Posted on 03/17/2020 4:34:32 PM PDT by gas_dr
I have spent the last several days like most Americans somewhat baffled, perplexed and even a little nervous at the rapidly unfolding events as to CoVID-19. The community seems to have been divided into two groups, those who are advocating that there is nothing more than the common flu here and that there is vast overreaction, and those that advocate that this is a serious illness that for the safety of all requires drastic measures in order to prevent mass death and tragedy. If one looks closely, it is possible to find everything from death rates calculated at 0.1% - 14% and beyond.
Fair warning, I tend to fall in the previous camp and think that this is likely an overblown situation that appears to be gathering inertia, and I have gotten into several heated and admittedly emotional arguments about this current situation. For full disclosure, I am a critical care physician practicing in the United States, and the fear of the unknown probably drives to a small degree my emotion. So this evening, I have decided to put emotion aside, and truly conduct a retrospective analysis of the data that is present in a multivariant system and see where the data lead us.
I have discovered something interesting, and will simply present the data without commentary. I have analyzed from the worldometer website six countries: China, Italy, United States, South Korea, Spain, and France. I have been curious as to the timelines and increase in daily cases in countries that appear to have rampant disease, and countries that have flattened the curve.
Methodology: Utilizing a base case rate of 100 infections, I standardized the time to 6340 infections, which happens to be the current report of United States infections updated at 1800 EDT. Datasouce: Worldometers.info
CHINA: Time to equivalent cases of United States infections: +7 days. (571 cases -> 7,711 cases). Time to Peak of newly reported cases (2nd inflection point) +15 days from current US case load. After inflection point, total new cases fell dramatically
South Korea: Time to equivalent cases of United States Infections: +15 days (100 cases - 6593 cases). Time to peak of newly reported cases (2nd inflection point) +4 days. After inflection point, total new cases fell dramatically.
Italy: Time to equivalent cases United States Infections: +15 days. (75 - 6,387). Time to peak of newly reported cases +7 days. This is where the data may become predictive. Between March 15, 16, and 17 there was a relatively flattening of new cases and decline in the last 24 hours reported period. What will be a test of this model is what happens to the cases in this 24 hour period. According to the other models, this should be the peak.
United States: Time from 100 cases - 6340 cases +15 days. If this model is predictive, we can ascertain in the next 4 - 7 days based on number of cases and shape of curve if we appear to follow South Korea numbers, or Italian and China Numbers. The current acting head of HHS repeatedly states out numbers track South Korea.
Spain: Time from 75 cases - 6391 cases +13 days. Today is day +2 from the relatively time constant 100 -> 6500 cases period.
France: Time from 100 cases - 6633 cases +16 days. Today is day +1 from relative time constant too >6000 cases.
Analysis: At this time, in the six major countries actively reporting all cases and under greatest scrutiny, there appears to be a constant of +14 days to grow from 100 - 6500 cases. The percentage variation in this is extremely small. From the time this 15 day time constant occurs, there is divergent data to the second inflection point in countries who are reporting a decrease in overall numbers of new cases (curve flattening). That time constant is from 4 - 7 days (South Korea (4) - China (7) - Italy (7)) If this is predictive model, what we should see it a flattening of the Italian curve starting today -- that would track with China. In the United States we are between (4) and (7) days from flattening if the data hold. The divergence of cases added between day 4 and day 7 are as few as 1500 new cases as in South Korea, and as many as 20,300 new cases in Italy, which fits an exponential growth from day 4 - 7.
If the Italian numbers are flat tomorrow and the next day, the model appears will become increasingly predictive. Questions that remain to be answered: Are aggressive measures able to reduce the time to second inflection as in the case of South Korea? If so, then we can predict in America that maximal saturation will be March 21. If it trends toward China and Italy, then it will be March 24.
I will update this as data become available. I look forward to reasoned discussion regardless of personal opinion as to the scope of this pandemic.
Thank you for your kindness — its just an analysis of the data. I hope it really it predictive. I think it may be,
“Okay....well, how about you bring the BF graphs over here? We can then compare.”
I. posted the link to the OP.
My good dr, this is some excellent analysis. And without null, we'd all be on the cart.
I'll post my forecast later, elsewhere. I've also decided to 'up our game' and will introduce a new logistic forecast to address the jump continuity in Hubei's data in Feb 11-13, and my belief that the logistic curve is more appropriate than the exponential or linear approach. I won't post it here since you've earned your moment in the sun.
Thanks for your enlightening work...will be interesting where things are in a week.
Looking forward to it.
Ping me, please?
The problem is that you are tracking date where countries take precautionary measures - social distancing etc. The "alarmists" here have been advocating those measures to prevent a debacle from unconstrained disease propagation, something hopefully we will not witness.
I share your hypothesis. In December a viral infection ran through many employees at BNA. My close friend was close to hospitalization with pneumonia and was bedridden for several days. Her co workers at the airport, many younger, were suffering symptoms of an URT infection that tested negative for the flu in almost every case. Whatever it was, it was highly infectious. Antibiotics were only effective for secondary infections and Tamiflu useless. I thought it strange and thought it a virus or mycoplasma since it was so infectious.
Bookmarking under Corona
Per data from Johns Hopkins, China has had 81,058 cases, 3,230 deaths, and 68,798 recovered. Some cases are still open but nearly 85% recover. But I realize, it’s data from China, so …
Also, the influenza outbreak of 2012-2013 killed 56,000 people in the USA alone. This data from the CDC.
Personally, I fear Comrade Mayor and Comrade Governor a lot more than I fear the coronavirus. Some Comrades have ordered no groups of 40 or more can gather. What about my Constitution right to peaceably assemble? At least one Comrade has banned the sale of guns. What about my Constitutional right to keep and bear arms?
And I think these Comrades will be very slow to give up their powers and very quick to grab power again the next time there’s an emergency. And they can apparently self-designate an emergency.
Thank you for your kindness. I look forward to your opinion. I was honestly looking for a way to avoid charting when I fell into this project :-)
My ADD got the best of me. Or at least my hatred of charting.
we will only know the true infection and death rates once the dust settles. Right now we are in the fog of war. I am encouraged that we had our first ICU case at our hospital 10 days ago and have not had another since. That would speak to a very flat curve. In addition we are starting to see promising treatments that may also flatten the curve or at least shift the hospitalization curve to shorter lengths of stay. Whatever comes of this when it is over we need a very robust discussion of the curtailing of civil liberties by government that has far exceeded its rights. Suggest a limit on gatherings ok. Mandate it? the tree of liberty is getting parched.
Please update us as data validates your analysis, or not. Very interesting.
smart people always impress me.....
I am just a dumb (critical care) anesthesiology. As my smart a** sister hospitalist. I am the Rodney Dangerfield of Medicine.
That is a false choice. I'm in the camp that thinks this is serious and there is a overreaction at the same time.
And I think these Comrades will be very slow to give up their powers and very quick to grab power again the next time there’s an emergency. And they can apparently self-designate an emergency.
You raise a good question. Why would our caring, charitable, paternalist Dear Leaders ever give them up?
We all know they already regard the Constitution as a worn-out piece of white racist drivel.
Guns,money and freedom? For them, not thee and me.
I think that is what explains the difference between South Korea (4 days to 2nd inflection) vs less mitigative measures (China and Italy) ->7 days. Wouldn’t it be fascinitaing if at Time constant +7 days this started to burn out. That resonates with the projected 4 - 7% penetrance in the population.
So you are a wishy washy moderate — just kidding, yes of course I did not offer that third opinion. Please forgive.
I agree. Once it is shown we will lay down our freedoms, the result is accelerating loss of liberty — that is the political question at hand.
Thatcher: If there is a problem and you appoint to it a bureaucracy, you will never be rid of the problem.
Franklin: They who are willing to trade liberty for security are deserving of neither.
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