The Road goes ever on and on ... Day 294 (794)

I ended with monkeypox yesterday, so let's start there today. It's now spreading in Portugal and Spain in addition to the UK. So far, cases seem to be concentrated among gay and bisexual males. 

I mentioned a while back that there seems to be a lot more bad driving out there now than there was before the pandemic, when I used to go out in the world on a more regular basis. I also mentioned a very short while back that gunshot, overdose, and sexually-transmitted disease deaths were up? While road deaths did not reach a new all-time high, in 2020 they were the highest they've been since 2005.

North Korea's new report mentions 62 deaths and 1.7 million cases. The report also includes that one million people have recovered. Blame for the outbreak is spreading. Kim Jong Un ordered the execution of two people for covid-related crimes. One was a customs official who allegedly did not follow virus prevention rules when importing goods from China. 

The levels of cases and hospitalizations in New York City is now at high alert, a level that comes with the recommendation that the city government require masks in all public indoor settings. The mayor replied, "We're not at the point of mandating masks." City health officials are recommending that masks be worn in offices, grocery stores, and other public indoor settings. Unfortunately, "recommended" and "required" have very different definitions.

Public school systems nationwide are losing students due to the pandemic. All together, there are now at least 1.2 million fewer students than there were in 2020. One possible cause is that in response to virtual or online learning, some parents switched to homeschooling or moved their children to private or parochial schools that chose not to stay closed as long as the public schools did. In some cases, the children just dropped out. Older teenagers may be staying at jobs to help offset income parents have lost. Parents may have simply stopped making younger children attend. Most interesting is that in some states, including Florida, that eschewed virtual learning, enrollment rebounded and is still on the robust side.

Senior citizens have been especially hit by the coronavirus. Now it seems that 32 percent of those older adults who survived covid had symptoms of long covid up to four weeks later compared with 14 percent of adults between the ages of 18 and 64. The difficult part is that many of the symptoms of long covid are the same as changes that occur with aging. It may be hard to identify to which group individual symptoms belong. Being able to know that would obviously help the people who care for those elderly.

The Road goes ever on and on ... Day 262 (762)

Once we exited the period in which the entire front page of major newspapers was devoted to coronavirus stories (back when it was called the novel coronavirus), it's been harder to find such stories on weekends. The war in Ukraine dominates the front pages now, as well it should, and many inside pages, too. It takes a major development or insightful human interest story to see the coronavirus on the first page or screen now. 

The major news I did find this morning concerned WHO's newly reported calculation of the coronavirus's global death toll. WHO added new information from localities and household surveys. They also used statistical models to account for missing cases. The numbers in WHO's total represent "excess mortality" or the number of deaths more than what is normally seen during that time period. In the coronavirus death total WHO counted people who died directly from covid, people who died of complications due to covid, and people who died not having or having had covid but who had a potentially fatal condition go untreated due to covid. 

WHO's calculation yielded a number more than double the official toll of six million reported by individual countries: around 15 million as of the end of 2021. WHO says these data are essential for understanding how the pandemic has progressed and what steps could mitigate similar future crises.  The sticking point is that India is disputing the calculation of its death toll. It also doesn't want the WHO total becoming public (given that I found the total, it's already public). Over a third of the additional nine million deaths, about four million, are said to have come from India. India maintains that its death toll is in the neighborhood of 520,000.

Some of the members of the WHO committee issuing the report say that India's complaints have actually helped ensure the accuracy of the result. A statistics and biostatistics professor at the University of Washington who helped build the model noted that they had "gone overboard in terms of model checks," and that they had done as much as they possibly could given the available data. I'm siding with WHO on this one. 

The View from the Hermitage, Day 418

I always though, as you may have as well, that the pandemic case and death tolls were underestimates. But on what scale? A new analysis by the University of Washington's Institute for Health Metrics and Evaluation suggests the true covid-19 death toll could be double the official count. Some countries only count deaths that take place in hospitals or in patients with confirmed cases. Some countries have a narrow definition or what they count as a covid-19 case. The IHME analysis suggests that the global death toll should be 6.9 million. Here's their "total" deaths versus reported deaths for the 10 countries leading the pack in terms of numbers of deaths. 

                           Total Deaths           Reported Deaths

 1. US                    905,289                    574,043

 2. India                 645,396                    221,181

 3. Mexico             617,217                    217,694

 4. Brazil               595,903                    408,680

 5. Russia             593,610                    109,334

 6. UK                   209,661                    150,519

 7. Italy                 175,832                    121,257

 8. Iran                  174,127                    72, 906

 9. Egypt               170,041                    13,529

10. South Africa   160,452                     54,390

We'll never really know how many people died from the now-not-so-novel coronavirus. We never really knew how many people died from the influenza pandemic a century ago. Looking at the numbers above, I wonder how much effect the larger numbers vs. the smaller ones would have on how we perceive the seriousness of the pandemic. Would people have viewed the mitigation measures more positively if presented with the numbers in the first column vs. the second?

India continues to rack up records, reporting 414,188 new cases on Friday. Brazil has now seen over 15 million total cases; in response, the government has ordered an extra 100 million doses of the Pfizer vaccine. Any prediction of the difference those doses might make should take into consideration what is happening in the Seychelles. It's the world's most vaccinated country, with more than 60 percent of the population fully vaccinated. It currently has its largest number of coronavirus cases per capita and is reinstating some of its earlier restrictions such as school closures and limited hours for shops and restaurants. It's seeing just over 100 new cases daily in a country with a total population under 100,000. 

Looking at a group of 1,068 active cases, about 65 percent were residents who were either completely unvaccinated or who had gotten only one dose. The Seychelles used both Sinopharm and the AstraZeneca vaccine, which appear to be less effective against symptomatic covid-19. The WHO estimated the efficacy of the Sinopharm vaccine at just over 78 percent for adults under 60, while US trials suggest 79 percent efficacy for the AstraZeneca vaccine. There is one more factor to consider: Increases came after tourists began to return beginning on March 15, with no quarantines nor vaccinations required, just a negative PCR test less than 72 hours before travel. (You know how I feel about tests--negative today does not mean tomorrow won't be positive.) Only 10 percent of the positive cases were found to be among tourists, though.

Some sources are saying that about 185 million Americans could be fully vaccinated by September, some 88 percent of the adult population. (I do not know how the researchers handled the vaccine-hesitant and vaccine-resistant.) It is not clear, though, if 88 percent will be enough and in time to fight predicted winter surges as variants become more prominent.

Other interesting but non-coronavirus-related snippets include that Wyoming, which produces 40 percent of the coal used nationally, is preparing to sue states that opt to power themselves with clean energy rather than Wyoming coal. A woman in California moved to a certain area for the "wealth of wildlife" there and now is dealing with 15 condors sitting around her house and deck doing what comes naturally to birds. There are only about 160 condors in California, so no harmful action can be taken to scare them away. And across the Pacific, a petition with the title "Cancel the Tokyo Olympics to protect our lives" gathered 200,000 signatures in two days.