As cities and states begin to re-open, everyone is waiting for things to return back to normal.

But even with business is re-opening, things are hardly back to normal.

Many businesses are forced to operate with limited capacity, such as only allowing in 25% of patrons. Other establishments are requiring or at least highly suggesting for customers to wear masks and to stand 6 feet from each other when shopping or when waiting in lines.

And beyond the policies put in place by these businesses, there is the underlying sense of anxiety that so many people have when heading out now.

You never know where the virus could be lurking or who could be carrying it.

These are things that I believe will completely change once a vaccine is ready. If you’ve been following news stories related to vaccines like I have, you have seen timelines thrown out of 12 to 24 months. Basically, in a best case scenario, people have stated that a vaccine will be ready in early 2021.

Those are largely based on precedent that we have to go by for other past viruses.

But some researchers out of the highly respected University of Oxford (Harvard of the UK) believe that there could be a coronavirus vaccine much sooner.

In fact, Oxford University researchers say that they have already developed a coronavirus vaccine that prevented the virus from spreading in a small study involving monkeys. They believe that if further studies go well, this coronavirus vaccine (called ChAdOx1 nCoV-19) could be widely available by September.

The vaccine apparently prevented lung damage to the monkeys who were exposed to high levels of coronavirus after they were given a single dose of the vaccine. 

The paper detailing the results still needs to be peer reviewed which could take weeks to months. But the researchers are showing a high degree of confidence largely because they were able to piggyback off data from viruses related to coronavirus.

Of course, working on monkeys is one thing and working on humans is quite another.

But they have already started human trials and the researchers are hopeful that the data will show the vaccine is effective for humans by June. If that is the case, this vaccine could be mass produced and widely available to the public by September.

There are many different institutions working on coronavirus vaccines which is obviously a great thing. But it appears that these researchers at Oxford University “are working at uncommon speed, starting a placebo-controlled clinical trial while finalizing the manufacturing of their potential vaccine,” according to Statnews, who tracks vaccine development. 

Oxford University is partnered with biopharmaceutical company AstraZeneca, who would develop, manufacture, and distribute the vaccine. 

In a press release from AstraZeneca, CEO Pascal Soriot said:

As COVID-19 continues its grip on the world, the need for a vaccine to defeat the virus is urgent. This collaboration brings together the University of Oxford’s world-class expertise in vaccinology and AstraZeneca’s global development, manufacturing and distribution capabilities. Our hope is that, by joining forces, we can accelerate the globalisation of a vaccine to combat the virus and protect people from the deadliest pandemic in a generation.

It’s still too early to tell if this vaccine will in fact be ready by September but personally it feels good to see such a well-known university working on something so ambitiously. 

If we were able to get vaccines in place before the fall flu season kicks in I think this would be tremendous on so many different levels.

Obviously, the top priority is the health of the public but this could expedite the return to travel.

Many people would feel safe traveling in time for the holidays and we could see a boom in travel demand return likely after the turn of the new year. 

And then imagine how safe you would feel traveling with a vaccine plus all of the enhanced sanitation methods that hotels and airlines are employing. 

Let’s hope that the trials continue to be successful and that we hear more good news in another month or two.

H/T

You’ve probably seen a lot of people debating on whether or not people should be wearing masks when out in public.

Many people feel like being required to wear a mask is too much of an infringement upon their individual liberties while others are proponents of wearing masks because they believe they are effective at reducing the spread of disease.

In many countries in Asia, wearing masks or face coverings has been socially acceptable for quite some time. But here in the US, wearing masks out in public is a recent invention that has only been around for around a month or so.

So resistance is only natural.

But there is new data coming out that shows wearing a mask could drastically cut down on the transmission of viruses. And the best part is that you don’t have to completely shut down everything for those masks to be effective, if Japan is any indicator.

If you compare the death rate between the US and Japan, it is clear that Japan is doing much better than the US. The total deaths in the US has surpassed 76,000 while in Japan they were just at 577. And if you account for the fact that Japan has a population about 38% the size of the US, you can see that their death rate is still only 2% of that in the US.

What’s interesting is that Japan has reportedly not issued massive lockdowns, still has active public transportation like subways, and many businesses have remained open. Social distancing is in effect but Japan is not even implementing widespread contact tracing, which is when countries track down all individuals that may have come into contact with an infected person.

So you might be wondering how Japan has been so successful.

Well recent research from De Kai, an American computer scientist with joint appointments at UC Berkeley’s International Computer Science Institute and at the Hong Kong University of Science and Technology, suggests that it is because nearly everyone is wearing a mask.

De Kai Is the architect of a new in-depth study that will be released in the coming days that lays out the science for why everyone should be wearing a mask.

The study has a number of findings but one of them that stick out is that if 80% of a closed population were to wear a mask then infection rates would drop approximately 1/12 compared to a population where no one wears masks.

The study used very sophisticated computer forecasting modeling that took all sorts of different variables and circumstances into consideration including randomness and unpredictability, effectiveness of different types of masks, all with the help of artificial intelligence. It’s thought to be one of the most thorough studies conducted on the topic.

Obviously, every model is only as good as its assumptions. But based on the data, including what has happened in Japan, it seems like wearing masks will be key to allowing societies to re-open again without major risk of virus spread.

We’ve already seen discussions about mask requirements for re-opening up places like Disney and now many airlines are requiring masks for all passengers. Some cities have even implemented mask requirements as have certain businesses.

I think as more details of this study and other similar studies are revealed, we will see just how beneficial wearing them can be. 

If we can continue to practice some basic level of social distancing and hygiene practices like regular hand sanitation, I think we can begin to get a little bit more comfortable with certain places opening up. 

You can read more about the model here.

5/4/20 Update:

The Institute for Health Metrics and Evaluation (IHME) just updated its latest model and this time the projected death toll has just shot up like crazy. It increased from 74,073 to 134,475 — this is the largest increase that we have seen as you can tell below. 

• 5/4/20: 134,475
• 4/27/20: 74,073
• 4/22/20: 65,976
• 4/17/20: 60,308
• 4/13/20: 68,841
• 4/10/20: 61,545
• 4/8/20: 60,415
• 4/6/20: 81,766
• 4/1/20: 93,531

According to CNN, the increase is a direct response from states loosening up on social distancing and re-opening of the economy.

We are truly at the most difficult point in the pandemic as far as decisions go.

Do you keep the lockdowns going and thus take almost total control over the transmission of the disease until it gets close to zero but in the process keep people from working? 

Or do you accept a certain number of casualties in the process of gradually re-opening up the economy so that unemployment can go back down and people have income to survive?

It’s a very difficult decision and there really is no best choice other than trying to measure the data and make educated guesses about which route will cause the least amount of damage.

I just hope that whatever decision is made does not result in a large surge of cases that threatens the healthcare system.

Hopefully, some middle ground can be found where establishments begin opening up but people are able to take precautions to mitigate the future spread of the virus until we see a vaccine. 

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4/27/20 Update:

The Institute for Health Metrics and Evaluation (IHME) just updated its latest model and this time the projected death toll has increased by almost 10,000 from last time. It increased from 65,976 to 74,073 — this is the largest increase that we have seen from this model this month.

• 4/27/20: 74,073
• 4/22/20: 65,976
• 4/17/20: 60,308
• 4/13/20: 68,841
• 4/10/20: 61,545
• 4/8/20: 60,415
• 4/6/20: 81,766
• 4/1/20: 93,531

This increase is not a huge surprise given how the death rate has continued to rise although it has greatly slowed down and we are already on the downside of the peak.

I think that is the most reassuring picture to focus on — the fact that we can see clear downward trend as a nation is huge.

We still have a ways to go but we are not far from having the deaths per day under control at a very low rate. It looks like that could start to happen sometime in the middle of May.

States are now starting to open things back up and so I think that there will be some spikes that occur in the next few weeks (that hopefully get put out pretty quickly). But based on this model, May will be the month of the start of reopening places for lots of states, likely on a staggered basis.

If these models hold true, by the time June starts, we should see a lot of states with reduced lockdowns, although many will likely drag on through at least June.  

If you would like to view the models for your state, the country, or for different international locations here is the link to view the models.

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4/22/20 Update:

The Institute for Health Metrics and Evaluation (IHME) just updated its latest model and this time the projected death toll has increased from last time. It increased from 60,308 to 65,976.

Based on the way the numbers have fluctuated over the past couple of weeks, it looks like the total death toll through August will be somewhere in the 60,000s. 

Here’s a look at how the projections have changed:

• 4/22/20: 65,976
• 4/17/20: 60,308
• 4/13/20: 68,841
• 4/10/20: 61,545
• 4/8/20: 60,415
• 4/6/20: 81,766
• 4/1/20: 93,531

So we are still almost 30,000 deaths under the original projection back at the beginning of April.

One trend that is pretty clearly emerging is that we have passed the peak as a country. I guess it’s possible for a spike to come out of nowhere but the graph looks like we are on a pretty clear downward trend at this point.

Some states like Georgia are talking about opening up right now and these models assume social distancing through the month of May. So if we start opening up too quickly, it’s possible that these projections could rise and perhaps rise dramatically.

Interestingly, the containment strategies (when it becomes possible to relax social distancing due to testing, contact tracing, isolation, and limiting gathering size) look like they have been pushed out towards the end of June for some states like Arizona. Meanwhile, other states like California have containment periods that could begin in the middle of May.

Recall that the White House announced different phases they will be using to re-open the country. Regions must meet certain requirements like a “downward trajectory of documented cases within a 14 day period” and a “downward trajectory of positive tests as a percent of total tests within a 14-day period” to begin phase one. 

If you would like to view the models for your state, the country, or for different international locations here is the link to view the models.

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4/17/20 Update:

The Institute for Health Metrics and Evaluation (IHME) just updated its latest model and this time the projected death toll has decreased from last time. It decreased from 68,841 to 60,308.

According to the model, we reached the peak two days ago as a country. But some states have still yet to peak. For example, Texas is projected to peak in two days.

The decrease is very encouraging because the last two updates to the model had the projected that increasing by a good amount. This number will still change based on future data but if this trend continues we might be able to see it dip below 60,000 which will be very encouraging (although still a staggering figure).

Something new that the model is showing now is a “containment period” that would begin June 1.

This means that social distancing could be relaxed at that point subject to certain conditions. For example, containment strategies will need to be in place like:

• Testing
• Contact tracing
• Isolation
• Limiting gathering size

According to IHME, containment could begin when the estimate of when COVID-19 infections drop below 1 per 1 million people in a given location, and its also influenced by each location’s available public health funding to implement new containment strategies.

These new projections come right after the White House just announced different phases they will be using to re-open the country. Regions must meet certain requirements like a “downward trajectory of documented cases within a 14 day period” and a “downward trajectory of positive tests as a percent of total tests within a 14-day period” to begin phase one. 

So these models could be used to help approximate when certain states could enter the first phase of opening things back up.

If you would like to do the models for your state, the country, or for different international locations here is the link to view the models.

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4/13/20 Update:

The Institute for Health Metrics and Evaluation (IHME) just updated its latest model but this time the projected death toll has increased by a much wider margin than last time. It increased from 61,545 to 68,841.

I was hoping that the death projections would be going down steadily but it looks like they are now going back up, unfortunately. While 68,000 is still a staggering figure, at least it is not in the ballpark of what some other early projections were showing with deaths in the range of several hundred thousand. 

It looks like we as a country are still in the midst of the peak although probably very close to things starting to decline. Take a look at the USA graph projections.

It looks like it won’t be until the beginning of June until we see things truly die down to less significant levels. But some states might reach that point at the end of this month.

New York looks like it is officially in an early state of decline and that things could be greatly under control by the end of this month.

It is also interesting to look at graphs for countries like Italy where they are clearly in a state of decline.

Remember, these models assume social distancing all the way through May so if our leaders change policies too quickly on social distancing we could see things drag out further.

If you would like to do the models for your state, the country, or for different international locations here is the link to view the models.

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4/10/20 Update:

The Institute for Health Metrics and Evaluation (IHME) just updated its latest model but this time the projected death toll has increased.

It is only a slight increase of 60,415 to 61,545. 

This is not completely unexpected given how they update the model with new data. I still think that it will eventually go down. Basically new data is coming in from states as they get hit with their first major waves of the virus in so I believe that is causing the slight uptick. This is just my speculation, but I believe once those states get things under control, these numbers may start to go down again.

Something interesting is that today is scheduled to be the peak for deaths. So if this model is correct, then things should start going downhill after today which is really great news.

So, it looks like the peak has been pushed out for certain states like Texas but only by a few days.

I try not to put too much stock into these projections because they are subject to change but I still feel like the trends are much more positive than we initially imagined, especially in terms of the worst case scenario.

If you would like to do the models for your state, the country, or for different international locations here is the link to view the models.

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4/8/20 Update:

The Institute for Health Metrics and Evaluation (IHME) just updated its latest model and it once again shows a decreased projected total death count.

This time the decreased death count has been more significant.

We recently saw the number of projected deaths drop from 93,531 to 81,766. But now the new model is showing an expected total number of deaths at 60,415. 

Once again, this is still an outrageously high number but it is consistently dropping as they input new data. I’ve got a feeling that this number is going to continue to drop over the next few days and weeks and may eventually resemble something closer to the annual death toll of the flu.

So this model has me feeling extremely optimistic in terms of the trends we are seeing, and I think it is proof that social distancing is having a great impact on the spread of the disease.

Something else that is new about the model is that you can now view data from different countries so it is interesting to see a few countries like Italy where you can see a clear downward trend going on now. If you would like to search for different countries or for your specific state, scroll down and you’ll see the link to find the charts.

4/6/20 Update:

The Institute for Health Metrics and Evaluation just released its latest model and it shows a decreased projected total death count. The total number of projected deaths in the last model was 93,531 through August but this has just been decreased to 81,766.

I want to reiterate that these are just projections and that they will be continuously changing as new data points are input but this is highly encouraging.

The other exciting development here is that the peak of infection looks like it has been pushed forward in some states. For example, in Texas the peak looks like it is about April 20th. But in prior models it was showing the first week of May.

If this trend holds true then this means that we will be hitting the peak sooner and therefore we should be able to lift lockdowns sooner as well.

Now, I am not a medical professional or statistician but I do know how to read graphs and seeing these trends change looks like a very positive change.

There are about 10,000 fewer deaths predicted and the peaks look flatter and like they are arriving sooner so I think those are all three very positive signals.

I would encourage you to check the link below to see when the peak is expected to happen in your state.

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4/1/20 Original article:

The Institute for Health Metrics and Evaluation is an independent research center at the University of Washington and they developed a model projecting coronavirus growth across the US.

These models break down the expected peaks of coronavirus for each state and also for the entire country over the next few months. These models are just predictions so they may not be accurate in all cases and will likely need to be updated as more data comes in over the next couple of weeks.

However, these models can still be helpful to people who are trying to figure out what to expect to happen to the country over the next few months and also how their state compares to others.

They will also be helpful for travelers who are trying to time when things may begin to calm down in their region or to another region that they plan on traveling to.

These models assume that social distancing is continued through the months of April and May.

For those of you who think that social distancing will end at the current 30 day period recommended by the White House, I think you will be disappointed as I fully expect that extension to go all the way through May. Maybe it won’t but that would be surprising to me.

Link to view models

Anyway, here is the link to view the models.

You will be able to select the country or the individual state that you would like to look into. It also has projections for medical needs, such as hospital beds, but if you scroll down you will see the projections for total deaths.

Here’s the model for the US:

Here’s the model for Texas:

It’s possible that we will not see as many deaths that are predicted but at this point I don’t think anybody really knows or can predict with certainty what will happen.

We really need to see how much of an impact of social distancing is going to have, and I think that is still going to take another couple of weeks for us to get a true grasp on based on what experts have been saying.

I will continue to monitor these graphs and update this article as the dates begin to change.

 

Los Angeles just announced that they will be providing free testing for all residents free of cost and even to individuals who exhibit no symptoms of the coronavirus. Los Angeles is the first major city to provide such widespread testing to its residents.

Reportedly, they will prioritize those with symptoms and put them at the front of the line which obviously makes a lot of sense.

But the testing will be very helpful for individuals who know or have a high suspicion that they were recently exposed to someone with coronavirus.

Also, while people are discouraged from getting tested every day, people will be able to get repeat tests done if they feel the need to do so.

The testing being done is for an active infection of the virus and not antibodies.

Ideally, communities will soon be able to implement both types of testing on a widespread basis.

But one issue with antibody testing so far has been the accuracy and also the unknown degree of immunity that exists with different levels of antibodies.

Regardless though, the more testing that can be done at this stage the better because it will allow infected individuals to be removed from society quicker and help flatten the curve until a vaccine is widely available. This will help prevent a major surge from developing and prevent our healthcare systems from getting overwhelmed.

People who would like to sign up for a test in the Los Angeles area can do so here: https://corona-virus.la/.

H/T

A lot of grocery stores and supermarkets are making new changes in order to combat the spread of the coronavirus.

We’ve seen stores limit entry of customers to a certain number and implement certain policies like installing sneeze guards and directing traffic one way through aisles.

Well, Costco has taken an additional step and on May 4 will be requiring all customers to wear face coverings that will cover up the nose and mouth. These will be required for all individuals except for those two and under and is not meant to decrease social distancing. 

“The use of a mask or face covering should not be seen as a substitute for social distancing,” Costco stated. “Please continue to observe rules regarding appropriate distancing while on Costco premises”

We are now seeing more companies requiring masks.

For example, the airlines JetBlue just announced that masks will be required for all passengers and others like Lufthansa are following suit.

These mask policies usually start by requiring staff and employees to wear masks and then eventually it gets applied to customers.

The timing is very interesting because we are seeing a lot of states getting ready to open up as we go into May. No state has met the 14 day decline criteria suggested by the White House, however so many believe that these places are opening up too soon.

If more large stores like Costco and perhaps Walmart and Target require face coverings, it’s possible that they could play a role in curbing the spread of the virus while things begin to open up. Most states are opening up with many restrictions for places like restaurants so requiring masks (where practical) could add to the safety of customers. 

I would expect to see more establishments make masks mandatory through the month of May as they try to balance opening back up with the safety of their customers and staff. Thankfully, it seems the US has made a lot of progress over the past few weeks with its stigma attached to wearing masks.

H/T

The data we have for the coronavirus has been evolving since day one. We’ve learned about how long it can survive on  surfaces like shoes for several days and we’re learning more and more about things like the widespread presence of antibodies. 

Well now, the CDC is officially recognizing new symptoms of the coronavirus. Initially, the CDC recognized the following:  

One of the most crucial aspects of getting the economy back up and running is proper testing.

If you look at the key considerations for many states when it comes to opening up the economies, testing is usually at the top. We need widespread testing across the country and we also need to be able to trace contacts in order to curtail the spread of the virus once we begin to open things back up.

Luckily, testing just took a major step forward with some great news.

The U.S. Food and Drug Administration (FDA) just allowed Emergency Use Authorization (EUA) for at home testing for the coronavirus.

The test will use nasal swab specimens that can be collected at home using the Pixel by LabCorp COVID-19 test home collection kit.

Individuals will be given a COVID-19 questionnaire and if recommended by a healthcare provider, they will proceed to receive the home collection kit for testing.

Initially, these tests and kits will be made available to healthcare providers and first responders who may have been exposed to COVID-19 or may be symptomatic.

This makes a lot of sense considering that those are the individuals coming into contact with sick patients on a regular basis and if they are carriers of the virus, they could end up spreading it to many people in a short amount of time.

The tests can also decrease the demand for personal protective equipment (PPE) since the tests do not require a clinician to perform the test collection. So the approval of these new tests will have substantial benefit for those in the healthcare industry.

But what about the general public? 

The great news is that, “LabCorp intends to make COVID-19 self-collection kits available to consumers in the coming weeks.”

So we are now seeing testing for active infections and also testing for antibodies becoming more readily available to the masses. Both of those things are going to help us prevent a second wave from emerging as we get ready to reopen the economy in the next month or two.

Read more about the press release here.