🦠Covid-19 29/02/20 1st US Death | 🤕86,993 | Deaths 2,979

📊 Daily Data Brief:

86,993 cases (+1,776)

New Cases outside China: 1,416

New Cases in China: 360

Total Death: 2,979 (+55)

Serious or Critical Cases: 7,569 (-250) (8.7%)

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

The main headline is the first death in the US. It will change the political discourse there and in country where health discussion are heavily politicized. Equally significant is the FDA relaxing its ruling for which labs are able to carry COVID19 testing. This will have a number of ramifications. Cases continue to grow outside China with South Korea above 3,500 cases, Italy crossing the 1,000 threshold and France reaching 100 cases. Equally worrying is the spread in countries with weak health systems like Iran, the Middle East generally and Africa.

🤕 The 1st death in the US is significant. It’s a man in his 50s, with underlying health conditions and resident of Washington State. There has also been an outbreak in a nursing facility in Kirkland, Wash. with 108 residents and 180 staff of which 27 and 25 have COVID19 symptoms. At this facility, thus far one resident has tested positive and is in “serious condition” and one other confirmed case is a health worker in her 40s and in “satisfactory conditions”. As Helen Branswell aptly reported on Twitter: “Washington State announced an awful trifecta today: The 1st US #Covid19 death, the 1st case in a health worker & the 1st outbreak in a long-term care facility.” Even though there is no link established as of now between the death and the facility outbreak, this trifecta is a worst case if repeated at scale: health care worker infected (at scale it would have significant implication on ability to mitigate the virus as health worker community gets infected), community spread amongst vulnerable elderly people. (Link)

🔬Limited testing ability in the US as reported in yesterday’s edition has been a worrying Achille’s heel for both detection and practicing early “surveillance testing”. Just some data here: China can test 1.6 million cases a week, South Korea has tested 65,000 and as of yesterday the US had tested 456 cases. Jon Cohen of Science Magazine has written an excellent article on “The United States badly bungled coronavirus testing—but things may soon improve”. As anticipated and as reported by Jon, the FDA approved the ability for “high-complexity testing laboratories” to carry their own COVID19 tests. This, combined with the ability of labs to use the CDC test without the faulty reagent which was partly at the origin of the testing fiasco, is positive news for both containment and mitigation phases. Obviously, we should now expect an upshot in number of cases in the US whilst communication till now has failed to prepare the public and that’s a negative. (Link)

📱Communication and information have been nothing short of problematic since the beginning of the outbreak: from China’s withholding potentially information internally and definitely externally, to the overemphasis in containment-as-panacea in the early days and to generally the other “virality” - that of social media. All of these have prompted a number of excellent articles (here or here) on the fact that whether or not we were in a pandemic, this was the first “infodemic”. Whilst social media’s revenue model has a big role to play in this problem because of their ad-driven revenue model, communication from the authorities has lacked authority (!), transparency and educational virtues. It has far reaching implications in terms of preparedness across the board for this outbreak (and its ultimate cost) and more generally the strength of our democracies. We cannot lament the rise of populism and authoritarians maintaining power, without giving ourselves a healthy public information ecosystem. Peter Sandman and Jody Lanard came out of near complete retirement to provide great commentary and advice on COVID19 on their website. They are now strongly advocating all government to message on imminency of pandemic and transition from containment to mitigation. Here’s Jody Lanard’s tweet with both links (Link)

🦠 Where’s AI in all of this? CT scan is one of the preferred method for evaluating lung infections in new COVID19 induced pneumonia. Finding a reliable AI to help radiologist assess these scans is reported to reduce interpretation time by 65%. Here’s a pre-print (as in not peer-reviewed article) in MedRxiv evaluation a deep learning based-model to achieve such result and based on an evaluation on 27 patients (Link)

🌍 The level of concern for emerging markets is also significantly rising especially in Middle East and Africa, where the outbreak seems to be more advanced. Iran has reported 593 cases and 43 deaths and Nigeria also reported its first case two days ago. This is of particular concerns as their health infrastructure is severely underinvested, and citizens of these countries will have to rely on their country’s limited ability to contain and then mitigate an outbreak. Some of these countries are also just recovering from having successfully fought the Ebola outbreak.

🎬 Here is an emergency #COVID19 episode of #DeepBackground with Noah Feldman in conversation with Marc Lipsitch, leading epidemiologist of ⁦@HarvardChanSPH. It goes over the widely circulated predicament of Marc Lipsitch that 40-70% of the world population could get infected in case of a pandemic (quoted notably in both the Atlantic and the NYTimes). He already had updated his thread giving context to and correcting his initial quote on Twitter and starts in the podcast that he wished he had said “adult population” given the that kids outcome remains uncertain as of now. This is fascinating, as Marc Lipsitch had gone out initially with an excellent and broadly praised blogpost on how to communicate responsibly to the public in the case of a virus outbreak like COVID19 to only be subsequently caught being misquoted and heightening inadvertently public anxiety. It is a reminder that even if the most seasoned and thoughtful epidemiologist can get it somewhat wrong, we should all not overreact to the news or commentary. Happy Sunday. (Link)