Monday, June 1, 2020

Notations On Our World (Special Edition): On #GeorgeFloyd, Racial Justice and the Need To Change


These have been challenging times in America.   We hereby present a discourse of the week that was and the debate that has ensued.    As we went to press, protests have continued in dozens of cities including in front of the White House.    In California and other States, The National Guard has been called out.    The Governor of Minnesota has appointed Keith Ellison, the Attorney General of Minnesota to serve as Special Prosecutor as President Trump was busy with his views on Twitter--and the Mayor of Atlanta and others implored him to Stop Talking. 

We captured the banner that Google released to  simply say:  We have to change--this is why we began this journey.   We look forward to being all we can in our power to be part of the Solution as America reels in the aftermath of the horrific killing of George Floyd to underscore the racist and bigotry in America as we note leadership in action to say we have to change.  We present a discourse of the deliberations over the weekend:










Sunday, May 31, 2020

Notations On Our World (May 2020 M-End Edition): On the Month That Was




It has been quite a month in our World.    The World has been in the midst of a pandemic and the United States has passed over 100,000 deaths China has launched a crackdown in Hong Kong and President Trump has just announced, as we went to press, that The United States is terminating its' relationship with the World Health Organization.

As we also went to press, we were also assessing the aftermath of the death of George Floyd.    Protests erupted throughout the United States and the National Guard was called out to help quell the violence.   The main culprit, a former Officer fired by the Mayor of Minnaepolis, was arrested and charged with murder.    President Trump also signed off on an Executive Order on Social Media after Twitter instituted a fact-checking process on President Trump.


As these developments were on-going, the US Election Season was well on its' way.     Our team captured a snapshot of some of the polling in some key US Senate races: 

COVID-19

EPI UPDATE The WHO COVID-19 Situation Report for May 26 reports 5.40 million confirmed cases (99,780 new) and 343,514 deaths (1,486 new). In terms of relative contribution to the global COVID-19 incidence, South America has surpassed all other continents, currently representing nearly 30% of the global daily incidence. North America represents 26% of the daily incidence (and steadily decreasing), and Asia represents 22%. Europe has dropped to approximately 18%, and Africa’s relative contribution continues to grow steadily, now more than 4%.

Brazil reported 16,324 new cases, consistent with the daily incidence reported last week. Brazil’s daily incidence is second to only the United States, and if the current trends continue, it could become #1 globally in the coming days. The per capita incidence in Peru and Chile continue to exhibit concerning trends as well, with Peru reporting more than 140 new cases per million population each day and Chile reporting more than 200, more than double and triple the per capita incidence in the United States, respectively. South America continues to emerge as a major global hot spot for COVID-19. These South American countries represent 3 of the top 7 countries globally in terms of daily incidence.

Potentially overlooked due to the total volume of cases in the United States and the growing incidence in Brazil, Chile, and Peru, Mexico’s COVID-19 epidemic is also exhibiting a concerning acceleration. Mexico is currently #5 in the Americas in terms of daily incidence and #8 globally. Mexico has reported a total of 74,560 cases, including 3,455 new cases, its highest daily total to date.

Russia reported 8,338 new cases, relatively consistent with its recent trend. India reported 6,387 new cases, and it has reported its 5 highest daily totals over the past 5 days. The state of Tamil Nadu, where a large outbreak has been linked to one of Asia’s largest markets, reported 646 new cases. Russia and India are #3 and #4 in terms of daily incidence, respectively.

After several weeks of generally increasing daily incidence, including 5 consecutive days near or greater than 1,000 new cases, South Africa reported its lowest daily incidence (649 new cases) since May 12. South Africa is currently reporting the highest cumulative COVID-19 incidence (23,615 cases) and second highest daily incidence in Africa.

Singapore reported 533 new cases, including 529 (99.2%) among residents of migrant worker dormitories. Outbreaks in migrant worker dormitories continue to drive Singapore’s COVID-19 epidemic, but these cases appear to be decreasing slowly over the past several weeks. Singapore estimates that the cases confirmed so far represent 9.48% of the total population across all migrant worker dormitories, compared to only 0.03% of the general public population. Of the total confirmed cases reported in Singapore, 93.1% are among residents of migrant worker dormitories, including 99.0% over the past 2 weeks. Singapore’s per capita daily incidence has declined substantially over the past several weeks, down from a peak of more than 200 new cases per million population on April 23 to fewer than 75 now, its lowest value since April 16.

UNITED STATES
The US CDC reported 1.66 million total cases (24,958 new) and 98,261 deaths (592 new). Daily COVID-19 deaths in the United States are generally on the decline, but the total could potentially reach 100,000 deaths by tomorrow’s update. In total, 12 states (no change) reported more than 40,000 cases, including New York with more than 350,000; New Jersey with more than 150,000; and Illinois with more than 100,000.

The New York Times continues to track state-level COVID-19 incidence, with a focus on state policies regarding social distancing. A number of states began to relax social distancing measures—including resuming operations at restaurants, retail stores, and barbershops/salons—at the end of April/early May, and mass gatherings associated with the Memorial Day holiday weekend (US) could have provided the conditions to drive increased community transmission. We will continue monitoring state-level trends over the coming weeks.

The Johns Hopkins CSSE dashboard reported 1.68 million US cases and 99,123 deaths as of 11:30am on May 27.

COVID-19 MORTALITY IN YOUNGER POPULATIONS As COVID-19 continues to spread beyond China, Europe, and the United States—including to Brazil, Chile, Peru, and Mexico in the Americas—the risk profile appears to be shifting. While severe cases and deaths in many countries impacted early in the pandemic tended to be reported in older patients, developing countries are increasingly reporting severe cases and deaths among younger individuals. As illustrated by this figure, most countries in Africa, South America, and Asia are reporting lower median age for COVID-19 patients, which could be contributing to the elevated incidence of severe disease in younger patients. Notably, 15 percent of COVID-19 deaths in Brazil have been in patients younger than 50 years old, and nearly quarter of deaths in Mexico have been between the ages of 25 and 49 years. These proportions are orders of magnitude higher than what has been reported in other severely affected countries like Spain and Italy. A myriad of factors—including high population density, pervasive poverty, high prevalence of comorbidities (eg, diabetes, obesity), and poor access to healthcare—could be contributing to a shift toward more severe disease in younger individuals. As COVID-19 incidence shifts toward developing nations, it will be critical to address all relevant risk factors, including those beyond patient health and demographics, in order to effectively mitigate the COVID-19 risk.

US VACCINE POLL As the world looks ahead to the availability of a SARS-CoV-2 vaccine, it is important to understand existing expectations and perceptions in order to begin messaging and education efforts. A recent poll, conducted by the Associated Press and NORC, aimed to understand public opinions regarding the future of a SARS-CoV-2 vaccine. Among the respondents, 61% expected that a vaccine will be publicly available sometime in 2021, compared to 20% who think it will be available in 2020 and 17% who believe it will be sometime after 2021. Notably, only 49% of respondents indicated that they intend to get vaccinated, while 20% said they would not get vaccinated (31% not sure). For comparison, a similar study in 2019 found that 52% of people intended to get vaccinated against seasonal influenza.

Among the reasons cited for not getting vaccinated were: concerns about side effects (70%), concerns that the vaccine could result in SARS-CoV-2 infection (42%), the belief that the individual would not experience severe COVID-19 illness (31%), and the belief that vaccines more broadly are not effective (30%). Notably, the accelerated process for developing, testing, and producing a SARS-CoV-2 vaccine could increase concerns regarding vaccine safety, including that manufacturers and regulators may be willing to sacrifice safety in order to shorten the time to vaccine availability. Considering that many of these issues are similar to those facing other vaccination efforts, including routine childhood immunizations and seasonal influenza, it is critical to begin messaging now, before a vaccine is available, in order to increase support for and participation in vaccination programs and appropriately frame the potential benefits and risks.

COVID-19 MISINFORMATION Mis- and disinformation are presenting substantial challenges to the global COVID-19 response, as rumors and conspiracy theories may be linked to increased transmission and unnecessary disease. Claims related to disease severity, government response, and vaccine or treatment efficacy are circulating widely, and it is extremely difficult to provide fact-checking or verification in real time, particularly across the myriad of traditional and social media platforms available worldwide. COVID-19 has presented optimal circumstances for the spread of rumors, including increased stress and anxiety around the virus that can make individuals more susceptible to mis- and disinformation. An investigation by the BBC identified a number of events—including mass poisonings and threats or incidents involving physical violence—linked to misinformation regarding COVID-19.

To combat the spread of misinformation and disinformation, social media sites are increasingly attempting to identify potentially false information through fact checking in order to alert users; however, mis- and disinformation campaigns persist. The nature of COVID-19 response activities, particularly those that disrupt daily life, can breed skepticism, which can potentially further susceptibility to associated misinformation, particularly information that confirms existing views or perceptions. Additionally, as people are spending more time at home, they have a greater opportunity to browse online content, which can further increase exposure to mis- and disinformation. 

SARS-CoV-2 TESTING IN AFRICA As the COVID-19 pandemic spreads beyond China, Europe, and the United States, concern is growing regarding the potential impact on African countries, particularly those with lower resources and underdeveloped healthcare systems. While the relative proportion of COVID-19 cases in Africa is slowly growing, the continent still only represents a small fraction (fewer than 5%) of reported cases worldwide. Lack of available testing is repeatedly cited as a barrier to the public health response in Africa. As has been illustrated in numerous other countries, including the United States, insufficient testing capacity can allow community transmission to go undetected, which creates major challenges for containing spread. Notably, the testing capacity varies considerably between countries in Africa, ranging from approximately 10 tests per 1,000 population in South Africa and 61 tests per 1,000 population in Mauritius to countries like Chad and Mali that have conducted only 1 or 2 tests per 10,000 population.

An article published in Nature discusses how scientists in some African countries are leveraging international professional networks to improve the availability of critical supplies to bolster SARS-CoV-2 testing capacity. Partnerships with colleagues in academic and other institutions in the United States, Europe, and elsewhere have been able to supply materiel needed to perform tests, and laboratories and networks that traditionally work on tuberculosis, HIV, and malaria have transitioned to provide SARS-CoV-2 laboratory capacity. Professional connections have made these critical supplies more widely available in Africa, supplementing the limited support provided by other national governments. The nature of COVID-19 as a global pandemic means that nations around the world are experiencing stressed healthcare systems and resource limitations. Under different circumstances, nations with great resource availability would be providing additional aid to countries in need; however, resource limitations in even the wealthiest countries means that external support may be lacking. Unique solutions may be necessary to ensure that countries have access to the supplies and equipment necessary to combat the pandemic. 

US SOCIAL DISTANCING Reuters published analysis of state-level COVID-19 incidence data—from The COVID Tracking Project—to evaluate epidemic trends. The analysis found that 20 states reported increased weekly incidence (for May 18-24) over the previous week, compared to 13 states identified last week. Notably, Alabama (28% increase), Missouri (27%), and North Carolina (26%) reported the highest weekly increases. After several weeks of declining incidence, Georgia reported a 21% increase as well. The US CDC and White House recommend that states exhibit declining incidence for at least 14 days before initiating or furthering efforts to relax social distancing measures. According to the Reuters analysis, 17 states have not met that criteria at any point since the onset of the US epidemic, even though every state has begun relaxing social distancing to some degree. Additionally, the analysis found that US COVID-19 incidence is actually holding relatively steady or potentially increasing slightly, if New York and New Jersey are omitted, illustrating that the decline in national incidence over recent weeks has been driven largely by these 2 states, which represent more than 10% of the national total. Numerous individual states are experiencing increasing incidence, which can be masked by the overall national-level trend.

SARS-CoV-2 MONITORING IN SEWAGE Researchers from Yale University (Connecticut, US) published (preprint) findings from a study that evaluated the presence of SARS-CoV-2 virus in a local sewage system. The study aimed to determine the potential for monitoring SARS-CoV-2 presence and concentration in sewage systems to provide insight into the level of local community transmission. Utilizing daily samples taken from a local sewage processing facility (March 19-May 1), the researchers performed quantitative viral RNA testing (qRT-PCR) for SARS-CoV-2 and compared the concentration to local COVID-19 reporting. They found a strong correlation between the amount of SARS-CoV-2 present in the sewage and the number of confirmed COVID-19 cases and hospitalizations several days later. The trend in hospitalizations lagged 3 days behind the peak viral concentration, and the reported cases lagged the viral concentration by 7 days. Because viral shedding often occurs before SARS-CoV-2 infections can be diagnosed, this study illustrates that conducting surveillance on the concentration of SARS-CoV-2 in wastewater systems could potentially provide several days advance warning of increased COVID-19 incidence in the community.

ANTIBODY PRODUCTION IN COVID-19 SURVIVORS Researchers at The Rockefeller University published (preprint) data from a study of 149 COVID-19 patients to evaluate the presence of antibodies in blood serum after their recovery. Their analysis identified a broad scope of immune response among the participants, including the production of various types of antibodies. The researchers found that the majority of the COVID-19 patients did not produce the appropriate type or quantity of antibodies necessary to result in the “neutralizing activity” necessary to prevent SARS-CoV-2 infection, including 33% whose neutralizing activity was below the minimum detectable level. They did identify “remarkably high” neutralizing activity in 2 of the participants. The researchers were further able to identify and clone key neutralizing antibodies from these “‘elite’ responders,” and they are working to translate them into a potential COVID-19 treatment.


We have also been assessing the conflict between India and China.  We also have been assessing the situation between Ethopia and Egypt over the River Nile.  

As we gear up for a new month of service, we close out with this as we look forward to being of service:


U.S. ElectionsCongressWhite HouseJusticeWorld
Travel Ban Hits as Bolsonaro's Future Darkens Amidst Calls for Impeachment
What's Happening: On Monday, the United States announced it would move up the implementation of travel restrictions from Brazil to midnight tonight. The White House originally announced the measure on Sunday as the number of recorded cases in Brazil rose to more than 363,000 and the death toll to nearly 23,000.

 

The travel ban is a blow to Brazilian President Jair Bolsonaro as he fights calls for social distancing and touted unproven drugs.

 

Bolsonaro’s foreign policy advisor Filipe Martins played down the restrictions, comparing them to similar travel bans on Chinese and European visitors. “There isn’t anything specifically against Brazil. Ignore the hysteria from the press,” he said.

 

dashboard DW News | Brazil court releases explosive Bolsonaro video as coronavirus cases soar

 

Pandemic Downplayed: It's not the first time the Brazilian president has downplayed the coronavirus pandemic and its impact on his country.

 

Bolsonaro has labeled COVID-19 as nothing more than a"little flu," and accused China of stoking hysteria. He believes the pandemic has been orchestrated exclusively to harm him and President Trump

 

To show that he wasn't worried, Bolsonaro and his delegation made an official visit to meet with Trump in early March. But after returning from his trip to Florida, more than 20 of Bolsonaro's aides tested positive for COVID-19 — a public relations disaster for the president.

 

Bolsonaro, a former paratrooper and athlete, has also been ignoring health advice issued by the World Health Organization (WHO) and his very own health authorities to practice physical distancing. He has made a point of shaking the hands of supporters and taking selfies with them, as they gather outside the presidential palace each Sunday to call for an end to coronavirus restrictions. Bolsonaro has publicly stated that with his "history as an athlete," he would only suffer light symptoms from a an infection.

 

He's also seen two health ministers leave office since Apr. 16. The first, Luiz Mandetta, was fired following disagreements over the social isolation measures, and the second, Nelson Teich, abruptly resigned after less than a month on the job.

 

More Immediate Issues: While Bolsonaro can claim the coronavirus pandemic was a problem he never instigated, a pending federal corruption investigation has hit closer to home.

 

Brazilian newspaper O Globo reported on Monday that prosecutors in the office of the attorney general have gathered enough evidence to charge Bolsonaro with a crime. The lawyers say that a video from a cabinet meeting on April 22 — released to the public last Friday — shows the president committing the crime of “administrative advocacy,” or using his public position to advance a private agenda: In this case, it was Bolsonaro allegedly pressuring then-Justice Minister Sergio Moro to fire the chief of the federal police in order to shield his sons from investigation. The punishment for such a crime is relatively light: up to one year in prison and a fine.

 

dashboard Market: Which of these seven Latin American leaders will leave office next?

 

Is he likely to go to trial? For that to happen, Bolsonaro would have to be impeached. As Bloomberg reported on May 21, the president has recently created an alliance with the centrist bloc, Centrao, obtaining their backing in return for political favors. Centrao, who hold 40 percent of seats in the lower House of Congress, could protect him from impeachment in the same way it did Michel Temer, Bolsonaro’s predecessor.

 

Approval Wanes: There is no doubt that Bolsonaro is in political trouble. His popularity ratings have tumbled and are now below 30 percent; some 50 percent of the population disapprove of his handling of the crisis. The support he once enjoyed from mainstream conservatives — who were desperate to see the back of the leftwing Workers’ party — is now crumbling away.

 

But impeachment in Brazil is as much a political as a legal process.

 

The misdemeanors that led to the removal of Dilma Rousseff as president in 2016 were fairly technical. It was more significant that Rousseff had sunk to a 10 percent approval rating in the polls and the economy had suffered a deep recession.

 

Bolsonaro’s ratings are still way above Rousseff’s nadir. And while the economy is heading toward a potentially deep recession and a surge in unemployment, his anti-lockdown rhetoric may buy him some political protection — at least for now.

 

Oliver Stuenkel, a professor at the Getúlio Vargas Foundation in São Paulo, says, “What Bolsonaro wants to do is to disassociate himself from the economic crisis that is approaching.”

 

The social isolation measures that the president has lashed out against could prevent the mass demonstrations that provided the impetus for the drive to impeach Rousseff.

 

dashboard Price list: Who will win the 2020 Democratic vice presidential nomination?

 

Wisdom of the Crowd: As it stands and despite the tough political climate, Brazil's president doesn't even lead PredictIt's market tracking which Latin American leader will be forced out next! That honor belongs to President Lenín Moreno of Ecuador.

 

Moreno currently leads the market of seven leaders with a YES outcome trading at 46¢, meanwhile Bolsonaro is trading at 32¢. Peru's President Martín Vizcarra is a distant third at 10¢.

 

Since the market launched on Apr. 14, traders have placed Bolsonaro’s odds of leaving as most likely or second most likely. Traders have had the Brazilian as high as 44¢, on Apr. 25, and as low as 14¢, the day after the market opened.

 

 

BOLSONARO'S ODDS
Today's New Markets