Coronavirus: estimated Scottish impact

Correction

When I wrote this, I assumed that vaccines could be ready in a matter of weeks. I now read in the Daily Mail:

The current record time for producing a vaccine is for Zika, which took academics seven months to go from the lab to human trials.

Doctors fear if it takes that long this time, the unnamed coronavirus could already have swept the globe.

Thus under “should we be worred” section I’ve had to remove anything that suggests we shouldn’t be worried. Especially as there are increasing signs of person-to-person spread outside China.


In early December 2019 a new coronavirus, designated 2019-nCoV,[8] was identified in Wuhan, the capital of China’s Hubei province. In January I started getting odd tweets on the subject and then I started looking into it seriously about a week ago. Obviously what follows are estimates and if you are interested in the subject, I ask you to check them yourself to see if you get similar figures.

Current Situation

There are reported to be 28,000 cases of which 565 (2.0165%) have died. There are now cases in numerous countries with Japan, Singapore, Thailand, Hong Kong, South Korea all having over 20. Person-to-person spread & two deaths have been reported outside China.

Should we be worried?

The answer is yes and no. Unlike SARS this coronavirus spreads rapidly and a large number of people do not have serious symptoms. That may sound good, but it means that it is virtually impossible to stop, because a large number of people will not seek medical attention and be isolated, but instead will continue meeting other people and pass it on. However, the death rate is much lower than SARS and in any case, if it arrives in Scotland, by the time significant numbers have got it, the warmer weather should slow and then grind to a halt the disease … until next Autumn.

However there are reports of a vaccine being produced. But if There is no vaccine, and we do will get an epidemic in Scotland, then and we are totally underprepared. There is no way the SNP could handle it (they can’t even handle cars stuck in a snowstorm). I’m sure the public will get extremely angry with politicians.

Who is most at risk

It is claimed most victims were older people who had pre-existing conditions. I’ve also saw one mention that more men were affected.

What should we do?

Nothing until there is person to person spread in Scotland or the UK and hopefully by then there will be a vaccine. But if we start seeing person-to-person spread before then, we should all

  1. Wash hands
  2. Write your will
  3. Stock up on essentials

Problems with Estimates

A huge problem with estimating what will happen is that reliable information is thin on the ground. In particular I think as of 9 days ago, the statistics coming out of China stopped being credible, either because of intentional alterations or through incapability of dealing with the problems of the outbreak.

Daily rate of increase in cases against date.

Below is the daily growth rate in cases. At first, the rate varies from day to day with only a vague overall trend. This is normal. Then on the 28th of January, the variability suddenly disappeared and the rate of increase suddenly dropped. That indicates a significant change of some form. If we look at the graph of total reported numbers below

We see that there is an obvious kink in the graph between the red and blue sections. This looks like someone changed something about the figures and from the politics it looks most likely that there was political action taken to reduce the figures. Fortunately, I’m not trying to estimate total cases, only the growth and rate of deaths, so whilst this is an alarm bell that other figures may not be accurate, it doesn’t directly affect these estimates.

Total number of reported deaths against date. Red indicates the data which appears credible. Blue represents data which I feel is suspect. The red thin line is overall trend, the green is the projected trend from the first period.

However, even with the likely tampering of data, there are numerous accounts of people who die not being counted in the statistics. But to be fair to the Chinese, whilst the data is suspect, they are certainly doing a cracking job trying to stop the spread, to the extent of locking people in their own homes.

With the proviso that the raw data is suspect, I’ve been watching numerous videos trying to assess whether these are compatible with the official figures. Bearing in mind that during an incident like this people will think that any deaths are “a lot” and that they will inevitably be many comments on body bags and suggestions of far large numbers, even if the numbers did match the figures, whilst I think the numbers have been adjusted, I think there is enough in what we have to make some educated estimates.

The deaths reported between 31st Jan and 2nd of Feb were 361-259 = 102. However, we have no information as to when these people reported as ill. This is important because the virus is spreading, so the death rate is the number out of those who got the illness when those who died did, not the much larger number who had the virus when they died. Reports suggest the virus lasts around 10 days. If we assume that deaths occur 5 days after they report symptoms, then this allows an estimate. The increase cases 5 days before the 102 was: 2744-1287. Thus the death rate is 7%. However, to show how sensitive the death rate is, if we picked a figure just 7 days earlier rather than 5, the death rate is 14%. And if 3 days then it is 3%

Therefore I have to use a broad range of between 3-14% death rate, this compares with the quoted figure of “2%”. However, here I have to say, that the death rate is so close to 2%, that I suspicious that some official has been told “it will be 2%”.

What is more, there is also under-reporting of deaths. The scale of this is difficult to ascertain for obvious reasons, but perhaps 10-50% might be reasonable, suggesting 3-21% mortality of those recorded as having symptoms.

One other issue is that China has a much lower number of >65yr olds who are most affected. (11% rather than 18%) So the total rates in Scotland would be higher. That suggests around 5-34% of those recorded as having the illness will die in Scotland (using same criteria as China).

However, in terms of the general population, it is now estimated by Imperial that only 10% of cases result in severe symptoms (i.e. recorded). If everyone eventually catches the virus, that suggests the likely death rate in the population is of the order of 0.5 to 3.4% or 25,000 to 170,000.

Hospital Beds

Reports suggest around 20-30% of those with severe symptoms end in hospital. It will be higher here because of the greater elderly population, so the number of people needing hospital care may be around 3 to 4%. suggesting around 300,000 to 400,000 will need hospitalisation. If we assume 10days in hospital that is 3-4million bed-days. The Wuhan outbreak initially spread at a rate that would infect millions within a month. If we suggest a slightly slower outbreak rising to a peak and falling over 100 days, that means an average of 30,000 to 40,000 beds will be needed in Scotland, but obviously the peak is higher.

There are 16,503 acute beds in Scotland’s NHS Hospitals

Discussion

When I presented these to someone in academia, I got the usual arrogant response I have grown used to from academia: “leave it to the experts”:

I’d suggest you to leave predictions to WHO and other experts in the field. There’s nothing you can do except wash your hands. Spreading false panic will bring only negative consequences

And because this response is almost knee jerk from academia, there is no point listening to it, apart from the “wash your hands.”

However, undoubtedly, this is a very simple calculation and the amount of guestimated data is far too high to make the results at all accurate. Indeed, there may be factors in Scotland that mean it is far milder in effect, but also it could be far worse. Also, it appears likely a vaccine would be produced before need to start panicking in Scotland.

But what if it weren’t? In China, people are literally being locked in their houses by the doors being welded shut. But even that kind of draconian measure is not stemming the spread. There is not a hope in hell that the gormless SNP who have failed so badly with our NHS, and left motorists stranded for 8 hours on a motorway within walking distance of a service station, have a hope in hell of dealing with a crisis like this.

The biggest problem is not the illness itself, which is pretty horrific, but that in China it has literally brought ordinary life to a standstill. The streets are empty, the shops are bare, people are literally being locked in their homes to die and those who are “fortunate” enough to get to hospital find huge halls filled with beds with not a doctor in sight. And that is in one of the most control-freak countries in the world which can and did build a new hospital in days. The epidemic would be over before the SNP could do anything as simple as choose the name of a new hospital.

So, whilst the chances are good that it won’t happen, if it does, we in Scotland are on our own!

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