Lockdowns return to some parts of Europe and the UK – EOH 10/16

After months of the data showing lockdowns have enormous consequences with little gain, politicians continue to push a failed policy with unimaginable social and economic costs. In the UK despite rising cases (with a rise in testing), deaths have remained flat with only a mild increase in hospitalizations, yet strict lockdown measures have been enacted. Modelers were wrong again yet a London lockdown still came. If it isn’t clear yet, lockdowns are not about COVID. 

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COVID News

Michigan Supreme Court denies request to extend Whitmer’s emergency powers

https://www.mlive.com/public-interest/2020/10/michigan-supreme-court-denies-request-to-extend-whitmers-emergency-powers.html

Another lockdown bites the dust.

The Michigan Supreme Court issued two rulings Monday reversing a lower court’s opinion that supported Gov. Gretchen Whitmer’s use of executive action during the coronavirus pandemic and denying Whitmer’s request to delay the impact of removing her emergency powers. The Supreme Court previously ruled in a federal case it was asked to weigh in on that Whitmer does not have authority under state law to continue a state of emergency without the support of the Legislature, effectively ending Whitmer’s executive orders. Whitmer had relied on the 1976 Emergency Management Act and the 1945 Emergency Powers of the Governor Act to issue a wide swath of orders that required masks in public spaces, limited crowd sizes, and closed various establishments, but the court ruled neither gave Whitmer the ability to unilaterally extend a state of emergency. Whitmer had asked the Supreme Court to postpone the impact of the ruling until Oct. 30, giving the state just under a month to plan a smooth transition before the orders were canceled. The governor argued Michigan workers could lose unemployment benefits while losing measures to prevent the spread of COVID-19. Chief Justice Bridget McCormack wrote in a concurring opinion the court does not have the authority to grant Whitmer’s request. Justice Richard Bernstein, the lone justice to dissent from the ruling, said he would have preferred to delay the effect of the opinion to give Whitmer and the Legislature more time to prevent any unintended consequences. Bernstein cited the loss of unemployment benefits that were expanded under one of Whitmer’s orders. “Even assuming that the Legislature will be able to respond quickly, the governor notes that up to 830,000 active claimants may lose their benefits once this court’s opinion takes effect,” Bernstein wrote. “This represents a significant potential disruption to the livelihoods of the people of Michigan in a time of great public crisis.” In a separate lawsuit filed by Republican legislative leaders that addressed similar questions, the Michigan Supreme Court reversed a Court of Appeals decision and ruled Whitmer did not have the authority to continue the state of emergency. Reiterating its ruling in the federal questions, the court found “the Emergency Powers of the Governor Act is incompatible with the Constitution of our state, and therefore, executive orders issued under that act are of no continuing legal effect. This order is effective upon entry.”

Please, Gov. Cuomo, listen to the science and quit it with deadly lockdowns

https://nypost.com/2020/10/12/please-gov-cuomo-listen-to-the-science-and-quit-it-with-deadly-lockdowns/

Politicians define which “science” is acceptable.

When will Gov. Andrew Cuomo start listening to the science, as he tells everyone else to do? By ignoring new warnings by two key experts, he’s adding to New Yorkers’ suffering — especially the poor and people of color. The World Health Organization’s COVID envoy, David Nabarro, is pleading for leaders to avoid lockdowns. “Stop using lockdown as your primary control method,” he begs. They’ve led to “a terrible, ghastly global catastrophe,” possibly “doubling” world poverty and child malnutrition by next year. And economist Emily Oster crunched the numbers to show that reopened schools are not virus “superspreaders.” Alas, Cuomo doesn’t care: Last week he reimposed lockdowns on several hot zones, shutting schools, non-essential businesses and indoor dining and drastically curbing religious activities. Other harsh rules also remain in effect throughout the city. Oster, meanwhile, cites Cuomo by name: “Democratic governors who love to flaunt their pro-science bona fides … don’t seem to be aware” of new data, she wrote. Cuomo calls schools “mass spreaders,” but her analysis of hundreds of thousands of school kids and staff in 47 states found a mere 0.13 percent student infection rate and 0.24 percent among staff last month. Yet kids “affected by school closures are disproportionately low-income students of color,” she adds. (Why isn’t first lady Chirlane McCray’s COVID racial equity task force screaming about school closures backed by Cuomo and her husband, Mayor Bill de Blasio? Oh … never mind.) Oster’s and Nabarro’s warnings aren’t the first from scientists: The American Academy of Pediatrics, the National Academies of Science, Engineering and Medicine and others all warn that remote learning is a disaster. And 30,000 scientists and medical practitioners have signed the American Institute for Economic Research’s Great Barrington Declaration against lockdowns. Cuomo no longer has any excuse for drastic steps. New York’s infection rate remains below 2 percent, and the case fatality rate has also plummeted. Rather than tightening rules, he should be relaxing them.

New York City Faces Critical Moment in Fight Against Second Wave of Covid-19

https://www.wsj.com/articles/new-york-city-faces-critical-moment-in-fight-against-second-wave-of-covid-19-11602618676

Don’t expect much of a performance.

New York City is facing a crucial test this week in whether it can prevent a second wave of Covid-19 by enforcing targeted shutdowns in areas that have emerged as coronavirus hot spots. Mayor Bill de Blasio said at a Tuesday press conference that aggressive outreach and testing, combined with tighter social-distancing restrictions, have already led to some “leveling off” in so-called red zones, which have seen the highest positivity rates for the virus. “This week will be absolutely decisive,” Mr. de Blasio said. “This is the week where we can start to turn the tide in those red-zone areas and contain the problems that we are seeing there.” The new restrictions, implemented last week, affect swaths of New York City and nearby Rockland and Orange counties. The measures take a tiered approach, with hot spots identified by the colors red, orange and yellow. In the red zones, which span parts of Brooklyn, Queens, Rockland and Orange counties, schools and nonessential businesses have been closed. Mass gatherings are off-limits and houses of worship are restricted to no more than 25% capacity or 10 people. Orange and yellow zones face fewer restrictions. The city has been ramping up enforcement of the new restrictions. Over the weekend, New York City authorities issued over 100 summonses in red, orange and yellow zones for a variety of violations, including holding mass gatherings, officials said. More than $150,000 in fines were also handed out. The number of people testing positive in New York City since mid-September has been on the rise, with the most recent seven-day average hitting 520 people on Sunday. A city threshold for new coronavirus cases is 550, an indicator that was set months ago as part of measures rolled out for the reopening of the city in June. Hospital admissions for Covid-19 were at 59 people on Sunday. The threshold for the city is 200. New York Gov. Andrew Cuomo said last week that mass gatherings and schools are places where the disease is transmitted easily. New York City reopened its middle and high schools this month, the final batch of public schools to reopen for in-person instruction in the nation’s largest school district. To contain the spread of the virus in schools, City Hall promised random monthly testing of 10% to 20% of students and staff showing up in person at each school. Across 56 schools, 1,751 people have been tested so far, Mr. de Blasio said Tuesday. Only one test came back positive.

No Home, No Wi-Fi: Pandemic Adds to Strain on Poor College Students

The ignored costs of the lockdowns.

Michelle Macario was struggling to follow online classes through the tiny screen of her smartphone. She had no laptop and no Wi-Fi at home, and the library where she normally studied at her community college in Los Angeles was closed. So two weeks into the coronavirus shutdown in the spring, she dropped all of her courses to avoid failing. Things are not much better this semester. Ms. Macario, 18, who is majoring in psychology at Santa Monica College, left the crowded apartment in Los Angeles that she shared with her immigrant family from Guatemala and has been crashing with her sister and friends. But the Wi-Fi is unreliable, she is living too far away from her hospital internship, and she toils to tap out exams and homework on her phone. “Between the internet, Covid and couch surfing, I haven’t been able to do a good semester,” Ms. Macario said. Trapped between the financial hardships of the pandemic and the technological hurdles of online learning, the millions of low-income college students across America face mounting obstacles in their quests for higher education. Some have simply dropped out, as Ms. Macario did previously, while others are left scrambling to find housing and internet access amid campus closures and job losses. “Every part of this pandemic is hitting low-income students hardest, and they were already in bad shape to begin with,” said Sara Goldrick-Rab, the founding director of the Hope Center for College, Community and Justice at Temple University, which studies the economic challenges facing college students. Some colleges and universities have increased financial aid to students in need, but others, facing their own financial challenges, have said they cannot afford to offer more. A federal stimulus package passed in March that provided $7 billion for student expenses such as food, housing and health care has largely been depleted, and Republicans have balked at passing further relief proposed by Democrats. President Trump pulled out of and then tried to restart negotiations for additional aid last week. The impact on struggling students can be seen most clearly at the nation’s roughly 1,400 community colleges, where nearly half of students start seeking degrees. Enrollment there declined by 8 percent this fall, compared with a 2.5 percent drop in undergraduate enrollment over all, according to the National Student Clearinghouse Research Center in Herndon, Va., which tracks college enrollment data.

Research

COVID-19 in New Zealand and the impact of the national response: a descriptive epidemiological study

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30225-5/fulltext

A study on how New Zealand handled COVID-19 and lockdowns. 

There is an international imperative to provide evidence of the effectiveness of non-pharmaceutical interventions against COVID-19. Early evidence in Asia, including China, Singapore, and South Korea, showed COVID-19 control using combinations of movement restrictions, physical distancing, hygiene practices, and intensive case and contact detection and management. The WHO-China Mission recommended decisive government leadership to rapidly enhance surveillance and apply risk based non-pharmaceutical interventions with effective population engagement. However, it was unclear how well this could be implemented in societies with little experience of successfully containing a novel respiratory virus. As evidence emerged that the unique nature of severe acute respiratory syndrome coronavirus (SARS-CoV-2) required distinct strategic approaches, New Zealand moved from a response guided by national influenza pandemic planning to a COVID-19-tailored approach focusing on suppression (stopping SARS-CoV-2 community spread) over mitigation (slowing down transmission), with a goal of COVID-19 elimination, to reach very low or zero COVID-19 incidence. Risk-informed border restrictions were implemented ahead of WHO advice before the first local case of COVID-19 was confirmed on Feb 28, 2020. Graduated suppression strategies were then applied, escalating to national lockdown (stay-at-home order with few exemptions) within 26 days. This response has international relevance, particularly for other island nations, high-income and western settings, and countries with ethnic and social health inequities. New Zealand is a high-income remote Pacific island state of nearly 5 million people, with an ageing population and diverse ethnic structure: approximately 16% Indigenous Māori, 7% Pacific peoples, 15% Asian, and 62% European or other. Inequitable morbidity and mortality for Māori and Pacific peoples, seen during previous influenza pandemics, continue for many communicable diseases today.  COVID-19 ethnic and social disparities have been observed overseas.  New Zealand’s response sought to prevent COVID-19 disparities and minimise transit of infection to lower-income Pacific countries. 

COVID-19 Transmission in US Child Care Programs

https://pediatrics.aappublications.org/content/pediatrics/early/2020/10/12/peds.2020-031971.full.pdf

More evidence proving that schools are low-risk. 

The COVID-19 pandemic has had an unprecedented impact on child care and schools. Within one week of the World Health Organization’s declaration of a pandemic, 107 countries had implemented national school closures. Within three weeks, the number had grown to 194 countries, impacting 91% of the world’s school-age children. When schools closed in the U.S., so did many child care programs, demonstrated by the loss of more than 35% of jobs in the child care industry between February and April 2020. These school and child care closures have been controversial regarding their benefits versus costs. Precautionary closure of child care programs was reasonable, given considerable evidence that these programs may be significant vectors for viral spread. However, several studies have indicated that school and child care closures may have had little impact on slowing the spread of COVID-19. Furthermore, child care and school closures may result in several negative consequences, such as child care providers’ loss of jobs and wages, parents’ inability to return to work, and children’s diminished educational, social, and nutritional opportunities. Pediatricians are key informers to parents about safety issues regarding child care and school attendance during the pandemic. Central to the debate over child care and school reopening is the uncertainty regarding whether children are efficient transmitters of COVID-19. Although there is a relatively infrequent risk for multisystem inflammatory syndrome in children, children appear to be far less likely to be infected and more likely to be asymptomatic or paucisymptomatic.  On the other hand, because viral loads may be similar in symptomatic and asymptomatic COVID-19 carriers including children,  there may be a high risk for transmission to other children and adults through asymptomatic children in settings serving large numbers of children, such as child care and schools. Unfortunately, most studies examining pediatric transmission risk are limited by small sample sizes of children and were conducted during widespread child care and school closures, when child transmission opportunities were greatly limited.

Charts and Graphics

Daily New Deaths in New York

So, why the talk of a second localized lockdown?

COVID-19 Deaths vs Other Types of Deaths in Scotland

A novice looks at reported deaths; an expert looks at all-cause mortality. 

COVID-19 Key Indicators (England & Wales)

Just like the US, the UK faces a casedemic.

Positive COVID-19 tests vs Vallance 

Modelers in the UK miss the mark again. 

International News

A medic’s case against another lockdown

https://www.spectator.co.uk/article/a-medic-s-case-against-another-lockdown

A Canadian doctor who treated COVID patients argues against the lockdown.

‘Do no harm’ are three words all doctors must follow in the course of their work. These words make me convinced that Covid-19 lockdowns are the wrong approach, and a growing number of doctors are on my side.  Medical students throughout the West are taught the principles of beneficence and non-maleficence as pillars of medical ethics. In simple terms, they dictate that the likely benefits of our treatments ought to substantially outweigh their potential risks. In my practice, I prescribe medications like atorvastatin to lower cholesterol, or warfarin to thin the blood, because international, randomised, double-blind control trials have proven that their benefits far outweigh their risks. If I were to prescribe thalidomide (which causes birth defects) for morning sickness, or phen-phen (which causes heart problems) for weight loss, that would be unethical malpractice; their risks outweigh their benefits. Generally, prescriptions for such medications are not allowed because regulatory bodies like the Food and Drug Administration in the US or the MHRA in the UK take them off the market once their disproportionate risks become clear.  If lockdowns were a prescription drug for Covid-19 treatment, the FDA would never have approved it. The seminal Imperial College London paper and other mathematical models like it were used to justify their use, but clinicians would never prescribe a drug or propose a surgery based on such modelling. The now well-publicised failure of these models to accurately predict Covid-19 outcomes proves the rule. Luckily, we no longer have to talk about mathematical models. We now have seven months of real-world data to look at. Some pundits compare Sweden to Norway to argue for lockdown. Others compare Sweden to the UK, or Florida to New York to argue against. Either sort is vulnerable to accusations of cherry-picking the data. In medical science, we rely on epidemiologists to take all the available data from all the countries and perform statistical analyses to correct for as many different variables as possible.  This has now been done for lockdowns. In August, the Lancet published an analysis of data from 50 countries. The researchers found that full lockdowns were ‘not associated’ with decreased mortality from Covid-19. These are hard outcome data; reality cannot be waved away with theories or projections.

Academics behind startling study which found half-term coronavirus lockdown could save up to 100,000 lives by New Year admits Britain may have ‘missed the boat’ on a circuit breaker

https://www.dailymail.co.uk/news/article-8838727/Academics-circuit-breaker-study-admit-death-figures-estimated.html

Modeling zealots strike again with their doomsday predictions.

One of the scientists behind a startling paper claiming a ‘circuit breaker’ half-term lockdown could save thousands of lives today admitted it may be too late for one to work effectively. Professor Graham Medley, a SAGE member who is based at the London School of Hygiene & Tropical Medicine, said England might have ‘missed the boat’. ‘The whole point of these is you do them before you have to,’ he said this afternoon at a virtual briefing, adding ‘the earlier you do it the better’. An unpublished paper that came to light today saw Professor Medley and colleagues at the University of Warwick – Professor Matt Keeling and Dr Mike Tildesley – outline how a short, planned lockdown could stop the UK’s spiralling outbreak in its tracks.  But timing one of the ‘precautionary breaks’ is becoming more complicated as cases continue to surge. The team said it was important to do it during a school holiday to minimise disruption to life but that October may be too soon and Christmas too far away – they appeared, however, to lean towards a December lockdown. In the paper the experts suggested more than 100,000 British lives could be spared by January if the country shut down over half-term. But Professor Keeling today said he wished he ‘hadn’t put these numbers in the study’ because it was an extreme scenario that was only included ‘for illustration’. The Government’s official Covid-19 death toll only puts the count so far at 43,000, by comparison. The finding was based on the assumption that all lockdown measures currently in place would be lifted, leaving the virus unchecked from now until January. Professor Keeling noted in the paper that this worst-case scenario would never be allowed to play out without the Government intervening. However, the paper’s findings have already been used as ammunition by those calling for the mini-lockdown, including Labour leader Sir Keir Starmer. 

Europe Overtakes U.S. in New Cases of Covid-19

https://www.wsj.com/articles/europe-overtakes-u-s-in-new-cases-of-covid-as-restrictions-tighten-11602669748

Remember when the media told America that the second outbreak in the US was Trump’s fault…

Europe’s fight to contain a second wave of the coronavirus has reached a tipping point. Months after authorities flattened the curve of coronavirus infections across Europe by imposing some of the Western world’s toughest restrictions on millions of people, the virus has crept back onto the continent. Hospitals are filling up. Bars and cafes are closing down. This week, Europe overtook the U.S. in a key metric that tracks the virus’s spread while accounting for differences in population size. The 27 countries of the European Union and the U.K. recorded 78,000 cases a day on average over a seven-day period ending on Oct. 12, or 152 cases for every million residents. The U.S. recorded 49,000 a day on average over the same period, about 150 for every million residents. That is the first time Europe has outpaced the U.S. since the virus’s peak in the spring, when the disease was spreading largely undetected because of countries’ limited testing capacity. Europe has now reached a critical mass of new cases similar to what the U.S. faced in late June when infections skyrocketed from Florida to California. Europe continues to trail the U.S. in average daily deaths per capita. Over the same seven-day period, the U.S. recorded an average of 2 deaths a day per million residents, double the European average. Both sides of the Atlantic ramped up testing over the summer, allowing countries to uncover far more cases. But in many hot spots in Europe and in the U.S., the share of positive tests is also increasing, a sign that disease-experts say indicates the virus might be spreading even faster than ramped-up testing programs are showing.