A. We have to learn from these 2 episodes “in real situation”
1. A specific environment: confinement
– Potential broth cultures by the proximity of the contacts (transmission by micro air droplets and through manual contact)
– Particularly on the CDG warship, with many small shared spaces (cabins, refectory, …)
– Different similar cases in progress on American aircraft carriers (Franklin Roosevelt ..)
2. Same risk exposure for 2 different populations:
– Diamond Princess: 80% of the passengers were over 60yo (see cost and duration of the cruise).
– CDG: 80% of passengers were under 40yo (see military personnel in operation)
3.What is (was) expected: Italian model (15/4/20 Journal of Epidemiology)
3.1 Resuscitation: 5% of C+ patients (order of magnitude) out of a general population (age, risk factors, etc.)
* The usual reference rate is around 4 to 10% (see in China where all cases diagnosed with C+ were hospitalized and among which 5% requiring resuscitation). This diagram produced on February 13 is indicative (even if Chinese data are often more or less rightlfully contested).
** In France if we consider that 20% of hospitalized patients are in intensive care (see 6000 / 31k), but that a large majority of Covid+ are sent home for observation because asymptomatic, in my opinion the figure of 5% of C+ in resuscitation holds up.
*** We will therefore retain this figure of 5% of C+ hospitalized in intensive care.
3.2 Mortality:
The recent Italian study (April 15, 2020) provides an unambiguous standard:
4.What we observe:
– 4.1 / “Diamond Princess”: over a period of approximately 3 weeks
* Number of cases observed (despite isolation and transfer of patients back to their home countries): 20%
** Resuscitation cases: 5.1% of C+
=> Relatively low considering the average age.
=> Partially explained by an over-representation of women on this type of cruise (and we know that men are much more inclined to experience decompensation than women on this pathology).
*** Death: 2%
=> Relatively low given the average age
=> Same partial explanation as for resuscitation (2.8% for men and 1.7% for women in China)
– 4.2 / “CDG”: over a period of approximately 12 days (first 6 cases on April 7, 2020)
Number of cases observed: 50%
** Resuscitation cases: 0.1% of C+
*** Death: 0
5. So what? What we can deduce for deconfinement:
* Extremely contagious pathology (see family cases…) with a rate of contagiousness around 2-3 infected individuals
** Benign pathology in the vast majority of cases in non-risky populations (see physically capable soldiers): it would be very surprising to have a death on the CDG, because all the sailors are “young” chronologically and physiologically (very selective aptitude health check).
*** More to come on this test laboratory in the next 15 days: the number of ICU cases, the number of deaths, the number and speed of immunization (IgG to S3 after discharge)
**** These elements will be extremely important for the deconfinement strategy by area, age, medical field, profession…
B. Europe and France D31: Scissors effect is emerging
1. East-West gradient observed in Europe in terms of number of diagnosed cases and mortality
Source : John Hopkins University
2. A three-speed containment Europe:
– Epidemiologically ready and equipped countries (Denmark, Austria, Germany, etc.)
– Countries that will possibly be epidemiologically ready within 1 month and may be equipped (Italy, France, Spain…)
– Countries still under epidemic phase: United Kingdom
3. France D29 – Good dynamic overall: containment is paying off
Intensive care beds slight decrease and stabilization of the hospital entry / exit balance record for the 9th day in a row:
-Source : Le Monde
4 France is walking in Italy’s steps.
Italy’s situation seems to be 10 days in advance compared to France’s, and it seems like a plateau has been reached, and not a peak.
(ICUbeds’ occupancy rate seems to be the fairest indicator)
5. At a local level : different situations but similar trends
– Hospitalizations : geographical distribution – source Le Monde
– ICU : evolution over time and space
C. World : 1,50 million active cases over 3 months… Will spring be the US’ saving grace ?
Thanks to the work of Mathieu Bouquet and Stéphane, whom I cannot thank enough for their full support since day 1.
Keep in mind that some figures (number of cases, death tolls…) are arguable, due to lack of testing in come countries, different method of measuring from one country to the other, and official records significantly underestimating the situation in some.
1. Prevalence : 1,5 million of active cases confirmed under observation
1. Prevalence : 1 523 000 of active cases under medical observation
2. Geographic distribution :
Source : John Hopkins University
-Top 10 countries : 600k cases in the US ( & 100 k cases in France), which is leading in number of active cases. (more than all of Europe combined)
Top 10 countries : the US and the UK are in the epidemic phase; Italy, Spain and France in stabilization phase
USA 612k (yesterday 583k)
France 95k (yesterday 114k)
Italy 107 (yesterday 107k)
Spain 96k (yesterday 89k)
UK 94k (yesterday 89k)
Turkey 68k (yesterday 65k)
Germany 54k (yesterday 56k)
Netherlands 27k (yesterday 26k)
Russia 30k (yesterday 25k)
Belgium 23k (yesterday 22k)
.
At a continent level: 80 % of official cases in the Western world (with similar numbers in the US vs Europe)
2. Incidence : potential slowdown… 80% of new cases are in the Western world but we need to pay attention to 3 emerging sources of new cases (Brazil, Russia, India)
Let’s keep in mind that the amount of tested cases depends on the number of tests done.
Incidence : 86 000 new cases detected yesterday
– Time distribution :
– At a continent level – 3 sources : the US, Europe and the Middle-East
3. North America : world epicenter according to all data reportings: The epidemic mainly spreads in densely urban areas. 10 Wuhan on the horizon
Incidence, and prevalence : cf graphic 3.1 & 3.2
– Deaths
– Regional prevalence : the virus is spreading towards the west
Source : politico
– Death tolls by state :
Source : politico
D. Tomorrow
www.covidminute.com website is planned to be launched on monday. We’ll add all our content along the way. 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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