Drowning in Coronavirus Research, Part 57

By August 3, 2020 Commentary

Did closing schools make a difference in the transmission of coronavirus and number of cases.  Not according to this study from Japan.   (IJID Article)   Japan closed schools beginning on March 1.  The researchers examined whether the closure had an impact on case rates from March 9 to March 31, giving a lag time for the effect of the closure to begin.  They found no impact on the number of cases.

Did lockdowns make any difference in lives lost from coronavirus disease?  Not according to this study.  (SSRN Study)   The author used measures of mitigation of spread tactic strictness and weekly mortality rates from 24 European countries to conduct his assessment.  He looked at mortality trends in the first half of 2017, 2018 and 2019, as well as 2020.  He avoided use of CV death reports, because of variation from country to country and  because of over-reporting of CV as the “cause” of death.  Just looking at raw patterns revealed that in the first ten weeks of 2020, compared to the earlier years, all-cause mortality actually fell by 200 per million population across all these countries, or an 8.7% decline.  Could be a mild winter or flu season that was responsible.  Then from week 11 through 22, there was excess mortality of 248 deaths per million population, a 10.7% increase.  The group of countries with the hardest lockdown had 372 excess deaths per million, while the countries with lesser lockdowns had excess mortality of only 123 deaths.  But this could be because lockdown strictness was tied to the number of deaths occurring rather than vice versa.  In the primary analysis, however, whether or not lockdown stringency appeared to affect deaths was related to lagging the effect.  Using a lag that approximated the time from infection to death, found insignificant effects of lockdowns on mortality.  The author concludes that given the economic and health damage they cause, lockdowns are completely unjustified and a policy failure.

As have a couple of other studies, the researchers in this one note that current antibody tests may not be sensitive enough to accurately detect coronavirus antibodies, particularly in mild or asymtomatic persons.  (Medrxiv Paper)    They base this on an analysis of over 9000 health care workers, with a focus on those who reported symptoms likely caused by coronavirus infection.

This paper looked at coronavirus cases among children in England.  (Lancet Paper)   From January 16 through May 5, 35,200 children under the age of 16 were tested.  The positivity rate was 4%, at least five times lower than that for adults.  In addition, in testing done for patients presenting with acute respiratory illness, only 2.8% of children in this age range were positive for CV.  Children represented only 1.1% of all coronavirus cases in this period in England.  The authors said that the data show that children have a limited role in infection or transmission of the disease.  They reviewed and cited a number of studies coming to the same conclusion.

A study from the National Bureau of Economic Research used electronic medical records on over 35 million Americans to ascertain trends in health care use during the epidemic.  (NBER Study)   As other research has suggested, they found a substantial drop in utilization, but less so for mental health issues, where telehealth seems to have largely substituted for in-person visits.   Outpatient visits dropped by almost 40% by early April, but rebounded somewhat in succeeding weeks.  Attempting to understand the role of state shutdown policies, the researchers found that about 15 of the 40 percentage point drop was due to those state actions.  But that would ignore the role of fear-mongering in inducing people to avoid health care facilities.

By now most people realize that residents of nursing homes have borne a large portion of the burden of coronavirus disease.  This paper examines the role of staff who work at multiple nursing homes in potentially spreading infections.  (NBER Paper)  The researchers used cell phone data to track the same cell phone in multiple facilities, presumably the cell phones of staff who work in more than one place.  (There are chains of nursing homes, so some of this may be normal assignment of staff.)  They found that the average nursing home had connections to 15 other facilities and that the number of connections was linked to number of cases in the facility.  They suggested limiting staff working in more than one facility, which might reduce infections, but is absurd to anyone who understands staffing issues in nursing homes.

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