🦠Covid-19 - 12/03/20 No fly zone| 🤕 126,643 | Deaths 4,638

📊 Daily Data Brief: 

126,643 cumulative cases 

% cumulative cases outside China:  36.2%

Total Death: 4,638 (+261)

Serious or Critical Cases:   5,708 (-40) 

Source: https://www.worldometers.info/coronavirus/

❗️New animation from @madlag of fatality curves

The WHO finally declared COVID19 a pandemic as the number of cases and death toll continue to mount (Italy’s is the most visible tip in this spread, but it is only a matter of days for other countries to show similar numbers unless individual behaviour and policy changes radically and immediately). The virus spread continues to follow an expected exponential growth curve which we need to urgently curb to limit the overwhelming of our respective health capacity with the most powerful tool at our disposal: social distancing ( #flattenthecurve is now a trending hashtag on Twitter).

Most of social distancing needs to be self imposed but government and businesses have an important role to play in facilitating (telecommuting) or by imposing bans on large social gathering. On the latter, the fact that the Liverpool-Athletico Madrid football champions league tie was played in Liverpool in front of a full stadium with over 3,000 Spanish fans while PSG - Borussia Dortmund was played in Paris in an empty stadium demonstrates eloquently the different policies). The NBA season in the US was also suspended after Utah Jazz player Rudy Gobert tested positive for the coronavirus. PSG and NBA are showing the way here.

The Skeptic in Chief, Donald Trump, made an address to the nation on the crisis from the Oval Office. The main measure was extending travel restrictions to now include - for an initial period of 30 days, non-American travellers having stayed in the EU’s Schengen Area over the last 14 days. Excluding the UK seemed more ideologic than founded in reason as COVID19 is not going to depend on the outcome of the ongoing Brexit negotiations between the UK and the EU... (put differently COVID19 does not respect no-fly zones). Furthermore, the epidemic in the UK is more advanced than most EU countries. On a more positive side (albeit more a first step than an adequately sized response) Trump also announced a deferred-tax economic stimulus to support small business because of the coronavirus. This followed on the heels of an economic stimulus form the UK Chancellor in the morning and a warning from the European Central Bank (ECB) Christine Lagarde of an economic crisis echoing that of 2008.

The noticeable highlights from the Trump address however, were more (1) his volte-face from someone who had recently publicly labelled the extent of the crisis a Democratic “Hoax” and (2) his unsubstantiated claim that the EU was responsible for seeding “a large number of new clusters” in the US because of its initial lax response. This followed on Mike Pompeo recently naming COVID19 the “Wuhan Virus” and further entrenches the anti-migration rhetoric of this administration. The first one will only seed anxiety in the public of ‘who and what’ to believe particularly as we already live in the “age of distrust”. The second highlight only serve to seed division amongst nations when what is most needed to solve this current complex epidemic (and other current global threats such as climate change) is more cooperation.

This crisis further reveals the inconsistency of most countries wanting to reap the economic benefits of increased interconnected whilst ignoring not only the inherent increased epidemic/health risks which result from it and but also unwilling to come up with the new modes of governance needed to solve them. In this crisis, businesses, states and cities have shown that intensity and appropriateness of response could vary at different levels and within their respective prerogatives. Decentralisation of powers is great in building resilience particularly when parts of the chain of commands are faulty. It might be too early to see the emergence of a well-functioning governance to guide us through this crisis but we should start immediately to think about what we need. In free societies we have the luxury of being able to decide what to do to combat the virus. It comes with responsibility but also requires education and a well-functioning public information sphere. Unfortunately fake articles and recommendation continue to be shared in ad-fuelled platforms and seed misinformation.

Self isolate and wash your hands is a clear message which we can all follow at our own level. Other policy decision will need to to be put in place at all organisational levels to effectively curb the spread.

What happens to the virus is still up to us.

🇮🇹 Graph of the day: Covid19 declared a pandemic from the Washington Post (case curves for China and Other Countries)

🌍 In the cacophony of our leaders and governments, the WHO has been a steady and reassuring voice in its communication. The WHO was previously criticised for not using the “p-word” (“Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now” was an article I shared previously from Peter Sandman and Jody Lanard published on February 23). However its reticence until yesterday appears to have mainly been with the aim to elicit the most robust initial response (rather than abdication) and foster lasting cooperation. As I wrote previously health is at best a neglected topic and at most a politically charged one. Furthermore, wilful concealment for two months from China when the most accurate and early data is critical to understand a new zoonotic threat and calibrate the appropriate response required careful engagement by Dr. Tedros (WHO Director General) is a reality that it had to deal with. Here is his opening remark at his daily media briefing yesterday when declaring COVID19 a pandemic (Link)

🇺🇸 Three reads on the Trump address depending: 1) The full speech (Link); 2) A summary and description of what POTUS announces from PBS (“What you need to know about Trump’s novel coronavirus response”) (Link) and, 3) A New York Times article (“In Rare Oval Office Speech, Trump Voices New Concerns and Old Themes”) (Link)

📃 Businesses have a key role to play in combating the virus. This is a review article in pre-print (not peer-reviewed) summarising on how organisations (from schools, to business and any organisation) should best implement policies to curb transmission of COVID19 through business environment mediated pathways (Link)

📃 There are two notable epidemiology papers analysing which work or social interactions are more risky to propagate a virus. Both find that limiting contact during leisure are as important as limiting contact during work and school. It also finds that leisure, school and work contacts are a much bigger risk than transport. The first study (chart below) and the second one were conducted in 8 European countries and the United Kingdom respectively.

Useful as we ALL try to self isolate or implement the right policies for the activities we have responsibility for (Link and Link)

📜 History also has important lessons. This is another interesting article in The Conversation: “Coronavirus and Spanish flu: economic lessons to learn from the last truly global pandemic”. There are 3 mains lessons according to the authors:

“First, the public health response to the spread of the disease must focus on containment. […]

The second lesson is that good information is key to disease control […]

The third lesson is that we must prepare for the economic and human consequences of the virus and act to minimise its impact.”

Monetary policy has already started and as noted previously might not be the most efficient. We need to focus on increased fiscal stimulus which we have seen announced yesterday in both the UK and the US. This a good development. We will see more and bigger stimulus as the extent of the crisis becomes apparent. The Marshall plan comes to mind when it comes to size (Link)

💰 Dion Rabouin for Axios writes “Coronavirus has disrupted supply chains for nearly 75% of U.S. companies”. The article reports on a special ISM survey of US companies (628 respondents; conducted between 22 February and 5 March) on the expected supply-chain disruption which will trigger a large recession. It reports on a list of disruptions already felt by the respondents and still the lack of preparation for 44% of the respondent. Chilling (Link)

💰 “Coronavirus Spurs U.S. Efforts to End China’s Chokehold on Drugs”, continues on the same supply chain theme outlining what to expect from the outbreak in terms of US current dependence on its drugs supply chain from China. The article notes the rethink and a push by the current US majority to tighten “Buy American” laws. The article also notes the difficulty of effecting such change whilst highlighting its real urgency on the wake of the current COVID19 outbreak:

“On Feb. 28, the Food and Drug Administration warned that one drug was already in short supply in the United States because of manufacturing issues, and said it was monitoring about 20 others that rely on China.”

This is also an area which will have major repercussions on global trade post COVID19, particularly if we cannot implement supranational governance on issues as vital as drug availability during a pandemic. A “Made in USA” doctrine can also be fallible as the insistence on the US to only make and approve COVID19 tests made locally have lead to the current fiasco in the US… (Link)

💰 This is a EU-based economic response proposal VOX (the CEPR Policy Portal): “COVID-19: Europe needs a catastrophe relief plan”. Given the size of fiscal stimulus advocated it is unlikely from the authors’ own acknowledgement unlikely to be received positively in European capitals. The authors wisely ask whether there is a plan B and whether denial and timidity might end up more costly (Link)

🦠 “How Coronavirus Hijacks Your Cells” is a very good article explaining how virus such as COVID19 operates. Lots of nice explanatory images and well done (Link)

📊 A picture is worth a thousand words

  1. This is a GitHub made by my friend Francois Lagunas (co-founder and CTO extraordinaire of Stupeflix, a company we backed). He has written a script to scrape deaths and number of cases in order to visualise the rate of growth on a logarithmic scale. He has taken a time offset for countries assuming that South Korea and Italy are 36 days behind China’s outbreak, and France and the USA a further 9 days behind. You can clearly see that South Korea is an outlier (as already shown in my newsletter “Better safe than sorry” and that the severity of this outbreak will depend on the behaviours of the governed and the decisive action of our respective governments). (Link)

  2. 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)

  3. 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”). 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)

  4. 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 Con prepared by Neel V. Patel for MIT Technology (Article)

  5. This is the New York Times data and graph page on COVID19 with an update map of the US alone (Link)

🎬  One video and one podcast:

  1. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a member of the president's task force on coronavirus was yesterday testifying in front of the House Oversight and Reform Committee Wednesday. Fauci said that the outbreak in the U.S. is only "going to get worse”. (Link and article)

  2. In in “Making Sense” podcast series, Sam Harris is in conversation with Amesh Adalja (MD, infectious disease specialist at the Johns Hopkins University Center for Health Security) providing early thoughts on the coronavirus pandemic (Link; 1h 6 min)

📈 Exponential growth and epidemics (permanent video)

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)