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Doctor Guillaume Zagury, based in Shanghai and specialist & consultant in international public health, comments on a daily basis the evolution of the epidemic for more than 3 months, and gives us a preview of the elements of understanding on its “country and regional analysis” and the foreseeable consequences (experiences of SARS in 2003 and Covid in China).
A whole remarkable multidisciplinary volunteer team allows this factual and objective analysis to be carried out (by the way don’t hesitate to join us): “each success is collective”. Our new site will be launched soon and you will be able to put faces on the names.
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A. The possible end of lockdown process in France
1. The decision makers must reason essentially according to 3 parameters
In terms of health, the decision to end the lockdown necessary for economic recovery (also health (taking care of Covid (-)) and mental), must be taken according to at least 3 parameters:
- Regional environment: risks differ completely between Limousin and Ile de France (see iconography)
- Age & co-morbidities: in the same region, those over 70 (80% mortality) or patients at risk (respiratory failure, etc.) will be the last to be not under lockdown.
- Professions: professions generating the most contacts (hotel, catering, …) will be deconfined later
2. In front of a “Patient-Actor” of Public Health, trust, therefore transparency is essential.
- The only current treatment is mechanical (even if more than 100 pharmacological trials are currently underway), it is necessary to obtain the adhesion of each.
- This membership will be total if people respect and trust the health authorities (see Scandinavia)
- At the time of Social Media, everything is known and the slightest “lie” (see iatrogenic masks / lack of stock …) can works against (“all rotten”, why believe them ..)
- The current rate of mistrust is more than 50%, and therefore, our leaders must reorganize themselves, so that the action “3M” (for some 4M with the attitude “Minute”) to relearn a new sociability.
3. M1 observation: Centralization and initial state bureaucracy are brakes during health war: bureaucracy slows down more than releases actions
-if initially, it was probably necessary to centralize the management of the masks, because the stocks were too low and distribution had to be done by privileging the Health professionals and the population at risk,
– Afterwards, it turned out to be counterproductive by wanting to control everything (blocking local initiatives) and slowing down the processes: the pharmacists had their own central purchasing office to stock up masks, biology laboratories could have submitted tests for evaluation, private clinics could have more quickly integrated into the response system,…
4. Let the loco-regional energies develop (mask, gel, biological kits, applications, isolation rooms, …) and the State rebalance the differences
5. Reminder: 1 successful lockdown requires 2 conditions and 3 actions.
6. Conditions are far from being met at national level:
- In epidemiological terms, we always observe that our intensive care beds are more than 75% occupied while there are fewer Covid (+) hospitalizations.
- Indeed, if Covid (+) beds become free after 2-3 weeks of intensive care, they are replaced by Covid (-) patients who have not had access to the healthcare system for almost a month.
- Knowing that it will be necessary to predict a new epidemiological peak around D7 of end of lockdown, so that intensive care still has 50% capacity
B. Europe and France D24: scissor effect takes shape
1. Europe with an East West gradient observed in terms of number of diagnosed cases and mortality:
Source : John Hopkins
2. a 3-speed european lockdown
– epidemiologically ready and equipped countries (Denmark, Austria, Germany, etc.)
– countries which will possibly be epidemiologically ready within 1 month and can be equipped (Italy, France, Spain…)
– Country still in epidemic phase: United Kingdom
3 . For intensive care beds: France follows the same dynamic as Italy
Italy still seems to have 10 days “ahead”, and seems to have reached not a peak but a high plateau (the occupancy of intensive care beds being the least questionable indicator).
4. At regional level :
5. France: daily mortality at its maximum (762 deaths) yesterday, which was expected, taking into account the standard development of the pathology
-We know that the pejorative course of the disease occurs most often in 2-3 weeks. As a result, the mortality peak follows the epidemiological peak at around 15 days of hospitalization.
Let’s note 2 things:
– we reached the 2003 heatwave mortality figures (15 k deaths)
– France is one of the rare countries which declares deaths outside hospitals (mainly Ehpad)
C. World: 120 000 deaths in 3 months and more than 1.4 million active cases
With the contribution of Mathieu Bouquet and Stéphane, companions from the beginning, whom I thank again for their unfailing support.
Beware of certain figures (number of cases, deaths, etc.) which are extremely questionable as they vary from one country to another (example: availability of tests), with measurement bias and therefore major under-reporting in certain countries. .
1. Prevalence: 1.4 million active cases confirmed under observation
Map: worldwide distribution of active cases
Source : John Hopkins University
Top 10 countries: USA largely first in terms of active cases
Top 10 countries
USA 546k (yesterday 525k)
Italy 104 (yesterday 104k)
France 99k (yesterday 94k)
Spain 88k (yesterday 87k)
UK 81k (yesterday 77k)
Germany 60k (yesterday 62k)
Turkey 59k (yesterday 56k)
Iran 22k (yesterday 23k)
Netherlands 24k (yesterday 24k)
Brazil 20k (yesterday 22k)
By continent: 80% of cases diagnosed in the Western countries (evenly distributed between Western Europe and USA)
2. Incidence: potential slowdown… but watch out for 3 new “emerging” outbreaks: BRI
The epidemic seems to be accelerating in Brazil, Russia and India.
Potential “stabilization”: 68 000 new cases detected yesterday (watch out for measurement bias)
Incidence : 67 000 new cases detected yesterday
By continent: 3 outbreaks – USA, Europe and Middle East
Chart: evolution of the number of new daily cases
By country: America still in epidemic phase….
– note that the number of cases diagnosed is an indicator to be taken with caution (thus the Americans launch massive campaigns of screening tests and therefore display figures in much higher proportion than many European countries which have very few tests).
By country: countries in epidemic phase: USA, United Kingdom, Turkey, Brazil, Russia, India, …
USA 24k (25k yesterday)
France 7k (4k yesterday)
UK 5k (4k yesterday)
Turkey 4k (4k yesterday)
Russia 3k (3k yesterday)
Italy 3k (3k yesterday)
Spain 2k (3k yesterday)
Iran 2k (2k yesterday)
Germany 1k ( 1k yesterday)
India, Brazil, Peru, Canada, Belgium, Ireland, Netherlands: 1 à 2k
By continent: Western countries goes from 83% to 72% of new cases with 3 new potential outbreaks to watch: India, Russia, Brazil
3. USA: in 2 days more deaths in the USA than in 2 months: the peak in line of sight ?
America remains the current epicenter of the epidemic.
We know that mortality generally follows incidence 15 days apart.
If the last 3 days the number of daily deaths observed had stabilized at 1 500, it has just started again at a record level of 2 200 deaths yesterday (more than 25 000 victims in total).
– As a result, as long as America is in the epidemic phase (despite the slowdown in the previous 2 days), the balance sheet (delayed by 15 days) is likely to be substantial and to follow: the following table gives the comparative space / time figures :
4. D-Day: end of lockdown in the world (see B2 for the western countries).
With the arrival of our new website (much more dynamic than this blog), within a few days, you will have access to all the tables of Carole Gabay (our expert in data analysis).Virus Preventions 4 W’s:
Wear a mask, Wash your hands, Watch out for sick people, Wait for new updates from covidminute.com !
Protect yourselves, and above all protect the most vulnerable!
Dr. Guillaume ZAGURY,
Specialist in Public Health and Health Innovations
Consultant at “Health Innovations”
HEC
In China for 20 years“All success is collective”, thanks to:
– the whole “Back Up” team (Mathieu Bousquet, Carole Gabay, Flavien, Marie, Laetitia, Anne-Sophie, …), without whom this project would not have been possible.
– all the “Medical” team (Dr Bachir Athmani, Dr Ibrahim Souare, Dr Taieb, Dr Viateur …) who allow this project to exist,
– all historical financial sponsors (Jerome, Benjamin Denis & B Square, Benoit Rossignol, Arnault Bricout) who work for “Citizen Actions”
If you feel like a patron or of partners to finance IT development, don’t hesitate to contact me (guillaume@covidminute.com).
Also, even if part of the team is based in Shanghai, do not hesitate to come and join us, because there is no shortage of work :-)If you want to find more analyses and infographics, follow our account at:Know the latest updates
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