COVID19 update, May 28, 2020: ACE inhibitors beneficial; asymptomatic infection rate as high as 80%; NYT on California economy in freefall

(1) The lead story of Chemical and Engineering News, the house organ of the American Chemical Society, is about rethinking the role of ACE inhibitors (angiotensin converting enzyme inhibitors, a commonly used family of blood pressure drugs).

https://cendigitalmagazine.acs.org/2020/05/22/rethinking-the-role-of-blood-pressure-drugs-in-covid-19/content.html

“Once thought to boost levels of ACE2 , the novel coronavirus’s doorway into human cells, these widely used medicines are now contenders to treat the respiratory disease”

(2) Meanwhile,  the Daily Telegraph has a popular write-up of an intriguing paper that just appeared in Thorax, a daughter journal of the British Medical Journal. It suggests the asymptomatic infection rate may be much higher than the 35% in the revised CDC figures

http://doi.org/10.1136/thoraxjnl-2020-215091

ABSTRACT: We describe what we believe is the first instance of complete COVID-19 testing of all passengers and crew on an isolated cruise ship during the current COVID-19 pandemic. Of the 217 passengers and crew on board, 128 tested positive for COVID-19 on reverse transcription–PCR (59%). Of the COVID-19-positive patients, 19% (24) were symptomatic; 6.2% (8) required medical evacuation; 3.1% (4) were intubated and ventilated; and the mortality was 0.8% (1). The majority of COVID-19-positive patients were asymptomatic (81%, 104 patients). We conclude that the prevalence of COVID-19 on affected cruise ships is likely to be significantly underestimated, and strategies are needed to assess and monitor all passengers to prevent community transmission after disembarkation.

The Uruguayan Ministry of Health provided on board SARS-CoV-2 virus testing of all passengers and crew, which occurred on 3 April (day 20; Atgen-Diagnostica, Montevideo) with CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel.

In the body text we find that: 

 

[The 128 who tested positive on RT-PCR]  included all passengers who tested negative on the VivaDiag qSARS-CoV-IgM/IgG Rapid [antibody] Test. There were 10 instances where two passengers sharing a cabin recorded positive and negative results.

[…]

From the departure date in mid-March 2020 and for the next 28 days, the expedition cruise ship had no outside human contact and was thus a totally isolated environment in this sense. […]

[…]

We conclude from this observational study that

• The prevalence of COVID-19 on affected cruise ships is likely to be significantly underestimated, and strategies are needed to assess and monitor all passengers to prevent community transmission after disembarkation.
• Rapid  [antibody] COVID-19 testing of patients in the acute phase is unreliable.
• The majority of COVID-19-positive patients were asymptomatic (81%).
• The presence of discordant COVID-19 results in numerous cabins suggests that there may be a significant false-negative rate with RT-PCR testing. Follow-up testing is being performed to determine this.
• The timing of symptoms in some passengers (day 24) suggests that there may have been cross contamination after cabin isolation.

 

Just how reliable is RT-PCR really?  According to this piece in IEEE Spectrum, current test setups reach are essentially 100% sensitive (no false negatives) and 96% specific (4% false positives) with lab-generated samples., i.e., if you feed them virus cultures. The trouble begins when you have to collect specimens from actual patients.  According to this piece in MD Magazine,   “Of the specimens collected [from known COVID-19 patients], bronchoalveolar lavage fluid specimens demonstrated the highest positive rates of at 93% (n = 14). This was followed by sputum at 72% (n = 75), nasal swabs at 63% (n = 5), fibrobronchoscope brush biopsy at 46% (6/13), pharyngeal swabs at 32% (n = 126), feces at 29% (n = 44) and blood at 1% (n = 3). The authors of that study pointed out that testing of specimens from multiple sites may improve the sensitivity and reduce false-negative test results.” 

 

(3) Via David Bernstein: the WSJ on New York’s long road to recovery even after a lifting of the lockdown. (Archived copy here.)

And via Instapundit, the NYTimes on The price of a lockdown: economic freefall in California

(archived copy ) To be fair, the tourism industry would have been bludgeoned with or without a lockdown, as the (proportionally less important) Swedish tourism sector has learned.

But a large part of the rest could have been mitigated, and can still be mitigated, by not going the “37-step reopening over 10 years” route in California.  (Heck, when did The Babylon Bee forget it was a satirical publication?) But — as much as this sickens even the jaded student of history — I suspect that for some politicians, ensuring that the recovery does not happen before November is worth any price…  

 

Finally, to my Jewish readers, happy Shavuot! There will probably not be an edition on the holiday unless breaking developments warrant it.

 

ADDENDUM: an op-ed in The Lancet in defense of prophylactic use of hydroxychloroquine in India.

2010 Census winners and losers

Paul Caron, a.k.a. the Taxprof, has the following useful table of the House seat winners and loser states from the 2010 Census (see also here: and here):

 

The table speaks for itself. Note one state absent in both columns: California. As Michael Barone points out, his is the first census in which California did not gain any congressional seats since it was admitted to the Union!

 

Private property in California… isn’t so private

http://www.jerrypournelle.com/view/2010/Q3/view638.html#Monday

Now a California legislator has said that, yes, California Consumer Affairs agents have the power to seize private property for testing, and do not pay compensation. The furniture or other item seized is destroyed in the tests. No compensation is paid and in the case under discussion no receipt was given; the agent suggested that the shop owner try her insurance company. The $1400  couch was confiscated to be tested for fire resistance to cigarette butts. Whether the state ought to be paying agents to go about seizing private property for destructive testing is a question worth debate, but apparently has not been debated.

But we were born free.

Whatever happened to this pesky little thing:

Amendment V

No person shall be held to answer for a capital, or otherwise infamous crime, unless on a presentment or indictment of a grand jury, except in cases arising in the land or naval forces, or in the militia, when in actual service in time of war or public danger; nor shall any person be subject for the same offense to be twice put in jeopardy of life or limb; nor shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation.

Add this to the list of reasons (approaching the length of the Nile) why I will never live in the People’s Republic of California again…

American Thinker: From Cordoba to Marbella, and everything in between

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via American Thinker: Clarice’s Pieces: From Cordoba to Marbella gives an excellent summary of the insanity of the past week, from Marie-Antoinette 0bama’s Marbella trip to tge Ground Zero mosque, and everything in between. Zjust about the one thing missing is the fire-sale of Newsweek to the husband of Rep. Jane Harman.

Light blogging continues here as, in realspace,we wrap up a relocation to a new assignment.

What’s the matter with California?

Four vignettes answering that question about the state I once called home:

(1) In a long and interesting article on the insurgent D primary candidacy of blogger Mickey Kaus (son of former CA Supreme Court justice Otto Kaus) against the cartoonishly vapid Barbara Boxer, this short summary:

It’s also a sign of the Times that California, long the butt of jokes about falling into the ocean, has seriously fallen into an ocean of unmanageable debt.  Everything and everyone in the state has already been taxed; everyone who has taxable income and the means has either moved or is in the process of moving.

California is a basket case of high debt, high taxes, suffocating regulations–and that’s before the tyranny of public employee unions and their apocalyptic pensions are factored into the equation.  As the state has steadily turned from Red to Blue, it’s just as steadily turned from Golden to Tin, from Free to Nanny.

An interesting sign of the times, BTW: the LA Times, rather than offering the usual kneejerk endorsement of Boxer (whom they euphemistically refer to as “lacking intellectual firepower”, which must be the understatement of the year), endorsed neither primary candidate. Kaus — a principled, rational liberal of the old school who seeks to take the D party back to its roots — won the endorsement of fellow D gadfly Victor Davis Hanson.

(2) Speaking of whom, don’t miss his “A tour through recession America” (which is really a tour through recession California). This is another “read the whole thing”.

(3) Here are the first three parts of a series on the decline of Silicon Valley:

http://pajamasmedia.com/edgelings/whats-happened-to-silicon-valley-part-1/

http://pajamasmedia.com/edgelings/whats-happened-to-silicon-valley-part-2/

http://pajamasmedia.com/edgelings/whats-happened-to-silicon-valley-part-3/

http://pajamasmedia.com/edgelings/whats-happened-to-silicon-valley-part-4/

(4) Via the comments there, I found the following very interesting site:

http://www.doctorhousingbubble.com/

Excuse me folks, $600K for an aging 900 sq.ft. house in the LA suburbs… One can buy a house of the same size in, say, the Dallas suburbs for one-tenth of the price (and a fairly new, well-appointed, 3,200 sq.ft. mansion in a good neighborhood for half the money).

California, the Beholden State, is 0bama’s ideal?

In the real world, California spent itself into de facto bankruptcy, and tax-paying Californians as well as the companies employing them are leaving in droves for places like Texas. In BHOzo’s alternate universe, “Washington needs to be more like California“.

Tim Cavanaugh explains why California hasn’t even seen the worst of its woes. He refers to a long, very detailed, and very depressing, piece by Steve Malanga on how public sector unions gradually saddled the state with unsustainable entitlements: “The Beholden State“. Read this latter article in detail. And weep.

UPDATE: Maybe true, definitely (and sadly) believable.

More Taxes or More Jobs: Pick One

Reason TV has a great video for Tax Day: “More taxes or more jobs? California shows we can’t have both“.

While on the subject of Tax Day, and the many Tea Parties planned for it, don’t miss this post on specious ‘raaaaacism’ accusations: “Don’t leave it to Cleaver, Part VII” And as Insty suggests: “SEE A TEA PARTY “CRASHER?” Report ‘em to PJTV.”

And finally, James Lileks: “No taxation without satirization“.

Looking around, Mar. 4

[Drive-by post]

Domestic violence lobbyist shoots husband young enough to be her son

Has the SPLC now truly and finally jumped the shark?

Street riots in Berkeley, CA over tuition hikes.

Must-read: Victor Davis Hanson, “Dronism”, about how California got to where it is now. I can’t do it justice by selective quoting.