Why the US is experiencing a coronavirus plateau

News Network
June 9, 2020

Washington, Jun 9: When epidemiologists talked about "flattening the curve," they probably didn't mean it this way: the US hit its peak coronavirus caseload in April, but since that time the graph has been on a seemingly unending plateau.

That's unlike several other hard-hit countries which have successfully pushed down their numbers of new cases, including Spain and Italy, which now have bell-shaped curves.

Experts say the prolonged nature of the US epidemic is the result of the cumulative impact of regional outbreaks, as the virus that started out primarily on the coasts and in major cities moves inward.

Layered on top of that are the effects of lifting lockdowns in parts of the country that are experiencing rising cases, as well as a lapse in compliance with social distancing guidelines because of economic hardship, and in some cases a belief that the threat is overstated.

"The US is a large country both in geography and population, and the virus is at very different stages in different parts of the country," Tom Frieden, a former director of the Centers for Disease Control and Prevention told AFP.

The US saw more than 35,000 new cases for several days in April. While that figure has declined, it has still been exceeding 20,000 regularly in recent days.

By contrast, Italy was regularly hitting more than 5,000 cases per day in March but is currently experiencing figures in the low hundreds.

"We did not act quickly and robustly enough to stop the virus spreading initially, and data indicate that it travelled from initial hotspots along major transport routes into other urban and rural areas," added Frieden, now CEO of the non-profit Resolve to Save Lives.

To wit: the East Coast states of New York, New Jersey and Massachusetts accounted for about 50 percent of all cases until about a month or so ago -- but now the geographic footprint of the US epidemic has shifted to the Midwest and southeast, including Florida.

Another key problem, said Jennifer Nuzzo, an epidemiologist at Johns Hopkins, is that the United States is still not doing enough testing, contact tracing and isolation.

After coming late to the testing party -- for reasons ranging from technical issues to regulatory hurdles -- the US has now conducted more COVID-19 tests than any other country.

It even has one of the highest per capita rates per country of 62 per 1,000 people, according to the website ourworldindata.org -- better than Germany (52 per 1,000) and South Korea (20 per 1,000).

But according to Nuzzo, these numbers are misleading, because "the amount of testing that a country should do should be scaled to the size of its epidemic.

"The United States has the largest epidemic in the world so obviously we need to do a lot more testing than any other country."

For Johns Hopkins, the more important metric is the positivity rate -- that is, out of all tests conducted, how many came back positive for COVID-19.

As of June 7, the United States had an average daily positivity rate of 14 percent, well above the World Health Organization guideline of 5 percent over two weeks before social distancing guidelines should be relaxed.

By contrast, Germany, which has tested far fewer people in relation to its population, has a positivity rate of 5 percent.

Even if testing were scaled up, carrying out tests in of itself does very little good without the next steps -- finding out who was exposed and then asking them to isolate.

Here also, too many US states are lagging woefully behind.

Texas, which is experiencing a surge in cases after relaxing its lockdown, is a case in point. The state targeted hiring a modest 4,000 tracers by June, but according to local reports is still more than a thousand shy of even that goal.

Opt-in app based efforts have also been slow to get off the ground.

Then there is the fact that some people are growing tired of lockdowns, while others don't have the economic luxury of being able to stay home for prolonged periods.

The government sent some 160 million Americans a single stimulus check of up to $1,200 back in April but it's not clear whether more will be forthcoming.

Still others, particularly in so-called red states under Republican leadership, have chafed under restrictions and mask-wearing guidelines that they see as an affront to their personal freedom.

"The US is kind of on the extreme of the individual liberty side," Sten Vermund, dean of the Yale School of Public Health, told AFP.

Part of this has to do with mixed messaging from Republican leaders, including President Donald Trump, said Nuzzo.

"We have had at the highest political level an assertion that this is a situation that's been overblown, and that maybe certain protective behaviors are not necessary," she said.

More recently, tens of thousands of people across the country have taken to the streets to protest the killing on an unarmed black man by police, risking coronavirus infection to demonstrate against the public health threat of racialized state violence.

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Agencies
July 3,2020

The dollar's dominance will slowly melt away over the coming year on weakening global demand and a sombre U.S. economic outlook, according to a Reuters poll of currency forecasters whose views depend on there being no second coronavirus shock.

Despite fears a surge in new Covid-19 cases would delay economies reopening and stymie a tentative recovery, world stocks have rallied - with the S&P 500 finishing higher in June, marking its biggest quarterly percentage gain since the height of the technology boom in 1998.

Caught between bets in favour of riskier investments, weak U.S. economic prospects as well as an easing in the thirst for dollars after the Federal Reserve flooded markets with liquidity, the greenback fell nearly 1.0 per cent last month. It was its worst monthly performance since December.

While there was a dire prognosis from the top U.S. medical expert on the coronavirus' spread, the June 25-July 1 poll of over 70 analysts showed weak dollar projections as Fed Chair Jerome Powell on Monday reiterated the economic outlook for the world's largest economy was uncertain.

"The dollar rises in two instances: when you see risk off or when there is a situation where the U.S. is leading the global recovery, and we don't think that's going to be the case anytime soon," said Gavin Friend, senior FX strategist at NAB Group in London.

"The U.S. is playing fast and loose with the virus, and chronologically they're behind the rest of the world."

Currency speculators, who had built up trades against the dollar to the highest in two years during May, increased their out-of-favour dollar bets further last week, the latest positioning data showed.

About 80 per cent of analysts, 53 of 66, said the likely path for the dollar over the next six months was to trade around current levels, alternating between slight gains and losses in a range. That suggests the greenback may be at a crucial crossroad as more currency strategists have turned bearish.

But more than 90 per cent, or 63 of 68, said a second shock from the pandemic would push the dollar higher. Five said it would push the U.S. currency lower.

Much will also depend on debt servicing and repayments by Asian, European and other international borrowers in U.S. dollars.

While an early shortage of dollars in March from the pandemic's first shock pushed the Fed to open currency swap lines with major central banks, international funding strains have eased significantly since. In recent weeks, usage of the facility has reduced dramatically.

That trend is expected to continue over the next six months with major central banks' usage of swap lines to "stay around current levels", according to 32 of 46 analysts. While 13 predicted a sharp drop, only one respondent said use of them would "rise sharply".

The dollar index, which measures the greenback's strength against six other major currencies, has slipped over 5 per cent since touching a more than three-year high in March.

When asked which currencies would perform better against the dollar by end-December, a touch over half of 49 respondents said major developed market ones, with the remaining almost split between commodity-linked and emerging market currencies.

"The dollar is so overvalued, and has been overvalued for a long time, it's time now for it to come back down again, as we head towards the (U.S.) election," added NAB's Friend.

Over the last quarter, the euro has staged a 1.8 per cent comeback after falling by a similar margin during the first three months of the year. For the month of June, the euro was up 1.2 per cent against the dollar.

The single currency was now expected to gain about 2.5 per cent to trade at $1.15 in a year from around $1.12 on Wednesday, slightly stronger than $1.14 predicted last month. While those findings are similar to what analysts have been predicting for nearly two years, there was a clear shift in their outlook for the euro, with the range of forecasts showing higher highs and higher lows from last month.

"In comparison to even a month or two ago, the outlook in Europe has improved significantly," said Lee Hardman, currency strategist at MUFG.

"I think that makes the euro look relatively more attractive and cheap against the likes of the dollar. We're not arguing strongly for the euro to surge higher, we're just saying, after the weakness we have seen in recent years, there is the potential for that weakness to start to reverse."

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News Network
April 28,2020

Washington, Apr 28: After nearly three weeks in an intensive care unit in Los Angeles, doctors treating 41-year-old Broadway actor Nick Cordero for COVID-19 were forced to amputate his right leg.

The flow of blood had been impeded by a blood clot: yet another dangerous complication of the disease that has been bubbling up in frontline reports from China, Europe and the United States.

To be sure, so-called "thrombotic events" occur for a variety of reasons among intensive care patients, but the rates among COVID-19 patients are far higher than would be otherwise expected.

"I have had 40-year-olds in my ICU who have clots in their fingers that look like they'll lose the finger, but there's no other reason to lose the finger than the virus," Shari Brosnahan, a critical care doctor at NYU Langone said.

One of these patients is suffering from a lack of blood flow to both feet and both hands, and she predicts an amputation may be necessary, or the blood vessels may get so damaged that an extremity could drop off by itself.

Blood clots aren't just dangerous for our limbs, but can make their way to the lungs, heart or brain, where they may cause lethal pulmonary embolisms, heart attacks, and strokes.

A recent paper from the Netherlands in the journal Thrombosis Research found that 31 percent of 184 patients suffered thrombotic complications, a figure that the researchers called "remarkably high" -- even if extreme consequences like amputation are rare.

Behnood Bikdeli, a doctor at New York-Presbyterian Hospital, assembled an international consortium of experts to study the issue. Their findings were published in the Journal of The American College of Cardiology.

The experts found the risks were so great that COVID-19 patients "may need to receive blood thinners, preventively, prophylactically," even before imaging tests are ordered, said Bikdeli.

What exactly is causing it? The reasons aren't fully understood, but he offered several possible explanations.

People with severe forms of COVID-19 often have underlying medical conditions like heart or lung disease -- which are themselves linked to higher rates of clotting.

Next, being in intensive care makes a person likelier to develop a clot because they are staying still for so long. That's why for example people are encouraged to stretch and move around on long haul flights.

It's also now clear the COVID-19 illness is associated with an abnormal immune reaction called "cytokine storm" -- and some research has indicated this too is linked to higher rates of clotting.

There could also be something about the virus itself that is causing coagulation, which has some precedent in other viral illnesses.

A paper in the journal The Lancet last week showed that the virus can infect the inner cell layer of organs and of blood vessels, called the endothelium. This, in theory, could interfere with the clotting process.

According to Brosnahan, while thinners like Heparin are effective in some patients, they don't work for all patients because the clots are at times too small.

"There are too many microclots," she said. "We're not sure exactly where they are."

Autopsies have in fact shown some people's lungs filled with hundreds of microclots.

The arrival of a new mystery however helps solve a slightly older one.

Cecilia Mirant-Borde, an intensive care doctor at a military veterans hospital in Manhattan, told AFP that lungs filled with microclots helped explain why ventilators work poorly for patients with low blood oxygen.

Earlier in the pandemic doctors were treating these patients according to protocols developed for acute respiratory distress syndrome, sometimes known as "wet lung."

But in some cases, "it's not because the lungs are occupied with water" -- rather, it's that the microclotting is blocking circulation and blood is leaving the lungs with less oxygen than it should.

It has just been a little under five months since the virus emerged in Wuhan, China, and researchers are learning more about its impact every day.

"While we react surprised, we shouldn't be as surprised as we were. Viruses tend to do weird things," said Brosnahan.

While the dizzying array of complications may seem daunting, "it's possible there'll be one or a couple of unifying mechanisms that describe how this damage happens," she said.

"It's possible it's all the same thing, and that there'll be the same solution."

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Agencies
July 2,2020

Ramallah, Jul 2: Several world countries renew a call for Israel to halt contentious plans to annex parts of the occupied Palestinian territory after the regime delayed the implementation of the land garb bid in the face of a series of stumbling blocks, including internal rifts, global criticisms and the US’s failure to give Tel Aviv the go-ahead for the move.

Israel's ruling coalition, led by Prime Minister Benjamin Netanyahu, had announced July 1 as the date to begin moving forward with the plan to impose Tel Aviv’s “sovereignty” over about a third of the West Bank, including settlements and the fertile Jordan Valley.

Without clarifications, the regime, however, failed to launch the scheme on the set date amid widening differences between Netanyahu and his coalition partner, minister of military affairs Benny Gantz.

Meanwhile, there are signs that the administration of US President Donald Trump, a staunch Israel supporter, has cooled its backing for the Israeli move amid what is believed to be troubles at home and fears that it might hurt the president’s chances of re-election besides international pressure.

On Wednesday, Netanyahu's office said in a statement that he would continue to discuss a possible West bank annexation with the US administration.

“In the coming days there will be additional discussions,” the statement said.

Labor, Social Affairs and Social Services Minister Ofir Akunis said the Israel would annex portions of the West Bank in July but only after the US president issued a declaration on the matter.

The annexation “will only happen after a declaration by Trump,” he told Israeli Army Radio.

Trump had already given Tel Aviv the green light for the land grab in his self-proclaimed “deal of the century,” which was unveiled in January with the aim of re-drawing the Middle East map.

However, the Trump administration has so far refrained from offering official support for the annexation sought by Netanyahu and his right-wing allies.

Unlike the US, several countries, including some of Israel’s allies, have expressed their opposition to Israel’s planned push to consolidate its occupation of Palestine.

Germany passes anti-annexation resolution

On Wednesday, the German parliament approved a resolution calling on the government to dissuade Israel from annexing the West Bank.

The motion, which was brought in the German legislature by the three parties in Chancellor Angela Merkel's coalition, was approved without opposing votes. 

Berlin should use its “special relations and contacts [with Tel Aviv] to express to the Israeli government our concerns and our urgent demand to refrain from an annexation of parts of the West Bank and from the continued expansion of settlements, both of which contradict international law,” read the resolution.

Speaking at the parliamentary debate before the vote, German Foreign Minister Heiko Maas said, “We reject unilateral changes of borders, and we won’t recognize them.”

He also stressed that peace “cannot be achieved through unilateral steps but only through serious negotiations.”

France warns of consequences

Similarly, French Foreign Minister, Jean-Yves Le Drian warned that any Israeli annexation would be a violation of international law and would bring about consequences.

“Annexation of Palestinian territories, whatever the perimeters, would seriously throw into question the parameters to resolve the conflict,” he told a parliamentary hearing. 

The top diplomat added, “An annexation decision could not be left without consequences and we are examining different options at a national level and also in coordination with our main European partners.”

Australia raises concerns

Additionally, Australian Foreign Minister Marise Payne voiced worries about the Israeli scheme, saying she had directly expressed this view to Israeli Foreign Minister Gabi Ashkenazi.

“We are following with concern possible moves towards the unilateral annexation or change in status of territory on the West Bank,” she said in a statement.

“The focus needs to be on a return to direct and genuine negotiations between Israel and the Palestinians for a durable and resilient peace arrangement, as soon as possible,” Payne added.

Vatican summons US, Israeli envoys

Meanwhile, the Vatican announced on Wednesday that it had summoned the American and Israeli ambassadors to protest Israel’s annexation bid.

In separate meetings, Vatican Secretary of State Cardinal Pietro Parolin told Israeli Ambassador Oren David and US Ambassador Callista Gingrich of concerns “regarding possible unilateral actions that may further jeopardize the search for peace between Israelis and Palestinians, as well as the delicate situation in the Middle East,”

“As already declared … the Holy See reiterates that ... Israel and the State of Palestine have the right to exist and to live in peace and security, within internationally recognized borders,” the Vatican said in a statement.

“It thus appeals to the parties to do everything possible to reopen the process of direct negotiation, on the basis of the relevant Resolutions of the United Nations,” it added.

Amnesty urges firm action

Amnesty International called on the international community to take firm action against Israel’s annexation plan and its “law of the jungle” mentality.

“Members of the international community must enforce international law and restate that annexation of any part of the occupied West Bank is null and void,” said Saleh Higazi, deputy regional director for Amnesty Middle East and North Africa.

“They must also work to immediately stop the construction or expansion of illegal Israeli settlements and related infrastructure in the Occupied Palestinian Territories as a first step towards removing Israeli civilians living in such settlements,” he added.

Palestinians mark ‘Day of Rage'

Also on Wednesday, Palestinians held “Day of Rage” rallies both in the West Bank and the Gaza Strip against the Israeli expansionism.

In Gaza city, several thousand protesters gathered, some brandishing Palestinian national flags and placards condemning Trump.

Some demonstrators carried signs in English reading, “We Can’t Breathe Since 1948” and “Palestinian Lives Matter,” in reference to the American Black Lives Matter movement.

“The occupation has killed us and killed our children and deprived us of a good life. May God grant the Resistance victory,” a protester told the al-Aqsa TV.

“The resistance must be revived,” Gaza protester Rafeeq Inaiah told media persons. “Israel is afraid of force.”

Similar demonstrations also took place in the West Bank cities of Ramallah and Jericho.

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