Lockdown Empire Strikes Back

As spring break festivities spiraled into violence and chaos over the weekend, Miami Beach declared a state of emergency and imposed a curfew. In addition, the CDC renewed its recommendation against travel, unnerving businesses trying to recover from the pandemic. 

Overseas, France, Germany, Italy, and several other European countries have reimposed national lockdowns. Germany’s lockdown in particular is the most draconian: All stores will close from April 1st to April 6th, including supermarkets, all food stores, manufacturing, essential services, everything…

Although AstraZeneca initially announced a glowing 79% effectiveness for its COVID vaccine, new revelations suggest its data is incomplete and outdated.

Daily COVID cases nationwide continue their downward spiral (despite mask mandates continuing to end nationwide. Governor Eric Holcomb announced Indiana will lift its mask mandate on April 6th, which will make Indiana the 21st state freed.

In other news:

  • Influential people in public health, government and the media failed to rise to the moment, says Florida Governor Ron DeSantis in the Wall Street Journal.
  • There’s no proof that lockdowns save lives but plenty of evidence that they end them, says John Tierney in City Journal.
  • Parents should bet on vacations with their kids this summer, says economist Emily Oster at The Atlantic.
    • Despite her data-driven and nuanced argument, COVID hysterics on Twitter pilloried and piled on Professor Oster who then self-censored herself.
  • The media does not pay sufficient attention to the good news regarding improved treatments and survival of patients with the coronavirus, notes Dr. Jay Bhattacharya and Christos Makridis in The Hill.
  • MIT Technology Review profiles several scientists who refuse to rule out the COVID lab leak hypothesis.

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COVID News

CDC advises against travel while spring break chaos worries some Miami Beach businesses trying to recover from pandemic

https://www.cnbc.com/2021/03/22/miami-beach-spring-break-curfew-businesses-fret-over-lost-sales.html

The Centers for Disease Control and Prevention on Monday again advised against travel, while Miami Beach, Florida, business owners fretted about spring break chaos.

Miami Beach officials declared a state of emergency and ordered a rare curfew over the weekend, an effort to avoid spreading Covid-19 and stop large crowds and unruly behavior in the popular tourist destination.

Some businesses in the area, eager to recover from a brutal pandemic year that drove down tourist numbers, say they are being unfairly punished.

Police have arrested more than 1,000 people since Feb. 3, with 50 cited over the weekend, Miami Beach officials said. The 8 p.m. to 6 a.m. curfew could be extended for up to three weeks to try to control crowds, which could hit businesses during the key spring break season.

“Everything is knee-jerk,” said Ashley Swanson, a bartender at Mac’s Club Deuce Bar in South Beach. “They’re blaming the wrong people. There’s no reason why we shouldn’t be open until midnight.

SWAT, military-style vehicles, pepper spray balls used to enforce South Beach curfew

https://www.miamiherald.com/news/local/community/miami-dade/miami-beach/article250102479.html

Pepper-spray balls, SWAT teams and a military-style vehicle rolling down Ocean Drive became the new picture Saturday night of spring break on South Beach as Miami Beach police tried to enforce an 8 p.m. curfew.

The city announced the curfew for South Beach’s “High Impact Zone” only hours earlier in reaction to spring break crowds so violently rowdy that Ocean Drive’s longest continuously open establishment, The Clevelander, announced Friday it was shutting down until March 24.

The curfew, announced as part of a State of Emergency declaration made at 4 p.m., included the closure of bars and clubs on jam-packed Ocean Drive. People were told to disperse.

“The problem is not with me, the problem is with [authorities] managing a crowd,” he added.

‘I was sort of stunned’: Fauci and U.S. officials say AstraZeneca released ‘outdated information’ from Covid-19 vaccine trial

.S. health officials raised concerns early Tuesday that positive results that AstraZeneca announced Monday for its Covid-19 vaccine may have been based on “an incomplete view of the efficacy data” from a clinical trial and relied on “outdated information,” throwing another curveball in the saga of the company’s vaccine.

In a statement issued soon after midnight Tuesday morning, the National Institute of Allergy and Infectious Diseases said it had been informed about the data questions by the data and safety monitoring board auditing the trial. DSMBs consist of independent medical experts who review data produced from clinical trials.

Indiana mask mandate will end April 6, governor changes it to advisory

https://www.indystar.com/story/news/politics/2021/03/23/indiana-covid-mask-mandate-heres-when-end/6964196002/

Gov. Eric Holcomb announced Indiana’s mask mandate will end April 6, a decision that comes after mounting pressure from within his own Republican party. 

Holcomb will join the leaders of six other states who have lifted mask mandates, a move that goes against the advice of the Centers for Disease Control, which still recommends masks to help stop the spread of COVID-19.

Alabama and Utah are set to lift their mask mandates in April as well. 

Masks still will be recommended, the governor said in his news address on Tuesday. 

Face coverings will remain mandatory in all state buildings and all vaccination and COVID-19 testing sites. K-12 schools will also still be expected to follow the current mask requirements already in place.

Commentary/Analysis

Ron DeSantis on the Pandemic Year: Don’t Trust the Elite

https://www.wsj.com/articles/ron-desantis-on-the-pandemic-year-dont-trust-the-elites-11616093752

The Covid-19 pandemic represented a test of elites in the U.S., from public-health experts to the corporate media. The results have been disappointing. Policy makers who bucked the elites and challenged the narrative have been proven right to do so.

To begin with, highly publicized epidemiological models were as consequential as they were wrong. The model produced by Neil Ferguson of Imperial College London—which forecast millions of Covid-19 deaths in the U.S. without mitigation efforts—sparked panic among public-health elites and served as the pretext for lockdowns throughout the U.S. and Great Britain. The lockdowns failed to stop the virus but did a great deal of societal damage along the way—damage that a more targeted approach, seeking to reduce total harms, would have been able to avoid (and did, in places like Sweden and Florida).

Similarly, models predicting massive shortages of hospital beds helped to precipitate the disastrous policy—enacted by states like New York, New Jersey and Michigan—to send contagious, Covid-positive hospital patients back to nursing homes. States like Florida that rejected the models and adopted policies to protect nursing-home residents had comparatively lower nursing-home mortality rates as a result.

The reliance on faulty models was matched by poor public messaging. Elites sent conflicting messages about the efficacy of cloth masks, the uniformity of risk across age brackets, the danger of outdoor transmission and the practical benefit of taking a Covid vaccine.

Death and Lockdowns

https://www.city-journal.org/death-and-lockdowns

Now that the 2020 figures have been properly tallied, there’s still no convincing evidence that strict lockdowns reduced the death toll from Covid-19. But one effect is clear: more deaths from other causes, especially among the young and middle-aged, minorities, and the less affluent.

The best gauge of the pandemic’s impact is what statisticians call “excess mortality,” which compares the overall number of deaths with the total in previous years. That measure rose among older Americans because of Covid-19, but it rose at an even sharper rate among people aged 15 to 54, and most of those excess deaths were not attributed to the virus.

Some of those deaths could be undetected Covid-19 cases, and some could be unrelated to the pandemic or the lockdowns. But preliminary reports point to some obvious lockdown-related factors. There was a sharp decline in visits to emergency rooms and an increase in fatal heart attacks due to failure to receive prompt treatment. Many fewer people were screened for cancer. Social isolation contributed to excess deaths from dementia and Alzheimer’s.

Researchers predicted that the social and economic upheaval would lead to tens of thousands of “deaths of despair” from drug overdoses, alcoholism, and suicide. As unemployment surged and mental-health and substance-abuse treatment programs were interrupted, the reported levels of anxiety, depression, and suicidal thoughts increased dramatically, as did alcohol sales and fatal drug overdoses. The number of people killed last year in motor-vehicle accidents in the United States rose to the highest level in more than a decade, even though Americans did significantly less driving than in 2019. It was the steepest annual increase in the fatality rate per mile traveled in nearly a century, apparently due to more substance abuse and more high-speed driving on empty roads.

Your Unvaccinated Kid Is Like a Vaccinated Grandma

https://www.theatlantic.com/ideas/archive/2021/03/go-ahead-plan-family-vacation-your-unvaccinated-kids/618313/

President Joe Biden wants all adults to be eligible for a COVID-19 vaccine by May 1. In a speech last week, he suggested that Americans should be able to celebrate July 4 with (smallish) barbecues. For many people, this was the first hopeful vision in a while. We still have a ways to go, but the speed of the vaccination process in recent days makes quasi-normalcy by July seem not completely out of reach.

At least one group feels left adrift, however, and potentially behind: parents. Vaccines for children under 16 are not yet available. Trials have begun, but realistically, children won’t receive a shot in the arm until the fall or winter. Parents are wondering if, after a year of remote school, no playdates, and a lack of grandparent visits, they’ll still have to socially isolate while everyone else enjoys their BBQ.

But the best available research indicates that families with young children don’t, in fact, have to live like it’s 2020 until 2022. Parents can go ahead and plan on barbecues and even vacations. The explanation for why lies in the resilience of kids to COVID-19, and in herd immunity.

Did the coronavirus leak from a lab? These scientists say we shouldn’t rule it out.

https://www.technologyreview.com/2021/03/18/1021030/coronavirus-leak-wuhan-lab-scientists-conspiracy/

Nikolai Petrovsky was scrolling through social media after a day on the ski slopes when reports describing a mysterious cluster of pneumonia cases in Wuhan, China, caught his eye. It was early January 2020, and Petrovsky, an immunologist, was at his vacation getaway in Keystone, Colorado, which is where he goes most years with his family to flee the searingly hot summers at home in South Australia. He was soon struck by an odd discrepancy in how the pneumonia cases were portrayed. Chinese authorities and the World Health Organization were saying there was nothing to worry about, but locals in the area, he says, were posting about “bodies being stretchered out of houses in Wuhan and police bolting apartment doors shut.”

Petrovksy is a professor at Flinders University, near Adelaide, and he is also founder and chairman of a company called Vaxine that develops immunizations for infectious diseases, among other projects. Since 2005, he’s received tens of millions of dollars in funding from the US National Institutes of Health to support the development of vaccines and compounds called adjuvants that boost their effects. After Chinese scientists posted a draft genome of the novel coronavirus SARS-CoV-2, the disease culprit in Wuhan, Petrovksy—who by this time had put skiing on the back burner to work from his Colorado home office—directed his colleagues down under to run computer modeling studies of the viral sequence, a first step toward designing a vaccine.

This generated a startling result: the spike proteins studding SARS-CoV-2 bound more tightly to their human cell receptor, a protein called ACE2, than target receptors on any other species evaluated. In other words, SARS-CoV-2 was surprisingly well adapted to its human prey, which is unusual for a newly emerging pathogen. “Holy shit, that’s really weird,’” Petrovsky recalls thinking.

Facts — not fear — will stop the pandemic

https://thehill.com/opinion/healthcare/528612-facts-not-fear-will-stop-the-pandemic

The media relish negative news. “If it bleeds it leads” still holds, and perhaps it’s never been truer than in the COVID-19 era. Every day the news highlights the spread of the virus and tells the sad stories of some of its victims.

And yet, much of the media does not pay sufficient attention to the good news regarding improved treatments and survival of patients with the coronavirus. In contrast with the international media, the American press has been unrelentingly negative in its COVID coverage, even when there is good news to tell. That negativity is part of what fuels a culture of fear that affects local, state and federal politicians and the decisions they make.

But there is a lot of good news to tell. The case fatality rate from the virus has dropped sharply since March. The infection survival rate is 99.95 percent for people under 70 and 95 percent for people over 70. Hospitals are much better equipped to handle patients, with improved ventilator protocols, improved management of outpatients and new therapeutic strategies to provide relief and recoveries. Moreover, thanks to multiple ongoing clinical trials around the world, there may soon be a safe and effective vaccine.

By contrast with their focus on COVID deaths, the media have paid scant attention to the enormous medical and psychological harms from the lockdowns in use to slow the pandemic. Despite the enormous collateral damage lockdowns have caused, England, France, Germany, Spain and other European countries are all intensifying their lockdowns once again.

Research

Incidence of Stress Cardiomyopathy During the Coronavirus Disease 2019 Pandemic

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768093

Abstract:

Importance: The coronavirus disease 2019 (COVID-19) pandemic has resulted in severe psychological, social, and economic stress in people’s lives. It is not known whether the stress of the pandemic is associated with an increase in the incidence of stress cardiomyopathy.

Objective: To determine the incidence and outcomes of stress cardiomyopathy during the COVID-19 pandemic compared with before the pandemic.

Design, Setting, and Participants: This retrospective cohort study at cardiac catheterization laboratories with primary percutaneous coronary intervention capability at 2 hospitals in the Cleveland Clinic health system in Northeast Ohio examined the incidence of stress cardiomyopathy (also known as Takotsubo syndrome) in patients presenting with acute coronary syndrome who underwent coronary arteriography. Patients presenting during the COVID-19 pandemic, between March 1 and April 30, 2020, were compared with 4 control groups of patients with acute coronary syndrome presenting prior to the pandemic across 4 distinct timelines: March to April 2018, January to February 2019, March to April 2019, and January to February 2020. Data were analyzed in May 2020.

Exposures: Patients were divided into 5 groups based on the date of their clinical presentation in relation to the COVID-19 pandemic.

Main Outcomes and Measures: Incidence of stress cardiomyopathy.

Results: Among 1914 patient presenting with acute coronary syndrome, 1656 patients (median [interquartile range] age, 67 [59-74]; 1094 [66.1%] men) presented during the pre–COVID-19 period (390 patients in March-April 2018, 309 patients in January-February 2019, 679 patients in March-April 2019, and 278 patients in January-February 2020), and 258 patients (median [interquartile range] age, 67 [57-75]; 175 [67.8%] men) presented during the COVID-19 pandemic period (ie, March-April 2020). There was a significant increase in the incidence of stress cardiomyopathy during the COVID-19 period, with a total of 20 patients with stress cardiomyopathy (incidence proportion, 7.8%), compared with prepandemic timelines, which ranged from 5 to 12 patients with stress cardiomyopathy (incidence proportion range, 1.5%-1.8%). The rate ratio comparing the COVID-19 pandemic period to the combined prepandemic period was 4.58 (95% CI, 4.11-5.11; P < .001). All patients during the COVID-19 pandemic had negative reverse transcription–polymerase chain reaction test results for COVID-19. Patients with stress cardiomyopathy during the COVID-19 pandemic had a longer median (interquartile range) hospital length of stay compared with those hospitalized in the prepandemic period (COVID-19 period: 8 [6-9] days; March-April 2018: 4 [3-4] days; January-February 2019: 5 [3-6] days; March-April 2019: 4 [4-8] days; January-February: 5 [4-5] days; P = .006). There were no significant differences between the COVID-19 period and the overall pre–COVID-19 period in mortality (1 patient [5.0%] vs 1 patient [3.6%], respectively; P = .81) or 30-day rehospitalization (4 patients [22.2%] vs 6 patients [21.4%], respectively; P = .90).

Conclusions and Relevance: This study found that there was a significant increase in the incidence of stress cardiomyopathy during the COVID-19 pandemic when compared with prepandemic periods.

Effects of non-pharmaceutical interventions on COVID-19: A Tale of Three Models

https://www.medrxiv.org/content/10.1101/2020.07.22.20160341v3

Abstract:

Objective: To compare the inference regarding the effectiveness of the various non-pharmaceutical interventions (NPIs) for COVID-19 obtained from different SIR models.

Study design and setting: We explored two models developed by Imperial College that considered only NPIs without accounting for mobility (model 1) or only mobility (model 2), and a model accounting for the combination of mobility and NPIs (model 3). Imperial College applied models 1 and 2 to 11 European countries and to the USA, respectively. We applied these models to 14 European countries (original 11 plus another 3), over two different time horizons.

Results: While model 1 found that lockdown was the most effective measure in the original 11 countries, model 2 showed that lockdown had little or no benefit as it was typically introduced at a point when the time-varying reproductive number was already very low. Model 3 found that the simple banning of public events was beneficial, while lockdown had no consistent impact. Based on Bayesian metrics, model 2 was better supported by the data than either model 1 or model 3 for both time horizons.

Conclusions: Inferences on effects of NPIs are non-robust and highly sensitive to model specification. Claimed benefits of lockdown appear grossly exaggerated.

Charts and Graphics

International News

Lockdowns return or are extended as third wave of Covid sweeps Europe

https://www.theguardian.com/world/2021/mar/22/lockdowns-return-extended-third-wave-covid-europe

Several European countries are extending or reintroducing lockdown measures as a third wave of the pandemic sweeps the continent fuelled by more contagious new variants of coronavirus such as the B117 mutation first detected in the UK.

Critics say the further restrictions have come too late, with politicians eager to start easing measures for pandemic-weary populations after a second series of lockdowns late last year leading to a surge in infections and health services stretched to breaking point.

The variant first found in Britain is spreading significantly in at least 27 European countries and is now dominant in Denmark, Italy, Ireland, Germany, France, the Netherlands, Spain and Portugal, according to the World Health Organization.

Up to 50% more transmissible than the original virus, it may also be more deadly. “The spread of the variants is driving the increase,” Hans Kluge, the WHO’s Europe director, said last week. “But so is the opening of society when it is not done in a safe and a controlled manner.”

Germany 2.6m cases, 75,000 deaths

After reopening schools in late February and allowing hairdressers and some shops to resume business in March, Germany is to prolong its partial lockdown into April as new cases surge to more than 13,000 a day on a rolling seven-day average.

Chancellor Angela Merkel met leaders of the country’s 16 states on Monday for what were supposed to be talks about a further easing of restrictions, but instead agreed a pause to the planned reopening of bars, restaurants, leisure and cultural venues.

Some hard-hit areas may have to reimpose strict measures again, with shops and some schools very likely to close. Staff who can work from home will be asked to continue doing so until 18 April rather than return to the workplace on 28 March.

Private gatherings are again expected to be limited to no more than one person from outside the household, excluding children under 14. Discussions about the closure of schools and nurseries, as well as a possible lifting of restrictions over Easter, continued.