How Covid-19 Might Spread to You

[Clima]

U.S. Will Soon Surpass 200,000 Deaths From Covid-19

This weekend, the U.S. will surpass 200,000 deaths from Covid-19. Lester Holt reflects on the lives lost and how our understanding of the coronavirus has evolved.

https://shrinke.me/UKOpgz

[S Landreth]

• Coronavirus can spread on airline flights, two studies show

The young woman and her sister had traveled across Europe just as the coronavirus pandemic was taking off there, visiting Milan and Paris before heading to London.

When the woman left London on March 1, she had a sore throat and cough as she boarded a flight home to Vietnam, but no one noticed.

By the time she got off the flight in Hanoi 10 hours later, 15 other people who had been on the plane with her were infected, researchers reported Friday.

This story is one of two published Friday demonstrating how coronavirus can spread on airline flights, and suggesting that simply spacing people out a little will not fully protect them.

In another incident, passengers on a flight from Boston to Hong Kong appear to have infected two flight attendants.

Both cases involved long flights early in the pandemic, before airlines began requiring face masks.

A team from Vietnam tracked down a cluster of cases linked to the flight that arrived in Hanoi from London on March 2.

"A 27-year-old businesswoman from Vietnam, whom we identified as the probable index case, had been based in London since early February," Nguyen Cong Khanh of the National Institute of Hygiene and Epidemiology in Hanoi and colleagues wrote.

"On February 22, case 1 and her sister returned to Milan, Italy, and subsequently traveled to Paris, France, for the yearly Fashion Week before returning back to London on February 25," they wrote in the journal Emerging Infectious Diseases.
At this time, coronavirus was starting to spread fast in Italy but very few cases had been reported in Britain.

The woman boarded a flight to Hanoi on March 1.

"She was seated in business class and continued to experience the sore throat and cough throughout the flight," the researchers added.

She went to a hospital three days after landing and tested positive for the virus. Health officials tracked down 217 passengers and crew who had been on the flight with her and found 12 fellow business class passengers, two economy class passengers and one crew member were also infected.

The investigators said there was no other likely way any of the 15 others could have been infected other than exposure to the sick patient on the flight.

"The most likely route of transmission during the flight is aerosol or droplet transmission from case 1, particularly for persons seated in business class," they wrote.

"We conclude that the risk for on-board transmission of SARS-CoV-2 during long flights is real and has the potential to cause COVID-19 clusters of substantial size, even in business class--like settings with spacious seating arrangements well beyond the established distance used to define close contact on airplanes," Khanh's team wrote.

"As long as COVID-19 presents a global pandemic threat in the absence of a good point-of-care test, better on-board infection prevention measures and arrival screening procedures are needed to make flying safe."

In the second incident, a couple flew from Boston to Hong Kong in business class on March 9. They both exhibited symptoms after they arrived and were diagnosed with coronavirus.

Contact tracing found two flight attendants were also positive for the virus. "The only location where all four persons were in close proximity for an extended period was inside the airplane," Deborah Watson-Jones of the London School of Hygiene & Tropical Medicine and colleagues wrote in a second report in the US Centers for Disease Control and Prevention's Emerging Infectious Diseases journal.

"Genetic sequencing linked all four cases. The near full-length viral genomes from all four patients were 100% identical," Watson-Jones and colleagues wrote.: https://www.cnn.com/2020/09/18/healt...ies/index.html

• Coronavirus Cases: 30,827,305

Deaths: 958,514

Underreported US death count: 203,455

US conflicts and 911 Casualties………

World War I - 116,516
Vietnam War - 58,209
American Revolutionary War – 8,000
Iraq War - 4,576
War in Afghanistan - 2,216
911 Casualties – 2,977

Total US Casualties in the conflicts above and 911 Casualties: 192,494

it's been blown way out of proportion.

[S Landreth]

Parliament passes budget bill at final reading

The House of Representatives on Friday passed a 3.29 trillion baht budget bill for the 2021 fiscal year starting in October, aimed at reviving an economy battered by the global impact of the coronavirus pandemic.

The budget planners have assumed Southeast Asia's second-largest economy will shrink 5-6% this year before growing 4-5% in 2021. The finance ministry predicts a record economic contraction of 8.5% this year.

After a three-day debate, the bill's final reading passed with 269 votes in favour, 60 against and 121 abstentions.

"The government will use the budget to drive the economy and urgent policies for the country's sustainable growth," Prime Minister Prayut Chan-o-cha told the House of Representatives.

The proposed budget foresees revised spending of 3.29 trillion baht for the fiscal year starting on Oct 1, up 2.8% from the current fiscal year. It projects a deficit of 623 billion baht, up 32.8%.

The bill will also need senate approval, expected on Tuesday, and then His Majesty the King's royal endorsement.

Earlier this week, the government said the 2021 budget could be delayed by a month but that should not affect spending plans.: https://www.bangkokpost.com/thailand...-final-reading

Perhaps a blessing in disguise for the Golden Land.

[S Landreth]

Forgot this graph my last post.

• Coronavirus Cases: 30,652,203

Deaths: 955,187

Underreported US death count: 203,073

US conflicts and 911 Casualties………

World War I - 116,516
Vietnam War - 58,209
American Revolutionary War – 8,000
Iraq War - 4,576
War in Afghanistan - 2,216
911 Casualties – 2,977

Total US Casualties in the conflicts above and 911 Casualties: 192,494

it's been blown way out of proportion.

[S Landreth]

• Pfizer follows Moderna’s suit in releasing Covid-19 vaccine study protocol

Shortly after one of the leading companies developing a vaccine against the virus that causes Covid-19 took the unusual step of releasing its Phase III clinical trial protocol online, another drugmaker with a vaccine development program already in the late stages has done the same.

New York-based Pfizer publicly released the 137-page protocol of its Phase I/II/III trial of the BNT162 vaccine program, which the company is developing under a partnership with Mainz, Germany-based BioNTech. The move closely follows a decision by Cambridge, Massachusetts-based Moderna to release its protocol for the Phase III trial of mRNA-1273.

A protocol is essentially the blueprint for a clinical trial and contains granular details on things like patient selection, statistical analysis and measurement of outcomes and adverse events. Drugmakers typically keep them closely under wraps until a study has been completed.

However, Moderna released its 135-page protocol Thursday as part of its R&D day as a way of demonstrating transparency in its study. The company also provided an update on the enrollment of the study, stating that as of Wednesday, it had enrolled about 84% of the 30,000 participants it is slated to recruit, while one-third of those participants – all healthy volunteers – have received both the primary and booster shots of the vaccine. The vaccine is administered in two doses, including one given 29 days after the first shot.

In a note to investors Thursday, Morgan Stanley analyst pointed to a number of highlights in the Moderna protocol that he thought would help address some frequent questions from investors. These included the study population used for primary efficacy analysis, who must have no known history of infection with SARS-CoV-2; and the fact that randomization is stratified by age and health risk with three identified health strata, namely those aged 65 or older, those younger than 65 but with increased risk of Covid-19 complications, and those under 65 who are not at risk, with at least 25% of those enrolled – but not more than 40% – having to be in the elderly or high-risk stratum. The methods for estimating efficacy – hazard ratio using a Cox porportional hazard regression model and cases being counted starting 14 days after the second dose – also differ from the bank’s analysis based on relative risk, he noted.: https://medcitynews.com/2020/09/pfiz...tudy-protocol/

• Coronavirus Cases: 30,590,746

Deaths: 953,866

Underreported US death count: 202,725

US conflicts and 911 Casualties………

World War I - 116,516
Vietnam War - 58,209
American Revolutionary War – 8,000
Iraq War - 4,576
War in Afghanistan - 2,216
911 Casualties – 2,977

Total US Casualties in the conflicts above and 911 Casualties: 192,494

it's been blown way out of proportion.

[serrollt]

The total number of military and civilian casualties in World War I was about 40 million: estimates range from around 15 to 22 million deaths^[1] and about 23 million wounded military personnel, ranking it among the deadliest conflicts in human history.
116,516 dead seppos

Vietnam war casualties
Total deaths: 1,353,000
58,290 dead seppos

Iraq war casualties
109,032 deaths including 66,081 civilian deaths.
4,576 dead seppos.

Afghanistan War Casualties
Est. 200,000~
2,216 dead seppos

[S Landreth]

• Moderna shares Covid-19 vaccine trial blueprints, Pfizer follows

US biotech firm Moderna, one of nine companies in the late stages of clinical trials for a Covid-19 vaccine, became the first to publish the complete blueprints of its study following calls for greater transparency.

Pfizer, the other American company currently carrying out Phase 3 trials in the US, followed suit a short time later and there is now added pressure for the remainder to do the same.

Phase 3 is the final stage before approval, in which a vaccine and a placebo are tested on thousands of participants to verify the medicine is safe and effective.

The vaccine race has become deeply politicized in the US in the run-up to the presidential election in November, as President Donald Trump touts a quick vaccine in response to criticism of his handling of the pandemic.

Trump repeated on Wednesday that the first vaccine would be approved by October, increasing concerns that the White House will place pressure on the approval body, the Food and Drug Administration (FDA).

"I don't trust Donald Trump," his rival from the Democratic party Joe Biden said Wednesday.

Experts and officials in the Republican president's administration agree that it's not possible to predict the results of the trials that are underway, and it's highly unlikely to have strong data before the end of 2020.

accine doses will be initially very limited, according to health authorities.

Moderna's CEO Stephane Bancel said on Thursday his company would know whether their vaccine works by November.

October is possible but unlikely, he told CNBC.

The trial protocol published Thursday, which runs to 135 pages and is marked "confidential," fixes the parameters of the experiment.

The most important of these is how it will judge whether results are conclusive.

Wait for it

The reality of an immunization trial is that it's necessary to wait until a certain number of volunteers become naturally infected, in order to compare outcomes in the placebo group against the group given the vaccine.

So the decline in the rate of infection in the US could theoretically delay the results -- possibly until December, said Bancel.

As of Thursday, Moderna had recruited 25,296 volunteers. Among them, 10,025 had received their second dose, 28 days after the first.

It'll take a few more weeks to recruit the full quotient of 30,000 participants and for them to receive their second doses.

Only Covid-19 infections recorded two weeks or more after the second dose are counted, to give the vaccine sufficient time to take effect.

Interim analyses by a committee of independent experts are planned over the course of the trial to verify whether a high statistical threshold of effectiveness has been reached, and to monitor for serious side effects.

The FDA has stated its bar for approval is a vaccine that reduces the risk of falling sick with Covid-19 by 50 percent.

The Moderna trial protocol "has the key information (for) stopping rules, interim analyses and efficacy assumptions. Applaud their transparency," Eric Topol, director of the Scripps Research Institute and one of the critics leading the charge against possible political interference, told AFP.

Pressure on

Moderna also said that 28% of its participants were from racial minority groups.

Having sufficient participants among black and Hispanic people in particular is crucial in obtaining statistically representative results for these communities that have been disproportionately hit by the pandemic.

The decision by Moderna, which has received $2.5 billion in US government money, left a spotlight on Pfizer, whose CEO has repeatedly said the company will have its results by the end of October, which is in line with Trump's wishes.

A spokeswoman told AFP Pfizer has traditionally not shared the full in-depth study protocol, but "the Covid-19 pandemic is a unique circumstance and the need for transparency is clear."

"As a result, the company is making the full protocol for its self-funded Covid-19 vaccine pivotal study available to reinforce Pfizer's longstanding commitment to scientific and regulatory rigor that benefits patients."

The other frontrunner is AstraZeneca, which has co-developed a vaccine with the University of Oxford.

The medicine's global trials were suspended last week after a participant had an unexplained illness, but were later restarted in the UK, Brazil, and South Africa. The US remains the exception for reasons that aren't yet known.: https://www.bangkokpost.com/world/19...erbox#cxrecs_s

• Coronavirus Cases: 30,490,264

Deaths: 952,223

Underreported US death count: 202,552

US conflicts and 911 Casualties………

World War I - 116,516
Vietnam War - 58,209
American Revolutionary War – 8,000
Iraq War - 4,576
War in Afghanistan - 2,216
911 Casualties – 2,977

Total US Casualties in the conflicts above and 911 Casualties: 192,494

it's been blown way out of proportion.

[S Landreth]

• Internal AstraZeneca safety report sheds light on neurological condition suffered by vaccine trial participant

CNN has obtained an internal safety report by pharmaceutical giant AstraZeneca that sheds light on the neurological condition suffered by one of the participants in its coronavirus vaccine clinical trial.

The report details how the study volunteer, a previously healthy 37-year-old woman, "experienced confirmed transverse myelitis" after receiving her second dose of the vaccine, and was hospitalized on September 5.

Four days later, AstraZeneca dismissed media reports about the participant having a confirmed case of the rare neurological condition, in which the spinal cord becomes inflamed.

The document, which is labeled an "initial report," describes how the study participant had trouble walking, weakness and pain in her arms, and other symptoms.

The internal safety report is dated September 10, and on September 11 it was sent out to doctors who are running the study's clinical trial sites.

Last week, AstraZeneca announced the study volunteer's "unexplained illness," and said it was voluntarily pausing the trial worldwide. On Saturday, the trial in the UK resumed. The trial has not resumed in the US.

As the world closely watches the development process of a number of vaccines, hoping for an end to a deadly pandemic, some scientists say AstraZeneca's communications about the patient's condition have not been fully transparent.

A company spokesperson says, as the trial sponsor, they "cannot disclose medical information."

In a press release last week, the pharmaceutical giant stated that "we are committed to the safety of our participants and the highest standards of conduct in our trials."

Fourteen days after receiving her second dose of the vaccine, the woman, who lives in the UK, "experienced confirmed transverse myelitis," with symptoms including trouble walking and pain and weakness, the safety report said. Researchers were sufficiently concerned that they filed a SUSAR, or Suspected or Unexpected Serious Adverse Reaction report.

After the patient's condition was reviewed by safety experts, the trial resumed in the UK and Brazil.

Much more: https://www.cnn.com/2020/09/17/healt...ent/index.html

• Coronavirus Cases: 30,407,305

Deaths: 951,469

Underreported US death count: 202,266

US conflicts and 911 Casualties………

World War I - 116,516
Vietnam War - 58,209
American Revolutionary War – 8,000
Iraq War - 4,576
War in Afghanistan - 2,216
911 Casualties – 2,977

Total US Casualties in the conflicts above and 911 Casualties: 192,494

it's been blown way out of proportion.

[S Landreth]

• Nearly 60% of people undergoing treatment for lung cancer experienced disruptions in care this spring because of the COVID-19 pandemic, according to an analysis to be published Thursday by JAMA Oncology.

Just under 40% of lung cancer patients at a major health system in Canada saw delays or discontinuation of "palliative chemotherapy," while slightly less than 15% had their treatment stopped completely, because of the danger of contracting or spreading the virus, the researchers said.

For some patients, treatment delays incurred between March 2 and May 30 lasted a month or more, the data showed.

"A significant proportion of patients experienced a change or modification in their cancer treatment plan as a direct result of the pandemic," study co-author Dr. Arielle Elkrief told UPI.

"This study shows that the pandemic deeply affected every aspect of lung cancer care, [and] it reinforces the need for hospitals and care units to keep track of these changes and their outcomes," said Elkrief, a resident in medical oncology at McGill University in Montreal.

Approximately 230,000 Americans are diagnosed with lung cancer each year, and more than 130,000 die from the disease annually, according to the American Cancer Society.

In the United States, more than 60% of lung cancer patients surveyed by ACS said that the COVID-19 pandemic had affected their care in some way, while nearly 40% reported treatment delays as a result.

The decision to delay treatment for lung cancer patients was likely made by "patients made in collaboration with their physicians," based on their risk for infection and more severe illness, Elkrief said.

People with lung cancer are at greater risk for serious illness and death from COVID-19, and the effects of chemotherapy on the immune system may place them at increased risk for infection, according to the American Society of Clinical Oncology.

For this study, Elkrief and her colleagues reviewed the cancer treatment of 275 patients receiving care at McGill's thoracic oncology clinic. Of these patients, 211 were undergoing active treatment when the COVID-19 outbreak began in Canada in early March, the researchers said.

Overall, 121 patients -- or 57% -- experienced at least one change in their treatment plan because of the pandemic, and 55% of them were receiving chemotherapy, immunotherapy or both, the data showed.

Just over 26% had adjustments made to their treatment dose or schedule, while 3% stopped treatment completely, the researchers said.

Nearly 7% of the patients also had routine follow-up appointments postponed or cancelled, according to the researchers.

"Since no clear evidence has emerged that cancer treatments increase the risk of severe COVID-19 outcomes, evidence-based cancer care should continue to proceed with caution," Elkrief said.

"Now we know which measures need to be taken, and how to prevent virus transmission thanks to clear infection control procedures.": https://www.upi.com/Health_News/2020...6901600263868/

• Coronavirus Cases: 30,296,361

Deaths: 949,391

Underreported US death count: 202,067

US conflicts and 911 Casualties………

World War I - 116,516
Vietnam War - 58,209
American Revolutionary War – 8,000
Iraq War - 4,576
War in Afghanistan - 2,216
911 Casualties – 2,977

Total US Casualties in the conflicts above and 911 Casualties: 192,494

it's been blown way out of proportion.

[serrollt]

The total number of military and civilian casualties in World War I was about 40 million: estimates range from around 15 to 22 million deaths^[1] and about 23 million wounded military personnel, ranking it among the deadliest conflicts in human history.
116,516 dead seppos

Vietnam war casualties
Total deaths: 1,353,000
58,290 dead seppos

Iraq war casualties
109,032 deaths including 66,081 civilian deaths.
4,576 dead seppos.

Afghanistan War Casualties
Est. 200,000~
2,216 dead seppos

[S Landreth]

• COVID pushes millions more children deeper into poverty, new study finds

Globally, the number of children living in poverty soared to nearly 1.2 billion – a 15 per cent increase since the pandemic hit earlier this year, according to a technical note on impact of COVID-19 on child poverty, issued on Thursday by the UN Children’s Fund (UNICEF) and the NGO Save the Children.

Although the analysis paints a dire picture already, UNICEF warns the situation will likely worsen in the months to come.

“COVID-19 and the lockdown measures imposed to prevent its spread have pushed millions of children deeper into poverty,” said Henrietta Fore, UNICEF Executive Director.

“Families on the cusp of escaping poverty have been pulled back in, while others are experiencing levels of deprivation they have never seen before. Most concerningly, we are closer to the beginning of this crisis than its end.”

The study – based on data on access to education, healthcare, housing, nutrition, sanitation and water from more than 70 countries – also finds that around 45 per cent of children were “severely deprived” of at least one of the critical needs in the countries analyzed before the pandemic.

It notes that child poverty is much more than a monetary value, and while measures of monetary poverty such as household income are important, they provide only a partial view of the plight of children living in poverty.

To understand the full extent of child poverty, all potential, multidimensional, deprivations must be analyzed directly, the study adds, highlighting the need for social protection, inclusive fiscal policies, investments in social services, and employment and labour market interventions to support families and preventing further devastation.

“This pandemic has already caused the biggest global education emergency in history, and the increase in poverty will make it very hard for the most vulnerable children and their families to make up for the loss”, said Inger Ashing, CEO of Save the Children.

“Children who lose out on education are more likely to be forced into child labour or early marriage and be trapped in a cycle of poverty for years to come. We cannot afford to let a whole generation of children become victims of this pandemic. National governments and the international community must step up to soften the blow.”

Worsening inequalities
The study also finds that not only are more children experiencing poverty than before, the poorest children are getting poorer as well. Some children may suffer one or more deprivations and others experience none at all, therefore the average number of deprivations suffered per child can be used to assess how poor children are.

Before the pandemic, the average number of severe deprivations per child was around 0.7. It is now estimated to have increased by 15 per cent to around 0.85, it notes.

Against this backdrop, governments must prioritize the most marginalized children and their families, underscored Ms. Fore, calling for rapid expansion of social protection systems including cash transfers and child benefits, remote learning opportunities, healthcare services and school feeding.

“Making these critical investments now can help countries to prepare for future shocks.”: https://news.un.org/en/story/2020/09/1072602

• Coronavirus Cases: 30,167,619

Deaths: 947,256

Underreported US death count: 201,652

US conflicts and 911 Casualties………

World War I - 116,516
Vietnam War - 58,209
American Revolutionary War – 8,000
Iraq War - 4,576
War in Afghanistan - 2,216
911 Casualties – 2,977

Total US Casualties in the conflicts above and 911 Casualties: 192,494

it's been blown way out of proportion.

[serrollt]

The total number of military and civilian casualties in World War I was about 40 million: estimates range from around 15 to 22 million deaths^[1] and about 23 million wounded military personnel, ranking it among the deadliest conflicts in human history.
116,516 dead seppos

Vietnam war casualties
Total deaths: 1,353,000
58,290 dead seppos

Iraq war casualties
109,032 deaths including 66,081 civilian deaths.
4,576 dead seppos.

Afghanistan War Casualties
Est. 200,000~
2,216 dead seppos

[S Landreth]

Coronavirus Cases: 30,063,255

Deaths: 945,542

Underreported US death count: 201,348

US conflicts and 911 Casualties………

World War I - 116,516
Vietnam War - 58,209
American Revolutionary War – 8,000
Iraq War - 4,576
War in Afghanistan - 2,216
911 Casualties – 2,977

Total US Casualties in the conflicts above and 911 Casualties: 192,494

it's been blown way out of proportion.

[S Landreth]

Little more

Bt51bn consumption stimulus package gets green light

The government's Centre for Economic Situation Administration (CESA) on Wednesday approved a three-month consumption stimulus package worth Bt51 billion.

The package will cover 24 million mainly low-income people via two schemes.

In the first scheme, 14 million welfare cardholders will receive an extra monthly discount of Bt500 from October to December on their shopping. The budget for this scheme is Bt21 billion.

Meanwhile, under the “Kon La Khreung” (Let’s Go Halves) scheme, 10 million people will get daily discounts of up to Bt50 on food, beverages and household essentials (not including alcohol, tobacco or lottery tickets). The subsidy is capped at Bt,3000 per person. Thai citizens aged 18 or over can register online.

A CESA meeting chaired by PM Prayut Chan-o-cha agreed on the Bt51-billion budget to maintain domestic consumption and increase purchasing power for low-income groups and the general public, as proposed by the Finance Ministry.

The budget will be allocated from the government’s Bt400 billion recovery loan and proposed to the Cabinet on September 22, with registration scheduled to open on October 16.

About 100,000 small stores and street vendors are expected to participate.: https://www.nationthailand.com/busin...ernal_referral

Perhaps a blessing in disguise for the Golden Land.

[S Landreth]

Coronavirus Cases: 29,951,526

Deaths: 942,933

Underreported US death count: 201,013

US conflicts and 911 Casualties………

World War I - 116,516
Vietnam War - 58,209
American Revolutionary War – 8,000
Iraq War - 4,576
War in Afghanistan - 2,216
911 Casualties – 2,977

Total US Casualties in the conflicts above and 911 Casualties: 192,494

it's been blown way out of proportion.