Doctor Guillaume Zagury, based in Shanghai and specialist in international public health & “health innovations”, comments on the evolution of the epidemic for 68 days, and gives us a preview of the elements of understanding on his “country analysis” and the foreseeable consequences (experiences of Sars in 2003 and of Covid in China for 3 months).
We know that many journalists and decision makers read this analysis served at breakfast, and we welcome them, just when they use our ideas / diagrams, let them have the courtesy to quote us.
A. The 3 types of countries : “COVIDSCORE”©
1. Countries that have succeeded with an “offensive” and total strategy:
– The countries of Asia Pacific (“Confucian”): Hong Kong, Korea, Taiwan, Singapore…
– Reasons already seen, for those who follow me, and which are declined on 2 levels:
> Population: acceptance of the population (cf. Sars 2003),
> Health authorities:
.stocks available: masks, biological kits,…
..technological tools (Big Datas & IA): in China geolocation of potential cases via the telephone number or the “Wechat” Application (= all in one: What’sApps + FB + digital payment …) listing 900 Millions registrants, or applications for tracing cases, drones for monitoring strict confinement in Wuhan, …
… responsiveness: confinement, construction of hospital structures, availability of human resources (30,000 professionals came to help in Wuhan), imported cases and airport closures, …
2. Countries that can succeed thanks to a similar approach: Israel, Central Europe, Germany Austria, …
– European countries: in particular the Czech Republic (see the country report yesterday), Slovenia, Austria, …
– Some countries, such as Israel, which practices an “offensive” policy and not a reaction or a rise in power …
3. Countries in difficulty: Southern Europe, United Kingdom, United States
– It is a global approach with prevention and identification measures, simultaneously.
– Without masks, we are already “out of the game”
– The table below, which has value only today, and already shows that France, the USA and the United Kingdom, are likely to be turbulent, since the cases are poorly diagnosed, they return home and will contaminate their environment recent example of the Mougins nursing home with around twenty cases and alas, it is not over, as the episode of the “Diamond Princess” showed or in 10 days, 16% of the boat was already contaminated). :
– Italy appears at the top of the table, following the massive purchase of tests, but the other preventive measures were initially absent (masks, date of confinement, …)
– Consequently, have the tests yes, and at best as soon as possible.
– Our leaders seem to be reacting well and France is equipping itself with masks, tests, etc.
– For information, South Korea (which was in 1960 had a GNP / inhabitant at the level of Chad!) Carried out, for more than 1 month, 15,000 tests per day.
4. The Taiwan case: tests (case identification) & Big datas
– I took my sources from Jean Marc Salmon
– To date (i.e. after more than 2 months of exposure): 360 cases and 5 deaths for a population of 21 million inhabitants (including nearly ½ million working in mainland China)
– Covid case more identified initially on epidemiological data (Hubei visit of less than 14 days) and suggestive symptomatology (fever, cough), … then quickly available tests to define a positive case.
Isolation of cases:
1 / Patients at risk of respiratory decompensation: in the base of patients potentially respiratory insufficiency 113 Covid cases more diagnosed at an early stage
2 / Covid plus at home (in China, patients were strictly isolated in ad-hoc structures) with telephone monitoring of the absence of discharge
B. SUCCEEDING IN CONTAINMENT WITH THE TOOLS OF THE 21ST CENTURY: THE CHINESE CASE
1. China does not appear in our new COVIDSCORE ©
– Note that we have no longer cited China in our COVIDSCORE © table, which Dr Athmani, Mathieu Bouquet and myself, produced a week ago, … and now taken up by all (which is a good thing if it can help make the right decisions and limit deaths).
– China deserves more balanced treatment in the West: the system is neither black nor white, but both its population and its government have done their utmost to eradicate the virus in 3 months (subject to a second wave), and without any initial epidemiological (distribution of mortality, …) or therapeutic knowledge!
– Let’s not look for a “scapegoat” for our inadequacies, the fight is not there!
2. And yet we have to learn from China in terms of technology !!!!
– The factory of the world: impossible to live 24 hours in France without buying a product “made in China”
– Even…. on strategic elements: 80% of French medicines are dependent on China, in their supply – see curare or midazolam currently for our ventilated intensive care patients
– This country has evolved over the 20 years that I have been here, to become one of the two real players in innovation with the United States (the Europe of innovation must regulate less and get back into a dynamic of conquest! !)
– Solar panels, electric batteries, nuclear, 5G, genetics…: they are in front of us !!!
3. In Asia, we have seen numerous digital applications and tools flourish: France (the beacon of humanity?) No longer races in the lead and must learn from others.
– Numerous digital applications and tools based on geolocation, Artificial Intelligence, even virtual reality, will come to help diagnosis and especially secondary prevention: referral of patients according to symptoms, follow-up of Covid plus cases, …
– You can contact me (address at the end of the email) because, as a specialist in Health Innovations, we will be able to share. Besides, our team is working on the implementation of an application…
4. The urgency is with the development of this type of tools and their use: this will allow to lift the massive and non-targeted containment measures (20th century)
=> with mask, tests and immune status,
=> the economic impact could probably be thus limited
C. France D20 & World – Still in the epidemic phase: 6 messages
Analysis with the contribution of Dr Bachir Athmani.
The elements below are to be read with the reservations concerning the validity of the data (case definition, possible underestimation, etc.) already mentioned above, and keeping in mind that it is the trends that count, rather than the raw figures taken at the moment.
I offer you the 6 figures to understand the important points (& 5 key diagrams):
1/4 billion people confined to the planet (60%)
2 / The USA becomes the epicenter
3 / Good news: it seems that the epidemic is starting to turn back in Italy with the last few days fewer cases in intensive care (4000 beds)
4 / In Shanghai, use of chloroquine, even in asymptomatic Covid plus patients.
5 / France: the aim is to rebuild the protective dike first on vulnerable or at risk people, then widen it to the population.
6 / A little memo (finalized with Hughes) for my emergency room colleagues (I am from the CAMU family) to communicate to your staffs:
“4 M ”
Mask (different levels depending on exposure): resuscitation / room
Manual (hand hygiene & glove)
Meter (1 m)
Minute: shortest possible care
———————————————————————
5 MINUTE ICONOGRAPHIES:
1. WORLD : PREVALENCE
2. PREVALENCE WORLD : BY COUNTRY
3. WORLD INCIDENCE
3. WORLD INCIDENCE : BY COUNTRY
4. FRANCE – RESUSCITATION: load capacity
5. FRANCE : REGIONAL ANALYTICS
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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