Orlando City Soccer in a Pandemic

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In March of 2020 Major League Soccer suspended the season due to COVID-19. That included the Orlando City Lions.  Five months later Orlando City Soccer re-opened to fans. At that time, Orlando Mayor Buddy Dyer said only 20% of the stadium’s capacity would be permitted and those fans must be season ticket holders. He estimated about 6,000 fans could attend. In October of 2020 a match was canceled because two staff were infected with COVID-19.

Orlando City Soccer Re-opened on April 16, 2021. All City Soccer Staff are supposed to have been vaccinated. On May day of 2021 the Lions played Cincinnati at home. Pam Schwartz had been offered a chance to watch the game from box seats so we decided to go. The mask mandates had just been changed by the CDC allowing people who have been vaccinated to not wear masks when outside. The CDC warned that masks should continue to be worn at any crowded stadium setting.

We were able to park right next to the stadium and security was surprisingly lax. There was a temperature check and hand sanitizer available at the entrance. I just had to raise my hands above my head and walk right through a metal detector. I usually have to empty out my pockets which were full of art supplies. My pencils are often mistaken for weapons, but not on this day.

In NYC fans can get a vaccine as they enter Yankee Stadium or Mets Stadium. On top of that the ticket is free if the fan gets a vaccine. A growing number of venues are asking visitors to prove they’ve gotten their shots by displaying what’s called a “vaccine passport.” Oracle Park, home of the San Francisco Giants, and Citi Field, home of the New York Mets, are among a growing list of sports spaces that now require digital vaccine verification’s. Those teams and others have been using an app called Health Pass from tech company Clear for COVID-19 screening.

The NBA has employed COVID sniffing dogs. Researches have found that the dogs are amazingly accurate at detecting people who are infected. Anyway other than a temperature check there was no assurance that infected individuals were not entering the Orlando City Soccer game. I had my vaccination card in my wallet but it was not needed.

Pam and I have both had two shots of the Pfizer vaccine so we are both about 95% protected. We were assured that everyone in the box where we watched the game were also fully vaccinated, but how can you really be sure that is true? The box seats offered some separation from the crowd. Fireworks went off during the Star Spangled Banner and I could smell the gun powder through my mask which was a stark reminder that everyone in the stadium was swapping air. The bleachers to my left were full of the more fervent fans. They stomped on the bleachers. A drum corp and flag waving fans shouted through out the match. I noticed many fans felt they needed to remove their mask in  order to shout their anger during the game. That kind of defeats the point of the mask. In those stands there was no social distancing. Shirtless men danced up and down the aisles belly to belly and one guy flung his beer all over the crowd around him. You would think there never had been a pandemic in Orlando. The COVID-19 numbers slowly continue to drop in America but the fervent COVID denial-ism that I saw in the stands will most certainly help circulate more infections in Orlando.

India is experiencing a devastating Covid-19 second wave killing thousands people every day. Despite the carnage, the Indian Premier League (IPL) cricket tournament is playing on less than a mile from hospitals filled to capacity.  “I’m advised that the Indian government is of the view that playing the IPL while the population is in lock down provides a few hours of joy and respite each day at an otherwise difficult time for the country,” Pat Cummins wrote in a statement on Twitter.

It felt good to be out and about sketching in public again, and I hope that the box seats, vaccine and mask were enough to keep me safe. I had a beer, but never drank it since I didn’t want to take my mask off. I thought getting back out to sketch on location would involve incremental steps, but this was like jumping into the deep end of the pool. 11,503 fans filled the stadium which can hold 25,500 fans. Is that too crowded? Only time will tell.

There have been 34,817 new cases of COVID-19 in Florida in the past week. 434 Florida residents died from COVID-19 this week. There have been 3,841 new cases this week. 31 Floridians died today, May 2, 2021.
Orange County Florida does not meet the criteria for the next phase of reopening according to the Florida Community Dashboard.
Decrease in ER Visits for COVID-like illness: NO
Decrease in ER Visits for influenza-like illness: NO
Decrease in new cases by date: NO
Decrease in percent positivity OR positivity below 10%**: NO  

One Third Test Positive

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The Wall Street Journal reported that a flight from Deli, India to Hong Kong was packed tight like sardines in a tin can. All passengers had to stay at a quarantine hotel upon arrival. More than a third of the passengers on flight UK6395, 52 so far — have tested positive for COVID-19. They had all tested negative before the flight.

One passenger, Mrs. Fathima said she feared her family picked up the infections on the April 3, 2021 journey, despite wearing masks almost the entire time and avoiding using the restrooms on board. Some passengers — including one in the same row — coughed repeatedly during the six-hour flight, people took masks off to eat, and some parents walked their crying children up and down the aisle, she said.

There is a debate as to weather the passengers were infected on the flight or in the quarantine hotel. Genome testing is being done to try and figure out the source of infection.  COVID spread could still have happened on flight UK6395 if a highly infectious patient had not worn a mask properly, or if germs had contaminated common facilities such as toilets when a passenger did not flush the water closet with the lid closed. Forbes reported that a new case study from New Zealand’s Ministry of Health finds that Covid-19 can spread on long-haul flights. In September, 2020 two other international studies came to the same conclusion. And last month, an Irish study linked 59 Covid-19 cases to one seven-hour flight.

According to The Sun, Poonam Nanda, the director of Nanda Travel, based in Hong Kong, added: “This one flight appears to be an astonishing outlier and we are all confounded by these numbers.” Hong Kong has now banned all flights from India starting  May 3, 2021 for 14 days.

The US Centers for Disease Control and Prevention (CDC) recently eased its domestic and international travel guidance for vaccinated people, stating that travelers who are fully vaccinated “can travel safely within the United States” but noted a greater risk for international travel. However, the agency is still discouraging nonessential travel due to rising numbers of Covid-19 infections. Driven by extremely contagious variants that have invaded all 50 states, the virus is currently hitting healthier 30 to 50 year-olds hard.

Breakthrough Cases

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The CDC has reported 5800 breakthrough cases of COVID-19 out of the nearly 77 million people who have been fully vaccinated. 65 percent of the cases were in women, and just over 40 percent were in people ages 60 and up. About 29% of those experiencing breakthrough infections experienced no symptoms, however, seven percent of people were hospitalized, and 74 people died.

It is unclear why asymptomatic individuals were tested for Covid-19 after being fully vaccinated. It could be that some employers, such as health care systems, require regular testing.

People are considered fully vaccinated two weeks after they receive their second dose of a two-dose vaccine, such as the Pfizer-BioNTech or the Moderna vaccines, or two weeks after a single dose of the Johnson & Johnson vaccine. (Use of the Johnson & Johnson vaccine is currently paused in the U.S. as federal health officials investigate cases of rare blood clots linked to the shots.) In clinical trials, the Pfizer and the Moderna vaccines were found to be around 95 percent effective against Covid-19, and the Johnson & Johnson vaccine was 72 percent effective against moderate-to-severe illness in its U.S. trial.

“I would encourage people to continue, once they’re vaccinated, to use all the prevention measures that we’ve been talking about when they’re outside their home, including masking and distancing and whatnot. And all of that should be active in the workplace,” the CDC’s director, Dr. Rochelle Walensky, said during a briefing for the press on April 12, 2021. These breakthrough cases are another reason that people should continue to wear masks, social distance and wash hands since research is not yet in on weather they could pass the disease on to others.

Vaccination remains critical to ending the pandemic. “It does not reduce the risk to nil, but it does reduce the risk to something that we can handle.”

Johnson & Johnson Blood Clots

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The Food and Drug Administration (FDA) recommended there be a “pause” for the Johnson & Johnson  vaccine after 6 women developed rare brain blood clots after getting the vaccine. One woman died.

The CDC‘s Advisory Committee on Immunization Practices will convene April 14, 2021 for an emergency session, with a vote scheduled on “updated recommendations for use” before the group adjourns at 4:30 p.m. Eastern Time.

Dr. Anthony Fauci, President Joe Biden‘s chief medical adviser, told CBS Evening News, that it appeared that the adverse effect occurred within six to 13 days, and “so if you’ve had it a month or two ago, I think you really don’t need to worry about anything.” He went on to emphasis that the chance of these adverse side effects is “less than 1 in a million,” but he said to be alert to the symptoms such as severe headache, some difficulty in movement — such as in a neurological type of a situation — or some chest discomfort and difficulty breathing.

The cases the FDA and CDC are investigating occurred involved a blood clot called cerebral venous sinus thrombosis, which was seen alongside low levels of blood platelets, according to their statement. All of the six women were between the ages of 18 and 48. “Treatment of this specific type of blood clot is different from the treatment that might typically be administered. Usually, an anticoagulant drug called heparin is used to treat blood clots. In this setting, administration of heparin may be dangerous, and alternative treatments need to be given,” they said.

The agencies said the “adverse events” seem to be extremely rare, but that the pause is important so that health care providers can be made aware of the reactions and properly recognize and manage the cases, given the unique treatment required. It has not yet been determined if the vaccine was the direct cause of the blood clotting cases. The AstraZeneca vaccine, used in Europe and not yet available in the USA has also been linked to cases of blood clots. Both the AstraZeneca and the Johnson & Johnson vaccines use an inactivated form of a common cold virus, called an adenovirus, to teach the immune system to recognize the spike protein found of the surface of the coronavirus. Experts believe it’s possible that on rare occasions, the adenovirus itself could lead to clotting, due to a reaction involving platelets.

Regardless this will become a rallying point for any anti vaxers.

5 States: 44% of Cases

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CNN reported that five states account for 44% of the COVID-19 cases in the past week according to data from Johns Hopkins University. New York, Michigan, Florida, Pennsylvania and New Jersey had more than 196,400 of the country’s 453,360 cases reported in the last week, according to data available the morning of April 7. 2021.

Michigan has been hit especially hard with 6,600 cases a day over a week as opposed to 1,350 daily cases five weeks ago. The highly contagious and deadly B.1.1.7 variant of the COVID virus has helped cause the spike in cases. People are also experiencing pandemic fatigue and are taking fewer precautions giving the virus plenty of opportunity to spread.

The B.1.1.7, first identified in the UK, is now the most common strain of coronavirus in the United States, CDC Director Dr. Rochelle Walensky said April 7, 2021.

With more-transmissible variants adding up, surges like Michigan’s may soon be seen more widely, even though vaccination rates have increased nationally, epidemiologist Dr. Michael Osterholm said. The CDC says more than 16,200 cases of the B.1.1.7 variant have been confirmed in surveillance testing in the US, and B.1.1.7 has been found in every state. This number does not represent the total number of such cases circulating in the United States, but rather only those found by analyzing samples. Florida has more that 3000 confirmed cases of the B.1.1.7 UK variant, more than any other state.

The US has averaged 774 Covid-19 deaths a day over the last week. According to the latest CDC data, 19.4% of the total US population was fully vaccinated as of the morning of April 7, 2021; and 57.4% of people age 65 and older are fully vaccinated. But the US has a long way to go before reaching herd immunity. Dr. Anthony Fauci has estimated 70%-85% of the population needs to become immune.

Future of Cruising

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There had been at least 3,689 COVID-19 or coronavirus-like illness cases on cruise ships in U.S. waters, “in addition to at least 41 reported deaths,” the CDC said last October 2020. The Centers for Disease Control and Prevention (CDC) recommends that all people avoid travel on cruise ships, including river cruises, worldwide. That’s because the chance of getting COVID-19 on cruise ships is high, since the virus appears to spread more easily between people in close quarters aboard ships.

Florida Governor Ron DeathSantis (R) is threatening to sue the federal government if the CDC doesn’t allow cruises to restart by the summer. The cruise industry is worth billions of dollars for the state’s economy, according to the Associated Press (AP).

University of Florida epidemiologist Cindy Prins told AP it’s “too early” for cruises to resume, given the higher risk of the virus spreading among passengers mingling on ships for long periods. She noted that “testing and symptom screening are not perfect methods of prevention.” Prins added companies would have to limit passenger numbers, with crews required to show they’re fully vaccinated in order to lower the risk of the virus spreading — something DeathSantis opposes, and no industry leader addressed. DeathSantis also opposed COVID-19 vaccine passports.

Florida became one of the world’s epicenters for the virus last July, forcing DeathSantis to pause the state’s first round of reopening. He fully lifted restrictions on restaurants last September, as part of a commitment to reopen the economy, saying “we’re not closing anything going forward.” He never set up a statewide mandate to wear masks.

Major U.S. cruise lines are accepting bookings for June 2021 trips out of Florida ports, a Spectrum News review has found. The bookings come as Norwegian Cruise Line this month canceled all cruises through June 2021. “The timing for re-start in the U.S. continues to be uncertain,” On April 6, 2021 Carnival said in a statement to Spectrum News. On April 6, 20211, Carnival Cruise extended its pause of all operations out of U.S. ports through June 30, 2021.

COVID-19 Deaths Under Counted in Florida

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A study published by The American Journal of Public Health this month says that Florida has under reported its coronavirus deaths by thousands of cases. The report stated that the impact of the pandemic in Florida “is significantly greater than the official COVID-19 data suggest.”

Researchers came to their conclusions by comparing the estimated deaths in the state from March to September and compared that figure to the actual number of recorded deaths, or the “excess deaths.”

Moosa Tatar, public health economist at the University of Utah and lead researcher of the study said, “I am sure that COVID-19 is responsible for most of these excess deaths.” According to Tatar’s study, nearly 5,000 deaths should have been included among the listed COVID-19 fatalities, but were instead attributed to other causes.

In May 2020, Rebekah Jones, a data scientist who helped create the state’s Covid-19 data dashboard, was fired from her role running a COVID-19 dashboard for the Florida Department of Health. Jones claims she was fired after refusing to falsify state Covid-19 data. Jones has harshly criticized Florida Governor Ron DeSantis‘ handling of the pandemic and filed a whistleblower complaint. She was fired and later her home was raided by police who took all her computer equipment. She has been running her own dashboard to keep track of Florida’s COVId-19 statistics. Her dashboard was back online in a few days when donors helped her get a new computer.

Governor DeathSantis has been less than forthcoming in releasing data to keep the public informed about the pandemic. He has consistently withheld information until media outlets sue the state to get the information released. Florida state Rep. Anna Eskamani said, “The governor does have a habit of picking the most positive numbers and ignoring the bad numbers. He hand selects data to fit a narrative rather than acknowledge the reality for people.” She said, “Access to even the basic tools to make decisions doesn’t seem like a priority for the governor.”

An investigation by the South Florida Sun Sentinel published in December found that the DeSantis administration worked to minimize bad news about the pandemic and spread misinformation, with some officials withholding crucial data about the spread of the virus.

According to the CDC, Florida has confirmed more than 33,000 deaths due to COVID-19 and more than 2 million cases of the coronavirus. Some 9.4 million coronavirus vaccine doses have been administered in the state. Florida has the fourth-highest number of COVID-19 deaths in the country, according to the Johns Hopkins University website that tracks national and international data.

Impending Doom

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New CDC Chief Rochelle P. Walensky warned on March 29, 2021 of her ‘Impending Doom‘ as Covid-19 Cases Rise. The following is a summery of her statement…

“Yesterday, we in America surpassed 30 million cases of COVID-19. CDC’s recent data shows that the 7 day average of new cases is slightly less than 60,000 new cases a day. This is a 10% increase compared to the prior 7 day period. Hospitalizations have also increased. Admissions rose from 4600 to 4800 a day compared to the prior seven day period. And deaths, that typically lag behind cases and hospitalizations, have started to rise, increasing 3% to about 1000 deaths a day.”

“When I fist started at CDC about two months ago, I made a promise to you. I would tell you the truth even if it is not the news you wanted to hear. Now is one of those times when I have to share the truth, and I have to hope and trust that you will listen.”

“I am going to pause here, I am going to loose the script and I am going to reflect on the recurring feeling I have of impending doom. We have so much to look forward to. So much promise and potential of where we are. And so much reason for hope. But right now I am scared. I know what it is like as a physician to stand in that patient room, gowned, gloved, masked, shielded and to know you will be the last person to touch someone’s loved one, because their loved ones could not be there. I know what it is like when you are the health care provider and you are worried that you do not have the resources to take care of the patient in front of you. I know that feeling of nausea when you read the crisis standards of care, and you wonder if there are going to be enough ventilators to go around, and who is going to make that choice. I know what it is like to pull up to your hospital every day and see the extra morgue sitting outside.”

“So I am speaking today not only as your CDC Director, but as a wife, as a mother, as a daughter, to ask you to hold on just a little while longer. I so badly want to be done, I know you all want to so badly be done, we are almost there but not quite yet. And so I am asking you to just hold on a little longer, to get vaccinated when you can, so that all of those people that we all love, will still be here when this pandemic ends.”

Original Sin

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The Original Sin of the United States response to the COVID-19 Pandemic was the inability to get enough tests to isolate and contain the outbreak. The US missed a critical window to ramp up testing and implement precautionary procedures to get on top of the virus.

January 2020: The World Health Organization opted to use an approach developed by Germany to test for COVID-19. The United States instead decided to develop its own testing approach. The German testing method was made public on January 13, 2020 and the American testing method was made public on January 28 2020. The American tests were defective and gave inaccurate readings. Because of this, The United States had a very slow start in widespread testing. The CDC gave restrictive guidelines on who could be eligible for COVID-19 testing. The initial criteria were people who had recently traveled to certain countries, or people with respiratory illness serious enough to require hospitalization, or people who have been in contact with a person confirmed to have coronavirus.

On February 19, 2020 the first U.S. patient with COVID-19 of unknown origin (a possible indication of community transmission) was hospitalized. The patient’s test was delayed for four days because he had not qualified for a test under the initial federal testing criteria. By February 27, 2020 fewer than 4,000 tests had been conducted in the U.S. Although academic laboratories and hospitals had developed their own tests, they were not allowed to use them until February 29, 2020 when the FDA issued approvals for them and private companies.

On February 25, 2020 a group of researchers from the Seattle Flu Study defied federal and state officials to conduct their own tests, using samples already collected from flu study subjects who had not given permission for COVID-19 testing. They quickly found a teenager infected with COVID-19 of unknown origin, indicating that an outbreak had already been occurring in Washington State for the past six weeks. State regulators stopped these researchers’ testing on March 2, 2020.

On March 5, 2020 Vice President Mike Pence, the leader of the coronavirus response team, acknowledged that “we don’t have enough tests” to meet the predicted future demand. By March 11, 2020 the U.S had tested fewer than 10,000 people. On March 12, 2020 Dr. Anthony Fauci acknowledged “a failing” of the U.S. system and that the demand for SARS-CoV-2 tests was not being met.

The first COVID-19 cases in the U.S. and South Korea were identified at around the same time. Critics say the U.S. government has botched the approval and distribution of test kits, losing crucial time during the early weeks of the outbreak, with the result that the true number of cases in the United States was impossible to estimate with any reasonable accuracy. South Korea’s aggressive testing, contact tracing and isolation of those infected succeeded where the US response failed. They flattened the curve.

By March 22, 2020 drive-through testing had started in more than thirty states, although the Associated Press reported that “the system has been marked by inconsistencies, delays, and shortages,” leading to many people waiting hours or days even though they showed symptoms and were recommended by a doctor to get a test.

On April 6, 2020 Federal health inspectors released a report stating that hospitals were experiencing shortages of test supplies, personal protective equipment (PPE), and other resources due to extended patient stays while awaiting test results.

By early May, 2020 the U.S. was testing around 240,000 to 260,000 people per day, but this was still an inadequate level to contain the outbreak.

By June 24, 2020 thirteen of the forty-one federally funded community-based testing sites originally established in March were set to lose federal funding. They remained under state and local control. Trump administration testing czar Admiral Giroir described the original community-based testing program as “antiquated”. In June 2020 Trump said several times that the U.S. would have fewer cases of coronavirus if it did less testing—”If we didn’t do testing, we would have no cases”—and he told a June rally that he had ordered a slowdown in testing. In July 2020 he continued to suggest that “if we did half the testing we would have half the cases”.

In August 2020 the CDC quietly lowered its recommendation for who should be tested, saying that people who have been exposed to the virus but are not showing symptoms “do not necessarily need a test”. The previous recommendation had been that people exposed to the virus should be “quickly identified and tested” even if they are not showing symptoms, because asymptomatic people can still spread the virus.

In December, 2020 the FDA authorized the use of a rapid testing kit developed by Brisbane, Australia-based Ellume Health. The test is available for purchase without a prescription for about $30 and can give results in about 20 minutes. The FDA approved the test for people with and without COVID symptoms.

Effective January 26, 2021 the CDC will require all air passengers two years of age and over entering the United States (including U.S. citizens and Legal Permanent Residents) to present a negative COVID-19 test, taken within three calendar days of departure​, or proof of recovery from the virus within the last 90 days.

March 5, 2021 the FDA issued an Emergency Use Authorization (EUA) to Cue Health Inc. for its over-the-counter at-home diagnostic test for COVID-19. As of March 9, 2021, there are 340 tests and sample collection devices are authorized by the FDA under EUAs.

Joe Biden met his goal of 100000 vaccine shots in arms early (58 days) and reset his goal for 200000 shots in arms in his first 100 days. He called for Americans to do their part to end the pandemic by wearing masks and keeping up social distancing as the vaccine rollout ramps up. “We’re in a war with this virus,” he said. Had testing been rolled out with the same level of resolve, hundreds of thousands of lives could have been saved.

 

Early Spike

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With COVID vaccines finally rolling out in a timely manner the tenancy of clueless governors is to assume the pandemic is over. The trouble is that the daily cases in America have plateaued at about 50,0000 to 60,000 cases a day which is similar to the case counts during last summer’s surge.

CDC officials warned a far more contagious variant of the coronavirus first identified in Britain (B.1.1.7) will likely become the dominant source of infection in the United States. Florida is leading the country with the most cases of the U.K. coronavirus variant. B.1.1.7 is about 50 percent more contagious than the original strain. This the virus can spread much faster and  cause more deaths than the original virus.

Dr. Fauci warned against early re-openings, he said, “We’re not in the end zone yet. And that’s one of the issues that when you plateau, there’s always the risk of a surge,” the top infectious disease expert added. Despite this warning, states like Texas and Mississippi have dropped mask mandates and opened 100%. President Joe Biden declared that every American should be eligible to get vaccinated by May 1, 2021. If everyone gets the first available vaccine tragedy can be averted. However about 49% the former president’s supporters have said they are against getting vaccinated. The former president and his wife were vaccinated in secret before leaving office. Fauci said he wishes the former President would use his popularity among Republicans to persuade more of his followers to get the COVID-19 vaccine.