🦠Covid-19 - 17/03/20 "We are at war"| 🤕 182,725 | Deaths 7,174
Oops I did it again - yesterday “Video of the day” link was missing. It provides the solidarity argument for “social distancing” as opposed to the selfish one. 18 seconds and important. (Link)
📊 Daily Data Brief:
182,725 cumulative cases (+11,880)
Active cases: 95,668 (+9,139) (this is the number of currently infected patients)
% cumulative cases outside China: 56.7% ❗️more infected cases outside China
Total Death: 7,174 (+648) ❗️more death outside China now
Serious/Critical Cases: 6,163 (+246)
Source: https://www.worldometers.info/coronavirus/
Case curves (update coming later once ECDC releases new data as well as new script to include more countries)
Emmanuel Macron addressed the French nation yesterday, so did Donal Trump, Boris Johnson and others. During his second address on COVID19, Macron repeated six times “We are at war”. It is a positive development. As opposed to Trump and Johnson who surround themselves in “science” during their conference, he was on his own delivering his political decision on how best to fight the pandemic. He tightened the lockdown.
For the first time, and taking into account that each country is at a different stage of the pandemic, there was unity on one point: the need for “social distancing”. A number of commentators have noted the shift in Trump’s stance. One even stated: “This version of Donald Trump will save lives”. I concur. Was it awaiting the result of his COVID19 test which made Trump ponder the severity of the crisis or the stock market crash. It does not really matter. What matters is that he showed up and that it is not a one-off. Boris Johnson seemed a bit more rattled. He seemed to have taken it on the chin before the conference. Was it on the G7 ring which preceded the briefing, did he get stung at the COBRA meeting or was it Professor Ferguson’s newly published paper. Maybe in a pandemic the G7 is the peer review process which leaders need and which scientist are so accustomed to. Although, of the three pressers the UK was the worst, I have confidence that the response there is also going in the right direction.
Yesterday was an important turning point when it comes to the top leadership. In many countries where civil society, businesses and lower levels of government had shown leadership, the top was missing. Now not only these three leaders (and others) have turned up but they also have shown unity in their response and communication. Cooperation and solidarity will be key in the speed and efficacy at which we are able to fight this pandemic. We are now finally in battle order at the top. A number of scientific unknowns about the virus remain, but the scientific community was the first to show this needed cooperation (over 24,000 research papers have now been made available in one place).
As we discover more about the virus we will know how formidable a foe COVID19 is but at least we are now in unison. As I wrote before, I am optimistic in the public and its resilience. We will nonetheless need to reflect later on on how we got there. How governments which we trust for our security have lost a key competence to deliver it: risk management. As for the climate we should stop arguing forever about numbers (CFR for COVID19 and PPM for the climate) and think about risk to the population (climate risk versus climate change). Words also matter. With proper risk management thinking we will much better prepare, communicate and react when the next crisis is upon us.
The upcoming fight ahead is challenging on many levels, but the top leadership around the world now knows: we are at war.
🦠 Tweet of the day: Jeremy Farrar, Director of the Wellcome Trust, pointing out that word matters and that maybe we should rename “Social Distancing” and talk more about “personal physical distancing”. An important distinction whilst fully supporting distancing. We will more than ever need our social ties to maintain our resilience as a community. . We only got top leadership to agree on communicating the need for distancing, so might have to wait a bit to rename it!
😃 Video of the day: #Dontbeaspreader. Great short video of Max (son) and Mel Brooks (Dad) about the need for distancing and the inter-generational responsibility to protect the elders. Also a reminder that laughing will be a powerful anti-dote.
📊 The Big Read❗️: The main story is something which I had been advocating in this newsletter previously (“We are not sheep”): “models should be shared and submitted to public scrutiny." Professor Neil Ferguson et al. (Faculty of Medicine, School of Public Health; Vice-Dean (Academic Development) at Imperial College) published: “Impact of non-pharmaceutical interventions (NPIs) to reduce COVID- 19 mortality and healthcare demand”.
It is a must read (at least the abstract) and is a very welcome development particularly Professor Ferguson is a world-class epidemiologist advising many governments. There are a number of assumptions in his conclusion, but now that his analysis is open these assumptions will be able to be challenged and the democratic debate will be able to follow. The microsimulation in it are done for two countries (UK and US) but other countries will be able to conduct the same with their respective numbers on health capacity thresholds.
The paper looks at the two strategies we have at our disposal and their effect o severity of outcome:
“Two fundamental strategies are possible: (a) mitigation, which focuses on slowing but not necessarily stopping epidemic spread – reducing peak healthcare demand while protecting those most at risk of severe disease from infection, and (b) suppression, which aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely.”
It finds that mitigation alone whilst still challenging would lead to “reduce peak healthcare demand by 2/3 and deaths by half.” (fatality still being in the hundreds of thousands range). The conclusion is therefore: ❗️“For countries able to achieve it, this leaves suppression as the preferred policy option.”❗️
Lastly, he highlights that it is very likely that suppression will have to last for a long period of time (potentially until a vaccine becomes available 18 months from now) as although South Korea and China have shown successful short term suppression we do not have any data about long term suppression.
An important, welcome and sobering read.
🇺🇸 Often labelled as the leader of the “Fake News Media” by Trump, Stephen Collins for CNN graciously and rightly pens “Trump, finally, takes the coronavirus emergency seriously”.
“He dispensed unimpeachable information based on fact. He called for national unity and seemed like he meant to help forge it. And he ditched his normal habit of hyping the best possible outcome to a situation with improbable superlatives -- instead communicating the gravity of a fast-worsening crisis.”
A welcome development on many fronts including the dampening of partisanship on this issue in favour of unity in the US. Unity will and should not forbid at times from both the media and the opposition the necessary scrutiny of the Federal Government. (Link)
💉 Denise Grady in the New York Times reports the start of the Phase I trial for Moderna Therapeutics vaccine candidate. As Neil Ferguson noted in his research, this will be a critical factor in a sustained eradication of COVID19 and Moderna's candidate is the first one out of the gate. Fingers crossed but still likely to be 12-18 months aways. (Link)
🦠 One of the key factors on how deadly the COVID19 pandemic will be depends on the extent of asymptomatic transmission (can an individual without symptoms transmit the virus). The ‘extent’ is: whether or not it happens, how easy it is and for how long of the asymptomatic phase can it happen. In a paper published in Science, Ruiyin Lu et al. publishes “Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2)”
“These findings explain the rapid geographic spread of SARS-CoV2 and indicate containment of this virus will be particularly challenging.”
(Link)
🦠 Another factor to look at is the ability of people to be re-infected. This has two major implications: do we developing personal immunity (short or sustained) versus COVID19 (which was a key assumption in the so-called “herd immunity” initial strategy of the UK government) and give us indication about vaccination. It was a question asked to Chris Whitty (UK Chief Medical Officer) at the press conference with the Prime Minister yesterday, as there were reports of a Japanese patient being reinfected. This will be another key area of research in the future. (Link)
👨⚕️ Carol Caldawar in the Guardian writes “'Everyone is scared to speak up': A&E doctor asks for Covid-19 tests”. Since the beginning of the crisis the World Health Organisation has highlighted the need to protect healthcare workers. The UK is lagging other countries. Important piece of journalism to speed the right governmental action and urgently protect NHS workers. (Link)
🌉 Again outlining US city mayors and state governors, pre-empting federal government measures to protect their constituents, San Francisco Mayor announces drastic lockdown measures to contain spread of COVID19 alongside five other Bay Area counties. Sadiq Khan (London) and others remain missing in action. (Link)
🙌 Although we have seen hoarding, there are an increasing numbers of community and help initiatives sprouting up. Two examples here: one in England and another one in Boston. The first one reported by the BBC is about Beauty Banks, a charity that supplies essential toiletries to people in poverty which launched an emergency virus-related appeal on Sunday for COVID19. The other one in Boston is the launch of the BostonHelp initiative “to solve a few of the local challenges stemming from the coronavirus pandemic.” on the Boston.com site. These are important to help us through as society and some will become more challenging to operate as more and more physical distancing becomes the norm. Heartening nonetheless. (Link and Link)
📊 A picture is worth a thousand words
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)
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)
UPDATE IN PROGRESS (visualisation by country coming)❗️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)
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)
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)
This is the New York Times data and graph page on COVID19 with an update map of the US alone (Link)
🏛 (NEW❗️) Notable collaborative projects
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)
Tariq Krim has started a COVID19 website tracking data about the government policy response to the pandemic (Link)
🙌 (NEW❗️) There are many ways in which you are giving back to our newsletter: comments, thank yous, links and sharing.
A volunteer journalist reached out a few days back offering to translate my newsletter in Portuguese. She did the first translation yesterday of yesterday’s edition (“Catching up”). I will post in later on in the comment section and in a more permanent place. Stay tuned.
📈 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)