at Dadhaleh Institute

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International Coordination is Essential to Avoid Resurgence

A new study in Science demonstrates the need for a coordinated approach for countries in Europe to [ ... ]

Snapshot of the State of the Pandemic

An article in The Lancet (Has COVID-19 subverted global health?) emphasize the importance of context and equity [ ... ]

‘The second wave is in our hands’: WHO

The doubling rate of confirmed COVID-19 cases dropped to once every 21 days from a high of [ ... ]

Regional Snapshot: Europe

Ten countries have now confirmed more than 1,000 COVID-related deaths, with 14 countries reporting more than 10,000 [ ... ]

Trump announces intention to suspend WHO funding

During this unprecedented global pandemic, U.S. President Trump announced his intention to suspend funding to the WHO [ ... ]

Global Snapshot

April 9 marks the 100th day since the WHO was notified of the first case of “pneumonia [ ... ]

Research on Forecasting Peak Transmission and Health System Utilization

Short-term forecasts of COVID-19 deaths in multiple countries Imperial College London, 8 April 2020 https://sangeetabhatia03.github.io/covid19-short-term-forecasts/index.html This weekly [ ... ]

Research: Canada Needs to Rapidly Escalate Public Health Interventions for Its COVID-19 Mitigation Strategies

Canada Needs to Rapidly Escalate Public Health Interventions for Its COVID-19 Mitigation Strategies (Wu et al, SSRN) [ ... ]

Research: Estimating the number of infections and the impact of non- pharmaceutical interventions on COVID-19 in 11 European countries

Estimating the number of infections and the impact of non- pharmaceutical interventions on COVID-19 in 11 European [ ... ]

Stats Summary: Global

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

Stats Summary: Europe

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

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 [ ... ]

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

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A new study in Science demonstrates the need for a coordinated approach for countries in Europe to lift lockdown measures in order to prevent subsequent outbreaks of cases. The research team from WorldPop highlight the significant impact of actions by countries that are populous, well-connected and with strong interventionsin place – which include France, Germany, Italy, Poland and the UK. The study produced over 1,200 exit strategy scenarios, using publicly available epidemiological data as well as anonymized mobile phone data to map population movement in 35 European countries. A notable finding of the study is that premature and uncoordinated easing of control measures by some countries could accelerate the resurgence of COVID-19 outbreaks across the entire continent by up to five weeks. The simulations furthermore show that synchronizing intermittent lockdowns across countries would lead to half as many necessary lockdown periods in order to achieve an end to community transmission in six months.

 

                    [post_title] => International Coordination is Essential to Avoid Resurgence
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                    [post_content] => An article in The Lancet (Has COVID-19 subverted global health?) emphasize the importance of context and equity as key principles of global health. In light of limited financial aid from wealthier countries, the authors urge developing countries to adopt policies that reflect their local context that focus on what is possible, acceptable, just, and sustainable.
What accounts was South Korea’s COVID Secret? Fast Testing, High-Tech Tracing, Zero-Tolerance Isolation (Atlantic)
Lockdown Is a Blunt Tool, We Have a Sharper One: Contact Tracing (NYT)
WHO issues a Technical Guidance on Contact Tracing for COVID-19 in Africa (WHO)
The U.S. can expect a series of ‘mini-epidemics’, as the flattening curve is misleading, as the CIDRP outlines three potential futures: recurring small outbreaks, monster wave, persistent crisis (NYT)
Where the latest models think we are headed and why they disagree (FiveThirtyEight)
Reopening some states can heighten risk of or recurring second waves in others (STAT)
Simulation: Ending restrictions earlier is associated with higher projected cases and deaths, but also quicker economic recovery according to a RAND Corporation online tool
In the New England Journal of Medicine, the authors provide two lessons in the Italian response to the pandemic, highlighting the important of testing of health care workers, and how “urgent and decisive” lockdown of the region earlier could have contain the epidemic (Adaptations and Lessons in the Province of Bergamio)
National Geographic reviews the lessons learned from national responses to the COVID-19 pandemic, including the spread of social mitigation, the effectiveness of travel restrictions, testing and the impact of speed of response on outbreak trajectory (How to measure your nation’s response to coronavirus).
It took the U.S. only seven days to exceed projected COVID-19 deaths for August (Newsweek)
A new paper in the Journal of Risk Research (Resilience in the face of uncertainty) describe how political interference undermined the ability of the U.K. National Health Service with COVID-19 preparedness and response. Similar to the Bank of England, the authors argue that national emergency preparedness requires greater independence.
While the full impact of the pandemic on food security remains unknown, Dr. Rhonda Ferguson (DIGHR Research Fellow) argues that the displacement of localized food systems require transformation in trade to protect the estimated 265 million people threatened by famine (Coronavirus: Another chance to transform the global food trade)
COVID-19 and Globalization (One Health)
Could COVID-19 mark a ‘turning point’ in the climate crisis? (WEF)
Effective transmission across the globe: the role of climate in COVID-19 mitigation strategies (Lancet Planetary Health)
Iran’s locust threats grow amid coronavirus pandemic, sanctions (New Humanitarian)
As the number of cases in Iran top 100,000, the spokesperson for the Health Ministry expressed concern in the “rising trend” over the least three days (Daily Star Lebanon)
Public Health Emergency of International Concern (PHEIC) Declaration for COVID-19 extended (WHO)
Why we can’t compare country responses to COVID-19: death rates, data and geography (WEF)

                    [post_title] => Snapshot of the State of the Pandemic
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                    [post_content] => The doubling rate of confirmed COVID-19 cases dropped to once every 21 days from a high of once every 7 days on April 1. As some countries experience stabilizing or declining national death tolls, it has prompted attempts to loosen lockdown measures. This includes France, Italy and Spain, three of the world’s hardest hit countries (accounting for 20% of cases and a third of all COVID-related deaths worldwide). Germany is begun to relax lockdown measures, as face masks have become mandatory in public. The National Health Service of the United Kingdom set out a six-week plan to ‘return to normal’ following projections that the U.K. has ‘likely survived the first wave’ of the pandemic and will get close to testing targets. Despite a record daily increase in confirmed cases,South Africa restarted some mining operations, as India has also begun to ease lockdown measures following a drop in reported
As some Asian-Pacific countries such as Singapore experience major outbreaks in the second wave of transmission, hospitals across Europe have raised concerns. The WHO noted that many states also do not have adequate testing capacity needed to support a safe reopening strategy that can detect, trace and isolate new COVID transmission. China has meanwhile provided a guide on how countries can prevent a second wave, including compulsory masks in public, fines for failure to exercise public hygiene practices, as well as public markings for social distancing lanes.
The LSHTM is gathering data on hundreds of intervention measures from around the world to determine factors contributing to disease outbreak as well as relative effectiveness of control strategies. For example, to date, Hong Kong’s swift surveillance, quarantine and social-distancing measures – such as the use of face masks and school closures – helped to cut Coronavirus transmission with only 4 deaths in a (urban) population of 7.5 million. The LSHTM platform is being developed to support the WHO’s technical support to member states, and includes more than 1,100 volunteers, multiple universities, public health organizations and non-profits, including ACAPS which analyses humanitarian crises.

                    [post_title] => ‘The second wave is in our hands’: WHO
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                    [post_content] => Ten countries have now confirmed more than 1,000 COVID-related deaths, with 14 countries reporting more than 10,000 cases. With less than 17% of all confirmed cases globally, Italy and Spain continue to account for more than 35% of all reported deaths (21,645 and 19,130, respectively). Both countries are experiencing a slow-down in the rates of transmission, however, and while Spain is beginning to relax control measures, Italy has extended lockdown measures until May.
Sweden (12,540) is the latest country to exceed 10,000 cases, as the number of deaths doubled in less than a week, which has been blamed on its controversial voluntary public health measures. France (147,863) and Turkey (69,392) continue to experience significant daily increases in confirmed cases and deaths, while the U.K. is expected to see a drop in new cases and hospitalization, despite surpassing 10,000 deaths and approaching 100,000 cases. The U.K. Prime Minister Boris Johnson was moved out of Intensive Care over the weekend, noting “I owe (NHS staff) my life.”
Transmission rates in Russia have also raised concerns, as daily reported cases continue to surge 20% for a second consecutive day, approaching 28,000 cases and 232 deaths. As the number of COVID-related deaths in Belgium surpass China, Germany is reporting an increase of COVID-related outbreaks in nursing homes and hospitals, where the elderly account for only 17% of cases but 86% of all deaths.
Many European countries are also reporting high CFR near or above 10%, including Italy, Spain, France, the U.K., Netherlands, Belgium, and Sweden. This has been partly attributed to selective testing strategies, as a paper this week in BMJ suggests early and widespread testing may be contributing to Germany’s relatively low CFR (2%). The European CDC has recommended that countries scale up testing and surveillance systems to guide and monitor the escalation and de-escalation of mitigation strategies.

                    [post_title] => Regional Snapshot: Europe
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                    [post_content] => During this unprecedented global pandemic, U.S. President Trump announced his intention to suspend funding to the WHO over accusations of mismanagement. The move has been roundly criticized by many governments and the EU, global health experts as well as the UN Secretary General. The U.S., meanwhile, has raised questions about its own handling of the pandemic, as it remains the epicentre with almost a third of all worldwide cases (644,806) and over 20% of all COVID-related deaths. The five worst affected countries (U.S., Spain, Italy, Germany, France) account for over 60% of all cases and almost 80% of deaths globally.

                    [post_title] => Trump announces intention to suspend WHO funding
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                    [post_content] => April 9 marks the 100th day since the WHO was notified of the first case of “pneumonia of unknown cause” in Wuhan, China.
As of April 12 at 10am EST, the total worldwide deaths from COVID-19 has surpassed 110,000, as confirmed cases approach 1.8 million. The actual number of dead and infected worldwide are believed to be much higher, but testing shortages, different counting practices and concealment by some governments limit detection and reporting.
The U.S. is the current global epicentre with over 530,000 confirmed cases and over 20,000 deaths, while the five worst affected countries (U.S., Spain, Italy, Germany, France) account for over 60% of all cases and almost 80% of deaths globally.
Community transmission is spreading, and the rapid increase of cases across low- and middle-income countries has become a critical global issue, as over 20 developing countries are reporting more than 1,000 cases. The number of African cases increased approximately by 40% over the past week, with all 55 countries reporting cases and 8 African countries seeing exponential rise. South Africa’s border controls and lockdown over the past two weeks have significantly reduced the number of new cases.
The economic fallout from the global pandemic could push 500 million people into poverty (8% of global population), according to a UN University report. This would be the first time that poverty has increased globally in over thirty years. The World Bank and IMF have scaled up and accelerated efforts to provide emergency funding to countries, while the UN Office for the Coordination for Humanitarian Affairs (OCHA) issued a US$2 billion appeal for a Coordinated Global Humanitarian Response Plan, which as of April 8, is only 20% funded.
As governments confront the dual challenge of containing the viral pandemic and economic crisis, public health experts warn countries that premature re-opening could lead to a second wave of outbreaks, echoed as well by modelling projections in a recent Lancet paper. Oxfam has urged world leaders to contribute to the $2.5 trillion economic rescue plan set out by the UN to “keep poor countries and poor communities afloat.” Mounting job losses and disruptions to global supply chains are also expected to result in chronic food shortages, as countries are urged to keep trade open and to protect farmers.

                    [post_title] => Global Snapshot
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                    [post_content] => Short-term forecasts of COVID-19 deaths in multiple countries
Imperial College London, 8 April 2020
https://sangeetabhatia03.github.io/covid19-short-term-forecasts/index.html
This weekly report by Imperial College London presents forecasts of transmission and mortality estimates over the coming week for 42 countries with active transmission, accounting for the impact of control measures. The caveat with these forecasts is that accuracy varies with the quality of surveillance and reporting, i.e. presenting likely underestimates for countries with poor reporting. That said, based on transmissibility estimates, the COVID-19 epidemic is expected to demonstrate:

Stabilizing patterns in 14 countries (including Italy, Iran, Iraq, South Korea);
Slow-growth transmission (1<Rt<2) in Spain and Netherlands; and
Rapidly growing transmission (Rt>2) across 26 countries (including Algeria, Brazil, Canada, China, Egypt, France, Germany, India, Japan, Peru, Turkey, U.K. and U.S.).

Based on central forecasting trends, reported deaths in the coming week are expected to be:

Relatively small (<100) and large (100-1000) in 29 countries;
Large (1,000-5,000) in 8 countries (including Algeria, Brazil, Germany, Iran, and Turkey); and
Very large (5,000+) in 5 countries (France, Italy, Spain, U.K. and U.S).

New COVID-19 forecasts for Europe: Italy & Spain have passed the peak of their epidemics; UK, early in its epidemic, faces a fast-mounting death toll
Institute for Health Metrics and Evaluation, 7 April 2020
http://www.healthdata.org/news-release/new-covid-19-forecasts-europe-italy-spain-have-passed-peak-their-epidemics-uk-early-its
New COVID-19 forecast from IHME found that among European nations, the peak daily death rate from the pandemic will occur during the third week of April, with the pandemic spreading from Southern Europe. According to current trajectories, 151,680 COVID-19 deaths could occur during the “first wave” of the pandemic in Europe, while the U.S. is expected to face 81,766 deaths. Declines in deaths are now occurring in Italy and Spain as most regions in the two countries have passed their peaks in the number of deaths, while other nations are approaching their peaks and still others facing peak mortality later in April. The death toll in many countries is compounded by demand for hospital resources well in excess of what is available. Predicted peaks in daily COVID-19 deaths appear to be highly variable among EEA countries, likely reflecting the equally variable ways that the novel coronavirus initially spread and then continued to affect Europe.
Projecting hospital utilization during the COVID-19 outbreaks in the United States
Moghadas et al, National Academy of Sciences, 3 April 2020
https://www.pnas.org/content/117/16/9122
Findings
Without isolation and with R0 = 2.5, treatment of critically ill patients at the outbreak peak would require 3.8x more ICU beds than exist in the U.S. (or 2x if R0 = 2). With self-isolation by 20% of cases within 24 hours of symptom onset, the outbreak trajectory would delay and flatten, and the number of ICU beds needed at the peak would reduce by 48.4% (or 73.5% if R0 = 2).
Interpretation
Hand washing and self-isolation is shown to significantly contribute to reducing the rate of spread of COVID-19, and therefore reducing the number of ICU beds needed at any one time. This could facilitate emergency mobilization to expand mobilization of critical care capacity to handle the burgeoning outbreak.

                    [post_title] => Research on Forecasting Peak Transmission and Health System Utilization
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                    [post_content] => Canada Needs to Rapidly Escalate Public Health Interventions for Its COVID-19 Mitigation Strategies (Wu et al, SSRN)
Findings
The initial growth rate in Italy (0.22) has reduced to 0.1 two weeks after the lockdown (8 Mar 2020). This corresponds to an extension of the doubling time from about 3.15 to almost 7 days. In comparison, the growth rate in Canada has increased from 0.13 from 1 March to 13 March up to 0.25 between 13 March to 22 March. This current growth rate corresponds to a doubling time of 2.7 days, and unless public health interventions escalate in Canada, we project 15,000 cases by March 31st. The case number can be reduced to 4,000 if escalated public health interventions can be implemented instantly to reduce the growth rate to 0.1, the same level achieved in Italy.
Interpretation
Intervention measures implemented by different countries have had various effects in reducing the growth rate and extending the doubling time, but their impacts come with a substantial delay (up to two weeks). Prompt and farsighted interventions are critical to counteract the very rapid initial growth of the COVID-19 epidemic. Mitigation plans must take into account the delayed effect of interventions by up to two weeks and the short doubling time of 3 to 4 days.

                    [post_title] => Research: Canada Needs to Rapidly Escalate Public Health Interventions for Its COVID-19 Mitigation Strategies
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                    [post_modified] => 2020-08-13 22:42:39
                    [post_modified_gmt] => 2020-08-14 02:42:39
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                    [post_parent] => 0
                    [guid] => https://covid19.dighr.org/developments/research-canada-needs-to-rapidly-escalate-public-health-interventions-for-its-covid-19-mitigation-strategies/
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            [8] => WP_Post Object
                (
                    [ID] => 2577
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                    [post_date] => 2020-04-03 12:39:50
                    [post_date_gmt] => 2020-04-03 16:39:50
                    [post_content] => Estimating the number of infections and the impact of non- pharmaceutical interventions on COVID-19 in 11 European countries (Flaxman et al, Imperial College London)
Findings
This study attempts to infer the impact of different interventions across 11 European countries using a semi-mechanistic Bayesian hierarchical model. The authors estimate that through the end of March, interventions taken by countries likely averted 59,000 deaths while reducing reproduction numbers. During this period, the authors also estimate that 7-43 million people may have been infected across the 11 countries (or approx. 2-11% of total population). Spain and Italy are estimated to have the highest attack rate, with Germany and Norway on the lower end (possibly reflecting the relative stages of the epidemics.
Interpretation
While the two to three-week delay between transmission changes and observed impact on mortality make it difficult to evaluate the effectiveness of recent interventions, the authors urge that preliminary evidence suggests that current interventions remain in place and that trends in cases and deaths be closely monitored to provide reassurance that transmission is slowing.

                    [post_title] => Research: Estimating the number of infections and the impact of non- pharmaceutical interventions on COVID-19 in 11 European countries
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                    [post_modified] => 2020-08-13 22:42:39
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                    [guid] => https://covid19.dighr.org/developments/research-estimating-the-number-of-infections-and-the-impact-of-non-pharmaceutical-interventions-on-covid-19-in-11-european-countries/
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                    [post_date] => 2020-04-03 12:37:50
                    [post_date_gmt] => 2020-04-03 16:37:50
                    [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_modified] => 2020-08-13 22:42:39
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                    [post_date] => 2020-04-03 12:34:50
                    [post_date_gmt] => 2020-04-03 16:34:50
                    [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_name] => stats-summary-europe
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                    [post_modified] => 2020-08-13 22:42:39
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                    [guid] => https://covid19.dighr.org/developments/stats-summary-europe/
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                    [post_date] => 2020-04-03 12:24:50
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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_modified] => 2020-08-13 22:42:38
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                    [guid] => https://covid19.dighr.org/developments/more-countries-are-adopting-the-whos-number-advice-to-test-test-test/
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            [post_date] => 2020-07-21 11:21:55
            [post_date_gmt] => 2020-07-21 15:21:55
            [post_content] => 
A new study in Science demonstrates the need for a coordinated approach for countries in Europe to lift lockdown measures in order to prevent subsequent outbreaks of cases. The research team from WorldPop highlight the significant impact of actions by countries that are populous, well-connected and with strong interventionsin place – which include France, Germany, Italy, Poland and the UK. The study produced over 1,200 exit strategy scenarios, using publicly available epidemiological data as well as anonymized mobile phone data to map population movement in 35 European countries. A notable finding of the study is that premature and uncoordinated easing of control measures by some countries could accelerate the resurgence of COVID-19 outbreaks across the entire continent by up to five weeks. The simulations furthermore show that synchronizing intermittent lockdowns across countries would lead to half as many necessary lockdown periods in order to achieve an end to community transmission in six months.

 

            [post_title] => International Coordination is Essential to Avoid Resurgence
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            [post_name] => international-coordination-is-essential-to-avoid-resurgence
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            [post_modified] => 2020-11-03 09:33:17
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