Monday, May 11, 2020

Two thirds of cases are missed, app expert says

The British government’s data on coronavirus cases is nonsense and two thirds of cases in Britain are undiagnosed, a leading epidemiologist has claimed.

Tim Spector, professor of genetic epidemiology at King’s College London, has criticised the British government’s refusal to class common symptoms as official indicators.

The government has listed a high temperature and a new, continuous cough as the primary symptoms of COVID-19. There is evidence, however, that a loss of taste or smell is a common sign of infection. Other countries, including the US, have recognised this as a symptom on more detailed lists.

The Australian Department of Health lists fever, coughing, sore throat and shortness of breath as possible symptoms.

Professor Spector has collected data from three million Britons on his team’s symptom-tracking app.

“The reason that we got a bit stuck in this country is we took the data from China and just instantly said, ‘OK, the disease only has two symptoms: it’s fever or it’s persistent cough.’ That meant we were missing about 60 per cent of cases,” he said.

“Only people with those two symptoms got tested and ended up on the statistics. All this governmental data on confirmed cases and how many people have recovered, it’s all nonsense.”

In partnership with the British Department of Health and Social Care, 10,000 app users are being sent COVID-19 tests each week, within the first day or so of developing symptoms.

Clear patterns have emerged from the data in the six weeks since the app went live and the team are close to being able to plot how the disease will progress, depending on the symptoms someone has on day one.

According to the data the virus may have arrived in Britain at the new year as many users reported symptoms in January. At the peak one in 10 people had the virus. The team estimated that at the end of April there were more than 300,000 symptomatic cases, a fall from a peak of more than two million at the start of the month.

Professor Spector said: “We’re able to allocate people into five or six groups at the moment that follow different patterns of symptoms at different time points. It’s not random.”

In one group are those whose symptoms are a sore throat and muscle pains, which then develop to include diarrhoea, stomach pains and fatigue.

People in another group start with a headache, which progresses to a cough and fatigue, then the cough gets worse, they develop shortness of breath and may need to go to hospital. This classification is important in determining which patients are high risk.

Alan McNally, professor of microbial genomics at the University of Birmingham, agreed that there were many other possible signs of coronavirus infection. “There are myriad less common symptoms attached to COVID: things such as COVID toe [a rash on the feet] and loss of appetite,” he said.

He defended the decision by the government to concentrate on a few, however, saying: “I don’t see where on earth you draw a line on symptoms and whether or not they are COVID.”

Users of the COVID Symptom Study app in Britain log how they feel daily, even if they are healthy. The most useful loggers are people who were in good health when they first logged on to the app and have since developed symptoms.



Flawed Models Show Why COVID-19 Policies Must Consider Total Mortality

Policymakers need to scrutinize their epidemiological models.

In response to the coronavirus pandemic, the federal government has been heavily influenced by the Institute of Health Metrics and Evaluation’s computer model, which has projected from 60,000 to 240,000 COVID-19 deaths in the U.S.

This epidemiological model is now being criticized as flawed and misleading as a source of public information and for government decision-making. Besides the institute’s model, all other COVID-19 models are grounded in important assumptions about which there is currently little knowledge.

Approaches other than models are needed to properly understand this pandemic.

One approach that has not been explored in any detail is the examination of deaths from all causes in addition to deaths from COVID-19, the disease caused by the new coronavirus.

Two major databases that track COVID-19 cases and deaths in the U.S., but not total mortality, are WorldOMeters and the Johns Hopkins University Hub. These trackers show major variation in COVID-19 mortality risk. 

For example, as of April 22, WorldOMeters showed 47,681 COVID-19 deaths in the U.S. (50 states and the District of Columbia) with a rate of 144 deaths per 1 million people.

However, note that 71% of the deaths have occurred in six high-risk states (New York, New Jersey, Connecticut, Massachusetts, Louisiana, and Michigan) with 17% of U.S. residents and a death rate of 624 per million.

Ten percent have occurred in five medium-risk states (Rhode Island, Pennsylvania, Illinois, Maryland, and Indiana) and the District of Columbia with 12% of U.S. residents and a death rate of 124 per million, and 19% have occurred in the remaining 39 low-risk states with 71% of U.S. residents and a death rate of 40 per million.

It remains to be determined, however, whether these COVID-19 deaths have actually increased the total U.S. deaths this year. The best data on both COVID-19 deaths and total deaths in the U.S. come from the Centers for Disease Control and Prevention‘s National Center for Health Statistics.

During the five weeks ending Feb. 1 through Feb. 29, the Centers for Disease Control and Prevention reported 282,084 total deaths, which were 96% of the expected deaths based on concurrent 2017-2019 deaths. During the five weeks ending March 7 to April 4, the CDC reported 273,798 total deaths, which were 96% of the expected deaths. 

Of the 9,474 COVID-19 deaths reported during these 10 weeks, 78.5% were among people over age 65, 21.4% were between the ages of 25 and 64, and only 0.1% were ages newborn to 24 years.

Those death counts through the end of March are preliminary, but they do not indicate that the total number of deaths in 2020 is greater than the comparable number of deaths during each of the three prior years.

Once the number of COVID-19 deaths and total deaths during the entire month of April are known, it will be clear whether there has been an increase in the total number of U.S. deaths this year.

One reason there may not be an increase in total deaths is because some deaths are being classified as COVID-19 deaths even when COVID-19 is not the underlying cause.

Normally, mortality statistics are compiled in accordance with World Health Organization regulations specifying that each death be assigned an underlying cause based on the current 10th revision of the International Statistical Classification of Diseases (ICD-10).

However, the Centers for Disease Control and Prevention reports that COVID-19 deaths are being coded to ICD-10 code U07.1 when COVID-19 is reported as a cause that “contributed to” death on the death certificate, but is not necessarily the “underlying cause.” Also, some of those deaths do not have laboratory confirmation of COVID-19 infection.

Thus, it’s possible that the focus on COVID-19 deaths has resulted in a lower number of deaths from seasonal flu, pneumonia, and other causes, compared with the number that would normally occur this year.

The CDC has stated that the number of flu hospitalizations estimated for this season is lower than total hospitalization estimates for any season since the CDC began making these estimates.

Furthermore, it’s possible that the lethality of COVID-19 is no greater than that of the seasonal flu. 

A new Stanford University survey indicates that the population prevalence of COVID-19 in Santa Clara County, California, ranges from 2.5% to 4.2% and that the number of infected persons is 50 to 85 times the number of confirmed COVID-19 cases.

This preliminary finding suggests that at most 0.1% of infected persons will die from COVID-19, comparable to the seasonal flu death rate. Several other new studies indicate similarly lower fatality rates for COVID-19.

Americans need clarity. The federal government response to the coronavirus pandemic should not be based on flawed models, but rather on a localized public health approach that focuses on the high-risk areas of the United States and also on the high-risk elderly and those with comorbid conditions.

The emphasis should be on changes in personal behavior, such as staying at home for work or school if ill, covering coughs or sneezes, hand-washing, and avoiding those with respiratory symptoms.

Above all, the pandemic and COVID-19 deaths must be put in proper perspective, given the unprecedented societal and economic disruption of the current national lockdown.



Coronavirus treatment: Antibody that blocks infection discovered

Researchers from Utrecht University in the Netherlands, as well as the Erasmus Medical Centre and the company Harbour BioMed (HBM), identified it as a potential method of neutralising COVID-19.

And while the team’s discovery was made on human cells grown in the laboratory, they are hopeful it will produce the same results in patients.

The breakthrough offers hope of a treatment or a vaccine for the deadly virus, which has infected more than 3.6 million worldwide and killed over 250,000 people.

Study co-lead author Professor Berend-Jan Bosch said the antibody targets the deadly bug’s infamous ‘spike protein’.

The virus hooks onto a locking point on human cells to insert its genetic material, make multiples copies of itself and spread throughout the body.

“Such a neutralising antibody has potential to alter the course of infection in the infected host, support virus clearance or protect an uninfected individual that is exposed to the virus,” Prof Bosch said

It could lead to a therapy that would be given to somebody immediately after they become infected or exposed.

The antibody binds to an enzyme called ACE2 which has been identified as the receptor COVID-19 latches onto when it attacks the body.

In tests, the monoclonal antibody neutralised SARS-CoV-2 – however, further studies are planned to see if the findings translate to the clinic.

Prof Bosch and his colleagues identified it from 51 cell lines from mice that had been engineered to carry human genes.

When they were exposed to different coronaviruses they produced antibodies to the spike protein.

Only one, named 47D11, destroyed both SARS-CoV and SARS-CoV-2. It was then turned into a human version.

Prof Bosch said: “This cross-neutralising feature of the antibody is very interesting and suggests it may have potential in mitigation of diseases caused by future emerging related coronaviruses.”

The study, published in Nature Communications, offers potential for “prevention and treatment of COVID-19,” said Prof Bosch.

It builds on almost two decades of work by the same team since the first SARS epidemic of 2002 which killed almost 800 people and infected over 8000.

Prof Bosch said: “Using this collection of SARS-CoV antibodies we identified an antibody that also neutralises infection of SARS-CoV-2 in cultured cells.”

“The antibody used in this work is ‘fully human’ – allowing development to proceed more rapidly and reducing the potential for immune-related side effects.”

Conventional therapeutic antibodies are first developed in other species and then must undergo additional work to ‘humanise’ them.

The therapy is being developed by Massachusetts-based global tech giant Harbour BioMed.




Federal judge orders officials to restore New York primary, drawing cheers from Sanders camp (The Washington Post)

Gov. Gavin Newsom's office refuses records request on "murky" $1 billion mask deal with Chinese company (Fox News)

In 1991, Joe Biden voted to block creation of Senate office that handles sexual-harassment complaints (The Washington Free Beacon)

Nothing to see here — move along! Obama's office condemns Senate investigation into Ukraine, Biden (The Washington Post)

San Francisco police chief bans "thin blue line" face masks (PoliceOne)

Policy: Tom Cotton is right about restricting Chinese student visas (The Federalist)

Policy: Washington must preclude a flood of tort claims that threaten to kneecap the economy even further (City Journal)

Justice John Roberts and leftist colleagues wary of exemptions to birth-control mandate — an issue that shouldn't even exist in a country that cherishes religious liberty (The Washington Free Beacon)

Supreme Court reverses fraud convictions of Chris Christie aides in New Jersey "Bridgegate" scandal (CNBC)

The EU is facing its worst-ever recession; economy projected to shrink by 7.4% (The New York Times)

Health workers that volunteered to come to New York during pandemic have to pay state income tax, says socialist Governor Cuomo (PIX11)

Policy: Blame the federal government for militarized police crackdowns on citizen protests (Washington Examiner)

Policy: America needs to rediscover civics in education (E21)


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