Ebola:

–You’re not going to believe me.  You’re going to say I’ve clearly grabbed the wrong report.  You’ll tell me I need to check the dates.  You’ll say that maybe the data just has not been entered correctly.  You will even go so far to say that I have been doing these for so long now that complacency or fatigue has set in, and I am clearly making mistakes.

Yet, I assure you, the data checks out.  The dates check out.  It’s still 2020.
And there has not been a new case of Ebola diagnosed in the DRC in the past week.  In fact, the last confirmed positive was September 18th.

Now, even the WHO thinks this is a little too good to be true.  There are still known cases being treated in the community.  Community “resistance” remains high.  Contact tracing remains too low.  And traveler screening at points of entry, as a percentage of total travelers, has gotten worse this week.

Yet, through all that, no new confirmed cases this week.  And so we start the clock to close out this latest outbreak–but don’t be surprised if it’s a quick clock and at least one new case pops up somewhere.  Still, good to know it’s 2020, and we can occasionally get nice surprises.

Coronavirus:

–General zeitgeist.  Cases continue to rise through much of Europe, including Russia and the UK.  Argentina continues to climb one giant peak.  However, Brazil and India are definitely finally on the downswing.  Overall cases in the US continue to trend down.  However, the Big Sky and Upper Midwest continue to a mini-resurgence in new cases.  Again, the last glowing embers of the dying campfire are to be expected somewhat.  The rate here in Indiana has certainly stayed steady.  Hospital census for COVID has picked up just a little, but admissions remain steady, and nowhere near “threat to health system” levels.  I will also say that despite the lifting of many COVID restrictions in the state (bars and restaurants can be back to full capacity), most places remain cautious and masks are still frequent.  Based on traffic this week, work at home still largely appears to be the rule.

–The New York update got a little more detail from a reader a little closer to the situation.  When you are reading again this week of “hotspots” within the city and veiled threats about certain private schools, the rumor is that schools and neighborhoods of a politically important group within the city have been less conscientious about some practical steps to reduce the spread of SARS-CoV-2, and were not quite as close to herd immunity as they may have thought.  There are also some rural upstate areas that are finally getting the first wave.  So you can see the alarming rise in new SARS-CoV-2 cases in the state of New York creating all of these headlines in the from the following graph from the Johns Hopkins tracker:

Yeah, yeah, I know.  You’re all about to send me this meme:

But there is a slight little rise in that pink section on the far right. 

No really.

You can get out a ruler and fit a line if you don’t believe me.  It will go up and to the right in that pink section.

Considering how dead that curve has been for months on end, and the usual solemn, austere, even fatalistic mode de vie which New York City, in particular, is so justly famous for, and takes minor inconvenience and clear catastrophe in equal, measured stride, one understands the recently screaming headlines and press conferences on these so far isolated hot spots.

Again, with appropriate action (and it sounds like they are trying to take those steps), such hot spots are containable.  I’m only going to worry about our back of the envelope herd immunity projections if the hot spots can rip the new positive case counts up closer towards those March/April peaks within the City.  My bet is that the virus already took that shot, and it ain’t happening again.  We’ll keep an eye on it though.

–In other news, the CDC snuck revised calculation of the IFR for SARS-CoV-2 out last week, hidden in pandemic “planning scenarios.”  Again, the IFR is the percentage of people who die of the disease including all symptomatic and asymptomatic people exposed to an infectious dose.

You can find their data, and different assumptions they used, here:  https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html

Under the “current best estimate” scenario, the CDC assumes that 40% of all infections of SARS-CoV-2 are asymptomatic.  However, they assume that 50% of infections can occur before symptoms manifest, and asymptomatic cases are 75% as infectious as a symptomatic case (so still pretty good chance to transmit to others). 

With those assumptions, your chance of surviving SARS-CoV-2 is heavily influenced by your age (I am just taking the inverse of the IFRs for this set of assumptions):If you are less than 50 (much of our readership and your kids), your chances of surviving are 99.98%.  Again, slightly lower if you have underlying associated conditions (particularly obesity)–but only slightly.  Your chances are still really good, and better than flu, in fact, for survival.

If you over 50, but less than 70, your chances of surviving are 99.5%.  This is a really bad flu to you.

If you are over 70, your chances of surviving are 95%.  Still really good, but 5% mortality is actually a little concerning.  You should -definitely- still take strict precautions.

–And by the way, under the worst case scenarios the CDC presents there, your chances of surviving if you are less than 50 drop to 99.97%, if 50 to 70 they drop to 99%, and if over 70 drop to ~91%.

–Again though, and I cannot stress this enough, the main risk is the hospitalization rate if it hits a naive population hard enough, quickly enough.  Right now, that has not been much of a threat stateside since July, and then only in select cities in certain states (think back to the isolated Arizona and Texas hospitals that were activating COVID emergency plans to handle overflow). 

–The FDA is expanding its look at safety data for the Astra Zeneca/Oxford vaccine.  Trials in the US for that vaccine remain halted.  That said, the EMA (the FDA of Europe) is moving forward with a rolling approval process for the AZ/Oxford vaccine.  So not sure what is going on.  I have no more information than what is publicly available.

–CNBC published some interviews with volunteers who have taken some of the available coronavirus vaccines.  You can find that here:
https://www.cnbc.com/2020/10/01/coronavirus-vaccine-trial-participants-exhaustion-fever-headaches.html

–If you are asking as a general question, no, there is no way for a trial participant on an active and recruiting double blind study to know if they got the study drug or the placebo substitute. 

–Correlation is not causation, but if you remember in the way back–the long long ago (~February-March), we mentioned vitamin D probably wouldn’t hurt.  Studies out now that show vitamin D level correlates to COVID severity.  Low vitamin D patients were more likely to be the ones running into problems.  Now that summer is ending and vitamin D via sun exposure gets a little harder to come by, it’s something to think about.  I personally take 2,000 IU per day as a supplement; have for years; even during the summer.

–Lastly, for those of you stateside (the question came up this week), this is a good summary of options for coverage for COVID illness, should you or someone you know be sick enough to think hospital, but not have insurance:  https://familiesusa.org/resources/are-you-uninsured-during-the-covid-19-crisis-what-you-need-to-know-about-finding-health-insurance-getting-tested-and-getting-care/

–Off topic, but Rusty Guinn has a good one out as a think piece: https://www.epsilontheory.com/the-projection-racket-pt-2/

–Your chances of catching Ebola are equivalent to the chances the outbreak in the DRC has staged a tactical retreat, and even as we speak, is actively shuffling its genome, mixing and matching with every form of plague and pestilence known to mankind.  Literally, as it swaps genes with all from the flu down to the bubonic plague itself.  Everything is on the table–there is even a brief flirtation with St. Vitus’ Dance after Ebola sits down with the streptococci.  Soon it will re-emerge anew, bigger, badder, angrier, as the final cataclysm and culminating battle for humanity in 2020…

–Your chances of catching coronavirus are equivalent to the chances the new Boss Fight Strain of Ebola above ruptures the very fabric of space to travel back in time and start the outbreak by infecting the producers of “Plandemic.”  Yes, that seems unlikely, and you may -think- that I am, by analogy, saying the chances of catching coronavirus are low.  My friends, they are not.  For if Boss Fight Strain of Ebola can do even half of what I just described, time travel would be its most mild symptom, and a near certainty.  Along with the Dance*.

<Paladin>

*–Not -quite- the same St. Vitus Dance as caused by group A strep, but an odd-but-true history nonetheless…