Anyone looking at the World Health Organization’s dashboard for 2019 novel coronavirus overnight might have been startled by a sudden jump in cases of nearly 20,000. But this didn’t actually mean a single new case had been reported. Instead, it meant that the WHO had finally to get on board with including clinically diagnosed cases, just as every other major organization had already done. So, after several days in which there were two sets of numbers, all the reporting agencies are once again on the same page—give or take a few hundred. And that’s a very good thing, for reasons that go beyond just keeping the charts straight.
Meanwhile, most of the Americans who were on board the ill-fated cruise ship Diamond Princess are back on the ground in Texas or California after a pair of chartered 747s delivered them to two weeks of quarantine in the U.S. Surprisingly, this includes 14 Americans who tested positive for the virus that causes COVID-19 while they were in the process of being evacuated. At late as Sunday evening, the State Department had indicated that those 14 patients would be remaining in Japanese hospitals, and it didn’t reveal that this had been changed until after the planes had landed. But the process seems to have been handled carefully, even if the result was to double overnight the number of cases on U.S. soil.
Each day since I’ve started doing this update, I’ve tried to handle a question that appeared in the comments on a previous day. So we’ve talked about topics such as why this does not yet qualify as a pandemic and how we know COVID-19 is not a bioweapon, and we’ve had an introduction to coronaviruses. We’ve also looked at concerns that China may be hiding the truth, tried to address what percentage of cases are actually reported, and of course responded to the massive jump in numbers caused by China changing how it reported cases.
And now, because it unfortunately seemed to dominate discussions on Sunday, I’m going to touch on a topic I’d really rather not deal with: me. Or more specifically: How concerned am I that COVID-19 is going to become a global pandemic resulting in widespread illness and death? The answer to that question is simply this: I don’t believe it will.
Naturally, I am far from 100% confident in that answer. This is a large epidemic. It’s an easily transmitted disease for which there is neither a vaccine nor natural immunity, and it has demonstrated its ability to overwhelm the health care capabilities of a large modern city, going from zero to 70,000 cases and 1,700 people dead in three months. You’d have to be more than a little self-delusional to have no concern, or to confidently state, “We got this.”
But despite the size of this epidemic—closing in on an order of magnitude greater than SARS—it appears that fast action by governments around the world stands a very good chance of holding COVID-19 in check and restricting its spread worldwide to a small number of cases that can be contained and given appropriate treatment, resulting in a very low rate of case fatality.
However, I say this very reluctantly, because I’ve tried hard to keep this series of updates from being, “What does Mark Sumner think of this disease today?” Believe it or not, I think of myself as a journalist, and I’ve tried very hard to skate on the edge of providing information without weighing it down with opinion that might cause a reader to reach a bad conclusion. After all, this isn’t, “Is Donald Trump an asshole?” This is a question where the answer is genuinely in doubt.
The biggest thing that concerns me is not the numbers, but the statements—that is, the frequent statements coming out of officials at the Centers for Disease Control and various epidemiology experts, all of whom seem to be playing some off-key version of “Swing Low, Sweet Chariot.” I do not see what’s in the statistics that makes them believe that a global pandemic is so likely … but then, they may feel that it’s better to keep the public concerned and vigilant rather than relaxed and planning that vacation to Wuhan. There’s also a cynical part of me that says, Well, if Trump is already cutting big slices out of the CDC, maybe it helps to remind him why they shouldn’t go away. But whatever the case, I find I’m more optimistic about the outcome of this outbreak than the average “expert” lined up on CNN (and for those wondering, repetition of an initial vowel sound is head rhyme, but not technically alliteration).
But I hate saying that. Because I don’t want to take on the role of patting you on the head and saying it will be all right, or providing a list of 10 Things Every Bunker Needs.
For the record, I am not panicked, panicking, or panic-ready. However, I am data-obsessed. I spent 10 years in a role in which what I did was use technology to provide more and better data. I’m a big believer in the idea that you can’t solve a problem until you understand the data— enough so that people start moaning whenever I get two words into that statement.
I want to give you the data, and hopefully help you understand the problem. I’m not up in the middle of the night running Google Translate on the latest reports from Chinese provincial governments because I’m scared. I’m doing it because they have the numbers, and dammit, I want them.
So now … boy, that seemed like a wasted question, but let’s look at the numbers.
That curve-screwing spike still makes the data messy, but with each passing day, its importance seems to be reduced as the numbers close in on something that seems more orderly.
The daily caseload was flat. Of course, it would be better had it continued downslope, but then, the backside of the curve has been more ragged than the growth curve.
Even if the daily number of cases has continued to fluctuate, one thing that hasn’t changed is the steady improvement in outcomes. Since recovery from COVID-19 takes about as long as recovery from the flu, it took weeks before the number of recoveries began to increase significantly. But over time it can be expected that this chart will head downward to match the case fatality rate.
In the next day or two, I’m going to replace this chart with one that better reflects the outcome data and gives a sense of the number of active cases (60,024 as of this morning), as that seems a better indicator of how the medical system is responding to the outbreak.
Meanwhile, here’s a quick chart:
The numbers here are bumpy, but they are climbing a slope that’s about two weeks behind that of the confirmed case count. One factor that’s probably dragging on these numbers a bit is the fact that ,in early days, health care workers tracked down those who had contact with known cases, so they may have been detected earlier in the course of the illness than those who were confirmed more recently. This could have the effect of “smearing” the numbers.
Outside of China, Japan and Singapore continue to be areas of concern. At 66 and 77 cases respectively, their numbers are swamped by those in many Chinese provinces, but both have had a concerning number of secondary and tertiary infections. The Tokyo cases that are connected with cab drivers seem particularly concerning entries in the “How to effectively spread a disease” category. Even not counting the Diamond Princess (which most sources have now moved to its own very special human Petri dish category), Japan added another 7 new cases on Sunday.
Finally, a number of Americans chose to stay on the Diamond Princess, with some apparently reasoning that leaving their rooms would expose them to riding in a bus and a plane with other Americans who may not have been as careful in their safety practices while on the ship. That doesn’t seem like a great decision, but good luck to everyone on board.
Resources
World Health Organization 2019 Coronavirus information site.
World Health Organization 2019 Coronavirus Dashboard.
2019-nCoV Global Cases from Johns Hopkins.
BNO News 2019 Novel Coronavirus tracking site.
Worldometer / Wuhan Coronavirus Outbreak.