What do we know about COVID-19?

Data from 18 Mar 2020

“Without data, you’re just another person with an opinion.” W. Edwards Deming

What do we know about COVID-19?

• This is a new coronavirus. It is very infectious. Globally, we have no immunity. Epidemiologists around the world estimate that about 70% of the world will catch the virus. 
• Data that I can get from https://www.worldometers.info/coronavirus/ 
  shows several European countries (Italy, France, UK, Germany) for which the rate of infection is exponential (doubling each few days). For several of these countries (Italy, France) the death rate and rate of severe infection is also increasing exponentially.
• If we have those rates in Australia, our hospitals will be overrun – our medical system overwhelmed.
• Severe cases need intensive care beds, ventilators, respirators and oxygen for an unknown length of time.
• If we have 70% infection and the same death rate as Italy and it all happens within a month or two, in Australia we will need 1,190,000 intensive care beds. (We have about 2,000.) And will have about 1,446,000 deaths.
• In my city of Wagga (population ca. 65,000) those numbers are 3,000 ICU beds needed (we have 30) and 3,500 deaths. We will also need about 5,000 ICU staff. (I think we have about 50.)
• Good, compassionate doctors will be forced to choose which one of 15 to 100 patients to save because there is only one respirator available. (We know this happened in Canada during the recent SARS epidemic and it has been recently recorded in Italy from this scary interview with an Italian doctor https://www.newsweek.com/young-unafraid-coronavirus-pandemic-good-you-now-stop-killing-people-opinion-1491797).

• In Australia, our infection rate is following the exact same path as France (we lag them by 11 days) and Italy (we lag them by about 19.5 days). Both those countries are tracking China. 
• What does that mean? If we keep on our current track, in 11 days Australia will have, like France, 7,730 infected cases and 175 deaths. And then 8.5 days later, like Italy, Australia will have 31,500 infected cases and 2,500 deaths.
• We need to slow the infection rate down so that our hospitals can cope. If those 3,000 people who will need ICU beds in Wagga can arrive at a rate as beds become available we will be ok and everyone who needs a bed can have a turn.
• The best way to slow it down is to lock down the country. France and Italy were eventually forced to that decision. We should be doing that now. We should all be confined to our residences except for essential travel (food shopping). All shops (other than supermarkets, pharmacies) should be closed – coffee shops, restaurants, hairdressers, shopping malls all closed. Schools should probably be closed.
• While this is happening, we need to identify early all those who have COVID-19 and isolate them. Until 12 Feb 2020, China was using the same testing methods we are using now. From that date, they began using new testing, they got ahead of the infection by early identification and isolation. The new tests included portable CT scans to identify lung infection and infrared facial heat scans to identify elevated temperature. We are way behind on early testing such as that.
• A very recent research article published in Science Magazine https://science.sciencemag.org/content/early/2020/03/13/science.abb3221 shows research that an estimated 86% of infections in China were initially undocumented. That is, until China introduced early testing, they were finding just 14% of people with the virus. Those apparently ‘symptomless people’ infected people around them – who may have gone on to experience a much more serious infection. Which explains the rapid spread of COVID-19 once it gets a hold in a population.
• On 28 Feb 2020, China published data that showed a marked increase in deaths for people over 60. In Europe, people on ventilators are in their 30s and 40s. Possibly because the older people are being tiraged away from ICU treatment – probably to die – rather than take a ventilator from a 30 year old with 4 kids.
• People who have needed intensive care treatment to save their lives will probably have extensive scarring of their lungs and may need rehabilitation for months before they can lead a normal life.
• Australia needs to lock down now. Close shops. Restrict people to their residences. Introduce methods of early testing. We must slow this down before we are overwhelmed.
• What can you do? Stay at home.