Mythbusting from the WHO

The Indian National Science Academy recently came up with some mythbusters. Anoop and Asawari, friends of mine, were kind enough to share this with me – putting up the link here.

Posting the graphics from that page here. Please, share this information far and wide. Thank you.

 

 

 

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Information about the Coronavirus in India

What is the corona virus?

There isn’t one specific coronvirus.

Coronaviruses are a large family of viruses which may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).

By the way, the’re called corona viruses because they look like coronas, or crowns.

Coronaviruses are named for their appearance: Under the microscope, the viruses look like they are covered with pointed structures that surround them like a corona, or crown.

The most recently discovered virus causes the disease COVID-19.

How does it spread?

People can catch COVID-19 from others who have the virus. The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. This is why it is important to stay more than 1 meter (3 feet) away from a person who is sick.

WHO is assessing ongoing research on the ways COVID-19 is spread and will continue to share updated findings.

 


 

When and how did it reach India?

As best we can tell, 30th January, 2020. This chart below shows you the spread since then.

Data and visualization can be tricky, and later on in this post, keep an eye out for another visualization about the corona virus.

Where does one get official data from in India?

The Ministry of Health and Family Welfare (MoHFW) is the official source that you should begin with. This is their website, this is their Twitter ID. At the moment of writing, the website reports 110 confirmed cases in India.

How is testing being done in India?

On the MoHFW website, there is a link about when to get tested for the corona virus in India. Shown below is a screen grab of that link.

Two things stand out:

  1. The second bullet point uses the word “and“. Having the symptoms is not enough, you must necessarily have traveled to any of the countries listed above. Other than whatever has been said in the previous sentence, you qualify for testing if you are a contact of a laboratory confirmed positive case. Unfortunately, “contact” isn’t clearly defined, at least on this page.
  2. Testing will currently be done by government laboratories only.

Which immediately leads to the next question:

What is our capacity to test for the coronavirus?

India has activated 67 laboratories for conducting the first test, and 51 of those are equipped to conduct confirmatory tests, which is not even one lab per district. India has 732 districts.

At present, cases are being reported from 13 States and Union Territories. In a country with a population of 1.3 billion, till now, only 6,500 throat swab samples from 5,900 individuals have been sent to these labs; at least 107 have tested positive.

That is from the Hindu Business Line, in a report that came out yesterday.

This is the COVID-19 page on the ICMR website. These are the locations of the testing laboratories in India. These are the locations of the sample collection laboratories.

 


 

OK, but 110 cases, how bad can that be?

Exponentials are hard. Anybody who has taught math or statistics will tell you that. Look at the graph(s) below:

A golden rule that I always teach my students in statistics: first look at the axes! On the horizontal axes here, we have the lag in days behind Italy. But the vertical axis is the more important thing to look at, because it is not linear. We go from 1 to 10, from 10 to 100, and from a 100 to a 1000 (and so on). Each tick on the vertical axis is a 10x increase.

In English? Every country where the virus has spread has seen a 10x increase. If you ask a data scientist to take a look at these data points, and then ask the about the trajectory in India, there’s only one possible answer: we probably go from a 100 to a 1000, and from a 1000 to 10,000. I hope not, of course, and mitigation is possible – social distancing is key!

By the way, if you want to play around with the data, click here to go to the Github page.

OK, so the numbers will go up rapidly, maybe. But the fatality rates are low, right?

Two important things to note:

Two numbers that you need to keep in mind when you think about the corona virus. The R0 and the fatality rate. The R0 for the coronavirus seems to be about two, although of course that number can vary because of a lot of factors. But a baseline R0 of 2 seems to be a reasonable estimate.

In English? If you get it, you will on average spread it to two other people. That’s why the quarantine and the social distancing measures are so very important. It’s not just because you shouldn’t get it yourself – it is more because you shouldn’t be giving it to others.

Now, the answer to the question itself: are the fatality rates low?

The Case Fatality Rate (CFR) for COVID-19 is 3.48 percent.

But as an statistician, it is important to state that the correct answer is it depends!

Unfortunately, it is common to report the CFR as a single value. But the CFR is not a biological constant. The CFR is not a value which is tied to the given disease, but is instead reflective of the severity of the disease in a particular context, at a particular time, in a particular population.

The probability that someone dies from a disease is not only dependent on the disease itself, but also the social and individual response to it: the level and timing of treatment they receive, and the ability of the given individual to recover from it.

This means that the CFR can decrease or increase over time, and that it can vary by location and by the characteristics of the infected population (age, sex, pre-existing conditions).

The real problem is rapidly overwhelmed medical facilities

Read the entire thread, not just the tweet quoted above. The point of sharing that tweet is to help you realize that opportunity costs will come into play very, very quickly at medical centers in India. Whom do I treat – patients with the coronvirus or other patients? And soon enough, it’ll be whom do I treat, this coronavirus patient or that one?

Worst of all, there is no treatment per se, yet. There’s encouraging news on the front from all over the world, India included, but there’s time for a recognized cure to be acknowledged and made widely available. Best to proceed on the assumption that there won’t be one, and prepare accordingly. That’s just good strategy in times like these: budget for the worst case scenario.

OK, so what can we do?

Follow government instructions! We’re all in this together, so whatever your local/state/national government is telling you ought to be followed, no questions asked.

Social distancing is key, and that’s fancy English for avoiding going out. Stay at home as much as possible over the coming days, and cooperate with local authorities. Classes, colleges, schools, clubs, restaurants, malls, gyms – anything in the nature of a public gathering ought to be avoided as much as possible.

Panic is not going to solve anything, but precautions will go a long way towards helping.

Stay home, stay safe!

Where can I learn more?

Here’s a list of resources:

Myth-busters from the WHO.

WHO’s advice for the public.

The Situation Update Report from the WHO (I have posted the latest update at the time of writing, but keep checking for more up to date ones as the days go by)

The WHO dashboard.

Read the Wikipedia article on the Epidemic Diseases Act.

A useful article about the how to think about exponentials.

A request: please email me at ashish at econforeverybody dot com with any resources that you think may prove useful. I’ll do my best to share the more useful ones with everybody.


 

Coming up tomorrow: technology in the times of COVID-19.