🦠Covid-19 - After the inevitable | 🤕 341,684 | Deaths 14,751

📊 Daily Data Brief: 

341,684  cumulative cases (+26,417)

Active cases: 227,892 (+22,107) (this is the number of currently infected patients)

Total Death:  14,751 (+1,161) 

Serious/Critical Cases:  10,560 (+432) 

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

Death curves (updated daily as ECDC releases). Major update with per country graphs now available❗️(Link)

Over the last 24 hours the world has added almost one third (26,417) of the cumulated number of cases of the whole tally for China (81,093) since the beginning of this epidemic. If New York was a country, the number of reported cases there (15,168) would place it as the 8th most affected country.

The numbers will get much worse around the world, and the US in particular which according to most estimates is only 7 days behind Italy and has only 25% of its population under State ordered lockdown. Policy wise Italy started its full federal lockdown of Lombardy 2 week ago and the whole country two days later (when it had 800 deaths). The numbers and stories of hospital under-capacity which we are about to see will make for grim reading and viewing. It is inevitable.

And yet in the middle of the grief, more than ever we need to come together and strengthen at community level. The response below the Federal Government has been outstanding in this crisis. The scientific community has showed and led the way in terms of cooperation. It is heartening and it shows the ability of the public at large to respond when faced with such a severe pandemic.

Testing continues to scale-up around the world and that effort should continue as it will be needed past this suppression phase of the fight. Mike Ryan (Director of the WHO Health Emergencies Programme) could not have been more unequivocal:

“The danger right now with the lockdowns ... if we don’t put in place the strong public health measures now, when those movement restrictions and lockdowns are lifted, the danger is the disease will jump back up.”

So we need to prepare for the next phase and not repeat the mistakes of the past. These will be reported increasingly in the press. We have a clear action plan beyond ramping up testing and protecting healthcare workers, to increase capacity (protective equipment, ventilators, ICU beds to name the most important). We need to go past the anger policy mistake might generate, and use them as a catalyst for change and action at the community and individual level. In my post yesterday (“Are 'we' all murderers?”), I predicted that COVID19 will be the start of a resurgence in common enterprises.

We need to prepare for ‘after the inevitable’.

Picture of the day: the worsening US situation. The map below is from the New York Times data and graph page on COVID19 (Link)

🇺🇸 Anthony Fauci is simply a star. Jon Cohen publishes an interview of the lead scientist in Trump’s COVID19 task force: “I’m going to keep pushing.' Anthony Fauci tries to make the White House listen to facts of the pandemic”. Fauci in a very straightforward yet diplomatic way goes over some of the glaring disagreement with Trump, as he should to protect his role and mission. A great read. (Link)

🇺🇸 Axios publishes “More states issue stay-at-home orders amid coronavirus outbreak” as one-in-four Americans are under shelter-in-place order:

“The big picture: The three states are the latest to announce an effective shelter-in-place order, joining New Jersey, California, New York, Illinois and Connecticut, in addition to many individual cities”

Ohio, Louisiana and Delaware were the last states to issue the orders. The article link to 3 articles to go deeper on the issue. (Link)

🇨🇳 Marisa Taylor at Reuters published an exclusive “U.S. axed CDC expert job in China months before virus outbreak”. Dr. Linda Quick was a CDC expert based in China to “help detect disease outbreaks in China”. She left her post in July. (Link)

🧪 Robert Service for Science writes: “The standard coronavirus test, if available, works well—but can new diagnostics help in this pandemic?”. Testing continues to be an important focus for the current and future phase of the fight against COVID19. Service reports on the different types of test and provided an helpful inset on how the current most common RT-PCR based test works. A great summary of where we stand which does not cover the state of serological (Nicholas Christakis excellent link) tests. (Link)

💊 A lot of you have asked about Chloroquine (CQ) and Hydroxychloroquine (HCQ). That is in part because of Trump having prominently put this particular potential treatment in the spotlight. Matthew Herper at STAT writes: “Why President Trump is at odds with his medical experts over using malaria drugs against Covid-19”. A bit of expectation-control highlighting where we really are on testing of these anti-malarials as potential treatments for COVID19 - alone or in conjunction with another antibiotic (Azithromycin). It does a very job at explaining the drug approval process with some great historical examples when the world was desperate to find a cure for the scourge of that time: tuberculosis. Herper writes:

“In the early part of the 20th century, it was a scourge, and many doctors turned to gold-based treatments, to try and control it. They turned out to be toxic and ineffective. In 1946, researchers in the United Kingdom’s Medical Research Council decided to conduct a randomized trial of another treatment, the antibiotic streptomycin, in 107 patients. The results were clear: 7% of those who received streptomycin died, compared to 27% of those in the control group.”

Highlighting the risk of chloroquine, there is a report of 2 deaths in Nigeria on Chloroquine in a ‘Facts First” article by CNN (“Nigeria records chloroquine poisoning after Trump endorses it for coronavirus treatment”).

Herper article is a needed read as the whole world awaits impatiently progress on potential therapeutics for COVID19. (Link)

💊 The US Center for Disease Control and Prevention (CDC) published “Information for Clinicians on Therapeutic Options for COVID-19 Patients”. It is a good review with the anti-viral Remdesevir, CQ/HCQ, status of Lopinavir-ritonavir and other drugs under clinical trials. It provides a link for clinicians to check on clinical trials of prophylaxis-based or other treatment of COVID-19 currently being in the approval process in the United States (Link)

👨‍👩‍👧‍👦 WIRED who has been providing some of the best reporting during this crisis and is also making it available for free. It writes on a critical aspect of community and individual preparation: “How to Care for Kids if You're Sick With Covid-19”. Below is their recommendation for a crisis plan:

Who is going to take care of your kids?

Your dog?

Identify nearby friends or family members who can help and are not in a high-risk population.

Post potential caregiver contact information prominently so that emergency responders can find it. If you have no one to ask, a hospital can usually advise you on community resources for families in crisis.

A great example a practical aspect which the community needs to prepare for to help parents and children. (Link)

📊 A picture is worth a thousand words: Global (🌎) andlocal (with relevant flag) visualisation and forecasting tool

  1. Going Critical” by Kevin Simler is a detailed interacting essay talking about complex systems, the importance of understanding networks, modelling and how this applies to: memes, infectious diseases, herd immunity, wildfire, neutrons and culture. Must read (Link)

  2. ❗️Offset update❗️🌎 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. Added a number of countries as well. Great resource (Link)

  3. CityMapper has started to produce City Mobility Index to show how much a City is moving. This is a very good indicator of how well lockdowns are respected around the world: Madrid (4% of city moving) at one end and Singapore at the other end (72% of city moving) for yesterday (Link)

  4. 🌎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)

  5. NEW❗️🇩🇪 The COVID19 dashboard for Germany is one of the best around. (Link)

  6. 🌎A helpful guide by VOX of the “9 coronavirus pandemic charts everyone should see” (Link)

  7. 🌎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)

  8. 🌎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)

  9. 🇸🇬/🌎 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 Cons prepared by Neel V. Patel for MIT Technology (Article)

🎬 Video: simple graphic showing how physical distancing helps in stopping the spread

🏛  Notable collaborative projects 

  1. 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)

  2. Tariq Krim has started a COVID19 website tracking data about each government policy response to the pandemic (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)