62nd Update on Corona Virus Pandemic with Dr Peter (last update was 3-15)

4/5/2021

CDC update:

Dr Wolensky said she still has a feeling of impending doom (which is a medical term) regarding the variants of concern that are circulating. Concern there may be another surge. Encouraged continued vigilance and keeping up the preventative measures (distance, masks, decreasing exposure to groups, etc)

Dr Peter is reminded of tracking hurricanes and trying to predict their path. Similar to trying to predict the next few months in the pandemic. There are many different forecasts and models, including the possibility of another surge and including continued dropping in cases.

Variants of Concern:

US: The B117 (from the UK) is the predominant strain in the US now. This has higher transmission rate and higher fatality rate.

On the west coast B1427 and B1429 are called the “California strains”. Now 75% of cases. These also have a higher transmission rate. These are also showing up in WA, OR, AZ, NV.

Genomic (looking at genomes) testing in US is slow – doing testing of about 6% of positive cases in CA and almost all in large cities.

Imagine if you were planning to give a lecture to 1000 people who were coming from a large area. If you wanted to get an idea of the kinds of people who were coming and where they were coming from and picked 30 people from the front row (about 3%) – you would not get a real representation of the group. All of those people you chose may have all come from the same town, on the same bus.

Calculating the impact – counting deaths

Main way we track is to count the death certificates. Public Health knows this is an undercount. Particularly older people often do not have noticeable symptoms before dying of Sars II and early in the pandemic those deaths may not have been counted. Also deaths from heart attack and strokes could have been precipitated by Sars II before we had the awareness we do now.

Excess deaths – look at deaths within the last 5-10 years and then look at the current year and see what the difference is. We call those “excess” deaths (above and beyond the “norm”).

For 2020 the excess deaths are about 500,000. This number agrees with the death certificate data. Deaths are at about 600,000 now (including 2021).

Russia – have reported about 100,000 deaths (the population is about 40% of ours) but if you look at excess deaths during the time of the pandemic, it is about 500,000. This is a much higher death rate if you look at population size. Adjust the population size to be comparable to the US and deaths would be about 1.2 million.

1918 pandemic – about 500,000 deaths were counted. But if you were to adjust the population size to the current level, the deaths would be more like 1.5 million.

Travel Guidance per CDC

Despite concerns about variants. If people are fully vaccinated (2 wks after 2nd shot) they do not need to be testing before or after flights unless the area they are traveling to requires it. Also no longer need to self quarantine after trips. International travel may have increased risk and exposure. Other countries may require testing. Returning to US after travel – people should get tested before flying back to US and need to have a test 3-5 days after return.

There seems to be some mixed messages, but some of that may be due to an attempt to encourage vaccinations and making traveling easier for those who are vaccinated.

Of course, all precautions apply – masking, distance, washing hands, etc

New Covid 19 study done with Pfizer vaccine:

Study done on teens age 12 – 15 (under 3000 subjects) showed 100% effective in preventing contraction of the virus. May see an emergency use approved for this population soon. This would be helpful in schools and keeping teens from bringing home the virus to families.

So what is going to happen?

At this time, we don’t know and we have to wait and see over the next couple months. Probably a surge in the winter, but we don’t know how significant.

World Health Organization – source of Corona virus

Dr Peter now sure how to respond. Researchers were not allowed to go to the area where it seemed to originate until a year after the pandemic was underway, making forensics impossible. The researchers were taken on a guided tour. Unable to determine if this was a lab experiment gone wrong. Seemed to be politically motivated. Did not determine anything. Even statements from WHO say they don’t agree with the report. Timeline points to the likelihood that the virus got out into the population in September.

People who are fully vaccinated

Probably an emphasis on this population being able to do things that those who are not vaccinated will not be allowed to do. Perhaps just travel, or large events. We will see how it develops.

Public Health Update

Less than 15 cases per day now in Nevada County. Trying to do contact tracing and people are more resistant to giving information.

Still seeing a small number of cases coming up with people who have been immunized. Fortunately those people don’t wind up with hospitalization. But they are able to transmit the virus. Still testing anyone who has flu or cold like symptoms. Routine testing in clinics and hospitals will probably continue that for some time to come.

If someone has had Covid 19 previously they recommend a 2 dose vaccine.

In NC – close to 50,000 vaccinations. Probably about 30% of population is vaccinated. 16 and older can get Pfizer and 18 and older can get the Johnson and Johnson or Moderna vaccine.

Hospitalizations are way down and the patients are much younger.

Eventually Novovax and Astrazenaca will be more available. Foresee a time when we can export vaccines to help other areas of the world.

Statistics (3 weeks since the last update)

Nevada County (about 100k pop)

4300cases, up about 200 cases from 3 weeks ago.

Case Positivity Rate: An average daily positivity rate (over 14 days): 5.1%, up from 3.6%

Hospitalized cases are younger. 3-4 people per day. ICU cases 1, down from average of 3.

Deaths in county: 74, same (this will go up as they get numbers compiled).

540cases, up 40 cases, in the 95959 zip code, where Ananda Village is located.

Vaccinations probably 25 – 30%

Sierra County (3100 pop)

5 new cases.

Case positivity rate listed as 0. Down from 2.8.

Yuba County (80Kpop) (younger average age than NC)

6000cases, up about 170

CPR: Averaged over 14 days is 3.4% down from 4.9%

Placer County (400Kpop)

22,000 cases, up 1700

CPR: 14 day average is 2.4%

Auburn area: cases 2300

California:

3.7 million cases, up from 3.6 3wks ago

CPR: 1.7%, down from 2.0%

60,000 up from 55,000 deaths.

US (330 mill pop)

31.4 million (about 10% of population has had a verified case – positive PCR test) Many other tests that are not reported.

60K to 70K cases per day, has gone up

Deaths per day 1000

Variants are driving cases up everywhere

Brazil:

Still having a very difficult time. Swamped with the P1 variant.

Highest new case count per day in the world. Days with 90K new cases, mostly the P1 variant.

Deaths: 3000-4000 per day

Poor country and medical system. Not getting vaccines there.

Europe and Eastern European countries:

Very high case rates and not getting vaccines. US is very fortunate to have vaccines. ICUs and Deaths are overwhelmingly high in many countries.

Fatality rates worldwide:

China: can’t know what happened there. Numbers unreliable.

Russia: 500,000 excess deaths means about 300+ deaths per 100,000 population. (compare to only 74 per 100K pop in NC)

New Jersey: 8 million pop. 280 deaths per 100K population

New York: 262 deaths per 100K

Massachusetts: 250 deaths per 100K

Czechia: 250 deaths per 100K

Hungary: 225 deaths per 100K

Next update in one month unless there is a surprise – a jump in cases.

Will talk about the 1918 pandemic and what we have learned.

62nd Update on Corona Virus Pandemic with Dr Peter (last update was 3-15)

4/5/2021

CDC update:

Dr Wolensky said she still has a feeling of impending doom (which is a medical term) regarding the variants of concern that are circulating. Concern there may be another surge. Encouraged continued vigilance and keeping up the preventative measures (distance, masks, decreasing exposure to groups, etc)

Dr Peter is reminded of tracking hurricanes and trying to predict their path. Similar to trying to predict the next few months in the pandemic. There are many different forecasts and models, including the possibility of another surge and including continued dropping in cases.

Variants of Concern:

US: The B117 (from the UK) is the predominant strain in the US now. This has higher transmission rate and higher fatality rate.

On the west coast B1427 and B1429 are called the “California strains”. Now 75% of cases. These also have a higher transmission rate. These are also showing up in WA, OR, AZ, NV.

Genomic (looking at genomes) testing in US is slow – doing testing of about 6% of positive cases in CA and almost all in large cities.

Imagine if you were planning to give a lecture to 1000 people who were coming from a large area. If you wanted to get an idea of the kinds of people who were coming and where they were coming from and picked 30 people from the front row (about 3%) – you would not get a real representation of the group. All of those people you chose may have all come from the same town, on the same bus.

Calculating the impact – counting deaths

Main way we track is to count the death certificates. Public Health knows this is an undercount. Particularly older people often do not have noticeable symptoms before dying of Sars II and early in the pandemic those deaths may not have been counted. Also deaths from heart attack and strokes could have been precipitated by Sars II before we had the awareness we do now.

Excess deaths – look at deaths within the last 5-10 years and then look at the current year and see what the difference is. We call those “excess” deaths (above and beyond the “norm”).

For 2020 the excess deaths are about 500,000. This number agrees with the death certificate data. Deaths are at about 600,000 now (including 2021).

Russia – have reported about 100,000 deaths (the population is about 40% of ours) but if you look at excess deaths during the time of the pandemic, it is about 500,000. This is a much higher death rate if you look at population size. Adjust the population size to be comparable to the US and deaths would be about 1.2 million.

1918 pandemic – about 500,000 deaths were counted. But if you were to adjust the population size to the current level, the deaths would be more like 1.5 million.

Travel Guidance per CDC

Despite concerns about variants. If people are fully vaccinated (2 wks after 2nd shot) they do not need to be testing before or after flights unless the area they are traveling to requires it. Also no longer need to self quarantine after trips. International travel may have increased risk and exposure. Other countries may require testing. Returning to US after travel – people should get tested before flying back to US and need to have a test 3-5 days after return.

There seems to be some mixed messages, but some of that may be due to an attempt to encourage vaccinations and making traveling easier for those who are vaccinated.

Of course, all precautions apply – masking, distance, washing hands, etc

New Covid 19 study done with Pfizer vaccine:

Study done on teens age 12 – 15 (under 3000 subjects) showed 100% effective in preventing contraction of the virus. May see an emergency use approved for this population soon. This would be helpful in schools and keeping teens from bringing home the virus to families.

So what is going to happen?

At this time, we don’t know and we have to wait and see over the next couple months. Probably a surge in the winter, but we don’t know how significant.

World Health Organization – source of Corona virus

Dr Peter now sure how to respond. Researchers were not allowed to go to the area where it seemed to originate until a year after the pandemic was underway, making forensics impossible. The researchers were taken on a guided tour. Unable to determine if this was a lab experiment gone wrong. Seemed to be politically motivated. Did not determine anything. Even statements from WHO say they don’t agree with the report. Timeline points to the likelihood that the virus got out into the population in September.

People who are fully vaccinated

Probably an emphasis on this population being able to do things that those who are not vaccinated will not be allowed to do. Perhaps just travel, or large events. We will see how it develops.

Public Health Update

Less than 15 cases per day now in Nevada County. Trying to do contact tracing and people are more resistant to giving information.

Still seeing a small number of cases coming up with people who have been immunized. Fortunately those people don’t wind up with hospitalization. But they are able to transmit the virus. Still testing anyone who has flu or cold like symptoms. Routine testing in clinics and hospitals will probably continue that for some time to come.

If someone has had Covid 19 previously they recommend a 2 dose vaccine.

In NC – close to 50,000 vaccinations. Probably about 30% of population is vaccinated. 16 and older can get Pfizer and 18 and older can get the Johnson and Johnson or Moderna vaccine.

Hospitalizations are way down and the patients are much younger.

Eventually Novovax and Astrazenaca will be more available. Foresee a time when we can export vaccines to help other areas of the world.

Statistics (3 weeks since the last update)

Nevada County (about 100k pop)

4300cases, up about 200 cases from 3 weeks ago.

Case Positivity Rate: An average daily positivity rate (over 14 days): 5.1%, up from 3.6%

Hospitalized cases are younger. 3-4 people per day. ICU cases 1, down from average of 3.

Deaths in county: 74, same (this will go up as they get numbers compiled).

540cases, up 40 cases, in the 95959 zip code, where Ananda Village is located.

Vaccinations probably 25 – 30%

Sierra County (3100 pop)

5 new cases.

Case positivity rate listed as 0. Down from 2.8.

Yuba County (80Kpop) (younger average age than NC)

6000cases, up about 170

CPR: Averaged over 14 days is 3.4% down from 4.9%

Placer County (400Kpop)

22,000 cases, up 1700

CPR: 14 day average is 2.4%

Auburn area: cases 2300

California:

3.7 million cases, up from 3.6 3wks ago

CPR: 1.7%, down from 2.0%

60,000 up from 55,000 deaths.

US (330 mill pop)

31.4 million (about 10% of population has had a verified case – positive PCR test) Many other tests that are not reported.

60K to 70K cases per day, has gone up

Deaths per day 1000

Variants are driving cases up everywhere

Brazil:

Still having a very difficult time. Swamped with the P1 variant.

Highest new case count per day in the world. Days with 90K new cases, mostly the P1 variant.

Deaths: 3000-4000 per day

Poor country and medical system. Not getting vaccines there.

Europe and Eastern European countries:

Very high case rates and not getting vaccines. US is very fortunate to have vaccines. ICUs and Deaths are overwhelmingly high in many countries.

Fatality rates worldwide:

China: can’t know what happened there. Numbers unreliable.

Russia: 500,000 excess deaths means about 300+ deaths per 100,000 population. (compare to only 74 per 100K pop in NC)

New Jersey: 8 million pop. 280 deaths per 100K population

New York: 262 deaths per 100K

Massachusetts: 250 deaths per 100K

Czechia: 250 deaths per 100K

Hungary: 225 deaths per 100K

Next update in one month unless there is a surprise – a jump in cases.

Will talk about the 1918 pandemic and what we have learned.