The Corona Outbreak seen by a Scientist and Engineer

ABSTRACT:

• This is meant to be a collection of data, predicting and tracking the Corona spread in key countries as selected on March 12, 2020 and providing daily monitoring - to see where the countries are going and whether government measures were in line with the data.
• It is seen below that all countries initially followed a simple exponential path of “confirmed case numbers”.
• The first major risk of Corona, besides deaths, is the collapse of the health system - China and Italy serve as well known cases. Collapse of the health system as staff will also get ill - it is not just about bed capacity. It must be the clear target to avoid this collapse as it will have impacts beyond just the Corona patients.
• Main conclusion: if you see a strictly exponential curve, as below, you have NOT touched the spreading mechanism at all. Until this changes highest focus is needed. Several countries are in this state. With the right actions this can change in a few weeks.

?? We had and outbreak in China and China got it under control.

?? Taiwan, South Korea and Japan learned from this and broke the exponential curve.

?? Almost all other countries have let it go exponential and now struggle to flatten the curve

For a while this will be updated regularily to track progress of containment.

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The motivation for this article is the combination of

• being personally affected (potentially)
• the obvious misinformation or lack of understanding by some people in charge which made me nervous on March 12 th 2020
• simple curiosity as scientist and engineer about mechanism and solutions

What can you expect here: FACTS, DATA, CONCLUSIONS AND JUDGMENTS, labeled as such. At the very end my personal strategy for the ??.

We all make mistakes - I will happily change this text based on critical reviews / additional or contradicting facts - but please no conspiracy theories or politics.

FACTS:

• The mortality rate suggests this virus will not kill mankind - not even close. No Armageddon. Most of us will party soon again. Statistically this is very very likely.
• Essentials of our life can well be sustained even in the - so far - severely affected areas - food, electricity, water etc. is available - panic not justified. Note: so far we have ~ 400.000 confirmed cases globally. Is this also true for 40 or 400 million cases? We do not know this yet.
• Here is the “but”. In areas of uninhibited outbreaks the hospital / intensive care units were flooded by a number of patients. Uncontrolled outbreak means a broken health care system (check out reports from Italy and China). So it is a all a number game of slowing this ramp down.
• This number game is tricky as across the globe we have very different testing practices and frequencies. So the numbers will not all be of the same quality. Some companies even limit the testing, which means they fly blind for several weeks and just count the dead.
• This number game was so far won by at least China, Japan and South Korea. These countries found recipes that worked. On March 16 2020, at least the following countries show almost uninhibited exponential growth: Spain, Switzerland, US, UK, France, Belgium, Netherlands, Iran.
• For those who took low absolute numbers in their countries as a good sign at March:12 : By now you have learned the lesson of exponential curves.
• Due to incubation times of the illness the effect of any measure can only be seen after weeks.

So what is the actual danger ???

• first brick wall: we overburden our health system - see China and Italy. Remember China building hospitals in days. Or refer to reports on hospitals in Italy now. For those who do not see the connection between the current numbers, exponential growth and the first brick wall - perhaps this helps ?
• second brick wall: we go beyond what has happened in China (where the outbreak is now contained). This I avoided to discuss at the beginning but there are now multiple signs it will have to be brought up. The second brick wall will be a combination of topics:
• 2-1 the infected will be brought to places outside the normal health system to keep the latter alive. Several options come to mind - exhibition or sport centers etc. This avoids the first brick wall and prepares hitting the second with a working country and health system.
• 2-2 we will start to live with rather high death rates and potentially accept those rather than a multi year economic depression. The second brick wall is an ethical one and associated to the loss of up to a few % of the population. Economically no problem.
• 2-3 as of March 24 the actions of several states and statements of several leaders suggest that the second brick wall is already being discussed and prepared. It is a Darwinistic approach towards their own population.

I hence distinguish between 3 types of governments and support systems:

(A) proactively, successfully protecting your country: South Korea as example.

(B) hard working as confronted with the challenge - fighting for their country to avoid the first brick wall: Italy, Spain, France, Germany, Austria, and more.

(C) Foolishly optimistic, unprepared and incompetent, losing precious time, behind the curve, perhaps already accepting the second brick wall: draw your conclusions. The statements, news, actions, numbers are all traceable.

DATA - PREDICTION MADE ON MARCH 12. DAILY TRACKING SINCE.

I wanted to see whether I can trust that we apply the lessons learned from Asia and sat down on March 12 2020, did some simple maths and posted this: https://www.dhirubhai.net/posts/wilhelmgraupner_china-wants-to-take-a-victory-lap-over-its-activity-6643498018618257408-mlF_

What did I do:

• took data from https://www.worldometers.info/coronavirus/
• calculated the exponential coefficient for a few countries by dividing the first derivative by the absolute number of confirmed cases.
• this way you get a super simple exponential model which you can trace to check. First for validity of the model and then about when the dynamics starts to break = the curve is starting to get flattened.
• I ranked the countries by the then highest dynamics and found my home country, Austria, on top, in spite of everybody else looking at Italy etc.

NOTE: I wanted to understand on the 12th of March how severe the measures should be - when I plotted the predictions and combined them with the experience from China and Italy it was clear: time to act decisively to stop community infection has come. A time when several governments still declared “no problem”. The statements are traceable for March 12, 13, 14, 15, .....and still.

Here is the image I posted then:

I checked the data on March 13, 14 and 15 - here are the respective posts

• 13: https://www.dhirubhai.net/posts/wilhelmgraupner_new-data-see-httpslnkdindphvpqs-activity-6644486322037760000-lNWm
• 14: https://www.dhirubhai.net/posts/wilhelmgraupner_updated-on-march-15-httpslnkdindwannwg-activity-6644711330781638656-OzrA
• 15: https://www.dhirubhai.net/posts/wilhelmgraupner_corona-dynamics-since-the-who-pandemic-statement-activity-6645067031337021441-Hbqv

4 days later, on March 16, you can see for yourself the quality of the very simple prediction, reported daily:

CONCLUSIONS MARCH 16:

• Let’s look where the prediction worked well until March 16:

(1) Spain, Switzerland, USA, UK, France, Belgium, Netherlands, Iran, Japan, South Korea, China. Unlikely that this was just luck. At the same time bad news as this means uninhibited exponential dynamics in some of these countries (not in China, Japan and South Korea)

(2) Sweden - as the huge gap shows that Sweden simply does not do broad testing anymore. At the same time Sweden acknowledged the status of “community infection”: https://www.thelocal.se/20200310/timeline-how-the-coronavirus-has-developed-in-sweden

• where did the prediction not work well - in all these cases actual numbers are LOWER then predicted ?:

(1) At this point I think Austria and Germany showed initially too high numbers - this could be due to imported cases, just like Denmark which got them from Ischgl in Austria. If true this means the community spread is slower than expected on March 12.

(2) I do think that the curve starts to flatten very slowly in Italy. No reason for party but maybe a thin layer of hope - next days and weeks will tell.

• I concluded from my data that the fast reaction of several governments to inhibit the spread of the infection WITHIN their borders was right. Examples of communication by the Austrian and German government below - flatten the curve to avoid what I called the first brick wall above.

CONCLUSIONS ON MARCH 17

I am plotting the updated numbers below and some figures as I keep getting remarks “that we are not doing to badly”, yet some countries up to now show full consistency with the very simple exponential model but fail to see the threat.

• Good news first - Austria, Germany, Denmark, Norway and Italy start to “see reduced dynamics”. Perhaps also Spain and Switzerland. If testing was unchanged this might be the start of what we want to see - certainty will come in the next days.
• Sweden has decided to reduce testing massively - the number is hence insignificant. But the simple model picks this change up.
• The countries with unchanged exponential behavior, perhaps even accelerating on a very fast rise are the UK, the US, Belgium, the Netherlands. Again to be watched for a few days.
• I have received comments from several sources that the UK and the US do fine and will follow their own path - currently they do, with some others, full exponential. I have plotted the curves below - please consider the scale is logarithmic.
• As every day - all measures count, once governments or companies start to actually take them.
• Below there is also a table, showing the top 40 countries ranked by exponential spread rate and above 100 total cases - based on new cases added on March 17. US, Austria, Germany, UK have high case numbers and high spread rates. Spain, Italy and France have high case numbers but lower spread rates....luckily.
• BBC reporting on the UK scenaria: “...The idea was that by pushing the peak back to the summer it would allow the NHS to cope. But new modelling released by Imperial College London then prompted a change in approach. It warned the policy of a managed spread could still lead to more than 250,000 deaths with hospital intensive care units getting overwhelmed. Ministers are now seeking to suppress the spread completely - hoping in the process to keep deaths below 20,000...” https://www.bbc.com/news/explainers-51632801

OUT OF CONTROL - EXPONENTIAL - US / Status March 17, 2020

OUT OF CONTROL - EXPONENTIAL - UK / March 17, 2020

IN CONTROL - SOUTH KOREA (same in Japan and China) / March 17, 2020

March 17 2020, countries with more than 100 cases ranked by dynamics based on number and first derivative on March 17:

CONCLUSIONS ON MARCH 18

1. Good news first. For the following countries the exponential growth coefficient has been reducing since March 12: Austria, Germany, Spain, Switzerland, Denmark, Norway, France, Italy, Japan, Korea.
2. For the following countries the exponential dynamics from March 12 are still holding: Belgium and China.
3. The US, UK and Netherlands show higher exponential coefficients = faster growth now, than on March 12. This could also be due to intensified testing.
4. Globally driven by many countries, the growth is out of control (=exponential). Too few counties have yet reached similar successes as China, Taiwan, Japan and South Korea in massively slowing down growth.

The table below shows prediction and actuals since March 12.

Many people have a problem understanding exponential growth - here is an example. Germany has currently about 12.000 cases - the figure shows how fast 100.000 can be reached IF we do not break the growth - breaking growth is key and the government has hence massively reduced the social interaction of people in Germany.

Finally, as of March 18 several states in the US high numbers of cases - the argument about “one nursing home” or NY being the problem is proven wrong. It would have been easier the other way....

CONCLUSIONS ON MARCH 19TH

• the good part first: China, Japan, South Korea are at stable very very low growth
• please focus on the cases added between 18th and 19th of March - absolute and %. 

- the countries are ranked by growth dynamics = daily % added on March 12th. The added 10-30% of cases a day then

- the ranking has changed: the US is now the growth leader, doubling the total case numbers every two days: 14.000 now, 28.000 Sat night, 56.000 Mon, 112.000 next Wed

- Switzerland, Austria, Germany following with 30% daily rates - that means they double every three days

- you can see all the other % in the last column

- Italy adding 15% a day - still these are > 5000 cases per day

• Efforts need be kept or stepped up. And perhaps the learning from China, Japan, South Korea. Neither Europe nor the US are anywhere NEAR yet the containment reached in these Asian countries.
• Data source as always : https://lnkd.in/dhk7-vJ

CONCLUSIONS ON MARCH 20TH

Corona Update March 20 - tracking the “top” countries since March 12

?? for all these countries new cases still grow - the growth has different dynamics though

(1) China, Japan, South Korea currently can be seen as “in control”, adding case numbers that the countries’ health systems can digest 

(2) Most countries below show a slow down of exponential growth. Still at new case numbers the national health systems will be overburdened with - leading example Italy. The sum of all cases in the last line below shows the same behavior.

(3) Switzerland, Belgium and the Netherlands show a constant exponential growth since March 12. No slowdown.

(4) The strongly, even accelerated, growth in the US is attributed to increased test coverage. I personally hope that this is true as the alternative would be bad.

?? Changing or different test practices do not improve data analysis BUT the priority everywhere is on effective MEASURES (In an ideal world those would be supported by abundant testing).

?? As a global community we see still a strong rise of cases but VERY slowly we seem to beat the exponential curve - which is the first important step.

CONCLUSIONS MARCH 21st:

9 days ago my motivation was to: 

(1) check problem status, 

(2) solution strategies and 

(3) solution success as well as 

(4) government announcements 

because I heard too many totally conflicting statements: compare e.g. China, Taiwan, South Korea, Italy, Austria, Germany, Sweden. 

Example: 8 days ago Austria was in lockdown, Spain declared emergency and UK said “no problem”. These differences in government approach were evident every day, yet we all had the same facts (for months).

(1) & (2) is now easy to get:

- https://lnkd.in/dswZzfq (image taken from there)

- https://lnkd.in/dNX4Fwn (data & curves)

For analysis try this by HARMONY LEI Zhou : https://lnkd.in/daf2jdv or my tracking since March 12: https://lnkd.in/dY3q_DK

Where are we ?

?? In a broader sense the West has failed to take the 3 CHEAP early steps Asian countries took (https://lnkd.in/dXKDXeX)

?? Now we are in EXPENSIVE late containment / lockdown and luckily see success slowly 

?? Now we have to further excute the lockdown, support those in the front line and think about the next or parallel sustainable steps (https://lnkd.in/d8p-kPp)

Casualties per inhabitant.

https://www.dhirubhai.net/posts/jsundqvist_covid19-coronavirus-activity-6647400228079054848-MbV_

It is PHYSICAL and NOT social distancing.

CONCLUSIONS MARCH 22nd:

Trying to understand which country has effective measures in place, I am tracking the data of the group below since March 12 2019.

?? when analyzing the dynamics from March 12-21 vs the rise of cases on Mar 22nd, only the US is showing acceleration - the growth has become faster in the last days. Image shown in comments below.

?? Luckily ALL other countries show a slow down - this means the new cases do not grow anymore exponentially

???? needs this slowdown really badly - shown in comments 

???? slows down

???? slows down 

And others do....

?? This does NOT mean victory at all - it means we are STARTING to get traction. 

?? It should be IMPERATIVE to all to practice physical distancing and support the people and countries in the frontline.

Where to find the best data:

- https://lnkd.in/dswZzfq

- https://lnkd.in/dNX4Fwn

- casualty comparison: https://lnkd.in/d-_DRMB

- do not forget: we know HOW to win this - https://lnkd.in/dXKDXeX (or look at Asian numbers)

Casualties “almost real-time”:

https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html

CONCLUSIONS MARCH 23rd:

?? I have tracked these countries since March 12 - they were the VOLUME leaders in cases then.

?? I have ranked them now by daily GROWTH determined via increase in cases from March 12 - 22. For this period the US shows the highest growth, followed by UK, Austria, Germany and Spain.

?? For the daily growth just on the 23rd in % - all countries besides France are showing a lower growth than for the previous 10 days. The curve is flattening, slowly. 

?? Time to continue the fight (the UK joined yesterday with a lockdown) and get it under control - Asian countries show the way since months - we need to learn:

- https://lnkd.in/dpFVX5B ???? 

- https://lnkd.in/dXKDXeX 

- https://lnkd.in/dEY3nk8

Global Data: 

- Pure data: https://lnkd.in/dNX4Fwn

- Casualties: https://lnkd.in/dsxkNUP

- Country status: https://lnkd.in/dswZzfq

Herd Immunity - pursued for a few days by UK and Netherlands as a counter strategy:

March 17 in https://www.technologyreview.com/s/615375/what-is-herd-immunity-and-can-it-stop-the-coronavirus/

.....Last week the herd immunity idea blew up in the headlines after UK prime minister Boris Johnson indicated that country’s official strategy might be to put on a stiff upper lip and let the disease run its course. The chief science adviser to the UK government, Patrick Vallance, said the country needed to “build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission.”

Yesterday, the prime minister of the Netherlands, Mark Rutte, struck a similar note, saying, “We can slow down the spread of the virus while at the same time building group immunity in a controlled way.”.....

https://youtu.be/2XRc389TvG8

Exponential Growth: Of course much nicer than my article but same message in Forbes

https://www.forbes.com/sites/startswithabang/2020/03/17/why-exponential-growth-is-so-scary-for-the-covid-19-coronavirus/

March 21, 2020 === IN CONSTRUCTION ?? ....IN CONSTRUCTION ??. ....IN CONSTRUCTION ?? ...===== March 21, 2020.

?My personal strategy