A. France seen from China: 1 digit, 1 table, 1 video to understand
(I encourage you to share these elements, so that everyone understands the issues).
This section is carried out with the exchanges with Dr. Bachir Athmani in Paris and Mathieu Bouquet in China.
1. A key figure: a ratio of 1 to 88 !
– In short: in half the time (1 month versus 2 months), the virus has caused a double number of deaths in Italy (and even more!) for a national population 22 times less: a ratio of more than 1 to 88.
We have been highlighting this disproportion for more than a week, so that decision-makers understand the issues of two types of crisis management:
one of the “360-degree offensive” type, military: time is in action, first, the discussions will come later.
2. The key table of understanding what works and what doesn’t
3. The 6 measures to be taken simultaneously as long as the technical means are limited
Asian lessons:
1. Isolation of positive Covid patients
2. Contact tracking
3. Disinfection of public places
4. Creating dedicated Covid centres by mobilizing clinics with their equipment and staff and possibly hotel resources for patients with little or no symptoms
5. Mobilisation of industrialists to make masks and tests
6. Variable geometry containment based on the availability of the above elements:
Strict confinement “at the Wuhan”
Less strict confinement as in Shanghai
Mobile Confinement 3 M “Mask, Hand, Meter (1)” as in Korea
4. A video :
Take a look at the latest video I’ve made here
5. An individual and collective (war) effort
Some hairy people spent months in the trenches. We have to spend 4 weeks at home.
B. Are Chinese data reliable?
We can certainly discuss the available data, here are my comments.
1. China and transparency of information
The case definition can be questioned: lack of biological tests at the beginning, redefinition of cases in Wuhan from the imaging elements around 10 February, under initial declaration to Wuhan (in the panic and incomprehension of the beginning of the epidemic).
But I think that this is also the case in Italy and France (where so far only cases identified in hospitals), that the proportions remain similar.
2. Crossing information :
In the age of satellites and indirect reporting elements, the cross-data seems to correspond: Hubei crematorium activity does not appear to be disconnected from the number of deaths over the period.
Recent doubts about the number of burial urns delivered to Wuhan are expressed only from the number of deaths in Covid-19, while other causes of death have not been suspended during the duration of the epidemic.
3. Country comparisons :
The data provided by South Korea are indisputable, and the results are also telling: in just over a month, 144 deaths out of 9,400 reported cases for a population of 51 million, the epidemic now seems to be under control in the country. As a result, South Korea is performing much better than China, which should dispel doubts about Chinese figures that would minimize the epidemic.
4. Hesitations from the beginning
The authorities can stammer initially, and this is normal in the face of surprise: even in France, the death count will be revised too at 20, as it has so far only taken into account hospital deaths (biologically diagnosed patients) and not other victims (particularly in the Ehpad).
5. In any case: “If you can’t measure it,… you can’t manage it”
What matters most in public health is not an isolated number (to which we can say a lot of things according to the denominator chosen) but its tendency.
6. The ultimate goal is to save lives
And thus avoid family tragedies (loss of loved ones, moreover, it is in appalling conditions, with no possibility of a final farewell) and a worsening of economic and social difficulties. The virus has no borders, and we also have to learn from other countries.
Through our Asian experience, we only offer elements of understanding, allowing everyone to understand but also the authorities to make their own opinion.
C. World Impact: Dynamic
Thanks to Stéphane, companion of the first hour for his participation.
Of course with all the necessary reservations as to the validity of the figures (availability of tests, validity of data,…), but what is essential is the trend.
1. Incidence: 65,000 new cases diagnosed (63,000 yesterday, 46,000 watch, 44,000 the day before yesterday)
2. Space vision: 90% of new cases are detected in the West (60% in Europe and 30% in the Americas)
There are currently the equivalent of 15 Wuhan-type outbreaks in the world, of which about ten are bursting in Europe and can converge.
America is likely to become the main focus of the epidemic in the coming days.
The United States and Spain remain exponentially.
3. Geographic analysis continent/country
3.1. By continent
3.2. By Country
Top 10 countries:
USA 18,000
Spain 8,000
Germany 7,000
Italy 6,000
France 4,000
Iran and England 3,000
Turkey 2,000
Switzerland, Netherlands, Belgium: about 1,000
D. World Prevalence – In a few days, the United States reaches a cumulative number of cases higher than that of China in 2 months!
The doubling time in the United States is currently 3 days.
1. Time Vision (chronological)
At the current rate, double cases worldwide every 5 days (stable).
Figures to be taken with caution given the disparity in testing strategies: the epidemic can spread without being reflected in the official figures, if patients are not subject to biological screening and an official count.
2. Space Vision
Geographic location of countries with more than 10,000 active cases (top 8):
USA 100k
Italy 66k
Spain 51k
Germany 44k
France 25k
Iran 19k
United Kingdom 14k
Switzerland 11k
Chart: distribution by continent: 85% of diagnostic cases worldwide are in the West:
E. GEOPATHOLOGY : HOW TO THINK ONE STEP AHEAD
1. United Kingdom
Prime Minister Boris Johnson and his health minister tested positive for Covid-19. This shows the strong contagiousness of this pathology and the absolute necessity to maintain the 3M (“Masque-Main-Mètre”), as mentioned more than 2 months ago in the first editions of this daily letter.
2. Late decision-making
Countries that have denied the disease (United States, Brazil, India,…) will be most affected:
– quantitatively, as there are few preventive measures on potential Favelas-type “culture broths” in Rio,
– qualitatively : in the United States, especially with 1/3 of obese adults (identified risk factor).
3. Data validity
The counts displayed by some countries (Russia, India,…) may question, but possible attempts to mask the epidemic may have a “boomerang effect” quickly because “everything ends up being known”, especially with the crossover of others data (satellite observations, indirect measurement sanalysis of crematorium activity in China, etc.) and there always comes a time when cases cannot be hidden (see Wuhan in early January).
4. USA
In the face of the epidemic, Donald Trump signed “the largest support plan in the history of the United States” of $2,200 billion.
But to believe that public health is only a matter of money to be injected at the moment t is a mistake: whether at the collective or individual level, the medical results are the consequence of the lifestyle of the previous 30 years. A patient with a medical condition with a pejorative prognosis after 30 years of defective lifestyle will not be cured, no matter how much money he puts on the table!
Thus there is a high risk of health catastrophe in the United States, where the best technology will not be able to cope with a massive influx of patients at risk, especially due to comorbidities. Obesity, with its pathological consequences, affects more than a third of American adults.
5. Africa
As we regularly see with my colleague Dr. Bachir Athmani in the “Crash Test Country” (already a dozen countries under the microscope), multiple scenarios are possible and not always predictable to date.
Thus in Africa, 3 unknowns remain to establish a prognosis:
young age of the population (Lagos: more than 50% under 20!)
Impact of temperature and humidity (tropical countries) on the virus: historically the fly “tse tse” (trypanosomiasis) limited the flood of white Africa on black Africa by devastating The Arab mares (competitive warrior advantage at the time) .
A region where malaria occurs with a wide spread of preventive nivaquine (anti-coronavirus properties?)
However, given the doubling time of “reported” cases (and we see the limits of this type of encryption : high probability of under-reporting) of about 4 days, the 2 key indicators on the continent will be the number of cases in resuscitation and mortality.
6. President Trump’s gamble: create a scientific shock to find effective therapy in a very short time (15 days): “The New Frontier”
For the President Trump, economic health takes precedence over public health.
In this election year, containment measures of more than 15 days would, according to his administration, be too risky in terms of unemployment, stock market index, etc.
After an initial scramble at the test level, America is back to its means.
One of its major maps is the use of Plaquenil, whose clinical trials began a week ago, and whose results are expected in the next 2-3 weeks.
Let us trust the dynamism of American research to try to find a technological solution (antivirals, platenil,…) to this major medical-social crisis.
Will the President’s atypical behaviour (“go-getter”) (accelerated testing and speed in the implementation of clinical trials) be an asset or a benefit?
To follow in 15 days: Go America, Go
Tomorrow: D62 of daily analysis
The situation is serious, but we must remain “positive” (for action).
“Crash test Russia” with Dr. Athmani.
Thanks to Mathieu Bouquet, partner of the first hour, for his precious help.
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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