For better or (mostly) worse, 2020 is shaping up to be an extraordinarily eventful year. I’ve missed writing about some of the more important recent themes, and now they all seem to be dwarfed by the emerging coronavirus pandemic sweeping country after country. I couldn’t resist tracking its spread with hard numbers instead of coincidental tweets, so I turned to the data compiled by the website Our World in Data. I imported their daily file in Excel and did a couple of simple calculations and graphs.
Just to say again, the answer to “who could’ve predicted this?” is everyone who studies infectious diseases.
— James Hamblin (@jameshamblin) April 2, 2020
For the time being, my own country Romania hasn’t been hit very hard by the pandemic, compared to other European countries, but that may well change in the months ahead. I was curious whether the measures implemented here, fairly early, had a measurable impact on the spread of the virus. I’m not going to post my own graphs in this article because they are too heavy with data points to look nice, but I will share other good online resources, including interactive visualizations. With the obvious caveat that I’m by no means an expert, and individual country data may be hard to compare because of different reporting methodologies, here are some of my observations.
Most graphs I saw online start from the day when the respective country first reported 100 cases of COVID‑19. I used instead the date when each country reported its 5th case. This reveals some interesting patterns. The growth curve is very similar in most countries, as pointed out time and again, but the starting conditions differ significantly. In my selection of countries, some start on the exponential trajectory almost immediately after reporting the first few cases (notably Italy and Spain, but also Poland, Romania, Brazil), while many others linger for weeks in the 10 to 100 range (France and Germany in Europe, Australia, the US, even the first outbreaks in China, South Korea and Japan) – which is consistent with the long incubation period of this coronavirus. Concretely, the first cases were reported in Italy on January 31st, same as UK, with Spain a day later. Italy then reported a huge increase from 3 to 139 cases in just three days after February 21st. Meanwhile Spain went in a week from 3 cases on February 25th to 114 on March 3rd. The UK on the other hand had 3 cases on February 7th, but only reached 100+ on March 6th, so nearly a month later.
There may have been several factors involved here, from the number of tests administered to the population (with few tests one would only catch few cases, to later discover the real size of the outbreak), to the initial number of infected transmitters (if you have multiple sources of the disease, it would spread more rapidly and it would be harder to contain). I suspect the second may better explain the different speed of the epidemic in Italy and Spain, but it would be best to have confirmation from genetic testing on the various viral strains. This obviously underlines the importance of acting quickly to contain the virus – despite having 20+ days at their disposal, most countries didn’t take measures fast enough.
A couple of days ago I encountered another method to visualize the spread, by comparing daily new cases to the cumulative number, as explained in this YouTube video. It clearly shows which countries have had success containing the spread (as you already known by now: China, South Korea, Japan), while all the rest are still on the exponential spread trajectory. I recreated the graph using a 5-day average of new cases to smooth out daily variations. The situation in Japan appears unique, with slower growth than the rest of the world, but not contained as in China and South Korea – you could also argue that China is covering up their real numbers, but let’s stick to the official figures. I get the impression Japan reflects on a small scale the evolution of the disease if we were to alternatively impose strict restrictions and relax them too quickly: small, recurring outbreaks, on an upward slope. There’s a small hint of good news here, because it appears that Italy is finally getting the outbreak under control, with the number of newly reported cases declining after a peak at around 6000 – still a very high number, remains to be seen if it will decrease further in the coming days and weeks. The amount of new cases seems to be leveling off in Spain and Germany as well.
Going back to the situation in Romania, both graphs suggest the measures implemented so far haven’t made a significant difference in the natural spread of the epidemic. Again, I think there are several factors at work:
- First, I don’t see many people taking the quarantine/social distancing measures seriously. Last week the administration put in place an additional curfew for people over the age of 65 (they are allowed to leave their homes only between 11 AM and 1 PM), but still there were many old people on the streets on Friday, when I went out for groceries. In fact, the streets seemed just as busy with cars and pedestrians as on any normal day.
- We also had a couple of egregious cases of super-spreaders (one person is reported to have infected at least 40 others because he returned from a trip to Israel with his mistress and didn’t want his wife to find out) and failure to follow quarantine protocol in the main hospital in Suceava, a city in the northern region.
- But our main issue long-term is that a lot of people who were living and working in other EU countries, mainly in Italy, are now returning home to weather out the storm, potentially adding additional sources of infection. I’ve heard some estimates of up to 800 000 people entering Romania. I fear the health controls on our borders are too lax, and many will head straight to the countryside, where they may spread the disease for weeks without restrictions or medical checks. And it looks like Poland is in a similar situation with returning migrants from the UK.
Overall, the situation looks rather dire, and I’m expecting the crisis to last a couple of months at least. There will be almost certainly a heavy impact on other countries that look relatively spared for the moment, for example India (it imposed strict restrictions practically overnight, which makes me suspect they fear rapid spreading, if that hasn’t already happened) and Brazil (where president Bolsonaro is openly dismissing the pandemic and it’s up to gangsters to impose quarantine measures). Hopefully we will be more vigilant in the future, because we haven’t managed this particular outbreak well at all.
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