I don't think anyone can pretend to be
happy with the situation in the United
States dramatically increasing cases up
till today Friday the 3rd of July so
doing quite well here lockdown measures
were working then we have a great
increase in cases and that is still
carrying on at the moment
and the reason that this is so
significant is we are starting to see
now an increase in deaths in the United
States so the deaths came down quite
dramatically quite gratifying reduction
in rate but we're now starting to see an
increase in case of deaths and I fear
because of the increase in cases the
increasing number of people being
diagnosed positive we're going to see
increasing deaths lagging behind that
there's always a lag but the number of
deaths are going to increase
unfortunately anyway welcome to this
update as we've suggested so far we're
concentrating on the United States at
the moment now first thing I would
notice today was the weather is very hot
in the u.s. virtually everywhere I think
especially in the central and southern
areas so this seems to indicate that the
weather is not going to protect us
against covered 19 the weather is not
going to be a big factor in reducing
cases now we had hoped that we more
seasonality as the summer increase but
that has not transpired to be the case
so that's that's unfortunate now the
testing in the United States at the
moment these is under strain in some
areas some of the labs are very busy and
some states are actually pretty full and
of course testing outside and in the hot
weather when it's 100 degrees or so
outside is not an easy thing to do so
there's been practical difficulties with
that testings were very roughly speaking
about half a million per day but the
plan is to increase that to 1 million
per day by September now the good thing
about dramatically increasing the
testing like this does it means you
could perhaps test before an event or
test a particular workforce which would
be useful now I'm not so concerned about
the increase in cases in the states I've
actually drawn out this drawn it out in
sort of words and numbers so Thursday
the 25th of June this was actually a
record day that was a record day then
then that was another record day then
then it went down slightly but in the
last three days we've had records every
day that was a record
I was a record and 2nd of July that was
a record so breaking the 50,000 new
cases per day mark on Wednesday the 1st
of July and unfortunately for the next
week or so or indeed we don't know how
long that that number I would predict is
going to increase because of the very
well-established community spread so
there's no real question that
unfortunately we're going to see greatly
increase in cases in the United States
for the immediate future case is now
heading towards the 3 million mark well
over the two and a half million mark
deaths 128 thousand seven hundred and
forty at the latest figures now there
was a great increase in after Memorial
Day a lot of people are starting to say
well Memorial Day trigger off a lot of
cases and of course tomorrow is the the
fourth of July so Independence Day so
many people are being forced to stay in
by the extremely hot weather which I
suppose in a sense is good but given the
increase in cases after Memorial Day
anxiety has to be high about increases
in cases after Independence Day now mr.
Trump is thinking about wearing a mask
he says he's thinking about it now this
is excellent now why doesn't he wear a
mask with and this is this is perfectly
soon
yes wear a mask see I don't care as long
as he wears a mask wear a mask is a
campaign slogan so I have a make America
great again on your mask or a flag of
the United States or a picture of you of
yourself anything you use the mask on as
an attribute and while we're on that
point it just amazes me that more people
aren't using masks as advertising okay I
can't understand why stores aren't
giving up masks with the reffered sizing
logos on it I'm sure that will come and
I'm sure they won't turn I'm sure I
won't be recognized for I'm probably not
the first to think of it but um but no
sit seriously if the problem is oh I see
as I understand it I'm a foreigner but
as I understand in the United States
wearing a mask has become political this
is just crazy the Surgeon General I've
just seen a news clip this is the
Surgeon General I'm begging you wear a
face covering of course when I say mask
I mean face cover to take away the
momentum of the air the Surgeon General
is begging you to wear a mask and the
president is seem to be softening about
this as well so mr. president if you're
watching or urinator to it mr. president
please say look John says wear a mask
for goodness sake and take if he started
work wearing a mask all the time in
public that would immediately remove
this political aspect to mask wearing
and would immediately reduce the
transmission of cases in the United
States that would happen just straight
away now thought thinking about the
individual states now and the the our
values that we've looked at before so
here we have the current situation now
this is the the RT this is the the
transmission rate in real time so we see
at the moment the highest state with a
value of one point four three and of
course you know what that means now it's
well over 1 this is bad
Nevada highest transmission race at the
moment
Idaho is the second 1.41 with these
transmission rates we're going to get
doubling of cases in fairly short time
intervals Wyoming 1.35 Montana 1.33
Florida 1.3 1 so obviously I always post
the link to these sites so go and look
at them but it's not till we get down
here where states are actually in the
green but even even though in Kentucky
it's but basically waters is 0.99 it's
not until we get to places like
Connecticut where the number of
infections are actually be dropping off
significantly so what we're seeing is
this not only a we're seeing this great
increase in cases overall we're seeing
the number of cases increasing in the
vast majority of states so please wear
face coverings this is believed to work
the Surgeon General's convinced mr.
president wore a mask then I believe
that would take the political aspect out
of this and save cases and save lives
and it cost nothing you know America is
supposed to be largely about profit and
business this cost nothing this is free
essentially free do it do it
save billions billions from the economy
and and save potentially tens of
thousands of life just wear these masks
so the worst affected states have kind
of looked at that again more references
that Alabama now now there was reports
in Alabama on the news I think it was
coming what news it was now NBC News NBC
Nightly News of college students having
parties trying to get deliberately
infected now I can't understand that I
hope that's not true do let me know if
it is but very alarming because
nationally what we're seeing in the
states is young people are becoming the
main drivers of infection they are
passing the infection between each other
and on to more vulnerable their more
vulnerable individuals Florida as we've
seen increase in cases increasing deaths
Arizona now ours owner this this this
this isn't good 30% of tests are coming
back positive so this means that the
rate of increase in Arizona is really
quite substantial as we know it is in
other states that we looked at before
such as a such as Nevada Idaho Wyoming
Montana yeah that's a lot of tests to
come back positive that means there's an
awful lot of covered 19 virus around in
the community and the spokesman I heard
on the news on the NBC I think hospital
capacity said it was maxed out and
looked quite short maxed out means but
doesn't sound good to me
now New York is doing quite well they
had a much more progressive opening and
people are wearing masks in New York so
from being an epicenter New York is now
a bit of a leading light in the country
so that is encouraging Texas now in
Texas just for an example 7,000 people
are now hospitalized and the hospitals
are really under quite severe stress at
that and the governor of Texas I
understand to begin with he was dragging
his heels very significantly on the
significant on the mask-wearing front
but now is mandated it so wearing masks
is now mandated all over the state of
Texas thank goodness because when it's
mandated by the governor that takes away
the political component when it just
becomes a public health matter because
you know what it is just a public health
matter so after initial resistance is
now mandated statewide mask-wearing in
public places outside in in
well-ventilated areas is less of a risk
it's inside it shops it's supermarkets
that the problem or super stores are not
quite sure
we call them in these days and is
imposing a 300 dollar fines so our
suspect guys being complied with South
Carolina now again these are anecdotal
reports but increasing numbers of young
people hospitalized in South Carolina
and there has been several cases of this
from around the United States now what
is going on here is it just that there's
so many more cases that the percentage
of young people it is inevitably going
to increase just because by the sheer
number of cases because we always knew
that some young people are affected it's
just a smaller percentage than all the
people but with so many people being
affected in the community we're going to
see larger overall numbers of young
people of course is it just that or is
there something else going on is there
some other reason why young people are
becoming more effective and more
hospitalized no we need more data on
this and we certainly need data with any
deaths in younger people or the
proportion of deaths in younger people
but that was concerning and when senior
doctors go on on the air to to vent
these fears ok still it's still
anecdotal but it's not it's not good as
concerning California's roll back bar
cinemas closed again Los Angeles Beach
is closed for the 4th of July now to be
fair this is kind of let me tell you on
thinking um beaches you get plenty of
vitamin D from the Sun and their open
spaces and there were by definition of
course well ventilated with sea breezes
but people get close together but
perhaps is not so much the beach itself
it's the toilets that service the beach
it's the facilities around about the
beach it's that it's the apprai beach
what you do after you've been to the
beach and all that the congestion that
can go around with that is probably more
of an issue so the authorities in Los
Angeles presumably have taken all these
things into cognizance and they've
decided to close the beaches for the 4th
of July which is a big thing of course
is this is a huge thing in American
culture to do
now I've been looked at some alarming
reports about people being build huge
amounts of money in the States and we
did have a we did have a mention
yesterday of how expensive some of the
drugs were in the states now I've done a
quick survey on this and I really must
talk to someone knows what they're
talking about but this not a new sight
here this NBC NBC News site says 32% of
working Americans currently have medical
debt and 28% owe more than $10,000 a
huge amount of money so quite what's
going on there I'm not entirely sure but
I think it varies a lot from state to
state but the financial burden that
people could be encumbered with after
their emergency care in covering 19
pandemic again could have effects for
decades into the future and is really
quite concerning now there's an old
saying in science that a little bit of
theory can undermine an awful lot of
practice and I'm hoping that this bears
true in relation to the effects of the
black lives matter protests in the
United States and particularly I've got
some information from New York now at
the time these starters you might
remember on about the 28th of May I
expressed a lot of concern that the
crowding and people shouting will cause
aerosolization of the virus and I was
fearful and indeed predicted there will
be an increase in cases but it looks
like I'm being proved wrong on that
which of course I'm absolutely delighted
about so let's look at that and see why
I'm hoping to be wrong so the
epidemiologists were braced for a surge
of new coronavirus cases in New York
particularly as a result of these
ongoing and crowded protests but the
increase in cases it has to be said is
not yet come so this is remarkably good
news and let's hope I continue to be
proved wrong as the empirical data
starts to come out but there are a few
caveats as we'll see now on May 28th the
spread in New York was already slowing
down so you remember that New York had
quite draconian lockdown measures and
that I'd really reduced the rate of the
iris and the benefits carried on from
these so for the people that were tested
in New York in June the proportion of
those testing positive of those that
were tested went down from 3% to 2% so
really quite an encouraging drop so why
have I got this wrong if indeed I have
got it wrong well I think there's some
factors to take into account that I
perhaps didn't take into account
sufficiently and let's look at these now
and the first is because of this
substantial drop that had already
occurred up to the 28th of May the
number of cases in the community in New
York was relatively low that means that
any individuals risk of encountering
another person who's infected was
relatively low so relatively low risk of
encountering a case because of the good
work that had been done over the past
couple of months in New York so that's
one possible region reason having said
that there's limited regional data from
New York so New York this kind of data
for all of New York is not really broken
down into demographics and segments so
that's kind of still a question mark yet
it could have been without the protest
the the rate would have declined even
faster of course we don't know that now
these protests were organized and the
organizers correctly distributed masks
so the New York Times is clear that the
protest organizers were distributing
masks to those that pitched up for the
protest so that's another good thing
given that the protests were currently
were occurring better to wear masks than
not now another good thing was there was
a lot of moving about
so people were moving around outside
they weren't standing in one place so
very often as the repose protesting they
were marching along and walking along
now what I don't know I'll be interested
if someone who was at those marches
would tell me this actually how windy it
was on those days of the protest because
if it was quite breezy in New York that
will
blowing the droplets and the viruses
away but the fact that people were
moving around is a good sign because the
virus wouldn't have time to concentrate
in a particular areas and of course the
biggie
the main factor by far and away is the
fact that the protests were outdoors now
recently we've seen an awful lot have
spread in the United States and a lot of
it has been put down to bars people
indoors in a bar talking into each
other's faces
that's the highest risk situation so
even although there was crowding here
because it was outdoors the risk is
massively less so if you need to do
things at the moment that involve
interacting with other people do them
outdoors and the fact that it was
outdoors and they were moving around
means there was a significant dilution
effect so the virus that any infected
person was breathing out that was
greatly diluted and to get infected with
this viral infection if you get one or
two viruses that's not going to cause
infection that there's an infective dose
you have to get a certain number of
viral particles into you now what that
number of viral particles is you can't
quantify because it will depend on the
immune state of the individual so
someone who's got good levels of
immunity good levels of local immunity
might require a relatively high viral
dose to be infected someone with poor
levels of immunity who for example has
another infection or is malnourished
they could be infected with a much lower
dose of the virus but nevertheless the
point remains that there is an infective
dose and hopefully because it was
outside this infective dose was not
reached now having said that Minnesota
which of course was the epicenter of of
the protests there's been an increase in
cases of covered 19 in young adults as
June has progressed now into July of
course
so was this caused by the protests or
was it caused by the fact that the
bars reopened as well and I think it's
because the bars reopened so the data
from New York indicates that the
protests in Minnesota would have a
lesser effect the opening of the bars
being indoors people talking together
talking loudly after a few drinks closer
contact after a few drinks I think the
bars was probably the bigger the bigger
factor but having said that the data is
limited we have limited data now Andrew
como you might remember governor of New
York he dedicated 15 testing sites to
people who've been at protests and
interestingly after all this time after
more than a month in some cases the data
from these testing sites is not yet
available make what you will of that but
this data is not yet available many
protesters were young adults therefore
less likely to be symptomatic now this
is interesting so if someone contracts
the disease then it's probably going to
be say about a week until they develop
their first symptoms it could be two
weeks of course and then they're going
to be capable of transmitting the
disease but if many people are
asymptomatic that means they could
transmit the disease to another young
person who was also asymptomatic for a
week and then they could transmit it to
an order person it was more prone to
becoming symptomatic and more prone to
catch the disease after another week
then it takes that person another week
to incubate the illness then another
week to get seriously ill so we end up
with very long delay effects so someone
with low risk of symptomatic disease
spreads the disease to someone else with
lower risk of symptomatic disease to
someone else potentially with low risk
of symptomatic disease who spread it to
someone who can get symptoms and die
that that's that's possible so the the
the lag effect in these things is often
much longer than you would expect by
adding together the incubation period in
the symptomatic period it can be a much
longer effect than that because it goes
from A to B to C before it gets to D so
that that's that's another possibility
so we may not know yet so there's the
lack of specific data on the testing
site is the fact that people were young
and might still be passing around
amongst asymptomatic s' city officials
have instructed tracers not to ask a new
covered 19 patients if they attended the
protests now the New York Times did
quote a source for that and it did seem
to be reliable now if that's the case it
means city officials are being
deliberately obtuse unteachable they
don't want to know this now to me any
information any data is good data so if
this is the case if officials in New
York are deliberately deciding to turn
the blind eye to this then there's a
whole tranche of epidemiological data
they are choosing not to collect and
this is the pity this really is a pity
because this could be done without
identifying any individuals this could
be done completely anonymously we do
this in research all the time to win we
have we have ways of ensuring that
people remain anonymous while we still
collect data on groups of people but it
looks like if that case is true and if
you're a New York City official is not
true do tell me but that's what the New
York Times is reporting and then there's
this other sort of weird thing we've got
this is Professor Markel historian and
physician University of Michigan and
this again this was quoted in the New
York Times and the professor said like
most every other aspect of this pandemic
the most predictable thing is the
unpredictability
we are indeed dealing with a weird virus
unfortunately so that's the state of
play from the the New York protest
situation I'm hoping to be proved wrong
I'm hoping unproved long but basically
we don't know yet but I just wanted to
do that in a bit of detail because I
thought that's interesting interesting
principles involved in that discussion
now you might remember a few weeks ago
we had David on from AG unity and one of
the things that organ
is doing a world post links of course
it's an excellent organization one of
the things they are doing are these
superb infographic posters I just love
these infographic posters and they are
working at the moment this report is
particularly from Indonesia now of
course I don't speak the local language
but does it matter you can kind of see
what these means keep your hands clean
stay in your own house or wear a face
covering we could all we could really
use these pictures without without any
explanatory text such as the power of
the the infographic and these are all
over the place this is how many people
can become infected so again you know
very useful graphical information I
think this is that I think this was the
R value so the R value is 2.5 you're
going to get that many in 30 days one
person is going to become that many in
five days that many in 30 days if the R
values one point five one person is
going to become one point five in five
days and that many if you've got the the
R value down to 0.5 the number of cases
is going to reduce so the sort of fairly
powerful them graphics there and that
one again you really don't need language
do you you can see this guy sneezing
these droplets out hence the need for
the 2 meter separation simple powerful
messages for the parts of Indonesia this
one's clearly about crowding at markets
and again even without the language you
can see you can see what it means I
can't zoom in on this program button you
can see what it means that one again
very useful again these these are going
up around Indonesia excellent
looks like these gentlemen they were
erecting the poster
good yep
in between two palm trees yeah proper
respiro tree hygiene proper hand washing
techniques because these are all huge
posters so they're like pop-up public
information things such a simple idea
but it's such a great initiative so it
looks like if you live in Indonesia
you're not going to be ignorant you know
most of the messages are just so simple
we just need to keep reinforcing them
excellent level of mask-wearing here
within these there this family looks
like some planting going on as well he's
getting the argument for me as a hot
cold
well the tent oughta culturalist would
be horticulturalist
so these are all different parts of
Indonesia David will have to have David
back on again very interesting
discussion I'll post a link to the to
the original video where we talk to
David
I'm convinced these all over Indonesia
how are you well I said just that one
looks like it's about temperature risk
of risk of spread low lowest of course
if yeah so the risk of spread if you're
wearing a mask on the infected persons
not you get some protection if the
infected persons wearing a mask and the
non infected person is not wearing a
mask you get more protection so say
that's how dangerous is that they're
saying that's right in the red but if
neither if both people are wearing masks
even better so that's the nice very
simple way to illustrate that there we
see that one again a powerful
illustration that actually I haven't
seen that one before
makes a nice change from beer adverse
doesn't it
don't know if we've seen them all yeah
looks like he's got plenty here because
I think we'd get any idea anyway the
public health campaign in in Indonesia
excellent excellent excellent so I think
that says for this one now I've got
plenty of other news from the UK in
other countries so we'll put that on a
separate video I think