Coronavirus (COVID-19) – Thoughts and Reflections on – Estimating the Number of Cases – Part 1 of a series

Admittedly, there are multiple problems with all of the numbers being reported.

1: The China cases appear in the early stages to have been underreported, partly at first because no one knew what they were seeing, pre Dec 31, 2019. Then the eight doctors in Wuhan (I call them the Wuhan 8) put out a post on social media there was a problem. One of those 8 died a few weeks after the lock downs started in Wuhan (Jan 23, 2020 or so). Since then there have been all kinds of indication that things are really bad in China. In recent weeks, there have been multiple indications that things are still a problem such as:

CHINA AREA:

A: Economic indicators still show output like the Chinese New Year’s Holiday is still going on but the party is telling everyone that production has returned to normal.

B: Various videos showing body bags every few doors on main streets.

C: Villages blocking roads so no one can enter them. (The family I live with had the grandparents talking about traveling to Fuzhou to attend a funeral but can’t go because the area closed itself off a few days later.

D: Tencent, a Chinese media company, accidently posted on the internet the number of cases being around 157K with a little over 25,000 deaths. The post was only up for a few minutes before it was changed. The thinking is that someone accidently posted the real numbers, thinking those numbers were the party approved numbers.

E: Someone noted that for several days the number of reported deaths was almost exactly 2.1%, like plus or minus one from what 2.1% of the total number of cases would be. The thinking is that someone was being ordered as to what to report for number of cases and told to make the reported deaths as 2.1%.

F: Satellite photos seems to show large amounts of organic material in Wuhan center, even though all factories have been closed for weeks. It is believed this is from crematoriums running around the clock to dispose of the dead.

G: A report that out of the 15 crematoriums in Wuhan that three broke down from ‘overuse’. It is the first time I ever heard of any crematorium breaking from too much use.

OUTSIDE CHINA AREA:

1: Until recently the United States only had a limited number of test kits. The CDC released a set of testing procedures, which I downloaded and read, but basically unless a person traveled to the infected area or had known contact with someone in the infected area, they did not test. COVID-19 is contagious even though a person may not show any symptoms for a few days. The R0 ( R naught, how many people will an infected person pass the illness to) appears to be somewhere between 2.4 and 4. As a comparison, the typical flu has a R0 of 1.2; every five people with the flu will pass it is 6 people.

2: A few of the people that have tested positive for COVID-19 had no known contact with someone who traveled to an infected area or themselves had traveled to an infected area. This also has happened in Germany. Basically, we are now getting to the point where some people who get COVID-19 we do not have any idea who they got it from, so we can’t test people to find out.

3: There are problems with the test kits. There was an earlier batch that didn’t work but that was fixed this week, but the current tests for COVID-19 still have a problem that a lot of the time they will return a ‘false negative’; meaning a person who is infected may test negative for the virus. To get around this problem a person that has or may have the virus has to be tested multiple times to make sure they are not infected.

4: Even if the reported numbers and deaths out of the China area are accurate, which indications are they are not,  there is still a disaster in a number of weeks. even starting from a low number, the results increase dramatically. Originally, most of the reports seemed to think the number of cases would double every 6 or 7 days. more recent reports seem to indicate that the number of cases may be doubling in 2.4 days.

For the estimate I did last week for the United States I used the reported number of 35 cases and a doubling every seven days, with 15% expected needing hospitalization. Using those assumptions I came up with that around week 25 all of the hospital beds in the US would be filled with COVID-19 patients.

The measure if I am right or not is to see if the number of cases double every seven days; so today we have 84 cases.

If my estimates are right, then next week at this time the number of cases should be over 160, then 320, 640, etc.

If the rate of increase in the number of cases starts to ‘flatten out’; i.e. no more doubling, then I am wrong and would need to redo my estimates.

At the moment, with no reliable test kit, no treatment, no vaccine and not even being able to tell who has been exposed to the virus, I expect the doubling of cases to go on.

It is also troubling that places like Africa have reported just about no cases, even though Wuhan had direct flights every day carrying about 1,500 people to Ethiopia. The fear is that with all of the cases elsewhere, there must be a number of cases in Africa and are spreading to other areas, but no one knows because they have no test kits.

Hopefully, something will change and things will not turn out as bad as the projections show they might.

Good Luck and Take Care,

Louis J. Desy Jr. – March 01, 2020

Louisdesyjr@gmail.com

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