One of the most interesting things that started recently was the testing of antibodies for the coronavirus.

This type of testing has the potential to tell us how widespread the coronavirus really is and could also allow us to get back to normal at a quicker rate.

If we can figure out how immunity works and we know a significant percentage of the population has the antibodies, those people can resume work much sooner than everybody else without the risk of getting very ill. 

In Los Angeles County, residents have been getting getting tested for antibodies and the results from the first large-scale study show that 2.8% to 5.6% of adults have antibodies in their blood.

This would translate to roughly 221,000 to 442,000 adults who have recovered from getting the coronavirus.

Why is that number so crazy?

Well, the county has only reported under 8,000 cases.

So this could mean that the spread of the virus is FAR more prevalent than most of us have conceived.

And if those trends remain roughly similar for the rest of the US, this means that a much larger portion of the population will potentially have immunity from the virus going forward.

This would also mean that the fatality rate is much lower than initially believed.

As some experts have pointed out, these estimates could mean that models will need to be recalibrated and public health strategies need to be reconsidered.

These results are not that surprising to some in California, as they come only three days after Stanford researchers found the virus had spread much more widely in Santa Clara County than previously thought.

That research team estimated that 2.5% to 4.2% of Santa Clara County residents had antibodies to the coronavirus even though the county had reported 1,000 cases.

So in that case, the carriers of the virus are actually estimated to be 50 to 85 times greater. That’s pretty wild.

It is still early with tracking these antibody testing results so I think we need to let the results and data come in from more than one region and from waves of tests before we arrive at conclusions.

But just be prepared for the reality that this virus may be significantly more widespread than you probably believed it was.

You might even have the antibodies yourself and not realize it.

I know from personal experience that this could happen. I have the antibodies for Zika virus meaning that I picked up the Zika virus at some point and my body fought it off but I never develop any Zika symptoms.

So you might be surprised that you could have come into contact with a potentially deadly virus and not have had any symptoms develop.

Hopefully, antibody testing will become widely available over the course of the next few months and we will have a more accurate picture of how widespread the virus is.

H/T

The White House just released the guidance that will determine how society opens back up after the coronavirus, and the plan is to open society up in three different stages.

Below is a breakdown of the three different stages and what you can expect in a post coronavirus world. It’s worth noting that they did NOT make any timeline projections.

First, before getting to the three stages, states or regions must meet “gating” criteria.

• There must be a downward trajectory of influenza like illnesses reported within a 14 day period and a downward trajectory of coronavirus like cases reported in a 14 day period.
• There must be 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 (flat or increasing volume of tests).
• Also, hospitals must treat all patients without crisis care and have a robust testing program in place for at risk healthcare workers which includes antibody testing.

 I think the biggest issue for getting past this stage is going to be implementing robust testing, as states will need to have the “Ability to quickly set up safe and efficient screening and testing sites for symptomatic individuals and trace contacts of COVID+ results.”

Testing and tracing has been a major issue so this is not exactly a quick fix.

Once a state gets those things in order, they can move to phase one. Here are the different phases and what to expect.

Phase 1

Phase 1 is for states and regions that satisfy the gating criteria above.

Vulnerable individuals should continue to shelter in place. (This includes people like the elderly and also those with compromised immune systems.) Precautions should also be taken to isolate vulnerable residents. 

When in public, all individuals should maximize physical distance from others.

This includes places like parks, outdoor recreation areas, and shopping areas. So national parks will be allowed to be open but you will need to keep your distance from others.

Social settings of more than 10 people (where appropriate distancing may not be practical) should be avoided unless precautionary measures are observed.

Nonessential travel should be minimized. So there will no longer be a ban on non-essential travel, it will just need to be toned down.

What exactly that will mean will be interesting to see. How do you sufficiently minimize something like that and how do you draw that line?

As for employers, remote working should be continued where possible and certain areas like common areas where personnel like to congregate and interact should enforce social distancing.

Nonessential travel should be minimized for businesses as well and they should consider special accommodations for employees with at risk factors.

During phase 1, certain types of facilities should remain closed like schools and daycares. Also visits to senior living facilities should be prohibited. Luckily, the summer is right around the corner so states have several months to get things under control before the next school year begins.

Surprisingly, large venues like movie theaters, sporting venues and places of worship, can operate but must operate “under strict to physical distancing protocols.” 

Also, while gyms can open, bars should remain closed.

Phase one sounds like it could be an interesting time because sports venues may be able to open, perhaps with some type of limited capacity that ensures social distancing.

I’m not sure if that could actually work but I think social distancing could be implemented in some places like movie theaters and restaurants without too much hassle. And honestly, it will probably be a nicer experience since you will not be able to elbow with strangers.

Phase 2

Phase two will be for states and regions that have no evidence of a rebound and that satisfy the gating criteria a second time.

Physical distancing should remain when individuals are in public places but the social gathering rules will apply only to gatherings of more than 50 people instead of 10.

Significantly, during this stage non-essential travel may resume. This is huge news for those in the travel space. So for those of you planning on future trips, the biggest factor you want to consider is if a rebound is on the horizon or not. If it is not, then your travels can probably resume at that point.

Although this makes me wonder how that will work — will two destinations need to be in the same phase for travel to resume or are we just talking about one-way flights here?

The same restrictions will be in place for employers to encourage remote work and to enforce social distancing in common areas but only to a moderate extent.

Also, non-essential travel can resume and special accommodations should be strongly considered for at risk employees.

Schools and youth activities like daycare can reopen in this phase.

Visits to senior care facilities should still be prohibited and large venues can operate under “moderate” physical distancing protocols.

I’m very curious about what moderate physical distancing will look like in large venues.

Is it going to be a matter of going from two empty seats between people to one? Will it mean more space between visitors at concession stand lines? Again, it’s going to be interesting to see how these definitions are interpreted.

Gyms will remain open if they adhere to strict physical distancing and sanitation protocols and bars may operate with diminished standing room occupancy.

Phase 3

Phase 3 will be for states and regions with no evidence of a rebound and that satisfy the gating criteria for a third time.

In this stage, vulnerable individuals can resume public interactions but should practice physical distancing and minimize exposure to social settings where distancing is not practical. Low risk populations should also consider minimizing the time spent in crowded environments.

(It sounds like phase 3 is basically the reopening of society while waiting for the vaccine.)

These stages sound very interesting and I think rolling out stay just like this is a good idea. But the devil is truly in the details with something like this.

The biggest surprise to me is that large venues can operate in phase 1 and it will be very interesting to see how that plays out.

Also, I want to know at what point do officials determine that there has been no rebound and open up nonessential travel? I wonder if that threshold will be clearly defined.  

You can read the guidelines here

 

In a perfect pandemic world, those who get infected with a virus would build immunity to it and not have to worry about getting reinfected again.

But we have seen some startling reports coming out of countries like Korea where those who were infected with coronavirus have tested positive for the virus again. This has also happened in other countries like China and Japan.

This is causing a lot of people to panic about our ability to fight off the virus and is making it look less likely that travel will return anytime soon.

But things may not be not as bad as they seem.

These apparent reinfections may be a product of faulty or unclear testing or even instances of virus resurgence that are not as threatening.

For example, it’s possible that the tests administered to patients simply were not sensitive enough to distinguish between an active infection and one that a patient has mostly recovered from.

Basically the body could begin to clear out inactive debris of viral cells that could be coughed up from the lungs and into the throat and if a test picks up on that genetic substance in the throat, it could trigger a false active infection, according to Richard Condit, a molecular biologist and professor emeritus at the University of Florida College of Medicine.

Also, there have been a lot of issues with false negatives, which are tests that show a patient does not have the virus when they actually do. These can be caused by a variety of reasons, such as not collecting enough material from a patient. So it could be that the patient never was free from the virus after getting affected originally, which would explain why a later test would still show positive.

Another possibility according to Brianne Barker, an associate biology professor at Drew University, include the potential for a virus to dip and then spike again which is something that happens in certain types of viruses like the one that causes chickenpox and shingles.

In cases like this though, it’s common for the infected patient to have much more mild symptoms the second time around because they have built an immunity response. So if this were the case with coronavirus, the second round of infection would be much less threatening.

And finally, it’s possible that a patient could be infected with a different strain of SARS-CoV-2. This one is the most worrying one to me but I don’t know enough about if or how immunity responses can crossover to different strains with this virus or if the different strains are equally as potent.

So the bottom line is that we don’t know exactly what is going on but these cases of infection probably have a lot to do with testing.

It will take more monitoring and observation to know for sure what’s going on but I think there is currently more evidence for why we should not be freaking out about reinfections rather than the opposite. 

H/T: QZ.

One issue that has been plaguing the world right now is the lack of testing done to verify the number of infected individuals with coronavirus. Although the US seemed to have gotten off to a slow start, they now or ramping up testing big-time.

But some other countries are severely lagging behind and disparities are being created between what’s really going on and what is being reported.

Brazil is a prime example.

According to Reuters, “Brazil likely has 12 times more cases of the new coronavirus than are being officially reported by the government.”

To arrive at this figure, researchers at Brazilian universities analyzed the ratio of cases resulting in death through April 10.

They compared the data to expected death rates from the World Health Organization and found a much higher death rate than expected. This figure, they believe, indicates that there are many more cases of coronavirus than are being counted. In fact, they estimate that only 8% of cases are being officially reported.

According to the Center for Health Operations and Intelligence, the government has focused mostly on only testing serious cases instead of suspected cases and there have also been issues with getting test results and just distributing tests in general.

The number of confirmed cases is 23,430, according to health ministry data, but as of last Thursday, Brazil had around 127,000 suspected cases. So we are talking about an enormous disparity.

The Center for Health Operations and Intelligence stated, “The high degree of under-notification could give a false impression about control of the disease, and consequently, could lead to a decline in containment measures.”

For those travelers who plan on being among the first to get back out and start traveling again, these type of reports should be good reminders that some countries may be worse off than they appear on paper.

H/T

Since the outbreak of the coronavirus, consumer spending has changed dramatically. Here are a couple of trends that have shifted over the past couple of weeks, according to Earnest Research, which tracks credit card and debit card purchases of nearly 6 million people in the US.

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Travel has plummeted

As most of you already know, travel has been hit extremely hard. But it is probably worse than you even imagined. In fact, revenue for the week ending on April 1 was down 85% from the same time a year ago.

That is a huge drop and has affected virtually every sector in the travel space like airlines, hotels, cruises, and rental cars.

The online travel agencies like Expedia have also been hit very hard and blogs like this one that depend a lot on people researching travel have felt the wrath of the pandemic.

It’s truly been a bloodbath.

Groceries sales have spiked

For the week ending on March 18, grocery sales shot up 79% from the prior year.

This was due in large part to the frenzy around certain goods like toilet paper and also processed foods and canned goods that ran through all parts of the country. 

Things have leveled off for the grocery stores since then but are still up around 7%, with large increases in online grocery delivery services and meal prep companies.

I think there are competing forces for grocery spending where people are cooking more at home and buying more groceries but also trying to preserve food longer to avoid grocery store visits. So it’s no surprise to me that the frenzy of grocery spending has fizzled a bit.

Restaurants have tanked

Unlike prior economic downturn periods, in this one, restaurants have taken a huge hit.

With social distancing forcing many of these to shut down or only provide limited service, they have struggled mightily to survive. And the effect has been filled with all different types of dining establishments from fine dining down to fast food.

I’ve seen a number of restaurants resort to only take out and then eventually completely shut down for the time being so apparently running on just take out is not feasible for a lot of dining establishments.

Media and entertainment hit with mixed effects

Many types of entertainment like movie theaters, theme parks, and concert theaters have been completely shut down for the time being.

But we’ve seen a large surge in spending on video games and streaming services. Anecdotally, my social media feeds have been getting blasted with advertisements from various games so they are really exploding right now — usage is up by 75%.

Retail shopping has decreased

Retail shopping was already struggling mightily over the past decade as malls were dying but it has really felt the heat from the current crisis.

Revenue has taken a nosedive for stores like department stores, sneaker shops, and others in the retail space. Meanwhile, online shopping has absolutely soared.

In fact, “the number of online orders for web-only online retailers were up 52% year over year in the United States and Canada for the 2 weeks of March 22 through April 4.”

Transportation spending has dropped

Spending on mass transit and even rideshare services like Uber has gone down a great deal — Uber rides are down 70% in hard hit cities. And it’s affected everyone from subways to scooter sharing companies. Even those selling cars and auto parts have felt the strain.

Spending on health is down

Since gyms are closed, major fitness companies like 24 Hour Fitness and SoulCycle are feeling the hits, although spending for home fitness equipment has increased.

Since many hospitals have suspended elective procedures, there are fewer specialists working and some hospitals have even been forced to cut the pay or furlough doctors and nurses.

So it’s clear that the coronavirus has impacted a wide range of industries in a seriously negative way, but some have come out on top. Luckily, I don’t think that we will need a vaccine for some of these trends to start getting reversed but in my opinion the recovery will likely be gradual and will hit a certain ceiling until we have a proven vaccine in 2021. 

H/T

One of the most important signs that we are currently waiting on is for the curve to “begin to flatten.”

This means that the rate of infections has slowed and plateaued which means that there is no longer an acceleration of disease in the country. When the curve flattens it will soon drop and we will be on the “other side of the mountain” as some have put it.

Well according to the leading infectious disease specialist in this country, it looks like we are starting to see the curve flatten.

“What we’re seeing right now are some favorable signs as I’ve discussed with you a few times on this show […] It’s looking like that in many cases, particularly in New York. We’re starting to see a flattening and a turning around.” 

Over the past couple of weeks, I have been following the main model used to project the number of deaths and hospitalization needs for coronavirus cases. It has shown a decrease in the total number of expected deaths and also earlier peaks as well as flattened curves. Basically, each time that it is updated it is virtually all good news.

Based on the facts that I have seen and what experts are telling us, it really looks like we are starting to get this disease under control. There is even talk about people being able to take summer vacations this year, which I think is something a lot of people did not expect.

There are still a lot of cases and deaths are happening and we still have a ways to go. We definitely still need people to stay at home Easter weekend and to not congregate in large groups.

But at this point it is undeniable that the country is making progress in curtailing the virus. So far, our healthcare systems have been forced to go beyond capacity in some cases and there have been serious issues with protective equipment.

But they have have not been overwhelmed like we saw in places like Italy and that is probably the most important and encouraging fact.

I know there are going to be a lot more issues that we face in terms of things like unemployment and getting the economy back up to speed. However, I think we are starting to see some light at the end of the tunnel and strong indicators that we will be able to get past this without incomprehensible levels of casualties.

And not only that, but travel may not be so far off in the future like many of us have thought.

H/T: CNN