I heard from many people that they have anxiety about the current development of the Covid crisis. Indeed, the situation makes me worried as well, since the cases in Europe and many other countries are steeply increasing. However, I think it is helpful to have some understanding of how the next few weeks are going to play out. At least to me it is helpful to know what is coming. Of course, I do not know all the details and complexity of the current crisis and its associated tragedies, but when it comes to the overall trend during the next few weeks, I feel I have a rather clear understanding of the timeline.
If you read the previous blog entries, then you know we are right now in the face of transition where case numbers in Germany and many European countries are not exploding as such, but instead continuously rising. I am writing this on 17 March and based on the current data it is fairly obvious that the numbers will continue to rise. This is as obvious as throwing a ball into the air and expecting that it will eventually fall downwards to the ground. Many people now believe that the curve of the ball will suddenly stop. The ball will stop flying mid air. This is not going to happen, I think. Instead the ball will continue to fly on its curve according to the laws of physics. In this case it is not the laws of physics that are at play in the Covid crisis, but the cruel statistical laws known in epidemiology. I want to highlight at this point again that I am no medical doctor but a statistician. However, in this capacity I can unfortunately assume that the current numbers may increase and within the next seven days may rise above 30,000 cases. Then it will start to show whether the necessary measures of our government will actually work. It is now our joint responsibility to tame this virus. However, the emotional burden that will be put upon us by the steeply and dramatically rising numbers will be serious. At this point data is too sparse to speculate on the number of people dying, but the data from China, Italy and South Korea clearly highlights that this grim trend will also happen in Germany.
As much as I trust the excellent health system of the German people and our medical experts these numbers of people dying may explode and will soon -that is within the next week- run well into three digits. As much as I would like to be wrong to this end, it is clear that the high number and increasing trend of people being infected will consequentially lead to the severe complications that often happen in the run of this disease after 1 to 2 weeks. We should be prepared to accept that the shadow of the infected people will soon follow and this may become even more severe in other countries.
In Italy it may soon show, maybe towards the end of the week, whether the drastic measures can diminish the trend, but the data from Wuhan clearly shows that cases still increase for weeks to come, and it would not help to discontinue the extreme social isolation that is the best hope that we have, and the best lesson we learned from the Chinese people. Be on the lookout for a decrease in percentage increase in cases in Italy, which you can look up on Wikipedia. Currently, the data from Italy also shows how severely the medical system became strained after the first week of March, as death rates increased dramatically. While this is of course partly expected due to the mentioned time lag that the disease takes to strike people down, an equally worrying trend can be seen in Spain. Here, measures were recently implemented and will take at least one or two weeks until there can be a positive effect, that is a smaller percentage increase. Meanwhile, cases will increase by probably more than 10% from day to day and even more than 20% are unfortunately still possible. Likewise, trends that started a bit later can be expected for France as well, probably Switzerland, the United Kingdom, the Netherlands and many more countries. These may have been earlier detected, which can make a huge difference in total numbers.
Within Europe alone within the next week the total numbers of infected people would remain in the five digits number, and accordingly more than 3000 people may die next week alone. For Europe the measures of extreme isolation and the combination of genetic testing and CT scans would help to reduce the numbers to localised clusters in April or May, if all goes well. I am personally more worried about the situation in Iran and the United States. What unites these two countries at this stage is the lack of clarity when it comes to the data, and a higher probability of many cases being undetected. If the official numbers in Iran are correct, then at least the increase in cases is becoming less and less severe. In the United States this stage is unclear and the percentage increase is way more pronounced. I would not be able to judge whether this is an artefact and how many cases are undetected, but the trends of community spread are quite worrying.
At this point I want to mention that the new study came out in science (https://science.sciencemag.org/content/early/2020/03/13/science.abb3221) that highlighted how the initial spread of this disease is often happening through hidden cases that show no or only mild symptoms. While this is problematic when it comes to the initial explosive spread of the disease, it clearly highlights that finger-pointing to Italy, Austria, Germany, or the United States is not helpful, as we have already known before. This disease sneaks its way into populations, and it has done so in the majority of countries affected right now. We must be careful now that it is getting restricted.
The next few weeks will be difficult, and we have two recognise that the increase in cases cannot be stopped at this point. It has already happened. For the next one or two weeks next to nothing can be done as the long incubation period of almost 1 week at an average will take its toll, and will be difficult to stop the butterfly effect from these people that do not know that they are already affected or may even only show mild symptoms. However, this is surely not the time for panic but instead of conscious and reflected measures. We need to remember that the numbers that I raised here must be seen in the context of the overall mortality of the population. About 800,000 people die in Germany every year – not through Covid, but for many other reasons- and despite all the tragedy and hardship, as a statistician it would be difficult to detect increase that we currently face. Epidemiologists raise the danger of the common flu that can claim tens of thousands of dying patients in extreme years. The mortality rate of the coronavirus makes it all the more severe and our actions now should help us to overcome this terrible disease in a few weeks or months. The increase of the next few weeks is predictable just as a ball that we throw up into the air follows the rising curve in the beginning, but it has to fall down to the ground in the end. I already mentioned that we cannot rely on gravity here, but the gravity of the situation is quite clear. As I have mentioned before our goal now must be to stay within the capacity of our medical system and to restrict any social interaction at all possible. Extreme jobs and spikes in data are to be expected and should not give reason for alarm. New clusters will be found, countries will shift from genetic testing to clinical diagnosis, and other factors will lead to jumps and spikes in the data. Overall, we are looking at a log linear pattern in the beginning, and the data from China clearly shows that the extreme measures can bring this crisis to an end.