Leiter Reports: A Philosophy Blog

Wuhan after the lockdown

An interesting study; among the findings of note:

(1)  "All city residents aged six years or older were eligible and 9,899,828 (92.9%) participated. No new symptomatic cases and 300 asymptomatic cases (detection rate 0.303/10,000, 95% CI 0.270–0.339/10,000) were identified."

(2) "The detection rate of asymptomatic positive cases was very low, and there was no evidence of transmission from asymptomatic positive persons to traced close contacts. There were no asymptomatic positive cases in 96.4% of the residential communities.  Previous studies have shown that asymptomatic individuals infected with SARS-CoV-2 virus were infectious³, and might subsequently become symptomatic⁴. Compared with symptomatic patients, asymptomatic infected persons generally have low quantity of viral loads and a short duration of viral shedding, which decrease the transmission risk of SARS-CoV-2⁵. In the present study, virus culture was carried out on samples from asymptomatic positive cases, and found no viable SARS-CoV-2 virus. All close contacts of the asymptomatic positive cases tested negative, indicating that the asymptomatic positive cases detected in this study were unlikely to be infectious."

(I came across this via the Twitter feed of the word's dumbest journalist, Alex Berenson, who (1) didn't realize that the study shows, among other things, that lockdowns work, something dumb-dumb likes to deny [how could they not work, we know how the virus is transmitted, and it requires people to come into contact with other people; that doesn't mean lockdowns are also worth the costs]; and (2) dumb-dumb also declared that the study shows that, "Asymptomatic spread isn’t real = masking healthy people is useless," but the study shows nothing of the kind:  it shows that asymptomatic people who don't go on to develop symptoms appear not to infect others; as the study notes, we have evidence that asymptomatic people who go on to develop symptoms are infectious.)

Oxford/AstraZeneca vaccine: 70% effective on average

Another two-dose vaccine, that was 90% effective in the group that got a half-dose first, and then a full dose second (but less effective in the group that got a full dose each time).  Note that in this trial they also checked for asymptomatic infections.   Various experts comment here.

North Dakota leads the world...

...in recent deaths per capita from COVID.  1 out of every 1,000 residents has died from COVID.  Unsurprisingly, North Dakota has done very little in the way of mitigation efforts throughout this catastrophe.

The Governor of California should resign

What a disgrace.  It's pretty easy not to have a dinner in a restaurant while people are dying from an infectious disease and you're requiring everyone else to not do this.   He should be crucified for this selfish stupidity.

What is wrong with the people in Farmington, Missouri?

Their local public health official  received threats because she is trying to implement simple measures to reduce the spread of COVID.  It got so bad, she resigned and moved.  Farmington is about 75 mile from St. Louis.  What is wrong with the people there?  I hope to God I never have to set foot in that place, or any place so benighted.

The latest on the Pfizer vaccine...

...from Statnews.  Between Pfizer and Moderna's vaccine, it looks like about 6-7% of the U.S. population may get vaccinated before the end of the year, which is better than nothing of course.  Hopefully by summer, it will be possible to vaccinate most of the population that wants it (states can mandate vaccinations, and hopefully some will, with exceptions only for health reasons).

Still to be determined, of course, is how long the protective effect of the vaccine lasts.  Does anyone know of any preliminary data or informed estimates?

The Moderna COVID vaccine

MOVING TO FRONT FROM YESTERDAY--SEE COMMENT BY NED BLOCK, WHICH NOTES A SERIOUS POSSIBLE OMISSION IN THIS STUDY

An informative report from Statnews:

The Moderna vaccine reduced the risk of Covid-19 infection by 94.5%. There were 95 cases of infection among patients who received placebo in the company’s 30,000-patient study. There were only five infections in patients who developed Covid-19 after receiving Moderna’s vaccine, mRNA-1273....

Moderna also released data about the number of patients who had severe Covid-19. There were 11 cases of severe disease, all of them in the placebo group — another point of encouragement for Fauci.

“There was always the concern … since the primary endpoint [of the trial] is just clinically apparent disease, how do we know it’s going to have an impact on severe disease? And the results with severe disease were striking — 11 to zero is very impressive,” he said. At the time of their data release, Pfizer and BioNTech had no severe cases in their study...

More on the Swedish COVID disaster: the "herd immunity" that wasn't

Here.  Of course, the Swedish disaster isn't as bad as the American one, but that's not saying much!

Mobility network models of COVID

People going to gyms and restaurants means trouble,  among other findings.

COVID vaccine and the universities

Next fall may be normal, but masks will probably be necessary through the Spring.

Mink-strain of COVID spreading to humans?

I don't know whether this is pure alarmism or whether it has some factual basis and we should worry.  Any insight from readers?

Promising initial data on Pfizer vaccine for COVID

The NYT story includes the appropriate notes of caution as well.   If it's 90% effective, that's phenomenal.  That it has proven safe in 43,000 people is good but does not yet mean it is really safe.  If it produces adverse effects in 1 out of every 100,000 people, they might not yet know, but that level of risk would produce thousands of adverse cases just in the U.S.  It would still be worth distributing such a vaccine in all likelihood.

Small Boston study finds 1 in 5 grocery store workers test positive for COVID

But the vast majority were asymptomatic.  Given that clerks in a grocery store will interact with several dozen people during a day, and in a closed environment, this isn't wholly surprising, but still sobering if it generalizes.  All the more reason to mask up carefully when grocery shopping.

AI to spot "COVID cough"?

This is interesting, although I do wonder whether by the time the "cough" is detectable, a person has not already been infecting lots of others.

(Thanks to Robert Condlin for the pointer.)

How the coronavirus spreads through a room, a bar, a classroom

Nice visuals.

Meanwhile the COVID disaster rolls on

Over 9,000 new confirmed cases in Chicago over the last week, the highest recorded number ever (the previous high, last Spring, was over 7,000, but that surely wildly undercounted, as Chicago was doing about 25% of the daily testing that's being done now).   On the other hand, Cook County, where Chicago is, is averaging about 30 cases per 100,000, well below other parts of Illinois which are closer to the neighboring disaster areas, especially Wisconsin, but also Iowa and Missouri.

What a fiasco the Trump Virus has been.  Apart from Bolsonaro, we couldn't have had a worse national leader during this world-historic event.

Another university succeeding despite COVID

This time Cornell University--but, in typical journalistic hysteria-mongering, the article treats this as "rare" rather than the norm.

Coronavirus infection: it's not just the nose, it's also importantly the mouth!

This is interesting.

(Thanks to Dr. David Ozonoff for the pointer.)

Hospitals in Utah preparing to ration care...

...due to surge of COVID patients.   Utah has a 7-day rolling average of about 1,400 cases per day in a population of a bit more than 3 million.  By way of comparison, Illinois has a 7-day rolling overage of about 4,100 cases per day, but with a population four times the size; Illinois is, not yet, facing such a crisis, but Illinois also has a fairly good ratio of beds to persons compared to many other states.  (Illinois has 2.8 ICU beds per 10,000 people, while Utah has 2.2.)

As COVID cases surge, one bit of good news is that doctors are now much better at averting death

A useful overview of the changes:

Two new peer-reviewed studies are showing a sharp drop in mortality among hospitalized COVID-19 patients. The drop is seen in all groups, including older patients and those with underlying conditions, suggesting that physicians are getting better at helping patients survive their illness....

The study, which was of a single health system, finds that mortality has dropped among hospitalized patients by 18 percentage points since the pandemic began. Patients in the study had a 25.6% chance of dying at the start of the pandemic; they now have a 7.6% chance.

That's a big improvement, but 7.6% is still a high risk compared with other diseases....

 

Horwitz and her colleagues looked at more than 5,000 hospitalizations in the NYU Langone Health system between March and August. They adjusted for factors including age and other diseases, such as diabetes, to rule out the possibility that the numbers had dropped only because younger, healthier people were getting diagnosed. They found that death rates dropped for all groups, even older patients by 18 percentage points on average....

COVID on campus: an update

Philosopher Gregory Pence (Alabama/Birmingham) kindly shared this list of universities with the biggest outbreaks of COVID on campus.  What they have in common is that they are all large, mostly state schools, most of which have big fraternity/sorority scenes.  (One surprise on the list is BYU, which is large, but is an alcohol-free campus, which one would have expected to contribute to more sensible behavior by students.)   But these schools are the outliers, as even the NYT data reveals, despite their best journalistic effort to emphasize the negative:

More than 35,000 cases [COVID] cases have been identified since early October.

Though some colleges moved all their fall classes online, many campuses remained open even as positive tests accumulated by the hundreds or thousands. Of more than 1,700 institutions surveyed by The Times, more than 50 reported at least 1,000 cases over the course of the pandemic. More than 375 colleges have reported at least 100 cases.

Translated into non-hysterical English:  3% of universities account for about a third of all the cases on campuses, and one-quarter of the schools account for almost all the cases--meaning about 70% of colleges and universities are doing quite well.  Considering that COVID is spreading out of control in huge parts of the country, colleges are performing admirably overall.

STAT News runs a very useful COVID-19 "tracker" of drugs and vaccines in development...

...here.

The Swedish COVID disaster

The chart here certainly sums it up:  Sweden has had 59.3 deaths per 100,000 people, compared to 11.8 per 100,000 for Denmark, 6.3 for Finland, 5.2 for Norway, and 11.7 for Germany, all proximate countries that were far more proactive in managing it.  Sweden is up there with other countries whose response everyone knows has been disastrously incompetent, including the U.S. (66.3 death per 100,000) and the U.K. (64.5 deaths per 100,000).

Good news about air travel and the risk of contracting COVID...

...although it does  require that passengers wear masks!  A question for anyone who has flown recently:  are airlines enforcing mask wearing?

Some striking COVID graphics...

...which document vividly the differential impact of the pandemic across the United States at different times.

(Thanks to Tushar Irani for the pointer.)

Reinfection with the coronavirus? Possible, but quite rare

An informative discussion of what we know, and why it's not a cause for concern.

On COVID and aerosol transmission

This is informative.  It's pretty clear by now that aerosol transmission (i.e., not just droplets when someone sneezes!) is important, more so than fomites for example.  Links to other sources on this issue welcome in the comments.

New study estimates 20% of Chicago residents have antibodies to the new coronavirus

Not wholly surprising, given that there have been more than 83,000 confirmed cases in a population of not quite 2.9 million in the city proper.  So 20% having been exposed would mean not quite 500,000 people with either symptomatic or asymptomatic cases over the last 8 months or so.  I've talked to some students who had COVID-like symptoms in the Spring who could not then get tested, and I suspect that phenomenon was widespread.  We're still far from "herd immunity," as the surging cases this past week illustrate:  more than 2,900 confirmed COVID cases this past week in Chicago, the highest total since last May (Chicago has been running a bit over 2,000 confirmed cases per week for a couple of months now, but it ticked up noticeably this week unfortunately).

This New England Journal of Medicine editorial would make a good opening statement at the "war crimes" trial for those politicians who failed us in the "war on COVID"

An excerpt:

Why has the United States handled this pandemic so badly? We have failed at almost every step. We had ample warning, but when the disease first arrived, we were incapable of testing effectively and couldn’t provide even the most basic personal protective equipment to health care workers and the general public. And we continue to be way behind the curve in testing. While the absolute numbers of tests have increased substantially, the more useful metric is the number of tests performed per infected person, a rate that puts us far down the international list, below such places as Kazakhstan, Zimbabwe, and Ethiopia, countries that cannot boast the biomedical infrastructure or the manufacturing capacity that we have.² Moreover, a lack of emphasis on developing capacity has meant that U.S. test results are often long delayed, rendering the results useless for disease control.

When COVID joins the family gathering

Not a happy event:  a 13-year-old with very mild symptoms (stuffy nose) nonetheless infected 11 others!

Notre Dame President Rev. John Jenkins should resign

As multiple news outlets are reporting, Rev. Jenkins tested positive for the coronavirus after attending last week's announcement of the nomination of former Notre Dame law professor (now Judge) Amy Coney Barrett to the Supreme Court.  Rev. Jenkins violated all the public health protocols that faculty and students at Notre Dame are expected to observe, most particularly, by not wearing a mask.  (By contrast, the Dean of Notre Dame's law school did wear a mask, while sitting right next to the President!)   You cannot demand compliance with public health protocols by your faculty, staff and students, and then flout those protocols yourself in such public fashion.  What an embarrassment; he should apologize and resign the Presidency and return to his role as a faculty member in the philosophy department.

UPDATE (October 4):  Some students are also calling for his resignation; they're correct.

A poll about COVID-related restrictions

UPDATE:  Moving to front from earlier today--vote!

Philosopher Peter Godfrey-Smith (Sydney) suggested I run this poll.  It asks whether you think the level of Covid-related behavioral and economic restrictions in your own local community has been "excesssive," "about right," or "not stringent enough."  Please take it.

ADDENDUM:  Be forewarned some odd ads pop up after you've taken the poll.  I got one for Dr. Phil and "how to lose 31 pounds in a month" (that would be good!), and some gossip about the Royal Family.  Others are, I'm told, more provocative.   Unfortunately, the poll service provider controls those.

ANOTHER (October 2, 6 pm CST):  Here are the results (with about 400 votes), albeit before most of the Asian, Australasian, and European readers weigh in:  about 14% find the restrictions "excessive," 49% "about right," and 38% "not stringent enough."

OCTOBER 3, 10 AM CST:   Now with about 700 votes (including many in the last 12 hours from Australasia, Asia, and Europe), the results have shifted a bit:  33% deem them "excessive," 38% "about right," and 29% "not stringer enough."   Of course, there's always a risk that the "Covid isn't a big deal" nuts may have linked to this somewhere, I don't know.  But certainly restrictions have been more dramatic in Australasia than many parts of America, which might explain the difference.

Finally, a news story about colleges *successfully* managing COVID

In the NYT.  But you heard it here first!

Trump's COVID diagnosis

Trump is 74 and obese, two facts we do know about him, and that puts him at higher risk for complications and even death from COVID.  But counting in his favor is that he will presumably be able to get access to newer treatments, like antibody plasma from recovered patients.   Since he is purportedly asymptomatic today, it seems unlikely he would have been infectious at Tuesday's debate with Biden, since people with COVID are, from what I've read, only infectious in the 48-72 hours prior to the onset of symptoms.  But Biden is being tested as well, of course.

If a candidate for President becomes incapacitated (e.g., on a ventilator) or dies, what happens?  It can get quite messy, but here's an extended and informed discussion by election law experts.

It's hard for those of us living through this nightmare not to experience some Schadenfreude.  As a philosopher elsewhere wrote me this morning:  "The arc of the pandemic bends towards justice."   Given Trump's gross mismanagement of the pandemic, which has cost tens of thousands of people their lives, and millions of others suffering and misery, there is a kind of "justice" that it has now come back to bite him.  If he becomes seriously ill, it may give him a face-saving way to withdraw before his likely defeat.  But it may also plunge this dysfunctional country into further turmoil in ways none of us can yet anticipate.

UPDATE:  The latest this morning (9:30 am CST) is that Trump does have "mild symptoms" now, meaning that he may have been infectious on Tuesday.  What a mess.

ANOTHER:   So as of 11:30 am CST, roughly, the Bidens have tested negative.  Of course, false negatives are not uncommon, so we'll see.

New study estimates 10% of Americans have antibodies to COVID

Study here.  Of course, we know that antibody levels wane fairly quickly, and that the key to immunity are T-cells.  Is there any way to estimate from this study how many people have T-cells that recognize COVID, even though they no longer have antibodies?

Four immunity scenarios for COVID

This is informative.

COVID risks while flying

Interesting, case study of ten-hour flight with one symptomatic passenger in business class:

We traced 217 passengers and crew to their final destinations and interviewed, tested, and quarantined them. Among the 16 persons in whom SARS-CoV-2 infection was detected, 12 (75%) were passengers seated in business class along with the only symptomatic person (attack rate 62%). Seating proximity was strongly associated with increased infection risk (risk ratio 7.3, 95% CI 1.2–46.2). We found no strong evidence supporting alternative transmission scenarios.

(Thanks to Dr. David Ozonoff for the pointer.)

The colleges that are succeeding, despite COVID

After the "bad news" stories about college openings that journalists love, the real story now is the number of schools that seem to be making this work.  Notre Dame, with 12,000 students and a rocky start, imposed a two-week lockdown; now they have a positivity rate of 1.2% and only about five dozen active cases on campus.  As we noted before, Duke University is doing quite well, with aggressive testing and good student compliance with behavioral expectations.  Bates College, with nearly 1,800 students in the boondocks of Maine, has had only 2 cases after several weeks of class.  Amherst College, far less isolated than Bates, has had a total of 3.  No doubt this will be disappointing to those invested in the idea that it was obviously nuts to open a school during a pandemic.  But it is good news for students and their families.

ADDENDUM:   Someone on Twitter points out that Brandeis, near Boston, is also doing quite well.  I'm opening comments for readers to add links to evidence of other schools that are faring well.

Most states are doing badly on COVID benchmarks

No state meets all four benchmarks; I'm lucky that Illinois is one of a handful that meets three of the benchmarks.  I doubt this would be happening if we hadn't thrown the Republican plutocrat bum out of the Governor's office in the last election.   The Democratic plutocrat now in office is at least competent on basic matters.

Possible new antibody-based treatment for COVID

Interesting, and hopeful.

Penn will not admit PhD students this coming year in any humanities/science fields

This is remarkable; we noted a couple of philosophy departments that were not admitting PhD students this year, but this is the first school-wide suspension of PhD admissions in the humanities and sciences.  Comments are open if readers know of other schools following a similar path; please include links.

Characteristics of young adults (ages 18-34) hospitalized with COVID

This is informative.  Of 63,103 hospitalized patients (April through June of this year), only 5% (3,222) were in the 18-34 age bracket (median age of 28.3).   36.8% were obese, and 24.5% were morbidly obese!  2.7% of the young adults died.  41% of those patients who died or needed mechanical ventilation were morbidly obese. From the discussion:

Morbid obesity, hypertension, and diabetes were common and associated with greater risks of adverse events. Young adults with more than 1 of these conditions faced risks comparable with those observed in middle-aged adults without them. More than half of these patients requiring hospitalization were Black or Hispanic, consistent with prior findings of disproportionate illness severity in these demographic groups.

ADDENDUM:  Comments making factual claims must include sources, or they will not appear.

Bad news for restaurants (but not a surprise)

CDC reports that in a sample of those recently diagnosed with COVID, having dined in a restaurant in the two weeks prior emerged as an important risk factor.  With colder weather approaching in large parts of the United States, this is bad news for restaurants and diners.  When this world-historic catastrophe is over, will there be any restaurants left in New York or Chicago or Minneapolis?

New study finds Vitamin D deficiency raises risk of COVID infection substantially

News item here.  Vitamin D deficiencies are easy to have, since not a lot of foods have substantial amounts of it--most people need to take supplements (most multivitamins include it).

(Thanks to Joshua Selby for the pointer.)

Duke University doing rather well with COVID to date

And better than neighbors at UNC/Chapel Hill and North Carolina State.  Extensive testing plus better student behavior seem to be key factors.

"Herd immunity": what it is and isn't

This is an informative interview.

All about a COVID-19 vaccine

Informative discussion with Dr. Paul Offit (Penn), a vaccine expert.  He thinks there will be a vaccine by the "first quarter" of 2021; he explains why we are able to produce this vaccine so quickly (basically, government is assuming all the risks); and other topics.   One interesting data point:  if a vaccine is 75% effective, then you would need to vaccinate about two-thirds of the population to stop spread of the virus; but if the vaccine is only 50% effective (like the flu vaccine), then to stop spread  you'd need to vaccinate the entire population (which you can't do, since some people can't take vaccines for health reasons).  As Dr. Offit emphasizes, the arrival of a vaccine will not eliminate the need for hygienic measures to control the virus.

(Thanks to Michael Weisberg for the pointer.)

More than 1/3rd of those on a 1 1/2 hour bus ride with a person with COVID...

...later tested positive.  Proximity to the index case wasn't decisive for risk either, suggesting, of course, aerosol transmission facilitated by air circulation.

Another university handling COVID effectively: U of Illinois/Urbana-Champaign

They're testing students twice per week, using saliva-based tests the university itself developed.  Impressive, let's hope it does the trick.

COVID cases at Arizona State University

Many years ago, my father quipped that, "Farmers hope for rain, journalists hope for floods," because disaster is more newsworthy.  So too with some of the COVID reporting, as in this piece from Phoenix.  It's headline reports that cases have "tripled" in a matter of days ("flood"!), but if you read the article, you see the positivity rate on tests is only a bit over 1% (very low, especially compared to the nearly 7% rate in Arizona)) and you also find this:

Officials said there were 452 positive cases out of the approximately 74,500-person student body in addition to 28 positive cases out of the 12,400 faculty and staff members. 

More than half of the positive cases reside off-campus within the Phoenix area. Officials said 205 of the approximately 9,600 students living on the Tempe campus were in isolation on Friday.

Given the prevalence of COVID in Arizona this summer, these are remarkably good statistics:  a bit more than half of one percent of students have tested positive (most of whom live off campus), and the rate is even lower for faculty and staff.   Of course, if growth is exponential then maybe this will turn into a disaster.  But so far these numbers are quite moderate, although you wouldn't know it from the emphasis in the headline.

(Thanks to Robert McGarvey for the pointer.)