SARS-CoV-2 ("Coronavirus") and COVID-19




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Parking Garage Infirmary, University of Tennessee Knoxville (March 21st, 2020)







DEFINITIONS

Death Rate - I use Death Rate in two different ways. Which is confusing and I am trying to think of a good way to split them up. The first way, which is used on the "base" charts (see the FAQ), is simply the number of people who contract the disease who go on to die from it, expressed as a percentage of the total who contract the disease. So if the disease has a 5% death rate and 100,000 people get it then 100,000 x 5% = 5,000 will die.

The other way I use Death Rate is on the projection charts. There it is expressed as the rate of change in the death rate on a day to day basis. So if on Monday 10 people die from the disease and on Tuesday 5 people die, that is a change of 5 / 10 = 50% (in the downward direction, which is where we want to go).

Infection Rate - The speed (rate) at which new people become infected. Throughout this I use a rate based on new infections per day. Thus if on Monday there are 100 people infected and on Tuesday there are 150 people infected, that is an Infection Rate of 150 / 100 = 1.5 = 150%. We can then use the "rule of 70" to find out how rapidly the number of infected people. 70 / 50% = 1.4. That means that the number of infected people will double every day and a half (14 days)




March 21st data highlights:

  • MOST IMPORTANT THING TO KEEP IN MIND: Because of delays in symptom onset (incubation delay), delays before death, delays before recovery, etc. none of the data here shows us what things are like today. As you review this data keep in mind that what you are seeing is a picture of what the world looked like three weeks ago.
  • US Growth in new infections running at 42% a day as of today (five day moving average). Possible sign that wide-spread testing is beginning to take hold but also consistent with expected early stage growth rates.
  • Growth in Taiwan's daily infection rate: Could this be due to elite Taiwanese returning to Taiwan after escaping the country in early stages of the disease? Growth continues as well as an uptick in Taiwan's death rate.
  • Most "SARS Countries" are stabilizing at a computed 5% death rate (China, Taiwan, South Korea, Hong Kong). Japan is upper outlier at 20% fatality rate. Singapore is lower outlier at 0% fatality rate. Hard to believe the Singapore numbers.
  • I have added a "5% projection" chart to the data. This chart is intended to show what growth would be like in the affected countries/states if growth can be held to 5% (bend the curve!). In most cases dramatically lowered infection/deaths are the result. Keep your distance!
  • Have begun adding individual charts for a select set of US states. US state level data is, as of today, EXTREMELY "jittery." Result is that some of the projections (Illinois, New York in particular) are ridiculous — New York's prediction right now predicts more infected than the entire state population. I think as we get a few more days worth of data from the states that projections will converge on more realistic numbers.
  • That said, a reminder that all of my charts are based on OFFICIAL data. What does that mean? In general the official data dramatically underestimates the total number of infected as well as the number who have recovered from the disease. For instance, in my home state of Indiana the official data says 86 infected (yesterday). According to our own health experts, the real number is close to 100,000. In neighboring Ohio, the official number is 173. Ohio's health experts believe the actual number is closer to 200,000.
  • You may notice negative death rates on some of the states. This is because, for reasons I do not understand, the Johns Hopkins/WHO data has "rescinded" several recoveries/deaths in the last couple days' worth of data. For instance, Illinois was reporting two recovered earlier this week. Last night it started reporting zero recovered. That hurts my computer's brain.
  • Because of the above and some other factors, I have closed my moving average window slightly from seven days to five which seems to improve the believability of the numbers a bit. I'll continue to watch the data as it comes in and conduct sanity checks.
  • All indications continue to support position that COVID-19 disease is expanding out of control at an average rate of 25-35% in the Western democracies (i.e. doubling every one or two days) and estimates of 2 million dead eventually are probably understating the case. I predict the final death count will be closer to 10 million worldwide absent dramatic effects from social distancing efforts.
  • SARS nations (China, Taiwan, Hong Kong, Singapore, South Korea, Canada) appear to have disease under control although there are troubling signs in Taiwan. And Canada is not under control.



March 20th data highlights:

  • US Growth in new infections running at 75% a day as of today. Yesterday infection count was 7786, today 13,680. Possible sign that wide-spread testing is beginning to take hold. Seven day moving average of growth now nearly 40%/day. I will not forecast what infection totals will be in mid April at this time as the infection rate appears to have a short-term perturbation as testing ramps up.
  • Growth in Taiwan's daily infection rate: Could this be due to elite Taiwanese returning to Taiwan after escaping the country in early stages of the disease?
  • Most "SARS Countries" are stabilizing at a computed 5% death rate (China, Taiwan, South Korea, Hong Kong). Singapore is lower outlier at 0% fatality rate. Hard to believe the Singapore numbers.
  • More later…



March 19th data highlights:

  • US growth in new infections still running at 30% a day (doubling every 2+ days). Anticipate an artificial bump in this rate next week as testing ramps up, assuming testing ramps up.
  • On track for 3.2 million infected in the US by Mid-April, 12,000 dead.
  • South Korea infection rate dropping dramatically, as is its death rate. End-stage for disease in South Korea? Direct South Korean death rate still 5% and stabilizing at that value
  • Taiwan's infection rate spiking. Unknown cause.
  • Explosive growth in Germany, France, UK (and US)
  • "SARS" countries (Taiwan, Singapore, Hong Kong, Japan, South Korea) generally doing well with exception of troubling spike in infection rate in Taiwan (and to a lesser extent Singapore)
  • Italy spiking in death rates and infections. However, since the data lags this represents the situation prior to lockdown. Need another couple weeks' worth of data before effect of lockdown in Italy is evident.
  • World rates reflect end of epidemic in China ("Phase 1") followed by rise of pandemic in rest of the world ("Phase 2"), particularly Western democracies. US & UK particularly poorly prepared for this due to widespread politically-driven institutional failure in both countries.
(March 17th) data highlights:

  • United States on track for over one million infections and ~20,000 deaths by mid-April
  • Infection rates in United Kingdom, United States, France and Germany currently running at 30%. This implies total number of infections in each country will double every two days.
    • Situation in those countries is currently out of control
    • France implementing draconian lockdown in response
  • Infection rates in Italy responding well to lockdown, currently below 20% day and falling.
  • Infection spread in China virtually halted and prior infected either recovered (95%) or dead (5%)
  • Data shows that nations hit by in the SARS-CoV-1 epidemic of 2005 well prepared for SARS-CoV-2 (Japan, South Korea, Taiwan, Hong Kong, Singapore) Low overall infection rates, low deaths.






REMEMBER: The disease has an incubation period of 5-14 days. Additionally, it takes, on average, two weeks to die from it and over a month to recover from it.

THIS MEANS THESE CHARTS ARE A LOOK AT HOW THINGS WERE TWO TO FOUR WEEKS AGO! The data that came out today, was "baked in" two weeks to a month ago. Do not expect to see the effect of mitigation efforts in this data until at least two weeks have passed from the initiation of the effort.



When the night shows
The signals grow on radios
All the strange things
They come and go, as early warnings
Stranded starfish have no place to hide
Still waiting for the swollen Easter tide
There's no point in direction we cannot
Even choose a side.

"Here Comes the Flood" — Peter Gabriel

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Canada Notes:

Still early stage. Looks like it will follow a path very similar to US — exponential growth and huge numbers of infected/dead. Test of Canadian health care model and ability to deliver care in far-flung provinces (esp. Newfoundland/Labrador/, Nova Scotia, New Brunswick, Northwest Territories & Nunavut)

Situation: Currently out of control



China Notes:

Reliable data
Infection controlled through extreme social distancing
Infection growth virtually halted. Zero new cases as of March 19th, 2020.

Situation: Stable



Diamond Princess Notes:

Little data
Most reliable source of actual fatality rates under controlled, well-measured conditions






France Notes:

Early stage exponential explosions in infections. Fatalities will soon follow
Just instituted mandatory lockdowns. Severe restrictions on leaving homes.

Situation: Currently out of control






Germany Notes:

Explosive growth.

Situation: Currently out of control.



Hong Kong Notes:
Very low number of infected. Infection appears contained
Model of what could have happened in other countries if they had taken aggressive measures early, before virus had chance to spread.

Situation: Stable.



Iran Notes:

Strong and steady decline in # infected

Situation: under control?
  • Italy Base Graph
  • Italy Projection Graph a href="CoronaGraphs/Italy_Proj5.png">Italy Projection Graph - 5% growth



Italy Notes:

Italy allowed infection to become uncontrollable. Under lockdown now and must simply wait for infection to burn itself out. Very high (~50%) fatality rate. Little understanding of why fatality rate is so high.

As data reflects situation two to four weeks ago, still need to see some time to see effect of lockdown.

Situation: Currently out of control according to historic data.






Japan Notes:

Very early proactive controls. Closed schools long before underlying data would have politically supported such move. Infection rates trending down healthily.

All rates falling nicely.

Situation: Appears to be under control.



Norway Notes:






Singapore Notes:

VERY low death rates (why?). Infection rate still increasing, although total infections are very low. Together with Hong Kong and Japan shows what the reaction looks like in countries with previous SARS experience (i.e. good)

Infection rates rising (March 19th). Need to watch this.

Situation: Uncertain



South Korea Notes:

Extensive testing. Infection and sickness clusters very different from rest of world (older are relatively unaffected, young very affected). Possible consequence of how they are gathering data. Infection rates now very low, appears contained.

Infection rates stabilizing at low levels. Appears infection is under control (March 19th)

Situation: Stable



Sweden Notes:



Taiwan Notes:

Very low death rate (why?). Although it is doing relatively well, infection rate is troubling and could get out of hand, quickly.

March 19th: Infection rates continue to rise. V troubling.

Situation: Uncertain






United Kingdom Notes:

Early state exponential growth in infections. Exponential growth in deaths will follow with three-week lag. Serious trouble and should consider lockdown similar to France ASAP. Unknown if UK institutions up to challenge. Similar to US in this regard.

Situation: Out of control



United States Notes:

Early stage exponential growth in infections and deaths. Will quickly overcome health care system (w/in 2-3 days). Current trajectory suggests 4+ million dead by mid summer, 30+ million in critical condition.

Should strongly consider minimum of three week lockdown similar to France.

Large-scale institutional failure in US & willful abdication to "private sector" to solve a problem for which there is an unclear profit opportunity reckless and likely to fail on a catastrophic level.

Situation: Out of control






World Notes:

Base graph shows initial infections in China followed by decline in infections in China followed by rise in infections in rest of the world.

All world-wide rates on the rise, again, as world outside China sees huge surge in infection rates (particularly Western democracies)

Situation: Under control in China and probably "SARS" countries. Out of control elsewhere.
  • World Base Graph
  • World Projection Graph