Day 213: No Health Service

India is making the news in its press to reach #2 in case counts by breaking all daily records with almost 80,000 cases yesterday. They also recently beat Mexico to become #3 in total deaths. (To be fair, Mexico has less than 10% of the population of India.) Elsewhere over the weekend, Oman and Kuwait surpassed China, leaving #38 Belgium as the last straggler, currently only six cases behind China.

In Britain, the NHS (National Health Service, though an alternate interpretation of the acronym is included in the title of this post) is even further behind on providing health care than usual, with the Telegraph reporting a two-year wait for a phone call from a specialist. The Daily Mail appears confused by Deputy Chief Medical Officer Jenny Harries admission that the evidence for masks is weak.

In Australia, a Perth resident is on his way to jail for sneaking out of a quarantine hotel to infect visit his girlfriend using a ladder and an accomplice. His lawyer claims the quarantine rules were "confusing." PlagueBlog recommends rethinking the legality of any plan that requires a ladder and an accomplice, unless home repair is also involved.

Also in Australia, there appears to be a black market for the experimental feline infectious peritonitis drugs PlagueBlog covered last week. GS-441524 in particular is being produced in China for illegal sale to Australian cat owners, who spend up to $5000 (Australian) per cat to save their lives. Government warnings about the dangers of the unapproved drugs fall on deaf ears, since the alternative is a dead cat, and no drug companies seem interested in producing the drug for legal sale in any cat market, never mind the Australian one. There does appear to be some interest in using GS-441524 against COVID-19 in people, however, as it is closely related to remdesivir.

In local news, the Commonwealth has mandated flu vaccine for students, including college students, this fall, leading to a bit of a backlash from parents. Considering that 80% of minors in Massachusetts already get the flu vaccine (never mind mandatory vaccines), the reaction seems a bit misplaced. PlagueBlog is more concerned about the largely unvaccinated college population depleting needed vaccine supplies than anything else.

P.S. Massachusetts' cases are up a quarter of a percentage point today.

Day 212: Nothing Much

Massachusetts’ cases are up 0.16% today. That is all.

Day 211: 25 Million Strong

The world case count has hit 25 million, and Romania has made the jump past China to #34 in cases. Massachusetts' cases are up a third of a percentage point again. A wedding in Millinocket, Maine continues to make the news as a bit of a superspreading event.

The New York Times meanders around the topic of coronavirus testing, dissing the CDC's decision to stop testing asymptomatic people while dreaming of tests that are faster or more informative than the current binary PCR results. In particular, a PCR test can give some indication of viral load:

The PCR test amplifies genetic matter from the virus in cycles; the fewer cycles required, the greater the amount of virus, or viral load, in the sample. The greater the viral load, the more likely the patient is to be contagious.

This number of amplification cycles needed to find the virus, called the cycle threshold, is never included in the results sent to doctors and coronavirus patients, although it could tell them how infectious the patients are.

In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus, a review by The Times found.

On the pie-hole front, a forthcoming meta-analysis in the open access journal Obesity Reviews found that the obese were 46% more likely to come down COVID-19, 113% more likely to be hospitalized for it, 74% more likely to end up in the ICU, and 48% more likely to die of it. The researchers didn't have much new to say about why, but they did hit the irony button pretty hard with their concerns that the pandemic response is exacerbating the worldwide obesity problem:

In addition to COVID‐19's critical economic constraints, its impacts on diets may pose lifelong risks to populations around the globe. Food habits developed during this period, particularly the intake of ultraprocessed foods, represent a major health risk.

Day 210: Even the Bunnies

Oman has gotten very close to the China point, but is still lagging behind at #35. The US is now well past 6 million cases, and Alabama is slowly working its way towards Massachusetts' #13 spot, where it may arrive in less than a week. Death tolls for the summer wave remain significantly lower than those from the spring.

Amnesty International reports on the gunning down of at least seven young men in Angola by security forces, apparently over mask and lockdown-related offenses.

The Times reports that the six minors who have died of coronavirus in the UK were all seriously ill:

Three were newborn babies with other severe health problems. The other three were aged 15 to 18 years old and also had “profound health issues”.

Calum Semple, professor in child health and outbreak medicine at the University of Edinburgh, who is the senior author of the study, said: “The deaths that we did observe were children with what we would describe as profound co-morbidities — not a touch of asthma, not cystic fibrosis.”

These children’s underlying illnesses would have been considered as “life-limiting”, he said. “We did not have any deaths in otherwise healthy school-aged children.”

Note that that was six minors out of about 70,000 hospitalized patients studied (only 651 of whom were minors). In total there have been about 41,000 deaths in the UK, some presumably out of hospital. The headline and text of the news article imply that the study covered all deaths of minors in the UK, though the actual research didn't explicitly claim to be exhaustive, nor did it include Northern Ireland or any overseas territories at all.

The Lancet preprints an American case of reinfection with a provably different coronavirus strain. It isn't the suspected Wisconsin case but a case in Nevada. The patient was symptomatic with his first strain for about a month beginning at the end of March, then relapsed at the end of May and was eventually hospitalized with hypoxia and pneumonia. No resolution of the second bout was reported.

The paper also notes that he may have been reinfected by a household member, and that he is 25 years old with no immunological issues to explain the reinfection (though it is otherwise silent on his health status and any comorbidities):

The individual associated with these cases possesses no significant conditions of an immunological nature that would imply facilitation of re-infection. They were not utilizing any immunosuppressive medications. The individual was negative for HIV by antibody and RNA testing (data not shown) and had no obvious cell count abnormalities.

According to a new preprint, rabbits are susceptible to coronavirus. While the three in vivo test subjects were asymptomatic, they did shed infectious virus from their twitchy little noses for up to seven days. The results are of some interest to rabbit farmers, though probably not a public health concern.

Nature reports on a promising drug for both original SARS-CoV and SARS-CoV-2, one that was previously shown to be effective against the coronavirus that causes feline infectious peritonitis.

P.S. Massachusetts' cases are up a third of a percentage point today.

Day 209: This Sort of Vague, Uneasy Feeling

Back in the height of the pandemic, CTV News reported on the phenomenon of losing track of time during lockdown. (PlagueBlog reminds readers that it's not a quarantine if you're not actually ill or the contact of a known ill person.)

Steve Joordens, a psychology professor in the department of Cognitive Neuroscience at the University of Toronto, described [daily routines] as a sort of “anchor” that gives people a sense of where they are in time.

“They are kind of like a rhythm to our lives,” he explained to CTVNews.ca during a telephone interview from Toronto on Tuesday. “They tell us where we are within a given day, you know if it's lunchtime, but also within the given week, you know if it's Thursday or Friday, they feel very different than a Monday or Tuesday do.”

When suddenly all of those rituals are gone, as in the case of a pandemic, Joordens said it’s easy for people to lose that sense of where they are in the workday or the workweek.

“They also lose sense of who they are,” he said. “This is what a lot of people kind of feel too, is that they feel a little adrift. They’re not really sure what they're supposed to be doing and they have this sort of vague, uneasy feeling.”

Although by now we may all have daily routines of going nowhere and doing nothing, but the article addressed that eventuality with the help of a Manitoba psychologist:

On the other hand, Abdulrehman said even those people who do develop a routine in quarantine may be susceptible to losing track of time if there isn’t enough variety within it.

“They don't know what day it is because it's the same thing every day,” he said.

This is all to say that the staff at PlagueBlog headquarters somehow forgot it was cities and towns day yesterday, so we're a bit behind with the cities and towns data. We have, however, updated last week's map to show Stop the Spread cities (outlined in maroon) and to include the old whole-pandemic case rates in the popup info (though not on the map). This week coming soon...

P.S. Massachusetts' cases are up three-tenths of a percentage point today. Our death toll has reached 9,008 (including presumptive cases). Here is the new daily/biweekly map:

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Day 208: Settled Science Isn't Science

Columbia has sprung ahead of Mexico to 7th place in case numbers, though likely not on their own demerits but only through lack of testing in Mexico. Oman, Belgium, Kuwait, and Romania are queued up behind China for their chance to somehow surpass the case numbers of a country with a population of a billion where the virus raged uncontrolled and unacknowledged for a month. The US is teetering on the cusp of six million cases.

The science continues to fluctuate. Yet another study in favor of hydroxychloroquine has come out, this one finding a 30% lower risk of death in Italian patients administered HCQ during the height of the pandemic there. For a nearly-daily dose of HCQ science, check the HCQ paper tracker.

On the actually-wrong science front, a paper in JAMA has been corrected, perhaps beyond recognition. Mistakes were made, and some of the significant findings of cardiac damage from COVID-19 became insignificant differences. Whether the remaining results justify, say, cancelling football season (an alleged effect of the original publication) is unclear.

On the relapse front, Newsweek reports on several cases of reinfection with COVID-19 proven by genetic sequencing: one in Belgium, one in the Netherlands, and one in Hong Kong (with his second strain ex Spain). Rumor (pending the release of a preprint) has it that the relapsed Hong Kong case was asymptomatic, but the disease status of the new European cases is unclear. A relapse has also come to light in Wisconsin, where a patient exhibited unspecified different symptoms from his first bout three months ago, but no proof (or genetic sequencing at all) has been reported.

Massachusetts' cases are up a quarter of a percentage point today.

Day 207: Our Poor Decisions

The Boston Globe reports, again, on that little incident in the spring where Biogen, a Boston-based biotech company chock full of people who Should Know Better™, managed to spread coronavirus across the nation and the globe with their ill-timed leadership conference:

Now, a sweeping study of nearly 800 coronavirus genomes, conducted by no less than 54 researchers at the Broad Institute, Massachusetts General Hospital, the Massachusetts Department of Public Health and several other institutions in the state, has found that viruses carrying the conference’s characteristic mutation infected hundreds of people in the Boston area, as well as victims from Alaska to Senegal to Luxembourg. As of mid-July, the variant had been found in about one-third of the cases sequenced in Massachusetts and 3 percent of all genomes studied thus far in the United States.

Biogen's special contribution is only part of the genetic data covered by the preprint at medRxiv. They document 80 "likely introductions" of COVID-19 to Massachusetts from four continents, and they also document an unusual outbreak at an unnamed skilled nursing facility in the area. (They didn't name Biogen, either, but everybody knows.)

Massachusetts' cases are up a third of a percentage point today.

Day 206: The MDPH Punts the Ball

Mexico is #7 in total coronavirus cases, with 560,000 cases and 60,000 deaths, which is bad enough, but the Mexican press paints an even worse picture. Like the mother country, their counting skills leave something to be desired, and some estimates place their case counts and death toll at as much as three times higher than the public numbers. While their "cratering economy" is allegedly due in part to austere fiscal policies, most of it sounds coronaviral in nature.

On the science front, a Korean study showed 79% greater risk of severe COVID outcomes from the use of proton pump inhibitors (a class of antacid already known to be associated with pneumonia).

Also, a study out of UC Davis found likely animal hosts of SARS-CoV-2 based on their ACE2 sequences. Not surprisingly, many old world primates share our ACE2, but they also found "12 cetaceans (whales and dolphins), 7 rodents, 3 cervids (deer), 3 lemuriform primates, 2 representatives of the order Pilosa (giant anteater and southern tamandua), and 1 Old-World primate" to be highly correlated to our ACE2 insofar as binding SARS goes, and 57 other species (including cats) with medium propensity for binding the virus. Dogs were low propensity. The American mink, which has proven to be the most susceptible of all animals, got their lowest rating of potential for infection: very low, as did another animal known to be susceptible, the ferret. They discussed the inaccuracy of their ferret result, but not the much more impressive miss on the mink. Make of that what you will.

Upon reflection, PlagueBlog realizes it was foolish to have ever expected backdated numbers from the MDPH, which has instead tossed all the weekend's cases into today's totals. While that still only puts the case count up half a percentage point, we prefer to report the average over the past three days (recalling that Saturday was a bit wedged as well): by this accounting, cases were up only a fifth of a percentage point per day.

It seems that even Miskatonic University has submitted its COVID-19 safety plans to the Commonwealth.

Day 205: The MDPH's Day Off

The Massachusetts Department of Public Health has taken today off of coronavirus reporting, due to the ongoing data changeover that reduced our Saturday numbers. Hopefully there will be a retrospective of the true weekend numbers on Monday.

Instead of gloating over our perpetually flatlined numbers, PlagueBlog will need to gloat over the state of New York State. The New York Post reports a quarter-mile lines at a food pantry in Queens this weekend. The Buffalo-Niagara Partnership surveyed businesses in Western New York State and found about half of them unable to carry on remotely. About 20% of them reported themselves as "at risk of permanent closure." A full two-thirds having reduced staffing in some way, with over 40% having furloughed or laid off workers entirely.

This is all despite record low numbers of cases and hospitalizations in New York State.

Day 204: More Misperceptions

India has reached 3 million cases, out of the world's 23 million cases (and 800,000 deaths). Panama has surpassed China, which is now only #35 in cases worldwide. In the US, #2 Texas has hit 300,000 cases but #3 Florida has not; #5 Georgia is over 250,000 cases (all college students, if the mainstream media is anything to judge by). Massachusetts (#13) hit 125,000 cases yesterday, with little further development today (a tenth of a percentage point) due to a shortened reporting period. (PlagueBlog readers are aware of how much the MDPH enjoys mixing things up every now and again.)

NPR reports on how voting is as safe as grocery shopping, if not more so, despite people's persistent misperceptions. They even cite a paper about Wisconsin's election in April, which produced no detectable surge.

The Hill also covered the Franklin Templeton poll results on real vs. perceived dangers of coronavirus; they give a bit more detail about the polling, but no pretty graphs.

Day 203: Fire Itself

CNN reports four deaths so far from wildfires in California, and implies (but never actually says) that some people may not be evacuating due to fear of coronavirus. One person refused to go inside a shelter over COVID and is sleeping in her car instead. One might hope that actual raging fires would put a damper on irrational reactions to coronavirus, but USA Today reports the gory details of the Red Cross shifting shelters, serving pre-packaged meals, and refusing donations over COVID concerns in California, as well as reporting an unspecified number of people sleeping in their cars instead of the shelters.

Franklin Templeton published some July survey data from Dynata (with a broken reference to the source) about just how far off the average American's opinion of coronavirus risk by age is from our actual risk by age:

Six months into this pandemic, Americans still dramatically misunderstand the risk of dying from COVID-19:

1. On average, Americans believe that people aged 55 and older account for just over half of total COVID-19 deaths; the actual figure is 92%.
2. Americans believe that people aged 44 and younger account for about 30% of total deaths; the actual figure is 2.7%.
3. Americans overestimate the risk of death from COVID-19 for people aged 24 and younger
by a factor of 50; and they think the risk for people aged 65 and older is half of what it actually is (40% vs 80%).

These results are nothing short of stunning. Mortality data have shown from the very beginning that the COVID-19 virus age-discriminates, with deaths overwhelmingly concentrated in people who are older and suffer comorbidities. This is perhaps the only uncontroversial piece of evidence we have about this virus. Nearly all US fatalities have been among people older than 55; and yet a large number of Americans are still convinced that the risk to those younger than 55 is almost the same as to those who are older.

P.S. Massachusetts' cases are up two-fifths of a percentage point today.

Day 202: Not So Unexpectedly

Brazil has topped 3.5 million cases and India is a day or two away from three million cases. In the US, #3 Florida has somehow crept up on #2 Texas, and may surpass it soon. All of the top three states are barely over 10,000 deaths, with death rates per capita that are quite low compared to the first wave states.

The New York Times describes the ongoing economic plunge (after a slight blip last week) as "unexpected", though they're never surprised when coronavirus case numbers pop back up after a lull. The economy is still bleeding from a thousand not-so-tiny lockdown-inspired cuts, like Governor Cuomo closing the malls, of all things, in New York City over ventilation issues that somehow don't obtain elsewhere in the state or in New Jersey.

On the mink front, there's apparently been a reprieve of the mink of Denmark. Despite the discovery of a fourth infected farm in North Jutland, officials have decided to enforce strict sanitary measures rather than kill all the mink like they do in the Netherlands (now at 33 mink farms culled, for an estimated body count of 1.5 million mink). In fact, the Dutch neovisicidal maniacs have threatened the entire mink population of the country if COVID-19 persists into late August.

On the big brother front, your Fitbit knows whether you have COVID-19 before you do:

Since launching a study to see whether its wearable activity trackers could pick up on the early signs of a COVID-19 infection, Fitbit has enrolled over 100,000 participants across the U.S. and Canada and is now delivering its first, preliminary results 90 days later.

That includes at least 1,100 users who have tested positive for the novel coronavirus. By tracking subtle changes in a person’s heart rate, breathing, physical activity and quality of sleep, Fitbit aims to develop an algorithm that can highlight potential cases before symptoms start.

So far, the company said its devices have been able to detect nearly half of COVID-19 cases at least one day before the participant reported any of the disease’s symptoms, such as fever, cough or muscle aches.

Massachusetts' cases are up a quarter of a percentage point again today.

Day 201: Even the Pepperoni

The Brazilian news reports that Brazil has exceeded our death rate; however Worldometers still has them nine deaths per million behind us, with 111,000 deaths total. Neither death rate tops the charts; the big performers there are Belgium and Peru (plus nominal country San Marino at #1).

USA Today reports that our latest shortage is pepperoni. So far it's only driven up the price for pizzerias, who, thus far, have not passed the costs on to their customers.

Massachusetts' cases are up about a quarter of a percentage point today. It's cities and towns day, for which event we've corrected some text on last week's maps and are still working on rearranging this week's.

P.S. After discovering and correcting an error in the raw data, PlagueBlog presents the state of the Commonwealth (modulo any remaining errors):

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Day 200: American American Minks

The world is at 22 1/4 million cases. Sweden snuck past China a couple of days ago, but Panama is still behind. In New Zealand, some pretty sketchy rumors allege that the suspect cold storage facility has been cleared of direct involvement in the outbreak. A new patient seems to be in the works for the main cluster, and genomic data has identified a second strain among the 17 patients in the current outbreak. The second strain seems to have been traced already to a isolation facility for imported cases where the corresponding patient worked, though the route of transmission remains unknown.

In the US, three million people are now recovered from coronavirus. Despite a general slowdown of cases, Arizona has crept past New Jersey to the #7 spot. Massachusetts' cases are up a fifth of a percentage point again today, not to brag.

The Washington Post reports mink at two mink farms in Utah have tested positive for coronavirus, the first cases in American mink (Neovison vison) in the US. The testing was performed posthumously after “unusually large numbers of mink died at the farms,” and five deceased mink were found to have been infected. The suspected route of infection is from infected human farmworkers to the mink. No neovisicide is planned for the remaining animals, as the US is a civilized country. The article notes that the US mink industry has also been suffering from lack of demand from China, apparently due in some unspecified way to coronavirus travel restrictions.

Day 199: The Rotten Apple

Long-time PlagueBlog readers may recall Day 2 of the coronavirus pandemic (February 2nd), on which New York City had a COVID-19 false alarm. They didn't really get going until Day 32 (March 3rd), and now, despite being the most recovered and immune place in the nation, they have a new problem: the death of New York City. A few days ago, James Altucher wrote up a resigned obituary of the city that never sleeps, recounting its death spiral in scenes from a rats-deserting-the-sinking-ship scrapbook he's been keeping. It's depressing. And I say that as a Bostonian who wants New York City to die just on principle.

As a Bostonian I also have to worry about whether it will happen here. Somerville has already made The Atlantic as a poster city for bad COVID decisions about sending children to school (one of the most basic functions of a modern society), not to mention our governor being the very first example in their article against the Fun Police.

The combination of criminalization and unscientific moralism is ineffective and counterproductive, and often leads authorities to take actions that may yield more infection.

We even need a map to track how many local colleges and universities have gone online this fall, despite our state being just as recovered as New York. I think the only thing we really lack here is a chattering class to navel-gaze about how many of their friends have moved to Phoenix or the woods and how many of their favorite restaurants have closed.

Massachusetts' cases are up a fifth of a percentage point today. Here is a map incorporating the new columns of the cities and towns data; the daily rate seems to be just a fourteenth of the bi-weekly rate (that we were computing for you out of the bi-weekly case counts), with certain towns omitted. As usual, we have estimated the rates for the omitted towns. The MDPH is also tracking the change in percent positivity explicitly. Though PlagueBlog considers this a relatively silly value, it is included in the map below.

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Day 198: Hair Loss

As threatened yesterday, he Prime Minister of New Zealand has postponed elections by one month. Unlike most government's panicked reactions to coronavirus, this is within her legal rights, though at this point it's basically pulling a number out of a hat.

Just when you thought coronavirus couldn't get any weirder than "COVID toes", a new symptom makes the news: hair loss:

Favini said coronavirus patients may suffer from telogen effluvium, a condition that leads hair to stop growing and eventually fall out roughly three months after a traumatic event. Whereas the average healthy person loses about 100 strands of hair per day, people with telogen effluvium may lose about three times that.

"When the body is in a really stressful situation, it basically diverts energy from growing hair to more essential things," Favini said. The stress can be either physical or mental, he added – a high fever or depression would both qualify.

The condition usually lasts for about six months, with patients losing up to half the hair on their scalp.

The news article goes on, of course, to speculate that COVID-19 may be entirely unlike any other disease known to man and who knows how long it will last? (PlagueBlog predicts about six months.)

Massachusetts' cases were up a third of a percentage point today.

Day 197: 51 Years Ago Today

The Dominican Republic has passed the China point to take up the #32 spot. Next up: Panama.

Today is the 51st anniversary of the start of Woodstock, the 400,000-person music festival that took place in the middle of the Hong Kong flu pandemic.

Massachusetts' cases are up three eighths of a percentage point today.

Day 196: The Mask on the Soapbox

Opinions seem mixed on whether New Zealand has traced its outbreak to a new strain (to them) or has yet to do so because many of their previous samples have yet to be sequenced. It's still up in the air whether COVID came in on cold freight, on people (through the not-entirely-sealed borders or a failure of quarantine), or had been percolating undetected for their 102 case-free days.

At a presser in Wilmington, Virginia, Democrat Presidential candidate Joe Biden called for a nationwide mask mandate:

“Every single American should be wearing a mask when they’re outside for the next three months at a minimum — every governor should mandate mandatory mask wearing,” Biden declared.

PlagueBlog doubts this is going to win him many swing voters, and reminds readers that in the vast majority of situations there is no reason or evidence for wearing a mask outdoors.

Though there's no new germ boat today, the Washington Post reports that the plague ships of Italy are getting ready to sail again. (Tourism is 13% of the Italian economy.) In passing they mention the Hurtigruten cruise line apologizing for "fail[ing] to follow its own procedures" to prevent the cases aboard Germ Boat #30, the MS Roald Amundsen.

Locally, the Commonwealth's deadline for school districts to figure out what they're doing about coronavirus is today. NBC reports that 31 districts have already decided to go all-online. (There are 292 regular school districts in Massachusetts, plus some vocational and charter districts that may or may not be treated separately for this purpose.)

Aside from some strangeness involving fewer than five people in Hancock (at the far west of the state), the old case map is looking pretty plateaued as usual. The newer, two-week positivity map has some hot-looking spots, including the cities involved in the Stop the Spread testing effort. A daily rate map is in the works but not ready yet.

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P.S. Massachusetts' cases were up a quarter of a percentage point today.

Day 195: Don't Drink the Hand Sanitizer

New Zealand is up to 17 cases (that's 3.4 cases per million residents), and people are already hoarding and protesting the lockdowns there. Elsewhere, the Ukraine has passed the China point. Next up appears to be the Dominican Republic.

Despite its being a relatively harmless alcohol that has only ever killed one person (a far cry from ethanol's body count), the FDA has freaked out about trace amounts of 1-propanol in some hand sanitizers from Mexico. They've been added to their list of unsafe hand sanitizers, which is 149 products long today. The FDA goes on at some length about how 1-propanol "can be toxic and life-threatening when ingested" instead of ethanol, particularly in children. (Presumably adults can hold this slightly-souped-up liquor.)

Until now, PlagueBlog was unaware that hand sanitizer was supposed to be potable, never mind fed to children as martinis. This hype can only reduce our estimate of the dangers of rubbing methanol on your hands; on re-examination of the FDA's five previous announcements about methanol in hand sanitizer, it turns out their main concern has always been children (and pets) drinking the hand sanitizer. Nevertheless, PlagueBlog recommends steering away from hand sanitizers that are composed entirely of methanol. As for the 1-propanol versions, we recommend drinking your hand sanitizer in moderation: no more than half as many Purell martinis as you would normally consume.

PlagueBlog is publishing this public service announcement immediately. Maps and/or complaints about the cities and towns data being as borked as yesterday's dashboard was will follow later today.

P.S. Massachusetts' cases are up a third of a percentage point today.

P.P.S. Unlike the daily dashboard, which has lost its county counts, the cities and towns report has only gained in intriguing new columns, some of them with color-coding. Sadly the county data that got included into the cities and towns report at some point (along with every other stray bit of data the MDPH felt like reporting on weekly) only covers the franken-county of "Dukes and Nantucket", so integrating it with the real counties of the census data would be a bit of a kludge.

Speaking of kludges, a third of every relevant page of the cities and towns PDF is devoted to the same footnote about the data. Fortunately, the MDPH provides an Excel file of the data these days so the punch card girls computers are grinding away at that instead. Results are expected sometime tomorrow.

Day 194: Canines and Cold Chains

New Zealand may have traced their outbreak to refrigerated shipping, as one of their four coronavirus cases worked in an Aukland cold storage facility. (Note that they are considering delaying elections over a 0.8 per million case rate.) China is also complaining again about COVID coming in on frozen seafood, though they don't say from where, and they do say they may have exported some of the contaminated imports.

Also in China, two more cases of COVID recidivism have come out. The more notable one involves a 68-year-old woman from Jingzhou who first tested positive on February 8th, recovered, and tested positive again on August 9th. Apparently she is ill enough this time to be receiving some unspecified treatment. News reports differ on whether she recovered from the first bout "a few months ago" or in late February, which would be over five months ago. The second case is of a man from Hulchun who was initially diagnosed on April 27th, recovered on June 16th, and tested positive on August 10th. He is also receiving treatment, though it's not clear from the report whether he initially sought treatment for COVID or for another condition.

A North Carolina dog who died of a sudden illness involving respiratory distress early last week has tested positive for COVID-19. A family member of the owner had tested positive previously, though the news reports do not note whether the human was ever symptomatic. The dog was an 8-year-old male Newfie. Autopsy results are still pending.

On the off-target vaccine front, a preprint reports somewhat promising results from BCG booster shots in a population that was immunized in childhood. A larger study of giving tuberculosis vaccine to adults in a naive population is underway in Australia, but results aren't expected until October (and may not be particularly significant unless their outbreak worsens before then).

Locally, the governor has backed off a bit on quarantining Rhode Islanders who live close to Massachusetts and tend to shop here (which is, practically speaking, all Rhode Islanders).

P.S. Massachusetts' cases were up a quarter of a percentage point today. To add insult to late reporting, the MDPH has buried the real case count even deeper (in an ethnicity pie chart) and removed the cases by county data altogether.