COVID-19 Update, August 4th

Fake news, Sweden, universities and colleges, T-cells, and new serology tests.

1. Fake News: yet another bit of fake news is going around about how +99% of people who get COVID survive. This is a completely false number. Is that supposed to be a mortality rate or a fatality rate? Because they are different. If it is supposed to be a fatality rate (it is even more wrong than if it is a mortality rate, but I digress), is it supposed to be a case fatality rate or an infection fatality rate? Because they are different. Is it an adjusted rate or a crude rate? Because they are different. But even if this number were accurate, which it is not, 1% of the total US population would mean 3.2 million American deaths. In related, and actual news, the CDC which previously forecast 148k deaths by the end of July (a number we hit a week early) is now saying we could hit 168 – 182k deaths by August 22nd with potentially 5-11k deaths per day by the months end at the current rate. As a side note, death is only one measure of disease severity. Some people are contracting COVID and doing fine. Some are ending up hospitalized for long periods of time. Others are getting sick and staying sick for over 100 days. Some are developing life-long chronic conditions. Death is not the only measure of severity.

2. An Update on Sweden. Sweden, as you may recall, didn’t institute strict lockdowns like the rest of the world. Some are holding them up as a beacon of success while others are using them as an example of failure. So which is it? Did Sweden really do nothing and turn out ok? Let’s take a look at the facts. It is important to note the Sweden didn’t “do nothing.” Their government laid out social distancing plans and requested that people wear masks and the people complied. They limited gatherings, even in public places/businesses to less than 50 people – and they adhered to it. They asked people to socially distance, and they did. They asked people to stay home when sick, and they did. They asked people to mask when out in public, and for the most part, they did. But similar to some places in the US, they did not issue formal lock-downs.

For the last 2 days Sweden’s numbers have been low – very low, although 3 days ago they had 300 new cases. (keep in mind they are a nation of about 10 million – so their entire country has roughly the population of NYC) Still, the number of new deaths is currently low. Over the course of the outbreak, they have had more deaths per capita than the United States (564 per 1 million compared to 444 per 1 million – as of July 30th) and 5x higher than all other Nordic countries. Less than 10% of Swedes are currently carrying antibodies for COVID, far below the requirement for herd immunity (which we now believe is not possible). And their economy is reporting losses of about 4.6% - comparable to other nations in the area. So if Sweden is a success story or a cautionary tale really depends on your definition of success.

3. Universities and colleges around the country are asking students to sign liability waivers and informed consent forms as they return to campus. Athletes at some colleges are pushing back regarding football season and a group of tenured faculty at UNC encouraged students to stay home if possible.

4. Some people may have immunity to COVID without ever actually getting it. This is very emerging and developing news so keep that in mind, but it does seem promising. Your immune system is a complex and wonderful thing. Within the immune system you have a host of different cells types each with specialized functions. One type, that is making scientific new is T-cells. Emerging science suggests that T-cells may play a critical role in the fight against COVID and may be another piece in why some people get so much sicker than others. They think (we don’t quite know for sure but early evidence is promising) that some people’s T-cells may already know what to do and be able to defeat COVID leaving them immune. More to come on that.

5. The FDA has authorized two COVID serology tests that can do more than just detect antibodies in the blood. They can also detect the level of antibodies giving a better indicator of immunity status. Prior/current tests were licensed under the EUA but the new tests will have full FDA authorization.

FINAL THOUGHTS: What do Batman, Ironman, Spiderman, the Lone Ranger, the Flash, Black Panther, and the Green Lantern all have in common? Masks, they all wear masks. And……they are popular with the ladies. But mostly masks. Don’t Hulk out today. People won’t like you when you’re angry, instead build others up, step away when you need to, and let your superpower be holding your tongue.