🦠 COVID-19 | The hammer and the tightrope
I am a scientist by education, banker at JPMorgan for a few years, then mature PhD student in Chemical Biology at Oxford under the supervision of Christofer Schofield (FRS) and Peter Ratcliffe (Nobel laureate in medicine in 2019). Founder and tech investor focusing on media and education. I care about science, learning and Democracy which are good bedfellows.
📊 Daily Data Brief:
2,912,046 (+93,870) cumulative cases
Active cases: 1,876,408 (+34,573) (this is the number of currently infected patients)
Total Deaths: 202,936 (+6,361)
Serious/Critical Cases: 58,178 (-497)
Recovered: 832,702 (+52,936)
Source: Worldometers
Death curves (updated daily as ECDC releases). Major update with per country graphs now available (Link) (US, UK, France, Germany, Sweden) (👈NEW❗️)
Tomas Pueyo, the talented and deservedly praised writer of Medium posts on COVID19, had titled one of his recent post: “The Hammer and the Dance”. It walks the reader through the adaptive policy that most countries will go through from strong-prolonged lockdown initially to sequential and shorter opening-lockdown phases.
There is a great interview from“Germany's Covid-19 expert: 'For many, I'm the evil guy crippling the economy' in the Guardian. Christian Drosten (director of the Institute of Virology at the Charité Hospital in Berlin) has high praise for Angela Merkel:
“She’s extremely well-informed. It helps that she’s a scientist and can handle numbers. But I think it mainly comes down to her character – her thoughtfulness and ability to reassure. Maybe one of the distinguishing features of a good leader is that they are not using this present situation as a political opportunity. They know how counterproductive that would be.”
Germany will start its reopening on Monday. When talking about re-opening Merkel had said that Germany, despite its leading testing capacity, was on thin ice (video of the day in previous Corona Daily). Most of the Corona Daily today is about testing and testing policies upon reopening, and how to best conduct tracing-testing-isolate to contain the pandemic while we wait for an eventual vaccines or treatment, or achieve herd immunity.
There is also a video on how much privacy we should cede to fight COVID19 by FiveThirty Eight and an article about the newly launched contact-tracing app in Australia. It is very clear that we do not yet have the tracing-testing-isolating capacity in place in most countries for successful exit from lockdown. Re-opening in these conditions would be perilous at best. Israel has shown us what it might look like today.
We are under the hammer, and will soon walk on a tightrope.
Tweet of the day: John Burn-Murdoch (Senior Data Visualisation Journalist)) headlines two tweets, headlining the “Global coronavirus death toll could be 60% higher than reported” article in the Financial Times. Just in case, some people still say “It’s like a bad flu”…
🧪 Two informative Twitter threads on tracing-testing-isolating from Adam Kucharski (London School of Hygiene and Tropical Medicine) and Trevor Bedford (Fred Hutch in Seattle) (Thread and Thread)
💉 Shortly after Jon Cohen wrote “COVID-19 vaccine protects monkeys from new coronavirus, Chinese biotech reports” in Science, Scott Gottlieb wrote “America Needs to Win the Coronavirus Vaccine Race” in the Wall Street Journal:
“The first nation to develop a vaccine for Covid-19 could have an economic advantage as well as a tremendous public-health achievement. […]
China is making rapid progress, with three vaccines entering advanced development. Chinese officials say they could have a vaccine available for widespread use next year. The Europeans are also making progress. While friendly nations will try to share a successful product—to a point—the U.S. can’t rely on vaccines from China or even Europe being available in America quickly.”
Gottlieb could not put the significance of winning this ‘race’ more chillingly. It is also somewhat worrying to ‘race’ on a vaccine which will be so widely administered. However, as a former Food and Drug Administration under Trump, Gottlieb makes it clear that speed cannot supersede safety:
“The urgency to develop a vaccine quickly is eclipsed only by the need to make sure it is very safe.”
While not expressively written in the article and given the high stakes, there is a fear in the US, that other nations might not be as ethical as the US in their approval process in winning that race. Gottlieb outlines three steps which the US can take to win without sacrificing the reputation of the FDA, particularly at the time when the anti-vaccine movement is so strong. (Link)
🧪 Matthew Cleevely, Daniel Susskind, David Vines, Louis Vines and Sam Wills publish “A Workable Strategy for Covid-19 Testing: Stratified Periodic Testing rather than Universal Random Testing”.
Corona Daily reader Sam Wills pointed me to the above paper he co-authored on how to optimally use a constrained testing-tracing capability to halt the pandemic. It is in part in response to Economics Nobel Laureate Paul Romer proposal to randomly test daily 7% of the population to reduce the effective rate of transmission of the virus below 1. The authors label that testing policy as “universal random testing”.
The paper starts by questioning the 7% number put forward by Romer and argues that the right proportion of population to test under a universal random testing to get to a transmission rate of the virus of 0.75 would actually be 21% which the authors believe is unattainable.
The authors suggest implementing instead “Stratified Periodic Testing” to make better use of constrained capacity:
“Instead, we argue that cheap, less reliable, tests will work for narrow groups. Testing rates of over 25% per day in certain groups, such as health workers, could eliminate the spread, enabling other lower risk groups to keep working and out of isolation. Our work has also shown that periodic testing would be a more effective and workable solution than random testing.
Additionally, if groups of high prevalence can be identified (say by geography or occupation) more frequent testing will both ensure that any infected person is isolated more quickly and that more infected people test positive and are isolated, thus maximising the effectiveness of any testing.”
In one scenario they show that their method would result in a 26% improvement in testing capacity utilisation relative to Romer’s “Universal Random Testing” approach.
Paul Romer published an article in the Atlantic with Ezekiel J. Emanuel (Oncologist, bioethicist, and vice provost of the University of Pennsylvania) titled “Without More Tests, America Can’t Reopen”. In it they write:
“One of the authors of this article, Paul Romer, has called for the capacity to run 20 million to 30 million tests a day. Even this has been criticized as insufficient for the task of identifying enough of the asymptomatic spreaders to keep the pandemic in check.”
This article was published 3 days after Sam Wills et al. published their paper on Universal Random Testing.
Apart from debating Romer’s paper and explaining why testing capacity is important in controlling COVID19, this paper shows the benefit of openly sharing and the value of peer-reviewing in learning collectively and arriving quickly at a better response to the pandemic. (Link)
🧪 Yesterday the World Health Organisation came out on immunity and immunity passport. Actually and as Phil Booth pointed out in a tweet they had to come out twice:
In an earlier tweet (now deleted) the WHO had written:
“At this point in the #covid19 pandemic, there is not enough evidence of antibody-mediated immunity to guarantee the accuracy of an “immunity passport” or risk free certificate.”
This point was covered in a previous opinion piece “Antibody Testing Alone is Not the Key to Re-Opening Society” by Angela Rasmussen (virologist on the faculty at the Center for Infection and Immunity at the Columbia Mailman School of Public Health) on April 20.
“Although this sounds reasonable in theory, there are many practical reasons why this is not a wise policy decision to ease off restrictive stay-home orders and distancing practices.”
Rasmussen looks at the current knowledge gaps still remaining and therefore questions whether although conceptually attractive immunity certificates would be effective. She then looks at the ethical and practical considerations which would be associated with immunity certificates and which compound against their usage versus a virus and serology testing-isolating strategy at scale.
Rasmussen categorically concludes:
“We should not, however, place our faith in assumptions and make return to normality contingent on an arbitrary and uninformative piece of paper. Re-opening society, the government, and the economy depends not only on accurately determining how many people have antibodies to SARS-CoV-2, but on a deeper understanding of how those antibodies work to provide protection.”
A great read on our current knowledge and why immunity certificates are for now a conceptual idea rather than a good or even desirable one. (Link)
🧪 Apoorva Mandavilli writes “Coronavirus Antibody Tests: Can You Trust the Results?” for the New York Times. Mandavilli reports on a recent publication looking at the reliability of current anti-body tests:
Of the 14 tests, only three delivered consistently reliable results. Even the best had some flaws.
The research is published by the COVID-19 Testing Project. The team is made up of researchers and physicians at UCSF, UC Berkeley, Chan Zuckerberg Biohub, and Innovative Genomics Institute. This is a great initiative. As long as we do not have more reliable tests (and know their characteristics), we should also question the finding and meaningfulness of serological surveys. This was point well made by Florian Krammer when commenting on the New York City serological survey:
(Link)
🚔🇦🇺 Brett Worthington writes “Coronavirus tracing app COVIDSafe released by Government to halt spread of COVID-19 in Australia”. The government of Australia launched its COVID19 tracing app, dubbed COVIDSafe on Sunday. In its first hours of existence it achieved over 1 million download. Worthington summarises the key points:
The COVIDSafe app will be voluntary for Australians to download
It traces only contact with other people who have the COVIDSafe app on their phone
People risk five years in jail for illegally accessing the data collected
The last point is particularly interesting and one which security experts had warned about for Bluetooth proximity apps. Sometimes the Law can complement IT security favourably. It is often forgotten (Link)
🎬🚔 “Should We Sacrifice Our Data Privacy To Fight The Coronavirus?” by FiveThirtyEight
“Senior writer Neil Paine looks into how data is being used to fight COVID-19 and wonders when such measures become too invasive.” (9 min 28 sec) (Link)
📊 A picture is worth a thousand words: Global (🌎) and local (with relevant flag) visualisation and forecasting tool
🌎The Financial Times (NEW❗️visualisation) 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 John Hopkins University resource center was the first one I used back in January they have now made available in their latest iteration a county by county dashboard in the US including information about health capacity, insurance coverage, ethnicity and age breakdown of the population (New York example below) (Link)
💊 The "Map of Hope" provides a geographical overview of planned, ongoing and completed clinical trials. It is put together with data from WHO Clinical Trials Search Portal by the Heidelberg Institute for Geoinformation technology. (Link)
🌍 MRC Centre for Global Infectious Disease Analysis started to publish weekly death estimates for countries (Link)
🇺🇸 The US Center for Disease Control and Surveillance (CDC) publishes “A Weekly Surveillance Summary of U.S. COVID-19 Activity” (Link)
Google has published a new website to “See how your community is moving around differently due to COVID-19”. They have a lot of data to do so… (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”). 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)
🏛 Notable tracking projects
💊“COVID-19 treatment and vaccine tracker”. This tracker contains an aggregation of publicly-available information from validated sourcesby the Milken Institute (Link)🏛Tariq Krim has started a COVID19 website tracking data about each government policy response to the pandemic (Link)
🏛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)
📰 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) 5. Supply Chain x COVID-19 (Link)
5. Supply Chain x COVID-19 (Link)
Human Rights x COVID-19 (Link)