Coronavirus by the numbers

I have always been fascinated by numbers, so looking at data on the coronavirus spread and its lethality is revealing and also raises lots of questions I cannot answer, since I am not a virologist, nor am I on top of what each country is doing to contain the spread of the virus.  There are several good sources of information on the numbers if this interests you.

A 17-year-old prodigy from Seattle has created an excellent database, which updates every minute.  Here is an article on the young software designer.  Johns Hopkins University, recipient of the largest gift ever made by one person to a university (Michael Bloomberg's gift of $1.8 billion), also has good data.

The country-by-country information, especially when examined over time, suggests that there are some disparities.  First: the incidence rate — that is, the number of cases compared to a country's population.  This virus began in China and grew rapidly there, particularly in one area of the country, but case volume now has leveled off with very small growth in the caseload, and well over half recovered.  This is encouraging, or should be; it suggests that containment is possible.

Now, an authoritarian country has tools at its disposal that democracies do not.  In any case, China has a total caseload of 80,000 that has been quite steady for a few weeks.  China has a population of 1.4 billion.  In other words, 1 in every 17,000 Chinese has come down with the disease.  Obviously, the incidence rate in the Wuhan area is higher than the national incidence rate in China — maybe more than 25 times higher.  This is also the area where the disease spread rapidly, since almost nobody early on knew what the population was dealing with.

Yesterday, Germany's Angela Merkel predicted that 60–70% of that country's population of roughly 85 million would come down with the virus.  Really?  Based on what?  One in 17,000 in China but 7 in 10 in Germany?

In the United States, the caseload has grown tenfold in little over a week.  That is a very high growth rate.  We now have just over 1,000 identified cases (the number infected is undoubtedly considerably higher, since few people have been tested).  The U.S. population is close to 330 million, meaning our incidence rate so far is 1 in 330,000, about 1/20 of China's rate.  In other words, if our incidence rate grew to match China's before leveling off, we would get to about 20,000 cases.  If our rate grew to match that of the Wuhan area, it might be 500,000 cases.  Why the U.S. incidence rate should grow to match the Wuhan area rate is not at all clear to me.  Some of the data in the country tables seems suspect.  Why would Russia have only 15 cases?  The world's highest incidence rate could be in Iran, if the official numbers represent just a small fraction of the actual caseload as some non-government sources in the country suggest.  Iranian leadership has been decimated by the virus, which has not occurred anywhere else.

This year's "regular" flu season has been a busy one.  This is from yesterday's New York Times, which makes clear that what we are now seeing with the coronavirus is not a repeat of the 1918 "Spanish Flu," nor as prevalent as a regular seasonal flu.

"But so far this year, the annual epidemic of seasonal flu in the United States is proving much more devastating than the coronavirus. The Centers for Disease Control and Prevention reports that there have been at least 34 million infected with flu this season, 350,000 hospitalizations and 20,000 deaths. So far, coronavirus has killed 27 people in the United States."

So, as many people have died from the seasonal flu in the United States as would be affected by the coronavirus if the incidence rate were 20 times higher than it is so far.

Several countries are experiencing higher incidence rates than China.  Among them are South Korea, Italy, Iran.  These countries are also experiencing highly differentiated death rates from the disease.  The head of the WHO stated the other day that the death rate is 3.4% worldwide.  I think he is wrong, and the real death rate is likely lower. 

In China, the death rate was near 5% in Hubei Province, which includes Wuhan.  But in other areas of the country, the death rate has been 1%.  South Korea, which has tested a large number of people, has a high incidence rate but a death rate of only 0.75%, less than 1%.  Italy has a similar caseload to South Korea's but a death rate nearly ten times higher.  Both are developed countries, with similar populations and population density.  I won't even try to explain this wide gap.  I can't.  There are apparently different strains of the virus, with different degrees of lethality. Cultural differences and differing government policies on quarantining, testing, and treating victims could all be contributors.  

In the cases around the world, the death rate is far higher for those 70 and older, than for those under that age who contract the disease. It is even higher among those 80 and older and highest among those 90 and older. Young children do not seem to catch the virus. Most of the deaths in the United States so far have been associated with one nursing home in a Seattle suburb. The typical nursing home population has a median age in the mid 80s. 

You will note that I have left politics completely out of this analysis, which is where I think they belong.  Our own government should become as familiar as it can with what other countries have done to contain the virus, especially if they have had some success doing so.  Taiwan has had a particularly positive experience:

Singapore had an initial burst of cases, which has not grown much. They early on issued some directives, which as this article suggests might be difficult to replicate in most places.

News coverage of stories like this are similar to stories concerning natural disasters. The media flood the zone with nonstop coverage. For this virus, the coverage undoubtedly has increased fears among many people. The stock market collapse and concern about an economic decline are also worrisome. If you work in the travel sector, the energy business, or the restaurant industry, things have gotten tough very quickly. 

It is troubling for a respected national leader like Merkel to make the comments she did. Best I know she is an economist, not a scientist nor a virologist. I cannot predict how many people in the US or anywhere else will be impacted by this. Here are a few things to consider: every day in the United States, 6,000-7,000 people die (over 2 million a year). In China, about 25,000 die every day (9 million a year). The great majority of those who die every year in both countries are older people. The virus added about 50 deaths per day in China for two months. Italy has just over 1,000 deaths a day from all causes. In the past few weeks, that number has grown by close to 50 per day from the virus. In other words, the Wuhan area of China experienced the same supplemental death toll from the virus for about 60 days that Italy has now experienced for close to two weeks. It is understandable why Italy has chosen a quarantine type approach for the entire country, as case volumes grow, and the death toll climbs.

In short, the world is not showing signs that the end is near (though it may be for some of us). The virus is a scary thing for many people for good reasons, and precaution is a good thing, as are active measures to deal with the economic fallout as well as testing, and treatment and speedier than normal adoption of any vaccines which prove effective. I do not have the scientific background to know whether warmer months will slow the growth of the virus, as some have argued.

Image credit: Annie Pilon.

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