🦠"I can't breathe" but it is not from COVID-19
I am a scientist by education, banker at JPMorgan for a few years, then mature PhD student in Chemical Biology at Oxford under the supervision of Christofer Schofield (FRS) and Peter Ratcliffe (Nobel laureate in medicine in 2019). Founder and tech investor focusing on media and education. I care about science, learning and Democracy which are good bedfellows.
📊 Daily Data Brief: (May 31, 2020, 14:58 GMT) (+/- 48hr❗️)
Cumulative case: 6,200,397 (+174,306) cumulative cases
Active cases: 3,065,790 (+62,067) (this is the number of currently infected patients)
Total Deaths: 371,748 (+5,333)
Serious/Critical Cases: 53,485 (-245)
Recovered: 2,655,953 (+129,081)
Source: Worldometers
1) Seven-day rolling average of new deaths (updated daily as ECDC releases). Major update with per country graphs now available (Link) (US, UK, France, Germany, Sweden, Nordic Comparison)
Showing a chart from the FT today highlighting the worrying situation in Brazil, Mexico, India and Russia. Also the FT comparative charts now allow up to 6 countries
2) U.S. states reopening risk map: this analysis includes current estimated R (reproduction number) for each state (Link) (NEW❗️4th indicator added)
3) Rt estimate per country (NEW❗️). This is a new resource link in the data section from a team which has led accuracy in modelling fatalities in the US for the past few weeks. (Link)
George Floyd death is a human tragedy, which could have broad implications for the COVID-19 pandemic in the US. And even before this shocking and tragic incident hit us, the inequality of African-Americans in the face of COVID-19 was known to us. This community had been hit the hardest in great part due to racial inequity which translated in health inequity.
Before Floyd, African-American lungs had disproportionally succumbed in the invisible hands of COVID-19. And even though COVID-19 was humanised as an ‘invisible enemy’, the reality of how it was disproportionally attacking the lungs of African-Americans, did not make the endemic racism which black people have suffered in the United States quite real. Statistics in daily briefings and pre-prints papers can only go so far.
The knee of a policeman on Floyd’s neck embodied the other deadly plague affecting African-American in the United States more than the invisible hands of the spike protein of SARS-CoV-2 could have ever done. I am talking about institutionalised and chronic racism.
And it is not that the Corona Daily has suddenly become a political newsletter, but it is as a former Food and Drug Administration director voiced on CBS Face the Nation:
“Need to resolve 'underlying problems' of racial inequity to stop coronavirus pandemic” (Link)
And it is not only that the riots which have spread across United States cities are conducted without social distancing. It is also that the media, POTUS, governors, mayors and communities might need to focus on stopping a civil war whilst battling the “invisible enemy”. If they fail it will be the whole country gasping for air.
It is not unimaginable if the riots are mishandled that SARS-CoV-2 might be narrated as the catalyst rather than the reaction in America’s future history books. And regardless of what happens, the inadequate responses to the two plagues which America is now facing have been seeded and ignored by many previous administrations for whom efficiency was more important than resilience.
I have open-sourced the articles feeds I curate the Corona Daily from and made them freely available below. The feeds included are listed here.
Today, the Corona Daily starts with an article from English doctor and writer Rachel Clarke which takes us away from the daily statistics of the pandemics to the human tragedy of caring for a dying patient in front of his two sons. It is these type of images, more than numbers, which will convey the reality and the depth of the COVID-19 tragedy and will elicit the needed accountability and reset which our societies badly need.
In the two videos of the day, we look at the worries expressed by scientists in the UK of a premature and hasty reopening, and by Scott Gottlieb in the US following the widespread riots.
Two Twitter threads by Tom Frieden (former CDC director) and Bob Wachter (Chair of Medicine at UCSF), both providing helpful analysis and answers on COVID-19.
Another study in San Francisco pointing to the particular vulnerability of low-wage workers. A policy recommendation on protecting people first, followed by a praise for the nationwide seroprevalence study conducted in Spain. Finally, reporting on increasing interest in analysing sewage to potentially provide an early indicator of COVID-19 spread, particularly in a testing constrained world.
🛑 Article of the day: “‘This man knows he’s dying as surely as I do’: a doctor’s dispatches from the NHS frontline” from Rachel Clarke (Palliative care doctor and author of Dear Life)
This is a very moving article from Rachel Clarke. As we increasingly focus on data from ‘number of cases’, to ‘fatality curves’, to ‘transmission rate’ and now ‘k-factor’, we can only be grateful and welcome that Clarke took the time to reconnect us with the human tragedy of this pandemic. She quotes one of the sons by the side of their dying father explicitly making that point:
“I don’t want him to be a statistic.”
At that moment the article hits you. It reminds you, maybe not as deeply as Rachel Clarke, of how the media and press briefing have normalised this pandemic as a set of sometimes “improving” data sets. Later on in the article, Clarke labels the UK government daily press briefing as the “number theatre” unlike the life and death theatre of the intensive care unit and its viscerally reality and deaths.
A study included previously in the Corona Daily (“The public do not understand logarithmic graphs used to portray COVID-19”) concluded:
“Consequently, merely changing the scale on which the data is presented can alter public policy preferences and the level of worry, even at a time when people are routinely exposed to a lot of COVID-19 related information. Based on these findings, they call for the use of linear scale graphs by media and government agencies.”
Clarke’s thoughtful and deeply human article moves its readers more than a logarithmic to linear scale change on a graph could. Read it and share it, because if a scale on a graph can alter public policy preference (and the accountability voters demand), this article will make ‘leaders’ hiding behind or finding success in improving numbers insupportable. (Link)
🇬🇧 Video of the day: “Dangerous moment” as senior scientists warn lockdown is being eased too quickly via BBC News.
“The UK is "at a dangerous moment" according to England's deputy chief medical officer, who urged people not to abuse the new more relaxed lockdown restrictions. Professor Van Tam reminded people of how rapidly the disease can spread through the population. People are being tempted out by the warm weather and there’s evidence that large numbers are ignoring the social distancing rules.”
🇺🇸 Video of the day: Scott Gottlieb (former Food and Drug Administration) director) talking about the impact of the riots on the epidemic. (Link)
Twitter threads of the day:
🦠 Insights from Tom Frieden (former Director of the Center for Disease Control and Prevention and CEO of Resolve to Save Lives) provides a detailed and insightful thread following the CDC weekly data release, but also covering Floyd, health inequality and the looming health disaster in Africa.
Starting with a word for George Floyd:
Also looking at the death toll in Africa potentially being 10 times greater from disruption from COVID-19 rather than COVID-19 itself.
Also commenting on race/ethnicity and how COVID-19 disproportionally affects African-Americans.
And though police inequality of treatment and brutality are the most shocking, Dr Frieden quotes Dr. Martin Luther King, Jr in the middle of his thread:
“Of all the forms of inequality, injustice in health care is the most shocking.”
The last tweet of this thread gives all of us an indication of where Dr Frieden believes we stand on the timeline of our struggle with this pandemic:
(Twitter Thread)
🦠💉: A great thread by Bob Wachter (Chair, UCSF Dept of Medicine) answering the most frequently asked questionson COVID-19 from whether vaccine or treatment will arrive first, potential virus seasonality, whether we will see another big city apocalypse like New York, school reopening, likelihood of identifying super-spreader and flying. Also his thoughts on George Floyd and the the risk of it dividing the US further at a time it needs to come together.
(Twitter thread)
🇺🇸 Usha Lee McFarling writes “When hard data are ‘heartbreaking’: Testing blitz in San Francisco shows Covid-19 struck mostly low-wage workers” for STAT news. McFarling reports on a large scale study in San Francisco, whose finding are important in keeping society together in the face of endemic and chronic inequalities. The study run by Diane Havlir who runs the HIV/AIDS division at the University of California, San Francisco found:
“Questionnaires administered with the tests gave her an answer: 90% of those who tested positive could not work from home. Most were low-income, and most lived in households with three or more people.”
There has been a lot of questions about who should be prioritised for as long as testing capacity is constrained. Whether in Singapore or now San Francisco have shown, it could be that prioritising testing amongst the most vulnerable might help save the most lives and improve social cohesion. (Link)
🏛 Jason Furman (Professor of the Practice of Economic Policy, Harvard Kennedy School) writes “Protecting people now, helping the economy rebound later” for VoxEU. Since the beginning of the pandemic, a number of governments have been too slow to respond in part because of a flawed framing of the pandemic response: saving lives versus saving the economy. Most of the countries which have flirted (UK) or embraced (Sweden) “herd immunity as strategy” were prioritising the economy over people. Although it is potentially too early to tell whether in a different time frame they will suffer less economic loss, as of today both countries are the worst performing in terms of new death per capita (Source: FT):
Furnam advocates for policies which prioritise the saving of lives, as protecting people is the best chance for the economy in the future. (Link)
🇪🇸 Emma Yasinski writes “Researchers Applaud Spanish COVID-19 Serological Survey” for The Scientist.
Carl T Bergstrom (Professor of Biology at University of Washington) cares deeply about fighting disinformation and even though he is not cited in the article, he came to the same conclusion on the Spanish serological survey:
A number of these surveys have been criticised, whether from Santa Clara or New York, but the design and disclosure of the Spanish team has been applauded and should serve as a template for other regions undertaking such surveys. Unfortunately, and despite Spain high death toll till now, the survey estimated that only 5% of the Spanish population had been infected (far from herd immunity levels). (Link)
🦠 Sharon Begley writes “Wastewater testing gains traction as a Covid-19 early warning system” for STAT news. Given the testing capacity constraints, and our remaining knowledge gaps in the spread of SARS-CoV-2, getting an early indicator of whether the epidemic would be exponentially spreading again would be hugely valuable. Given that scientists have now established that SARS-CoV-2 was shedding in stools, researchers have studied whether wastewater analysis could provide such early indicators. Wastewater epidemiology is not new as Begley writes:
“Wastewater epidemiology” has been used for decades to detect polio in countries where the disease remains endemic and, more recently, to estimate the prevalence of opioid abuse in U.S. communities.
A team at Yale has published a promising pre-print (not peer reviewed): “SARS-CoV-2 RNA concentrations in primary municipal sewage sludge as a leading indicator of COVID-19 outbreak dynamics”. The graph below shows that sewage sludge provides “a seven-day leading indicator ahead of compiled COVID-19 testing data”:
Begley reports on a number of studies and countries looking into “wastewater epidemiology” to guide their policy response. (Link)
(New❗️) Weekly newsletter on masks: “Smart masks news #1”. As masks are likely to become either a voluntary or mandatory part of our life, Rodolfo Rosini:
“This if the first issue of my weekly newsletter about smart mask tech. I will experiment with different types of formats over the next few months, and feedback is welcome.
This list can only grow with the help of its readers, so please forward this to one person you know that might be interested.
“The mask is the new t-shirt” - David Galbraith”
(Link)
📊 A picture is worth a thousand words: Global (🌎) and local (with relevant flag) visualisation and forecasting tool
🇺🇸
(NEW❗️) “The COVID Racial Data Tracker”“The COVID Racial Data Tracker is a collaboration between the COVID Tracking Project and the Antiracist Research & Policy Center. Together, we're gathering the most complete race and ethnicity data on COVID-19 in the United States.”
(Link)
🦠 “Science Forum: SARS-CoV-2 (COVID-19) by the numbers” (Link)
“The COVID-19 pandemic is a harsh reminder of the fact that, whether in a single human host or a wave of infection across continents, viral dynamics is often a story about the numbers. In this article we provide a one-stop, curated graphical source for the key numbers (based mostly on the peer-reviewed literature) about the SARS-CoV-2 virus that is responsible for the pandemic. The discussion is framed around two broad themes: i) the biology of the virus itself; ii) the characteristics of the infection of a single human host.”
🇺🇸🌎 This model has led accuracy for several weeks in the US. It also does projection for Europe and Rest of the World. (Link)
🇺🇸 “Is your community ready to reopen?”: A map of the US (50 states and 2,100+ counties) looking at reopening risks with metrics around 3 criteria: 1. Is COVID in retreat? 2. Are we testing enough? 3. Are our hospitals ready? (Link)
🌎The Financial Times (visualisation) has a data tracking page which is in front of the paywall, looking at cases and fatality curves for selective countries and metropolitan areas/region. It is not as extensive as the Madlag link below, where you can see static as well as animated images for a greater number of individual countries. (Link)🇺🇸 The Johns Hopkins University resource center was the first one I used back in January they have now made available in their latest iteration a county by county dashboard in the US including information about health capacity, insurance coverage, ethnicity and age breakdown of the populatio (Link)
💊 The "Map of Hope" provides a geographical overview of planned, ongoing and completed clinical trials. It is put together with data from WHO Clinical Trials Search Portal by the Heidelberg Institute for Geoinformation technology. (Link)