🦠 COVID-19 | In this for the long haul | 🤕 724,592 | Deaths 34,017
📊 Daily Data Brief:
724,592 cumulative cases (+52,506)
Active cases: 538,499 (+41,474) (this is the number of currently infected patients)
Total Deaths: 34,017 (+2,826)
Serious/Critical Cases: 26,719 (+1,342)
Source: Worldometers
Death curves (updated daily as ECDC releases). Major update with per country graphs now available❗️(Link)
Slowly the reality of COVID19 is sinking in. Not only its deadliness or its vitality, but how long it will affect our lives. The mood is a bit more somber in some corners but there are some ray of lights at the end of the tunnel. Nobody knows how long the tunnel is. And even during the White House briefing yesterday where physical distancing guidelines in the US were extended for 30 days, Trump was showing unusual restraint about when this will end and couching all his optimistic statements in hope rather than firm reality. It is a welcome development. Fauci is a rockstar and one can see how his character, shrewdness and communication style is a great fit with Trump. There is a greater sense of cohesion within the US task force and POTUS was even urging journalist to be part of the team when they asked aggressive or uncomfortable questions.
As I have written before cooperation, cohesion and communication are key assets which we need to strengthen in our fight over COVID19. Civil society, the scientific community, the corporate sector and philanthropy were first out of the gate exhibiting these qualities in the US and elsewhere. The top of government is now fully aligned and this is great news.
Nonetheless, we are not in this for a couple of weeks, we are talking several months. April will be a tough month as we inevitably see a number of healthcare system stretched and more likely overwhelmed, number of cases and fatality exponentially grow. But we will also likely to see the strict lockdown bear their fruit in Italy, France and other countries which have followed suit. This will provide a temporary anti-dote to help us endure the human suffering and grief which COVID19 is wrecking around the world. It is hard to see how the elder in our society are not even in for the longer haul, until an eventual vaccine is approved 18 months from now and until them without being able to see their children and grandchildren.
We should also trust our capability, and learn as we act against this deadly pandemic. Learn to correct and improve our acts but also learn for the future. One of the area we need to improve on is the flow of information and not only communication. Knowledge flows strengthen cooperation, cohesion and communication.
I have been looking at the UK New and Emerging Respiratory Virus Threats Advisory Group) (NERVTAG) minutes released last week. The UK government should be lauded for having made them public. However, a number of questions linger in my mind. What if these had been released earlier? What if the public had known of the first NERVTAG meeting when it was convened? Would these have affected our level of preparedness and questioning of our government policies? We need to urgently rethink information flows between government and its public as well as inter-governmental flows (the example of Taiwan communication in my newsletter yesterday). This is not about blame or the upcoming inquiry which people are already talking about. This is about now, and making sure that from today onwards (and even beyond this pandemic) all of us benefit from the best knowledge flows to guide our actions and learn.
There are a number of similar threats which we are facing and for which we need information flows which spread more efficiently than a deadly virus to effectively tackle them.
We are in this for the long haul.
Picture of the day: Since the beginning of the pandemic and the fact that it affects the elderly so lethally, an African proverb has kept in my mind: “When an old person dies, a library burns to the ground.”
Yesterday, in his address to his nation, Ghana President, Nana Akufo-Addo said: “We know how to bring the economy back to life. What we do not know is how to bring people back to life”.
😷 Video of the day: Masks for all - (I protect you, you protect me. #Masks4All)
The shortage of personal protective equipments (PPE) in particular for healthcare workers has been a symbol of our lack of pandemic preparedness. There has been a secondary failure which is costing lives: the inability of our government to admit their failings and earlier urge citizens to make DIY masks until they are able to ramp up production/distribution. This would curb asymptomatic transmission of COVID19 and other respiratory illnesses.
It is potentially the fear of inquiry that has deterred governments to communicate clearly with the public and tap the DIY ability of their public. It is not only the nanny state, it is the fear-of-getting-fired-nanny state. The data from Hong Kong was there since March 2 that masks reduced “all respiratory virus infections” as HKers started wearing masks from early February against government recommendations. Free will is an asset.
Yesterday in Face the Nation, former FDA director Scott Gottlieb, advocated wearing masks and even DIY ones. Time to get the sewing machine out.
🇺🇸 It was such a comprehensive and sensible report, that I am reposting the American Enterprise Institute’s “National coronavirus response: A road map to reopening”. As important and hopeful the report is, it is by no means a call to revise the current physical distancing measures which Trump and others have extended last week. Scott Gottlieb one of the lead authors of the AEI report still advocates strict physical distancing to curb the spread of the virus, but what we cannot afford is not prepare for the next phase. A very welcome planning document.
If you do not have time to read the report, Laurie McGinley and William Wan wrote “Experts converge on plans for easing coronavirus restrictions safely” in the Washington Post. Its subtitle is already out of date as Trump has now extended for 30 days the physical distancing recommendation. Agility and preparedness remain key in this fight. (Link)
🧪 The immunity passport is coming. Daniel Wighton and David Chazan PARIS write “Germany will issue coronavirus antibody certificates to allow quarantined to re-enter society” in the Telegraph. This is a policy which is also outlined in the AEI report above:
“Serological Surveys to Determine Population Immunity. One key input for understanding the population at risk is the fraction of the population who have recovered and are protected against reinfection. If a sufficiently high fraction of the population has become immune either through natural recovery or vaccination, remaining restrictions can be lifted. The CDC should be the lead agency for coordinating ongoing serological surveys.”
This is why ramping up serological testing capability is so important. The immunity certificates in Germany are part of a research project at the Helmholtz Centre for Infection Research in Braunschweig. It will take several weeks to complete. There is still knowledge gaps about the immunity which infected individuals develop (starting by how long it lasts? how fast is the virus mutating?), but these are good research projects to get started and learn from. (Link)
🇺🇸 Another example of how fast policy and news are moving on COVID19, but the article is nonetheless informative. Isaac Chotiner writes “The Contrarian Coronavirus Theory That Informed the Trump Administration” for the New Yorker. It is an interview of a libertarian legal scholar Richard A. Epstein of the Hoover Institution whose view got circulated by leading Republicans to President Trump and might have informed his tweet “WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF.”
The Q&A starts with, Chotiner asking Epstein:
“You wrote last week, “In the United States, if the total death toll increases at about the same rate, the current 67 deaths should translate into about 500 deaths at the end.” We are currently at eight hundred deaths—over eight hundred deaths. [This was true when we spoke; the number is now over two thousand.]”
An interesting piece nonetheless. (Link)
💊 🇺🇸 Todd Ackerman writes “Houston Methodist first in the nation to try coronavirus blood transfusion therapy” for the Houston Chronicle.
The Food and Drug Administration earlier Saturday evening had approved Methodist's "emergency investigational new drug" application to test the therapy in the first patient.
The therapy consists in transfusing blood plasma (and its COVID19 antibodies) from a recovered patient into that of a critically ill patient. I will be following and reporting on this trial going forward. (Link)
💊 It is almost reluctantly that I post an article on Chloroquine and Hydroxychloroquine. I have actually created an open access feed for people to follow relevant and curated news on this specific sub-topic of COVID19 (here). The regulators are doing their dutiful and careful job in assessing this potential treatment. We should be patient and trustful of their assessment. Derek Lowe makes a sceptical commentary in Science Translational Medicine “More on Chloroquine/Azithromycin. And On Dr. Raoult”. It is almost necessary for the public and policy makers to have these articles written now to counter the hype without necessarily prejudging of the outcome. (Link)
👧👦 There is another great and well referenced thread by Nicholas Christakis (Sterling Professor of Social & Natural Science at Yale) summarising current knowledge of COVID19 infection in children as well as potential cause for the variability of outcome versus other age groups. Gretchen Vogel writes “New coronavirus leaves pregnant women with wrenching choices—but little data to guide them” for Science. This article needs to be read in conjunction with Professor Christakis thread. One of the questions is the diverging policies around the world around whether or not to separate (or which protection are needed) infected mothers and newborn. While the article cites that there is little data, it fails to mention study on children and brief parental separation such as the movies made by James and Joyce Robertson which historically guided rules about parental visits in children hospitals. (Link)
🍏 In the UK we have seen images of the Excel conference centre being transformed into NHS Nightingale with the help of the military and soon ready to accept 4,000 COVID19 patients. In heartening news we also have heard that 20,000 ex-NHS staff are returning to help fight COVID19. In New York, John del Signore writes “an Emergency Field Hospital Is Going Up In Central Park As Coronavirus Cases Surge In NYC” for the Gothamist. increasing healthcare capacity (Link)
😷 Jeremy Howard writes “Simple DIY masks could help flatten the curve. We should all wear them in public” for the Washington Post. It makes the case for DIY masks to help us control the spread of COVID19 and challenges the initial advice of the WHO. Specifically Howard writes:
“WHO cites for its anti-mask advice are based not on science but on three spurious policy arguments. First, there are not enough masks for hospital workers. Second, masks may themselves become contaminated and pass on an infection to the people wearing them. Third, masks could encourage people to engage in more risky behavior.”
There is a difference between keeping N95 masks for front line healthcare workers which are subject to specific airborne transmission in hospital settings and communicating clearly the benefits of DIY masks with a simple “I protect you, you protect me” messaging. Please put in the comment sections pictures of your DIY mask and I will post the best one this week. (Link)
🎬 Videos of the day:
Dr. David Price of Weill Cornell Medical Center in New York City shares information in a Zoom call, on how to empower and protect your family during the COVID-19 pandemic.
A very human and helpful video with a doctor on the front line of the fight in New York. Thanks to reader of the Corona Daily Benji Rogers for sharing this one with us. (57 min) (Link)
This is a video of the “Science and Technology Committee” with the witness statement of Professor Neil Ferguson, Director, MRC Centre for Global Infectious Disease Analysis, Imperial College London (via video-conference). The paper of Neil Ferguson et al. has been key in policy making in both the UK and US, and was cited again yesterday at the White House briefing. Thank you to reader of the Corona Daily Benjamin Yeoh for sharing this one with us. (44 min) (Link)
🇺🇸/🌎: ❗️The American Enterprise Institute has published “National coronavirus response: A road map to reopening”. It is excellent and is a roadmap for all nations. It provides hope as it is outlines in details what are the steps necessary to reopen. A must read. (Link)
📰 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. COVID-19 General (Link)
2. COVID-19 x Resilience (Link)
3. COVID-19 x HCQ/CQ (Link) (HydroxyChloroquine and Chloroquine)
4. Gig Economy x COVID-19 (Link)
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)
NEW❗️Here is a blog post from Valerie Pegon at Cronycle: “Grow knowledge about Covid-19, not anxiety!” (Link)
📊 A picture is worth a thousand words: Global (🌎) and local (with relevant flag) visualisation and forecasting tool
🌎The 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)🇺🇸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)🇺🇸Another valuable resource by Unacast ( a data company providing human mobility insights). Their “Social distancing scoreboard looks and compares (State by State and County by County), the change in mobility to prior to COVID19 (Link)
🌎 Country by Country Curves (
❗️) 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. 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)
🌎A great resource put together by Ben Kuhn and Yuri Vishnevsky. At a time when we need solidarity and cooperation, I prefer their subtitle “We need stronger measures, much faster” than their title. It’s a simulator on what case growth looks like depending on your community’s measures. Fantastic resource to stir communities and governments to action (Link)
🇩🇪 The COVID19 dashboard for Germany is one of the best around. (Link)
🌎A helpful guide by VOX of the “9 coronavirus pandemic charts everyone should see” (Link)
🌎Data and chart regularly updated by the Centre for the Mathematical Modelling of Infectious Diseases at the 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. (Link to see charts and more data about your country)
🌎This is a great COVID19 Dashboard prepared by Andrzej Leszkiewicz. Andrzej has also written an introductory and explanatory blog for it (“Coronavirus disease (COVID-19) fatality rate: WHO and media vs logic and mathematics”). 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)
“Going Critical” 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)
🇸🇬/🌎 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)
🏛 Notable collaborative projects
Oxford COVID-19 Government Response Tracker (OxCGRT) was launched yesterday. Data is 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 “Coronavirus Tech Handbook”. (They are ‘cousins’ of ours who originally created the 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)
🎬 The Grant Sanderson permanent video corner:
Exponential growth and epidemics
This is an excellent video explaining “exponential growth” and epidemics. Although we are all familiar with the phrase, its authors rightly says that “yet human intuition has a hard time recognising what it means”. This is a ❗️MUST WATCH❗️to 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)
“Simulating an Epidemic”
This is the second video by Grant Sanderson looking at simulating an epidemic under different physical distancing measures. (Link)