Week 5

Problem 1: Was the WHO right to say “test, test, test” ?

 

We must remember that these are still early days, and the final picture of the pandemic will not be known for some time. When everything has stabilized, and we all know how things were when it was actually over, everything will be much clearer. Both South Korea & Germany started their preliminary program before they had to. In each country when a positive result for Covid-19 was obtained, detailed  contact tracing was carried out, and all secondary cases were put into quarantine.

 

South Korea never had to introduce full lockdown, but did introduce some partial measures.  The outbreak number of cases stands at 8,652 cases and 94 deaths as of March 19, now has a case rate in relative decline. During the worst periods of February, Korean officials had been recording more than 900 a day. By March 19, the country has conducted more than 307,000 tests, the highest per capita in the world. . The Wall Street Journal reports that the country can test more than 20,000 people a day at 633 testing sites nationwide. A smartphone app provides GPS maps to track the infection’s spread. Medics pitch massive white tents on roadsides, where citizens receive free drive through testing, reducing the need to clean infected hazmat suits. Results are swift, too, coming by text within 24 hours.

Germany has the highest rate of testing in the world, rising to 1,500/M population at risk by April 15, 2020.  The high rate of testing is part of a containment strategy,  linked to contact tracing with quarantine of all secondary cases detected.  They also have a much younger population at risk – only 10% >60 (cf  50% in spain)..They also have far more high intensity beds (the number of acute-care beds in Germany is 621 per 100,000 people, compared with Italy’s 275 beds per 100,000 and the UK’s 228 beds per 100,000

Spain will be used as an example of a European countries, whose governments did little to mitigate what was to come. We could just as well have used France, Italy or (of course) the UK.

 

                                                            South Korea        Germany               Spain

 

Time to double prevalence            22 days                 8 days                    12 days

 

Total deaths   (April 8)                     217                       2,799                    16,800

 

Daily new deaths                                  3                         186                      619

 

Area of country                                 100/km2           357/km2               505/km2

 

Size of population                             51,3M                   88M                      468M

 

Density of population/km2             517/km2              233/km2          93/km2

 

GINI Index                                         31.3                         31.9                      34.9

 

Date of lockdown                              Only partial         March 19              March 14

 

Tests/M pre-lockdown                     205.4                    1,453                    hospital                                                                                                                                use only

 

Comment: Spain, despite its huge population, when size of the country is taken into account emerges as the least densely populated of the 3 countries – so relative densities of population, nor GINI index can account for this huge mortality relative to the others! Early population testing does help in these 2 countries

 

Problem 2:  How is it possible for the Swedish Government’s policy on Covid-19 to be so liberal?    (While the Italian population has been under severe lockdown, in Sweden at present the population is still able to shop, to go to restaurants, to get haircuts and to send children to school).

 

                                                                        Sweden                      Italy

 

Cases /million (today, 6th april)                  37                               2,244

 

How many days to double prevalence?      8 days                         16 days

 

Size of population                                         10.2M                         60.4M

 

Area of country                                             450,295km2              301,338 km2

 

Density of populations/km2                        22.65                          200,4

 

GINI Index                                                     28.8                            35.9

 

Comment:   The Swedes have a small population spread over a huge area; they are a long way from stabilization to their final case rate; Italy has a population density much higher than Sweden. The doubling time is much less for Sweden, indicating that there is still much to be done before stabilization, while Italy is further along its curve. This gives the Swedish government extra time. Any sensible government will delay the time they restrict their population.

(The inequality between the rich and the poor is much less in Sweden than in Italy. Wait and see: but I suspect that by the stabilization at the end, Sweden will still have fewer cases than Italy, perhaps related to its lower GINI index).

 

 

David Goldberg

Sunday 19 April

35 days survived, 56 days to go

Comments

Post a Comment

Popular posts from this blog

Week 6

This will be the week when courageous countries try taking the brakes off. We will wait to see what such Trumpian procedures achieve for them. Austria, Denmark and Czechia are all wondering which brake to remove.   Problem 1:   Let’s start with some countries which appear to be on a descending path of prevalence,   they will have longer values for the number of days to double prevalence, and all have fewer than one death /day, /million at risk. They have a range of different climates, with one in Europe, two the other side of the world, and one very hot.                                             Australia              NZ             ...
Read more

Week 10 - Where do we go from here? Should we be just a little flexible?

At present, we seem to be at a cross-roads. Either governments should have a single policy for their entire country,   or they might be some advantages in having a flexible policy, treating some parts of a country differently from others.   Have conditions been satisfied to begin to release the lockdown?   Most European countries (UK, Italy, Spain and France) are nervously emerging from lockdown after experiencing very high levels of Covid-19 cases. The reasons that politicians are keen to relax the lockdown as soon as possible are that the economic costs of the lockdown are huge, and we are likely to move into a recession.   They may possibly be hoping, as ours seems to be, that just bringing their R number below 1 will somehow, magically, make the virus disappear. But in countries that have experienced such high prevalence, if a vaccine proves impossible, and if anti-viral treatments are only partially effective, it seems more likely tha...
Read more

Week 12 - What will happen next? Super Spreader Events (SSEs)

Most previous blogs have largely relied on published work, but in order to cover the immense number of papers on Covid-19 this blog includes papers that have not been accepted for publication but are sponsored by Wellcome Open research   SSE’s can either apply to a cataclysmic event, with several people involved, or to an individual who has infected several people. The old idea, that single people passed infection on to single people, went out some time ago. We now have the 20/80 model, where 20% of the population are potential superspreaders , and they spread the virus to people who were near them at the time of the SSE. So, an SSE at a religious service will affect individuals who were at the same service, at a football match the new cases will be among those who were at that match, and so on. The new cases will be just as infectious as anyone else who is positive for the virus.   A recent example of an SSE When 61 people met for a choir pract...
Read more