COVID19 update, May Day edition: reduced contagion of and from children; reopening schools in Israel; miscellaneous updates

(1) De Standaard (in Dutch) reports on a study by the Dutch institute for public health about the infection risks from and to small children. I had intuitively expected that they would be mostly asymptomatic spreaders with a minority of mild overt cases (the few exceptions of young children who went into cytokine storm appear to be ‘man-bites-dog news’: newsworthy precisely because they are rare). Now the study[s main findings, mostly based on contact tracing, can be summarized as follows:

  • children are much less likely to be infected (symptomatically or asymptomatically) than adults if both are exposed to the same infection source
  • if they are infected, viral swabs of their throats show similar virus levels as in adults, but they cough less, and owing to smaller lung volumes, coughs can’t project as far

Needless to say, this has implications for whether it is safe to open schools (apparently, more so than previously assumed).

(2) Speaking of which, Israel is reopening Grades 1-3 of primary schools on Sunday, as well as preparation classes for the bagrut (high school leaving [and college placement] exam, like the French baccalauréat or the German Abitur) in the last two years of high school. (These exams play an important role in college admission and placement, together with the psichometri which is somewhat similar to the SAT.) Kindergartens will be opened on or before May 10 — originally they were to be opened on Sunday as well, but personnel requested more preparation time. Remaining elementary and high school grades will open June 1.

(3) Miscellaneous updates:

  • According to De Standaard’s breaking news ticker, Portugal intends to start reopening on Monday. It has been much less hard-hit than neighboring Spain despite similar demographics and climate: Sarah Hoyt (herself born and raised near Porto, and an alumna of Porto University) attributes much of the difference to the continued existence of a parallel private medical system in Portugal, while Spain’s was nationalized. Choice is always good for quality.
  • Shaarei Tzedek in Jerusalem, one of the largest hospitals in Israel (and the largest Orthodox hospital) is closing down its purpose-built corona ward as the last patient in it was discharged some days ago. The hospital had already gradually resumed normal operations as its COVID19 patient load declined.
  • Le Figaro (in French) reports that France will reopen by Départements [France’s administrative regions/provinces], not one-size-fits-all. Based on various criteria such as new infections, mortality, and hospital case load to capacity ratio, the ninety-odd Départements are classified as green (most permissive unlock), orange (more limited unlock), or red (most limited unlock).
  • And in what is probably the most exasperating thing I read on Victims of Communism Day, Die Welt’s reporter in Italy describes Italians looking on Germany as “the enemy” and China as “their friend”. Italians, remember timeo Danaos et dona ferentes. [I am wary of Greeks, even if bearing gifts.][*] As much as I can understand your resentment of the EU, becoming a client state of China will make even you nostalgic for the EU one day.

[*] There is a Hebrew idiom taken from 1 Kings 21:19 for one who unleashes a calamity, then sets himself up to benefit from the resulting devastation: ratzachta ve-gam yarashta? [Literally: hast thou murdered, and also inherited?]

UPDATE: a writer at City Journal calls for people to volunteer for “Hunan challenge trials” with the new Oxford University candidate vaccine, and put his money (or life) where his mouth is. In HCTs, willing subjects get the vaccine (or a placebo) then deliberately expose themselves to infection. This way it can be definitely ascertained whether a vaccine candidate has protective value. So far, over 8,000 others have signed on to a grassroots call for volunteers.

COVID19 update, April 13, 2020: Italy and Israel grappling with exit strategies

(1) Italy, which has seen mortality well past the peak and on a downward trend (on a moving average) since the beginning of the month, and where new cases are lowest since March 13, is starting to grapple with “the day after”. As reported earlier, both Austria and Denmark are starting the road back to normal on April 15, with Norway to follow suit on April 20. Spain has started some normalization measures today.

(2) Israel too seeks to emerge from its “induced economic coma”. [Not all sectors have been idled: in fact, transportation infrastructure works have been carried out ahead of schedule as they were minimally disruptive now.] COVID19 cases have crossed the five-digit threshold here and are still increasing, but this is nearly compensated by an upswing in the number of recoveries, leading to an apparent stabilization in the number of active cases. Sure, we’re not out of the woods yet, as deaths have now grown into triple digits, but according to deputy director general of the health ministry, Itamar Grotto:

“I think we can say that we’ve pretty much succeeded in the stage of stopping the spread” of the coronavirus. Speaking to Ynet, he said that although there could be unexpected results from the outbreak in Bnei Brak and some other [c]hare[i]di communities, which would only be seen in the next few days, “It can be said that we’re in a relatively stable situation, and we’re in the stopping phase. Now, we need to see how we get out of this.” 

A group of captains of industry and business published an open letter, calling to start reopening things after Passover, “or face economic collapse”. Well, according to Haaretz (h/t Mrs. Arbel; I will deviate from my usual policy of not sending links there) these are the recommendations of the National Security Council, in four phases:

Phase 1: could begin as early as Thursday. In a nutshell: 

  • hi-tech and finance sectors reopen, as distance compliance etc. easier to assure there.
  • Government offices, currently down to essential staff, are ramped up to 50% staffing again
  • Preschools and special education are reopened. (Preschoolers are least in danger from the virus.)
  • It is being considered to permit preparation of small groups of HS seniors for their Bagrut (matriculation) exams
  • Public transportation, currently running on a severely curtailed schedule, to be partially restored again

Phase 2: two weeks later

  • Reopen retail stores other than large shopping centers
  • Elementary schools reopen

Phase 3: two more weeks later

  • Reopen remaining stores
  • Reopening cafes, restaurants, and hotels with social distancing and hygiene restrictions 
  • Junior high and high schools reopen. Strict hygiene and social distancing required
  • Universities and other postsecondary education will continue online teaching until the end of the school year, as they have already adapted to this
  • large, crowded events will still be prohibited

Phase 4: only when pandemic is under full control

  • Leisure and entertainment industries back in operation
  • Flights resume
  • Anyone over 60 and at-risk populations still under lockdown

One main worry expressed is whether, if a flare-up occurs, the public will abide temporary back-tracking.

Some might wonder if gregarious and notoriously “in your space, in your face” Israelis will adjust to a new normal of keeping at two arms’ length and no touching, hugging, backslapping, kissing,…

UPDATE: welcome, Instapundit readers!

COVID19 update March 24, 2020: (1) anosmia as an early warning sign? (2) Italy vs. Germany redux.

Dr. John Campbell, a British retired nursing school instructor, has been posting daily COVID19 blogs on YouTube. This is his latest installment:

He draws attention to a paper by the Ear, Nose and Throat [Specialists Association] of the UK,
Loss of sense of smell (and taste) is an early symptom of a number of respiratory diseases, and appears to be an early warning sign for COVID19. (Actually, my daughter mentioned this the other day as popping up in a number of first-person stories by people who’d survived COVID19.)

The remainder of his daily update is here:

In an op-ed in the JPost, an investor and chairman of the board of a medical devices company claims he recognizes a “bell-curve” pattern of about 8 weeks in infection statistics of countries.

The extreme difference between CFRs (case fatality rates) in Italy and in Germany (as low as 0.3%) continues to attract attention. This article in Towards Data Science appears to be the original of the article I saw elsewhere. Much of the story is in these two graphs. While the age distribution of the population is actually fairly similar:

The age distribution of patients is actually radically different: predominantly elder people in Italy, predominantly young and middle-age adults in Germany. As I already mentioned in past installments, intergenerational living arrangements are quite common in Italy, comparatively rare in Germany. Homes for the elderly in Germany appear to have gone on lockdown comparatively early.

Also, Germany has been testing more thoroughly than Italy: on average, 3.9 people were tested in Italy per positive result, compared to 13.1 in Germany. A more thorough testing regime likely will pick up more mild cases that in Italy might simply not even appear on the radar.

UPDATE: via Roger Seheult, MD’s video series (COVID19 update 43) on his medicine tutoring channel, I found out about indications (link to SCIENCE) that the obsolete, century-old BCG (bacille Calmette-Guérin) tuberculosis vaccine might impart full or partial immunity against a number of other diseases — including COVID19?

And one Italian village eradicated the infection completely through a program of aggressive testing,

UPDATE 2: (H/t: Jim B.) This could be huge if true: A study by epidemiologist Sunetra Gupta at Oxford (highlighted in the Financial Times) claims that, based on a new epidemiological model, as much as half of the UK population may already be carrying SARS-nCoV-2, with the vast majority of cases asymptomatic or masquerading as mild colds, and that the IFR (infection fatality) would be in the 0.1% range. This would also imply that the UK population would be approaching “herd immunity”, and that hence new case counts should start dropping soon. Time will tell…