TODAY’S (6月21日) #COVID19 update for #Taiwan 🇹🇼
📉75 local + 0 imported cases 📉trend
📉20 deaths 📈trend
📈0.6% test positive rate
📈4.2% case fatality rate (CFR) since May 1
🧪13k tests ⤵️capacity
⚠️It's Monday. Numbers of tests and their positive rates are key metrics. ⬇️ 1/6
DAILY CASES REPORTED (pink bars) and their 7-DAY AVERAGE (pink line), where each day is the mean of itself and the previous six. DEATHS (crimson red bars) at the bottom. THRILLED to have room for the chart legend specifically in the top right quadrant! 2/6
AGE DISTRIBUTION OF CASES. Local cases from May 1-June 20 (age data for cases lag by a day), including those with missing locations. Only a single category is provided for ages >70, which constitute 14% of all cases. DATA ➡️ data.cdc.gov.tw/en/dataset/ags… 3/6
Our local case fatality rate for May 1-June 20 is 4.2%—sadly another new record for us, and higher than the world average of 1-3%. This is largely due to a disproportionate number of older cases, but undetected cases could contribute too. 4/6
CASES & DEATHS and their 7-DAY AVERAGE BY AGE for May 1-June 20. Keeping eyes peeled for 1) new clusters 1-2 weeks after Dragon Boat, when some traveled of necessity and 2) a- or pre-symptomatically founded clusters in places like workplaces or nursing homes. 5/6
WORKPLACE MOBILITY remains higher in Taiwan than other outbreak-halting countries. Our continued #COVID19 success arguably depends on updated guidelines, more #WorkFromHome, and #testing. Check out this 中文 piece w/ @cptwei in today's #天下@CWM_en ⬇️ 6/6
SUMMARY: I was positive for 12 days. Day 1 had debilitating headache, fever, and fatigue. I was functional by day 5, followed by steady improvement. Post-nasal drip continues to the present, weeks later.
Some observations. 1/11
ME: male, 34yo, healthy, 4x vaccinated. My last boost (Moderna 2v) was 252 days before getting infected.
VIRUS: likely Omicron XBB or BA.2.75.
WHAT HELPED: Advil, neti pot, water, sleep, vitamins, fruit. Lemon, honey, cinnamon, and a dash of cayenne pepper in warm water. 2/11
WHERE ACQUIRED: unknown. Suspect a coffeeshop 4 days prior, where several individuals were coughing, some maskless.
DAY 0: the day before I fell ill, I had throat discomfort, as if a piece of food were stuck in tonsil area. This abated midday and I thought all was well. 3/11
Nice science by @flodebarre & team in the raccoon dog report, providing important details and (in my view) weak evidence for a wildlife origin of SARS-CoV-2.
However, relevant evidence and reasons for preferring scenario A over B below are not discussed & I remain agnostic.
1/14
Favoring a wildlife origin (scenario A), I found the following most compelling:
🔹SARS-CoV-2+ environmental samples are clustered in the area where susceptible wildlife were held
🔹sample Q61 contained sequence with 100% match to raccoon dog but none with 100% match to human
2/14
Unfortunately, sampling locations were not randomly distributed, but were intentionally concentrated in the area with susceptible wildlife.
Because all samples are spatially concentrated, positive samples are spatially concentrated.
Specifically, the rate of death decreases with each additional vaccine dose, for every age group in the population.
This is despite numerous assumptions biased against vaccine effectiveness.
1/13
First, consider the population of Taiwan, stratified by age and vaccination status. The single largest group is 30-49 year-olds with 3 doses (dark green).
This is the pattern of deaths one would expect if deaths were random, i.e., if both vaccination and age had no effect.
2/13
Second, consider the observed deaths. The single largest group is 75+ year-olds with 0 doses.
Thus, the observed pattern of deaths differs drastically from random expectation.
For example, 75+ year-olds with 0 doses are a small demographic but dominate the deaths.
3/13
Everyone should know:
1⃣COVID is airborne
2⃣the top symptoms of COVID-19 resemble a cold
3⃣some people develop long COVID
4⃣risks from COVID-19 vs. vaccines
5⃣rapid antigen tests are a good indicator of whether you're contagious, but can be negative even when you’re infected
2/
Some good news:
1⃣the population of Taiwan is relatively freshly vaccinated
2⃣Omicron may be slightly less severe than previous variants, like Delta (but remains highly dangerous to the unvaccinated)
3⃣Taiwan has antiviral medications
3/
@US_FDA Given #molnupiravir's usage to treat #COVID19 is inevitable, what can be done to prevent the potential acceleration of #SARSCoV2 variants?
1⃣patients should strictly ISOLATE WHILE TAKING, especially in the first days on the drug
2⃣ALL DOSES should be taken PRECISELY as directed
@US_FDA Our own reasons for these recommendations are presented here 👇
@US_FDA@Merck First, @Merck and the @US_FDA panelists have done excellent work compiling and analyzing the available data. This was not an easy vote (13 YES/10 NO).
However, specifically on the potential for molnupiravir to induce new viral variants, the results only augment my concerns.
2/n
@US_FDA@Merck 1⃣MUTATION VS. SELECTION. The materials repeatedly confuse mutation and selection (e.g., "The Spike protein is already under evolutionary pressure with or without molnupiravir", 3hr).
Contrarily, the concern is this drug is a mutagen and provides RAW MATERIAL, not selection. 3/n