] make structural mistakes in analyzing outbreak response. They ignore standard Contact Tracing [2] allowing isolation of infected prior to symptoms. They also ignore door-to-door monitoring to identify cases with symptoms [3]. Their conclusions that there will be resurgent outbreaks are wrong. After a few weeks of lockdown almost all infectious people are identified and their contacts are isolated prior to symptoms and cannot infect others [4]. The outbreak can be stopped completely with no resurgence as in China, where new cases were down to one yesterday, after excluding imported international travelers that are quarantined.
Now, scientists as a whole rarely agree on stuff. So direct wording like this isn’t uncommon. As an aside, this is why when you hear that 95-percent of scientists agree Climate Change is a thing, it means something.
The authors of this rebuttal go on to write that given other research (like what is touched on below) that suggests that you need a certain number of infected people in the community not just a certain percentage, and that once a person is no longer sick – the virus is “dead” in so many words – that person can no longer pass the virus along.
According to what I’ve read, it looks like (A lot like weather models) projections with epidemics are difficult because they include a lot of assumptions and can be susceptible to errors and “math gone wild” where things can look worse (or better) than things actually are.
Sort of like those spaghetti models and hurricanes.
The take home point from this “Elephant in the room” is to take the necessary steps to protect you and your family from this virus and follow the CDC guidelines. But, try not get too worried about one study showing one thing. A lot like we try to say “don’t get worried about the one spagheti line that takes the hurricane to South Mississippi.”
What’s next?
Thats a great question that I don’t think anyone has the answer to. Because this virus is a bit like a tornado (you can follow that link to an analogy I discussed the other night) we can make predictions about total cases and potential deaths, but we can’t tell you specifically what it will be like for you and your family.
But until people start to self-quarantine, isolate, practice good social-distancing, etc. it looks like this will continue to spread.
It is good to know that there is some research out there – based on math and numbers – that shows once isolation and quarantine are established this is only transmitted as rampantly as the flu. Still bad. But much more manageable.
The problem? Wuhan has been under a lockdown since January 23rd. And it is March 18th. That is almost eight weeks of lockdown. Capitalism may not be able to survive that.
So, if you are wondering, “How long will this last?” it may be awhile before this is all over. Both in the United States and around the world.
Are facemasks a good idea
This is straight from the CDC:
CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19. You should only wear a mask if a healthcare professional recommends it. A facemask should be used by people who have COVID-19 and are showing symptoms. This is to protect others from the risk of getting infected. The use of facemasks also is crucial for health workers and other people who are taking care of someone infected with COVID-19 in close settings (at home or in a health care facility).
From the Mayo Clinic
Here is a quick note from the Mayo Clinic for cancer patients during the COVID-19 outbreak.
They also have a podcast up with extra information for everyone.
From the Mayo Clinic website: “Dr. Gregory Poland, head of Mayo Clinic’s Vaccine Research Group, discusses who is at risk, how to stay protected from the virus, and, if there will be a coronavirus vaccine in the future.”
From the Annals of Internal Medicine
Annals On Call – Understanding the Spread of COVID-19: Dr. Centor discusses the epidemiology of the novel coronavirus responsible for COVID-19 with Dr. David Fisman of the University of Toronto.
From Harvard Medical
Dr. Greg L. Fricchione, Mind Body Medical Institute Professor of Psychiatry at Mass General Hospital and Harvard Medical School and faculty editor for the Harvard Health Publishing special health report Stress Management, places in context the worries we all feel when an infectious disease like the coronavirus COVID-19 comes calling.
Author of the article:
Nick Lilja
Nick is former television meteorologist with stints in Amarillo and Hattiesburg. During his time in Hattiesburg, he was also an adjunct professor at the University of Southern Mississippi. He is a graduate of both Oregon State and Syracuse University that now calls Houston home. Now that he is retired from TV, he maintains this blog in his spare time.
