Coronavirus - worldwide spread and control

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If the current infection rate keeps up, and folk keep ignoring the social distancing policy, by mid April everyone (who isn't isolating or protected) will (might/could?) be infected. If the mitigation strategies work (to flatten the curve), it could take a lot longer than that, but things should start to slow down in a couple of weeks - and by "slow down", that means the rate of increase will slow down. Italy's infections are still climbing, and we are 3 weeks behind them.

Ultimately, it's really difficult to tell, and it's even harder to predict when the authorities are giving such mixed messages.

That’s a scary thought. I’m watching and waiting every day for the govt to announce some proper measures at press conference - but am not seeing it.

I think London is not 3 weeks behind Italy. From a scientist I follow, they said London is 7-10 days behind Italy.
 
"New data has revealed that the United Kingdom has one of the highest coronavirus death rates in the world" ...

Just saw a tweet with image titled "The Case Fatality Rate Varies by Country" dated 16th March 2020. I'll just copy the image here in case some folks have trouble with embedded twitter.

Code:
https://twitter.com/DrEricDing/status/1240669044300296192

Case Fatality by country 16 Mar.jpg
 
When you said, if things are locked down then the current peak will go down within 10 days. But with Italy, I think it’s been over 10 days since they’ve been locked down and the number of new cases and deaths per day are still rising?

Or do you mean with a 14 day lag, and then 10 days?

I would have thought that it isn't as simple as a 14 day peak with lock down as if one person in a family (locked down together) has it then it is likely to spread to others in the family. So I would have thought there could be increases as lockdown happens beyond the detection of those that have it over the 14 days.
 
Just saw a tweet with image titled "The Case Fatality Rate Varies by Country" dated 16th March 2020. I'll just copy the image here in case some folks have trouble with embedded twitter.

I assume fatality rates will vary hugely with population health and demographics. Given the death rate with older people is worse then if you have an ageing population then you would expect a higher fatality rate.
 
Just saw a tweet with image titled "The Case Fatality Rate Varies by Country" dated 16th March 2020. I'll just copy the image here in case some folks have trouble with embedded twitter.

Code:
https://twitter.com/DrEricDing/status/1240669044300296192

View attachment 10208

Quite a lot has changed since then (for the UK definitely). Deaths are ~140 I think today, and ~3300 cases.
 
I would be taking fatality rates anywhere with a grain of salt right now.

Truth is that we just don't have a good handle on them yet, and will not for a while. This is a work very much in progress.

What this pandemic is showing is just how badly we have structured our societies over the last few decades, especially the industrialised societies.

Stressors always show up weaknesses, and this is a massive stressor.
 
I think this only kicks in when the system is overwhelmed. Is that the case already?

I was being slightly flippant; probably entirely inappropriate in the circumstances. I assume that we would have heard if there was no access to ventilators.

I was speaking to a friend, who is a doctor, who described having to hand ventilate a patient overnight before a bed could be found (in another country i.e. no beds in UK!) - that was before coronavirus. We really are starting from low numbers of ventilators; I find it very hard to accept the statement "we are ordering them" - they need to be in place now, not one year + from now.
 
These heroic people should already have healthy food available without any effort from them.



"The recording was played this morning to Britain’s Health Secretary Matt Hancock, who told the BBC’s Today programme that his heart went out to people like Dawn.

He said that people should follow the guidance which has aleady been set out but the government “would do whatever it takes” if necessary."
 
I think there are some fundamental misunderstandings regarding "herd immunity" being propagated.

Although the Science Media Centre provides some good explanations about what it is (https://www.sciencemediacentre.org/expert-comments-about-herd-immunity/), very little is actually known about the dynamics of SARS-CoV2 precisely because it is a new virus.

The assumption that the epidemic will start to "burn out" at about 60% is just that, an assumption (based on what the likely R0 might be). It is also an assumption that reaching that point will convey lasting "herd immunity" or anything like it. Herd immunity is usually reached after vaccination programmes, because vaccination can often confer much better and longer-lasting host immunity than exposure and recovery from the virus itself (this is particularly true in the case of measles, and we are only just beginning to learn why that is the case). But it also requires constant maintenance to keep levels of protection up. That's why we have vaccination programmes to make sure that new entrants into the population are covered. If immunity to SARS-CoV2 wanes after a few months in some people, any protective herd immunity could easily drop below the required level and the epidemic start up again. This is how virus infections either establish seasonality or even become endemic.

So when talking about "herd immunity", be aware that it is something that it is likely to be transient, it may not even be achievable at all, and it is unlikely to be desirable to achieve, given the mortality/morbidity associated with COVID19.
 
I assume fatality rates will vary hugely with population health and demographics. Given the death rate with older people is worse then if you have an ageing population then you would expect a higher fatality rate.
There is some great data from Italy on this. Apologies to whoever posted it earlier in the thread (tweet of a newspaper article, I think, and PDF with data - all in Italian), can't find the source now. But here are the key figures. It's all about age and health.

https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_17_marzo-v2.pdf

2004 cases, mostly from Northern Italy
355 deaths
Document dated 17 March 2020 (but I think this is only 10% of total deaths)

Median age at diagnosis: 63
Median age at death: 81

So it appears that the high death rate in Italy is primarily driven by an older age at infection, By contrast, a day or so ago Germany had 30 deaths from 10k cases: they had no data on age but anecdotally most people tested were young.

Health also matters. Here's the number of existing health issues - mostly cardiovascular

0: 1%
1 pathology: 25%
2 pathologies: 26%
3 or more: 48%

So co-morbidities are hugely important. Would be good to analyse the interaction of age and co-morbidities (there was no data on that).

There's more data but I don't speak any Italian.

UPDATE: more data on Italy from this tweet


Lombardia and Emilia Romagna are the 2 regions with most of the deaths in the first analysis as well
Italian region covid deaths.png


@Michiel Tack
 
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