🦠 COVID-19 | Waiting for Boris Johnson

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:  

Cumulative case: 4,097,060 (+84,223cumulative cases 

Active cases:  2,385,146 (+33,660) (this is the number of currently infected patients)

Total Deaths:  280,144 (+3,928)

Serious/Critical Cases: 47,698 (-1,001)

Recovered:   1,431,770 (+46,635)

Source: Worldometers

1) Cumulative death curves (updated daily as ECDC releases). Major update with per country graphs now available (Link) (USUKFranceGermanySweden) (👈NEW❗️)

2) “Coronavirus tracked: has your country’s epidemic peaked?” from the Financial Times. Looking at seven-day rolling average of new deaths. You can compare two countries per chart by clicking on the Link. (NEW❗️)

3) U.S. states reopening risk map (Link) (West Virginia and Idaho went from ‘reduced’ to moderate’ risk)

At 7pm (UK time), Boris Johnson will address the nation. It will be significant as the UK government was the first one to advocate “herd immunity as strategy” policy (similar to Sweden now) to only backtrack shortly after. It is also significant because the UK has now become the country with the highest fatality in Europe and its testing -tracing-isolate capacity whilst improving is not at the level of the most advanced countries like Germany, South Korea or Taiwan to cite a few. Thirdly, it is significant because Boris Johnson has had a near-death encounter with COVID-19 and probably does not think “it’s like the flu”.

While we wait for Boris Johnson’s address and sense an increased polarisation between the end lockdown and extend lockdown camp, the Corona Daily curates two articles looking at history for an answer. The image of the day and an article in Vox, looks at the situation in the US, where states which appear at risk of a second spike are reopening nonetheless. The article of the day is from Peter Piot (director of the London School of Hygiene & Tropical Medicine) who was also infected by COVID-19.

A great article looks at the long-term implication of the disease (“lung scarring, heart damage, and neurological and mental health effects”). On the more positive side the Corona Daily also looks at the promise of recombinant antibodies and rapid vaccine development with two great articles from Science.

Dr. Nathalie E. Dean publishes another great example of “Science at work” (the title of a previous edition of the Corona Daily) where she Twitter peer-reviews three articles questioning the herd immunity threshold for COVID19.

And now I am “waiting for Boris Johnson”.

NEW❗️I am open-sourcing my curated feeds and making them freely available below.

Free COVID-19 curated feeds

🦠 Article of the day: Dirk Draulans writes“‘Finally, a virus got me.’ Scientist who fought Ebola and HIV reflects on facing death from COVID-19” for Science. This is a great interview of Peter Piot (director of the London School of Hygiene & Tropical Medicine).

The article narrates the personal journey of Piot as he became ill with COVID-19. It would be interesting to know whether his case was registered as ‘mild’.

There are two particularly interesting quotes in the article. One is about the long term side effect of the disease beyond its fatality rate:

“Many people think COVID-19 kills 1% of patients, and the rest get away with some flulike symptoms. But the story gets more complicated. Many people will be left with chronic kidney and heart problems. Even their neural system is disrupted. There will be hundreds of thousands of people worldwide, possibly more, who will need treatments such as renal dialysis for the rest of their lives.”

And the second part is about the vaccine:

“Let’s be clear: Without a coronavirus vaccine, we will never be able to live normally again. The only real exit strategy from this crisis is a vaccine that can be rolled out worldwide. That means producing billions of doses of it, which, in itself, is a huge challenge in terms of manufacturing logistics. And despite the efforts, it is still not even certain that developing a COVID-19 vaccine is possible.”

A great Sunday read. (Link)

Image of the day: The image below looks at states in the US which are re-opening and not necessarily meeting the criteria of effective reproduction number, daily case per million or positive rate of diagnostic tests for a low risk lockdown exit. (Link)

❗️ Brian Resnick writes “4 reasons state plans to open up may backfire — and soon” in Vox. Resnick goes into detail on why state reopening might bring more pain if done prematurely by dissecting four lines of relevant factors:

“1) America is still at the peak of the epidemic. Cases have, at best, plateaued.

2) Many, many people are still vulnerable

3) The biology of this virus makes it formidable

4) There aren’t enough plans in place to stop the spread — and to learn from reopenings”

It is not that Resnick does not understand the pain (both in terms of job loss and psychologically), it is just that opening pre-maturely might put to waste the initial sacrifice. As Eleanor Murray, an assistant professor of epidemiology at the Boston University School of Public Health, says”

“If we open up, and do exactly what we were doing in March, we’re going to see a huge increase in cases. We’ll go back to that same exponential trajectory.”

And then what? Lockdown again. (Link)

🦠 Lois Parshley writes “The emerging long-term complications of Covid-19, explained” in Vox. One of the big unknown of COVID-19 is the long-term damage on organs for the patients who avoid death. This is what Parshley investigates in his article, which provided (if needed) one more argument in favour of controlling the disease spread. As Joseph Brennan, a cardiologist at the Yale School of Medicine:

“The difficulty is sorting out long-term consequences”

Parshley goes into some of the potential long-term side effects that are being investigated including “lung scarring, heart damage, and neurological and mental health effects”.

A grim but necessary read, particularly for the fervent advocates of “herd immunity as strategy” policy. (Link)

📜 Gina Kolata writes “How pandemics end” for the New York Times.

Kolata writes at the beginning of her article:

“According to historians, pandemics typically have two types of endings: the medical, which occurs when the incidence and death rates plummet, and the social, when the epidemic of fear about the disease wanes.”

The article looks through the ending of past pandemics (black plague, Spanish flu, smallpox) and posits that maybe COVID-19 will have a socio-political end before it has a medical end. An interesting read. (Link)

📜 Helen Branswell writes “What the world learned in eradicating smallpox: Unity mattered” for STAT news. Branswell looks at the 21-year campaign which eradicated smallpox in the midst of the Cold War, and how cooperation (including between the US and USSR, and with the WHO acting as coordinator) was key in its success.

One another interesting quote is from William “Bill” Foege, who was one of the architect of the smallpox campaign and director of the US Center for Disease Prevention and Control (CDC) from 1977 to 1983

“You hear with coronavirus about contact tracing and how difficult that is. That’s what we were doing with smallpox”

This is particularly relevant for COVID-19, particularly as some countries and US states have given up on building up their test-trace-isolate capacity before opening up. This early abdication is puzzling given that our communication and technological capacity are greater than they were at the time of the smallpox campaign. (Link)

💊 John Cohen writes “The race is on for antibodies that stop the new coronavirus” for Science. Cohen goes through one of the promising area for therapeutic against COVID-19: monoclonal antibodies. Clinical trials are due to start shortly but as Jeremy Farrar (Director of the Wellcome Trust) notes:

“Monoclonals may well have a very important role. The big questions will be the capacity to manufacture at scale, distribute, and the cost.”

The article is both a great explainer of the technology as well as a great overview of the leading efforts in the field from Astra Zeneca, to Regeneron and Vir Biotechnology. (Link)

💉 Barney S. Graham writes “Rapid COVID-19 vaccine development” in Science. Graham, as Cohen for monoclonal antibodies, explains the different vaccine technologies, but also spends part of the article talking about vaccine safety. This is going to be particularly important at a time where the anti-vaccine movement is active in a number of countries.

There are two types of risks which Graham goes through: antibody-dependent enhancement (ADE) and vaccine-associated enhanced respiratory disease (VAERD).

This is a fairly technical article, but an area which will be of significance given the scale at which a COVID-19 vaccine will be administered. (Link)

🧮 Nathalie E. Dean (associate professor of biostatistics at University of Florida) writes a fantastic Twitter review of 3 papers which have emerged and suggested that herd immunity for COVID-19 might emerge at population treshhold much lower than originally thought and publicly communicated. The spreed at which these publications were politicised by proponents of ‘herd immunity as strategy’ policy or end the lockdown advocates, makes this an important thread.

Once again it shows the value of a platform like Twitter for such rapid ‘peer review’ process to happen. On the other hand the speed at which pre-prints like these are politicised (also on Twitter) and spread might limit the containment of such politicisation. John Swain is starting to do some interesting work/mapping on this on different COVID-19 topics (lockdown, vaccine, or the NHS).

The thread explores the two points Dean outlines in the first tweet:

One of the most interesting point about the politicisation of this type of publications is that one of the co-authors of one of the 3 papers felt the need to write in own thread (included in Dean’s thread) to clarify their pre-print and debunk its politicisation:

Thank you Dr. Dean (and Dr. Souto Maior). (First tweet and Twitter thread)

🎙 “The Edition: who can tame the virus?” by The Spectator. With science writer Matt Ridley, virologist Elisabetta Groppelli.

The podcast can be read in conjunction with Matt Ridley articleWe know everything – and nothing – about Covid”. (Link)

📊 A picture is worth a thousand words:  Global (🌎) and local (with relevant flag) visualisation and forecasting tool

  1. 🇺🇸 NEW❗️ “Is your community ready to reopen?”: A map of the US (50 states and 2,100+ counties) looking at reopening risks with metrics around 3 criteria: 1. Is COVID in retreat? 2. Are we testing enough? 3. Are our hospitals ready? (Link)

  2. 🌎 The Financial Times (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)

  3. 🇺🇸  The Johns 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)

  1. 💊 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)

  2. 🌍 MRC Centre for Global Infectious Disease Analysis started to publish weekly death estimates for countries (Link)

  3. 🇺🇸 The US Center for Disease Control and Surveillance (CDC) publishes “A Weekly Surveillance Summary of U.S. COVID-19 Activity” (Link)

  4. 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)

  5. 🌎 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)

  6. 🌎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)

  7. 🇩🇪 The COVID19 dashboard for Germany is one of the best around. (Link)

  8. 🌎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)