COVID Transmissions for 8-18-2020
Greetings from an undisclosed location in my apartment.
It has been 275 days since the first documented human case of COVID-19. One of these days I am going to forget to update this and you’re all going to be worried you’re stuck in a time loop. If this happens, rest assured it’s probably just my fault.
Housekeeping note:
Extended headlines section today, so no in-depth. Lots of news around the world!
Glossary terms are bolded words with links to the running newsletter glossary.
Keep the newsletter growing by sharing it! I love talking about science and explaining important concepts in human health, but I rely on all of you to grow the audience for this:
Now, let’s talk COVID.
COVID-19 data retrospective
STAT News has a retrospective piece summarizing what we have learned about COVID-19 over the 7 months that humanity has now lived with it: https://www.statnews.com/2020/08/17/what-we-now-know-about-covid19-and-what-questions-remain-to-be-answered/
Like everything in the press, there are things here I agree with and things I don’t. I take particular issue with the claim that “Vaccine development can be accelerated. A lot.” This remains to be seen; we don’t have a successful vaccine yet, so we don’t know if the rapid acceleration worked. It may well have. We shall see.
Case spike in South Korea; New Zealand delays election
With 197 new daily cases yesterday, South Korea is experiencing a bit of a spike. What they call a “spike” we would call “a good normal day” here in NYC.
If the situation there continues, they plan to institute additional behavioral control measures. 319 cases there currently are linked to spread from a church, and government officials are having trouble getting that church to cooperate with their attempts at infection control. The original, larger cluster of infections in South Korea was also linked to a religious group.
New Zealand, on the other hand, has decided to delay its election by a month after they reached a total of 58 cases in a new cluster. Yes, that’s 58 total in the country. New Zealand previously had a streak of eradication that lasted about 100 days, so you can imagine why they are being very cautious. This is the approach the US should have taken in January; be aggressive and prevent it from expanding.
These international stories, and a note on the deteriorating virus situation in Lebanon, are summed up by CIDRAP here: https://www.cidrap.umn.edu/news-perspective/2020/08/korea-sees-covid-19-spike-new-zealand-delays-election
South Carolina mask mandate data
One upside of nearly unrestrained transmission in the US, if there can be said to be upsides, is that we collect a lot of data that are geographically controlled and that have demographically similar populations.
Recently, the state department of health in South Carolina released some data comparing counties that have a mask-wearing mandate to counties that do not have such a mandate.
Forbes has an article summarizing it, but their headline is a little bit confusing: https://www.forbes.com/sites/nicholasreimann/2020/08/12/coronavirus-cases-drop-46-in-parts-of-s-carolina-with-mask-mandates-compared-to-areas-without/#391eb6507123
The real conclusion comes in the part where they give the amount of case growth in mask-mandate counties vs non-mandate counties for a time-matched period. Mask mandate counties saw cases drop by 15.1%, while over the same period non-mandate counties saw an increase in cases of 30.4%. The overall spread was about 45 percentage points, but since the counties don’t have equal population I’m not sure that making that comparison is appropriate.
NY Gym Reopening Guidelines
New York State announced preliminary guidelines today for reopening gyms, starting August 24th: https://www.governor.ny.gov/news/governor-cuomo-announces-gyms-and-fitness-centers-can-reopen-starting-august-24
[This may be slightly delayed in NYC, though: https://gothamist.com/arts-entertainment/cuomo-announces-gyms-can-reopen-limited-capacity-starting-next-week]
I believe the guidelines are well-considered, especially considering a study from Norway that showed that with masks and distancing and an overall local low prevalence of disease, indoor gyms are not necessarily a meaningful hazard: https://www.sciencemag.org/news/2020/06/it-s-safe-go-back-gym-if-there-s-little-covid-19-around-study-suggests
The New York rules call for universal masking, 33% occupancy, and that individual shower stalls be cleaned between each use. It’s unclear if universal masking applies while you’re using the shower stall. I would skip the mask in the shower—having been caught in a downpour while wearing a mask once, it’s sort of like waterboarding yourself.
Gyms in several other states have already reopened with similar guidelines, and I’m generally in favor of this provided that the local prevalence is low. Gyms are an essential health service that keep people at peak performance. Exercise is thought to boost the immune system. Cardiopulmonary health is important for keeping yourself at low risk of serious complications if you do eventually get sick. So if they can be safely open, they should be. But emphasis on “safely.”
Herd immunity threshold
We’ve covered before how herd immunity thresholds are variable; one pathogen may require a lower number of immune people in a population to protect the non-immune individuals than another pathogen.
We’ve also covered before how COVID-19 doesn’t seem to spread entirely evenly through the population; certain people and communities appear to get hit harder. It’s possible that these variations are entirely behavioral, or biological. If they’re behavioral, it’s not clear whether they rely on what people are doing to combat the coronavirus (eg, staying home, wearing masks) or whether they are based on people’s inherent behavior (eg, going to a choir practice, visiting 10 bars in a night).
However, there are some epidemiologists suggesting that, if susceptibility and the likelihood that a given person spreads the virus are more inherent to certain people and certain communities, it’s possible that the herd immunity threshold for COVID-19, thought to be around 70%, is actually a lot lower.
I don’t buy this; it’s possible, but it’s not easily determined and it’s a big guess. However, a rather balanced view is provided in an article from the New York Times’s Apoorva Mandavilli: https://www.nytimes.com/2020/08/17/health/coronavirus-herd-immunity.html
I think it’s possible that the threshold is lower, don’t get me wrong, though I’m skeptical that it’s so low that even places like NYC are close enough to be there already at an estimated 21% prevalence of antibodies (keep in mind also that we still don’t know when or if antibodies equal immunity). I also think it’s possible that this threshold is only lower if we continue to largely stay home, skip indoor dining, keep theatres closed, and other measures that I’d like to see safely end.
Instead I’d prefer that we count on the highest estimate for herd immunity, and vaccinate to that number. We can’t take chances.
What am I doing to cope with the pandemic? This:
Cooking
Can one survive on cabbage alone?
No.
Watching
Netflix needs to have a “shuffle” feature for shows in the Star Trek genus. Unfortunately, it doesn’t, so we’ve been watching the channel “Heroes and Icons,” which may be local to New York, but that shows Star Trek of all TV-syndicated varieties 6 nights a week.
Last night, the Star Trek episode “Miri” from 1966 was on at 8 pm. This episode is sort of dated, though at the time it was rather groundbreaking. It concerns a planet that has been devastated by a plague that killed all the adults but spared all the children. Naturally, Kirk and crew beam down and they don’t wear masks or social distance, beginning a dramatic series of events.
In the episode, the children refer to the pre-plague period as “the before-time.” This may be when that phrase, used widely today to refer to the pre-COVID era, entered the wider cultural lexicon, which is kind of neat.
Join the conversation, and what you say will impact what I talk about in the next issue.
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This newsletter will contain mistakes. When you find them, tell me about them so that I can fix them. I would rather this newsletter be correct than protect my ego.
Though I can’t correct the emailed version after it has been sent, I do update the online post of the newsletter every time a mistake is brought to my attention.
Correction: yesterday’s email had the wrong date in the subject line. It was, in fact, 8-17-2020. I can’t correct this online so it stays online.
See you all next time.
Always,
JS