Case Update: December 12, 2020; Important news on Vaccines and ADE!

Here’s an overdue case update. Cases continue to rise for the US, California, and San Diego County. The timing of the current US peak makes it clear that the bump is directly related to the Thanksgiving holiday, starting less than a week after Thanksgiving, and after cases had started to come down. LA County currently has more that 100,000 active cases, more than twice the number than the next highest county, Cook County, the home of Chicago.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.

New case peaks have left the Northern states and are now centered in the Southwest and Northeast.

Endcoronavirus County Level Map, December 12th, 2020

San Diego County now has 24,000 active cases, far higher that the 4,000 we had at the low point between peaks 2 and 3.

Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.

More on ADE and Vaccines: Some potential very good news for me on the vaccine front. For months I’ve been warning about ADE, the phenomena that some viruses can be even more dangerous in a second infection than the first. Karen Parrott, a former colleague at Quest Diagnostics, often provides me with interesting COVID related stuff. This week she sent me a podcast featuring Paul Offit, the developer of the first Rotavirus vaccine and an author of many books on immunology and vaccine production. I am not an immunologist but he is. More importantly, he’s the first authoritative person that I’ve heard in the media speak at length on the ADE issue and how it relates to COVID. He claims in the attached clip (time stamped at 14:40) that the current vaccines do not appear to trigger the ADE pathway in animal models, and human trial subject never displayed the signs that ADE was involved in secondary exposures. This difference from SARS-1 and MERS may be related to the fact the SARS-2 is much less virulent than these other 2 viruses.

This makes me more optimistic that the vaccine will be safe from an ADE perspective. I won’t be able to get the vaccine for some time, but I am more willing to get it now than ever before. Several physicians I know are eager to get it as soon as it is available. This is great news!

In the interest of full disclosure, I will point out the some patients receiving the vaccine the UK have experienced some injection site irritation, especially in those with allergies. This is actually somewhat normal for vaccines, and appears to pass within a few days.

In addition, now that mRNA vaccines have been produced for the first time, future development of this new kind of vaccine should be even faster than this time!

Don’t fear, but be smart,
Erik

Case Update: December 4, 2020

Well folks, I’m disappointed to report that after a dip in cases, the confirmed case numbers are rising fast again. The timing clearly suggests that the rise in cases is related to the Thanksgiving holiday. The numbers really seem to have peaked a few weeks ago, but are back on the rise again in the US, California, and San Diego. The situation is still developing of course, so we don’t yet know how much of a rise we will see. I’m reporting this early to give you a heads up that this is happening.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.

Don’t fear, but be smart,
Erik

Case Update, December 1st, 2020

Friends,
This is a case update. As I suggested last week, it appears we may be past the peak of wave 3 for now. New confirmed case numbers for the US continue to trend downward, and California and San Diego County numbers appear to perhaps have peaked as well. Tammy Stevenson was right last week to point out that holiday gatherings may produce some new outbreaks. New cases don’t appear for between 5 and 20 days, so we may still see some Thanksgiving related increases, but for now, the numbers look very encouraging.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.

The Northern states, where the 3rd wave started, are recovering, except perhaps for Michigan and Minnesota, and the peak of the wave is moving southward. Los Angeles County now has the most new cases in the country, surpassing Cook County (Chicago). Gallatin, Madison, and Carbon counties in Montana are all past their 3rd wave peak.

Endcoronavirus County Level Map, December 1st, 2020
New confirmed cases in Gallatin County, Endcoronavirus County Level Map, December 1st, 2020

Note: Since writing the above, several of my friends in the medical community have told me that they are not as optimistic as I am! While their info doesn’t contradict mine per se, they are expecting a spike in cases due to holiday gatherings. Just posting this in the interest of completeness.

Don’t fear, but be smart,
Erik

Case Update: November 24, 2020

This is a case update. We are continuing to see a rise in cases for the US, California, and San Diego County. However, there is a glimmer of hope. If you look carefully at the graph for the US (or just look at the red arrows), you’ll see that this Sunday’s new confirmed case number is very close to last week’s.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.

With numbers varying so much every day, it can be hard to see trends. But I noticed some time ago the Sunday consistently had the lowest new case numbers of the week. If a Sunday’s number was higher than the previous Sunday’s number, we would have a bad week, but if it was lower, things were getting a little better. After several weeks of steadily increasing case numbers, Sunday number suggests that we may have reached the peak of the 3rd wave. Of course, this may not pan out, and I may be apologizing later for misleading you, but it looks good right now. Also, lots of extra people are getting tested right now before Thanksgiving, which will also add to the numbers for this week.

Also notice a few more orange counties in the northern states on the map of US counties. These are likely counties where things are improving. Peaks of new cases are moving south however.

Endcoronavirus County Level Map, November 24th, 2020
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.

So we can be optimistic while still working toward the end of the 3rd wave!

Don’t fear, but be smart!
Erik

Case Update: November 19th, 2020

This is a case update. The US continues to see a large spike in new cases during a 3rd wave. New cases appear to be centered in the northern states and around the Great Lakes, but more southern states are now experiencing new cases as well. The county with the highest new cases right now is Cook County, the home of Chicago. New confirmed cases in the US are now double what they were during the second wave. This is all likely being driven by colder weather causing people to gather indoors.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Endcoronavirus County Level Map, November 19th, 2020

California and is also experiencing a 3rd wave, just slightly higher in numbers than the 2nd wave.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.

San Diego County’s 3rd appears substantially higher than the 2nd wave. County Health reports that most known outbreaks are occurring in restaurants, especially those with bars, with the second most being businesses. The County is not reporting to the public what kind of businesses are experiencing outbreaks.

Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.

Don’t fear, but be smart,
Erik

New Vaccines and ADE

Vaccines – Because of this week’s announcement about vaccines, lots of folks are asking me about it.  I’ll give you my thoughts.  I am not an immunologist, I’m a molecular biologist specializing in infectious disease testing, so my thoughts on vaccines are informed, but not expert.

As I’ve discussed before, I’ve been pessimistic about COVID vaccines, mostly because of the phenomena of Antibody Dependent Enhancement, or ADE (link below).  This is the phenomena in which some virus can use antibodies against a similar but not identical virus to infect the immune system and cause more severe disease.  As this relates to a vaccine, a person given a vaccine could gain immunity against virus very similar to the vaccine given, but less similar strains may still infect and cause more severe illness.  This has been my concern about both vaccines and the herd immunity approach. 

In the past few months, however, a trickle of known cases have come out about people who have been reinfected with SARS-2. Some of these patients have had worse symptoms, and some more mild.  It’s also evident that they are not being infected with the same strain they had before, but by a different strain.  If all this is true, then the ADE experiment is already being done.  And it looks like while some experience more severe illness, not all do, and reinfection appears to be rare, despite several circulating strains.

This week Pfizer announced that studies with their vaccine show 90% effectiveness in preventing COVID infection.  My hesitation with vaccines has always been about ADE.  It’s still not well known if ADE will play a significant role, but if it doesn’t, then perhaps there is reason for hope.

All medications and vaccines carry the risk of side-effects and harm.  However, I’m actually becoming cautiously optimistic about a COVID vaccine.

Some technical info about vaccines.  There are actually several kinds of vaccines.  Various developers tried different pathways to a COVID vaccine, and several kinds are in trials right now.

Killed vaccines – These are vaccines that have been deactivated or broken down into various parts and then injected into the body.  They cannot replicate and degrade in the body, so parts are attached to molecules called adjuvants that serve to boost their visibility to the immune system. 

Attenuated vaccines – These are live viruses that have been engineered to cause infection, but with no or mild symptoms.  Some are other viruses like Adenovirus which are symptom free, but produce viral proteins that your body can recognize and raise a response against.

RNA vaccine – This a brand new kind of vaccine that has been in testing for years.  Several SARS-2 vaccines are of this kind, and are the first potential viable candidates ever.  The patient is injected with a piece of RNA that codes for a viral protein. The RNA enters a cell and temporarily causes the cell to make the viral protein. RNA naturally degrades rapidly in the body and does not persist or permanently change the patient’s genetic material. This promising technique has the potential to generate new and more effective vaccines in the future.

Personally, I’m still taking a wait and see approach.  Vaccines will probably not be available to the general public for few months.  By then we may know more about how people are responding.

Don’t fear, but be smart!
Erik

Antibody Dependent Enhancement

Originally posted July 7th, 2020

I’m going to bring up an issue that I’ve been avoiding talking about for some time. I’ve been avoiding talking about it because it’s not a certainty, and also because the possibility will be scary for some. The reason I feel compelled to talk about it now is that many are having a hard time understanding why I am still so concerned about the virus when the fatality rate is low and dropping, and folks want to get back to normal life. I’m even hearing about young people having COVID parties in which people gather with a sick individual so they can all get infected and be immune from the virus thereafter.

Before I share this, I’ll also say that the medical community is doing a better job treating patients with COVID, and the disease is becoming more survivable. In addition, we now know a lot about how the virus is spread, and if a person wants to remain uninfected, they can do that, while still getting together with friends and family, and still working and getting on with life. You can be reasonably certain you will not get infected if you do the following:

1) Wear a mask or face covering in public. Avoid places with unmasked people.
2) Keep 6 ft away from others.
3) Avoid indoor gatherings, especially ones in which singing or shouting is likely.
4) Small outdoor gatherings are fine, even without masks, if everyone maintains a distance. Have guests bring their own food.
5) While many restaurants are open for limited indoor seating, I personally am still not comfortable eating indoors at a restaurant. I enjoy eating outdoors at restaurants, however.

Antibody Dependent Enhancement: Several years ago, scientists were developing a vaccine against Dengue Fever, a mosquito borne disease which causes debilitating joint pain in patients. Some time after trial vaccination, several vaccinated patients died suddenly of Dengue Fever. This became the most studied example of Antibody Dependent Enhancement (ADE). Normally, for the annual flu let’s say, a person gets infected by the flu, is sick for a few days, and the immune system develops a response by creating antibodies against that specific strain of the flu. If they are exposed again in a month, nothing will happen. If the patient is exposed to a different strain the following year, they may still get sick, but the antibodies they developed the year before may help them have less severe disease and recover more quickly. Part of the immune response is that some immune cells display antibodies on their surface to capture new invaders.

With Dengue and some other viruses, the first stages are normal. A person gets infected and develops a response. If they get re-infected a month later, nothing happens. But if they get infected with a slightly different strain months or years later, instead of being protected, the virus attaches to antibodies displayed on immune cells and uses the antibodies as a site of entry into the immune system. The immune system is quickly infected, and the patient has a more severe disease with the second infection. Some estimates are that disease may be 3-4 x more severe in these patients.

As it turns out, SARS-1, which arose in 2002, and MERS, which has small outbreaks every year, are both Coronaviruses and both appear to be able to use the ADE pathway. This raises the possibility that SARS-2, the current virus, can also use the ADE pathway. This means that a person infected for a second time with a different strain of SARS-2, or any other Coronavirus for that matter, may be at much higher risk for severe disease.

This is why I’m not in favor of pursuing herd immunity as a pathway out of this crisis, because it will prime people for ADE related problems if a similar strain should strike next year.

This is not a new idea. If you search for “ADE” or “Antibody Dependent Enhancement”, you will see many articles, some peer reviewed from respected journals, on the phenomena. Dr. Fauci has even referenced it using the term “enhancement” when talking about vaccine development.

Why haven’t the government public health departments been more open about this? They tend to make statements only based on what they can be reasonably certain of, which is why they have been so slow to react to many aspects of the current crisis.

Again, it’s not certain that ADE will play a role next year. It’s too early to know. I’m informing you of the possibility so you can make wise decisions for you and your family.



Update: November 20, 2020

Since writing the above post, things have changed a little. There have been a handful of known cases of people being re-infected with SARS-2. In some of these patients, symptoms were worse, while in others, symptoms were less severe. In all of the well characterized cases, the 1st and 2nd strains that infected them were different, suggesting that it’s not a re-infection by the same strain, but a new infection by a different strain.

We’ve had at least 2 main strains in the US, SARS-2 which arrived in January or February, and a strain called D614G which probably arrived in April or May and likely caused the 2nd wave in June and July. The D614G strain is likely more infectious than the original SARS-2 strain, but is perhaps less virulent, since the fatality rate during the second wave appears to have been lower. In fact, there may have been several strains circulating around the world and the US for much of the pandemic.

How does this all relate to ADE? The fear with ADE is that a 2nd infection will cause worse symptoms than with the first infection. This may still be true. But we’ve had several circulating strains and so far, no real evidence the re-infections have universally been worse. So it appears for now that the ADE experiment is already going on, and that perhaps the phenomena will not have as great an impact as I feared. I am currently cautiously optimistic that ADE will not cause significant additional mortality.

This also has some impact on the vaccine discussion that is currently ongoing. If ADE will not have a significant impact, than the vaccine may be safer that I previously thought, and I have become cautiously optimistic about the success of the vaccine.

Update: December 12th, 2020

More on ADE and Vaccines: Some potential very good news for me on the vaccine front. For months I’ve been warning about ADE, the phenomena that some viruses can be even more dangerous in a second infection than the first. Karen Parrott, a former colleague at Quest Diagnostics, often provides me with interesting COVID related stuff. This week she sent me a podcast featuring Paul Offit, the developer of the first Rotavirus vaccine and an author of many books on immunology and vaccine production. I am not an immunologist but he is. More importantly, he’s the first authoritative person that I’ve heard in the media speak at length on the ADE issue and how it relates to COVID. He claims in the attached clip (time stamped at 14:40) that the current vaccines do not appear to trigger the ADE pathway in animal models, and human trial subjects never displayed the signs that ADE was involved in secondary exposures. This difference from SARS-1 and MERS may be related to the fact the SARS-2 is much less virulent than these other 2 viruses.

This makes me more optimistic that the vaccine will be safe from an ADE perspective. I won’t be able to get the vaccine for some time, but I am more willing to get it now than ever before. Several physicians I know are eager to get it as soon as it is available. This is great news!

In the interest of full disclosure, I will point out the some patients receiving the vaccine the UK have experienced some injection site irritation, especially in those with allergies. This is actually somewhat normal for vaccines, and appears to pass within a few days.

Now that mRNA vaccines have been produced for the first time, future development of this new kind of vaccine should be even faster than this time!

Update: April 13th 2021

ADE and the next SARS virus: I wanted to explain a little more about my continued concerns about ADE. As the pandemic progresses and we have numerous variants circulating around the world and the US, ADE does not appear to have had an impact on the current situation. This is certainly good news. If it did have an impact, we would be seeing additional deaths from the new variants, which we do not.

My continued concern comes because ADE impacts our ability to fight the NEXT virus. SARS viruses (SARS, MERS, SARS-2) have the ability to easily infect the immune systems of those previously infected with closely related but different strain of the virus. If a future strain of SARS comes out, let’s call it SARS-3 for now, ADE may become a big deal. I stress that this is only theoretical at this point. SARS was moderately infectious, but also very pathogenic, giving all known patients severe symptoms and killing 10%. It was actually less dangerous globally, since outbreaks tended to be detected early and quickly snuffed out. SARS-2 is highly infectious, but much less pathogenic. It’s greater global impact came from it’s very high infectiousness and very long incubation time, being passed even from pre-symptomatic patients. The tendency of all viruses is to become more infectious and less pathogenic over time, a pattern followed by SARS and SARS-2. If we have a SARS-3 someday, it will likely be even more infectious than SARS-2, but less pathogenic. On the other hand, MERS is more pathogenic than SARS, so this pattern doesn’t always follow. The next time another SARS coronavirus breaks out, we will need to be very careful initially until we understand the parameters of the new virus.

So what do you do if you had COVID or had a COVID vaccine if a SARS-3 comes out? If that happens, vaccine production will likely be much faster than this time. Be very careful with the virus initially, and get the new vaccine as soon as it is available to you, because you may be at greater risk for severe symptoms. I know some of this is confusing and counter-intuitive! Feel free to ask questions below!

More than ever, don’t fear, but be smart,
Erik


A selection of relevant papers:

ADE and it’s potential impact for SARS-2:ade-and-sars-2 Download



ADE in SARS-1:ADE and SARS-1 Download



Overlapping symptoms for SARS, MERS, and SARS-2:ade-sars-mers-sars-2-liu_et_al-2020-journal_of_medical_virology Download



Is COVID-19 receiving ADE from other coronaviruses?ADE_and_COVID Download



Possible mechanism for ADE:ade-mechanism-jvi.02015-19 Download

Case Update: November 11th, 2020

This is a case update. The US is experiencing a third peak in cases. This is likely being driven by cold weather, driving people indoors where the virus spreads more easily. The 3rd peak is already almost 2x as high as the 2nd peak in July and August, and it’s still going up fast. Some states are experiencing record hospitalizations.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Endcoronavirus State Map, November 11th, 2020
Endcoronavirus County Level Map, November 11th, 2020

California has been trending up for the last several weeks, and San Diego is trending up this week for the second week since the 3rd wave began.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.

I been seeing new ads in California, talking about benefits of mask wearing. The ads have several shots of people wearing masks in small groups outdoors. As you know, I am a big fan of masks in indoors environments, and wear a mask a lot when at work in a lab or when traveling. However, wearing a mask outdoors is almost always unnecessary unless you are in a large group of people. I’m am not saying that you should ignore local guidance if they require mask wearing outdoors! I am saying, however, that as far as getting infected is concerned, you don’t need to wear a mask while you’re jogging, hiking, or riding a bike.

Don’t fear, but be smart,
Erik

Case Update: November 1st, Quadruple Therapy, Air Travel, Symptoms in households with small children.

I have the weekly update, and I’ll also talk about a promising new treatment regimen and a surprising paper about children and COVID.

Update: Unfortunately, the US is experiencing a 3rd wave.  This is driven by new confirmed cases in the Northern states, likely because colder weather is driving people indoors.  I traveled to Anchorage and Minneapolis in the last few weeks, and I will tell you first hand that eating outside at a restaurant is not an option in those places, but the restaurants have lots of people in them.  They’re not full, mind you, they are following the current rules, but lots of people are indoors without masks on.  I’ve also been in plenty of airports, in “red” and “blue” states, in which people are filling the restaurants in between flights, with seemingly no regard to the virus.  No, I can’t tell you for certain that people are being infected in restaurants, but this is consistent with the idea that indoor activity is driving the increase in new cases.  Several European countries are also experiencing 2nd or 3rd waves at this time.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Endcoronavirus County Level Map, November 1st, 2020

California has had a flat but persistent new case load for the past several weeks, but new cases are starting to increase here too.  This is likely most driven by new cases in LA County (18k), which has by far the most confirmed cases in California (308,000), and indeed has almost twice as many confirmed cases as the next highest county, Cook County, the home of Chicago (185,000).  Yes, counties in Northern California are experiencing the big upticks in cases right now, but the population and actual case numbers of these counties is so low that they cannot drive the increase in California.  Incidentally, Cook County currently has the most confirmed new cases of any US county at 24,000.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.

San Diego County continues to have a stable but persistent new case load of about 300 new confirmed cases per day. There may be just a hint of 3rd wave starting in San Diego County right now.

Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. “Active Confirmed Cases” numbers are calculated based on the assumption that patients confirmed to have SARS-2 virus at least 17 days ago have recovered.

Air Travel: When I travel by air, I pretty much never take off my mask on the plane.  On layovers, I grab lunch to go at restaurant or convenience store, then go find an isolated spot to eat it.

Delta and Alaska are currently keeping middle seats open. United and American are not. The airlines claim that the air on the plane is filtered by industrial grade HEPA filters every 4 minutes. A pilot friend tells me that this is true. The intake vents are on the floor, and output vents are in the ceiling, like your personal vent, so air is constantly moving to the floor during the flight. If all this is true, then a commercial airplane is a relatively safe place to be!

New Treatment:  Doctors in India have developed a treatment combination that has shown great success.  Ivermectin is a drug that is commonly used for parasite infections, but is now being used for COVID.  It is being used in combination with Doxycycline, Zinc, and Vitamin D.  In a study, 93% of confirmed patients do not move on to severe disease while using this regimen, as compared to 58% who developed severe symptoms in the control group.

I’ve said before that Vitamin D has protective effect against the virus, so consider supplementing daily with Vitamin D, or getting out in the sun 30 minutes a day.  This is especially important if you have darker skin.  Also, supplement with Zinc and Vitamin C.

Less severe symptoms in households with small children: A pre-published study from Scotland claims that adults in households with small children get less severe symptoms if infected than those without small children!  This is a counter intuitive result of course.  We have known for some time that a low viral load on exposure can lead to less severe symptoms.  Also, it appears that most infected children carry a low SARS-2 viral load.  This paper puts these pieces together.  It suggests that adults with infected children are getting exposed to a lower viral load and having less severe symptoms that adults getting exposed to a higher viral load.  In fact, the paper suggests that the more children a household has, the less likely adults are to have severe symptoms!

Don’t fear, but be smart!
Erik

Case Update: October 21st, 2020

Friends,
Just a short update today. For the US, new case numbers continue to rise. Most new cases are centered in the Northern states, and new cases are spreading South. My guess is that the cold weather is driving these new cases, as people are spending more time indoors. Despite this, new cases are so far not producing an increase in fatalities.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from Johns Hopkins University COVID site.
Endcoronavirus County Level Map, October 21th, 2020

California and San Diego continue to have a persistent number of new daily confirmed cases.

Graph is by me, from data collected from Johns Hopkins University COVID site.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County.

Don’t fear, but be smart,
Erik