12 June 2020 – Friday – #89

The EU is pushing Spain to open its borders in three days, but Spain still plans on opening the first of July. The preparations are underway to screen arrivals to Spain for Covid-19. Passengers will submit to a temperature check, which is not a reliable screen for Covid-19, and provide written details on their health and contact information. Seven months into the pandemic and we still don’t know understand how to screen for Covid-19.

Fernando Carreras, deputy director of Sanidad Exterior, the ministry department in charge of the screening, said that his team is incorporating automated processes such as computerized health declarations and thermal imaging cameras, which can check the body temperature of several people simultaneously, an improvement from doing it one at a time with a thermometer pointed at a person’s forehead.

El País, “Thermal imaging and e-forms: How Spain will screen for Covid-19 when the travel ban is lifted,” 12 June 2020.

To its credit, Spain has detected 108 Covid-19 cases entering the country during its lockdown, mostly residents returning from the Americas, but scaling its Covid-19 detection effort for thousands of daily travelers introduces tremendous risk. This is when I pray for government to be competent.

Things in the US look worse as Covid-19 heats up. The hardest hit states in the past week are Arizona, North Carolina, Texas, Alabama, and Arkansas. Except for North Carolina’s governor, these are Republican controlled states that have pushed to reopen quickly.

After correcting a data error, Alabama reached a record 629 hospitalizations of confirmed Covid-19 cases. In Arizona, the state issued a warning to hospitals to gear up for more Covid-19 cases as its public health director said business would go on as usual.

Arizona public health official says “… we can’t stop living” as Covid-19 outbreak brings more death.

US Treasury Secretary Mnuchin also said business must take priority over Covid-19.

“We can’t shut down the economy again. I think we’ve learned that if you shut down the economy, you’re going to create more damage.”

Treasury Secretary Mnuchin appearing on Squawk on the Street with Jim Cramer.

Wall Street wasn’t impressed. The Dow Jones Industrial Index dropped over 1,800 points.

The Covid-19 response in Republican controlled states shuns lockdowns, much as Sweden, Ecuador, and Brazil have done. At this point, the results are predictable. Higher Covid-19 mortality and about the same economic outcome as locking down.

Here’s a chart with three countries that have made contact tracing work (South Korea, Vietnam, Ghana), one country which locked down early and put in place effective testing after it was too late for contact tracing (Germany), and four countries with conservative governments that were late to lockdown and poor on testing (US, UK, Brazil, India).

Covid-19 per capita mortality for Brazil, Germany, Ghana, India, South Korea, UK, and US, 11 June 2020.

I realize this is not scientific, but I think it’s indicative of how much leadership style affects Covid-19 outcomes. There’s no question that getting contact tracing is the most effective Covid-19 response in terms of mortality rates and economy. Short of contact tracing, Germany shows that early lockdown and good testing flatten the mortality curve effectively. US, UK, and Brazil demonstrate that waiting to lockdown increases the mortality without improving the economy. India isn’t registering yet, but unfortunately I expect it will soon.

With this much data, the assumption that people will go on with life during a pandemic as though nothing is happening and that the economy will work itself out seems delusional to me. That’s especially true from here in Spain where things are coming cautiously back to normal.

But, you know, what can I say? Delusion is so much easier. Welcome to Las Vegas!

Also, please note, you are responsible for the outcome of your delusion. Not Las Vegas. Not the Republican Party. Certainly not Trump. To attend Trump’s Tulsa rally next week, you must “voluntarily assume all risks related to exposure to COVID-19.” Unfortunately, all the risks include spreading Covid-19 to others in your community. Good luck, Tulsa!

Some quick science updates.

Vitamin D. I have friends recommending it for Covid-19. I’ve taken supplements for years because I have a deficiency. There is no clear evidence Vitamin D protects against Covid-19.

“People with lower vitamin D have a higher risk of COVID infection, but it looks like this is explained by other risk factors and not by the vitamin D itself. Our findings do not support a link between vitamin D concentration and the risk of COVID-19 infection.”

Dr. Claire Hastie, University of Glasgow, public health research associate

Covid-19 Vaccine. Derek Lowe has his usual great summary of Covid-19 vaccine development here. The good news is lots of human trials soon. For some reason, “it doesn’t seem like the NIH/NIAID coordinated trials will be sharing control groups,” something that could speed the testing process. Nevertheless, there is a huge P.R. opportunity for the company that comes up with a Covid-19 vaccine first, so lots of investment.

Sand. Who knew that there is a worldwide shortage of sand? Who knew a sand shortage would slow Covid-19 vaccination?

Medical vials are traditionally made with borosilicate glass, which is highly resistant to extreme temperatures changes and more chemically durable than commercial glass. It has been shown to preserve vaccine potency and pH stability. That’s important in making sure that a vaccine does what it’s supposed to.

CNN Business, “Finding a coronavirus vaccine is hard. Getting it to people is a whole other problem,” 11 June 2020.

There aren’t enough sand mines in the US to produce the vials needed for vaccine. The search is on for alternatives.

Baldness. This is my 89th diary entry and I’d never heard of a relationship between baldness and Covid-19 until now. But there is! And it may lead to new therapies for Covid-19.

Until recently, scientists have been at a loss at why this might be, pointing to factors such as lifestyle, smoking, and immune system differences between the sexes. But increasingly they believe it could be because androgens – male sex hormones like testosterone – may play a part not only in hair loss, but also in boosting the ability of coronavirus to attack cells.

The Telegraph, “Bald men at higher risk of severe case of Covid-19, research finds,” 4 June 2020.

One of the new therapies? Maybe an election will take care of this Covid-19 superspreader, but you never know.

Trump’s bald spot.
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