🦠 COVID-19 | Nearly 100,000 deaths in the U.S.

I am a scientist by education, banker at JPMorgan for a few years, then mature PhD student in Chemical Biology at Oxford under the supervision of Christofer Schofield (FRS) and Peter Ratcliffe (Nobel laureate in medicine in 2019). Founder and tech investor focusing on media and education. I care about science, learning and Democracy which are good bedfellows.

📊 Daily Data Brief: (❗️48 hours period +/-)

Cumulative case: 5,389,180 (+175,141cumulative cases 

Active cases:  2,810,081 (+25,182) (this is the number of currently infected patients)

Total Deaths:  343,460 (+8,463)

Serious/Critical Cases: 53,536 (+7,938)

Recovered:   2,235,639 (+141,496)

Source: Worldometers

1) Seven-day rolling average of new deaths (updated daily as ECDC releases). Major update with per country graphs now available (Link) (USUKFranceGermanySweden,  Nordic Comparison)

Showing a chart from the FT today highlighting the worrying situation in Brazil, Mexico, India and Russia. Also the FT comparative charts now allow up to 6 countries (NEW❗️)

2) U.S. states reopening risk map: this analysis includes current estimated R (reproduction number) for each state (Link) (NEW❗️4th indicator added)

3) Rt estimate per country (NEW❗️). This is a new resource link in the data section from a team which has led accuracy in modelling fatalities in the US for the past few weeks. (Link)

[❗️ I forgot to include the helpful ‘🦠’ in the header of the Corona Daily on Friday. Here is a link to it in case you did not find it in your inbox: “Is Big Government the answer or the problem in a "patchwork pandemic"?”]

As we approach Memorial Day in the U.S. honoring and mourning the military personnel who had died while serving in the United States Armed Forces, we will also likely mourn on Monday the 100,000 people who have died from COVID-19 in the US.

Today the New York Times cover list 1,000 of them on its front page writing: “they were not simply names on a list, they were us.”. And whilst the U.S. is as of today the county which has suffered the highest human toll, Brazil’s death curve remains on track to surpass it.

And yet, apart from the infamous hydroxychloroquine which now seems not only to not be beneficial but potentially to even be harmful (Corona Daily Tweet of the Day), there are a number of positive results on remdesivir, vaccines, and convalescent plasma. Our toolbox to limit death from SARS-CoV-2 continues to improve.

Today, we also include two articles on China: a critical one published in Project Syndicate and an interview of one of China’s top virologist. They are both interesting reads.

We also have a great podcast discussing the ethics of human challenge trial where even one of its advocates would recommend his children against enrolling for one, and the weekly podcast from Bob Wachter (Chair of the Department of Medicine as UCSF).

NEW❗️I have open-sourced the articles feeds I curate the Corona Daily from and made them freely available below. The feeds included are listed here.

Free COVID-19 curated feeds

Image of the day: today’s New York Times front page. After their previous cover highlighting the job loss caused by COVID-19, this one focus on the tragic human loss.

💊 Tweet of the day: largest study on hydroxychloroquine published in the Lancet and tweeted by Eric Topol (Founder and Director of the Scripps Research Translational Institute).

💉🇨🇳 Helen Branswell writes “Early study of Covid-19 vaccine developed in China sees mixed results” in STAT news. Branswell reports on the first Phase 1 trial for a vaccine being published in a peer review scientific journal. This is a vaccine being developed in China. It is a viral vector vaccine made by combining a “a live but weakened human cold virus, adenovirus 5 (Ad5), onto which genetic material of the SARS-CoV-2 coronavirus has been fused.” The risk of this approach is that the immune system of patients who have existing immunity to Ad5 focuses on adenovirus 5 rather than the novel SARS-CoV-2 part thereby modulating down immune response to the latter. It is a particular concern given that in some region 70% of the population has had previous exposure to Ad5.

The good news is that the vaccine was shown to elicit the production of neutralising antibodies to SARS-CoV-2 in all patients. Unfortunately, and as expected, patients who had previous exposure to Ad5 developed a less robust response. More worrying is that the effect was stronger in older patients, who are the ones to benefit the most from a vaccine. It remains to be seen wether the level of neutralising antibodies elicited by the vaccine in the worst-case is still sufficient for it to show efficacy against COVID-19. Phase 2 trials are starting and we will find out then. (Link)

💉 Douglas Green writes “SARS-CoV2 vaccines: Slow is fast” for Science. A really good explainer on adaptive and innate immunity, the potential protein targets of a COVID-19 vaccine, worrying precedents of only going for induction of neutralising antibodies as an endpoint (the 1966 Respiratory Syncytial Virus vaccine), the risk of ADE (antibody-dependent enhancement), and the ethics of human challenge trials.

A great summary of the issues surrounding fast-tracking a vaccine. At the end, Green quotes the eminent cancer biologist, Charles Sherr, that in experimental research: “Fast is slow, and slow is fast”.

A great read alongside, Helen Branswell “The world needs Covid-19 vaccines. It may also be overestimating their power” article in STAT News. (Link)

💊 “Remdesivir for the Treatment of Covid-19 — Preliminary Report” was published in the New England Journal of Medicine. It reports on the NIAID trial of Remdesivir which shows that the drug reduces the time to recovery by 27%. As previously reported it is not a cure, but a helpful drug in the arsenal of doctors to help patients recover. (Link)

💊 Sean T. H. Liu et al. publish the pre-print “Convalescent plasma treatment of severe COVID-19: A matched control study” in MedRxiv. (Link)

The authors conclude in the abstract:

“Convalescent plasma transfusion is a potentially efficacious treatment option for patients hospitalized with COVID-19; however, these data suggest that non-intubated patients may benefit more than those requiring mechanical ventilation.”

The study was also reported in the Wall Street Journal “Study Points to Efficacy of Convalescent Plasma for Covid-19”. The WSJ writes:

“By day 14 after transfusion, the condition of 18% of the patients who received the plasma had worsened compared with 24.3% in the matched control group.

As of May 1, the authors wrote, 12.8% of the plasma recipients had died compared with 24.4% of the control patients. “Overall, we observed improved survival for the plasma group,” they wrote.”

🇨🇳 Brahma Chellaney (Professor of Strategic Studies at the New Delhi-based Center for Policy Research) writes  “China Is Its Own Worst Enemy” for Project Syndicate. A critical look at China’s response to the broadening criticism of its acts and behaviour since the beginning of this pandemic. Xi Jinping’s latest move in Hong Kong seeking to overturn Hong Kong’s “one country, two systems” is only the latest escalation. As Chellamey writes:

“China currently faces the most daunting international environment since it began opening up in the late 1970s, and now it risks suffering lasting damage to its image and interests. A boomerang effect from Xi’s overreach seems inevitable.”

Chellaney is not the only commentator to have labelled Xi Jinping’s behaviour as “overreach”. (Link)

🇨🇳 Jon Cohen writes “‘The house was on fire.’ Top Chinese virologist on how China and U.S. have met the pandemic” in Science.

This is an interview of virologist Shao Yiming, chief expert on AIDS at China’s Center for Disease Control and Prevention (China CDC). It somewhat offers a counterpoint to Chellaney’s Op-Ed above. The article covers a number of topics including the origin of the virus, China’s openness to internal criticism and outside experts, the importance of testing and tracing (and digital surveillance), the current Chinese vaccine effort, the ethics of human challenge trials, and the mounting international criticism towards China. Yiming is predictably very positive about China’s response and critical of the US.

There is nonetheless two answers, which put together support the international community criticism of China. When asked about China’s response Yiming says:

“We have done modeling work. If we locked down 1 week later, we would have had about a sixfold increase in infected cases and a 16-fold increase in deaths. If we locked down 4 weeks later, the number jumps to over 30 million infected cases, and over 3 million deaths. We prevented these tragic things from happening and saved a lots of lives. You had a much longer time to respond.”

When asked about China’s delays on sharing sequence or other information, and external blame on its openness early in the pandemic:

“Even if you insist on saying China delayed for 1 or 2 weeks, other countries have had delays of 4, 6, and even 8 weeks. We should count time with the same scale, not 1 day as a week for China and 1 week as a day for others.”

As Yiming said himself earlier: one week is a 16-fold increase in deaths… (Link)

🎙 Podcasts:

  1. The New Yorker Radio Hour: To Test a Vaccine for COVID-19, Should Volunteers Risk their Lives?” (Link)

    Larissa MacFarquhar, who has written extensively about altruism, talks with Marc Lipsitch, an epidemiologist who co-authored a journal article calling for human-challenge trials, and Angela Rasmussen, a virologist who feels that SARS-CoV2 is too unknown for any volunteer to meaningfully give informed consent to its risks.”

  2. Special Medical Grand Rounds hosting by UCSF Department of Medicine and hosted by Bob Wachter (Chair, UCSF Dept of Medicine). Professor Wachter also posts a summary Twitter thread if you do not have the time to watch the whole grandstand or only want to watch certain section (Twitter thread - 10 minutes read; Grandstand 1 hour and 46 min). A lot of great references if you have not followed the news daily this week. 

📊 A picture is worth a thousand words:  Global (🌎) and local (with relevant flag) visualisation and forecasting tool

  1. 🦠  “Science Forum: SARS-CoV-2 (COVID-19) by the numbers” (Link)

“The COVID-19 pandemic is a harsh reminder of the fact that, whether in a single human host or a wave of infection across continents, viral dynamics is often a story about the numbers. In this article we provide a one-stop, curated graphical source for the key numbers (based mostly on the peer-reviewed literature) about the SARS-CoV-2 virus that is responsible for the pandemic. The discussion is framed around two broad themes: i) the biology of the virus itself; ii) the characteristics of the infection of a single human host.”

  1. 🇺🇸🌎 NEW❗️This model has led accuracy for several weeks in the US. It also does projection for Europe and Rest of the World. (Link)

  2. 🇺🇸  “Is your community ready to reopen?”: A map of the US (50 states and 2,100+ counties) looking at reopening risks with metrics around 3 criteria: 1. Is COVID in retreat? 2. Are we testing enough? 3. Are our hospitals ready? (Link)

  3. 🌎 The Financial Times (visualisation) has a data tracking page which is in front of the paywall, looking at cases and fatality curves for selective countries and metropolitan areas/region. It is not as extensive as the Madlag link below, where you can see static as well as animated images for a greater number of individual countries. (Link)

  4. 🇺🇸  The Johns Hopkins University resource center was the first one I used back in January they have now made available in their latest iteration a county by county dashboard in the US including information about health capacity, insurance coverage, ethnicity and age breakdown of the populatio (Link)

  5. 💊 The "Map of Hope" provides a geographical overview of planned, ongoing and completed clinical trials. It is put together with data from WHO Clinical Trials Search Portal by the Heidelberg Institute for Geoinformation technology. (Link)

  6. 🌍 MRC Centre for Global Infectious Disease Analysis started to publish weekly death estimates for countries (Link)

  7. 🇺🇸 The US Center for Disease Control and Surveillance (CDC) publishes “A Weekly Surveillance Summary of U.S. COVID-19 Activity” (Link)

  8. Google has published a new website to “See how your community is moving around differently due to COVID-19”. They have a lot of data to do so… (Link)

  9. 🌎 Country by Country Curves: This is a GitHub made by my friend Francois Lagunas. He has written a script to scrape deaths and number of cases in order to visualise the rate of growth on a logarithmic scale.  Great resource (Link)