🦠 COVID-19 | Towards a new normal| 🤕 2,322,033 | Deaths 159,659
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:
2,322,033 (+74,280) cumulative cases
Active cases: 1,567,284 (this is the number of currently infected patients)
Total Deaths: 159,659 (+4,571)
Serious/Critical Cases: 55,218 (-1,716)
Recovered: 595,090 (+24,316)
Source: Worldometers
Death curves (updated daily as ECDC releases). Major update with per country graphs now available (Link)
Another rich Corona Daily and it does not even properly cover the Twitter peer review of the Santa Clara study. Here is a tweet with some links about the flaw found in the pre-print:
Most of the articles today deal with how far away we are from a new normal. The New Yorker posits 1/10th of the way. Nate Silver then argues that maybe more lock-down extension now is better than potential more painful death by a thousand cuts. A great but grim article walks us to the extent of the damage COVID19 wreaks on its victims.
How much do we really know or what can we infer from immunity looking at other coronaviruses (a great review article) informs us on how able or ready we are to ease physical distancing as covered in two complementary New York Times articles.
Addressing the re-surfacing question about origin of the virus and the need to not let it fester and instead seek China unequivocal cooperation now. Dissecting next our current supply chain fragilities (and the widespread but misguided belief that people were hoarding toilet paper). Cooperation between the NIH and big pharmas to potentially better allocate resources on drug and vaccine discovery is the last article today’s Corona Daily, only after having heard Caitlin Rivers speak about her proposal to set up a national infectious disease prediction center.
On the data front, JHU has updated its dashboard in the US by providing richer data at county level. Impressive.
Happy Sunday evening.
🏛 Article of the day: David Wallace-Wells writes “We Are Probably Only One-Tenth of the Way Through This Pandemic” in the New Yorker (Link)
The article title sets the scene, and if needed Wallace-Wells writes at the beginning:
“But getting out of the lockdown — and out of your shelter-in-place bunker — is not the beginning of the end of the pandemic. It is only the end of the beginning — the very brief beginning of what seems likely to be an epically long saga of disease, fear, and uncertainty.”
The article narrates the possible paths and timeline to get to the famous herd immunity (60% of population immune to COVID19) with or without a vaccine. As outlined below through a great review and articles the data, communication and capacity are still somewhat lacking to confidently embark on the ease of physical distancing in most countries.
As of today, only Angela Merkel has publicly and eloquently warned its population that easing the lock down is a challenge akin to walking on “thin ice”. Wallace-Wells does the same for the readers, until other leaders show the courage and clarity which Merkel has.
Tweet of the day: Nate Silver on pain now rather than death through a thousand cuts later particularly as we live in the Age of Distrust:
🦠 Meredith Wadman, Jennifer Couzin-Frankel, Jocelyn Kaiser and Catherine Matacic wrote “How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes” for Science.
This article is not for the faint hearted. It starts with:
“Clinicians and pathologists are struggling to understand the damage wrought by the coronavirus as it tears through the body. They are realizing that although the lungs are ground zero, its reach can extend to many organs including the heart and blood vessels, kidneys, gut, and brain.”
The article follows the journey of COVID19 in patients, through five distinct sections:
The infection begins
Striking the heart
Multiple battlefiels
Buffeting the brain
Reaching the gut
As Wadman writes “a clear picture is elusive, as the virus acts like no microbe humanity has ever seen.” In spite of unprecedented levels of scientific collaboration and number of pre-print publications, scientists and doctors are only starting to sketch the damages which the virus wreaks through patients’ body. It will take years of research and observations to understand it fully and assess the extent of long-term damage for the ones lucky to escape death. (Link)
🦠 Angkana T. Huang et al. wrote “A systematic review of antibody mediated immunity to coronaviruses: antibody kinetics, correlates of protection, and association of antibody responses with severity of disease” in MedRxiv. This is a superb and thorough review of on an important subject. Until we built more serological testing capability and data on COVID19 specifically, past research on anti-body mediated immunity to other coronaviruses (SARS, MERS, others) is important to help policy makers frame and risk assess lock-down exit as well as the viability of the much touted and considered immunity certificates.
On the latter the authors write
“On the other end, the proposed policy of “immunity passports” to allow individuals presumed immune to return to work once social distancing measures are relaxed requires highly specific serological tests to mitigate adverse outcomes. Evidence from past emerging HCoVs suggests low false positivity from cross-reaction with endemic HCoVs. However, antibody titers do not necessarily translate to immunity. Challenge studies indicate multiple candidates that may serve as correlates of protection including serum and mucosal measures; however, these will need specific evaluation for SARS-CoV-2. The knowledge gap in correlates of protection and their durability must be filled before immunity passports are safe for general use.”
On top of the civil liberties and discrimination concerns on immunity passports, the authors are clear about the scientific knowledge gaps which remain to be resolved before giving the green light on immunity certificates.
The authors also highlight:
“There is a need for development of serological assays with high sensitivity for screening and sufficient specificity to exclude individuals from unneeded interventions.”
Again we are progressing on specificity of serological assays around the world, but given the sacrifice that lock-down population have endured, policy makers will need to carefully time and communicate the uncertainty around relaxing social distancing given the state of serological asset capability at the time of their decision. (Link)
🏛 Gabriel Leung (Dr. Leung is an infectious disease epidemiologist and dean of medicine at the University of Hong Kong) writes “Lockdown Can’t Last Forever. Here’s How to Lift It.” for the New York Times. This is an increasingly covered topic in the press as a number of citizens around the world enter another day of their already multi-week lockdown. It actually expands on the “adaptive policy” concept which Professor Ferguson had put forward in his influential paper mid-march.
“Given suppression policies may need to be maintained for many months, we examined the impact of an adaptive policy in which social distancing (plus school and university closure, if used) is only initiated after weekly confirmed case incidence in ICU patients (a group of patients highly likely to be tested) exceeds a certain “on” threshold, and is relaxed when ICU case incidence falls below a certain “off” threshold”
Leung goes into somewhat more details and write in a prose which is potentially understandable by a wider audience. The implementation of such “adaptive policy” will be context-dependent. As Leung writes:
“Each community must determine the real-time effective reproductive number it can accept given its own circumstances, in particular the stage of the epidemic it is at.”
What Leung fails to address explicitly, is what level of trust local or federal authority will need to command with their respective population to successfully implement such sensitive policies following on the heels of an initial period of high sacrifice.
Kai Kupferschmidt tweeted about what an epidemiologist had told him off the record about the UK:
Donald Mc Neil writes an article (“The Coronavirus in America: the year ahead”) which focuses more on the human aspect of these policies, and with a more realistic timeframe setting in the title. Mc Neil summarises early on the choice we have:
“Exactly how the pandemic will end depends in part on medical advances still to come. It will also depend on how individual Americans behave in the interim. If we scrupulously protect ourselves and our loved ones, more of us will live. If we underestimate the virus, it will find us.”
Two great reads. (Link)
🇨🇳 Matt Ridley (“Writer, biologist, rational optimist, peer, Northumbrian”) wrote a well-referenced twitter thread on the origin of the virus as this is a story which is resurfacing. Matt Ridley is a controversial character in certain circles in the UK, but this is a worthy thread given his expertise. It is important to insert some rationality on this question to avoid it being seized by populists or nationalists and turn into an even more poisonous and dark issue than it needs to be.
If left in the hands of populists only, it will certainly wreak more damage to the global world order. Whilst it might be that we never find out the origin of the virus, the population deserves to see that we have made a good attempt to find out. It is one of these questions which needs to be addressed rationally so as to avoid primitive and racist biases to unnecessarily feed on it.
It is also an opportunity for China to cooperate transparently on the matter and for the international community to test its regime. Matt Ridley finishes his thread with the following and easy to implement suggestion:
Dr Tian Jun-hua is a leading researchers on bat viruses. China should make him available to speak freely as soon as the international community demands. (Link)
🚚 Maggie Koerth writes “How COVID-19 Is Wreaking Havoc On Our Ability To Make Things — Including Vaccines” for Five-Thirty-Eight. This is an article about the state of our supply chain. Megan Ranney, a professor of emergency medicine at Brown University is quoted early on:
“Up until a few weeks ago, I knew very little about the supply chain. It always just worked. But I’ve learned a bunch, and it’s more fragile than we ever thought possible.”
Koerth takes us to the three layers of problems which COVID19 has exposed when it comes to our supply chains:
“First, the push toward lowest-cost production means a lot of cheap goods and cheap components of more valuable goods are made in places with low-cost labor. […]
The second problem is that a global pandemic causes sudden spikes in demand for certain products.
Finally, supply chains are also getting disrupted in some truly surprising ways — ripple effects that spread from one industry to another. Take the transportation of goods. Turns out, it’s pretty dependent on European tourism — 80 percent of the air cargo capacity across the Atlantic comes aboard passenger flights.”
A great read and one that explains that despite the headlines, maybe no one hoarded toilet paper. (Link)
💡 Brian Resnick wrote “The US has a national service for predicting the weather. It needs one for predicting disease.” This is an interview of Caitlin Rivers about her proposal to set up a national infectious disease prediction center. As the world is likely to face more zoonotic epidemics, this would be a valuable agency to set up. (Link)
💊💉 Jocelyn Kaiser wrote “To streamline coronavirus vaccine and drug efforts, NIH and firms join forces” for Science. Kaiser reports on a welcome effort for coordination and potentially more optimal allocation of resources to fight the pandemic. A perilous but worthy exercise. (Link)
📊 A picture is worth a thousand words: Global (🌎) and local (with relevant flag) visualisation and forecasting tool
🇺🇸
(NEW❗️)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)
🌎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)🇺🇸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)
And I have added a new feed below
5. Supply Chain x COVID-19 (Link)
NEW❗️Human Rights 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: “Grow knowledge about Covid-19, not anxiety!” (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)