📊 Daily Data Brief:
New Cases outside China: 2,156 (+719)
New Cases in China: 160
Total Death: 3,287 (+83)
Serious or Critical Cases: 6,420 (-351)
The spread of COVID19 continues and accelerates outside China. In Europe, Italy is the hardest hit while cases in the UK are soaring from a low base. In the US Washington State is the focal point, California reported its first death and LA declared a state of emergency while Congress passed an $8.3bn coronavirus emergency package. The underlying reality of case numbers remains in doubt given the limited number of tests undertaken outside China and their lack of reliability overall. Genetic epidemiology is now inferring undetected community transmission in new countries. We are slowly adapting to a new reality that the virus is amongst us. In the “age of distrust” we live in, the cacophony from our “leaders” on COVID19 is distressing for now until it will make us angry. In the absence of leadership in most countries and for our well-being we need to counter community spreading with community caring. We had delegated public health to these leaders but need to take it in our own hands (washing that is) until they finally step up. Social distancing demands a behaviour change which is having an undetected and profound economic costs. The distance learning and working it requires will increasingly put video at the centre of our life at least temporarily.
🤬 COVID19 is spreading mainly undetected in the US. In spite of limited testing ability, it has already been reported in 12 states. The importance of testing in containment is well accepted and yet it remain a fiasco in the US. I reported on Monday that the FDA decision to relax who was habilitated to test would finally unlock this bottleneck, the former FDA commissioner forecasted that the US could test 20,000 patients/day by the end of next week and a Trump administration official went on the records promising testing of a million by the end of this week.
This seems all a fantasy now reading the article from Politico which reports that large scale testing is weeks away. By way of comparison, South Korea is reported to have run 18,000 tests on March 3. This fiasco means more undetected community spreading, as surveillance testing at scale for better containment will not be feasible let alone effective. (Link)
🦠 The scientific community has been a standout since the beginning of this outbreak particularly in showing the benefits of collaboration and data sharing to tackle a complex and global problem. We will increasingly need to emulate it beyond academia to solve for the emerging global and complex problems we are facing. The field of genetic epidemiology has rightly gained prominence with the Bedford Lab at its head. In a Twitter thread, Trevor Bedford from FredHuch continues to infer “cryptic communication” of COVID19 beyond his initial occurrence findings in the Washington area. He uses the same technique but focused on Bavaria and Italy to discover and understand whether community spreading occurred between these places. Another good resource to follow here with great visualisation and narrative is the work published by Nextstrain, an open-source project to harness the scientific and public health potential of pathogen genome data. They published narratives for Italy yesterday inferring at least two introductions of the virus into Italy, with subsequent community spread. There is also a very good article on the topic in the MIT Technology Review: “Gene sleuths are tracking the coronavirus outbreak as it happens” (Link)
🦠 Continuing on the genetic epidemiology of COVID19, an article was published yesterday on the virus evolution and identifying two main strains dubbed the L-Type (~70% of prevalence) and S-Type (~30%), with the former being the earlier strain. The prevalence numbers might stem from the fact that the L-Type might be a more aggressive strain and therefore more detected than the S-Type. The discovery is significant particularly as the variant of the two strains seem to occur mainly in the "spike protein” I mentioned in yesterday’s Corona Daily. The “spike protein” is a differentiating characteristic of COVID19 among coronaviruses and therefore a focus of investigation for designing a vaccine and a treatment. If you get the flu vaccine every year, you are aware of the flu virus’ mutation and the need to get inoculated every year for the new strain. This result therefore also highlight the difficulty in coming quickly and safely with an effective vaccine, and therefore explains why it will take longer than 12 months to get a working one. We should take the fact that human trials have started on a first candidate with cautious optimism (Link)
💊 Julia Belluz and colleagues at VOX have published a very comprehensive article detailing a substantive numbers of drug/vaccine discovery in the pipeline as well as advocating for better funding and preparation for the next zoonitc virus epidemic. An excellent read (Link)
🎬 There was some cacophony yesterday coming out of Italy on whether or not school will be closed nationwide for two weeks. It was eventually confirmed later in the day. Italy has been the hardest country hit in Europe with 3,089 reported cases and 107 deaths. These school closures will have significant effect on society and the economy as parents will have to either work from home or take time off-work for the jobs which cannot easily telecommute. Video conference stocks like Zoom Video Communications have surged as social distancing and telecommuting currently seems our best tools in slowing the spread go COVID19. Equally, interesting in the EdTech (educational technologies) world is the fact that an increasing number of pupils will do online classes to advance their education while schools are closing as is currently envisaged in the UK (Link)
📱 It looks as if China is slowly moving from censorship (yesterday’s newsletter) to propaganda in its communication strategy. James Palmer in a Foreign Policy article (“Beijing Knows Who to Blame for the Virus: America”) looks at how China is managing the PR crisis resulting from COVID19. The article also highlights that America has also not been short on its own conspiracies. One that has lingered on and has public health consequences is the fact that the virus originated in a lab in China. It has unfortunately been relayed by prominent politicians on mainstream and social media and this conspiracy has not died (in fact, a reader answer question in the comment section of my newsletter about the origin of this virus by this conspiracy). This was in spite of a number of prominent scientists refuting the claim early on in the outbreak with an open letter. Elizabeth Barclay at Vox tries again and put this conspiracy theory to bed in “The conspiracy theories about the origins of the coronavirus, debunked” with a well written article. (Link)
🤔 As some are already telecommuting or in forced lockdown, the open (and anonymous) letter from a China resident dreaming about free speech in his country makes me wonder what type of thinking and conversations will happen as we get to spend more time at home and the virus slows down our activity and tests our resilience. It is one issue which I discussed with my friend Tariq Krim yesterday who experienced a life changing experience during the Bataclan terrorist attack in Paris and wrote a beautiful essay about it. He is unsurprisingly an advocate of the ‘Slow Web’ movement. Here is the “Personal Essay: Coronavirus Lockdown Is A 'Living Hell'“ from the Wuhan resident (Link)
📊 A picture is worth a thousand words
Singapore remains the gold standard of government and communication in the time of an outbreak. It started with the highly praised communication from its leader posted on Facebook to this wonderful data dashboard publicly available for its resident to see and the rest of the world to emulate (Article and Dashboard link)
This is a data visualisation page by John Selanikio (MD) on COVID19 (Link)
This is the New York Times data and graph page on COVID19 with an update map of the US alone (Link)
🎬 Two videos today.
A short video from the best manager in football (soccer for the American readers) on answering a question about coronavirus in our celebrity-obsessed world (Link)