Comments on Covid-19 – the Best Ones You May Have Missed

Comments on Covid-19 – the Best Ones You May Have Missed
March 30, 2020 Chris Rowland
In COVID-19, Free

The standard of debate on this site has if anything been elevated to even greater heights by the Coronavirus crisis. There have been some brilliant, perceptive and highly informed comments – and here are some of the best of the last week:

1 – TerryD on the importance of growth rate rather than daily death numbers:

First some context: I’m not a medic, I’m a systems engineer – working with complex telecommunications systems – with experience of data analysis and data viz.

I’ve been trying to understand the data related to Covid-19. I’m not claiming any great insights. I’m sharing my ongoing analysis which is primarily to help me try and understand the data trends, seeking  positives where possible.

Here is a plot of the Covid-19 cumulative death rate for China. All the data is sourced from John Hopkins github repository.

The graph is similar to a logistic function. There is a primer on exponential and logistic growth here. The growth factor (new cases on day n / new cases on day n-1) of the logistic function is ~1.0 at the ‘inflection point’. This is important as it is the point at which the logistic curve turns and exponential growth ends.

Here is a plot of Covid-19 growth factor for China.

And here is the plot of the growth factor for several countries that currently appear to have the pandemic under control locally.

As you can see the growth factor for these countries appears to have stabilised around 1.0 or less. These countries could of course see a second wave.

Here is the growth factor for UK and Italy.

Italy appears to be converging, which is very encouraging. The UK is not yet stable, which is no surprise given that the lockdown is relatively recent.

My takeaway is rather than simply look at ever increasing daily death numbers it is useful to consider the growth rate as this gives an indication of how close we are to the inflection point, the point at which the curve turns indicating that the growth is starting to come under control locally. The inflection point can also be used to predict the final mortality count.

Though we need to be careful to avoid prematurely predicting that the pandemic is under control locally. And we need to help those countries that do not have sufficient resources to fight Covid-19, for example relatively poor countries in Africa. The ability to maintain local control will be at risk if the pandemic is not controlled globally.

2 – Mekokrasum – a frontline doctor -with some recommended reading:

Articles from the NEJM – New England Journal of Medicine:

Apologies people, it is all rather dry and academic but worth a read if you are interested in the interface between the science and real doctoring. A lot of the COVID-19 articles are published free, available without subscription, so you don’t need to be a member to read most of the editorials and commentary.

Please stay safe, please keep social distancing at 2 metres if possible and wash your hands thoroughly!

3 – David – another frontline doctor – with some first-hand experience:

“Worried Sick”

Our numbers of infected and succumbed continues to rise but holding below capacity for now.  During last night’s shift I crossed paths with Drs and Nurses from ED, Site Managers, the Med Reg, Support Workers and the amazing Domestic crew that turn up for the enhanced clean down. I also had a visit from the ITU Reg and a gaggle of ITU Nurses. (Visualise a critical care patient then imagine the logistics of trying to get him or her through a scanner and produce diagnostic quality images – it takes quite a few hands and a lot of working out!). Although I had some first hand accounts from most of the areas at the sharp end if you want to know the state or mood of the “whole hospital” ask an experienced Porter.  Its a question I often ask of D as I arrive as my routine coincides with his and we always bump into each other. The answer last night: “Anxious”. Unlike other hard times – winter pressures and local disaster – there is so much more for everyone to worry about on top of what we face during our working hours and that angst no matter how well you can manage it, putting on the brave face adds so much to your growing load of personal fatigue.

While the numbers coming through doors remain lower than normal there is an increase in patients presenting with mental health challenges. More of the “barely holding it together”are struggling, many in supported community places are challenged by their own predicament, how their fellow residents may/may not be coping with it, and the stresses on the providers in staffing and provisioning. Any novelties of lockdown are going to wear off anytime now and as the realities of the next few months start to bite the psychological challenges will grow, for all of us.

4 – El Indio with a report that China’s coronavirus death toll could be far higher than the figures show:

I just read a startling report that China’s numbers could be vastly under reported.

Chinese public has started questioning the death toll numbers, and experts believe the zero infection numbers seem to be a suspect.

Not sure if it is the economy or the debt that China can’t finance but lying to your own public or the world doesn’t seem like a good idea. The least they can do is come clean on this mess.

Link to Bloomberg article

The families of those who succumbed to the virus in the central Chinese city, where the disease first emerged in December, were allowed to pick up their cremated ashes at eight local funeral homes starting this week. As they did, photos circulated on Chinese social media of thousands of urns being ferried in.
Outside one funeral home, trucks shipped in about 2,500 urns on both Wednesday and Thursday, according to Chinese media outlet Caixin. Another picture published by Caixin showed 3,500 urns stacked on the ground inside. It’s unclear how many of the urns had been filled.

5 – Stevenson1988 sees possible ramifications to the EU itself following Coronavirus:

I’ve been reading in this morning’s Telegraph (behind a paywall I’m afraid, so can’t reproduce) more details of the delayed response in Italy – in particular the lunacy of allowing the Atalanta CL match against Valencia, less than 6 weeks ago, to go ahead in Bergamo which they think has accounted for a huge explosion of extra cases in both Italy and Spain. Also the dismay that is being felt throughout Italy at the every man for himself approach seemingly being taken by the EU with, as usual, the Northern states unwilling the bail out the Southern states without all the usual strings attached. This is really going to push the EU one way or the other: either full monetary union and effectively a United States of Europe or the potential collapse of the whole EU project. For the first time Spain and Italy have forged an alliance and denounced the approach being taken in Brussels and the cracks are starting to show. This virus is going to have huge ramifications for the whole world moving forwards, way above anything to do with health.

6 – And Jeff reports that even the whole idea of globalisation may be threatened by the virus:

The other day behind the Wall Street Journal paywall Professor Frank Snowden of Yale who is arguably the world’s leading expert on what we call pandemics posted an interesting article which in spite of my efforts I could not post but if you can read it it is worth reading.

His major point is what we call pandemics cause change and in today’s world the change he speculated with revolve around the rethinking of globalization both in its economic and political realities. He does not speculate on what this change will be but based on what has happened in the past, it does seem that there will be change maybe massive changes in the reality of globalisation.