š¦ COVID-19 | Do we have a problem with China? | š¤ 940,622 | Deaths 47,516
CORRECTION: Axios has issued a correction on a story it printed yesterday and which I included in my newsletter on the FDA approval of a 2-minute test. Hereās is the correction (Link)
šĀ Daily Data Brief:Ā
940,622 Ā cumulative cases (+79,696)
Active cases:Ā 696,892 Ā (+56,866) (this is the number of currently infected patients)
Total Deaths:Ā Ā 47,516 Ā (+5,156) Ā
Serious/Critical Cases:Ā Ā 35,828 (+2,736)Ā
Source:Ā Worldometers
Death curves (updated daily as ECDC releases). Major update with per country graphs now availableāļø(Link)
There is a statue in front the National Archives of the United States in Washington D.C. which bears the inscription "Eternal vigilance is the price of liberty".
As the death toll of COVID19 significantly rises across the world, the urge to ascribe blame and responsibility will increase. One of the narrative which is being circulated and gaining traction is that China lied about its numbers. Yesterday there was a news on Bloomberg headlined āChina Concealed Extent of Virus Outbreak, U.S. Intelligence Saysā (see below) and today there was a follow-up article in Bloomberg again: āChina accuses US of shifting Virus Blame after Intel Reportā. Bloomberg seems to be a conduit for state propaganda during a highly emotional time rather than help the public assess the reality or significance of the allegation in the increased severity of the pandemic. Bloomberg is failing the public at a time where the media should be a strong pillar of Democracy (the āFourth Estateā).
One argument when China is mentioned which some of the anti-Trumpian or democrats (as in proponent of Democracy), is that the US government and other democratic governments should be able to take good decision with imperfect data. Another argument is that the US government (or other western governments) has also not reported the number of cases accurately because until recently it was incapable of scaling testing. Another one, is that attacking China is serving the nationalist and populist agenda of Trump and Putin.
I do not believe that a large part of the publicās visceral reaction vis-a-vis China is challenging the usefulness of āimperfect dataā. I do not think either that the point at hand is whether governments outside China have taken the necessary measures with the āimperfect dataā which was coming from China. On that point, I think the answer to that question is ānoā. Ā Linear decision making is not well suited for exponential crisis. Finally, I do not think the questioning of China reporting is about the numbers of cumulative cases either, but more about the number of reported deaths. There are a number of technical and testing policy reasons which make accounting appropriately for cases problematic: testing capacity, testing policy, asymptomatic characteristics of the disease,....
One of the other arguments to deflect discussion on the issue is to look at the exemplary and immediate cooperation of the Chinese scientific community . As I reported yesterday, since the start of the COVID19 outbreak the scientific community is an example of cooperation and coordination which political leaders should follow. Ā
I would add also that I understand that a number of countries and especially the old communist block ones are still fighting U.S. hegemony, and that a number of countries are joining them since Trump came to power as that hegemony is becoming less and less benevolent. Ā
However, I still have a growing problem with China.Ā And the problem is around its wilful concealment and censorship.Ā And this point demands scrutiny and vigilance because of our attachment to freedom. It is important that we evaluate its reality and address it correctly. āEvery country does itā is not addressing it correctly.Ā
My problem/questions around China and COVID19 fall into three areas: (1) their censorship of their own people with sophisticated methods, (2) their delay in letting the World Health Organisation in, and once in China the decision to visit Hubei last, and (3) whether or not they wilfully misreported the number of deaths. Ā
On (1) and (2), I shared two articles in previous newsletters:
(1) there is the Citizen Lab investigative piece: āCensored Contagion - How Information on the Coronavirus is Managed on Chinese Social Mediaā
(2) On obfuscation of the WHO and delay in letting the foreign scientific community in the country, I previously shared this piece: āThe Comprehensive Timeline of Chinaās COVID-19 Liesā
āOn January 6, the CDC offered to send a team to China to assist with the investigation.Ā The Chinese government declined, but a WHO team that included two Americans would visit February 16.ā
On (3) I do not think we have a definite answer on whether or not China wilfully concealed its COVID19 death counts, but (1) and (2) demand that we are vigilant about it.Ā There has been an article about inferring lies from the number of urns, but it is not definite given that funerals have been suspended for 3 months and given the historical mortality rate in the region. Ā The age group profile of China and the prevalence of co-morbidities like diabetes, heart disease in the population versus the West will have an incidence also on the mortality rate in China versus Italy and rest of world.Ā So (3) remains a question mark.Ā There is even an article which came out in pre-print which compares mortality rate in China and Italy ( see more below). There is no smoking gun and maybe looking for smoking guns is always a negative exercise.Ā
And even though we need to tackle the rising public critique of China and should debunk the emotional versus rational basis of the critique. We should still level the critique of the Chinese regime where it is due. And doing the latter does not preclude citizens of the West to do some questioning about their own government (but this should be a separate and needed exercise).Ā
Reuters printed a story (āIn China, a young diplomat rises as aggressive foreign policy takes rootā) two days ago:
āOver the past year, more than 60 Chinese diplomats and diplomatic missions set up Twitter or Facebook accounts, by Reutersā count, even though both platforms are banned in China, often using them to attack Beijingās critics around the world. Zhao this month promoted a conspiracy theory on his personal Twitter account that the U.S. military brought the coronavirus to the central Chinese city of Wuhan, where the outbreak began late last yearā¦ā
Ben Thompson rightly wrote in reference to the above that the āInternet is a two-way streetā.Ā The same applies to the respect of patent and to sharing information on a COVID19 pandemic, particularly when you are well placed to do so having the experience of SARS (another coronavirus epidemic between 2002 and 2004) .Ā
We should continue to investigate whether there has been wilful concealment of number of deaths in China. We should be vigilant and critical about China not to unnecessarily fuel nationalistic/populist tendencies in governments around the world.Ā We should not do it to absolve our governments of the adequacy of their COVID19 policies. But if the critiqueĀ is rightful and rational, and is partially responsible for a lack of preparation in the rest of the world we should address it sooner rather than later across all our interactions with China.
Standing of a country in our interconnected world depends on trust. Eternal vigilance is the price of liberty.
š¦ Article of the day: āBill Gates: Hereās how to make up for lost time on covid-19ā
This is a great Opinion piece by Bill Gates. Whilst he acknowledge lost time and inadequate policies, he writes.
āBut I still believe that if we make the right decisions now, informed by science, data and the experience of medical professionals, we can save lives and get the country back to work.ā
The other sobering part of the Op-Ed is:
āThe countryās leaders need to be clear: Shutdown anywhere means shutdown everywhere. Until the case numbers start to go down across America ā which could take 10Ā weeks or more ā no one can continue business as usual or relax the shutdown.ā
He also urges the US federal government to pre-build the vaccines production capability ahead of an eventual vaccine and across methodology. This is something that Anthony Fauci, of the Trump task force has already talked about. (Link)
š¬ Video of the day: Richard Aylward who headed the World Health Organisation (WHO) mission in China appears to refuse answering a question from Honk Kong RTHK News about Taiwan (which is not a member of the WHO).
šŗšø Picture of the day: John Burn-Murdoch (senior data visualisation journalist) tweeted his updated cumulative case chart yesterday.
āUS curve is higher and steeper than any other, as the lack of early testing or lockdowns takes its toll. Action now is too late.ā
š¦ Marc Lipsitch and Yonathan Grad āNavigating the Covid-19 pandemic: Weāre just clambering into a life raft. Dry land is far awayā for STAT. A great read echoing Bill Gates piece. (Link)
š¦ Martha Henriques writes āCoronavirus: Why death and mortality rates differā for BBC Future. This a very well researched and documented explainer on what affects mortality rates looking at age, policies around testing and different accounting for cause of deaths and cases. (Link)
š° Leslie Roberts writes āWe have no choice.ā Pandemic forces polio eradication group to halt campaignsā for Science. Eradicating polio has been a fight which has lasted 3 decades and needs to be paused given the lack of resources and the emergency to fight COVID19 pandemic.
āOn 24 March, GPEIās leadership called on all countries to postpone until at least the second half of this year both mass campaigns to boost immunity to the polio virus and the targeted campaigns underway in Africa to stop outbreaks sparked by the live virus vaccine itself.ā
A sad reality check of the level of our investment decision around public health, and also a reminder of the other deaths which will result from our fight against COVID19 and go unaccounted forā¦ (Link)
šŗšø Vann R. Newkirk II writes āThe Coronavirusās Unique Threat to the Southā for the Atlantic. While in the US all eyes are currently on New York, the South is increasingly a source of concern. Newkirk looks at preliminary data suggesting that more young people are dying in the South than in the rest of the country. This might be due to a bigger co-morbidities in the population combined with an underinvestment in public and private health in those poor American states. (Link)
šØš³/š®š¹ Anthony Hauser et al. published āEstimation of SARS-CoV-2 mortality during the early stages of an epidemic: a modelling study in Hubei, China and northern Italyā as a pre-print in MedXriv.
āOverall mortality among all symptomatic and asymptomatic infections was estimated to be 3.0% (95% credible interval: 2.6-3.4%) in Hubei province and 3.3% (2.0-4.7%) in northern Italy.ā
A great paper to assess accuracy of data reporting in China.Ā (Link)
šØš³ āChina Concealed Extent of Virus Outbreak, U.S. Intelligence Saysā published on Bloomberg.
The article starts quite bluntly:
āChina has concealed the extent of the coronavirus outbreak in its country, under-reporting both total cases and deaths itās suffered from the disease, the U.S. intelligence community concluded in a classified report to the White House, according to three U.S. officials.ā
Mike Pence, US Vice President is quoted as saying on CNN: āThe reality is that we could have been better off if China had been more forthcoming,āĀ
Expert more on this story and U.S. rhetoric going forward.(Link)
š¦ Roman Wƶlfel et al. publishes āVirological assessment of hospitalized patients with COVID-2019ā in Nature. The issues of virus replication, immunity, and infectivity investigated in the paper are of great importance for viability of issuing immunity certificates to allow safely people back in the community and at work as well as whether the population will be able to develop sustained herd immunity from COVID19.Ā
āShedding of viral RNA from sputum outlasted the end of symptoms. Seroconversion occurred after 7 days in 50% of patients (14 days in all), but was not followed by a rapid decline in viral load.ā
The good news in the paper is the absence of virus in stools which could have otherwise increased transmission of COVID19. Virus is also detectable in sputum (saliva and mucus) which could make testing easier than collecting swabs. The bad news is that even thought anti-body are detected after 7 days, immunity does not appear immediately having implication on how soon after positive serological testing it would be safe to let patient back in the community.(Link)
šĀ A picture is worth a thousand words:Ā Ā GlobalĀ (š)Ā and local (with relevant flag) visualisation and forecasting tool
šĀThe Financial Times has a data tracking page which is in front of the paywall, looking at cases and fatality curves for selective countries and metropolitan areas/region. It is not as extensive as the Madlag link below, where you can see static as well as animated images for a greater number of individual countries. (Link)šŗšøĀ The Institute for Health Metrics and Evaluation (IHME) is an independent global health research center at the University of Washington (UW). It has put out a simulation for the US (overall and by state) of what is the expected shortfall in health capacity (bed, ICU, ventilators) and when is the expected peak of the epidemic for each state. A valuable resource. (Link)šŗšøAnother valuable resource by Unacast ( a data company providing human mobility insights). Their āSocial distancing scoreboard looks and compares (State by State and County by County), the change in mobility to prior to COVID19 (Link)
šĀ Country by Country Curves (
āļø)Ā Ā This is a GitHub made by my friend Francois Lagunas. He has written a script to scrape deaths and number of cases in order to visualise the rate of growth on a logarithmic scale.Ā Ā Great resource (Link)CityMapper has started to produce City Mobility Index to show how much a City is moving. This is a very good indicator of how well lockdowns are respected around the world: Barcelona (4% of city moving) at one end and St Petersburg at the other end (68% of city moving) for yesterday (Link)
šA great resource put together byĀ Ben KuhnĀ andĀ Yuri Vishnevsky.Ā Ā At a time when we need solidarity and cooperation, I prefer their subtitle āWe need stronger measures, much fasterā than their title. Itās a simulator on what case growth looks like depending on your communityās measures. Fantastic resource to stir communities and governments to action (Link)
š©šŖ The COVID19 dashboard for Germany is one of the best around. (Link)
šA helpful guide by VOX of the ā9 coronavirus pandemic charts everyone should seeā (Link)
šData and chart regularly updated by theĀ Ā Centre for the Mathematical Modelling of Infectious DiseasesĀ at theĀ London School of Hygiene & Tropical Medicine. It maps the effective reproduction number (also known as R0) of COVID19. You want to get it below 1 as fast as possible to contain an epidemic. (LinkĀ to see charts and more data about your country)
šThis is a great COVID19 Dashboard prepared by Andrzej Leszkiewicz. Andrzej has also written an introductory and explanatoryĀ blogĀ for it (āCoronavirus disease (COVID-19) fatality rate: WHO and media vs logic and mathematicsā). It is a very extensive dashboard with 28 pages. I particularly like the country comparison tab, which allows you to track and benchmark the curve of the epidemic (number of cases and deaths) in your country with that of another. Very well done and informative. (Link)
āGoing CriticalāĀ by Kevin Simler is a detailed interacting essay talking about complex systems, the importance of understanding networks, modelling and how this applies to: memes, infectious diseases, herd immunity, wildfire, neutrons and culture. Must read (Link)Ā
šøš¬/š Singapore remains the gold standard of dashboard. Here is an article with the Best and Worst of all dashboard in the world, with Pros and Cons prepared by Neel V. Patel for MIT Technology (Article)
š¬ VideosāNoam Chomsky: Coronavirus - What is at stake?ā This is a video echoing the article from Chomsky in a previous newsletter. Classic Chomsky. (Link)
š Ā Notable collaborative projectsĀ
Oxford COVID-19 Government Response Tracker (OxCGRT)Ā was launched yesterday. Data isĀ collected from public sources by a team of dozens of Oxford University students and staff from every part of the world. It also looks at stringency of the measures and plots stringency with case curves. A great initiative and resource (Link)
Mike Butcher (Editor at Large Techcrunch and founder of TechforUK), had refocused TechforUK on the fight against COVID19. It is a very effective hands-on team of volunteer. Do reach out to them. He has also teamed up with We are now working closely with the volunteers behind the āCoronavirus Tech Handbookā. (They are ācousinsā of ours who originally created theĀ Electiontechhandbook). Volunteer collaboration at its best! (Link)
Tariq Krim has started a COVID19 website tracking data about each government policy response to the pandemic (Link)
š°Ā Cronycle resource:
Cronycle has made available a number of open-access feeds on its website which I extensively use for the Corona Daily. The four first feeds are:
1. Ā COVID-19 General (Link)Ā
2. Ā COVID-19 x Resilience (Link) Ā
3. Ā COVID-19 x HCQ/CQ (Link) Ā (HydroxyChloroquine and Chloroquine)
4. Gig Economy x COVID-19 (Link)Ā
And I have added a new feed below
5. Supply Chain x COVID-19 (Link)
I will write more in the future on how you can leverage Cronycle for keeping up to date in between two editions of this newsletter. (Link)
Here is a blog post from Valerie Pegon at Cronycle: āGrow knowledge about Covid-19, not anxiety!āĀ (Link)
š¬Ā Ā The Grant Sanderson permanent video corner:
Exponential growth and epidemicsĀ
This is an excellent video explaining āexponential growthā and epidemics. Although we are all familiar with the phrase, its authors rightly says that āyet human intuition has a hard time recognising what it meansā. This is a āļøMUST WATCHāļøto understand fully what is upon us but also how early behavioural changes at scale can have a massive impact on the level of exponential growth of COVID19 (Link)
āSimulating an Epidemicā
This is the second video by Grant Sanderson looking at simulating an epidemic under different physical distancing measures. (Link)