🦠Covid-19 - 15/03/20 Underestimating the public| 🤕 159,670 | Deaths 5,960

📊 Daily Data Brief: 

159,670 cumulative cases (+13,712)

Active cases: 77,752 (+9,787) (this is the number of currently infected patients)

% cumulative cases outside China:  49.4%

Total Death: 5,440 (+520)

Serious/Critical Cases:  5,654 (-428)

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

Case curves (update coming later once ECDC releases new data)

The Committee on Public Information (1917–1919), also known as The Creel Commission was set up in the US by President Wilson who wanted to gain support from America to go into war. As Chomsky writes in “Media Control: the Spectacular achievements of propaganda”:

The population was extremely pacifistic and saw no reason to become involved in a European war. The Wilson administration was actually committed to war and had to do something about it. They established a government propaganda commission, called the Creel Commission, which succeeded, within six months, in turning a pacifist population into a hysterical, war-mongering population which wanted to destroy everything German, tear the Germans limb from limb, go to war and save the world.

A war is always a political choice. It is a last resort for many but in recent times some “wars” have been perceived by many to also be of choice. The policy to combat a virus, as I have written before, needs to be guided by science but is ultimately a political decision. Unlike traditional wars, we do not have a choice: COVID19 is here and we need to fight it. It is a different foe. It knows no borders. A number of governments have been rather slow to respond and even more to mobilise the public against this foe. This is changing fast as both France and Spain have tightened their lockdowns yesterday, and undoubtedly more will follow. The UK has already made a U-turn in its communication on herd immunity in light of the upheaval not only from the scientific community (including from members of SAGE - its own scientific advisory group) but also from the public. The G7 will gather tomorrow for increased cooperation as well.

The more populist governments around the world have been the ones who have until now had both the worst communication and the worst policies on COVID19 (including no policy). It might be expected, but will ultimately be their downfall unless they become responsible governments. Every day counts for them as well. One of the reason, they might be so behind the curve, is because they are still emboldened and maybe still bewildered by how they were able to arrive to power. They have made great use of social media and ‘strategic communication’ (the pompous word for PR when applied to government) to gain power. But this time is different, they are dealing with policy choices which will determine how many of their people die. This time is different because they have underestimated two characteristics of the public in 2020: their intelligence and resilience. They also underestimated how the distrust which led them to power would be the sword that seal their fate.

We are in time of war. It is a clear war of necessity against COVID19 and governments will have to deal with a different type of public that they are accustomed to. Social platforms while still spreading misinformation will play a much more beneficial role to the public during this crisis. The spectre of death will change the public level of scrutiny of policies and its acceptance of misinformation. It will be as ruthless as the virus. This will infect the populist politicians before COVID19 infects the public. The more populist ones are doubting the resilience of the public and the length of time it could endure a quarantine. Believing otherwise would acknowledge the reason and the solidarity which the public is capable of. It is a foreign or maybe frightening concept for a populist government and its spin doctors.

And although, science has a critical role to play in guiding the right policy response it is not the only one which will make us succeed globally. History and war-like logistics will be equally important. Since the beginning of the crisis we have heard that the West could not do what the Chinese have done in containing the crisis, even though as I have argued yesterday a lot of the good measures had no authoritarianism in them. Governments in the West now doubt that freedom and security can co-exist, when history shows us otherwise and democracy demands it. They are maybe too conscious of the distrust they elicit, or underestimate the pubic or both. The two World Wars have shown a very different picture of resilience, solidarity and adaptability.

The top of government have a key role to play. The public, the private sectors, philanthropists, cities and state have already been more creative and quick to respond to the crisis and build resilience for us all. It is now urgent and key that governments believe in the public to refine and adapt their policy towards COVID19.

We are at war with COVID19. Stop underestimating the public.

🦠 Video of the day: In this video, Dr Michael Ryan, Executive Director, WHO Health Emergencies Programme, make a number of key points on the need to “engage with communities deeply” and the need for “cooperation”, but the most important in containing an outbreak is speed:

“If you need to be right before you move you will never win. Perfection is the enemy of the good. Speed trumps perfection.”


🇬🇧 Article of the day❗️: Jonathan Boff, Senior Lecturer in the Department of History at the University of Birmingham, writes: “Crisis Management for Beginners: Lessons from two World Wars”. Boff argues that controlling COVID19 will not all be about science and looks to draw lessons from two World Wars to inform policy. Whilst we were not particularly expecting Boris Johnson to shine on the science side, as a popular biographer of Churchill, we were at least expecting him to heed the lessons from his idol. In a damning passage, Boff writes

So overall, it’s Emmanuel Macron and Leo Varadkar who are taking a Churchillian line, while Boris Johnson, meanwhile, may ironically end up looking more like Asquith or Chamberlain.

Great read. (Link)

🐑 I have written a lot about herd immunity and the need for a democratic debate on UK government’s COVID19 policy particularly if the chosen one was an outlier. Adam Kucharski (Mathematician/epidemiologist at @LSHTM and part of SAGE) wrote a twitter thread yesterday morning:

I am deeply uncomfortable with the message that UK is actively pursuing ‘herd immunity’ as the main COVID-19 strategy. Our group’s scenario modelling has focused on reducing two main things: peak healthcare demand and deaths...

It was followed later on by a rebuttal from a World Health Organisation official, normally careful about openly criticising a government given its focus on increasing cooperation during outbreaks, and an open letter from leading scientists urging the government to “take stronger measures of social distancing across the UK with immediate effect”. Robert Peston, a friendly Downing Street journalist then published an articleElderly could be quarantined for four months in 'wartime-style' mobilisation to combat coronavirus”, and finally in the evening Matt Hancock, UK Health Secretary, buried herd immunity as a policy goal. He wrote:

We have a plan, based on the expertise of world-leading scientists. Herd immunity is not a part of it. That is a scientific concept, not a goal or a strategy. Our goal is to protect life from this virus, our strategy is to protect the most vulnerable and protect the NHS through contain, delay, research and mitigate 

No more sheep. (Link)

⚔️ “Toilet paper and total war - the psychology of shortages and what it means for resilience” by David Beaumont (who runs a blog on war logistics) is a fascinating read. Beaumont makes a parallel between the looting of toilet paper around the world and war logistics in general. It demonstrates in his mind how critical human behaviour will need consideration in building preparedness and strategic resilience against COVID19 (Link)

🧬 Trevor Bedford, genetic epidemiologist who I have featured many times before writes another interesting thread attempting to estimate the real number of cases of COVID19 in the US, particularly given the early misfiring of the country on its testing ability. Bedford current best estimates is that between 10,000-40,000 Americans have been infected by COVID19 compared to the 3,045 officially reported cases. ( Link)

🇮🇹 In a very good Medium blog, Andreas Backhaus, tries to explain why the fatality rate in Italy is so much higher than in other countries and what could play a role in this difference looking at scale of testing and different age make-up of the respective population. A very informative read on comparing what is comparable and not making hasty global inference on the intrinsic CFR of COVID19 based on widely disparate country samples (Link)

🦠 A timely and important read of Jon Cohen at Science looking at whether it is reasonable to expect COVID19 to wane with the coming summer months and looking at a dozen other diseases. SARS and MERS (two other coronaviruses) “offer no clues”. Three out of four human coronaviruses that cause colds and other respiratory diseases have “marked winter seasonality” according to molecular biologist Kate Templeton, at the University of Edinburgh. Another interesting field of research is on whether the human immune might also have a circadian cycle (i.e. changing with seasons). This is an emerging field ad more funding and research will be need. We will have to wait for a definite answer. (Link)

🦠 Another timely and important read is attempting to clarify the confusion about “airborne” given the different meaning which scientist ascribe to the word. The “airborne” properties of COVID19 have important implication on how best to combat its transmission. Unfortunately most of the research is still in pre-print (not peer review) and it is therefore better to err on the side of caution. A very good article in WIRED (Link)

💊 Biocentury published a very good infographic and article on the 30 different therapeutics currently in different stages of trial to fight COVID19. (Link)

😢 Mental health and resilience are critical factors as noted above with devising and implementing policies for everyone and in particular for health workers in time of a pandemic. “Psychological Effects of Quarantine: A Qualitative “Rapid Review” is an important read (Link)

📊 A picture is worth a thousand words

  1. NEW❗️A helpful guide by VOX of the “9 coronavirus pandemic charts everyone should see” (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 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)

  4. 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)

  5. 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)

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

🎬  Two videos today:

  1. A great short video from Adam Kucharski from TED: “For more information about how you can protect yourself and loved ones from the spread of COVID-19” (Link)

  2. An interview from WGBH News with leading journalists on COVID19 for Science and STAT, on disinformation and what is key to report on: “Frustrations of a Science Reporter Covering Coronavirus”. (Link)

📈 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)