On Friday, the number of countries where patients had been diagnosed with COVID-19 topped 50. China, which for more than a month was the only significant location of infections, produced fewer than a third of the new cases on Thursday. The Diamond Princess cruise ship, which once accounted for the majority of cases outside China, is now responsible for about 15%. This is a different world than it was a week ago.
Thursday brought the first case in Mexico, and in a half-dozen new countries in Eastern Europe. It brought the first case in Nigeria. For those who have been practicing a Kiwi accent as a back-up plan, it also brought the first case in New Zealand. It even brought the first case in San Marino—a nation whose entire population is only 33,400.
One way to tell that the coronavirus pandemic has suddenly become a top issue around the globe is simply to look at the growing numbers. Another is to look at the sources of those numbers. Some of the websites that have regularly collated and provided information on the growth of this epidemic are simply being blasted off the internet by levels of demand that their servers simply can’t handle. People are worried, and that worry can be measured in millions of clicks. If the site you are checking doesn’t come up the first time, understand that there is a lot of interest and take a deep breath before making another try.
Within the United States, most attention is focused on a single patient currently at the University of California Davis Medical Center. Understanding how that patient became infected is critical to understanding whether the virus behind COVID-19 is circulating among a handful of people in the United States, among dozens, or among thousands. That patient lived in the same county where evacuees from Wuhan, the epicenter of the original virus, were taken on their return from China. A whistleblower has made it clear that the workers handling those evacuees—some of whom subsequently tested positive for the virus—did not have either the training or the protective gear to handle them safely. With the first case of “community transmission” emerging in the same county as one of the incidents highlighted by the whistleblower, it seems unlikely this is a coincidence.
The concern caused by the fact that the workers involved didn’t have what they needed to conduct business safely is only heightened by Donald Trump’s frighteningly incoherent press event on Wednesday, and by the absolute fact that Trump and Health and Human Services Secretary Alex Azar absolutely knew about the community circulation case but did not mention it at Trump’s event. And by the White House announcement that the Mike Pence-led Coronavirus Task Force includes Treasury Secretary Steven Mnuchin and the director of the National Economic Council, Larry Kudlow.
Everything that’s happened so far lends credence to the idea that the possibility of a COVID-19 epidemic within the United States is being intentionally downplayed in an effort to protect financial markets, with little or no concern for how deliberately making light of the potential threat increases the risks to American lives. This is … not a good morning in America.
This would be a great day to tell you that the vaccine already being rushed into trials by drugmaker Moderna is going to offer protection. Or that Israeli researchers are right in saying they’re just weeks away from having an effective vaccine. Or that the money that Congress is now trying to insert into the process—largely to replace funds that were earlier cut by Trump—will rush those vaccines to your door in short order, free of charge. Unfortunately, none of that is likely to be the case. If COVID-19 is, as seems to be the case, becoming widespread in a way that would make it a new seasonal addition to the threat already posed by the flu, the odds are Americans will need to get through this COVID-19 season and the next one before a vaccine will be widely available.
Believe me when I say I want to be wrong about that. And it is absolutely fine, good, and hopeful to follow the announcements of possible vaccines closely and pull for their success. The same goes with more generic antiviral drugs that may genuinely be deployed over the next few months, especially in severe or critical cases. Just, please, do not let that optimism stop you from planning for how you and your family are going to deal with the coming weeks.
Let’s look at the numbers.
COVID-19: Total case status
Overall, the world continues to see a decline in the total number of active cases. A steady decline in reports of new cases from Hubei and other Chinese provinces, combined with recovery numbers that are growing by the day, is resulting in a nice happy blue wedge of recovered cases that is steadily eating into the overall number of active cases. We’re almost back to the point where we were before China made the decision to begin incorporating clinically diagnosed cases. Which is great.
But don’t be too surprised if this changes over the next three days. The growth in numbers of new cases outside China is now just at about the point where Hubei was at the end of January … the uncomfortably fast part of that upward trend. It’s likely, though far from certain, that new cases from outside China will exceed China’s “recovery gap” by early next week. Again … I’ll be happy to be proven wrong.
COVID-19: Case status outside China (countries with fewer than five active cases omitted)
South Korea has now moved into a whole new league as its growing number of cases takes it off the top of yesterday’s chart. By the end of the day, Italy will put the Diamond Princess at another slot down the chart, and Iran … don’t trust Iran. It’s good that it’s started reporting a boatload of recovered cases, but there’s no more evidence of accuracy in those numbers than in anything else coming out of Iran. Plus, there’s the risk that it may be sending patients home too soon, as seems to have happened with about 15% of early patients in China.
I may be hedging my bets on vaccines and case counts, but here’s something I can say for sure: This chart is rapidly losing value as the number of nations with cases increases and the gap between those with high rates of infection and those with a handful of counts spreads out. Between the time I was a geologist and the time I started doing this for a living, I had the title of “Automation Architect” for a giant evil company (no, seriously evil). In that role, my job was to make sure that everyone, from a truck driver to the CEO, was presented with information in a way that was clear and actionable. Despite the name, it wasn’t so much about building robots as it was making warning lights, dials, gauges, data tables, and charts so that people’s eyeballs and earballs were constantly under siege with the best mix of Do This Next that I could provide.
As someone with every Edward Tufte book stacked on my desk and Charles Minard’s chart of Napoleon’s 1812 efforts on my wall, I can only promise you that this is a bad graph in terms of giving you information that you can use to benefit your own judgment. So expect something different … when I figure out what that is.
In the meantime, those 50+ nations continue to demonstrate the effectiveness of Italy and Iran as secondary hubs for this infection. Right now, it’s easy to finger almost every infection as having its origin in China, Iran, or Italy. That is going to change in the very near future. Because the United States is far from the only nation that is currently reporting low numbers of infections, but in which some level of “community transmission” is taking place. When those cases are three, four, or more generations away from their original source, it will be much more difficult to put a name on their place of origin … and frankly, much less important. Because by then, telling airports to suspend flights from Country X is unlikely to have much value.
And if I earlier kicked sand at an Israeli firm that is generating hopes of a vaccine Real Soon Now, let me throw some serious kudos at another Israeli firm, which this morning announced a rapid test for COVID-19. Even when the doctors at UC Davis finally finagled a test of their suspect patient, it took four days to get results back. The new quick diagnostic kit looks to reduce that turnaround time to minutes. The availability of such a tool would make attempts to screen passengers and populations much more meaningful, especially when a significant portion of those infected by SARS-CoV-2 appear to be asymptomatic.
Finally, back on Tuesday the World Health Organization put out a report from the WHO-China Joint Mission on Coronavirus Disease 2019 that is filled with fascinating information on the genetics of the virus and its relationship to other coronaviruses. That information has a direct bearing on the possibility of creating an effective vaccine and the time it will take to make this happen. So, barring unexpected developments, I hope to spend some time tomorrow talking about the coronavirus family, including COVID-19, cousin SARS, second cousin MERS, and way too many things that have “Bat” in the title.
Resources on novel coronavirus
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.
CDC Coronavirus-2019 (COVID-19) information site.
Information on preparing yourself and your family
Some tips on preparing from Daily Kos.
NPR’s guide to preparing your home.
Ready.gov (which was actually down as I entered this … so, that’s nice.)