COVID19 update, May 4, 2020: French evidence that epidemic got to Europe in December; intriguing hydroxychloroquine find; Michael Levitt interview

(1) Via reader Yves [not Cohen], a French media report that COVID19 was found in a blood sample taken from a lung patient at a suburban Paris hospital on December 27, 2019. [Hand-corrected DeepL translation]

Invited on the set of BFMTV on Sunday, May 3, Professor Yves Cohen, head of the intensive care unit at the Avicenne hospital in Bobigny (Seine-Saint-Denis), and at the Jean-Verdier hospital in Bondy (Seine-Saint-Denis), claims to have had a patient infected with Covid-19 at the end of December 2019. […] “We had a positive case at Covid-19 on 27 December 2019, when he was hospitalised with us at Jean Verdier,” he explained on the air. An analysis of the serological PCR tests carried out on the 24 pneumonia patients in December and January in these two hospitals led to this conclusion.[…] Dr Olivier Bouchaud, an infectiologist at the same Avicenne hospital, confirms this information. “PCR samples taken from a patient clearly show that he [tested positive for] Covid. We did have a first case in France on 27 December,” he adds. […] Professor Cohen mentioned that the infected patient had been ill for 15 days and that he had infected his two children, but not his wife. This person had not made any recent trips. For Doctor Bouchaud, “this does not necessarily mean that he is patient zero in France. But it does suggest that more research is needed to find out”. […] So far, the first officially recorded cases in France are those of three people, on January 24: a Frenchman of Chinese origin and two Chinese tourists who stayed in Wuhan, the original focus of the epidemic which appeared in December.

This, together with the earlier report that COVID19 was found during autopsy of a Santa Clara County patient who had died early February (which places the infection roughly at mid January), pushes the COVID19 timeline further back. [The French story is of course being picked up in Chinese propaganda media as “proof” that the virus did not come from China. Mais bien sûr, et je m’appelle Napoléon Bonaparte.]

(2) In the middle of an article about an Italian pharmacist who claims she has uncovered the main mechanism behind severe COVID19 this interesting nugget can be found:
“Chiusolo told the Post, the Italian Society of Rheumatology interviewed 1,200 rheumatologists throughout Italy to collect statistics on contagions. Out of an audience of 65,000 chronic lupus and rheumatoid arthritis patients who systematically take hydroxychloroquine, only 20 patients tested positive for the virus [and none of those ended up in the ICU or died].”
Time for a little back-of-envelope calculation. According to Worldometers, Italy has 210,717 documented cases out of a population of 60.2 million, or 0.35% of the population. This is almost certainly a gross underestimate, but 0.35% of 65,000 lupus and rheumatoid arthritis patients would be 228 — more than ten times the observed number.

An interesting control would be to check patients on some other long-term mild immunosuppressor drug (steroids? Multiple Sclerosis patients on Copaxone? Reader Laura R. suggests https://en.wikipedia.org/wiki/Methotrexate )

(3)

Mike Levitt, 2013 Nobel Prize winner in Chemistry, getting interviewed about COVID19 on UnHerd. I disagree about 30% of the time (and he should hire a fact-checker — his claim that Germany did not go on lockdown is peculiar to say the least), but a lot to chew on. 

He has a rather interesting way of expressing mortality: weeks-equivalent of annual all-causes mortality. He estimates COVID19 will end up being about 4 weeks worth, which may be an easier number to grasp and keep in their head for people who don’t juggle data all day in their day jobs.

(4) Via Instapundit: a long WIRED article “inside the early days of China’s coronavirus cover-up”. https://www.wired.com/story/inside-the-early-days-of-chinas-coronavirus-coverup/

Seasoned journalists in China often say “Cover China as if you were covering Snapchat”—in other words, screenshot everything, under the assumption that any given story could be deleted soon. For the past two and half months, I’ve been trying to screenshot every news article, social media post, and blog post that seems relevant to the coronavirus. In total, I’ve collected nearly 100 censored online posts: 40 published by major news organizations, and close to 60 by ordinary social media users like Yue. In total, the number of Weibo posts censored and WeChat accounts suspended would be virtually uncountable. (Despite numerous attempts, Weibo and WeChat could not be reached for comment.)

Some people say this is China’s Chernobyl. On the contrary. While both disasters happened under totalitarian Communist regimes, COVID19 makes Chernobyl look like a kitchen ketchup spill. 

(5) Bloomberg looks at how the Hawaii tourist industry (about 20% of the island’s economy[*]) has been devastated by the pandemic. At least they have the naval and other military presence to keep the rest of their economy going, plus some agriculture.

[*] indirectly it’s more, of course. In another illustration of Bastiat’s timeless essay “That which is seen and that which is not seen” (original title: Ce qu’on voit et ce qu’on ne voit pas), the sudden drop in purchasing power of those working in the tourist industry has a knock-on effect in other sectors.

UPDATE: what does the milder version of the disease feel like? In this article from March 12, a woman age 37 from the Seattle area shares her experiences:

Schneider revealed how she first began experiencing flu-like symptoms on Feb. 25. The symptoms occurred three days after she attended a party that was later identified as the place where at least five others caught the bug.

“I woke up and I was feeling tired, but it was nothing more than what you normally feel when you have to get up and go to work, and I had been very busy the previous weekend,” she said.

She felt a headache coming on around noon, along with fever and body aches. This was enough to cause her to leave her office at her biotechnology firm and head home.

The marketing manager napped but woke with a temperature that peaked at 103 degrees Fahrenheit that night.

“And, at that point, I started to shiver uncontrollably, and I was getting the chills and getting tingling in my extremities, so that was a little concerning,” she said.

She took over-the-counter flu medication, and called a friend to be on standby in case she needed to be taken to the hospital, but the fever receded over the following days.

Schneider wrongly assumed she didn’t have COVID-19 because she didn’t experience the usual symptoms such as coughing or shortness of breath.

She was up to date with her flu shot, but thought her illness was due to a different strain. When she visited her doctor, she was instructed to go home, rest up and drink large amounts of fluids.

The way she began to suspect she had something more serious was via social media. A friend on Facebook posted that several folks from the party had developed similar symptoms. These people went to their doctors, where they tested negative for the flu, but were not offered coronavirus tests because they were not showing the common signs of coughing and difficulty breathing.

Smartly, Schneider enrolled in a research program called the Seattle Flu Study in hopes of getting to the bottom of her sickness. She was mailed a nasal swab kit by the researchers, which she mailed back. Then began a wait of several days.

On March 7, she got a call with the bad news: She had tested positive for COVID-19. Surprisingly, Schneider felt relieved. “I was a little bit pleasantly surprised, because I thought it was a little bit cool,” she told the AFP, adding that she found it interesting from a “scientific perspective.”

Her symptoms had already subsided by the time she was diagnosed.

COVID19 update, April 5, 2020: Australia and the seasonality enigma

Australia is a very large country, sure enough, but human settlement is mostly limited to a coastal zone. Still, except perhaps for downtown Sydney and Melbourne, population densities are nowhere near what New Yorkers would take for granted.

According to worldometers., Australia has 5,687 cases, and thus far “only” 35 fatalities. Most cases are in the two most populous states, New South Wales (where Sydney is the largest city) and Victoria (with Melbourne as the largest population center), followed by Queensland (Brisbane being its largest city).

The country has been on what is locally denoted Level 2 lockdown. All arrivals to the country are mandated to self-quarantine for 2 weeks.

But this is possibly the most hopeful graph.

How is this possible? The mind wonders whether Australia coming out of an (unseasonably hot) summer could have something to do with it? After all, seasonality of flu viruses is a well-known phenomenon — but does that even apply to SARS-nCoV-2? To be sure, some things will apply to any viral infection — the vitamin D one gets from being in the sun sure is welcome to the immune system, and of course, in humid weather you don’t get the dried-out mucous membranes that are good ports of entry.

So what about hot and humid locales elsewhere? As of the time of writing, Hawaii has just several 351 cases and 3-4 deaths right now, despite the most populous island (Oahu) being densely populated. The tropical city-state of Singapore has coped well, but this could be explained by other factors without invoking the weather — particularly long-standing preparation since the 2003 SARS epidemic. Puerto Rico has so far just 475 cases with 20 deaths.
But then there is Ecuador, on the literal equator, currently being ravaged by the epidemic, with the largest city Guayaquil being completely overwhelmed. And in the US, despite its famously swampy weather, Louisiana has been hit very hard, particularly New Orleans with a death rate per capita twice that of NYC. (This has been attributed to “super-spread” events at Mardi Gras. I cannot help noting that Belgium’s largest outbreak also has been traced to a Carnival festival in the provincial town of Alken that was not canceled, and several infection foci in Israel have been traced to Purim celebrations.) In fact, hot and humid Florida has a similar number of COVID19 cases as Louisiana — despite having eight times the population!

Clearly, there is more here than meets the eye.

Meanwhile, in Belgium, for the first time during the epidemic, the daily hospital bed occupancy goes down, as the sum of discharged and deceased patients exceeds the number of new admissions.

And Instapundit links to a story about a team from Monash University that has found that the simple antithelmintic Ivermectin — which has been used in humans and animals for decades, in areas where parasitic worm infections are common — kills SARS-nCoV-2 in vitro within 48h.

Finally, Derek Lowe (h/t Cedar Sanderson) has a clear and informative discussion of antibody testing.

Hawaii, tipping, and cultural misunderstandings

Fox News had a segment on about how restaurants in Hawaii are now proposing to add a 15% surcharge to the bill for Japanese tourist.
You say: “Whiskey Tango Foxtrot?” The rationale is: since Japanese tourists don’t tip (tipping is not customary in Japanese restaurants), the customary 15% tip should be added to the bill so the waiters are not cheated out of their money.
While Japanese are of course the most numerous/visible such group, let’s remove the racial component by pointing out the numerous times I’ve had to remind Belgian and Dutch visitors to the USA about tipping. Now the alleged “excessive parsimony” of the Dutch is a common theme of Belgian jokes about them (the Dutch have similar jokes about the Scottish — neither Belgium nor the Netherlands are big on “political correctness”), but neither the Belgians nor the Japanese have a reputation for stinginess. It’s simply a cultural misunderstanding: waiters in Belgium, the Netherlands (and presumably Japan) are salaried employees and restaurant bills in Belgium, for example, typically state “VAT and service included”. If you were to add a 15% “service charge” to a restaurant bill the Belgian would pay it without a second thought. When I explained to Belgian visitors to the USA or Israel that their tips are the income of the waiters, they understood immediately.
It remains to be seen how mainland American tourists would react if Hawaiian restaurants were to add on a blanket 15% “service charge” to all bills. Yet this would, to a naive outside observer, seem to be the obvious solution…