COVID19 update, July 6, 2020: mortality lower than generally perceived; easier to synthetize alternative to remdesivir? Tightened restrictions in Israel

(1) “Masgramondou” sent me the following:

https://www.wfae.org/post/wake-forest-covid-study-death-rate-severity-symptoms-lower-first-thought

A study by Wake Forest Baptist Health has found that between 12-14% of people tested in North Carolina have antibodies for the coronavirus — meaning they have been exposed to the virus — with most of them showing little or no symptoms. 

The majority of the study participants are in the Triad area. 

The findings suggest that COVID-19 is less deadly than originally thought and that the death rate for the disease could be in the range of 0.1%.

But the study also shows that there is significant community spread and that efforts so far to curtail COVID-19 are faltering. 

“It’s a double-edged sword,” said John Sanders, the chief of infectious diseases at Wake Forest Baptist. “We are clearly seeing a rapid increase in the number of people that we have antibody evidence who have been infected.”

But he said “the vast majority of these people have very few or no symptoms.”

“We can look at it and say the death rate is lower than we have estimated,” Sanders said. “The severity of symptoms is lower than we estimated and the vast majority of people who were infected are going to do fine.”

[…]

There are about 10.5 million people in North Carolina. If 14% of the population has been infected with the coronavirus, that would translate into about 1.47 million people.

The state has more than 66,000 confirmed cases as of Wednesday and 1,373 confirmed COVID-19 deaths.

Stanford U. Professor John Ioannides, a medical doctor and statistician best known for his research Into the reliability and reproducibility of the medical literature, points out that mortality for those below 45 is “almost zero”, and slams statewide lockdowns. (I approve of lockdowns as a targeted measure in densely populated areas, but don’t believe in their use as blunt instruments.)

“The death rate in a given country depends a lot on the age structure, who are the people infected, and how they are managed,” Ioannidis said. “For people younger than 45, the infection fatality rate is almost 0%. For 45 to 70, it is probably about 0.05%-0.3%. For those above 70, it escalates substantially.”

[…]

Several states have seen spikes in cases, especially in the southeastern part of the country, where lockdown measures were lifted earlier than in other states.

The mortality rate nationwide appears to be tapering, however, a trend U.S. health officials attribute to a younger age bracket in terms of infection. The national single-day death rate from the virus fell to a three-month low last month. Additionally, Massachusetts reported zero new deaths from the coronavirus on Tuesday for the first time since March.

(2) From an ACS virtual issue of COVID-19 related articles across its journal family, this one caught my eye:

https://doi.org/10.1021/acsmedchemlett.0c00316

Advantages of the Parent Nucleoside GS-441524 over Remdesivir for Covid-19 Treatment
Victoria C. Yan* and Florian L. Muller

While remdesivir has garnered much hope for its moderate anti-Covid-19 effects, its parent nucleoside, GS-441524, has been overlooked. Pharmacokinetic analysis of remdesivir evidences premature serum hydrolysis to GS-441524; GS-441524 is the predominant metabolite reaching the lungs. With its synthetic simplicity and in vivo efficacy in the veterinary setting, we contend that GS-441524 is superior to remdesivir for Covid-19 treatment.

(3) Was the lockdown worth it? The Daily Telegraph has a long piece in which twelve experts and writers of the paper make their cases pro and con.

(4) Israel, with escalating COVID-19 infections in what is probably the one pronounced second wave at the moment, announced tightened restrictions. Prof. Eli Waxman, head of the Coronavirus ad hoc committee, speaks out in this interview. This needs to be seen in the context of a tug-of-war between public health authorities fiercely defending their own turf, and perceived “upstarts” with “no background in medicine” (never mind what they can bring to the table in terms of logistics, tracing, and testing knowhow). A somewhat similar situation pertained in the US at least at the beginning of the outbreak, where it often seemed the CDC was excessively preoccupied with protecting its own backyard — particularly on testing, whic Germany wisely decentralized from the beginning.

5 thoughts on “COVID19 update, July 6, 2020: mortality lower than generally perceived; easier to synthetize alternative to remdesivir? Tightened restrictions in Israel

  1. I will look forward to any comments you have on this report. (If you can explain the difference between blood antibodies and T-cells, that would be nice LOL)
    If it pans out, it seems like a key development.
    https://www.dailymail.co.uk/news/article-8495829/Three-quarters-people-live-coronavirus-sufferer-develop-silent-immunity.html

    Summary: The number who have suffered Covid-19 may have been hugely underestimated
    Tests are looking for antibodies in blood rather than the body’s ‘memory’ T cells
    6 out of 8 people living with Covid-19 sufferers tested negative for antibodies
    They had suffered Covid-19 with mild symptoms, T cell immunity tests found

  2. FWIW Japan is also experiencing a second wave.

    But if you look at the data (see https://covid19japan.com/ for some very good graphs) you see that
    a) the uptick is heavily concentrated in the Tokyo area
    b) is not accompanied by an uptick in deaths (which are essentially at 1/day nationally and have been for so for the last month or two)

    Tokyo is, as a result, reimposing some of the closures that it had lifted but nowhere else is.

    Mind you Japan has ridiculously low rates of both infection and death compared to most developed nations. Just under 20k cases as I type this with just under 1000 deaths total. I strongly suspect that there’s a significant under-reporting of asymptomatic cases because the implicit fatality rate in those number is 5% which is a good order of magnitude higher than we are seeing elsewhere

  3. Low mortality in youngers, but I see in the hospital daily that it’s a miserable disease even for the youngers. We have people in their 30s who stay for long periods in the hospital simply suffering, can hardly walk or breathe. Oddly, my anecdotal experience is that it is burly, muscular, physically active people who seem to have greater trouble at the younger ages.

  4. So what happened to the “herd immunity” gambit? I thought that was one part of the strategy, “Once we get herd immunity…”
    Or isn’t that a thing anymore?

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