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Wednesday, May 20, 2020

We know many things about Sars-CoV-2 , but the 'science’ is incomplete and there are no experts yet.

Every new disease
 is different.

There's a slow 
learning curve.


Is COVID-19 transmitted 
mainly by breath, or
mainly by touching ? 

We're not sure.



Why do so few 
children get 
infected, and 
why do those 
infected 
children 
often have 
no symptoms ?

We don't know.



Are ventilators 
helping or hurting ?

We're not sure.



Will there be 
a second wave? 

There have 
already been 
some small
second waves.



Countries that
did a lot of testing 
from the start 
fared much better 
than countries 
that did little 
testing. 

Consider Groningen, 
in northern Holland:
  The 2020 
overall death rate 
as of early May, 
from all causes, 
was up only 4% 
from the prior year.

For North Brabant, 
in southern Holland:
The overall 
death rate 
doubled. 

The difference 
may be due 
to testing:

Groningen 
refused to adopt 
the national policy
of testing ONLY 
severe and 
priority cases. 

They tested 
as many people 
as possible. 



Britain did not ramp up 
testing until mid-March , and
then limited testing to those 
already in the hospital with 
COVID-19 symptoms.

Of course testing 
does not cure 
the disease, but can
inform people they
are, or were, infected,
when they did not 
know.



For early cases, 
the disease was 
probably spread 
in hospitals 
and doctors’ 
offices, where
there were 
any elderly, 
sick people.

The elderly
were more likely 
to be going 
to hospitals 
or clinics for 
other ailments,
at least until 
mid-March.


Chinese authorities 
quarantined those 
who tested positive 
in special facilities, 
keeping them away 
from the hospitals.


In Belgium, 
all 210,000 people
in care homes, 
both residents 
and staff, 
were tested in 
the second half 
of April -- about 10%
tested positive 
for COVID-19.


The per capita 
hospital admission
numbers for 
different countries
in Europe all show
a dampening of the 
growth that you 
would expect from 
the lockdowns.



A study of 391 cases 
of COVID-19, and 1,286 
of their contacts, 
in the Shenzhen region 
of China, found that 
80% of cases were 
transmitted by just 9%
of carriers, and that 
only 11% of those 
sharing a household 
with a case, 
caught the virus. 



For the infamous 
nursing home 
in Washington state, 
23 days after 
the first case 
was diagnosed, on 
January, 20, 2020, 
64% of residents
tested positive, 
half showing 
no symptoms. 



It seems obvious 
that prolonged 
and close contact 
with an infected
person transmits 
the virus.

And  the risk 
is highest 
in enclosed 
environments,
such as households, 
long-term care facilities 
and public transport.

That's true of flu, 
in general.



Ordinary flu strains hit 
young people hard.

But not COVID-19.

And children do not seem 
to transmit the virus much,
if at all, according to 
pediatricians.

Children seem to have 
ACE2 receptors,
the cellular lock that 
the coronavirus picks, 
in their noses, 
but not their lungs.



Vitamin D protects 
against colds and flu.

At the end of winter, 
Vitamin D levels
are often deficient 
in obese, dark-skinned 
and elderly people, 
groups that have been 
more susceptible 
to COVID-19. 


17 years after the severe 
acute respiratory syndrome 
( SARS-1) outbreak, 
and 7 years since the first 
Middle East respiratory 
syndrome ( MERS ) case, 
there is still no vaccine
for either of those
coronavirus family
viruses !



How people react 
to an easing of the 
economic lockdown 
is another mystery.

I expect to see
a lot of caution
from people 
over 40 years
old.

After two months 
of lockdown,
as of mid-May, 
the U.S. probably 
reached the point 
where continuing 
to hold back 
the economy 
is becoming
worse than 
the disease.