On August 7, South Dakota Governor Noem sent out a press release expressing An Optimistic Outlook about COVID-19. She brought a grade-school vocabulary to the discourse:
Last week, when I was in Sioux Falls to discuss reopening schools with parents and superintendents, I saw a great bulletin board in a 4th grade classroom. It said, “Put your positive pants on.” That message reminded me of a lesson that is often easy to forget: an optimistic outlook can be tremendously helpful when responding to life’s challenges. That’s especially true in the fight against COVID-19. . . .
So let’s remember to “put our positive pants on.” We need to emphasize facts, not fear. Let’s tell the story of what works in the fight against this virus, and let’s continue to get through this together.
The first term Governor from Castlewood made a number of assertions in the document. So how are we doing with regard to her claims?
There's this:
As we get more and more data about this virus, it’s becoming increasingly clear that most of us aren’t at high risk. This virus has a clear vulnerable population; we know that elderly folks are far more likely to get seriously ill, especially when paired with certain pre-existing health conditions. That leaves about 95% of the population that is not at risk for serious infection. For these folks, we can continue getting back to normal, while making the best decisions for ourselves and our loved ones.
We need to make sure to take care of the vulnerable population, and that starts with good hygiene and social distancing. Our vulnerable friends and family should continue to take extra precautions and to stay home when they are able, and we can all take precautions to avoid spreading the virus to them.
How has the coronavirus spread in South Dakota? Trevor Mitchell reported in Nearly 30 reported dead from COVID-19 Friday in South Dakota, another record high, in the Argus Leader on Friday:
South Dakota saw a record number of deaths from COVID-19 for the second day in a row as 28 more people died according to data released Friday morning by the South Dakota Department of Health.
An additional 816 active cases brings the state to a total of 14,426 — another record for the state.
The new deaths bring the state to a total of 510 dead from COVID-19.
Deaths occurred among residents of Aurora (1) Beadle (3) Brookings (1) Buffalo (1) Butte (1) Dewey (1) Faulk (1) Jackson (1) Lincoln (4) Lyman (1) Marshall (1) Minnehaha (3) Todd (2) Turner (5) and Union (2) counties.
Of the people who died: one was in the 50-59 age range, two people were 60-69, nine people were 70-79, and the largest group by far was 16 deaths among people over 80.
Current hospitalizations rose by 18, with 493 people currently in South Dakota hospitals with COVID-19. The number of people listed as having been ever hospitalized went up by 68.
State data shows just over 17% of hospital beds are occupied by COVID-19 patients, with 31% available. Just over 30% of the state's ICU beds are occupied by COVID-19 patients, with nearly 30% of them available.
Today, the Brookings Register reports in 13 new COVID-19 deaths, 1,337 new cases in South Dakota Saturday:
The new deaths, eight women and five men, are being reported in Brown, Davison, Grant, Lawrence, Lincoln, Oglala Lakota, Roberts, Spink (2), Todd (2) and Turner (2) counties. The age ranges of the deceased are one 30-39 years, one 50-59 years, one 60-69 years, two 70-79 years and eight in the 80-plus years category.
Increases in positive cases Saturday included, but are not limited to, 49 in Beadle County, 54 in Brookings, 57 in Brown, 45 in Codington, 56 in Davison, 30 in Dewey, 31in Hughes, 42 in Lawrence, 57 in Lincoln, 27 in Meade, 295 in Minnehaha, 21 in Oglala Lakota, 164 in Pennington, 24 in Union and 22 in Yankton.
The counties with the highest total case counts are Minnehaha (14,116), Pennington (5,639), Lincoln (3,598), Brown (2,501) and Codington (1,928).
In the Star Tribune, Associated Press staffers Stephen Groves and James MacPherson report in Doctors fear more death as Dakotas experience virus 'sorrow':
With coronavirus cases running rampant in the Dakotas and elected leaders refusing to forcefully intervene, the burden of pushing people to take the virus seriously has increasingly been put on the families of those killed.
The ranks of those who know what it means to lose someone they love to COVID-19 are on the rise. North Dakota and South Dakota have the nation's worst rate of deaths per capita over the last 30 days. Despite advances in treating COVID-19 patients, hundreds more people have died in recent weeks than during any other period — a grim exclamation point on the virus outbreak slamming the northern Plains and Upper Midwest.
In the Dakotas, the virus has shown few signs of slowing down. With winter approaching and hospitals scrambling to make room for COVID-19 patients, medical experts worry that virus deaths will continue to climb in a region where people have been slow to adopt mitigation measures like wearing masks. The Republican governors of both states have derided government orders to help halt the outbreaks, leaning on ideals of limited government. . . .
South Dakota reported 252 deaths, a 98% increase in the last 30 days. It had a death rate of roughly 29 people per 100,000 over the last 30 days, according to the Johns Hopkins data. . . .
In South Dakota, Noem has cast doubt on whether wearing masks in public is effective, saying that she'll leave it up to the people to decide. She has said the virus can't be stopped. The state's largest medical groups recently launched a campaign to make it clear that masks work. . . .
Back in August, Noem also claimed:
Data shows that the antiviral drug Remdesivir substantially reduces the mortality rate and cuts recovery time significantly. Similarly, a study out of Michigan’s Henry Ford Health System indicates that hydroxychloroquine may cut mortality rate for COVID-19 in half. And progress on a vaccine is moving along ahead of schedule.
Those positive pants talking points appear to have dimmed. In an article originally published on October 8, the New England Journal of Medicine concluded in Remdesivir for the Treatment of Covid-19 — Final Report:
Given the preliminary results about remdesivir, the Food and Drug Administration issued an Emergency Use Authorization on May 1, 2020 (modified on August 28, 2020), to permit the use of remdesivir for treatment in adults and children hospitalized with suspected or laboratory-confirmed Covid-19. Remdesivir has also received full or conditional approval in several other countries since that time. However, given high mortality despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient for all patients. Current strategies are evaluating remdesivir in combination with modifiers of the immune response (e.g., the Janus kinase [JAK] inhibitor baricitinib in ACTT-2, and interferon beta-1a in ACTT-3). A variety of therapeutic approaches including novel antivirals, modifiers of the immune response or other intrinsic pathways, and combination approaches are needed to continue to improve outcomes in patients with Covid-19.
At Science, Jon Cohen and Kai Kupferschmidt reported on Friday in A very, very bad look’ for remdesivir:
October was a good month for Gilead Sciences, the giant U.S. manufacturer of antivirals. On 8 October, the company inked an agreement to supply the European Union with its drug remdesivir as a treatment for COVID-19—a deal potentially worth more than $1 billion. Two weeks later, on 22 October, remdesivir became the first COVID-19 drug approved by the U.S. Food and Drug Administration (FDA). The decisions mean Gilead can cash in big in two major markets, both with soaring COVID-19 cases.
But they baffled scientists who have closely watched the clinical trials of remdesivir unfold over the past 6 months—and who have many questions about its worth. At best, one large, well-designed study found that remdesivir, which must be infused intravenously, modestly reduced the time to recover from COVID-19 in hospitalized patients with severe illness. A few smaller studies found no impact on the disease whatsoever, and none has found that the antiviral reduces patients' level of SARS-CoV-2, the causative virus. Then, on 15 October, the fourth and largest study delivered what some believed was a coup de grâce: The World Health Organization's (WHO's) giant Solidarity trial showed that remdesivir does not reduce mortality or the time COVID-19 patients take to recover. . . .
Oh. On November 6, in The Lancet, April Jorge looked at Hydroxychloroquine in the prevention of COVID-19 mortality:
COVID-19 has affected tens of millions of individuals across the globe and upended the lives of countless others. Despite advances in supportive care and treatment, mortality remains high, and prevention of infection continues to be crucial.Early on in the pandemic, hydroxychloroquine was suggested as a possible prevention method or treatment for COVID-19, given evidence of in-vitro inhibition of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),propelling this mainstay treatment of rheumatic diseases to prominence and controversy. However, multiple high-quality studies subsequently showed no benefit of hydroxychloroquine use as post-exposure prophylaxis or as a COVID-19 treatment.As enthusiasm for hydroxychloroquine as a treatment of SARS-CoV-2 infection rapidly declined, the possibility of the use of this medication to prevent COVID-19 remained, with multiple randomised clinical trials designed to address this possibility. Furthermore, with the spotlight shone on hydroxychloroquine with regards to COVID-19, patients with rheumatic diseases and their care providers have been highly interested as to whether this commonly used medication for systemic lupus erythematosus and rheumatoid arthritis could protect against adverse outcomes of COVID-19.In The Lancet Rheumatology, Christopher Rentsch and colleagues address whether hydroxychloroquine use before SARS-CoV-2 infection could prevent mortality from COVID-19.They did a population-based cohort study using the OpenSAFELY platform, an electronic health records database capturing 40% of the population of England. They included 30 569 patients with systemic lupus erythematosus or rheumatoid arthritis who were already taking hydroxychloroquine in the 6 months before what was considered as the start of the pandemic in England and 164 068 patients with these rheumatic diseases who did not use hydroxychloroquine.Their primary outcome was COVID-19 mortality per death certificate data, and they used cause-specific cox regression models, adjusting for age, sex, ethnicity, geographical region, and other immunosuppressive drugs (ie, other conventional synthetic disease-modifying rheumatic drugs [DMARDs] and oral corticosteroids). The study found no significant difference in standardised cumulative COVID-19 mortality associated with hydroxychloroquine use (0·23% among hydroxychloroquine users and 0·22% among non-users) with an adjusted hazard ratio of 1·03 (95% CI 0·80–1·33). The findings were similar in an extended analysis additionally adjusting for established or suspected risk factors for COVID-19 mortality. Additionally, no difference was seen in non-COVID-19 mortality associated with hydroxychloroquine use.These findings are not surprising given the mounting body of literature suggesting no clinical benefit for hydroxychloroquine use against COVID-19. However, this study is important in addressing the potential role, or lack thereof, for hydroxychloroquine as a preventive medication for this novel infectious disease. This observational study is the largest, to our knowledge, to address this issue thus far.. . .available evidence does not support the use of this medication in the prevention or treatment of COVID-19.
As we continue planning to reopen schools in the fall, let’s remember that kids are less likely to contract the virus and far less likely to get seriously ill. In fact, science suggests that influenza is a greater risk to kids than COVID-19. If children do contract the virus, data indicates they are less likely to spread it to others.
3M announced Friday that two new production lines installed at its Aberdeen factory soon will increase production of N95 respirator masks due to high demand amid the coronavirus pandemic.
The 3M facility will be adding 120,000 square feet to expand production of N95 masks, thank to grants issued by U.S. Department of Defense contracts to further expand its U.S. production of N95 respirators.
3M produced about 22 million masks a month in the United States in 2019. Due to increased demand from the pandemic and the Aberdeen expansion, that number will increase to nearly 95 million per month by the end of 2020.
Two buildings have been constructed and one production line is already running.
3M anticipates as many as 100 new jobs will be created from the expansion, in addition to the 200 jobs that were added since January.
Gov. Kristi Noem, who attended the announcement of the expansion Friday with South Dakota's congressional delegation, said the increased production of N95 masks and local job growth has helped boost the economy.
"That's the example we're setting here in South Dakota that we can fight the virus, that we can fight the virus together and keep people safe and address public health, but also that we can work together to make sure that families have their other needs met as well," she said.
While the rest of the delegation wore non-N95 masks (FDA guidance here) at other times during the event, Noem appears to have remained maskless throughout. From the Aberdeen News via the Argus Leader:
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