24 January 2021 – Sunday – #131

Most of the Covid-19 news is in the US this week, but Covid-19 also has its share of news in Spain, Catalonia, and Barcelona. The door on the corner Catalan restaurant Can Saia has been closed all week with a handwritten sign that reads “Closed until further notice, sorry for the inconvenience.”

Can Saia closed until further notice.

I’m hopeful, of course, that Can Saia’s closure is temporary. Eduard, the chef there, likes to serve fresh food and I assume it’s just not worth his time to shop and cook until he can open for a full lunch and full dinner. Plus he drives an hour each way to and from his restaurant. Under current restrictions, he’d be spending more time in his car than serving food.

In other Barcelona news, my friend M. came in contact with someone who tested positive for Covid-19, so M. is in isolation for ten days. Our chats about Covid-19 testing protocol reminded me that if you’re exposed to Covid-19, wait 5-7 days to get a test. The El País article from last month on Covid-19 transmission offers good graphics on why it’s best to wait a few days for a test and why a cheaper and faster antigen test is more useful than a more accurate and expensive PCR test.

Duration of positive Covid-19 tests for PCR, antigen, and antibody tests. Source: Nature.

I think M. will be okay. He’s young, healthy, and the rest of his immediate family has cleared Covid-19 unscathed. Still, there’s a bit of HIV / AIDS PTSD for me, remembering young, healthy friends who vanished so quickly during the 1980s and 1990s.

The good news in Catalonia is that the Christmas and New Year’s wave of Covid-19 seems to have peaked about 10 days after Three Kings Day. Catalan public health imposed more Covid-19 restrictions the day after, on 7 January 2021. The latest restrictions look like they are paying off, although hospitalization and infection rates are dangerously high at the moment.

Covid-19 Outbreak Risk (blue) and Reproduction rate R (yellow) through 22 January 2021. Source: Catalan News.

The race in Catalonia and Spain is between the spread of the new, more virulent strains of Covid-19 and the ramp up of vaccinations. Three Spanish regions, Madrid, Basque Country, and Valencia, have imposed additional Covid-19 restrictions as their infection rates skyrocket. Seems likely that the skyrocketing rates are due, in part, to the new B.1.1.7 variant from the UK which is 30% more deadly and 70% more transmissible than previous Covid-19 strains.

The new strain wouldn’t be so scary if Catalonia were vaccinating people faster. Last week the region vaccinated fewer people than the week before. It’s hard to know whether that’s because of supply issues (Pfizer says it temporarily reduced supply to supplement long-term production capacity) or local administration issues. At a great almuerzo yesterday, my friend Joanmi said the former was to blame. It makes more sense that something happened to reduce the supply than to reduce administration capacity.

The big, big, big news last week was in the US. After the failure of Trump’s insurrection at Congress that left five dead (coincidentally on Three Kings Day), he left the White House of his own volition, allowing President-elect Biden to become President Biden without further incident last Wednesday.

This chart sets the stage for President Biden’s Covid-19 challenge. It should be no surprise that Trump’s promise that there would be plenty of Covid-19 vaccine by the end of February was another of his false promises.

US Covid-19 case timeline leading up to Biden inauguration. Source: Financial Times.

Hours after his inauguration, Biden signed several executive orders that reversed Trump policies. With respect to Covid-19, Biden mandated masks in all federal buildings and created the position of Covid-19 response coordinator, a position that will report directly to the president. The administration is sending Dr. Fauci to attend WHO meetings next week and proposing economic measures to protect people from evictions, place a moratorium on student loans, and provide US$1.2T in stimulus funds. That was day one.

On the day after the inauguration, Biden signed even more Covid-19 executive orders. These orders establish Covid-19 related transportation rules, provide FEMA support to states, and start a process of building vaccination centers around the US. As I read details about Biden’s executive orders, I wondered why Trump hadn’t signed similar orders. After all, if there’s one thing everyone knows about Trump, it’s that he loved signing executive orders in front of an audience.

Well, turns out that Biden administration officials have found that Trump didn’t seem to think much about Covid-19. He left behind very few Covid-19 plans and a vaccine distribution system that’s “worse than we imagined.” The Tiberius vaccine tracking system operated from the Pentagon lacks the information to manage supply and demand. As a result, the Trump’s HHS recommended broadening vaccine eligibility to increase demand in January. States followed the recommendation, but now there’s not enough vaccine to meet demand in many locations.

“There is nothing for us to rework. We are going to have to build everything from scratch.”

Biden administration source on Trump’s Covid-19 vaccine distribution plan. Source: CNN.

The reason the Trump administration wasn’t willing to share Covid-19 information with the incoming Biden administration has become clear: there was nothing to share.

Dr. Fauci’s interview with Rachel Maddow last week covers a lot of important Covid-19 topics. It’s like the White House Covid-19 information dam broke. Here Fauci describes to Maddow how different the Trump administration was from the other five he’d worked for previously.

Dr. Fauci describes to Rachel Maddow how Trump distorted and discounted science.

I commend the entire interview, especially the segments on additional Covid-19 vaccines in the pipeline and therapeutics in development to treat the disease.

I don’t want to imply that scientists got everything right. Recent reporting on the CDC finds plenty of problems in its Covid-19 response, especially with respect to testing. Unfortunately, because of Trump’s political interference, which started well before the pandemic, it will be difficult to parse what parts of the US Covid-19 failures were due to institutional issues at CDC, FDA, and HHS, and what parts due to Trump’s interference.

Trump has left states with no good way to plan for vaccinations because the Federal government can’t predict supply and track demand. California public health officials, for instance, say it will take until June to vaccinate Californians over 65. The state can only count on receiving 400,000 to 500,000 doses per week because that’s what it’s been receiving, but even that’s not certain.

Trump’s Covid-19 legacy also includes dissuading people from taking Covid-19 vaccines or, if not dissuading, than at best not promoting vaccines as an important way to contain the Covid-19 in the US.

Likelihood to take Covid-19 vaccination by US county. Source: MIT Technology Review.

Eyeballing the distribution of people in the US who say they’ll get a Covid-19 vaccine, it looks like a pretty good overlap with people who voted for Biden rather than Trump.

Compared to the rest of the world, Spain and the US are doing better than most countries in Covid-19 vaccinations, as this Bloomberg world vaccination map shows.

Covid-19 vaccinations to date by country. Source: Bloomberg.

The problem is that doing better than most countries right now translates into somewhere between two or four more years of vaccinations to achieve herd immunity.

As of last night, 63 million people have been vaccinated worldwide. Very roughly, the world is about 1% of the way to herd immunity after a month. At the current rate, it will take eight years for herd immunity. In other words, the world needs to deliver Covid-19 vaccines about 10x faster for herd immunity next year.

While I’m on the world stage, a couple of shining stars in Covid-19 management have slipped up lately. Japan’s Prime Minister Yoshihide Suga decided to promote domestic tourism last fall. Travel related Covid-19 cases appear to have jumped three times, so the travel discounts were discontinued last month.

China is having its worst Covid-19 outbreak since March. New cases are running in the low hundreds per day. By comparison, the new US cases of Covid-19 are running about 2,000 times higher even though the US has about 1/4 the population of China. In front of New Year celebrations, China is stepping up Covid-19 testing in an attempt to bring new cases back down to zero.

Still, since May, the worst days for Covid-19 in Japan and China are better than the best days in Spain and the US. Leadership and government have made a difference in Covid-19 responses.

Covid bits.

Now that Biden has reintroduced expertise to the White House, it’s worth noting one of the many moving performances during his inauguration. Here’s a great musicological examination of Lady Gaga’s performance of The Star Spangled Banner.

The metaphor is clear. Expertise matters for great performance, even in a piece of music as mundane as a national anthem, and Biden wants the White House to deliver the way Lady Gaga delivered.

Here’s another expert performance that’s gone into distribution from the White House website.

The White House Twitter account has useful information again.

Thanks for reading. I write this to create a record of living during the Covid-19 pandemic. If you like it, please pass it on to family and friends. For more frequent Covid-19 updates, check my Twitter feed.

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