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Right now Australia has one of the lowest death rates from coronavirus in the world. With 4,561 cases but only 19 deaths, the clumsy Case Fatality Rate is only 0.4% — lower even than Germany. While some commentators think that’s a reason to ease up it may be partly due to temporary good geographical luck. Plus winter is coming…
1. Australians with Coronavirus are younger (for the moment).
Most infections in Australia came from overseas travel — something the 20 to 70 year olds do a lot of, but apparently the 80+ age group aren’t flying on 20 hour long haul trips across the Pacific. (Last week the most common source of Australia’s cases was the USA, especially Aspen). This week the main source is Europe, and the nation called “cruise ships”. If and when the virus starts to spread among the older cohorts the death rates will rise. (Unless we figure out that treatment first).
Source: Australian government
Compare the ages groups of patients in Korea and Italy. Fully 40% of Italian (known) cases are 70+.
Statista — demographics of Italian and South Korean cases
Italy and South Korean demographics
Fortune
Good. Real signs of the flattening of new daily cases of Coronavirus or #CCPVirus in Italy, and possibly in Spain. Instead, ponder that if Italy didn’t slow the spread the 6,500 new cases on March 21 could have become 17,000 new cases every day by now.
Italy appears to have peaked — starting on March 21st — but may need to stop keeping sick people at home
On March 9th when Italy had about 9,000 cases in total, and 500 deaths, the government declared a quarantine across the whole nation. By March 11 everything that could be shut down, was. These changes appear, finally, to have stopped the exponential growth in new cases about 10 days later. But even after three weeks of lockdown there are still 5000 new people getting infected every day. One professor, Andrew Chrisanti, thinks it is because they are telling infected people to stay home instead of isolating them from their families. Presumably if Italians live in larger extended families, they must get the infected out of homes.
“In our opinion, the infections are happening at home.” Crisanti helped coordinate the coronavirus response in Italy’s affluent northeastern region of Veneto, where blanket testing […]
Professor Kim Woo-Ju, Professor Infectious Diseases, Korea, says that masks are “definitely effective”. “I find it quite odd” that the west people don’t wear masks.” “People wearing a mask have a significantly lower chance of getting infected than those who don’t.” WHO says not to wear masks, he says “I disagree.”
Around the middle of the interview he says that one of the reasons Korea has low rate of infection is because they wear masks — as good as N95 (P2) — this is the same type as what the doctors wear.
He says Korea, and all the South East Asian countries are also experienced because they went through the SARS and MERS outbreaks. They knew what to do, they knew they needed tests fast.
He speaks well. h/t MichaelSmithNews. (via Annie ) and Chiefio somewhere (via Bill in Oz)
“In 30 years of pandemics, Ebola, MERS, Swine Flu … the Covid-19 epidemic is the most challenging”.
In the 80+ age group the death rate is 11% With the largest number of tests anywhere, they find 20% have no symptoms. But it is still not random testing. And the number may be different in other countries due […]
If you only read one serious page about how to deal with this crisis read Coronavirus: The Hammer and the Dance. The countries that “get this” approach will be the first to recover.
It’s all the things I’ve been suggesting but done on big scale with an expert team.
What I call the Slow Bleed is officially known as Mitigation. It’s the 6 month Flu strategy that kills people and the economy.
When I said Crush the Curve, they call it The Hammer, the hardest form of suppression. The Dance is the delicate recovery process until we get a vaccine, a treatment or a nicer mutant version of the virus.
1. Hammer and Dance — there is a better plan (click to enlarge)
Eventually we’ll all get to the Hammer Crush approach because the alternative is so horrible.
Even Imperial College concludes that slow “Mitigation” is just not viable: in the UK the demand for ICU beds would exceed capacity 8-fold, and there would be something like a quarter of a million UK deaths, and over a million in the US. They conclude that epidemic suppression is the only strategy, yet their predictions on that are dire. […]
Apparently no one listened to him.
The thing we were always afraid of was a virus that people could shed even if they felt well enough to get on a plane…
He’s right about “the blood of survivors” — blood contains antibodies to the virus after they recover. So plasma from survivors might help current victims. And that trial will happen in New York.
But we don’t need a “global heath system”. We have that already and it’s worse than useless. Back in January the WHO was telling everyone not to stop flights from China. Absurd WHO declarations became the convenient excuse for weak Chief Medical Officers to recommend exactly the wrong thing. WHO advice worked out well for China, but is currently killing citizens everywhere else.
How cheap and easy closing those borders looks now eh?
China bought the WHO a long time ago. WHO chief, Tedros Adhanom, was recently the Foreign Minister for Ethiopia, which is now securely Debt Trapped on China’s Belt and Road. Even as the CCP suppressed doctors, hid the true statistics, and welded their own citizens in their apartments, Tedros fawned over President Xi.
The petition calling to sack the WHO […]
Be wary of reports that the new Imperial College modeling on Coronavirus has downgraded the threat. With headlines like these (below), you could be forgiven for thinking Coronavirus posed less of a problem. The updated model talked of UK deaths being “only” 20,000, not 500,000, but because they were modeling two totally different scenarios. The update assumed that drastic action had started.
The headlines could have said “Draconian Shutdown could save 480,000 lives”.
If Ferguson has any confidence now that the virus will peak a lot sooner — in mid-April — and the UK will not crash their hospital ICU bed supply, it’s only because the country is finally taking serious action and because “the UK should have the testing capacity “within a few weeks” to copy what South Korea has done and aggressively test and trace the general population.
The full Imperial College report by Neil Ferguson’s team doesn’t suggest anything like these headlines imply. Ferguson himself has responded on twitter that the transmission of the virus is slightly faster than they thought, but the lethality is the same.
He now thinks the Ro (rate of infection) is over 3, up from 2.5.
UK has enough […]
Asleep at the wheel.
The Lucky Country wakes up to the cost of globalization. There are only 3,000 Covid cases here, we have barely begun, yet we’re already running out of protective gear. The lives of our doctors and nurses are at risk because bureaucrats were too slow to see the obvious, blindly unaware of foreign allegiances, and they kept using the old Influenza plan when this wasn’t influenza.
The media, led by the bloated ABC, reinforced all the incompetence, more worried that we might made bad jokes about shaking hands in hospital.
Meanwhile, below, China now has excess masks which it is donating to Belt and Road Slaves in Europe and to nations where it wants access to 5G network deals. Our masks, used as levers for China to gain power.
50 shades of incompetance
Chinese-backed company’s mission to send Australian medical supplies to China, by Kate McClymont.
According to a company newsletter, the Greenland Group sourced 3 million protective masks, 700,000 hazmat suits and 500,000 pairs of protective gloves from “Australia, Canada, Turkey and other countries.”
This is the free market at work — to some extent, those supplies were more needed in Wuhan […]
In the West the public have been discouraged from wearing face masks, and told they aren’t much help. This is mostly because they are “much help” and the front line docs and nurses really need them but no one in charge ordered enough in advance, and none of them had the honesty to say so. The daft push-me-pull-you messaging of how the useless masks are needed on the front line will go down as a case study in how not to communicate (or build trust). The truth is we do want people to wear masks in the street, because it almost certainly does slow transmission. (These Lancet authors think so too).
In high density East Asian nations, face masks are common. (And viral growth curves are generally slower, though for lots of reasons.) Possibly after Coronavirus has gone, masks in winter might be more common here too.
Things can change fast:
Kamil Chudačík, twitter:
In Czech Republic we went from: “Look at the idiot wearing a mask!” to “Look at the idiot not wearing a mask!” in 2 days. I can say the czechs are very conservative in terms of changes so I’m surprised by this behavior. The […]
Option three gathers wings
Finally the world is tossing out the pointless old Influenza Pandemic plan that called for six months of slow bleeding. Leaders are waking up to the high speed, hard and fast option. Tonight 20% of the worlds’ population are crushing that curve with a full lockdown because it’s the only option. 1.3 billion people in India are now in a three week home quarantine, joining France, Italy, China, Poland, Spain, Belgium, the United Kingdom, New York, California, South Africa, Colombia, Bolivia, Jordan and Tunisia and New Zealand. Sadly half a million people (at least) have caught Covid-19 and there will be another few doublings before the new lockdowns even start to show on the graphs.
Maybe stop feeding it fresh meat?
The Lucky Country Downunder, meanwhile, is copying the Italian-plan-that-failed with a bunch of wishy arbitrary rules that change by the day and are not remotely enough. We know the infection is spreading, but we’re still able to share our germs in Centerlink queues, at Kmart and while getting a haircut. We can’t have 6 people at a wedding, but we can have 600 at a school. Borders are closed but people are still going through […]
A High Stakes Game
If the trials of the anti-malarial chloroquine (or variants) work, Trump will get away with all the understatements he said in February.
On twitter the combination of Hydroxychloroquine and azithromycin are known as #TrumpPills. The trials started Tuesday. We don’t know the results but doctors are buying up pharmacy stocks across the US — presumably to protect themselves (hopefully).
As the death tolls mounts, the Democrats are surely planning to put all the Trump quotes like “it’s going to disappear. One day, it’s like a miracle” on high rotation leading up to the election. But if the trials of anti-viral agents bring good news, he can reframe the past as if he was betting on that in February. (Perhaps he was?)
Though not many people spend two trillion dollars on a problem that’s disappearing.
Combo of existing drugs shows promise against COVID-19
Most patients treated with hydroxychloroquine alone cleared the virus in three to six days, compared to an average of 20 in China — …
The authors advise: “Use this treatment cocktail early, and don’t wait until a patient is on a ventilator in the intensive-care unit.” They also note that […]
Message to the young and immortal
A fully fit 28 year old who ran marathons tells what it was like for him to get Coronavirus. He ended up spending 13 days in ICU. His ongoing liver problems and weakness will take a month or two to get better.
His message to young people out at parties or on the beach: ” You might survive, but the old person that didn’t get that ventilator might not…”
But the spread of stories like this rule out some future paths.
Forget all the pussy-foot weak quarantines
This shows that the “Let it RIP” approach and the “Herd Immunity” approach were never even worth discussing. The community would not tolerate the risk or inhumanity of either. But this also shows that the Slow Bleed approach of weak Social Distancing for six months will be dumped like a hot rock asap (it’ll be rebadged and quietly wrapped in stronger stuff). As Italy found (and now Spain) weak quarantine doesn’t work very well. Only serious quarantine can solve this.
Speaking of solving this: Good to hear that cases are possibly slowing in Italy. Looks promising. What did Italy do 12 days ago — On March […]
There is a third way — Why are we so fatalistic?
It’s not a choice between Let It Rip and the slow bleed of “Flatten the Curve”. It’s not a choice of health versus money. The third option no one is mentioning is to Crush The Curve: we go hard, fast, and do a major short sharp quarantine. It’s not radical, it’s just textbook epidemiology, it saves more lives and it saves the economy too.
SlowMo, Boris and Trump are still two weeks behind the virus. It’s time to get the Third Option on the table.
Flattening the Curve is a fatalistic slow bleed that must last months. It rescues us from the demolition derby that the Let It Rip disaster is cursing on Italian hospitals, but it’s deadly for the economy. All leaders who are keeping schools open while turning student dorms into triage units are locked into this limited thinking. It’s the Influenza-plan rejigged.
There is another way — (as I’ve been saying) — we stop dithering and acting two-weeks-late, and jump ahead of this inanimate code. We aim for extinction — hunt every infection down, keep most people at home, reduce the spread, then finish by following […]
Amazing. Sinbad reports on the situation in Iran. He is a commenter here who speaks the language. I can’t confirm this except to say that #Coronavirusupdates Iran looks like everything he is describing. Officially there are only 388 cases and 34 deaths. But on twitter, just like China, censorship and denial and so much more. Mass graves. Corrupt officials. Mass spraying of the streets. But if there is no attempt to stop it spreading (no lockdown like China has done) this will truly run wild. Those poor people. Germany closed flights in January, related to other problems in Iran. In the last week Iraq, Oman, Turkey, Pakistan, Afghanistan, Tajikistan, UAE, Kuwait all closed borders with Iran. Australia, with lower medical standards imported a case from Iran today instead. – Jo
UPDATE: Finally, today the Australian government banned arrivals from Iran without a two week holiday stopover somewhere. That’s a lot better but should be mandatory proper quarantine. The government now has the arduous job of tracking the 40 people (or more) she may have infected and the people those victims may have infected (their families). Those 40+ people now have the stressful wait to find out if they got “lucky”. […]
Something does not add up
So the virus is on its way. Even though Australia has no known community transmission we are choosing to slow down the spread by actively importing it even though we are surrounded by a moat, and are pretty much self-sustaining. We have thousands of high risk people and the disease that’s coming is largely unknown — today there are reports a Japanese case of a woman medical experts had thought had recovered who tests positive again. Is this a biphasic disease like anthrax? That’ll be fun.
Winter is twelve weeks away for Australians, and we know the coronavirus potentially threatens to overwhelm our medical systems and could be a GDP-type hit on national economies. It’s highly infectious, and between 5 – 17% of current cases outside China require hospitalization, and probably 1 -3% will need intensive care. Inviting the virus to start spreading now will mean it will peak during winter — the worst possible time in Australia.
Australia is one of the easiest countries to protect from this scourge, yet we are obediently following policies of northern hemisphere nations in a different situation. Hmm?
As I keep saying, it’s easier to import a deadly […]
The good news — babies and children appear to be not at risk. The not-so-great news, people over 80 in China have up to a 15% fatality rate (usual caveats, based on unreliable communist statistics and will hopefully be lower for many reasons, see below.) Note that even with the “one child” policy effects in China, that most western nations have a higher proportion of older folk — especially France, Germany and Greece.
The news on “rates of severe cases” is mixed. Singapore, Japan and HK are looking at 15% early rates. But many other nations are looking at 0%. Hmm?
A/ Fatality rate per age group. b/ Demographic age groups in different nations. C/ Relative mortality compared to China (apparently due only to the age demographic). | Click to enlarge. Age and Sex of COVID-19 Deaths REF China CCDC
*Fatality rates calculated by the China CCDC won’t include many unrecorded asymptomatic infections, nor the deaths outside hospitals and don’t appear to include the lag either. But they show which groups are at most risk.
Worldometer now gives us rates according to sex and preexisting conditions. (Reproduced below). Basically there are 30% higher death rates in men, […]
In short:
Outside China, 2% of cases have progressed to “severe”. But if the lag is eight days then progression to severe is more like 5%. In China about 1/5th of severe cases are “Critical” If that rate occurs in the West, hospitals will be overwhelmed if just 1% of the population gets infected. In Singapore, the doubling period for confirmed cases is about nine days. Currently the spread is not exponential outside China (most days)
News today: First victim in Europe — an 80 year old Chinese tourist.
Stats: Total cases outside China: 787 Deaths: 4 Severe cases: 18 (2%)
Early days of “outside China” data
The 2% rate of severe cases is an underestimate above. There is an eight day lag from diagnosis to “severe,” and then a longer lag to death. Total cases outside China on Feb 8th was 354. So a more realistic estimate is that about 5% of confirmed cases outside China have now progressed to “severe” (i.e. 18/354).
What does severe mean? It appears “severe” means hospitalized but not necessarily in ICU. In China, the rates issued in a Feb 7 press release were 82% mild, 15% severe, and 3% critical. From […]
Partial post hoc reactive quarantine holds seven planes at London airport– seriously?
Madness. Eight planes have been held up for hours in London airports as they land with people with coughs and colds and try to check suspected cases. By the time people are symptomatic, its too late. Temperature checks may catch the most contagious people but now one person with a unrelated common cold can also cause a major and unnecessary disruption while other infective people can freely fly in and walk straight through.
Asymptomatic people can potentially infect 2 to 3 random people (or 10) who may then also infect 2 – 3 random people each before the Epidemiology SWAT Team realizes and starts testing and tracking. We play an impossible game of catch up in a race to isolate all possible contacts.
HOURS of misery in coronavirus lockdown at Heathrow:
DailyMail UK
Passengers endured hours of misery at Heathrow Airport this morning when up to eight planes were put on lockdown over coronavirus fears after passengers on board complained of symptoms of the deadly virus.
MailOnline understands a British Airways flight from Kuala Lumpur was held up on the tarmac for […]
Global Markets were shaken by the sudden rise in numbers out of China yesterday. But the increase was not a surprise for anyone who has been watching social media and the measures being taken in China. That China is now allowing the WHO in may be an admission that they really do need help. The explanation for the jump is that China changed the definitions. They are also admitting that there may be many cases of people with low grade infections, but also unattributed deaths as well. For days the ratio of cases to deaths was suspiciously 2.1%, 2.1%, 2.1% … Now perhaps it’s a tiny bit closer to the truth.
The tally outside China continues to rise: there now 587 cases, with 3 deaths (1 new one in Japan) and 24 people classified as “serious critical”. These are the key figures to watch. We expected the number of cases that were severe to rise as the five to eight day lag unfolds from the first symptoms to the onset of breathing trouble. So at the moment 4% of cases outside China are headed for hospital intervention, perhaps ICU (does anyone know the definition of “Serious Critical”?). That will keep […]
So Coronavirus is now CoVID-19.
We’ve been walking the cusp of containable versus pandemic for two weeks but the growth of infections outside China is just a bit too fast, a bit too random and the news suggests its easier to spread. At least the number of severe cases outside China is still only 2% of the total. But there’s a lag of a week or two, so that’s likely to rise. If it is even possible to stop, I suspect only the mass closure of borders will do.
World (ex China) Cases: 517 Deaths: 2 Recovered: 54 Severe: 12
Click to enlarge
While Australia and the US and even India have the illusion of stability, the rise in Singapore, and on that ship is hard to ignore. Singapore is doing advanced tracking, yet still it spreads (see the chart, right). The difference between Singapore and Australia may be part luck — one superspreader versus one man who didn’t infect anyone on a whole plane.What matters then, is just how many people are superspreaders? The one ray from Singapore is that 15 people on that list are already listed as recovered. When I say we hope it’s […]
One day ago, the statistics were looking good but there have been a few ominous shifts. Another 26 infections have been recorded, some in a French ski chalet, some in Singapore —at least three of which are hard to explain. These appear to be transmissions outside China, which is what we are hoping to avoid. It’s bad, but could have been a lot worse. Fortunately the Diamond Princess tally hasn’t risen much — standing at 64. Another plus — it’s almost two weeks since one passenger on a Tiger Air flight in Australia flew as he was coming down with symptoms yet the other 157 passengers appear to be OK. Promising.
…
Just 2% of cases so far are severe outside China (but that may grow)
The all important statistics outside of China are starting to accrue — So far there are 355 infections. Of those, 35 have recovered and only eight are marked as severe (see the table below). It’s good news that only 2% are severe, however it’s too soon to know — 90% are still unwell.
The illness appears to be less severe outside China, but a new study reports that this virus often looks benign […]
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