at Dadhaleh Institute

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 [ ... ]

A new WHO study projects that up to 190,000 people in Africa could die and an additional 29-44 million could get infected by the Coronavirus in the first year if containment measures fail.
Harvard Professor Joseph Nye – one of the world’s leading scholars on global governance- examines the “abysmal failure of leadership” from the U.S. and China, urging that more global solidarity and recognition of mutual interest is essential to address the pandemic
In collaboration with DIGHR, the Ilisaqsivik Society, and Médecins Sans Frontières (Latin), SeeChange Initiative is launching a Community Roadmap planning tool today to support communities organize, prepare and respond to COVID-19. See:
- CommunityFirst COVID-19 Emergency Readiness Checklist
- What the Covid-19 pandemic is teaching us about community (STAT)
In a commentary, Nobel Peace Prize laureate, Kailash Satyarthi, highlights the compassionate work of community and civil-society groups working with vulnerable populations, urging G20 to increase international aid and coordination through UN agencies like WHO, UNICEF and UNOCHA.
A study in Lancet Global Health projects an additional 0.25-1.2 million children under 5 could die indirectly in the next six months as a result of the pandemic though disruption of health systems and decreased access to food. This would be the first increase in global child mortality since World War II. The researchers from Johns Hopkins also estimate that indirect maternal deaths could rise from 8% to 38%.
An analysis by the New York Times reveals spikes in fatalities across Latin America (including Brazil, Ecuador and Peru) that exceed the worst pandemic trajectories in Europe and the U.S. The Brazilian president, when asked about the death toll, replied “So what? What do you want me to do?”.
Amazon indigenous leaders warn of the potentially devastating effects of COVID-19 (New Humanitarian), where “no specific attention has been given to indigenous communities”.In Brazil, the potential effects highlight the lack of government support with food and health services. The former health minister of Ecuador, meanwhile, warns that “everyone is at risk” if marginalized communities are not able to afford basic health services, while officials in Mexico suggest that thousands of deaths are not being reported, obscuring the true toll of the COVID-19 epidemic.
China, South Korea and Japan are experiencing a resurgence in COVID cases, as the WHO and public health experts warn against lifting containment measures too early (CNBC)
- Authorities in Wuhan plan to test all 11 million residents over the next ten days after discovering new infections for the first time since its lockdown was lifted, prioritizing vulnerable groups and high-density areas (BBC)
Exceptionally heavy seasonal rains across East Africa since late April have resulted in widespread floods that caused a heavy loss of life and property, compounding the risks to human health and food security from the COVID-19 pandemic and the most serious desert locust invasion in decades. (WMO)
COVID19 epitomises why a “One Health” approach – which recognises the fundamental interconnectedness of humans, animals, and their shared environment- is key to ensuring the healthy and sustainable future of the planet. coChairs of the Lancet One Health Commission are calling for a COVID-19 One Health Research Coalition (Lancet)

A paper in Nature this week reports that Chinese scientists discovered RNA of the virus in tiny droplets in Wuhan hospitals, raising the possibility of airborne transmission. The range of clinical manifestations in patients that test positive for COVID-19 remains a public health challenge, with some remaining asymptomatic while others die quickly. Despite the more than 1,000 papers that are published every week, a Science articles concludes that a “clear picture is elusive, as the virus acts like no pathogen humanity has ever seen.”

The CDC this week added six new symptoms that may be linked with COVID-19. These include chills, repeated shaking with chills, muscle pain, headache, sore throat and a loss of taste or smell – in addition to previously listed symptoms (fever, cough and shortness of breath or difficulty breathing).

The number of cases in Russia has surged past 100,000 following a record daily increase that included its Prime Minister testing positive. The Prime Minister of Japan has also suggested the country is likely to extend the state of emergency past May 4. Yesterday, Chile announced that it will back away from plans to distribute immunity cards following warnings by the WHO of the lack of evidence of ‘sufficient immunity’ to COVID-19 that would prevent reinfection. In its daily briefing, the WHO also has urged countries to be vigilant and to avoid prematurely lifting control measures as early evidence of sero-epidemiological data suggests a significant proportion of infected people may have been missed by surveillance measures.

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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.

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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.

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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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A new WHO study projects that up to 190,000 people in Africa could die and an additional 29-44 million could get infected by the Coronavirus in the first year if containment measures fail.
Harvard Professor Joseph Nye – one of the world’s leading scholars on global governance- examines the “abysmal failure of leadership” from the U.S. and China, urging that more global solidarity and recognition of mutual interest is essential to address the pandemic
In collaboration with DIGHR, the Ilisaqsivik Society, and Médecins Sans Frontières (Latin), SeeChange Initiative is launching a Community Roadmap planning tool today to support communities organize, prepare and respond to COVID-19. See:
- CommunityFirst COVID-19 Emergency Readiness Checklist
- What the Covid-19 pandemic is teaching us about community (STAT)
In a commentary, Nobel Peace Prize laureate, Kailash Satyarthi, highlights the compassionate work of community and civil-society groups working with vulnerable populations, urging G20 to increase international aid and coordination through UN agencies like WHO, UNICEF and UNOCHA.
A study in Lancet Global Health projects an additional 0.25-1.2 million children under 5 could die indirectly in the next six months as a result of the pandemic though disruption of health systems and decreased access to food. This would be the first increase in global child mortality since World War II. The researchers from Johns Hopkins also estimate that indirect maternal deaths could rise from 8% to 38%.
An analysis by the New York Times reveals spikes in fatalities across Latin America (including Brazil, Ecuador and Peru) that exceed the worst pandemic trajectories in Europe and the U.S. The Brazilian president, when asked about the death toll, replied “So what? What do you want me to do?”.
Amazon indigenous leaders warn of the potentially devastating effects of COVID-19 (New Humanitarian), where “no specific attention has been given to indigenous communities”.In Brazil, the potential effects highlight the lack of government support with food and health services. The former health minister of Ecuador, meanwhile, warns that “everyone is at risk” if marginalized communities are not able to afford basic health services, while officials in Mexico suggest that thousands of deaths are not being reported, obscuring the true toll of the COVID-19 epidemic.
China, South Korea and Japan are experiencing a resurgence in COVID cases, as the WHO and public health experts warn against lifting containment measures too early (CNBC)
- Authorities in Wuhan plan to test all 11 million residents over the next ten days after discovering new infections for the first time since its lockdown was lifted, prioritizing vulnerable groups and high-density areas (BBC)
Exceptionally heavy seasonal rains across East Africa since late April have resulted in widespread floods that caused a heavy loss of life and property, compounding the risks to human health and food security from the COVID-19 pandemic and the most serious desert locust invasion in decades. (WMO)
COVID19 epitomises why a “One Health” approach – which recognises the fundamental interconnectedness of humans, animals, and their shared environment- is key to ensuring the healthy and sustainable future of the planet. coChairs of the Lancet One Health Commission are calling for a COVID-19 One Health Research Coalition (Lancet)

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