Editor’s Note: This article was written on March 15th.
What the wise virgins should do about Coronavirus:
The parable of the wise and foolish virgins advises us to be prepared. However, the parable of the lilies of the field advises us against panic buying: “And seek not ye what ye shall eat, or what ye shall drink, neither be ye of doubtful mind”. (Luke 12:29)
These two earthly stories with heavenly meanings are not as contradictory as they seem. One should take sensible precautions, but one need not be too obsessed with the material things of this world: there will be enough loo-rolls to go round. The two parables, taken together, are very much in keeping with what governments have been saying.
How, then, should we prepare for the Coronavirus epidemic?
Two weeks ago I set out what governments should do (lock down the world for six weeks, test everyone, isolate carriers and take stock) full article here. I also advised ecclesiastical authorities to think about suspending public Masses. No doubt that advice may have seemed extreme at the time.
However, you will have noticed not only that the infection is suddenly spreading very rapidly for no apparent reason but also that governments are beginning to take something approaching the drastic steps I had recommended two weeks ago.
Before I set out the best advice from various front-line medical authorities on what you can personally do to reduce the risk that you or those close to you will become infected, I shall reveal how I knew two weeks ago that Coronavirus would become a global emergency. The surge in cases since my last article on this subject two weeks ago does not surprise me.
I studied elementary epidemiology – the science of how diseases spread – when HIV first appeared. At that time I minuted the Cabinet in London advising them to halt travel, test everyone and isolate all carriers immediately, compulsorily and permanently. The advice was not heeded. Since then, 50 million people have needlessly died from HIV.
Speed is of the Essence:
As soon as a new and fatal infection appears, it is absolutely necessary to act at once. Failure to do so is culpable. I am going to explain exactly why one must act immediately.
During the early stages of any epidemic, it rapidly becomes clear how fast the new infection is being transmitted. During the first stage, the growth of the infection is exponential – in other words, one multiplies each day’s total cases by the observed growth factor to obtain the next day’s likely total. That exponential growth factor will not diminish except in one of five circumstances:
- Decisive public-health measures control its transmission. China and South Korea are good examples.
- An environmental factor (such as warmer summer weather) temporarily reduces the growth rate of the infection.
- There are no more susceptible people to infect.
- A vaccine is found. Even then, testing it for safety takes a year.
- The population acquires immunity.
Governments and hierarchies should not wait for items 2 to 5. In particular, they should not be tempted to take the foolish virgins’ approach and faff about until the summer in the hope that fine weather will do their job for them. It may, or it may not. Only the foolish virgins would bet on the former.
The most important step, where a new pathogen is spreading and is proving fatal to some, is that the public authorities should act determinedly and at the very earliest possible moment to hinder its transmission.
Here is why:
In the early stages of an epidemic, transmission follows an approximately exponential curve. We now have enough data from the past 52 days of transmission outside China to derive the exponent.
As with all good science, we begin with the real-world data. We plot the curve of the daily cumulative case count. www.worldometers.info has done that:
Fig. 1. Cases of COVID-19 from January 22 to March 13, 2020 (www.worldometers.info)
Now for the mathematics. And if this is the first time you have ever seen equations in an article for a religious newspaper, you will soon see why.
By January 22 there had been 9 Coronavirus cases outside China. Thus, C1 = 9. Now, 52 days later, by March 13, there had been 64,659 cases. Thus, C52 = 64,659.
From these two values, it is a simple matter to derive the daily exponential-growth factor g over 52 days d:
From the shape of the curve shown in Fig. 1, it is evident that the epidemic is still in its early stages. Public health measures adopted to date by most countries have been ineffective in preventing what appears to be the exponential rise in cases that one would expect from a standard epidemic curve in the absence of prompt and determined preventative action.
The equation shows us that every day, on average, the number of cases has been increasing by a little over 19% compared with the previous day. And this is a compound increase: that is what the word “exponential” means.
Next, we verify using the Mk. 1 eyeball that the curve of actual reported cases from all around the world, as plotted in Fig. 1 follows at all points an exponential curve calculated from the exponential-growth factor derived via (1). Here is the equation of the curve:
Fig. 2 shows the graph derived from this equation, in thousands of cases:
Fig. 2. Cases of COVID-19 from January 22 to March 13, 2020 (calculated)
Figs. 1 and 2 are scaled and drawn to the same aspect ratio. The below GIF ((graphic interchange format) image uses a technique originally developed by astronomers to find moving satellites or planets in successive images of a field of fixed stars: the blink comparator. This display mode flicks rapidly between the two slides showing their similarities.
You will at once see just how very close curve of the actual data plotted in Fig. 1 is to the idealized exponential-growth curve calculated and plotted in Fig. 2.
Information presented like this that is useful when trying to persuade public authorities that the predicted rate of transmission in the absence of more stringent measures on their part is essential.
What this blink comparator shows, is that the two curves are near-perfectly coincident. The fact that the two fit one another exactly permits us to be confident in using the second equation above to calculate how fast the infection will spread from now on.
We may legitimately deduce that the daily rate at which the total cases will grow is likely to continue on the exponential-growth curve unless one of the reasons 1-5 listed at the beginning of this article comes into play.
This is not speculation. The epidemic curve has been well studied, and its characteristics are sufficiently understood. With more than 50 days of data one can derive the growth factor, as we have done, and one can use it to give a quite reliable indication of how fast the infection is likely to continue to be transmitted if the existing generally limp-wristed policies continue.
Why does this work? The reason is that each infected person will, roughly speaking, pass the infection on to the same number of uninfected people, who will, roughly speaking, acquire or resist the infection to the same degree, and pass it on in their turn to approximately the same number of people each.
For policymakers at government level, the question is, “when should one make determined efforts to contain the transmission of the infection, and how determined those control measures should be?”
When I prepared an earlier version of this article for a U.S. website for which I write from time to time, the article was rejected on the ground that a policy decision not to publish speculative articles about the infection had been taken.
Instead, the website ran a fatuous speculative article by someone with no knowledge of epidemiology, indicating that the infection would rapidly decline.
Within hours, the website had been made to look foolish, for Donald Trump, whose advisers well understand the underlying mathematics, announced that his administration would henceforth treat the pandemic as a national emergency. The Marxstream media hooted and hollered and sneered, as usual.
Should governments adopt the Trump approach of declaring a national emergency and engaging the public and private sectors at once to curtail transmission, or the Johnson approach of mumbling about the desirability of enough people contracting the infection to acquire what his Chief Medical Officer has contemptuously described as “herd immunity”?
We shall continue to use the elementary mathematics of epidemiology to answer that question.
We shall set Friday, 13 March 2020 as Day 1 of the predictive calculation, starting with the 64, 659 reported cases to date. We shall calculate how rapidly the infection will spread over the next eight weeks, using the established exponential-growth factor for COVID-19 that we found in Equation 1 above.
For it is that growth factor that would unfortunately prevail if the world continued with the talk-a-lot-but-do-too-little policy that continues to prevail in all but a few countries.
Table 1 shows the expected cumulative worldwide cases outside China for each day from now until May 10.
MARCH PREDICTED CASE NUMBERS OF COVID 19
It is this calculation which is beginning to alert the more intelligent governments around the world to the fact that they can no longer rely on the corrupt and incompetent World Health Organization, an unelected and regrettably unsackable body of expensive inadequates accountable to no one. The WHO has grossly underestimated the impact of the infection, just as it did with SARS and HIV.
Here, then, are the figures. Read them and be concerned.
Table 1. Cumulative COVID-19 cases from March 14 to May 10 on present policies
From mid-May on, but not until then, enough people will already be infected, as a percentage of global population, to start reducing the exponential-growth factor.
But how realistic is this table? Will there really be 1 million cases by 19 April, 100 million by 25 April, 500 million by 4 May, 1 billion by 8 May and 1.5 billion by 10 May?
The answer is that the table is indeed a realistic portrayal of what would happen if governments continued to fail to take determined steps to prevent transmission.
Since most governments are not wicked, they will realize in due course that they need to raise their game. Even the lumbering government in London is beginning to wake up to its responsibilities.
Therefore, this table, based on the current do-little option, is a benchmark against which one can measure henceforward the effectiveness (or ineffectiveness) of public-health containment measures. If, as we must all hope, the actual cases begin to decline markedly compared with the numbers shown in the table, then the public-measures will be starting to work.
In reality, governments will now begin to take the threat more seriously than most of them have done so far. One can also hope that, at least in the northern extratropics, the warmer weather of spring and early summer will inhibit transmission.
Viscount Monckton’s table above predicted 522,413 cases outside of China by March 25th, the actual figure was 389,750 a difference of 132,663. Viscount Monckton’s table predicted an average daily percentage growth from March 14 to March 25th of 18.61%. The actual average daily percentage growth in coronavirus cases for this time was 16.09%. Whilst the growth in the number of cases has slowed, it is still growing at just over 2% slower than predicted. Please God the drastic government measures announced around the world will see the growth rate continue to decline.
But the value of the present exercise is to give readers of the Catholic Voice a handy policy primer that they can show to their own elected representatives, and to their bishops. Make sure you write to them, and request that they should immediately ensure that much more decisive containment measures are taken from now on.
To this end, the comparator showing how the formula derived from the known cases to date precisely follows the curve of those reported cases will help to convince your elected representatives.
Given the known characteristics of the transmission of epidemics, the formula will just as reliably predict future cases based on current public-health policies worldwide. In short, the table of future case numbers represents approximately what would happen unless tough decisions were taken immediately.
In particular, it is in the nature of exponential curves that the sooner one intervenes to prevent the curve from continuing unabated the more effective the control measures will prove to be.
Fig. 3. Outcome of closed COVID19 cases outside China (www.worldometers.info)
Difficult to Accurately Predict a Death Rate:
What will be the cost in lives if the fumblesome, do-little option continues? It is notoriously difficult, early in an epidemic, to establish the true death rate. One cannot simply divide the number of deaths to date by the number of infections to date, because the number of infections is rising very steeply, and the deaths tend to lag by about a week.
A more reliable method – though not definitive at this early stage and not as reliable as the future cases predicted in the table above – is to express the death rate as the percentage of closed cases – i.e., of cases whose outcome is known.
People either recover or they die (or they are not yet a closed case). At present, as Fig. 3 shows, the death rate appears to be about 7% of all cases with an outcome. I had hoped that 6% would prove to be the asymptote, but in recent days the death rate has increased to 7%.
Thus, those who suffer frank symptoms have a 1:14 chance of dying of the infection. In reality, however, anyone under 50 is at negligible risk. Small-sample studies of hospitalized patients with serious symptoms suggest death rates of 4-15%.
Age-related mortality rates are as follows: over-80s, 15-22%; 70-79, 8% in all cases; 60-69, 3.6%; 50-59, 1.3%; 40-49, 0.4%; 10-39, 0.2%; children 0-9 zero.
For comparison, the death rate from other recent new infections is as follows: SARS 9.6% against an original World Health Organization prediction of 2%; MERS 34%; Swine Flu 0.02%; COVID-19 (based on closed cases to date) 7% against an original WHO prediction of 2% (since revised to 3.4%).
Based on Chinese data, the overall death rate for males is 2.8-4.7%; and in females 1.7-2.8%.
Death rates for patients with relevant co-morbidities – chronic illnesses that increase the mortality rate from COVID-19 – are as follows: cardiovascular disease 10.5-13.2%; diabetes 7.3-9.2%; chronic respiratory diseases 6.3-8.0%; hypertension 6.0-8.4%; cancer 5.6-7.6%; no pre-existing conditions 0.9%.
If 1.6 billion people become infected by May 10, up to 54 million (at the WHO’s 3.4% mortality rate) or 110 million (at the current 7% mortality rate) may have died worldwide by a month or two later. This is one more reason why governments would do well to act sooner than later. It is Mr Trump who is right and Mr Johnson who is wrong, with Mr Varadkar somewhere in between.
What can the individual citizen do? The following does not constitute medical advice. It is precautionary, and the precautions may not be sufficient. Your own public health authorities will have their own advice online. At present, however, it is not likely to be as detailed or as useful as what follows.
First and foremost, if you are over 60, and particularly if you are male and have pre-existing co-morbidities, protect yourself by isolating yourself at home for the time being.
A couple of weeks ago, when I first did the mathematics summarized here, I cancelled two holidays in the north of England, an important business meeting in Yorkshire and a dental appointment. I have kept myself at home ever since.
If you must go out, travel by car or motorcycle. Avoid all forms of public transport. In particular, do not use public washrooms: go before you go.
In any public place, wear motorcycle gloves and a motorcycle helmet (a lot more effective than a face-mask and silly plastic gloves). Modern helmets are quite lightweight. Also, wear leather knee-boots and, if possible, leather breeks and a leather jacket rather than any kind of fabric clothes, gloves or boots: the virus can endure on fabric for up to 12 hours, whereas you can wash down leather with soap and water as often as you like.
Japanese doctors add the following advice:
Take a few sips of water at least every 15 minutes. Warm water is best: avoid iced water. Drinking works because, if the virus gets into your mouth, drinking will wash the virions into your stomach, where the digestive acids will dissolve the lipid membrane encasing them, rendering them harmless. Regular drinking also prevents the virus from entering the windpipe and lungs.
Sidenote: I use bottled water, because the tap-water is fluoridated and there is peer-reviewed medico-scientifcic evidence that, in the United States alone, about 1 million cancer deaths have occurred as a direct result of fluoridation, which in any event does little to inhibit dental caries, the original purpose of that misguided experiment.
The Japanese doctors also advise us that a runny nose and sputum are symptoms of the common cold. Coronavirus gives a dry cough without a runny nose (unless you have a cold as well).
The new virus appears to be unable to endure an ambient temperature above 26-27 Celsius. If so, the summer will help a lot. But there won’t be much summer by May 10.
If anyone who is infected sneezes, the virions will travel up to 10 ft (3 m) before reaching the ground. Therefore, try to keep away from other people in public places by at least 15 feet (4.5 meters), and more if you are downwind. And keep your helmet on while away from home.
Do not touch any surface in any public place unless you are wearing motorcycle gloves. Virions on a metal surface can survive for at least 12 hours.
The symptoms of COVID-19 are as follows:
The throat is typically infected first, with a sore throat lasting three to four days. The virus then blends into a nasal fluid that enters the trachea and subsequently the lungs, inducing pneumonia. The nasal fluid is not as normal: it feels as though the patient is drowning.
This process takes 5-6 days after the sore-throat phase. With the pneumonia comes high fever and breathing difficulties. At this point, telephone your doctor’s office or health provider, but do not visit them.
The moral of this tale is this. Like it or not, every epidemic spreads exponentially during its early stages. It has here been demonstrated – graphically in both senses of the term – that COVID-19 is no exception to this iron rule of epidemiology.
Exponential transmission at the now-known rate will diminish in the near future if and only if determined public-health measures are put in place at once. Even one day’s further inexcusable delay will have fatal consequences, and, as the Romans used to say, salus populi suprema lex. ( the health of the people is the highest law).
The sooner we act the better. As Table 1 shows, unlike global warming the coronavirus is a real emergency. Thirty years after IPCC’s First Assessment Report, CO2 emissions continue to exceed IPCC’s then business-as-usual case, and yet the world has warmed at only half the 0.33 K/decade that IPCC had then confidently predicted, and deaths attributable to warmer weather are comfortably outstripped by lives saved from cold-related fatalities.
Thirty days after you read this, if your governments have not taken heed, and if the exponential growth rate therefore continues, 12 million people worldwide will be infected with COVID-19, of whom close to a million will die.
Like it or not, the now-known exponential growth-rate of COVID-19 will continue unless and until effective control measures are taken not only by governments but also by you and me. Tell your governments and tell your friends. If they say you are merely speculating, show them the blink comparator.
Be safe, and do not be afraid to be careful. Yes, a motorcycle helmet looks ridiculous except when on a motorcycle, but ridiculous is better than dead.
Like all things, this thing will pass. Have courage, make sure your legislators and bishops see this article, and don’t panic-buy, but be prepared! It is the wise virgins who will inherit the Earth.