Coronavirus, Pandemic Designation, and Exponential Growth

[zzz]

We just finished another bad day in the US, with COVID-19 deaths jumping by 1321 for a total of 7392. Here are the latest historical charts from Worldometer:

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Note that I have selected the logarithmic scale for the first chart. To the extent that that data falls along a straight line, it means that growth is proceeding at a steady exponential rate. If you put a straightedge connecting March 2nd to April 2nd, you'll see that it fits the data very well. On average, since March 2nd, the total deaths have been increasing by a factor of 10 every 10 1/3 days. This means that after three cycles - 31 days - the total number of deaths has increased by a factor of 1000. Sure enough, March 2nd had 6 deaths, while April 2nd had 6071.

For those who don't think that 6071 is a big deal, if the line continues at its present slope, the total deaths for April 12th will be about 60,000, and the total deaths for April 23rd would be about 600,000 - far above official projections. Hopefully, the mitigation procedures will be having much more of an effect by then, and we won't get anywhere near 600,000. On the other hand, if what we do isn't working, and we do see around 600,000 or so deaths by April 23rd, the next 10-day period ending on May 3 could see total deaths rise into the millions. A factor of 10 growth resulting in total deaths of 6 million would be unlikely in the extreme, as by this time there would be many forces working to level the curve.

BTW, the numbers for the UK are even worse. In the 30-day period ending today, total deaths rose from one to 3605 - almost exactly half the total deaths as in the US. Considering that the UK has only a fifth of the population of the US, this bodes poorly for total mortality as a percentage of population in the UK.

If these numbers look outrageous to anyone, please review the video in the first post in this thread. It is in the nature of exponential growth to appear to be going nowhere for a long time, and then suddenly become totally overwhelming.

 

[Gingergrrl]

Thank you @zzz for providing such thorough and helpful data and information for all of us . Although it is very scary to read, knowledge is power.

 

[andyguitar]

BTW, the numbers for the UK are even worse.

But there is some good news from over here. Our hospitals are coping and we still have 2000 critical care beds spare and a new hospital that will have capacity for 4000 beds has opened in London. It was a convention centre. Now one of our new 'Nightingale' hospitals. Couple more on the way.

 

[percyval577]

Today morning in the radio here was a report from Sweden. Sweden has only 523 ICU´s, the whole country, 426 now occupied by corona patients. The reporter said that by end of april 10.000 might have died.

He also said that it is not the case that the Swedish Government didn´t bother, only Sweden has an extended tradition of "may"´s, now the governments seeks to implement stricter orders, which may be not that easy (if I understood it rightly).

A bit later there was an interview with German virologist Gant... or so. He said that the situation is still unclear, and only at end of the year one can make an assessment. Every year there would die 900.000 people in Germany, and he don´t want to sound cynical, but it still can be that the people now dying would have died in the next couple of months anyway. I think until now it´s more than 1.000 people who have died with corona, since three or four weeks.


Yesterday I was a bit shocked by two comments. Director of the Robert-Koch-Institute Wieler said, that now R would be 1, i.e each person is infecting round about one other. And he added, it should be less than one, obviously conveying that than the virus would die out ... My understanding though was that the tests will be done with underdetermination, for sure not be able to detect every infected citizen. I was speechless.

A bit later the speaker of the ministry for health answered in a press conference that the there is no official attempt by the Bund (maybe not knowing anything about the Counties/States, but includiing the official Robert-Koch-Institute) to estimate the real number of people who have been in contact with the virus (say by an antibodytest, as soon as somehow reliable). Already a couple of days ago Virologist Streeck mentioned that to his knowledge and astonishment no such attempt is intended, and that therefore his Institute is about to carry out one. There would also be one in Munich, as he mentioned. However, I couldn´t believe it.

 

[pamojja]

"Eastern Europan nurses", those are not nurses.

In the Süddeutschen Zeitung 2 days ago (transl. by deepl.com):

https://www.sueddeutsche.de/politik/coronavirus-pflegekraefte-ausland-1.4866124
April 3, 2020, 4:46 a.m.
Coronavirus:The flight of the nursing staff
Care Age

Many people in Europe are dependent on 24-hour care at home. But what to do if the carers can no longer come? (Photo: dpa)

The borders are closed, the care of the elderly is endangered. Many carers no longer come to their workplace. The EU wants to take countermeasures.

By Karoline Meta Beisel, Brussels, Peter Münch, Vienna, and Florian Hassel, Warsaw

Vienna Airport has long been closed for normal passenger traffic, but at the beginning of the week two planes from Sofia and Timisoara (Timișoara) landed there. In the orphaned arrivals hall, 231 mainly female nurses from Bulgaria and Romania were received. They were flown in for emergency home care in Austria. A total of 33,000 persons in need of care in the country are dependent on 24-hour care at home. Most of them are provided by nursing staff from Eastern and Southeastern Europe, who come to the country for two or four weeks at a time. However, the border closures and quarantine regulations in the Corona crisis have raised acute concerns about the collapse of this system.

And not only in Austria. Throughout Europe, the pandemic is endangering the care of elderly people at home because nursing staff can no longer visit them - or have left the country in question in a hurry to return home.

In the meantime, the EU has also realised that the movement of people is as important to the European Union as the movement of goods. "Thousands of women and men have to cross EU borders on their way to work," said Nicolas Schmit, EU Commissioner for Employment. "We have a shared responsibility to ensure that we do not put obstacles in their way."
Austria wants Eastern Europeans to stay as long as possible

The EU Commission wants to use guidelines to encourage the member states to make it easier for these workers to cross borders. This applies to harvest workers, medical staff - but also to child or elderly care workers. "The Commission urges the Member States to facilitate rapid border crossing procedures for these workers," the guidelines state. For example, Member States could open special lanes at the borders. Another option would be "special stickers" recognised by neighbouring countries. Health checks should not be stricter for foreign workers than for nationals working in the same professions.

In principle, Austria, for example, has agreed with its neighbouring countries on exceptions for people working in the health and nursing professions. They may enter the country if they can present a health certificate that is no more than four days old. One problem, however, is that there is often a lack of testing capacity in the home countries. A further difficulty is that, for example, in Hungary and Slovakia, nursing staff have to go into a 14-day quarantine when they return home, if they have not only been deployed in the immediate border area. The situation is particularly complicated for nurses from Romania and Bulgaria because Hungary does not allow them to transit to Austria. For this reason, the airlift has now been arranged for them with two Austrian Arlines aircraft.

After landing, however, the urgently needed 231 helpers must now first be quarantined for two weeks. After that they will be deployed mainly in Lower Austria. There, according to the Ministry of Social Affairs, they will be "motivated to stay as long as possible, at least four to six weeks". A bonus on their wages is planned for this.

In Poland, the newspaper Gazeta Wyborcza estimates that at least 300,000 Poles - mostly women - work as doctors, nurses and care workers in German hospitals, old people's homes and private households. In addition there are tens of thousands more from other countries in Eastern Central, Eastern and South-Eastern Europe...

 

[pattismith]

France: number covid death for 100 000 (in hospitals and in senior/care homes)

https://sante.journaldesfemmes.fr/m...gne-monde-etats-unis-strategie-deconfinement/

 

[pattismith]

In France, Institut Pasteur published a mathematical model for the epidemic;

The model is based on Diamond Princess observations, so I don't find it a perfect fit to reality, but I can find some interesting datas.

https://hal-pasteur.archives-ouvertes.fr/pasteur-02548181/document

Estimating the burden of SARS-CoV-2 in France

Abstract

France has been heavily affected by the SARS-CoV-2 epidemic and went into lockdown on the 17th March 2020. Using models applied to hospital and death data, we estimate the impact of the lockdown and current population immunity.

We find 2.6% of infected individuals are hospitalized and 0.53% die, ranging from 0.001% in those <20y to 8.3% in those >80y.

Across all ages, men are more likely to be hospitalized, enter intensive care, and die than women.

The lockdown reduced the reproductive number from 3.3 to 0.5 (84% reduction).

By 11 May, when interventions are scheduled to be eased, we project 3.7 million (range: 2.3-6.7) people, 5.7% of the population, will have been infected.

Population immunity appears insufficient to avoid a second wave if all control measures are released at the end of the lockdown.


We find that 2.6% of infected individuals are hospitalized (95% CrI: 1.4-4.4),
ranging from 0.09% (95% CrI: 0.05-0.2) in females under <20y to 31.4% (95% CrI: 16.7-52.6) in males >80y (Figure 2A, Table S1).

Once hospitalized, 18.2% (95% CrI: 18.0%-18.6%) patients enter ICU after a mean delay of 1.5 days (Figure S1). There is an increasing probability of entering ICU with age - however, this drops for those >70y (Figure 2B, Table S2).

Overall, 20.0% (95% CrI: 19.6-20.4) of hospitalized individuals go on to die (Figure 2C). The overall probability of death among those infected (the Infection Fatality Ratio, 4 IFR) is 0.53% (95% CrI: 0.28-0.88), ranging from 0.001% in those under 20y to 8.3% (95% CrI: 4.413.9) in those >80y (Figure 2D, Table S2).

Our estimate of overall IFR is similar to other recent studies that found values of between 0.5%-0.7% for the Chinese epidemic (5, 8, 9). We find men have a consistently higher risk than women of hospitalization (RR 1.26, 95% CrI: 1.21-1.31), ICU admission once hospitalized (RR: 1.69, 95% CrI: 1.61-1.78) and death (RR: 1.45, 95% CrI: 1.26-1.74) across all age groups (Figure S2).

We identify two clear subpopulations in delays between hospitalization and death:
- individuals that die quickly upon hospital admission (15% of fatal cases, mean time to death of 0.67 days) and
- individuals who die after longer time periods (85% of fatal cases, mean time to death of 13.2 days) (Figure S3).
The proportion of fatal cases who die rapidly remains approximately constant across age-groups (Figure S4, Table S3)