For May 4th, 101 days since Canada’s first diagnosed case and we record the biggest yet one day jump (+2,760) in new cases.

@DrZoeHyde (add her to your follows)

Latest #COVID19 forecast from team at Imperial. Epidemic likely declining in 4 countries (inc. France, Italy, & Spain), stabilising or growing slowly in 23 (inc. Germany, Netherlands, UK, & USA), and growing in 9 (inc. Brazil, Canada, India, & Russia).

Dr Matt Strauss : The underground doctors’ movement questioning the use of ventilators

With our modern insistence on evidence-based medicine, we would never significantly invest in medical infrastructure that has not been proven beneficial by a randomised control trial. Except of course we have, and we continue to do so. No area of medicine is immune to these lapses. But it is my own specialty of life-support medicine where this has recently been thrown into the sharpest relief.

 

As I previously reported in the Spectator, there has never been a randomised control trial to show that sedating people with severe pneumonia in order to put a breathing tube down their throat (the process known as intubation), in order to hook them up to a mechanical ventilator is lifesaving at any particular point in their illness. Neither has there been such a trial in chimps, dogs, sheep or rats. Yet it is a firmly entrenched belief that intubation and ventilation are necessary once a patient requires a high level of supplemental oxygen. Or it was.

THE US SECRETARY OF STATE IS ALWAYS THE LAST TO KNOW: ‘Enormous evidence’ connects coronavirus outbreak to Wuhan lab

University of Texas under investigation for possible ties to Wuhan biolab: Suspicions arose that UT neglected to report all gifts and exchanges between itself and the Chinese state-owned institutions. 

Belgium is a hot zone for COVID-19 and nobody knows why.

Your related news and morning developments can be shared in the comments.

Update: Related

A worthwhile read from Michael Yon, on how the famously combative Thais approach different challenges with different societal solutions.

“The disease itself appears to be shape-shifting before our eyes.”

We are now almost six months into this pandemic, which began in November in Wuhan, with 50,000 Americans dead and 200,000 more around the world. If each of those deaths is a data point, together they represent a quite large body of evidence from which to form a clear picture of the pandemic threat. Early in the epidemic, the coronavirus was seen as a variant of a familiar family of disease, not a mysterious ailment, however infectious and concerning. But while uncertainties at the population level confuse and frustrate public-health officials, unsure when and in what form to shift gears out of lockdowns, the disease has proved just as mercurial at the clinical level, with doctors revising their understanding of COVID-19’s basic pattern and weaponry — indeed often revising that understanding in different directions at once. The clinical shape of the disease, long presumed to be a relatively predictable respiratory infection, is getting less clear by the week. Lately, it seems, by the day. As Carl Zimmer, probably the country’s most respected science journalist, asked virologists in a tweet last week, “is there any other virus out there that is this weird in terms of its range of symptoms?” […]
 
In a fantastic survey published April 17 (“How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes,” by Meredith Wadman, Jennifer Couzin-Frankel, Jocelyn Kaiser, and Catherine Matacic), Science magazine took a thorough, detailed tour of the ever-evolving state of understanding of the disease. “Despite the more than 1,000 papers now spilling into journals and onto preprint servers every week,” Science concluded, “a clear picture is elusive, as the virus acts like no pathogen humanity has ever seen.”

“Doctors at New York City's Mount Sinai Hospital say a growing number of recovered COVID patients are developing heart disease, lung disease, blood clots and kidney problems. All issues they did not have before.” https://t.co/cMloxZsoEi

— fred walton (@fredwalton216) May 1, 2020

The blood clot issue — “The virus is acting as if its primary target is the endothelium”

Watch This Before It’s Removed by YouTube:

#FollowTheMoney

A morning sampling.

This is insane: In a memo this week, Dean Lett, director of long-term care for the city [of Ottawa], asked families to stop visiting their loved ones at windows “to help ensure that physical distancing remains in place for all our residents.”

Practicing communist De Blasio’s stubborn refusal to take the coronavirus seriously may have caused thousands of deaths.

Ask him about Taiwan: The WHO refuses to clear WHO official Dr. Bruce Aylward to speak at the Parliamentary Health Committee. The committee may take the unusual step of issuing a summons, which would force Aylward to testify.

At Instapundit:

Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study. A Facebook friend’s succinct summary of the findings in this study: “Just under half (49.7%) of cases had normal vitamin D status, and only 4% of them died. Just over a quarter (27%) had insufficient vitamin D status, and most of them (88%) died. Just under a quarter (23%) had deficient vitamin D status, and almost all of them (99%) died.”
 
The study calls anything over 30 ng/ml as normal Vitamin D; my doctor prefers in the neighborhood of 60. No guarantee from these data, though, that more is better, but I wouldn’t be surprised if that were the case. On the other hand, you’d expect lower death rates in Italy and Spain than Germany, then, wouldn’t you? Or are that many Germans going on winter holidays in the Greek islands?

Cardiac risks are not getting nearly enough attention: Retrospective study of out-of-hospital cardiac arrest in Lombardy, Italy, during first 40 days of #COVID19 outbreak. There was a 58% increase compared with same period in previous year. Of the extra cases, 77.4% suspected or confirmed to have Covid-19.

Hydroxychloroquine by the state: Cases vs Recoveries

Please let this be true: Tests in recovered patients in S. Korea found false positives, not reinfections

Your related links in the comments. Off topic will be deleted.

China's puppet, the WHO, "accidentally" published negative (and presumably untrue) data about remdesivir while China was actively stealing Gilead's IP by trying to patent it in China. #DecouplefromChina https://t.co/93fNfc1tU7

— Scott Adams (@ScottAdamsSays) April 29, 2020

Update: It seems the @WHO is doing its part to combat Fake News by removing its own January press conferences from YouTube so @YouTube wouldn’t have to.

Your morning grab bag.

This earns a gold star: NYC mayor Bill De Blasio to start rounding up Jews

Is hydroxychloroquine helping in New Brunswick? Maybe. It didn’t prevent serious disease in a small study of Lupus patients. So, results remain mixed.

Trump signs an executive order on Tuesday invoking the Defense Production Act to keep meat processing plants open, a senior White House official told CBS News. Plants owned by some of the country’s largest food companies have struggled with outbreaks of the coronavirus among workers and a growing death toll.

Consumer activity has yet to return in China, despite an economic re-opening.

Nothing to hide: Australia will continue campaigning for an inquiry into the origins of the coronavirus outbreak despite a furious reaction from Beijing

Alex Baldwin gives his Stamp Of Approval: Wash. State Came One Vote Away From Releasing Green River Serial Killer So He Wouldn’t Get Wuhan Virus

Better news;

A new antibody test to check whether someone has been infected with coronavirus which claims to be 99 per cent accurate has been certified for use across Europe. Global diagnostics specialists Abbott, which has a UK base in Maidenhead, has said it is expecting to have shipped millions of the laboratory based lab tests across Europe by the end of May.

…accumulating data on Remdesivir suggests it’s active against covid and there’s now enough data to support consideration of access under an emergency use authorization by FDA. The data from NIAID study should push this firmly over the line.

Your related links in the comments.

Comparing COVID-19 Deaths to Flu Deaths Is Like Comparing Apples to Oranges

When reports about the novel coronavirus SARS-CoV-2 began circulating earlier this year and questions were being raised about how the illness it causes, COVID-19, compared to the flu, it occurred to me that, in four years of emergency medicine residency and over three and a half years as an attending physician, I had almost never seen anyone die of the flu. I could only remember one tragic pediatric case.
 
Based on the CDC numbers though, I should have seen many, many more. In 2018, over 46,000 Americans died from opioid overdoses. Over 36,500 died in traffic accidents. Nearly 40,000 died from gun violence. I see those deaths all the time. Was I alone in noticing this discrepancy?
 
I decided to call colleagues around the country who work in other emergency departments and in intensive care units to ask a simple question: how many patients could they remember dying from the flu? Most of the physicians I surveyed couldn’t remember a single one over their careers. Some said they recalled a few. All of them seemed to be having the same light bulb moment I had already experienced: For too long, we have blindly accepted a statistic that does not match our clinical experience.

Update: A related discussion here. (h/t dizzy)

*** YOU MUST SHARE THIS ***

🇺🇸 U.S. RANCHERS ARE WARNING THAT OUR CATTLE / CHICKENS / PIGS WILL BE KILLED & TRASHED… FOOD SUPPLY IN DANGER!!!! 🇺🇸

(Part 1 of 3)

🚨 NOT A DRILL 🚨 pic.twitter.com/cSi1UtrWWX

— Rev. Scott Anthony ⭐️⭐️⭐️ (@ScottAnthonyUSA) April 28, 2020

I recommend following Trent Loos on Twitter and Damian Mason (Facebook) for emerging developments in US agriculture.