12 May 2020 – Tuesday – #58

Yesterday I was scheming with Brad to return to Spain. Today, we can forget about our schemes. It appears Spain will open its borders.

Spain orders 14 day quarantine for travelers arriving from abroad.

I’m not sure how the Spanish travel order squares with Ryanair’s plan to fly 40% of capacity by 1 July. Sure, you’ll be able to snag a ten quid flight from London to Spain, but then you have pay for 14 days of quarantine accommodations. Also, if you’re concerned about your privacy, well, good luck.

As a temporary public health measure, while EU countries emerge from their Covid-19 lockdowns, Ryanair will require all passengers flying in July and August to fill in details at the point of check-in of how long their planned visit will be, and their address while visiting another EU country. This contact information will be provided to EU governments to help them to monitor any isolation regulations.

The Guardian, “Ryanair passengers will have to ask to use toilet when flights resume,” 12 May 2020

Also, if you have to use the loo, please raise your hand first. As I said, good luck with privacy. It’s gonna be a bumpy ride.

Yesterday I also teased a diary entry today on business adaptation to Covid-19. I forgot about the bomb of Covid-19 news that comes on Mondays. Businesses will continue to adapt and I’ll have more to report on that in a later entry.

In today’s news, the spike of Covid-19 cases in South Korea is of particular interest to me. It seems that 29 of 34 new infections occurred in Seoul’s gay district, Itaewon. Many of the new cases are tied to an infected man who visited a sauna. South Korea’s evangelical press has used this as gay hate fodder.

After Kookmin Ilbo, a local media outlet with links to an evangelical church, reported that businesses visited by an infected man over the long weekend were gay clubs, many other South Korean media followed suit, revealing not only the identity of clientele but also some of their ages and the names of their workplaces.

The Guardian, “South Korea struggles to contain new outbreak amid anti-gay backlash,” 11 May 2020

This reminds me of the beginning of the AIDS crisis when, for instance, gay men were fired after testing positive for HIV, as much for being gay as for testing positive. The South Korean evangelicals may raise lots of money on the backs of gay men, but they also push gay men further into the closet and thwart public health efforts to test, track, and quarantine Covid-19.

But public health officials now are using private credit card transactions to track down the three thousand people who were at Itaewon clubs. It’s a smart public health tactic with treacherous consequences. Of course, anyone getting a request from Seoul public health department to get a Covid-19 test this week will assumed to be gay and, as a result, may lose their job and social status. Many gay South Koreans report suicidal feelings as their identities are challenged.

In many parts of the world, the AIDS crisis led to more gay men taking the risk to come out and greater acceptance of homosexuality. The best outcome is for greater acceptance of diversity in South Korea and the rest of the world. That’s unlikely in the short term.

Covid-19 reveals us for who we are, closeted or out, bigoted or accepting.

There are lots of science updates, and you know I love science.

It turns out that a major cause of Covid-19 death is blood clots rather than lung disease. It also turns out that elevated D-dimer levels may predict Covid-19 mortality. A D-dimer test detects a “small protein fragment present in the blood after a blood clot is degraded by fibrinolysis.” Using D-dimer tests for Covid-19 patients, healthcare workers may be able to identify early on which patients are likely to need extra care. Identifying high-risk patients early should reduce overall Covid-19 mortality. That’s really good clinical news.

Also, it’s important to keep in mind as Covid-19 deaths increase that there are lots of treatment studies underway. BioCentury provides lots of useful Covid-19 updates including Covid-19 treatment studies here.

BioCentury chart of Covid-19 treatment studies, 11 May 2020.

As the chart shows, there are over 150 immunosuppresent and antiviral studies in the works. Eyeballing the rest of the chart, it looks like there about another 150 studies of other classes of treatments.

One treatment that keeps failing is our old friend hydroxychloroquine. The latest study from New York measure no hydroxychloroquine benefit to Covid-19 patients.

A quick detour to 1600 Pennsylvania Avenue. While Trump urges Americans to return to work without enough testing in place to monitor new Covid-19 outbreaks, the White House is getting Covid-19 testing and has an outbreak. Turns out the Abbott ID Now Covid-19 testing system used at the White House has a 15% false-negative rate. A false-negative here, a false-negative there, and all of sudden senior White House staff is infected.

And those meatpacking workers Trump ordered to return to work without adequate Covid-19 testing? It’s not bad just for the workers. Turns out communities around meatpacking plants now have double the national average of Covid-19 cases. Two weeks ago, I noted that the US is performing about 300,000 tests per day. As of Sunday, the US was still performing the same number of tests per day. No testing progress in two weeks.

Which brings me to two public health topics. One is a Years of Life Lost (YLL) study from the University of Glasgow. One anti-lockdown argument is that people dying from Covid-19 are on their last legs anyway, so we should let them die. The Glasgow study determined the YLL for people who die of Covid-19 is greater than ten. That is, the average person who dies from Covid-19 lives ten years less than expected.

“This paper is compelling in that it aims to provide a better understanding of the mortality impact of COVID-19. Clearly, there has been a school of thought that individuals that succumbed to COVID-19 are already seriously ill with minimal years of life left to live. This quantitative assessment clears up that misconception showing that years of life lost is over a decade.”

Dr. John Brownstein, Chief Innovation Officer, Boston Children’s Hospital, ABC contributor

The bigger public health issue today is the plight of the underdeveloped world. The UN issued a devastating report about health prospects for poorer countries as a result of the emerging Covid-19 worldwide economic depression. It predicts major setbacks in everything from Malaria mitigation to domestic violence.

My anti-lockdown friends argue that, see, I told you so, these lockdowns are creating a lot more loss of life than if we’d kept the economy going. When I look at how scared people are to board an airplane or dine in a restaurant, I don’t think avoiding lockdowns would have prevented a worldwide depression. But who knows, really. The important thing is that here we are, and it’s bad economically.

In a way, Covid-19 is a preview of the impact of climate change on the underdeveloped world. If UN member countries can figure out responses to help underdeveloped countries through the Covid-19 depression, it may create a template for how the world deals with climate change.

I think I need to buy some jug wine.

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