Coronavirus - worldwide spread and control

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“Dr Lewis Mackenzie, a Biotechnology and Biological Sciences Research Council Discovery Fellow, commented: “Why on earth has this been sent to the media via a third party PR company instead of the Oxford University press team? Seems very irresponsible to encourage reporting on this topic before the scientific community had a chance to comment and peer-review it.

Caibre Sugrue is the founding director of Sugrue Communications, a technology PR agency. He is also a non-executive advisory board member of 100%Open, an innovation consultancy – which has worked for several British Government agencies, including the UK Ministry of Defence’s Defence, Science and Technology Laboratory (DSTL) and a leading charity which co-owns the Cabinet Office’s Behavioural Insights Team (BIT) or ‘nudge unit’.”
 
Hospitals are reaching peak capacity in major cities now in CA and NY especially, and many healthcare workers are getting sick, unfortunately one nurse has died in NYC already. PPE is now a common word on every news channel.


Three Boston hospitals reported Wednesday that a combined 100 of their employees have tested positive for the new coronavirus [. . .] At Massachusetts General Hospital, 41 hospital employees have contracted the coronavirus, though the institution noted in a statement that "it is believed that the vast majority of these individuals did not contract the virus at work.
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Note that these are massive hosptials to be fair, but so far Mass. has run low on total numbers of infected and this suggest there are many more in fact. But it's communte proximity to NYC is small and CT, NJ, PA are redzone candidates as well.
 
Here's something interesting that could explain a few things:

The mayor of Bergamo says a soccer match between the Atalanta and Valencia teams held in Milan may have spread the virus in Italy and Spain. Several members of the Valencia team later tested positive. There were 40.000 people in the stadium and Atalanta is a team from Bergamo.

There also was a patient early on whose covid-19 went undetected for a while and he spread the virus to healthcare workers.
 
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Andy said:
How the Pandemic Will End. The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out.
https://www.theatlantic.com/health/archive/2020/03/how-will-coronavirus-end/608719/
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Well worth reading.
He gives three possibilities.
1. All countries will control the virus simultaneously (unlikely)
2. Let the epidemic rip (terrifying)
3. Flatten the curve (takes forever and economy destroyed)

I think however unlikely 1 may seem as a pure option it has to be what ends up being done even if after false starts because the others are unthinkable. It is the choice China has taken. It is the choice the WHO recommends.
 
BurnA said:
Would it possible for countries to eradicate it individually and then only open up borders to similar countries?
It might be hard to patrol all borders.
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That was sort of what I was meaning by ending up with 1 after false starts.
Air travel is going to be a thing of the past for a few years now. Borders are going to need staffing in a completely new way. What you do with long porous borders on big continents I have no idea but the Soviets managed it for forty years. The aftermath of Covid19 may look eerily like post war Europe all over the world.
 
strategist said:
Here's something interesting that could explain a few things:

The mayor of Bergamo says a soccer match between the Atalanta and Valencia teams held in Milan may have spread the virus in Italy and Spain. Several members of the Valencia team later tested positive. There were 40.000 people in the stadium and Atalanta is a team from Bergamo.

There also was a patient early on whose covid-19 went undetected for a while and he spread the virus to healthcare workers.
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That game was in February 19th in Italy (Milan). It would've been very early for both countries, but it's possible it contributed. I remember many were already calling the 2nd legs (just two weeks ago) of the CL to be called off, it seems insane that they went on even at the time, particularly Liverpool hosting Atletico Madrid, and the 2nd leg of the Valencia Atlanta game. There was also PSG/Dortmund and Spurs/Leipzg at the same dates. On those dates March 10/11 Germany had around 2000 cases, Italy 10,000, France 2200, UK 460.

I suspect it was many forms of transmission going on at once early on, but mass gatherings were certainly a problem.
 
Thought this was an interesting report in the BMJ (it's open-access):Covid-19: identifying and isolating asymptomatic people helped eliminate virus in Italian village
An Italian academic has claimed striking evidence that most people infected with covid-19 show no symptoms but are still able to infect others, which he says has huge implications for testing policy, particularly in hospitals.

Sergio Romagnani, a professor of clinical immunology at the University of Florence, has reported how blanket testing in a completely isolated village of roughly 3000 people in northern Italy saw the number of people with covid-19 symptoms fall by over 90% within 10 days.

[...]

In an open letter to the authorities in the Tuscany region,1 Romagnani wrote that the great majority of people infected with covid-19—50-75%—were asymptomatic, but represented “a formidable source” of contagion

He told La Repubblica, “We’re deciding not to test doctors and nurses if they’re not developing symptoms. But in the light of the results, this decision could be dangerous; hospitals risk becoming zones with high infections rates in which infected people are not isolated.”
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Look forward to seeing his data published.
 
In the last few hours, the US has surpassed both Italy and China to become the country with the most confirmed coronavirus cases in the world. This is just a day after the US passed 1000 total deaths, and occurs as the total global number of cases passes 500,000, also today. Below is a list of all the the countries with the number of confirmed cases of 10,000 or greater. The full list containing all countries in the world can be found at https://www.worldometers.info/coronavirus/#countries.

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Notice that the US is the only country in this list (and in the world) with more than 10,000 new cases; no other country has even half as many. The number of daily cases in the US is expected only to grow for the foreseeable future.

If you click on the country name, you will end up on a country page with much more statistical information about the country. Of particular interest are the graphs and charts of the cases and deaths for each country. For example, for the US, here is a graph of the total confirmed cases, followed by a chart of the new daily cases. These figures are updated at the end of each day (GMT time), so today's figures are not reflected here. Nevertheless, a clear pattern of fairly pure exponential growth can be seen here, and today's figures from the chart above merely confirm that trend. There is no indication that this trend is beginning to turn at all yet.

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For more context about how exponential growth works and what it means for the future spread of this disease, I would again recommend the following YouTube video, which was referenced in my previous post.

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The government says a communications mix-up meant it missed the deadline to join an EU scheme to get extra ventilators for the coronavirus crisis.

Ministers were earlier accused of putting Brexit before public health when Downing Street said the UK had decided to pursue its own scheme.

But No 10 now says officials did not get emails inviting the UK to join and it could join future schemes.
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https://www.bbc.co.uk/news/uk-politics-52052694
 
Andy said:
https://www.bbc.co.uk/news/uk-politics-52052694
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Yet..
A week ago.. “Yes we’ve engaged with that process today. We’re not clear how many ventilators we will get, we’re getting on with it”.
Didn’t seem like they missed the emails.

I really am hoping they do join future schemes because it sounds like it would have helped the Uk a lot.

 
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Todays briefing from White House, just the doctor's, I had to transcribe this so I hope there are no errors.

Deborah Brix
  • States w/ low numbers can do contact tracing
  • 550,000 tests run (14% positive rate in people symptomatic enough to get tested)
  • Focused on UK report from 500,000 to 20,000 deaths in a model (ferguson?), looking at that to understand that adjustment
    • In that model you need to have a large group of asymptomtic that don't present for test to get to 60M ppl infected because in no country do you see an infection rate of 1/1000 people OR transmission is wrong
    • Prediction of those models don't match results in China or Italy. Italy should have 400,000 deaths with those predictions
    • Enough data to make predictions more sound
    • 20% of a population getting infected does not match data
  • NYC does have enough ventilators [this is contradictory topic in news], ventilators can be moved to urban areas
  • No reality where 60-70% of Americans get infected in 8-12 weeks.
  • [me wondering - is she ignoring the "if nothing is done scenarios"]
  • Only ppl over 1/1000 are small population countries (Monaco, Lichenstein)

Fauci

Vaccines - just starting multiple phase 1 trials, 3 months minimum, phase 2 (high number phase 2/3) looking for 'efficacy signal' despite high infection rates, possibly rushed after that, at least 6 months of production. Working to produce vaccines before trials are complete. Understands risk of vaccines.

Therapies - only wants to talk about rcts, confident in some effective or semi-effective therapy developing.

Questions

-Want IGG droplet test to test asymptomatic case rates.

Source: Content starts after the 30 minute mark.
 
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Woolie said:
We've just had our first day of complete lockdown in New Zealand. Schools are closed, and businesses. Only "essential services" are allowed to remain open (pharmacies, doctors, supermarkets). We're not permitted to mix with anyone outside our household "bubble". Who you were with last night is who you're gonna stay with for the duration. :nailbiting:

One household member is to be appointed to shop for food, etc. No travel is allowed outside of your neighborhood (except for essential services and their workers). But going for walks, jogging, skating in your neighborhood are encouraged. Cycling is allowed too.

Cyclists here are in seventh heaven - they have empty roads all to themselves.

I'm looking at the growth curves, to see if we go the way of Japan and Singapore or whether we head towards Europe/US. It will be an interesting test case to see the effect of very early-applied social distancing interventions. We are getting in early in a relatively sense, because there are still relatively few cases here (260 odd, and no deaths). Will post tomorrow to see if the curve is flattening (although it might be too soon to see results just yet)
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Guess we won't really know for a couple of weeks. The health authorities keep saying to expect cases to rise for at least another 10 days or so, possibly into the thousands.

This seems to be some of the modelling data they're using, not dissimilar to the Imperial College study.
https://cpb-ap-se2.wpmucdn.com/blog...ession-and-Mitigation-New-Zealand-TPM-006.pdf
Suppression and Mitigation Strategies for Control of COVID-19 in New Zealand
25March 2020
Alex James1,3, Shaun C. Hendy2,3, Michael J. Plank1,3, Nicholas Steyn1,2,31.School of Mathematics and Statistics University of Canterbury, New Zealand.2.Department of Physics, University of Auckland, New Zealand.3.Te Pūnaha Matatini:the Centre for Complex Systems and Networks, New Zealand.

Executive Summary
•Suppression strategies aim to keep the number of cases to an absolute minimum for as long as possible. This requires early and effective control interventions.
•Suppression can only delay an epidemic,not prevent it, but may buy enough time for a vaccine or treatment to become available.
•Mitigation strategies aim to control an epidemic so that herd immunity is acquired by the population without overwhelming healthcare systems.
•Mitigation strategies are likely to be very high risk: they are unproven internationally, potentially sensitive to uncertainty, and it may take years for herd immunity to be acquired.
•Strategy can be switched from suppression to mitigation.For example,once successful mitigation strategies have been tested in other countries. It is likely to be difficult or impossible to switch from a mitigation to a suppression strategy.
•A combination of successful suppression, strong border measures, and widespread contact tracing and testing resulting in containment could allow periods when control measures can be relaxed, but only if we can reduce cases to a handful.
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Radio NZ report on the above:
https://www.rnz.co.nz/news/covid-19...ws-nz-s-lockdown-could-buy-time-for-a-vaccine
Modelling showed that, left unchecked, the virus would infect 89 percent of the population and up to 80,000 people would die.


Hospital capacity would be exceeded once 40,000 people had the virus, and the peak of the epidemic here would exceed that capacity ten times over.

Under the strictest suppression measures, which included social distancing, case isolation, household quarantine, and closing schools and universities, the fatalities would drop to just 0.0004 percent - about 20 people. Hospital capacity would not be exceeded for over a year.

However, that scenario would require the restrictions to remain in place until a vaccine or other treatment was developed.
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And this:
https://www.rnz.co.nz/news/in-depth...g-nz-s-covid-19-spread-from-his-kitchen-table
That research was given to the government last week as it grappled with how to respond to the pandemic. The team's best-case scenario - strong suppression - is essentially what the government has gone with, Hendy says. "One of the great things about going into lockdown now is it really does make the job easier for the contact tracing and the testing… If that works and we can stamp out the disease, then we really might only see a handful of deaths and be able to keep this thing out. It still means we're going to have international travel restrictions for a long time, because the disease is out of control internationally and we're going to have to keep it out."
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Updating you with the results of day 2 of the New Zealand experiment. So far, our curve isn't looking as good as Japan and Singapore at the same timepoint (4 days since 100 cases), but it may be too early to tell:

Edited: this figure was incorrect - see latest one for april 5 here.
 

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youtube channel numberphile shows modeling spread. It´s essentially a fun channel, sometimes said to be a bit yellow. However, paremeters being:
S - people who can get infected
I - actual infected people
R - people who don´t have the infection anymore (dead or being immune in some sense)

Graphs start at about 13.00

 
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Coronavirus: Why Germany has such a low COVID-19 death rate
Germany's low case fatality rate is therefore partly caused by the fact it has tested more people and, as a result, has identified more mild instances of the disease.

In comparison, in the UK, only people who need medical assistance are being tested and as a result the UK's case fatality rate is much higher, at 4.8%.

However, carrying out more tests will not just have made Germany's case fatality rate look low compared to other places, it will also have helped reduce it even further.

By testing people who might have been exposed to the disease, Germany has been able to identify cases of coronavirus quicker and isolate people who have been infected.

This has helped prevent the disease from being spread to vulnerable groups - as the charts below illustrate.
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https://news.sky.com/story/coronavirus-why-germany-has-such-a-low-covid-19-death-rate-11964051
 
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