Covid-19: Analysis of an Outbreak
Context: I read about the fable of the lily pads last night on the Washington Post - https://www.washingtonpost.com/opinions/2020/03/10/coronavirus-what-matters-isnt-what-you-can-see-what-you-cant/. In their example, the R0 was 2.
My organization spends a lot of time on counting past events (fundings, employment, etc.). And from that, we attempt to make educated predictions about future events. We are often wrong – but always have an opinion.
My read on the pandemic is that we are thinking about it on a national or a state level – when we should be thinking about it on a community level. “Blocking” the spread of the virus means preventing it from entering or exiting communities, and when in a community, locking it down hard to prevent intra-community and inter-community spread. This is why conferences, like SXSW, must be canceled (which it was).
However, the artificial boundaries of states mean that we have communities, such as Spokane, where there are zero cases, thrown together with areas, such as Seattle, where there are many. However, the risk of transmission from Seattle to Portland is probably as great or greater than the spread within Washington.
That being said, the data is provided (for the most part) on a national basis. I was unable to find reliable data from Iran or China from the initial phases of the pandemic – and thus, I have excluded them. However, if you look at the spread of the cases on a weekly basis (5-14 day incubation period was my rational), you see that there is an explosion in cases in both Italy and South Korea. Italy’s continues to grow rapidly and has not leveled off, South Korea’s appears to be leveling off.
One challenge with this data set is that it involves a period that is not a day. Most of the data is being provided to people on a daily basis – but in looking at the data and considering that it takes about a week for cases to arise – such that a sick individual is tested. The more correct measure is to think of that period. I arbitrarily chose Mondays as the date of measure. Thus, intra-week fluctuations are missed.
Moreover, this data involves tested cases – many of these become hospitalized because they represent very sick populations. The actual spread and infection rate may be misrepresented by the data, as many, apparently do not present with strong symptoms.
Time to Prepare: It gets worse before it gets better
My prediction, therefore, is that this is going to be much worse in the United States before it gets better (see above). My prediction is a pale comparison to expert, Dr. James Lawler’s worst case scenario which leaked to Business Insider earlier in the month. Multiple reports place his worst case at 96 million infected and just under 500k dying. Hospitalizations would be in the millions.
The point of these projections is not to scare people – but to prepare people for the bad-ness that is about to happen. We can mitigate and slow the spread by being intentional – but even in that case, infections will likely still occur or have already occurred and patients are simply a-symptomatic at this point.
It is incumbent on local leaders – mayors and governors – to begin the process of social distancing and quarantining outbreak areas – as the Governor of New York and Mayor of New Rochelle have. As individuals, we have a social duty to begin to separate ourselves from the herd to protect the entire population – not just ourselves.
While it would be better if the federal government was prepared, the point is that they are not, and we cannot wait for them to provide us with the appropriate information by which to make individual decisions. Instead, we have reached the point where collective action is necessary – not just desired. It is inconvenient and possibly expensive (both financially and socially) – but in this case, preventative protection requires most of us to simply act for the group’s best interest, not just our own.
feature Photo by Polina Tankilevitch from Pexels