Virus notes: March 29, 2020

MERCED (BLJ) – Johns Hopkins data dashboard reports that globally there are 716,101 confirmed cases, 33,597 deaths, and 148,995 recovered patients. In the US, there are 137,294 confirmed cases, 2,414 deaths, and 2,660 recovered patients.

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San Jose Mercury News

Coronavirus: California surges past 5,000 cases and 100 deaths

Gov. Gavin Newsom was in Sunnyvale Saturday, where Bloom Energy is fixing ventilators

California hit several grim milestones Saturday in the coronavirus pandemic, surging past 5,000 positive cases and surpassing 100 deaths even as people remained sheltered at home in a desperate bid to stem the spread.

Continuing a steady march upward over the weekend, the number of positive COVID-19 cases in California reached 5,446 and deaths soared to 118 by the afternoon, according to data compiled by the Bay Area News Group.

And, Gov. Gavin Newsom announced during a visit to Sunnyvale earlier in the day, the number of people in intensive care beds across the state because of the virus doubled overnight to 410 from 200 on Friday.

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The Guardian

Pelosi: Trump inaction cost American live

Ed Pilkington

Nancy Pelosi, the top Democrat in Congress, has just delivered a devastating critique of Donald Trump on CNN’s State of the Union, accusing him directly of costing American lives through his constant denials and delays.

 “The president’s denial at the beginning was deadly,” she said. “His delay in getting equipment to where it’s needed is deadly … As the president fiddles, people are dying.”

Asked by host Jake Tapper if she was saying Trump’s early downplaying of the severity of the coronavirus crisis “cost American lives” Pelosi replied: “Yes I am. I’m saying that.”

She said that after the crisis was over, there would need to be an investigation into Trump’s handling of the pandemic.

“What did he know?” Pelosi asked. “When did he know it?”

But for now it was a question of making sure he stopped failing to act.

“We still don’t have adequate testing,” Pelosi said, “and we still don’t have protective equipment for our health workers who are risking their own lives to save lives.”

Pelosi ended on this note: “Don’t fiddle while people die, Mr President.”

Such a direct accusation is certain to inflame Trump. Expect fireworks later.

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As of Friday, the Merced County Public Health Department reports that there are seven confirmed cases of coronavirus in the county, 61 people have been tested through the public health system, the department doesn’t know how many others have been tested by commercial labs, clinics, and hospitals, and Golden Valley Health Center announced it was opening drive through swap tests for free to its clients. Perhaps the free tests will improve reviews of the Center published on the Internet.

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Of course, if you live in a country that rations coronavirus testing by socioeconomic privilege, and can’t meet the low bar of social responsibility of Italian neo-fascists, you don’t have the opportunity of mass testing. -- blj


Al Jazeera

Do try this at home: how one Italian town fought coronavirus

The evidence is clear: Mass testing for the virus is the key to its eradication – and to saving lives.

by James Melville

Cases of the coronavirus in Italy have continued to soar in recent weeks. The country has reported 86,498 cases and 9,134 deaths as of Saturday, March 28.

But one small Italian town claims to have eradicated coronavirus infections, having now reached zero new cases after implementing a mass-testing programme in a bid to curb the spread of the virus.

The town, Vo Euganeo - population 3,300 - based in the heartlands of the most contaminated area of northern Italy, saw a cluster of cases of COVID-19 in the third week of February and was home to the country's first death from the virus, on February 21.

So, while the draconian measures taken in China to get the coronavirus under control may not be suitable for other countries, could we learn, instead, from this small Italian town?

Following the town's first death from coronavirus, the whole town was put under lockdown.

No one was allowed to enter or leave, while goods (medicines and food) could only reach the town if authorised to do so by the Prefetto, the central government representative in Padua. Then all of the town's 3,300 residents, including those with no symptoms, were tested for the virus starting from March 6.

This allowed quarantining of people who had been infected, before they showed any signs of infection and stopped any further spread of the coronavirus in its tracks.

Within 14 days, the virus had been eradicated from the community. This mass testing revealed that about 3 percent of residents were infected with the virus at that point, and, of these, about half were not showing any symptoms when they tested positive.

After two weeks of a strict lockdown of the entire town and the quarantine of infected patients, only 0.25 percent of residents were testing as infected. Vo Euganeo has not reported any new cases since Friday, March 13.

In the first round of testing, 89 people in Vo Euganeo tested positive. In the second round of testing, the number of positive cases had dropped to six.

Because of a combination of universal testing and lockdown across the entire town, Vo Euganeo managed to avoid the number of cases spiralling out of control, thereby minimising the risk of a huge demand on their health services. In effect, they nipped it in the bud by taking aggressive and decisive action early to stop the spread of the disease.

All of this was achieved with a 100 percent recovery rate for those previously infected.

Writing about this case, Andrea Cristani, a professor of microbiology at the University of Padua in Italy who helped carry out the testing, and Antonio Cassone, the former director of the department of infectious diseases at the Italian Institute of Health, said: "In the last two weeks, a promising pilot study here has produced results that may be instructive for other countries trying to control coronavirus.

"Beginning on 6 March, along with researchers at the University of Padua and the Red Cross, we tested all residents of Vo, a town of 3,000 inhabitants near Venice - including those who did not have symptoms. This allowed us to quarantine people before they showed signs of infection and stop the further spread of coronavirus. In this way, we eradicated coronavirus in under 14 days."

Elsewhere in Italy - as in other countries - however, the authorities chose only to test those who already displayed symptoms.

The decision to only test those who presented for treatment with symptoms of the virus was taken by major Italian public health experts, apparently in line with World Health Organization (WHO) suggestions.

But, according to Cristani and Cassone, asymptomatic or quasi-symptomatic subjects represent a good 70 percent of all virus-infected people and, still worse, a huge number of them can transmit the virus to others without realising they are doing so.

As shown in Vo Euganeo, full community testing gives a clearer picture of how many people actually have the virus, and how many pass it on.

The key factor is that testing only those who display symptoms of the virus gives only a vague and misleading indicator not only of how many people have caught the virus but also of the overall percentage mortality rates.

Other countries should look closely at the results of the case study in Vo Euganeo.

It may be difficult to implement such a testing strategy right across a major city or indeed the whole of a country, but it may well be possible to implement this approach in pocket areas where infections are spreading rapidly and therefore contain the spread of the virus before the number of cases increases. This would help to avoid the risk of high demand on hospitals.

Governments could identify and isolate coronavirus cluster areas, test everyone in these communities and quarantine each resident - whether they have symptoms or not - and then trace their recent contacts, and test and quarantine those people as well.

Full testing is the only way in which countries will gain a clear picture of the actual numbers who have the virus and, therefore, how many people risk infecting others without even knowing they are doing it.

In the absence of a vaccine, the identification of all carriers (both symptomatic and asymptomatic) appears to be the most effective way to control the pandemic.

The mass testing example in Vo Euganeo echoes the recent statement from the World Health Organisation (WHO).

"We have a simple message to all countries - test, test, test," Tedros Adhanom Ghebreyesus, director-general of WHO, said at a news briefing last week.

"All countries should be able to test all suspected cases. They cannot fight this pandemic blindfolded."