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,
https://www.entuk.org/sites/default/files/files/Loss%20of%20sense%20of%20smell%20as%20marker%20of%20COVID.pdf
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…