Coronavirus - worldwide spread and control

Thanks @Roy S I didn't access the material as you needed to agree to a bunch of stuff. Anyone got the statistics for fatalities in men versus women?

 

Thought y’all might be interested in this analysis of Irish cases. Smaller numbers and earlier stage of the pandemic than some other European countries. Bit of context first:

Population is approx. 5 million.

Ireland had its first case confirmed 29th February. (Compare to UK end January.)

Schools were closed in Ireland from 13th March, at which point 70 cases had been confirmed.

(Compare to UK where a BBC report 14th March reported 1410 confirmed cases.)

Ireland has 557 confirmed cases as of Wed 19 March. Testing is being ramped up, so as well as the spread itself increasing, Ireland’s numbers are expected to increase quite a lot.

This analysis is of the first 350 confirmed cases:

https://www.gov.ie/en/publication/c...at-as-of-midnight-tuesday-17-march-350-cases/


Median age of Irish cases to 17th March is 43.

Compare to median age of 63 in Italy in @Simon M ’s post above, although the median age of Irish cases could increase as testing and spread etc increases.

Compare also to the Chinese data:

It seems possible that the median age of cases increases as the virus spreads through the community. The younger, more mobile people might be the first to get it and then it gradually makes its way to the older ones?

31% of the 350 Irish cases were hospitalised and the stats show that more older patients were hospitalised.

2% were admitted to ICU.

There have been 3 deaths.

No information on co-morbidities unfortunately. My understanding is that the first two deaths did have other illnesses, and the third fatality did not.

There was a big jump in confirmed cases between March 18th (74 new cases) and March 19th (191 new cases).

More on how covid-19 has evolved in Ireland here:

https://www.irishtimes.com/news/health/coronavirus-how-it-has-affected-ireland-day-by-day-1.4206691

 

It's a very bad situation that in the UK the concept of 'herd immunity' has been seeded in the minds of the public. Reading through comments on news sites, such as the BBC (a depressing reading at the best of times) it's very clear that many people still (as of today, days after the U-turn on this approach) believe that the government should have kept to that 'original plan' and that we are now over-reacting and needlessly sacrificing the economy.

 

I am wondering what the implications of this might be. Secondary infection is possible for some people, but tends to be pretty mild. That is good for the individuals concerned but not good for the herd immunity and those people are also likely to spread the illness to those not yet exposed.



Does that mean such people would need quarantining again, and would that be possible with a mild infection which might be hard to spot or may even be a symptomatic?



Does it mean everyone has to hunker down until there is a vaccine or good treatments?



I would love to know how it's going in China as they relax controls. Not that there's much chance that the UK government would want to follow good practice elsewhere, judging by events so far.

 

In London they shut lots of tube stations from today. Except now everyone is getting on at the few stations that are still running. Because they’re forced to go to work as there’s no provisions for proper sick pay / citizens income etc, and many could lose their jobs otherwise. I really despair.

https://twitter.com/user/status/1240923403919515648


Palliative care doctor:

https://twitter.com/user/status/1240901048409227264

 

How will age distribution in populations affect how covid-19 spreads and impacts different countries? If Italy's high death rate is due to its older population, then will countries with younger populations fare better, at least in terms of fatalities? Or will younger people spread it so effectively, while asymptomatic or mild, that...I don't know how to finish that sentence.

The difference in median age of covid-19 cases between Italy (63) and Ireland (43, but very preliminary data) could have a lot to do with the difference in median age between those countries’ populations. Italy’s population is unusually old, and Ireland’s is unusually young.

According to an EU commission report in 2010:

Median age in the UK is 40.5, says Google.

Germany's death rate is apparently low, though, so far, despite its older population:

I’m too wrecked to see anything useful in these age pyramids for Italy, the UK & Ireland, but here they are, for clearer minds (all from Google):

Italy:


UK:



Ireland:

 

Hate to promote the SMC but some good comments on there.

Prof Willem van Schaik, Professor of Microbiology and Infection, University of Birmingham, said:

This puzzles and concerns me too. Why did the UK Government adopt a different strategy to the rest of the world? Did it have access to different modelling data that it believed justified taking a different approach? If so, why did it not share this data with the rest of the work to try to save lives in other countries? Or was it that the UK Government was seeking to achieve different objectives to rest of the world – perhaps, placing a higher degree of importance on minimising the economic impact rather than minimising mortality rates compared with other countries. Whatever the reason, it does not reflect well on the UK Government.

 

I wouldn't be surprised if the thinking was along the lines of "if we can avoid a major shutdown, then our economy will be in a much better shape once most people are back at work and we'll then be ahead of the curve". Add in a belief in the ability to build herd immunity in a sustainable way, and you get the situation we were in.

 

Richard Horton is continuing to collate experiences of frontline healthcare workers:

https://twitter.com/user/status/1240992878421254149


https://twitter.com/user/status/1240993409567010818


https://twitter.com/user/status/1240994161949638656


https://twitter.com/user/status/1240994842831982592

 

There are several figures and other preliminary info and speculations.
I can't summarize it well.
I'm sure the subject will be covered more as time passes.

 

The UK government has just published the papers that have been informing it's decisions:

https://www.gov.uk/government/news/...vidence-supporting-the-uk-government-response

 

Cornwall has asked people not to take holidays in the area:

 

Guess which group they fail to link to further information on?

 

There's this on the govt's behavioural advice:

https://assets.publishing.service.g...oural-science-in-the-coronavirus-outbreak.pdf

3. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, Rubin GJ. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet 2020; 395: 912-920.
4. Webster RK, Brooks SK, Smith LE, Woodland L, Wessely S, Rubin GJ. How to improve adherence to quarantine: Rapid review of the evidence. Public Health, in press.

Only the first paper is public yet, and I didn't see much of value in there.

This article I already posted mention how there wasn't really any info in their to justify delaying social distancing measures, or concern about behavioural fatigue undermining social distancing measures at some vital point:

https://unherd.com/2020/03/the-scientific-case-against-herd-immunity/

I want to see what led to the view that behavioural fatigue meant that social distancing measures should be delayed. Was Wessely privately hyping his own work again?

 

https://twitter.com/user/status/1240954544105848832

https://twitter.com/user/status/1220606842449072128

 

Also there's this evidence list for SPI-B. 3 of the 7 papers have Wessely as a co-author. It will be interesting to see if any of them have any good evidence to support the decision to delay social distancing.

https://assets.publishing.service.g...t_data/file/873741/09-spi-b-evidence-list.pdf

 

I don't think folk do get it. But because [some people] have warned the govt against scaring people too much, they seem to be much more worried about causing PTSD than they are about people actually dying. Human beings are not good at assessing risk, and sometimes we just need to be shouted at to get us to act. All this "would you mind awfully" is not terribly effective!

 

It's a bit like a massive invading army marching its way towards you, but as yet you have only so far encountered small platoons of their advance forces. Instead of heeding what your own scouts are telling you - that a massive invasion is following on behind, and you absolutely must prepare before it is too late - you instead choose to believe what you want to believe. By the time you have no choice but to believe the reality, it is far, far too late.

 

Sorry for making lots of quick posts while I look through this - I'm keen to get other people's ideas.

I still cant find the evidence under pinning their concerns about fatigue but they are hyping themselves for their transparency: "In fast moving situations, transparency should be at the heart of what the government does." https://www.gov.uk/government/news/...vidence-supporting-the-uk-government-response

This is their behavioural advice from 9th March, but I couldn't see anything on fatigue or the advantages of delay:

https://assets.publishing.service.g...ventions-on-an-epidemic-of-covid-19-in-uk.pdf

This 16th March consensus seems thin to me too considering their talk of the need for transparency:

https://assets.publishing.service.g...w-on-behavioural-and-social-interventions.pdf

Still of interest though, eg: