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A Tale of Two Chinas and COVID-19

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SARS-CoV-2 is still ravaging the world 2.4 years after it first appeared in China.   For the first 2 years, many countries were vigilant in the defense of their people against the spread of COVID-19 but since early this year many countries have given up the fight assuming that with the wide availability of effective vaccines Omicron is mild enough to live with and too contagious to resist.   Taiwan and mainland China were both hit with the latest Omega subvariant BA.2 in March.  While China has continued with its zero-COVID policies, Taiwan gave up on its zero-COVID policy 4 weeks ago along with most other countries.  The results show how rapidly and explosively the virus can spread with few mitigations in place. Cases are growing exponentially in Taiwan with 17k new cases reported yesterday while China reported 7.4k.  If China had dropped its zero-COVID policy a month ago, it could have reported 1M new cases yesterday (scaling u
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Governments Asking the Vulnerable to Fend for Themselves Against SARS-CoV-2

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It seems many governments are determined to expose as many of their citizens to the Omicron variant as possible on the assumption that Omicron is mild.   As states and countries rush to drop #COVID19 mitigation measures such as masking and social distancing against CDC and WHO guidance, it is more important than ever for the elderly and the immunocompromised to learn how to fend for themselves (in consultation with their doctors).   1.      Vaccines and boosters are still the #1 method to protect against #COVID19 but a second booster may be recommended as the first booster wanes after 4 months.  Not enough elderly in the USA are vaccinated .   2.      For the 10M Americans who are immunocompromised or at high risk, it could be helpful to get Evusheld monoclonal antibody treatment pre-infection as a prophylactic.  Prescription necessary.  3.      Test using at-home rapid antigen test kits , and rapid PCR test facilities at the first sign of symptoms or suspicion of exposure 4.
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Living with Covid-19 is Living Dangerously

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Living with COVID-19 has become the catchphrase of the Pandemic recently even though the WHO warns that it is too early to relax our vigilance.   Pandemic weariness has taken hold and many people just want to resume “normal” life.   Moreover, some countries that have experienced the more contagious but milder Omicron variant and survived its strain on their hospital systems have encouraged others to think that they might also be able to manage the crisis just as well.   What are reasonable benchmarks to use to mark the transition of a pandemic to endemic phase that society can live with?  One benchmark is seasonal flu which can kill 20k-30k Americans, and 300k-600k globally each year.  Countries have built enough hospitals and have enough healthcare resources to handle such outbreaks each year without shutting down their economies.  In the US 30M Americans develop symptoms of seasonal flu each year and 30k die so a case fatality rate (CFR = deaths/cases = 0.1%) seems to be acceptab
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COVID-19 Death Reporting – Global Implications

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Ever since Florida switched its COVID-19 death reporting from as-reported date every day to as-of-actual date reporting aperiodically, death reporting has continued to confuse reporters, scientists, and database managers.   Now other states are reporting a mix of these methods so it is very difficult to get an accurate measure of total deaths in the US.   Furthermore, other countries have had similar issues with death reporting including not reporting or underreporting deaths totally compared to alternative methods which rely on excess deaths  - current year compared to previous years’ averages. We discuss 4 different ways that COVID-19 deaths can be tracked for Florida.  1.      Health and Human Services (HHS) ask hospitals around the country to report deaths every day (red curve).  It is the most accurate and timely way to track deaths but it does not count all deaths since many occur outside the hospital system.  2.      Florida’s Department of Health (FL-DOH) reports deaths t
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Omicron Rising Everywhere Including Florida

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The Omicron variant of SARS-Cov-2 is highly transmissible with a doubling time of near 2 days.   It has now spread into over 100 countries globally and is spreading rapidly throughout all 50 states in the US. 1M Floridians and 10M Americans could be infected before the end of January.   Luckily Omicron appears to be less virulent than the Delta variant, but more importantly, it is arriving at a time when the developed world is well vaccinated.  This means that the majority of cases will affect 3 different groups: 1.      unvaccinated who are mostly young and who are less susceptible to hospitalizations and deaths (as in South Africa)   2.      vaccinated folks who while susceptible to infections are still well protected against serious illness by 2 doses and sometimes 3 doses (as in Denmark).  Breakthrough probability is much higher with the Omicron than the Delta 3.      reinfections of middle-aged adults who have survived
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