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  1. An update on "excess deaths" and what that means with regard to COVID death counts. The bottom line is that there were far more deaths than usual in almost every state and, overall, in the US, from 3/15-7/25 and that only about 73% of the excess deaths were officially documented as COVID deaths. Specifically, 200,700 more people died than would have usually died during this period and that number is 54,000 more than the 146,700 than the CDC has tallied to that date (vs. 150K in Worldometers, as the CDC is typically behind in reporting). This does not mean that those 54,000 additional deaths were due to COVID, but it's certainly very likely that a substantial number were, since there are no other obvious reasons for the difference to be that great. The excerpt below discusses that nicely. These data also make it clear that the likelihood that we're overcounting COVID deaths is extremely low. The article shows week by week details for every state and has a summary table for all 50 states (the top 13 or so are below). https://www.nytimes.com/interactive/2020/05/05/us/coronavirus-death-toll-us.html π‘€π‘’π‘Žπ‘ π‘’π‘Ÿπ‘–π‘›π‘” 𝑒π‘₯𝑐𝑒𝑠𝑠 π‘‘π‘’π‘Žπ‘‘β„Žπ‘  π‘‘π‘œπ‘’π‘  π‘›π‘œπ‘‘ 𝑑𝑒𝑙𝑙 𝑒𝑠 π‘π‘Ÿπ‘’π‘π‘–π‘ π‘’π‘™π‘¦ β„Žπ‘œπ‘€ π‘’π‘Žπ‘β„Ž π‘π‘’π‘Ÿπ‘ π‘œπ‘› 𝑑𝑖𝑒𝑑. 𝐼𝑑 𝑖𝑠 π‘™π‘–π‘˜π‘’π‘™π‘¦ π‘‘β„Žπ‘Žπ‘‘ π‘šπ‘œπ‘ π‘‘ π‘œπ‘“ π‘‘β„Žπ‘’ 𝑒π‘₯𝑐𝑒𝑠𝑠 π‘‘π‘’π‘Žπ‘‘β„Žπ‘  𝑖𝑛 π‘‘β„Žπ‘–π‘  π‘π‘’π‘Ÿπ‘–π‘œπ‘‘ π‘Žπ‘Ÿπ‘’ π‘π‘’π‘π‘Žπ‘’π‘ π‘’ π‘œπ‘“ π‘‘β„Žπ‘’ π‘π‘œπ‘Ÿπ‘œπ‘›π‘Žπ‘£π‘–π‘Ÿπ‘’π‘  𝑖𝑑𝑠𝑒𝑙𝑓, 𝑔𝑖𝑣𝑒𝑛 π‘‘β„Žπ‘’ π‘‘π‘Žπ‘›π‘”π‘’π‘Ÿπ‘œπ‘’π‘ π‘›π‘’π‘ π‘  π‘œπ‘“ π‘‘β„Žπ‘’ π‘£π‘–π‘Ÿπ‘’π‘  π‘Žπ‘›π‘‘ π‘‘β„Žπ‘’ 𝑀𝑒𝑙𝑙-π‘‘π‘œπ‘π‘’π‘šπ‘’π‘›π‘‘π‘’π‘‘ π‘π‘Ÿπ‘œπ‘π‘™π‘’π‘šπ‘  π‘€π‘–π‘‘β„Ž 𝑑𝑒𝑠𝑑𝑖𝑛𝑔. 𝐡𝑒𝑑 𝑖𝑑 𝑖𝑠 π‘Žπ‘™π‘ π‘œ π‘π‘œπ‘ π‘ π‘–π‘π‘™π‘’ π‘‘β„Žπ‘Žπ‘‘ π‘‘π‘’π‘Žπ‘‘β„Žπ‘  π‘“π‘Ÿπ‘œπ‘š π‘œπ‘‘β„Žπ‘’π‘Ÿ π‘π‘Žπ‘’π‘ π‘’π‘  β„Žπ‘Žπ‘£π‘’ π‘Ÿπ‘–π‘ π‘’π‘› π‘‘π‘œπ‘œ, π‘Žπ‘  β„Žπ‘œπ‘ π‘π‘–π‘‘π‘Žπ‘™π‘  𝑖𝑛 π‘ π‘œπ‘šπ‘’ β„Žπ‘œπ‘‘ π‘ π‘π‘œπ‘‘π‘  β„Žπ‘Žπ‘£π‘’ π‘π‘’π‘π‘œπ‘šπ‘’ π‘œπ‘£π‘’π‘Ÿπ‘€β„Žπ‘’π‘™π‘šπ‘’π‘‘ π‘Žπ‘›π‘‘ π‘π‘’π‘œπ‘π‘™π‘’ β„Žπ‘Žπ‘£π‘’ 𝑏𝑒𝑒𝑛 π‘ π‘π‘Žπ‘Ÿπ‘’π‘‘ π‘‘π‘œ π‘ π‘’π‘’π‘˜ π‘π‘Žπ‘Ÿπ‘’ π‘“π‘œπ‘Ÿ π‘Žπ‘–π‘™π‘šπ‘’π‘›π‘‘π‘  π‘‘β„Žπ‘Žπ‘‘ π‘Žπ‘Ÿπ‘’ π‘‘π‘¦π‘π‘–π‘π‘Žπ‘™π‘™π‘¦ π‘ π‘’π‘Ÿπ‘£π‘–π‘£π‘Žπ‘π‘™π‘’. π‘†π‘œπ‘šπ‘’ π‘π‘Žπ‘’π‘ π‘’π‘  π‘œπ‘“ π‘‘π‘’π‘Žπ‘‘β„Ž π‘šπ‘Žπ‘¦ 𝑏𝑒 𝑑𝑒𝑐𝑙𝑖𝑛𝑖𝑛𝑔, π‘Žπ‘  π‘π‘’π‘œπ‘π‘™π‘’ π‘ π‘‘π‘Žπ‘¦ 𝑖𝑛𝑠𝑖𝑑𝑒 π‘šπ‘œπ‘Ÿπ‘’, π‘‘π‘Ÿπ‘–π‘£π‘’ 𝑙𝑒𝑠𝑠 π‘Žπ‘›π‘‘ π‘™π‘–π‘šπ‘–π‘‘ π‘‘β„Žπ‘’π‘–π‘Ÿ π‘π‘œπ‘›π‘‘π‘Žπ‘π‘‘ π‘€π‘–π‘‘β„Ž π‘œπ‘‘β„Žπ‘’π‘Ÿπ‘ .
  2. Excellent article today from the Washington Post, based on work from some leading epidemiologists. After graphically illustrating what herd immunity really means (the % of people who need to be infected in order to essentially stop new infections), they share the modeling work done by these Harvard/Yale scientists at their covidestim.org site, based on their paper from 6 weeks ago (3rd link). Their modeling essentially assumes little to no "native immunity" from T-cell cross reactivity, since we simply don't know enough about it and probably because several communities in NYC, London, and Italy have reached 40-60% infected, which makes it harder to believe there's some magic cap on infections at 20-40%. Obviously, if there were, say a 30-40% cap, we'd be closer to herd immunity and less would die, but with the US at ~9% infected, even getting to 30% infected will still mean an awful lot of very sick people and hundreds of thousands of more deaths. They then take the 60% midpoint of the range of herd immunity estimates of 40-80% (I've been seeing more like 55-80%, but these guys should know better) and through their model develop estimates for total infections (actual infected, not just positive cases) and from that they calculate cumulative infections or seroprevalence, which has also been measured by antibody testing populations, like has been done in NY/NYC and about a dozen other places in the US by the CDC. Interestingly, they have NJ with the highest rate, of 19.4% infected (no seroprevalence statewide testing in NJ), with NY at only 11.0% (vs. their seroprevalence testing, which showed 13.4% for NY, but 21.6% for NYC) and the US at 9.1%. They then go through the same calculations I've been sharing for months, which is simple math: 330MM in the US x 60% infected at herd immunity = 198MM infected x the infection fatality ratio to get the total number of US deaths possible. Most experts have been saying we'll have an IFR of 0.5-1.0% (CDC says 0,65%), which would then translate to roughly 1-2MM US deaths, eventually, although these numbers don't take into account recent improvements in procedures/treatments that should lower the IFR from here on out. They also assume no interventions to slow transmissions and certainly no cure/vaccine, since they're simply trying to provide the baseline, credible worst case scenario, which is pretty bad and why we need to be doing a lot more to prevent transmissions/deaths, at least until we have a cure/vaccine. As an aside, I'm praying for cross-reactivity to be real (and I'm an atheist, lol) and to equate to some cap on how many can become infected, which could lead to herd immunity levels being much lower than currently thought (55-80% range), but in the absence of compelling data to that effect, I think our focus should be on: a) reducing transmissions, cases, hospitalizations and deaths by masking/distancing with testing/tracing/isolating to prevent small flare-ups from becoming major outbreaks and b) continuing our extraordinary scientific efforts to find working treatments/cures and on developing and distributing vaccines (also vaccines should improve everyone's immunity, even those with cross-reactive T-cells). https://www.washingtonpost.com/graphics/2020/health/coronavirus-herd-immunity-simulation-vaccine/?tid=a_classic-iphone&p9w22b2p=b2p22p9w00098&no_nav=true&fbclid=IwAR3eLhlZlD7wwc6UheAdY30JWe_rmDn0FcsrD65gDA9Tgq_xFR3fLXFQrkg https://covidestim.org/ https://www.medrxiv.org/content/10.1101/2020.06.17.20133983v1
  3. Excellent article from a few days ago in the Times, discussing convalescent plasma in more detail. While the 57% mortality reduction calculated from pooling various smaller studies, above, is great, it's still not a single randomized controlled trial (RCT) showing that, so there will always be nagging doubts on its effectiveness until we have such data. This article at least dives in and explains some reasons why we don't have such data yet, with two key issues emerging: doctors/patients being unwilling to forego plasma vs. possibly getting a placebo (or standard care, which hasn't been that great) as part of a trial, plus outbreaks being greatly reduced in areas where some RCTs were underway. At this point, there are researchers now sending plasma to places like Brazil to try to complete their trials. In many ways the success of the expanded access program (over 80,000 now have been treated with CP and 1500 patients per day are now being treated across the US) has killed the ability to do these RCTs. In hindsight, it probably would've been better to simply start with an RCT to eliminate any doubts. Assuming the 57% mortality reductions are real, at 1500 patients per day, this would likely be part of the significant reduction in deaths per cases we're seeing in this 2nd wave. There are parallels to HCQ here, also, where it would've been better to do an RCT before giving the drug to hundreds of thousands of patients without any indication of efficacy. At least CP has a history of being safe and effective in previous viral diseases and has absolutely been shown to be safe in COVID patients. Given its past history and very promising data to date, though, it's clear that the medical community, including our top goverment medical leaders are very supportive of expanding CP use further, as per comments by Drs Birx and Hahn in the article. https://www.nytimes.com/2020/08/04/health/trump-plasma.html But the unexpected demand for plasma has inadvertently undercut the research that could prove that it works. The only way to get convincing evidence is with a clinical trial that compares outcomes for patients who are randomly assigned to get the treatment with those who are given a placebo. Many patients and their doctors β€” knowing they could get the treatment under the government program β€” have been unwilling to join clinical trials that might provide them with a placebo instead of the plasma. The trials have also been stymied by the waning of the virus outbreak in many cities, complicating researchers’ ability to recruit sick people. One of those clinical trials, at Columbia University, sputtered to a halt after the outbreak subsided in New York. One of its leaders, Dr. W. Ian Lipkin, looked for hospitals in other hot spots in the United States to continue the work. But he found few takers.
  4. The latest updated model from the U of Washington's IHME group and it's not good. Nearly 300K US deaths by 12/1/20 at our current rates with current interventions; 68K of the additional 135K deaths from where we are now with 160K deaths, could be saved by 95% mask wearing, according to the model (the reason that's not higher is that a huge number of infections are already underway without the infected knowing it). I don't know if they're taking into account the lower death rates per infection (half or less, due to age, severity, and better procedures/treatments) we're seeing vs the first wave. NY is projected to reach 34K deaths and NJ is projected to reach 16.5K deaths by 12/1, which are actually slightly below the projections from a week ago through 11/1, reflecting the strong interventions that have been adopted in this area. The graphics don't add any additional info so aren't included here. https://covid19.healthdata.org/united-states-of-america
  5. Posted the above in May, thinking we weren't that far away from having far more sensitive antigen testing that could possibly be done at home, which could, in theory, allow people to at least know on a daily basis if they are infected and this information could be captured on a smart phone and be one's "passport" for that day to attend all sorts of events or go to work and bars/restaurants. An instant test that was sensitive and reliable could also be used at the point of entry, although that would still slow entry down, but I'd arrive an hour early if I knew it could get me into a football game. Well, fast forward 3 months and progress has been agonizingly slow and according to this article in Science, it's at least partly because the government hasn't funded this effort anywhere near the extent we've funded R&D on treatments and vaccines (as per the excerpt below). Very disappointing. The other element highlighted in the article is the still ongoing lack of testing infrastructure in most states and lack of federal support, leading to test results often taking a week or more to come back to patients, which makes our testing much less useful as a tool for preventing spread, as most people aren't quarantining for that long waiting for results. We need to do better on both angles of testing. https://science.sciencemag.org/content/369/6504/608.full β€œAmerica faces an impending disaster,” says Rajiv Shah, president of the Rockefeller Foundation. Testing, he says, needs to focus on β€œmassively increasing availability of fast, inexpensive screening tests to identify asymptomatic Americans who carry the virus. Today, we are conducting too few of these types of tests.” Rebecca Smith, an epidemiologist at the University of Illinois, Urbana-Champaign (UIUC), agrees. To stop outbreaks from overwhelming communities, she says, β€œwe need fast, frequent testing,” which could mean faster versions of existing RNA tests or new kinds of tests aimed at detecting viral proteins. But researchers say the federal government will need to provide major financial backing for the push.
  6. More on Africa in the article linked below, which is superb - Africa is a real conundrum with this virus. Africa was expected to see possibly millions dying, with poor health care, crowded cities, and substandard water and sewage systems, but we've seen the exact opposite. Apart from South Africa, which has almost 150 deaths/1MM, every other country has <50 deaths/1MM and most have <20 deaths/1MM, vs. the US with about 500 deaths/1MM and much of South America and Europe having countries with 300-700 death/1MM.https://science.sciencemag.org/content/369/6504/624Africa, as a continent is comparable to the very low death rates seen in most of Asia, but in Asia, most of those countries have been given credit for better, more proactive interventions, like masking/distancing from early on, and strong testing/tracing/isolating systems (or at least some combination of those). While most of Africa has not been noted for doing as well with these interventions, one thing most African countries did do early was stop international travel (and they had far less to begin with than most first world countries), which probably bought them a lot more time and reports since then have been that masking has caught on since late April, plus many countries are used to testing/tracing/isolating from experience with Lhasa/Ebola (2nd link talks about masks, which, oddly weren't discussed in the Science article).There has also been much speculation about whether the death numbers are correct or if perhaps there's something genetic or environmentally different in Africa (far more exposure to pathogens leading to better immunity?). The Science article delves more deeply into those topics. Anyway, an interesting read and the graphic below is telling with regard to Asia/Africa vs. Europe and the Americas...https://theconversation.com/african...masks-mandatory-key-questions-answered-137516
  7. I don't think that's correct - Worldmeter and COVID Tracking list 1200-1250 for Thursday.
  8. Novavax published a preprint paper today with promising results on their early clinical trials with their recombinant protein vaccine for the coronavirus. Nice to see the first recombinant coronavirus protein approach, where the entire spike protein is essentially being injected as the antigen the body will respond to (producing antibodies and T-cells). This one also comes with an "adjuvant" which is often some sort of chemical that improves bioavailability or active transport of some "drug" making it perform better and in this case, the patients dosed with the protein and the adjuvant responded with far more production of antibodies vs. the protein, alone. My favorite clinical/R&D science source, Derek Lowe, seemed pretty upbeat with the Novavax results so far. I liked his last paragraph, below. Links to the blog and the actual paper are below. https://blogs.sciencemag.org/pipeline/archives/2020/08/06/vaccine-data-from-novavax https://www.medrxiv.org/content/10.1101/2020.08.05.20168435v1.full.pdf π‘‡β„Žπ‘’π‘ π‘’ π‘™π‘œπ‘œπ‘˜ π‘™π‘–π‘˜π‘’ π‘ π‘‘π‘Ÿπ‘œπ‘›π‘” π‘Ÿπ‘’π‘ π‘’π‘™π‘‘π‘ , π‘Žπ‘›π‘‘ πΌβ€™π‘š π‘”π‘™π‘Žπ‘‘ π‘‘β„Žπ‘Žπ‘‘ π‘‘β„Žπ‘–π‘  π‘π‘Žπ‘›π‘‘π‘–π‘‘π‘Žπ‘‘π‘’ 𝑖𝑠 𝑖𝑛 β„Žπ‘’π‘šπ‘Žπ‘› π‘’π‘“π‘“π‘–π‘π‘Žπ‘π‘¦ π‘‘π‘Ÿπ‘–π‘Žπ‘™π‘ . π‘‡β„Žπ‘Žπ‘‘β€™π‘  π‘ π‘œπ‘šπ‘’π‘‘β„Žπ‘–π‘›π‘” π‘‘π‘œ π‘’π‘šπ‘β„Žπ‘Žπ‘ π‘–π‘§π‘’ – π‘€π‘’β€™π‘Ÿπ‘’ π‘Žπ‘™π‘™ (π‘›π‘Žπ‘‘π‘’π‘Ÿπ‘Žπ‘™π‘™π‘¦ π‘’π‘›π‘œπ‘’π‘”β„Ž) π‘‘π‘Ÿπ‘¦π‘–π‘›π‘” π‘‘π‘œ π‘šπ‘Žπ‘˜π‘’ π‘€β„Žπ‘Žπ‘‘ π‘π‘Žπ‘™π‘™π‘  𝑀𝑒 π‘π‘Žπ‘› π‘π‘Žπ‘ π‘’π‘‘ π‘œπ‘› π‘‘β„Žπ‘’ π‘ƒβ„Žπ‘Žπ‘ π‘’ 𝐼 π‘–π‘šπ‘šπ‘’π‘›π‘œπ‘”π‘’π‘›π‘–π‘π‘–π‘‘π‘¦ π‘‘π‘Žπ‘‘π‘Ž π‘Žπ‘›π‘‘ π‘‘β„Žπ‘’ π‘›π‘œπ‘›-β„Žπ‘’π‘šπ‘Žπ‘›-π‘π‘Ÿπ‘–π‘šπ‘Žπ‘‘π‘’ π‘β„Žπ‘Žπ‘™π‘™π‘’π‘›π‘”π‘’ 𝑒π‘₯π‘π‘’π‘Ÿπ‘–π‘šπ‘’π‘›π‘‘π‘ . 𝐡𝑒𝑑 π‘€β„Žπ‘Žπ‘‘ π‘šπ‘Žπ‘‘π‘‘π‘’π‘Ÿπ‘  𝑖𝑠 π‘Ÿπ‘’π‘Žπ‘™ β„Žπ‘’π‘šπ‘Žπ‘› π‘‘π‘Žπ‘‘π‘Ž π‘“π‘Ÿπ‘œπ‘š π‘œπ‘’π‘‘ 𝑖𝑛 π‘‘β„Žπ‘’ 𝑓𝑖𝑒𝑙𝑑 π‘£π‘–π‘Ž π‘‘β„Žπ‘’ π‘ƒβ„Žπ‘Žπ‘ π‘’ 𝐼𝐼/𝐼𝐼𝐼 π‘π‘™π‘–π‘›π‘–π‘π‘Žπ‘™ π‘‘π‘Ÿπ‘–π‘Žπ‘™π‘ . π‘…π‘–π‘”β„Žπ‘‘ π‘›π‘œπ‘€, 𝑀𝑒 β„Žπ‘Žπ‘£π‘’ π‘ π‘’π‘£π‘’π‘Ÿπ‘Žπ‘™ π‘£π‘Žπ‘π‘π‘–π‘›π‘’π‘  π‘‘β„Žπ‘Žπ‘‘ π‘™π‘œπ‘œπ‘˜ π‘™π‘–π‘˜π‘’ π‘‘β„Žπ‘’π‘¦ 𝑀𝑖𝑙𝑙 β„Žπ‘Žπ‘£π‘’ π‘”π‘œπ‘œπ‘‘ π‘β„Žπ‘Žπ‘›π‘π‘’π‘  π‘œπ‘“ π‘€π‘œπ‘Ÿπ‘˜π‘–π‘›π‘” (π‘‘β„Žπ‘–π‘  π‘œπ‘›π‘’ π‘£π‘’π‘Ÿπ‘¦ π‘šπ‘’π‘β„Ž π‘Žπ‘šπ‘œπ‘›π‘” π‘‘β„Žπ‘’π‘š). 𝐴𝑛𝑑 π‘€π‘’β€™π‘Ÿπ‘’ π‘”π‘œπ‘–π‘›π‘” π‘‘π‘œ π‘ π‘œπ‘Ÿπ‘‘ π‘‘β„Žπ‘’π‘š π‘œπ‘’π‘‘ π‘‘β„Žπ‘’ π‘œπ‘›π‘™π‘¦ π‘€π‘Žπ‘¦ π‘‘β„Žπ‘Žπ‘‘ π‘‘β„Žπ‘’π‘¦ π‘π‘Žπ‘› 𝑏𝑒 π‘ π‘œπ‘Ÿπ‘‘π‘’π‘‘.
  9. Even more convincing data just out from a South Korean study that infected people who are and remain asymptomatic, never getting symptoms, carry fairly high levels of the virus and are very likely key sources of infection for others - even though they might not be coughing or sneezing, that is quite possibly balanced out by then not sitting at home not feeling well, like many/most symptomatic patients infected with the virus. The study also found that about 30% of all those infected are true asymptomatics - as opposed to people who are pre-symptomatic, but later go on to have symptoms. A Times article and the paper are linked below. Obviously, this reinforces the heart of the argument for masks/distancing, since we simply don't know who might be infected and contagious (and masks will reduce viral particles/droplets from their breath reaching others); it's also why contact tracing and isolating those who have been in contact with those known to be infected are so important, as this can prevent asymptomatic, but contagious people from mingling in society, causing flare-ups to become outbreaks. It's also why waiting more than a day for test results is just unacceptable, since so many will likely not self-isolate for days to a week or more without a positive test. https://www.nytimes.com/2020/08/06/health/coronavirus-asymptomatic-transmission.html https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2769235
  10. I didn't take anything "at face value" and was arguing on AmericanWx (page 54) and elsewhere (didn't post on that here) that I thought the few folks implying the Euro/HRRR could verify were wrong and that we'd likely see mostly 60-70 mph gusts (with a few in the 70s) as per the official NWS/NHC forecasts and that verified. The Euro map was also posted here on page 31 and there was some discussion of it and even Jeff Berardelli posted the HRRR//Euro wind gust maps on Twitter, saying he thought 80+ mph gusts were possible. My original point, which maybe I didn't make that well, was that there were some on social media talking about how we were possibly going to get 90-100 mph gusts (not really here, though).
  11. Am a day late, due to our power outage and don't have time for the full analysis of past weeks either, so just going with a summary... Note: I'm using 7-day moving averages on a per capita (per 1MM) basis for these discussions of cases, hospitalizations and deaths, from the Covidtracking site. National Stats: cases peaked and plateaued for about 3 weeks at roughly ~2X the first wave, but are clearly now on the decline, while hospitalizations have also started to decline, after peaking at slightly more than the peak in the first wave, but this turns out to be only a little more than half of what they were in the first wave (relative to cases, which were 2X, as much per capita). Deaths are up over 2X from their early July low and look like they might be starting to peak at about half of the April peak (1100-1150/day now vs. 2250/day in April). So, relatively speaking, a bit of better news, although our current peak death rates are still worse than all but a handful of countries with over 50MM in population (Brazil, Mexico, Colombia and South Africa), per capita. Cases in AZ/FL/TX/CA: For the 4 states I've been looking at, closely (Florida, Texas, California, as all three spiked and are the 3 largest states, plus Arizona, as it peaked earlier and has a similar population as NJ, the comparator) cases are continuing to decline in AZ and in FL/TX/CA, cases appeared to be just starting to decline last week, but are definitely declining now. The AZ peak was about 30% more, per capita (per 1MM people) than the NJ peak (about 3500/day or 400/1MM), while the FL peak was ~50% more, the TX peak was ~10% less and the CA peak was ~40% less. Hospitalizations in AZ/FL/TX/CA: AZ's hospitalizations peaked (and are declining) at ~55% of NJ's (which were 8000 total or 900 per 1MM), while FL peaked at about 50% of NJ's per capita rate (and is declining) and TX peaked at ~45% of NJ's rate and is now declining. CA peaked last week at 25% of NJ's peak and have started to decline. As per previous reports, these reductions vs. NJ are likely due to the much younger age of those infected in this wave, combined with far more aggressive testing than during our peak (we had positivity rates of 40-50% due to lack of tests), which is discovering more mild/asymptomatic cases. Deaths in AZ/FL/TX/CA: My guesstimate has been that deaths in AZ/FL/TX would likely be about 1/3-2/3 of the peaks of NJ (about 270-300/day or ~31/1MM), partly due to the younger age and milder cases of those infected (as above) and partly due to improved treatments and procedures. AZ peaked at ~40% of NJ's peak and despite having major fluctuations, they're death rates finally appear to have levelled off and may be starting to decline. FL is now at about 30% of NJ's peak and it's possible they're approaching their peak, while TX looks like it may have peaked at 30% of NJ's peak, but their death data have been all over the map, so let's wait another week before declaring they've peaked. CA's case/hospitalization rates have been well below the other 3 states and is why CA is only at 12% of NJ's peak and will likely max out at <15% of NJ's peak, as I've been predicting based on lower case rates per capita vs. the other 3 states. It's quite possible that deaths have been on the low side of my guesstimates given the recent data showing convalescent plasma likely has over a 50% mortality reduction and it's being used heavily in seriously ill patients.
  12. We had full leaves in CNJ for Sandy, also. The wind impacts were significant for Isaias, but nowhere near the devastation seen for Sandy. I couldn't go more than a block without seeing a tree down for Sandy (and it took me 2 hours just to find a path to Route 1, which is 1/2 mile from my house!) early in the morning after Sandy, as I had to get into work.
  13. You're missing my point on the winds. A few were saying 80+ inland and up to 100 mph based on the Euro and HRRR the night before - that did not verify. I thought the NHC/NWS forecasts and what most of the folks here and elsewhere were predicting was well done. The track forecast, overall, was pretty good, but was not that great, however, near the end, so the rain shield (the general amounts were spot on, just not the locations) was displaced 25-30 miles NW, which is a fairly significant error 12 hours out.
  14. Didn't have time to dive into this yesterday, and for those who don't know, we lost power yesterday afternoon until this evening, so I've been off the grid (which wasn't all bad, lol), but Regeneron's antibody cocktail showed some strong results in both prevention and treatment for both macaques and hamsters (hamsters are used, too, since macaques don't get nearly as ill from COVID, so hamsters provide good insight into treatment effects). If we see results like these in humans, we're looking at, by far, the most effective treatment to date (a "near cure"), as well as a potentially effective prophylactic for most people. The paper is linked below and the abstract is very nicely done - concise, but gets the key points across. Phase III clinical trials are ongoing and approval could come as early as the end of August. Really need this to work - this has been my pick, since March, to be the best treatment, mostly based on their Ebola success - having done it before counts (being a potential prophylactic would be a bonus).https://www.biorxiv.org/content/10.1101/2020.08.02.233320v1.full.pdfAbstract: An urgent global quest for effective therapies to prevent and treat COVID-19 disease is ongoing. We previously described REGN-COV2, a cocktail of two potent neutralizing antibodies (REGN10987+REGN10933) targeting non-overlapping epitopes on the SARS-CoV-2 spike protein. In this report, we evaluate the in vivo efficacy of this antibody cocktail in both rhesus macaques and golden hamsters and demonstrate that REGN-COV-2 can greatly reduce virus load in lower and upper airway and decrease virus induced pathological sequalae when administered prophylactically or therapeutically. Our results provide evidence of the therapeutic potential of this antibody cocktail.However, we just don't know how long something like this might work as a prophylactic, however (probably for at least a few months - not as long as a vaccine, though, based on the Ebola experience, where a similar cocktail was used successfully for treatment, but the Merck vaccine was used for prevention) The other issue is that the large cell culture bioreactors that make these antibodies will only likely be able to make enough for treating moderately ill to worse patients and for prevention in a subset of the population (likely health care workers and those in other high risk occupations and highly vulnerable populations) - at least through the end of the year. The link below is to Derek Lowe's blog on this, which was excellent, as it nicely explains the details of the treatment and prevention studies in both animal species as well as what it all means; the comments also contain some good intel on the manufacturing challenges.https://blogs.sciencemag.org/pipeli...rons-monoclonal-antibody-cocktail-in-primatesFor those who don't recall, the cocktail features two monoclonal antibodies developed to target different parts of the all-important spike protein, which is the key for how the virus connects to and infects cells. The idea was to have dual activity in case some mutation occurred within patients, that could help the virus "get around" just a single antibody, as multiple viral mutations to elude both antibodies was deemed extremely unlikely; see the link below for a discussion of the cocktail approach and all the R&D that went into it (and links to the primary papers on it).It'a also worth reminding people of the difference between the antibody cocktail approach and a vaccine. A vaccine is supposed to elicit a full immune response to the antigen (RNA/DNA/attenuated virus, etc.), producing a suite of antibodies and T-cells to detect and disable/destroy the virus, while the antibody approach simply is giving examples of antibodies shown to work against the virus, but it's likely not as complete of an "attack" on the virus, since the immune system isn't activated at all (as per the Ebola example). This is a different virus, though, so maybe this can work as well as a vaccine for prevention.
  15. Wow, that's bad - we've had about a dozen people come to the house for various things (repairs, intalls, contractors, etc.) and every single one has worn a mask and anyone who did actual work also disinfected their work area before leaving and the pay was all contactless (we just stayed out of the way and were available for distanced questions with our masks on.
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