š¦ COVID-19 | Inconvenient truths | š¤ 1,030,285 | Deaths 54,199
šĀ Daily Data Brief:Ā
1,030,285 cumulative cases (+89,663)
Active cases:Ā 756,190Ā Ā (+59,298) (this is the number of currently infected patients)
Total Deaths:Ā Ā 54,199Ā (+6,683) Ā
Serious/Critical Cases:Ā Ā 38,178Ā (+2,350)Ā
Source:Ā Worldometers
Death curves (updated daily as ECDC releases). Major update with per country graphs now availableāļø(Link)
It is hard to look at the current COVID19, and not often make the link with aspect of another existential threat: climate risk. It was in 2006, that āAn inconvenient Truthā, the Oscar Winning documentary about formerĀ United States Vice President Al Gore's campaign to educate people aboutĀ global warming, was released.
And there remains today a number of inconvenient truths from COVID19 for the public to accept, or maybe ones which are unbearable to accept or impossible to imagine. The disclocation and rethinking which COVID19 has or will bring are profound. Yesterday, I featured Bill Gatesā Op-ed in the Washington Post in which he advocated a 10-week national lockdown in the US. This was a recommendation in stark contrast with POTUS recent announcement to first re-open by Easter and now by April 30.
Just as we are starting to see the initial results of the positive effect of the lockdown it is hard to imagine that we would now risk opening ourselves to the deadly virality of COVID19 without first building more capacity to deal with subsequent and hopefully more contained outbreaks. Testing issues has been at the forefront, and even though the UK Health Secretary has promised yesterday that the UK will be able to do 100,000 tests per day by April 30, it would still take nearly two years to test the whole population at that rate. We are also rightly talking about immunity certificates and the serological testing to accompany it, but we are at the beginning of the science and have not even started the scaling. Another inconvenient truth, is that we are making progress on testing but the timeline for coverage of population are several months away rather than several weeks or days.
Bill Gates also rightly talked about pre-empting now the future manufacturing need for vaccines capacity, highlighting that no private enterprise could take that risk but that the Federal Government should and could. He is absolutely right. What he did not say and which is a corollary to that is that the Federal Government will have to repay the money it borrows, and the way the Federal Government gets its revenue is through taxes. This is another inconvenient truth. This does not take into account that the underfunding of public health and science, including reducing pandemic prevention agencies, PPE stock and scientific research around coronavirus (or other threats) were done because government could not afford them. What is striking is that countries like the US or UK, which have gone for fiscal discipline (also known as austerity) are the ones whose fatality curves currently appear the steepest. Focusing only on efficiency does affect your resilience.
Finally, we are starting to hear that beyond the current shortage of PPE we are also running low on key medicines in hospital. 80% of the Active Pharmaceutical Ingredients (API) to make drugs originates in China. Apple proudly writes on the back of its iPads: āDesigned in California, Assembled in Chinaā. Again it was efficient to do so from a profit margin point of view, but resilience and independence of key supply chains were affected.
The US has also proudly become self-sufficient or even an exporter of oil though shale oil, and has gained market share in the world oil market versus OPEP countries and Russia. The 'āprice warā between Saudi and Russia has put this independence at risk, and added another sector where the US might become dependent on regime it did not want to deal or pander with anymore.
Of course, free enterprise underpins the scientific breakthrough and innovation we need to get through this pandemic. But the truth is that we will need to reassess areas of investment that we deem strategic and expect the Federal to fund and agree the resulting tax regime to support them. We will need to better balance efficiency and resilience.
COVID19 has just started to expose some inconvenient truths.
šŗšø Article of the day: āWearing Masks Must Be a National Policyā by the New York Times (Link)
There is another NPI (Non Pharmaceutical Intervention) policy which has not been implemented and could save thousand of lives in the US and be launched immediately: wearing masks (even DIY ones). It is hard to understand why this has not happened previously. As the authors point out:
āThe medical and epidemiological data supporting mask use is not conclusive, but it is persuasive enough to warrant this policy, with little to recommend against it.ā
The benefits would reduce viral spread now and in a potential and upcoming second wave of COVID19 in the fall:
āWearing masks will not only reduce viral spread, it would also help us return to work, get back to school, and avoid what could be a devastating second wave of the coronavirus.ā
The authors point that making it a national policy would reduce the stigma, particularly when initial guidance (including by the World Health Organisation) was that only sick people would benefit for wearing masks. In addition:
āAuthorities should provide detailed instructions forĀ how to makeĀ face coverings from materials in our homes, and how to safely use them.ā
There was rumours that it would be announced at last night White House briefing but it did not happen.
š Video of the Day: āStaying at home is a luxuryā. I have written about refugees before and how fighting COVID19 in refugees camp is a challenge. Arieh and Nachson, brothers and co-founders of To.org, have been doing a lot of inspirational work with refugees particularly at the Navikale refugee camp in Uganda. They have just launched the Together Fund campaign to help fight COVID19:
āRight now, we are all being told to āstay homeā, for our own safety as well as the safety of our fellow humans. But many people do not have the luxury of staying home, including the tens of millions of refugees and displaced people around the world. This is why To.org has teamed up with theĀ TOGETHER FUND.ā
See below a video of Mike Zuckerman To.org activist in Navikale refugee camp preparing for COVID19. (Link)
š° & š· There is a great interview ($$ Link) between Ben Thompson (Author/Founder of @stratechery) and Zeynep Tufekci (Associate professor at the University of North Carolina, at the School of Information and Library Science, and a faculty associate at the Berkman Klein Center for Internet and Society at Harvard University). They discuss Mask4Alls (how Zeynep became central to changing the narrative even though she is not an epidemiologist), the role of the media in the current crisis and the deficiencies of our information ecology in the age of COVID19.
The interview gives further context to two articles which Zeynep wrote āWhy Telling People They Donāt Need Masks Backfiredā in the New York Times (March 17) and āIt Wasnāt Just Trump Who Got It Wrongā in the Atlantic (March 24).
In the first article, and echoing what I wrote about in āUnderestimating the publicā (March 15), Tufekci writes:
āResearch shows that during disasters, people can showĀ strikingly altruistic behavior, but interventions by authorities can backfire if they fuel mistrust or treat the public as an adversary rather than people who will step up if treated with respect.ā
In the second article, the opening should entice you to read the whole:
āAs it turns out, the reality-based, science-friendly communities and information sources many of us depend on also largely failed. We had time to prepare for this pandemic at the state, local, and household level, even if the government was terribly lagging, but we squandered it because of widespread asystemic thinking: the inability to think about complex systems and their dynamics.ā
šŗšø Stephanie ArmourĀ andĀ Sadie Gurman write āCoronavirus Task Forceās Fauci Receives a Security Detailā in the Wall Street Journal. I believe that Fauci has been incredibly valuable in this pandemic since he was appointed to Trump COVID19 task force. As the authors write, not everybody agrees:
āDr. Fauci has become polarizing in a politically divided country with right-wing conspiracy theorists attacking him online, calling him part of a ādeep stateā plot to undermine the presidentās re-election.ā
As a result Dr Fauci will now have a 9-person strong team to protect his security and continue to do his best to save American lives. (Link)
šŗšø The New York Times published āWhere America Didnāt Stay Home Even as the Virus Spreadā using visualisation and data to show difference in mobility in US states where shelter-at-home were imposed versus states where they were not. Olivia Paschal (journalist at Facing South - Online magazine of the Institute for Southern Studies) has written a Twitter Thread providing a bit more context and showing some limitations of the data provided in the New York Times article. It also includes some good articles on why the US should worry about COVD19 spreading in the southern states. (Link)
š Kai Kupferschmidt from Science wrote a short explainer Twitter thread on specific drug discovery strategies to fight COVID19. One hopes that this pandemic will motivate a number of people to pursue medical and biological sciences as a curriculum and career choice. The thread links to his Science article āThese drugs donāt target the coronavirus - they target usā.
One of the areas he focuses on in the article is so-called āhost-directed therapiesā, an approach which benefits from the work by the Krogan Group as UCSF (see newsletter of March 18) who built āan interaction map of COVID19 to find existing drugs which could interfere with the virus pathwayā. A virus needs to co-opt our cell machinery to replicate and infect us.
One protein which has been identified as a potential one to interfere with and prevent it from cutting COVID19ās spike protein entering our cell is a cell-surface protein called TMPRSS2. There is already a drug (Camostat mesylate) licensed in Japan. Yesterday, āDanish researchers managed to put together a clinical trial at lighting speedā and administer the drug to a number of patients. Nothing might come out of it, but it shows how the scientific community and the drug regulators around the world are working together to accelerate finding a treatment for COVID19 while we wait for a potential vaccine. (Science article Link)
š·Ā Nancy H. L. Leung et al. āRespiratory virus shedding in exhaled breath and efficacy of face masksā in Nature Medicine. This article has been widely circulated as the push for getting governments around the world to back Mask for All campaigns gathers steam. The paper shows that masks could reduce onward transmission from symptomatic individuals with some respiratory infections. The study found reduction for influenza and some existing seasonal coronaviruses (but the findings are unclear for rhinoviruses). As the New York Times article points out, studies like these should be āpersuasive enough to warrant this [mask for all] policyā (Link)
š· Ed Yong writes āEveryone Thinks Theyāre Right About Masksā for the Atlantic. It is a bit more balanced piece on the different points of view about whether wearing masks would be effective. It has the merit of being extensive and aggregating a number of good references as an academic review paper would. I would have wished Yong would be more emphatic about the use of masks. Free will and maybe National Policy will agree. (Link)
š§® David Adam writes āSpecial report: The simulations driving the worldās response to COVID-19ā for Nature. This is a very well documented and written article on the interaction between epidemiology modelling and public policy. (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¬ Videos: Matt Pattinson (CEO of Ten) runs a podcast debating #masks4uk #masks4all. Should we wear masks to curb the spread? It looks at the issue from all angles: cultural, human, social as well as scientific. A comprehensive and useful overview. (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)