Wednesday, April 29, 2020

Coronavirus Update 9

Some states are going to start reopening their economies within the next few days and weeks. That is coming despite a persistent inability to do large scale testing in the US. Reopening has already started in some places such as Georgia and Alaska. Some states never issued stay-at-home orders and are under various degrees of business and health care closures. Despite assertions from some governors that it is safe to begin to reopen, there is no way to know that without large scale testing. In essence, each state will be a separate experiment in how the Covid-19 pandemic will play out.

Absent testing data, it will be basically impossible to follow the course of the infection in detail. The number of infections and deaths could increase in coming weeks. The president continues to reject responsibility for spearheading and coordinating testing efforts. The New York Times commented: “A White House document makes clear that the states are still primarily responsible for testing and that Washington is only the ‘supplier of last resort.’” Clearly, the president has rejected a major role for a federal government testing effort, despite being the only source of national authority for coordination efforts. That level of incompetence and stupidity is incomprehensible.


The new set of symptoms
The CDC announced that it now considers nine symptoms to be common to most Covid-19 infections. Previously, three symptomes were considered dominant, i.e., shortness of breath, cough and fever. The list now also includes chills, repeated shaking with chills, muscle pain, headache, sore throat and new loss of taste or smell. These nine symptoms most commonly appear at two to 14 days after exposure to the virus. This nw listing of overt symptoms is an astonishing change in how the disease is perceived by the CDC. Why it took this long to simply see what the dominant symptoms are suggests that there is a profound problem or dysfunction in the CDC. This revelation comes weeks after hundreds of thousands of cases have been observed.

My guess is that the president has neutered the CDC for his personal political reasons. Maybe the president has muzzled the experts. Maybe he put incompetent loyalists in charge. Whatever the reasons, it is very hard to understand why it has taken this long to simply characterize the main symptoms of the disease, except for attributing it to factors such as the president's typical gross incompetence, his blatant dereliction of his duties, concern for his own re-election, and/or just plain corruption.


People still trust Trump
Reuters reports that an astounding 47% of Americans report that they are “very” or “somewhat” likely to follow recommendations the president makes about the virus. Although that is a 15% decrease from a poll at the end of March, it is arguably staggeringly high in view of how poorly the president has performed so far. The poll did indicate that 08% of democrats and republicans will not take the president's advice to inject themselves with bleach or other disinfectants. At least that sliver of reality appears to have sunk in with Americans. Reuters comments that the president’s popularity remains stable: “Overall, Trump’s overall popularity has not changed much over the past week. Forty-three percent of Americans said they approve of his overall job performance, and the same number also approve of his handling of the COVID-19 pandemic.”


Where we are and where we are going
Given America’s feeble, failed federal response to Covid-19, the imminent reopening of states and our continuing inability to do adequate testing, it now appears reasonable to speculate that the virus is going to spread through almost the entire US population. Isolated pockets of people may avoid the disease, but most of the US population seems destined to develop herd immunity on its own whether we want to get immunity that way or not. That will probably happen before a widespread antiviral treatment or vaccine becomes available. It also assumes that once people recover from an infection, they will have protective immunity. That is an open question at the moment, but it is reasonable to think that that protective immunity probably will result in most people who survive the infection.

Some evidence indicates that an antiviral drug now in testing, remdesivir, may be somewhat helpful if given fairly early in the course of the infection. That is good news, but it needs to be confirmed. Also of concern is whether the company can ramp up to large scale production if the drug does prove to be useful. Also, a team in England is optimistic that an effective vaccine they are developing can be available by September of this year. If that comes to pass, it would about as close to a medical miracle as humans can muster in such a short time.

That is something no longer possible from the US government. It is too late for that.

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