Coronavirus update, 2335 GMT. Lessons from Wuhan

More regional lockdowns and social distancing recommended.

Regional lockdowns plus social distancing are MORE effective than a vaccine would be in stopping this virus from spreading.

Regional lockdown and social distancing measures seem to be beginning to work. Non-China growth rate approaching non-exponential but more measures will help

Evidence from China and South Korea that they are more effective than a vaccine:

Because of the lockdown of Hubei province, <10% of cases occurred in the remainder of China. Because of social distancing inside Hubei province, >99% of the total population of the province was NOT infected. A typical vaccine, by comparison, is >85% effective; this years 2019-20 influenza vaccine is about 50% effective.

However, because of the nature of this virus, there are many cases which will appear AFTER the above measures are put in place. Specifically, based on South Korea and China, the US will have up to 70 new cases for every case identified on the day those two measures are initiated. It also took 10 and 13 days, respectively, before the daily case rate peaked (growth rate of 1.0) in South Korea and China, after these measures were put in place.

True vaccines, of course, are prophylactic and so don’t suffer from this delayed action.

The true danger: given the limited quantity of US resources and the large number of potential cases, the public health reality is that patients in the US may have to experience this disease OUTSIDE of the modern medical environment, hospitals, doctors, etc. Truly draconian. 1800s style, when families would support their loved ones at home and recovery was dependent on the patient’s constitution and God. The healthcare of my Great-Great Grandparents.

Data and analysis used to reach the above conclusions:

Graph 1. This graph was prepared on Jan 27 for Wuhan, China. It shows the growth of cases in Hubei province over the previous nine days. The blue line (actual cases) and the brown line (calculated cases) are right on top of each other. ‘Perfect’ exponential growth. Hubei had 830 cases on the day of lockdown/social distancing (the red arrow).

Graph 2. This is the same graph as graph 1 but extending the trend line into the future (the future as of Jan 27). The virus is infecting 2.5 people per infected person and can be asymptomatic for five to fourteen days. This projects that on Feb 14, 100% of the people in Hubei province would be infected. It also projects 185 million infected people on Feb 21! All 7.7 billion of us on the planet at the time I am writing this post.

Pure, unchecked exponential growth is a Biblical, Book of Revelations, Apocalypse-level event.

Graph 3. Reality in China. Black arrow, the start of lockdown and social distancing. The purple, dotted line is the daily new cases, showing the continued growth for 13 days in daily cases after the lockdown. The brown is cases under the care of the health care system. Blue is recovered cases and red is deaths.

The total cases in all of China as of today, Mar 11; 80,796 cases. As you can see, exponential growth completely ‘flopped over’ as I call these kinds of graphs. As of today, >99% of the over 11 million people living in Hubei province did NOT get infected. Analysis shows 84% of all cases in China were in this province, only 16% had spread before the lock down.

But some dangers lurk in this chart. The patients identified in brown: who is taking care of those patients and where are they? ICU beds, total hospital beds, number of respirators, number of doctors/nurses, etc. couldn’t handle this level of disease in the US.

Graph 4. The growth of cases in South Korea (SK). The arrow on Feb 20 is the day after the case load jumped from 20 to 104 in 24 hours, attributed to a church gathering. From that point on it was reported the ‘streets were empty.’ By the time it leveled off there were 67 cases for each one case on Feb 20.

I don’t have an official lockdown date for SK so this may be more US-like. Look around America; are the streets empty where you live or not?

An interesting metric: how long it has taken different countries to go from 100 cases to 1000 cases? The longer, the better

China, 5 days; South Korea, 6 days; Iran, 6 days; Italy, 7 days; France, 7.5 days; Germany, 7.5 days; US, 9 days.

Graph 5. The daily growth rate for ‘the outside China’ world is at 1.04 for the last 24 hours. It has averaged 1.10 over the last seven days. Remember, a growth rate of 1.1 is a doubling of cases in a week; 1.04, a doubling in 18 days.

Only two countries have seen exponential growth peak and tapper off, SK and China, and the day before they peaked they were above 1.1. Qualified good news as it is probably unfair to compare two closed systems/countries to the world, where we still have places at the beginning of the growth.

P.S. – When Taiwan closed all school for two weeks over a month ago, I recommended the same thing for the US. We have had 48 cases and 1 death, the lowest in China neighbors, as of this writing.

Caveat: all of this is subject to the ‘garbage in/garbage out’ principle. It is impossible to independently verify ANY of the data provided by these countries. Keep that in mind.

Steven Quay is the founder of Seattle-based Atossa Therapeutics Inc. (Nasdaq: ATOS), a clinical-stage biopharmaceutical company developing novel therapeutics and delivery methods for breast cancer and other breast conditions.

He received his M.D. and Ph.D. from The University of Michigan, was a postdoctoral fellow at MIT with Nobel Laureate H. Gobind Khorana, a resident at the Harvard-MGH Hospital, and was on the faculty of Stanford University School of Medicine. His contributions to medicine have been cited over 9,600 times. He has founded six startups, invented seven FDA-approved pharmaceuticals, and holds 87 US patents. Over 80 million people have benefited from the medicines he invented.

His current passion is the prevention of the two million yearly breast cancer cases worldwide.

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