Day 62: Friends in High Places

The Wall Street Journal reports (sans paywall here) that 1.2 million N95 masks are on their way from Shenzhen to Massachusetts aboard the Patriots' 767.

Massachusetts’ quest to acquire these masks was a tense, weeks long saga that began with the state’s governor and winded through embassies, private partners and the U.S.’s most successful football franchise. After a layover in Alaska and an anxious process to win approval from Chinese officials, the plane was given permission to land in China to collect the masks.

“I’ve never seen so much red tape in so many ways and obstacles that we had to overcome,” said Robert Kraft, the Patriots’ owner.

The article notes that 300,000 of the masks will be sent on to New York, and half a million are still in China waiting for transport "on another shipment."

The Governor also spoke about it at his press conference this afternoon, referring to a previous shipment of 3 million masks that the state had bought from BJ's but that the feds confiscated in the Port of New York back on March 18th. The Boston Globe reported last week on that and several smaller incidents.

Bloomberg reports on our record unemployment, 6.65 million last week for a total of about 10 million in the past two weeks. They're hedgily predicting 15% unemployment in April and a possibly high of 20% if staying-at-home goes on longer than that.

P.S. The Governor also mentioned we will be giving an unspecified number of masks to Rhode Island as well. It's still open season down there, so PlagueBlog recommends not shooting the delivery folk if you want your masks.

P.P.S. The world has surpassed a million cases of coronavirus, with over 52,000 deaths. In Massachusetts, we went up 1,228 cases (16%) to nearly 9,000 cases. There were 32 deaths added, with one of a woman in her 30's in Suffolk County who had pre-existing conditions, but most over 60. Dukes (5 cases) and Nantucket (7) counties have finally been broken out. The state is also reporting some numbers regarding long-term healthcare facilities, where there are 197 individual cases and 85 different facilities reporting infections.

The Governor also mentioned at the presser that we're getting a Battelle N95 mask sterilizing setup at the empty K-Mart in Somerville, which should be sterilizing 80,000 masks a day by next week.

PlagueBlog neglected to mention that a 44-year old crazy man tried to ram a Navy hospital ship with a train in the Port of Los Angeles yesterday. PlagueBlog notes that psychosis is not a common symptom of COVID-19.

Day 61: April Fools

The civet saw its shadow, so we're expecting six more weeks of quarantine. Or something like that.

PlagueBlog is saddened to report the death of Star Wars actor Andrew Jack from coronavirus, and hopes he was able to leave a Do-Not-CGI order behind.

The world has exceeded 911,000 cases, and the US has surpassed the 200k mark and is already at 205,000 cases with 4,500 deaths. Italy is at 110,000 with 13,000 deaths, and Spain at 100,000 with 9,000 deaths. New York State is at 83,000 cases with 1,900 deaths, with New Jersey the runner-up at 22,000 cases but only 355 deaths.

There's an interesting preprint at medRxiv correlating the varying rates of COVID-19 morbidity and mortality across countries with their rates of tuberculosis vaccination:

BCG vaccination has been reported to offer broad protection to respiratory infections. We compared large number of countries BCG vaccination policies with the morbidity and mortality for COVID-19. We found that countries without universal policies of BCG vaccination (Italy, Nederland, USA) have been more severely affected compared to countries with universal and long-standing BCG policies. Countries that have a late start of universal BCG policy (Iran, 1984) had high mortality, consistent with the idea that BCG protects the vaccinated elderly population. We also found that BCG vaccination also reduced the number of reported COVID-19 cases in a country.

You can check out your country's BCG vaccination policy at the BCG World Atlas. Most notably, Spain had a child vaccination program from 1965 to 1981 only, though it appears that Basque children may still be getting vaccinated.

The Bozeman Daily Chronicle reports an undue touristic interest in Montana. The governor has expressed legal qualms about closing the border, trusting in the usual quarantine period instead. PlagueBlog recommends applying the National Guard to the issue instead.

The AP reports that Wisconsin is calling out the National Guard to staff polling sites for their primary next week, even though even Bernie recommends postponing the primary. PlagueBlog also recommends they save the Guard for a real election.

CNN Philippines reports that Duterte has declared open season on quarantine protestors. PlagueBlog is surprised it took him this long.

Time expresses the usual doubts about China's numbers, though in slightly different language than the usual urn-focussed story. Instead, Time opens with China's moving case counting standards:

After several days of trumpeting just a handful of new COVID-19 cases, on Wednesday China once again switched up exactly what that means, and included asymptomatic infections of the coronavirus in its official statistics for the first time.[...]

It was the eighth different definition of what constitutes a COVID-19 infection in China’s official statistics since the outbreak began in late December, with critics arguing that the lack of clarity has made it harder for other nations to adequately understand and prepare for the disease.

P.S. Our numbers are in: Massachusetts is up 1,118 cases (17%) to 7,738, with 33 additional deaths (122 overall). The state conducted a hundred-odd tests while Quest did 2,300 or so. Over 50,000 people have been tested; about 15% were positive.

The governor has also launched an independent investigation of the situation at Holyoke Soldiers' Home.

P.P.S. WFSB Hartford reports that a six-week-old baby has died of coronavirus there.

P.P.P.S. Something I didn't notice in our numbers at first was the death of 31-year-old Riley Rumrill of Suffolk County, an former Alabaman with pre-existing conditions (apparently asthma and obesity), and our youngest victim to date.

P.P.P.P.S. Also, there seems to be another Holyoke Soldiers' Home-level outbreak of stupid going on at the Life Care Center of Nashoba Valley in Littleton, MA. The town felt the need to publicize the facility's bad behavior in a press release.

Day 60: Even the Queen

PlagueBlog is saddened to report the death of the Spanish Royal Princess Maria Teresa de Borbón-Parma, aged 86. Having started on FaceBook, the news took some time to reach us.

USA Today reported yesterday that the Federal Reserve Bank of St. Louis is projecting an unemployment rate of 32.1% for the second quarter. Bodies are piling up at morgues in Iraq due to fears about burying them. Japan is planning to extend its entry ban to countries including China, South Korea, the US, the UK, and most of Europe.

On the mask front, CNN reports that the WHO has dug in in their recommendation against masks. People don't seem to be listening, though; more of the unqualified masses in the streets (and more specifically, the supermarkets) seem to wearing them every day.

Rhode Island was apparently not the first spicy island state to declare open season on tourists. El Pais reports that police in the Andaman and Nicobar Islands, an Indian territory, ejected at least thirty foreign tourists at gunpoint earlier this month, shipping them all to the airport on the main island where they were forced to buy plane tickets to the mainland (while being sprayed with window cleaner). The tourists now appear to be holed up in an abandoned embassy building in Chennai, because the locals there beat one of them up when he emerged.

The New York Times reports on a super-spreading event in Georgia similar to our ill-thought-out Biogen conference. Reuters reports on a super-spreading event in France that puts all of ours to shame:

The prayer meeting kicked off the biggest cluster of COVID-19 in France - one of northern Europe’s hardest-hit countries - to date, local government said. Around 2,500 confirmed cases have been linked to it. Worshippers at the church have unwittingly taken the disease caused by the virus home to the West African state of Burkina Faso, to the Mediterranean island of Corsica, to Guyana in Latin America, to Switzerland, to a French nuclear power plant, and into the workshops of one of Europe’s biggest automakers.

And last but never least, the plague ships: Tasmania's second death is directly linked to Germ Boat #13, the Ruby Princess. According to The Guardian, the ill-fated (and ill-docked) cruise ship transported 440 cases to Sydney, which represents 10% of Australia's total case count, and 5 of its 19 deaths.

In a move the NSW health minister later admitted was a mistake, 2,700 passengers were allowed to disembark without checks from NSW Health on 19 March, with many boarding flights interstate. Another boatload of passengers did the same on 8 March.

Since we're on the topic, DutchNews reports a Dutch national was the fourth to die aboard Germ Boat #18, the MS Zaandam (Holland America), which has been at sea for a two-week tour out of Buenos Aires since March 7th. Eight people have tested positive but about 200 are showing symptoms. After the Zaandam was refused docking at its original destination in Chile as well as in other South American nations, it spent some time anchored off Panama, where it transferred some healthy passengers to Germ Boat #19, the MS Rotterdam (so designated because, despite being apparently uninfected, it is as much of a pariah as #18 and is now also its travelling companion).

Panama reversed its initial decision and let both ships through the canal "for humanitarian reasons" on Sunday. The plague ships are now chugging towards Florida, though the governor has expressed his disinterest in allowing foreigners to be "dumped" in his state.

P.S. The Hill reports that the CDC may buck the WHO and encourage Americans to wear masks.

P.P.S. Today's Massachusetts numbers are up 868 (15%) to 6620. There were 33 more deaths, though, for a total of 89. Deaths are now broken out by decade (only one was under 60), county, hospitalization status, and pre-existing conditions (yes or no). Quest performed another 2,200 tests while the state did 20 (and also somehow went down one positive over yesterday). Suffolk County has pulled ahead of Middlesex again.

It's unclear how many of today's seven deaths in Hampden County are due to the "stunning breakdown of public health protocol" at the Holyoke Soldiers Home; the Boston Globe reports a death count of 13 with 17 cases among living residents and staff and more tests pending.

[Health and Human Services Secretary Mary Lou] Sudders said state officials are still trying to confirm important details, including precisely when the residents died, when they were tested for COVID-19, and who in their families were informed. She said the deaths were not reported to state officials.

Day 59: Mask Madness

Bolsonaro continues to keep Brazil open for business, saying "We're all going to die one day." (Todos nós vamos morrer um dia.)

Business is a little different in the Czech Republic, where Aktuálně.cz reports that 680,000 masks and 28,000 respirators were seized by the government after a local company attempted to sell them to the Ministry of Health at inflated prices. The reseller obtained the masks from one Zhou Lingjian, a man allegedly "directly linked" to the government of Communist China. All PPE was seized from his warehouse, including (allegedly) some intended as humanitarian aid for Italy. How the supplies stopped in Czechia instead remains unexplained, as the border was open for such shipments the whole time. The Czech police suspect theft.

Austria will be requiring people to wear masks in grocery stores starting Wednesday (free at the door), and recommends wearing them elsewhere. The FDA has approved using an Ohio company's mask sterilization technology at full capacity (80,000 masks a day), apparently in response to the governor's criticism of their initial arbitrary restriction to 10,000 a day.

The US has reached 164,000 cases, and Italy is now over 101,000. New York at 67,000 cases is ahead of Germany (66,000). Massachusetts has sadly risen in the rankings lately and is now at 5th in the nation with 5,752 cases (up 797 or 16% from yesterday). Eight new deaths, including several of people in their 60's, brings us up to 56 deaths.

Reddit reports that your Android phone will now warn you when you cross the state line into RI, where it's still tourist hunting season. PlagueBlog recommends turning off this feature if you live on the state line.

Day 58: Ash Lines and Riots

Today's numbers are down; Sunday seems to be the state lab's day of rest, and we'll surely get another Monday leap. Massachusetts now has 4955 cases, up 698 (16%) from yesterday, with 4 new deaths (all of persons over 70). Middlesex has retaken the lead with 981 cases as opposed to Suffolk County's 940. Essex has pulled ahead of Norfolk, 570–548. Quest tested 2,000 more people, while the state lab tested 2.

In Maryland, a man was arrested for inadequate social distancing outdoors. People seem to be smuggling video out of New York hospitals to the New York Times. If you want to know when your state will reach Peak New York, the Institute for Health Metrics and Evaluation at the University of Washington has projections for peak hospital demand (including how many hospital and ICU beds your state actually has). Just select your state from the dropdown to read 'em and weep.

There's also a new kid on the case-counting block, covidly.com, which makes nice graphs but doesn't seem to be updating in real time. Over on worldometers, the pandemic has already hit 718,000 cases with well over 33,000 deaths. Italy is nearing 100,000 cases. Spain is close to pulling ahead of China in cases, and is second only to Italy in deaths, if you believe China's numbers.

PlagueBlog's faith in China's numbers, if it existed at all, would be shaken from news out of Wuhan of thousands of people queueing up at funeral homes for urns of their relative's ashes. Urn counts have been estimated at 45,000, far in excess of the nation's official death toll of 3,300. Pictures and video of the ash lines posted to social media have been censored.

The Sun also reported rioting when residents of Hubei discovered their quarantine wasn't as over as they thought it was: they're still not allowed to travel around China.

P.S. After Cuomo threatened to sue, Rhode Island extended tourist hunting season to all out-of-staters. Those Massachusetts folks with houses straddling the state line should exercise caution when entering their living rooms.

Day 57: Turkey Sightings

With the world at 663,000 cases and 30,000 deaths, the US is firming up our grip on the lead with over 123,000 cases and over 2,000 deaths. Only Italy has also surpassed China, with 92,000 cases and 10,000 deaths (despite undercounting their deaths).

Today's count for Massachusetts is 4257, up 1017 (31%) from yesterday. In a surprise upset, Suffolk County has surged ahead of Middlesex County by one case (843-842). There have been 9 more deaths, for a total of 44. Quest is up another 3,000 tests to over 17,000, which is almost half the tests ever done in the state.

We have not taken to hunting down New Yorkers like the neighbors yet, though we are quarantining visitors to the state. (Presumably Rhode Islanders with homes straddling the state line can travel to the kitchen and back without being quarantined, but they should not hunt New Yorkers while they're here in Massachusetts. Apparently people in distant places like New York disapprove.) Instead, the new sport here is turkey-spotting. They've been seen all over the Boston area, including at the Anna's in Brookline.

In other local news, New Balance is ramping up to produce masks, and the Public Health Commissioner has COVID-19 and so is working from home. Partners hospitals are banning visitors, and a Scituate animal shelter has set up a pet food food pantry.

Day 56: The Herd Strikes Back

Today's title is for Boris Johnson, currently self-quarantining at Number 10 Downing Street.

Do you recall when PlagueBlog did not recommend closing the border to New York State? Well, clearly the governor of Rhode Island is not listening to our recommendations, because she has instituted a house-to-house search for roving New Yorkers, using the National Guard. (This somehow reminds PlagueBlog of the popular theme in Portuguese COVID-19 memes of reconquering a disease-ravaged Spain, or at least Galicia.)

Science Alert suggests that the current coronavirus may be a chimera of a bat coronavirus and a pangolin one.

RaTG13, isolated from a bat of the species Rhinolophus affinis collected in China's Yunan Province, has recently been described as very similar to SARS-CoV-2, with genome sequences identical to 96 percent.

[...]

However, the coronavirus isolated from pangolin is similar at 99 percent in a specific region of the S protein, which corresponds to the 74 amino acids involved in the ACE (Angiotensin Converting Enzyme 2) receptor binding domain, the one that allows the virus to enter human cells to infect them.

By contrast, the virus RaTG13 isolated from bat R. affinis is highly divergent in this specific region (only 77 percent of similarity). This means that the coronavirus isolated from pangolin is capable of entering human cells whereas the one isolated from bat R. affinis is not.

In addition, these genomic comparisons suggest that the SARS-Cov-2 virus is the result of a recombination between two different viruses, one close to RaTG13 and the other closer to the pangolin virus. In other words, it is a chimera between two pre-existing viruses.

P.S. Our numbers are in: Massachusetts is at 3240 cases, up 823 (34%) over yesterday. There were ten more deaths, mostly of patients over 80, for a total of 35. Sex is a growing mystery to the DPH, as is the source of the infection, with over 800 more in the "under investigation" category. Quest has tested 2,800 more patients, more than three times the next runner up (the state lab). A total of seventeen labs (plus "other") are now performing tests.

The commonwealth has officially extended the tax filing deadline to July 15th, and the Governor is on the case of cities who've banned construction.

Also the US has now topped 100,000 cases and 1,500 deaths. New York State is far in the lead with 44,800 cases and 519 deaths.

Day 55: 525,000 Strong

Today the world has exceeded 525,000 cases of the coronavirus we are uniquely not naming after where it came from (well, uniquely except for the other coronavirus from China), with over 23,000 deaths and over 123,000 recovered. With a new high of over 82,000 cases, the US has edged out China for most cases, though not for deaths. Despite underestimating deaths, Italy is still ahead of the viral superpowers with over 8,000 dead. Spain is moving up in the ranks, with second place in deaths and fourth place in cases.

Today's bad news in Massachusetts isn't as bad as yesterday: we are up 579 cases (32%) to 2417, with ten new deaths, mostly among 80-year-olds, for a total of 25. Middlesex still leads the counties; one notable case here is a Market Basket employee in Chelmsford. An Easton Shaw's employee of unknown residence also tested positive.

Failure to trace continues apace, with one more travel-related case, 17 more official local transmission, and over 500 more untraced cases, for a total of over 2000 under investigation. Strangely, a sex unknown category has appeared in the state statistics, with 2 cases. Quest has another 333 positives, out of 2,330 more tested. A fourteenth lab has appeared in the list (BROAD) but without numbers because it is not yet validated.

In the battle over hydroxychloroquine, the Detroit News reports that the governor of Michigan has taken the other side, forbidding doctors from prescribing it off-label. The article is too stupid to explain why, but the restriction is most likely related to a similar one in Ohio meant to guarantee access for patients needing the drug for its on-label purpose (fighting autoimmune disease).

Day 54: Diana's Revenge

Basically everyone on the internet has informed PlagueBlog that Prince Charles has come down with coronavirus, so we're passing it on to you. Take it as you will.

Here in Massachusetts, things have gone from bad to worse, or at least from untested to tested. The total is now 1838 cases, up 679 from yesterday (59%). We also have 4 new deaths, all over 70 and most with pre-existing conditions. The jump is mostly due to testing by Quest, whose numbers have gone up from 379 positive out of over 5,000 tested yesterday to 805 positive out of over 9,000 tested today. The state comes in a distant second with 4,774 tested. LabCorp remains in third place, and the lab count is up to thirteen, plus "other".

P.S. If you're on hydroxychloroquine, PlagueBlog hopes you're also a prepper and stocked up ahead of the rush. Buzzfeed reports Kaiser Permanente is denying hydroxychloroquine prescriptions to lupus patients in California. Also, PlagueBlog recommends against drinking your fish tank cleaner because you don't understand chemistry (or for any other reason).

Day 53: It's a Doozy

I was going to start out with Hong Kong's official report of a second pet case, detected earlier this week in a German Shepherd tested and quarantined on account of its sick owner, but the Massachusetts numbers are out for today and they're a bit much. We are up 382 cases (49%) to 1159, with two additional deaths. Middlesex County alone is over 300 cases, and Essex County is up-and-coming. There are 11 more travel cases, 16 more local transmissions, and an ever-growing backlog with the source under investigation. (Possibly included in the case count for today are the President of Harvard University and his wife; he emailed the community that he got their results back this morning.)

On the bright side, there's a full lab breakdown starting from yesterday, with 12 labs listed (plus, of course, an "other" category). Testing is up 54% over Sunday, with 13,749 tests performed. About 8% have been positive. Though there's been discussion of repeated testing of healthcare workers, this doesn't seem to be reflected in the table.

In case you didn't believe that was the bright side, CTV News reports that Spain has set up a temporary morgue on a Madrid ice rink, as well as field hospitals and military cleaning patrols.

Day 52: Anosmia Joins the Symptom List

Today the world exceeded 350,000 cases, 15,000 deaths, and 100,000 recoveries. Italy is eyeing 60,000 cases, which will be 0.1% of their total population. The US is at 35,000 cases and Spain, a nation of fewer than 47 million souls, is attempting to catch up to us with over 33,000 cases. Germany has pulled ahead of Iran despite their similar populations (around 80 million) and Iran's significant head start. France is falling behind.

In Massachusetts, yesterday's mysterious Duke/Nantucket combined counties case has turned out to be on Nantucket, and the entire island is now sheltering in place. The governor discouraged people from traveling to the islands, then also discouraged the latest fad, traveling across the mainland in search of the ever-more-elusive haircut, by shutting down all non-essential services. FYI: Packies are essential, recreational marijuana dispensaries are not.

One of the more interesting symptoms to emerge from the pandemic is post-viral anosmia or hyposmia, most notably in otherwise asymptomatic patients. If you want to read a bunch of anecdotal reports of the loss of the sense of smell (and therefore of much of the sense of taste), see yesterday's Hacker News thread inspired by the ENT UK post. According to the anecdotal evidence, most people recover their senses eventually.

Also on the science front, last week Cell Discovery finally posted a letter about the efficacy of hydroxychloroquine (a milder form of everyone's favorite repurposed malaria drug, chloroquine) against coronavirus in vitro.

P.S. Today's numbers are in: Massachusetts is at 777 cases total (+131, or 20%), with no new deaths. There were seven more travel cases, 21 more cases of local transmission, and now almost 500 unsourced cases. My county (Middlesex) still leads the pack with 232 cases, well over Boston proper (Suffolk, 154) or anywhere else. Dukes County (Martha's Vineyard) remains free of disease.

Locals should note that besides the state closing for non-essential business tomorrow, indoor gatherings are now limited to 10 persons. Outdoor gatherings are allowed, but I saw a lot of parks padlocked today anyway.

P.P.S. The death count for today is actually 9, up 4 over yesterday. PlagueBlog could swear the PDF said 5 this afternoon. Also, more news sources cannot count the counties of Massachusetts.

Day 51: Next Stop, Italy

The US has reached 30,000 cases, putting us in a firm third place after Italy (53,000) and the source of it all, China (81,000). New York State alone has exceeded 15,000 cases (with 9,000 in New York City alone), leaving all the other states with their impaired testing capacities in the dust. PlagueBlog does not recommend closing the border with New York at this time.

On the plague ship front, The Patriot Ledger reports that hundreds of passengers aboard Germ Boat #15, the Silver Shadow, remain quarantined in the port of Recife (Brazil) after a single passenger tested positive. Despite promises of an airlift out for Americans this weekend, about a hundred remain aboard.

A sister ship, the Silver Explorer, earns Germ Boat #16 status by being in a similar situation off the port of Castro, Chile, after an 85-year old British man disembarked in the south and tested positive in Coyhaique. Silversea Cruises is a subsidiary of Royal Caribbean.

Chile has also refused docking to Germ Boat #17, the Azamara Pursuit, despite its having no verified cases aboard. Other South American ports have refused it entry, and it may need to make the entire 13-day sail back to Miami to offload its (for the moment) healthy passengers. Azamara Cruises is a wholly owned subsidiary of Royal Caribbean.

P.S. Massachusetts' numbers are out for today: 646 cases, up 121 (23%) from yesterday, with 5 deaths (+3). The commonwealth is now providing age ranges on the case numbers. The curve is fairly flat and may be an archive of the testing priorities. Two more cases have been attributed to the Biogen conference, fifteen to travel, fourteen to local transmission, and almost 400 remain unsourced at this time. Positive results are down to 11% for the state lab and up to 7% for the commercial labs.

For some reason the DPH lumped Dukes County and Nantucket County together (with 1 case total), misleading some news outlets into claiming that every county now has a case.

P.P.S. I corrected some number comparisons above.

Day 50: And the Ship Sailed On

The worldwide case count has exceeded 309,000 with over 13,000 deaths. In Massachusetts, today's number is 525 cases, up 112 (27%) from yesterday, with 4 travel-related cases and the remainder due to community spread or not yet sourced. The biggest jumps are in the Greater Boston counties, along with noticeable increases in Essex, Bristol, and Plymouth counties. In a considerable number of cases the county is unknown.

Although not included in today's numbers, Channel 25 reports the death of a Middlesex County woman in her 50's with pre-existing conditions.

Some updates from yesterday: the death in Suffolk County was of an 87-year old Winthrop man. More disturbingly, Channel 25 reported that 9 health care workers at Brigham and Womens and 10 health care worker at Tufts Medical Center tested positive, far exceeding their actual case counts (though not the number of patients pending results at both hospitals). It's not clear how many days of testing this total represents. PlagueBlog is duly alarmed.

On the plague ship front, the numbers have changed yet again for Germ Boat #2, the Diamond Princess, with an eighth death today, a Canadian man in his 70's who had been hospitalized (apparently in Japan). Also some time last week, the Japanese suddenly counted fifteen more positives among ill passengers and their contacts who disembarked before the end of quarantine, bringing the total back up over 700 to 712. The New York Post reported Friday on a study determining that foodservice workers were the nexus of this particular germ boat outbreak.

The New York Times reports on yet another ill-omened cruise aboard Germ Boat #14, the Costa Luminosa. PlagueBlog was surprised by the Princess Cruise yesterday, but always suspected that Carnival Cruise Lines would go on operating its other cruise lines after announcing the apparently quite half-hearted closure of Princess. One of those lines is, of course, Costa Cruises.

The Costa Luminosa sailed out of Fort Lauderdale on February 24th for a Caribbean cruise on which its Italian passengers experienced some issues disembarking, though one Italian passenger was allowed to be hospitalized for an apparently unrelated condition. (He later died of coronavirus.) The ship sailed on out of Fort Lauderdale again, for Europe, reportedly only "half full". A second ill Italian was removed to hospital at a stop along the way. She also eventually tested positive. A comedy of errors ensued with no precautions being taken against the spread of the virus for a week, and then the homemade napkin masks appeared on the waiters.

The US would not permit the ship to dock at its original destination in Italy, so the plan was changed to Marseilles. Several other European ports of call turned the ship away. Yesterday, 400 American and Canadian passengers were finally airlifted home from Marseilles under "harrowing" conditions. Today the plague ship docked in Savona, Italy, despite the country being closed. Italian and Swiss passengers began to disembark; more will disembark tomorrow.

There is so much more news: more plague ships, more disturbing clusters across New England, and a run on chloroquine. PlagueBlog struggles to keep up while also working on a better view of the Massachusetts data.

Day 49: A Quarter Million Strong

Today the international case count has hit 255,000, with 10,000 deaths and almost 90,000 recovered. Italy has over 41,000 cases and 3,400 deaths. Spain has exceeded Iran in cases; both are nearing 20,000. Germany has well over 17,000 cases and the US is approaching 15,000, with 160 deaths.

Today the Treasury Secretary moved Tax Day to July 15th; filing and payment can be delayed without penalty. In a sudden move, Governor Newsom locked down the entire state of California late yesterday with a "shelter in place" order, though marijuana dispensaries and other "essential" businesses will remain open. Pennsylvania is also under a similar order. Massachusetts is still looking good, having dropped to 9th in the nation in case count with no deaths (unlike 28 states and the District of Columbia).

The Internet dug up this gem of a paper from 2007 [PDF]:

[SARS'] acute and dramatic impact on health care systems, economies, and societies of affected countries within just a few months of early 2003 was unparalleled since the last plague. The small reemergence of SARS in late 2003 after the resumption of the wildlife market in southern China and the recent discovery of a very similar virus in horseshoe bats, bat SARS-CoV, suggested that SARS can return if conditions are fit for the introduction, mutation, amplification, and transmission of this dangerous virus.

And lastly, the gift that keeps on giving: plague ships! Lucky Germ Boat #13 is the Ruby Princess, a Princess Cruises ship that (despite Carnival allegedly suspending operations of Princess Cruises a week ago) was still cruising around as late as yesterday when it docked in Sydney. Although thirteen people were ill with flu-like symptoms, the 2,700 passengers were allowed to disembark. Only the ill seem to have been tested; two passengers and one crew member tested positive. Another passenger who travelled to Tasmania has been hospitalized there and is a suspected case.

PlagueBlog trusts this germ boat will continue yielding cases for some time.

P.S. Forbes has an article on the homemade mask movement.

P.P.S Governor Cuomo tweeted his intention to lock down New York State.

P.P.P.S PlagueBlog apologizes for jinxing us: the governor reported the first death in Massachusetts during a press conference this afternoon. The victim was a Suffolk County man in his 80's with pre-existing conditions who died yesterday. The remaining numbers for today are not out yet.

P.P.P.P.S Our numbers are now out. Massachusetts has 413 cases, up 85 (26%) over yesterday, with 17 new cases of local transmission, 15 more travel-related cases, and the remainder under investigation. Middlesex County has 25 new cases, Suffolk 14, Norfolk 12, and Essex 10. Fifty of the new positives were found by the commercial and mystery labs. The state lab positive rate has gone down to 11% while the commercial lab rate has gone up to 5%. (There is still no denominator on the mystery labs.)

Day 48: Lies, Damn Lies, and Statistics

The international case count has exceeded 222,000, with over 9,000 deaths and 84,500 recovered. Italy is approaching 36,000 cases and 3,000 deaths. Iran, Spain, and Germany remain in the teens, and the US, at nearly 9,500 cases and 157 deaths, is now on the wrong side of both France and South Korea.

Massachusetts has dropped to 8th in the nation in case counts. We still have no deaths, though 23 states have at least one already. Many Massachusetts grocery stores have implemented senior hours, and daycare centers will be shut down on Monday, except in certain circumstances involving essential workers.

The Sun Chronicle reports a hospitalized case in Attleboro from an unspecified nursing home, as well as the first case in Mansfield. As of yesterday, there were twelve cases in Southeastern Mass: five cases in Bristol County, five in Plymouth County, two in Barnstable County (the Cape), and none on the islands.

PlagueBlog recommends a New York Times opinion piece from Tuesday about the public health consequences of lying to the public about the need for face masks.

P.S. BBC News reports Italy's death toll has exceeded China's.

P.P.S. Our numbers are out for today: 328 cases total in Massachusetts, up 72 cases (including 4 in Southeastern Massachusetts), with 8 more cases of local transmission, 8 more travel-related, and 56 still under investigation. Hospitalizations went up from 27 to 43 (with a large number still unclassified).

The state lab found 37 of the new positives, the commercial labs (only LabCorp today) found 18, and the underspecified other labs found 17. Total test rates are still unavailable for the other labs, but the state and the commercial labs are still holding at 13% and 4% positive, respectively.

Day 47: 200k and Still Rising

In an overnight leap, worldwide coronavirus cases have passed 200,000 and reached somewhere between 203,529 (JHU CSSE) and 204,831 (WoM). Italy is over 31,000 cases with over 2,500 deaths. Iran also leapt up overnight to over 17,000 cases and over 1,100 deaths.

Also on the wrong side of South Korea are Spain (at almost 14,000 cases and over 600 dead) and Germany (over 10,000 cases but only 27 dead). Portugal (642 cases, 2 deaths) stopped trains and flights to Spain Monday night at 23:00, for at least a month.

The US is still on the right side of South Korea (though not for long) at about 7,300 cases and 116 deaths. New York has not been doing as well as Massachusetts; WoM reports 2,480 cases and 16 deaths for them. In fact, New Jersey has pushed Massachusetts into 5th place, and Florida is looking likely to overtake us soon as well. We are the only state with more than 100 cases but no deaths (out of 12).

New Hampshire is up 9 cases to 26. In Maine (32), Reddit reports that the L.L.Bean flagship store in Freeport is installing locks in preparation to lock its doors for the first time since it opened. Apparently they did close on some occasions; like Massachusetts and RI, Maine law requires retail stores to close on Thanksgiving. (PlagueBlog thinks the rest of you are animals.)

P.S. The Massachusetts numbers are out in their PDF hidey-hole. We have 38 new cases, -5 attributed to Biogen (so it's hard to say exactly where those five presumably misclassified folks went), 5 to community spread, 2 to travel, and 36 under investigation. The Commonwealth tested 377 new cases, 28 of whom were positive. The commercial labs tested 144 new cases, 10 of whom were positive. Their overall rates are now 13% and 4% respectively.

The Boston Globe reports that a swab shortage is now interfering with coronavirus testing. PlagueBlog hopes you got tested back when PlagueBlog recommended it.

Day 46: The Swiftness of Wind

Through the sneaky approach of guessing the URL, PlagueBlog brings you the Massachusetts numbers for St. Patrick's Day before 4:30pm today. We have 21 new cases, for a total of 218: 2 new Biogen cases, 6 new travel cases, 5 new local transmission cases, and 8 new mysteries. Quest has reported 5 new positives, while LabCorp has 116 new negatives and no new positives.

I've been noticing the difference between the state lab positive rate (17% yesterday, 14% today) and the commercial lab one (4% yesterday, 3% today). The LabCorp rate is particularly low at 0.6%. Unfortunately, without a breakdown of where the commercial tests are being done, it's difficult to speculate about why the commercial lab rates are quite so different from each other. The state lab's high rates clearly have to do with its restrictive testing requirements, especially before they were eased up last week.

Elsewhere on the continent, Brazil announced its first death, of a 62-year-old São Paulo man who also had hypertension, diabetes, and an irrelevant prostate condition which O Globo felt the need to explain. His travel history was not provided.

P.S. The South China Morning Post reports that the coronavirus-positive Pomeranian died Monday, after having never shown symptoms, testing negative, and being released from quarantine to return home Saturday. The late Pomeranian first tested positive nineteen days ago (on Day 27 of the Boston count).

The owner has refused an autopsy; not surprisingly, the government that destroyed previous research into the disease seems to also be allowing this vital dog data to be lost. PlagueBlog notes that human beings have also died after testing negative.

P.P.S. West Virginia has joined the club.

Day 45: Last Diner Before Summer

The Governor's crackdown on eating out begins tomorrow, so tonight is your last chance. Other states besides Massachusetts following Hoboken's lead include Connecticut, New York, New Jersey, California, Ohio, Illinois, Washington, Oregon, Maryland, Minnesota, Michigan (on very short notice), and 5 counties in Pennsylvania. Also the cities of Los Angeles, Washington DC, and Harris County, TX (i.e., Houston). Abroad, countries like Poland, Belgium, France, the Netherlands, Albania, Israel, and Czechia have closed restaurants.

Open Table reports things were looking pretty depressed for the industry already. PlagueBlog assumes the Open Table reservation numbers understate the situation, because you know you don't need a reservation these days.

The Boston Globe reports that unfortunate Worcester man who died on his way home Saturday has (posthumously) tested negative for COVID-19. The numbers for Massachusetts today are 197 total (+33 over yesterday), of which 100 have been connected to Biogen, 18 are travel-related, 28 are officially due to local transmission (apparently including the previous Western Mass cluster), and 51 are still under investigation. Of the positive tests, 8 are being excluded from further tabulation for being pre-March tests conducted by the CDC, 1 was done by LabCorp, 7 by Quest, and the remaining 181 were performed by the DPH.

Day 44: Dubaious Death

The National reports that a 59-year-old Worcester man returning home to Logan from Chennai via Dubai died of cardiac arrest en route. The state police here are awaiting the autopsy and coronavirus test results—as are the 321 other passengers and 18 crew aboard the Boeing 777, especially the crew members who attempted CPR. The man had no pre-existing conditions but had been ill with gastrointestinal issues for an unspecified number of days before his flight. (Unlike "cold symptoms", gastrointestinal symptoms are an early sign of coronavirus infection.)

Here on the ground, the Commonwealth reported 164 cases total as of today, 108 traced to Biogen, 35 not yet traced to Biogen, 8 new travel-related cases, and no change in the Western Mass. cluster. PlagueBlog has heard that it's not clear to outsiders from the news that the Greater Boston area has pretty much shut down, with most school systems closed and many bars and restaurants now voluntarily closing. The mayor of Boston has also declared a health emergency, though it's not clear that means much at this point.

Rhode Island reached 20 cases yesterday, with no new cases today. Two recent cases are particularly notable, though: the Providence Journal reports that two children (age not specified) are among the cases. One had been on a cruise, and the other had gotten a signature from one of the two infected Utah Jazz players at their game in Boston on March 6th.

New Hampshire is up to 13 cases. The seventh case, a Rockland County woman, apparently worked at the Manchester DMV. If you visited the DMV in early March, you may want to read more about the case.

The New York Times reports that, due in part to union pressure, even the New York City school system will be closing starting Monday, until at least April 20th. The school system has 24 hours to figure out how to provide meals and childcare to some of the displaced students; remote education is to be planned out later this week. Public schools on Long Island and in Westchester County will also close.

NYC has now had five deaths, all involving pre-existing conditions, and the state has over 700 cases. The New York presidential primary may be delayed from late April until the date of a local election in late June. Louisiana and Georgia have also delayed their primaries.

Because, understandably, people just keep on drinking, the city of Hoboken (NJ) has closed all bars and restricted all restaurants to take-out only service, as well as implementing a 10pm curfew. The mayor excused all this in part with a confusing story about lack of EMS response to a bar fight on Saturday night.

Across the US there are 3,621 cases with 63 deaths, still mostly in Washington State and California. Italy is approaching 25,000 cases and Iran 14,000. Rumors about the UK "herd immunity" plan are greatly exaggerated. Hopefully the rumored vaccine from Israel (193 cases) is slightly less exaggerated. Austria, at 800 cases, has banned all gatherings of more than 5 persons.

P.S. The Governor of Massachusetts held a rare Sunday night presser to announce that our gatherings are now restricted to 25 people (down from 250), our restaurants are restricted to delivery and take-out only, and all schools, public and private, are closed for three weeks starting Tuesday. He closed some number of government offices, and the RMV (our DMV) is offering some extensions.

Visits to nursing homes are no longer allowed, hospital visitors must be screened, and non-essential procedures will be cancelled starting Wednesday. All commercial insurers are required to cover telehealth now, for free in the case of COVID-19, and some pharmacists will be allowed to make hand-sanitizer. (I suppose you used to have to be a compounding pharmacy to do so.)

The presser also claimed community spread in seven counties, even though we only have six counties with more than one case documented by the MDPH. It seems they've been peeking at the commercial lab results (seven of these have been positive already) and have decided some other cases won't be traced. Still, I think they may be exaggerating a bit to get people to hunker down before it's too Washington State.

He also mentioned the postponement of the Boston Marathon until September, news I'd missed earlier in the week. The Boston Globe article mentions that the MBTA will be running in full force Monday, but public transit service is likely to get reduced as soon as they come up with a plan to do so.

Day 43: Just Get Tested

PlagueBlog has noticed that the mob microphone that is the Internet has not actually caught on to the fact that you can just get tested now in the US, by your own doctor, using the same labs (Quest and LabCorp) they use for every other test they give you, without any clearance, interference, or gate-keeping from your state, commonwealth, or the CDC. If your doctor refuses to test you, do not blame your state, commonwealth, or the CDC; blame the malfunctioning mob microphone.

The US is at over 2,800 cases and 57 deaths. Massachusetts is at 138 cases, 104 attributed to Biogen, 21 not yet attributed to Biogen, travel-related cases unchanged, and the Berkshire 8 unchanged except now somewhat anonymized as "Western MA cluster". (Nevertheless, the Boston public schools will be closed until April 27th.) New York State is at over 600 cases and two deaths, an 82-year-old woman in the city and a 65-year-old man in Rockland County. Connecticut has reached 11 cases.

Remember, you can just get tested.