1) Pretty much everyone who’s argued that we are overreacting to the coronavirus has pointed to Sweden as the “shining city on the hill” – the country that didn’t lock down, yet is doing fine.
Well, not so fast…
The architect of Sweden’s no-lockdown strategy is now admitting that: Sweden Should Have Done More to Combat Coronavirus, Health Chief Says (if you have access to the Financial Times, it has a much better article here). Excerpt:
The architect of Sweden’s controversial lighter lockdown policy for dealing with coronavirus has for the first time conceded the Scandinavian country should have imposed more restrictions to avoid having such a high death toll.
Anders Tegnell, Sweden’s state epidemiologist, agreed with the interviewer on Sveriges Radio that too many people had died in the country.
“If we would encounter the same disease, with exactly what we know about it today, I think we would land midway between what Sweden did and what the rest of the world did,” said Mr Tegnell in the interview broadcast on Wednesday morning.
Mr Tegnell’s admission is striking as for months he has criticised other countries’ lockdowns and insisted that Sweden’s approach was more sustainable despite heavy international scrutiny of its stubbornly high death toll.
Sweden’s centre-left government on Monday said it would appoint a commission to investigate the country’s approach to coronavirus before the summer, bowing to pressure from opposition politicians.
The public mood in Sweden appears to have shifted somewhat since neighbouring Norway and Denmark last week opened their borders to each other but not their close neighbour. Sweden has reported a much higher death toll relative to its population size than Norway.
Mr Tegnell said in the interview: “There is quite obviously a potential for improvement in what we have done in Sweden. It would be good to know exactly what to close down to better prevent the spread of the virus.”
Tegnell has come under increasing criticism because the coronavirus deaths in Sweden have been among the worst in the world, as this chart shows:
Even worse, Sweden’s deaths per day per capita hasn’t declined as quickly as other countries such that it is right now the highest in the world (though Brazil will likely soon surpass it), as you can see in this chart (note that the U.S. is 4th-worst):
2) Sadly, a few other countries emulated Sweden, including Mexico, which is now paying a huge price: Mexico’s hospitals strain to treat coronavirus as officials say cases are peaking. Excerpt:
There’s now more protective gear available, González de Cosio said, but staffing remains insufficient. “At night, my goodness, it’s chaos,” she said. Sometimes there are only two doctors on the late shift to handle 40 covid-19 patients, she said.
There aren’t enough monitors, so they’re moved between patients on ventilators. “We want to monitor them all constantly,” she said. “But we don’t have the equipment.”
The government says it has acquired enough ventilators. But a longtime doctor at the National Institute of Medical Science and Nutrition, one of Mexico’s most prestigious public health centers, said it occasionally ran out of them. Patients were then taken to other hospitals. Some didn’t make it, she said, speaking on the condition of anonymity because she was not authorized to comment.
“It’s traumatic seeing people die because you can’t offer them intubation,” she said.
3) Instead of treating this as a public health crisis that we all need to come together to fight, some politicians and some network (who shall remain nameless – mustn’t be political!) have turned this into a partisan brawl such that 40% of Republicans say they definitely or probably wouldn’t get the vaccine against the coronavirus, even if it were free. MADNESS! 27% unlikely to be vaccinated against the coronavirus; Republicans, conservatives especially. Excerpt:
4) This just must be a coincidence (not!). Where the Virus Is Growing Most: Countries With ‘Illiberal Populist’ Leaders. I love that women-led countries are doing so well! Excerpt:
The four large countries where coronavirus cases have recently been increasing fastest are Brazil, the United States, Russia and Britain. And they have something in common.
They are all run by populist male leaders who cast themselves as anti-elite and anti-establishment.
The four leaders — Jair Bolsonaro, Donald J. Trump, Vladimir V. Putin and Boris Johnson — also have a lot of differences, of course, as do their countries. Yet all four subscribe to versions of what Daniel Ziblatt, a government professor at Harvard and co-author of the book “How Democracies Die,” calls “radical right illiberal populism.”
This pattern isn’t a coincidence, many political scientists believe. Illiberal populists tend to reject the opinions of scientists and promote conspiracy theories.
“Very often they rail against intellectuals and experts of nearly all types,” Steven Levitsky, Mr. Ziblatt’s co-author, said. The leaders, he said, “claim to have a kind of common-sense wisdom that the experts lack. This doesn’t work very well versus Covid-19.”
In Brazil, Mr. Bolsonaro fired his health minister and has repeatedly called for states to end stay-at-home orders. In the United States, Mr. Trump rejected the views of experts for almost two months, predicting the virus would disappear “like a miracle.” In Britain, Mr. Johnson’s government initially encouraged people to continue socializing, even as other countries were locking down.
All four leaders also flouted guidance on personal protective measures early on, refusing to wear a mask or continuing to shake hands.
The pattern is apparent beyond just those countries, too. Iran — a country with a theocratic supreme leader — is fifth in case growth over the past two weeks among countries with at least 50 million people. Health experts say the government did not heed warnings about reopening too quickly. Mexico — where President Andrés Manuel López Obrador is a left-wing populist whose government published posters saying the virus “no es grave” (is not serious) — is sixth.
An academic effort to track countries’ responses to the virus has shown that a delay in government reaction allows the virus to spread much faster, said Thomas Hale of the Blavatnik School of Government at Oxford University, who is leading the effort. Many of the countries seeing bad outbreaks now share a “late recognition of the urgency of the crisis,” Mr. Hale said.
Often, leaders who responded more slowly have cited the need to prioritize economic growth. But the trade-offs between the economy and public health may not actually exist, scientists and economists say: The fastest route to economic normalcy involves controlling the spread of the virus.
“There’s this false tension that exists between public health and economic health,” said Wafaa El-Sadr, an epidemiologist at Columbia University.
The flip side of the pattern involving illiberal populists is that countries run by women appear to have been more successful in fighting the virus, as some observers have previously noted. Germany, New Zealand and Taiwan are all examples.
5) An important finding: Just Stop the Superspreading. The key is to identify the superspreader people and settings. Excerpt:
In our study, just 20 percent of cases, all of them involving social gatherings, accounted for an astonishing 80 percent of transmissions. (That, along with other things, suggests that the dispersion factor, k, of SARS-CoV-2 is about 0.45).
Another 10 percent of cases accounted for the remaining 20 percent of transmissions — with each of these infected people on average spreading the virus to only one other person, maybe two people. This mostly occurred within households.
No less astonishing was this corollary finding: Seventy percent of the people infected did not pass on the virus to anyone.
… The infectiousness of SARS-CoV-2 appears to peak within the first few days of the onset of Covid-19 symptoms and then decrease with time. That said, one can be contagious before displaying symptoms or without ever displaying any symptoms. (Hence the importance of face masks.)
It stands to reason, too, that a highly contagious person is more likely to spread the infection in a crowd (at a wedding, in a bar, during a sporting event) than in a small group (within their household), and when contact is extensive or repeated.
6) Speaking of superspreader locations, meat plants are high on the list – no wonder, with people packed together, needing to shout to be heard. Today, Tyson Foods Released Results from COVID-19 Testing at Storm Lake, IA Plant. Excerpt:
Tyson Foods, Inc. (NYSE:TSN) announced today the results of facility-wide testing for COVID-19 at its Storm Lake, Iowa pork facility, where limited production will resume on June 3 following a temporary halt during which additional deep cleaning and sanitizing was conducted. Of the 2,303 team members who work at the facility and were tested, 591 tested positive, more than 75 percent of whom did not show any symptoms and otherwise would not have been identified.
The total comprises 58 individuals who were tested by the Department of Health or when seeking care through their own health care providers and an additional 533 who were tested onsite from May 18 to May 21. Team members who test positive receive paid leave and may return to work only when they have met the criteria established by both the CDC and Tyson. In all, 186 of the team members who tested positive have been through their required absence and have now returned to work.
The Storm Lake facility is among more than 40 production facilities in the United States where Tyson is rolling out advanced testing capabilities and enhanced care options onsite to team members in partnership with Matrix Medical, a leading medical clinical services company, and other partners.
“We are thankful for the efforts of Tyson Foods’ management and team members to ensure the safety of employees as they continue in the best manner possible to process food for our country,” said Keri Navratil, City Manager for Storm Lake. “We know that the efforts to protect Tyson team members also protect their families and, in turn, our other residents.”
Roughly 26% of the workers got coronavirus… And more interesting is that 75% were asymptomatic! This is good news, as this is another case study that supports a thesis that up to 80% of COVID-19 infections may be asymptomatic.
7) More on how the virus spreads: It’s Not Whether You Were Exposed to the Virus. It’s How Much. Excerpt:
Three factors seem to be particularly important for aerosol transmission: proximity to the infected person, air flow and timing.
A windowless public bathroom with high foot traffic is riskier than a bathroom with a window, or a bathroom that’s rarely used. A short outdoor conversation with a masked neighbor is much safer than either of those scenarios.
Recently, Dutch researchers used a special spray nozzle to simulate the expulsion of saliva droplets and then tracked their movement. The scientists found that just cracking open a door or a window can banish aerosols.
“Even the smallest breeze will do something,” said Daniel Bonn, a physicist at the University of Amsterdam who led the study.
Observations from two hospitals in Wuhan, China, published in April in the journal Nature, determined much the same thing: more aerosolized particles were found in unventilated toilet areas than in airier patient rooms or crowded public areas.
…Apart from avoiding crowded indoor spaces, the most effective thing people can do is wear masks, all of the experts said. Even if masks don’t fully shield you from droplets loaded with virus, they can cut down the amount you receive, and perhaps bring it below the infectious dose.
“This is not a virus for which hand washing seems like it will be enough,” Dr. Rabinowitz said. “We have to limit crowds, we have to wear masks.”
8) Good for West Virginia:
Before we celebrate one state testing a few thousand high-risk people, consider that China just finished testing nearly all 11 million residents of Wuhan in only 19 days. This kind of well-organized government response is why China has crushed the virus…
9) That said, however, China screwed the rest of the world here: China delayed releasing coronavirus info, frustrating WHO. Excerpt:
Despite the plaudits, China in fact sat on releasing the genetic map, or genome, of the virus for more than a week after three different government labs had fully decoded the information. Tight controls on information and competition within the Chinese public health system were to blame, according to dozens of interviews and internal documents.
Chinese government labs only released the genome after another lab published it ahead of authorities on a virologist website on Jan. 11. Even then, China stalled for at least two weeks more on providing WHO with detailed data on patients and cases, according to recordings of internal meetings held by the U.N. health agency through January — all at a time when the outbreak arguably might have been dramatically slowed.
WHO officials were lauding China in public because they wanted to coax more information out of the government, the recordings obtained by the AP suggest. Privately, they complained in meetings the week of Jan. 6 that China was not sharing enough data to assess how effectively the virus spread between people or what risk it posed to the rest of the world, costing valuable time.
10) Various other articles:
- Nearly 30,000 nursing home residents died during coronavirus pandemic, government report shows, Washington Post
- New coronavirus losing potency, top Italian doctor says, Reuters
- Six Months of Coronavirus: Here’s Some of What We’ve Learned, NYT
- After 6 Months, Important Mysteries About Coronavirus Endure, NYT
- Medical Workers Should Use Respirator Masks, Not Surgical Masks, NYT
- An excellent thread on why the President’s decision to pull out of WHO may be a risky one
- It is no surprise that the coronavirus is expected to be seasonal, as this study finds
- A good thread on the impacts of protests on COVID-19 spread