Lots of new research coming out, both hopeful and alarming. Two different studies indicate that COVID-19 patients can be contagious up to eight days *after* symptoms subside.
LOCAL
* Washington state now has 7,984 confirmed cases, with 338 deaths. Local counties: King, 3,158 cases/208 deaths; Pierce, 536/10; Snohomish,1,486/47. The city of Tacoma recorded its first death today.
* Gov. Jay Inslee announced that Washington will return 421 ventilators it had received from the federal government, to be distributed – hopefully – to states in greater need. This is an indication that public health officials believe that Washington is near its apex of cases. COVID-19 hospitalizations and new cases here have flattened in recent days.
* Research from Bellevue’s Institute for Disease Modeling shows that each infected person infects 2.7 others without mitigation, but that after a month of social distancing, that average is down to 1.4 persons. Social distancing works.
* Contrary to yesterday’s announcement, today Boeing now says its Puget Sound plants will remain closed indefinitely.
* CRISTA Rehab & Nursing Center in Shoreline is the latest elder care center to become a locus of COVID-19 cases. Its nursing home wing has 26 residents and 16 staff members who have tested positive.
* Amazon announced that an employee at its Everett distribution center has tested positive.
* A new study shows that despite stay at home orders, as of a week ago Seattle area traffic was still about 55 percent of normal. Nationally, the rate was about 60 percent.
NATIONAL
* Friday, the former captain of the virus-stricken aircraft carrier, the USS Theodore Roosevelt – who was relieved of his command Thursday, after a letter the captain sent to Navy superiors detailing the Navy’s failures in dealing with his ship’s outbreak was leaked to the media – left the ship to rousing applause from the sailors formerly under his command.
* Today, that captain, Capt. Brett Crozier, tested positive for COVID-19.
* Trump: “I thought it was terrible what he did [in sending the letter].” That should cement Capt. Crozier’s status as a folk hero. Hopefully he fully recovers along with the over 100 ill sailors on the ship. The Navy only moved to disembark the thousands of apparently healthy sailors still on that ship after Crozier’s letter became public. His action likely saved lives.
* Seventy percent of all COVID-19 deaths in Chicago – 61 of 86 -have been of African-Americans. Eighty-one percent of those dead had hypertension, diabetes, or both. In Illinois, the rate of hypertension among black residents is about 48 percent – a reflection of the racism, social inequity, and class issues that pervade access to the American health care system. In the pandemic, issues of poverty also play a key role in its spread – living in crowded homes, needing to rely on public transit, and having jobs that can’t be done from home, for example.
* In both Illinois and Michigan, African-Americans account for 14 percent of those states’ populations. In Illinois, they’re 38 percent of COVID-19 cases; in Michigan, 35 percent, and 40 percent of the deaths, primarily in Detroit. Neither the CDC nor the states where a number of other hard-hit urban areas are located – New York, New Jersey, Pennsylvania, Massachusetts, Georgia, and Louisiana – appear to provide racial breakdowns of cases.
* If any cohort, i.e. a segment of the population, for any reason, has a statistically significant difference in infection or mortality rates – you want to know about it, and you want to investigate why. The lack of racial data, nationally and for so many states, means either that the respective health departments don’t want to know, or they don’t want the public to know. Either way, the lack of racial data on those sites is a political decision, not a public health one.
* Adding to the advance warnings the Trump Administration had, a new report says the military warned the administration in 2017 about the risk of a new coronavirus pandemic.
* In Saturday’s press briefing, Trump doubled down on the notion that the nation needs to go back to work, with or without a pandemic, because “you lose more people that way [with an economic shutdown].” Yes, if you rush people back to normal life, you WILL lose more people that way. Happy Palm Sunday. Those packed churches on Easter are a week away.
* Trump also bragged that the US had stockpiled 29 million doses of hydroxychloroquine, and he continued to promote it as a cure for COVID-19 (see the research item under “Global”) against the advice of medical experts. Trump acknowledged that he wasn’t a doctor – duh – but said he was touting it due to his “gut instinct.” When a reporter asked Dr. Anthony Fauci to answer a question about the drug’s effectiveness, Trump cut him off. Silver lining: at least Trump’s not promoting using leeches to bleed the virus out of patients.
* Trump nominated Brian Miller, a member of the White House Counsel’s office who helped defend Trump during impeachment proceedings, to become an inspector general overseeing the federal government’s pandemic response. Miller previously served for nine years as an inspector general at the General Services Administration under President Bush. Miller would need confirmation by the US Senate, which is in recess until at least late April.
* Dallas, Nashville, and Phoenix are the latest cities to report a major spike in confirmed cases.
* The Republican-controlled state legislature of Wisconsin is rejecting calls, including from the Democratic governor, to delay in-person voting in that state’s presidential primary, now scheduled for this coming Tuesday. The election will also decide thousands of state and local offices. Wisconsin voters have the option to vote by absentee ballot until a week from tomorrow, April 13, but a Republican-backed lawsuit is seeking to remove that option and require people to show up at the polls – even though residents are under a stay at home order. Nearly 60 percent of the state’s municipalities report a shortage of poll workers for Tuesday – meaning long lines and high infection rates if people actually turn out.
* Likely Democratic presidential nominee Joe Biden suggested today that Democrats hold a “virtual convention,” rather than the in-person one now scheduled for mid-August in Milwaukee. For his part, President Trump has been adamant that the Republican convention, scheduled for a week later in Charlotte, proceed as planned.
* About a third of nurses and doctors at the Brooklyn Hospital Center are out sick. The hospital temporarily ran out of protective gowns, a blood pressure medication, and the sedative used for patients on ventilators. Shortages and illnesses among medical staff compound New York City’s struggles with a tsunami of COVID-19 patients.
* A tiger at the Bronx Zoo has tested positive for COVID-19, according to multiple local reports. Other lions and tigers at the zoo also appear ill.
* Top ten states (Saturday’s totals in parentheses)
New York 123,177 (103,169)
New Jersey 37,505 (29,895)
Michigan 15,718 (12,744)
California 14,055 (12,507)
Louisiana 13,010 (10,297)
Florida 12,151 (9,585)
Massachusetts 11,736 (10,402)
Pennsylvania 11,589 (8,570)
Illinois 10,360 (10,268)
Washington 7,986 (6,967)
GLOBAL
* Lots of promising – and sometimes alarming – research is now being published.
* The Mayo Clinic reports that two studies of patients who had recovered from COVID-19 found that they may still be infectious even after symptoms have disappeared. One study looked at people who had mild infections and found that half of them continued to test positive for up to eight days after their symptoms disappeared. The other study found that the virus could still be detected in a patient’s mucous and feces even after they had tested negative on two consecutive throat swabs.
* A separate German study, published by the Annals of Internal Medicine, found that shedding of SARS-CoV-2 in the upper respiratory tract occurs most efficiently early on, when patients still have mild symptoms. They could detect the infectious form of the virus in the throat and lungs until day eight of symptoms, and viral RNA in mucus from the lungs after the symptoms were gone. They did not detect the virus in blood or urine, and did not find the infectious form in feces, despite high levels of viral RNA.
* A team of researchers at Stanford University may have found a way to use heat to disinfect N95 masks, allowing the masks to be reused up to 20 times as personal protective equipment. The masks are in dangerously short supply in hospitals across the country.
* Australian researchers say that an anti-parasitic drug, Ivermectin, has been found to kill COVID-19 in the lab within 48 hours.
* A study of the drug hydroxychloroquine, much touted by Donald Trump as a miracle cure for COVID-19, shows that it *may* be effective in treating the early stages of an infection and in mild cases. More study is needed.
* Another public health study looked at factors influencing individuals’ compliance with quarantine rules during infectious disease outbreaks. Adherence can vary from as little as zero per cent up to 92.8 per cent, according to a review of existing research. The factors that have the biggest effect of adherence are the knowledge people had about the disease and quarantine procedure, social norms, perceived benefits of quarantine and perceived risk of the disease, as well as practical issues such as running out of supplies or the financial consequences of being out of work. This is why the persistent downplaying of the outbreak by President Trump and various Republican governors has had such a disastrous impact.
* UK Prime Minister Boris Johnson, 55, was hospitalized as a “precautionary” measure today, ten days after testing positive for COVID-19. Johnson is the most prominent head of state in the world so far to have contracted the virus. His girlfriend, Carrie Symonds, who is pregnant, disclosed that she is also symptomatic. Queen Elizabeth addressed the nation today, only the fourth time in her remarkable 66-year reign that she has done so.
* Spain reported another drop in its daily death rate, to 674 overnight. Spain’s daily death toll was over 1,000 per day much of the last week.
* Italy saw a dramatic reduction in the number of new cases today, with only 2,316 – about a third of its previous new daily cases this past week.
* Ireland’s Prime Minister, Leo Varadkar, who trained as a physician but left his practice to pursue politics, announced that he will work one shift a week to help combat the pandemic.
* The global total of confirmed cases is 1,274,923, with 69,614 deaths in 183 countries. Today was the first day the global total of cases increased by more than 100,000. Germany became the fourth country to pass 100,000 cases. For the second day in a row, China reported less than 100 new cases.
* Countries with over 5,000 cases (Saturday’s total in parentheses):
USA 337,620 (301,915)
Spain 131,646 (124,736)
Italy 126,948 (124,632)
Germany 100,123 (95,637)
France 93,780 (90,842)
China 82,602 (82,543)
Iran 58,226 (55,243)
UK 48,440 (42,441)
Turkey 27,069 (23,934)
Switzerland 21,100 (20,505)
Belgium 19,691 (18,431)
Netherlands 17,953 (16,727)
Canada 15,764 (12,949)
Austria 12,051 (11,781)
Portugal 11,276 (10,524)
Brazil 11,254 (10,278)
South Korea 10,237 (10,156)
Israel 8,430 (7,851)
Sweden 6,830 (6,443)
Australia 5,687 (5,550)
Norway 5,687 (5,550)
Russia 5,389 (<5,000)
Wash your hands, stay at home, and WASH YOUR HANDS AGAIN. We're all in this together.