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Research: Substantial undocumented infection facilitates the rapid dissemination of COVID-19

Substantial undocumented infection facilitates the rapid dissemination of COVID-19 (Li et al, Science) Findings Using a model-inference framework, [ ... ]

Stats Summary: Global

The total number of cases continue to increase by at least 10% for a second day to [ ... ]

Stats Summary: Asia

While China has virtually interrupted local transmission, it remains the fifth leading country with 81,620 confirmed cases [ ... ]

Stats Summary: Europe

As of April 3, Italy and Spain together make up almost half of all confirmed deaths globally [ ... ]

Stats Summary: Americas

The numbers continue to surge in the U.S., with at least 6,098 reported deaths and 245,442 confirmed [ ... ]

More countries are adopting the WHO’s number advice to “test, test, test”

Countries are increasingly adopting the WHO’s main advice to “test, test, test,” with total number of tests [ ... ]

Official numbers of reported cases and deaths are questioned

A number of countries including Iran, China and Japan are also increasingly facing questions about official reports of case counts and mortality [ ... ]

Research: Maternal, Fetal and Neonatal Outcomes

Lancet: Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a [ ... ]

Research: Evidence of initial success for China exiting…

Imperial College London: Evidence of initial success for China exiting COVID-19 social distancing policy after achieving containment [ ... ]

Global rise is exponential

The pandemic continues to grow exponentially. As of March 25, It took only 6 days for the [ ... ]

China’s numbers remain high even as local transmission interrupted

While China has virtually interrupted local transmission, it remains the third leading country with 81,340 confirmed cases [ ... ]

Europe needs testing capacity and mitigation strategies

The European CDC warned that with current testing capacity and if nations do not enact mitigation strategies, [ ... ]

ngq, you sexy beast! Here is a sanity check for that clean meta. ;)

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                    [post_content] => Substantial undocumented infection facilitates the rapid dissemination of COVID-19 (Li et al, Science)
Findings
Using a model-inference framework, the authors estimates the contagiousness and proportion of undocumented infections of COVID-19 in 375 cities in China before (Jan 10-23) and after (Jan 24-Feb 8) implementation of control measures in Wuhan (including: travel restrictions self-quarantine and contact precautions, access to rapid testing and PPE). The effective reproduction number (Re), i.e. number of secondary infections per index infection, was 2.4. The authors estimate that before control measures, 86% of all infections were undocumented, estimated to be about half (55%) as contagious as reported infections. After Control Measures, the proportion of undocumented infections fell to 31-35%, while the Re decreased to 0.99-1.4.
Interpretation
Although inference results should be interpreted with caution, the study suggests that control measures in Wuhan as of Jan 23 altered the epidemiological characteristics of the outbreak.

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                    [post_content] => The total number of cases continue to increase by at least 10% for a second day to 1,039,158, and 55,000 confirmed deaths, as of 3 April 2020 (9:25am EST).
Although the U.S. and Europe constitute over 70% of confirmed cases, the rapid increase of local clusters across low- and middle-income countries has emerged as a major concern.
CFR figures (in order of countries with the highest number of deaths)
Italy (11.4%)

Spain (8.7%)

Iran (6.5%)

U.K. (8.2%)

France (6.8%)

China (4.1%)

US (1.9%)

Netherlands (8.3%)

                    [post_title] => Stats Summary: Global
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                    [post_content] => While China has virtually interrupted local transmission, it remains the fifth leading country with 81,620 confirmed cases and 3,322 reported deaths. Two thirds of new infections reported in China yesterday were asymptomatic, which has been concerning as authorities have taken steps to end the lockdown of Hubei province (with Wuhan remaining under lockdown until at least April 8).
The number of reported cases and deaths in Iran, meanwhile, keep rising to 53,183 and 3,294, respectively. There are no official lockdowns in Iran’s major cities, despite internal government estimates that mortality rates could be drastically limited to 7,700 instead of the projected “tens of thousands” of deaths by adopting ‘maximum’ interventions (e.g. banning movement inside cities, quarantines).
In South Korea 35% of confirmed cases within the last two weeks have been imported cases; more stringent control measures and monitoring have gone into effect as of today to deter incoming international travel. South Korea, Taiwan and Singapore have significantly slowed new case counts, with the focus shifting to the containment of imported cases.

                    [post_title] => Stats Summary: Asia
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                    [post_content] => As of April 3, Italy and Spain together make up almost half of all confirmed deaths globally (13,915 and 10,348, respectively), while each country has also surpassed 110,000 confirmed cases. Across Europe, ten countries are reporting more than 10,000 cases, while seven countries have reported over 1,000 deaths. Many European countries are also reporting alarmingly high Case Fatality Rates over 5%. Including Italy (12%), Netherlands and Spain (9.1%), UK (8.7%), France (7.1%), Belgium (6.6%), and Sweden (5.2%). This has been partly attributed to selective testing strategies in these countries, while widespread testing is likely contributing to relatively low CFR rate in countries like Germany (1.2%) and Austria (1.4%). The European CDC has nonetheless warned that current testing capacity and if countries do not enact mitigation strategies, Europe could see a scenario similar to China by the middle of April.

                    [post_title] => Stats Summary: Europe
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                    [post_content] => The numbers continue to surge in the U.S., with at least 6,098 reported deaths and 245,442 confirmed cases, accounting for almost a quarter of all worldwide cases. New York State has become the epicentre of the outbreak with almost 100,000 confirmed cases, while the U.S. reported over 1,000 deaths for the second day in a row. In Canada, the number of confirmed cases has also increased to 11,283, including 173 reported deaths. With the outbreak expected to spread more widely across the continent over the next two weeks, there are increasing concerns over health care system capacities. The number of cases in South and Central American countries continue to grow, with reported cases in Brazil continuing to jump almost 20% a day to 8,044, while Chile and Ecuador have seen spikes to 3,404 and 3,163 cases, respectively.

                    [post_title] => Stats Summary: Americas
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                    [post_content] => Countries are increasingly adopting the WHO’s main advice to “test, test, test,” with total number of tests performed increasing 42% over the past week, as of April 1. Limited availability of diagnostic kits and laboratories in many low- and middle-income countries remain a critical concern and is almost certainly masking more widespread local transmission.
Similar to prior pandemics, high initial Case Fatality Rates for COVID-19 are expected to trend downwards over time as countries adopt more wide-spread population testing (i.e. recording those dying with as opposed to from the virus). This is reflected in these CFR figures (in order of countries with the highest number of deaths), as of 3 April: Italy (12%), Spain (9.1%), U.S. (2.4%), France (7.1%), China (4.1%), Iran (6.3%)

                    [post_title] => More countries are adopting the WHO's number advice to "test, test, test"
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                    [post_content] => A number of countries including Iran, China and Japan are also increasingly facing questions about official reports of case counts and mortality figures, as modelling estimates and informal proxy indicators (e.g. total mortality, demand for funeral services, local and social media accounts, etc.) suggest real figures may be significantly higher. There is likewise concern that the true outbreak size in India may be significantly higher than the 2,567 confirmed cases, which has doubled in just two days.

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                    [post_content] => Lancet: Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study (March 24)

                    [post_title] => Research: Maternal, Fetal and Neonatal Outcomes
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                    [post_content] => Imperial College London: Evidence of initial success for China exiting COVID-19 social distancing policy after achieving containment (Ainslie et al. 2020)
Findings
Estimated transmissibility from reported cases and compare those with daily data on within-city movement as a proxy for economic activity in order to determine the public health and socio-economic impact of imposing and relaxing social distancing measures by China to control COVID-19. The results suggest that after very intense social distancing which resulted in containment, China has successfully exited their stringent social distancing policy to some degree.
Interpretation
China is at a more advanced stage of the pandemic globally. While the results do not preclude future epidemics in China, the policies implemented to reduce the spread of COVID-19 and the exiting strategies that followed can inform decision making processes for countries once containment is achieved.

                    [post_title] => Research: Evidence of initial success for China exiting...
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                    [post_content] => The pandemic continues to grow exponentially. As of March 25, It took only 6 days for the global case number to double from 200,000 to over 400,000 (and 2 days from 300,000 to 400,000).
At least 650,567 cases and 30,299 deaths have been reported in 199 countries as of March 28 at 2:30pm EST. Europe and the U.S. account for almost two thirds of all cases globally.  There is growing alarm, however, as case reports are increasing in many low- and middle-income countries.
Select Case Fatality Rates (for countries with at least 50 deaths)
Worldwide: 4.7%

Italy: 10.6%

Spain: 7.9%

Iran: 7.1%

China: 4.1%

France: 6.1%

US: 1.6%

South Korea: 1.5%

Canada: 1.2%

Germany: 0.7%

                    [post_title] => Global rise is exponential
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                    [post_content] => While China has virtually interrupted local transmission, it remains the third leading country with 81,340 confirmed cases and 3,292 reported deaths. Imported cases are on the rise and there are small numbers of locally acquired cases periodically being reported. Authorities have indicated that China will end its lockdown of most of Hubei province while Wuhan will remain under lockdown for another ten days.

                    [post_title] => China's numbers remain high even as local transmission interrupted
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                    [post_content] => The European CDC warned that with current testing capacity and if nations do not enact mitigation strategies, Europe could see by the middle of April a scenario similar to what China experienced in Hubei province at the beginning of the outbreak.
Spain and Germany are leading the increase in number of confirmed cases, accounting for 12% and 13.5% of newly confirmed cases globally on March 28, totalling 65,719 and 50,871 respectively. While Germany has maintained a relatively low CFR (0.75%), the death toll in Spain (5,138) now exceeding China. The decreasing trend in Italy earlier this week did not continue, as the total number of confirmed cases surpassed 86,498 with an alarming CFR of 10.56%.

                    [post_title] => Europe needs testing capacity and mitigation strategies
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            [post_date] => 2020-04-03 12:42:50
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            [post_content] => Substantial undocumented infection facilitates the rapid dissemination of COVID-19 (Li et al, Science)
Findings
Using a model-inference framework, the authors estimates the contagiousness and proportion of undocumented infections of COVID-19 in 375 cities in China before (Jan 10-23) and after (Jan 24-Feb 8) implementation of control measures in Wuhan (including: travel restrictions self-quarantine and contact precautions, access to rapid testing and PPE). The effective reproduction number (Re), i.e. number of secondary infections per index infection, was 2.4. The authors estimate that before control measures, 86% of all infections were undocumented, estimated to be about half (55%) as contagious as reported infections. After Control Measures, the proportion of undocumented infections fell to 31-35%, while the Re decreased to 0.99-1.4.
Interpretation
Although inference results should be interpreted with caution, the study suggests that control measures in Wuhan as of Jan 23 altered the epidemiological characteristics of the outbreak.

            [post_title] => Research: Substantial undocumented infection facilitates the rapid dissemination of COVID-19 
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