Overnight the number of cases from S.Korea’s pro-active testing regime has increased to 2337 but the number of deaths remain the same. This means the number of infected individuals per current death is 180 which is the same as on the cruise ships. Turning this around means the death rate is 0.56%. If we assume 80% of people are infected, then the total death rate is about 0.4% and the most serious hospital care rates are around 2%. This means in terms of figures:

As the government are suggesting 80% is a worst case scenario for infection, the rates may be lower, but these seem to be realistic worst case projections. To put this in perspective, according to Oxford university’s Vaccine Knowledge Project, an average of 600 people in the UK die from the flu per year. Thus even if the scale of infection is much lower e.g. 8% of population are infected, the number of acute cases in Scotland will be similar in scale to the entire number of acute beds in Scotland. And with the Wuhan epidemic largely coming to a peak and falling back within a month, the vast bulk of these cases (even with Chinese style quarantine) would require the beds at the same time and thus swamp our NHS.

However a worst case scenario will see 10x as many acute beds needed as there are acute beds in Scotland. This is truly a crisis, and I can see why China acted in the way it did.

The unseen pandemic

The biggest concern right now is that taking the 0.56% figure (180 infections per death) as a general figure, suggests that in all countries excluding China, S.Korea, cruise ships and Iran (which is using a “different” approach), it appears that 80% of infected cases are likely not being identified and therefore not being quarantined. The UK have detected 16 cases of coronavirus, so that suggests there are ~50 infected people in the UK who are just going about their ordinary lives without knowing they are infecting others.

By next week those 50 will likely have infected 500 more, of whom only 125 will come to the attention of medics, leaving ~425 people free to infect others. Those will infect ~4250 others, of whom only ~1000 will be picked up by medics leaving 3000 infecting othres. The next week (assuming improving weather has no effect) those 3000 will by ~30,000.

Estimated position 20th March

First, whilst the current detection rate is 20%, I estimate during the epidemic it will rise to 25% of infected people self-reporting for testing with 75% being undetected.Therefore of those 30,000 I estimate will be carrying the virus on 20th March, my calculations suggest there will be 165 deaths, 300 acute cases, 1500 in hospital  acute cases,  3000 in hospital and 7500 “reported” cases. I saw somewhere there were only 600 of the most acute beds, so these estimates sugget that within 2-3 weeks it will be felt that the virus is “out of control” in the UK and there will be no choice but to impose quarantine.

What might be done

Border control

It is already probably too late, as my estimates suggest we already have coronavirus spreading out of control.

However, there is no point putting into place the following actions and therefore improving the UK situation compared to rest of world, without also 100% strict control of the border. The obvious thing to do, is to quarantine everyone who arrives into the UK (whether UK citizen or not), test them all, and only release them when the results show no infection. It may sound impossible, but as they say: it is only 24hours of hunger between what people think they can’t and what they will. Likewise, it may just be a week between what seems impossible and what is being done.

But that 100% testing might be relaxed for any other countries who are also doing the following types of things:

Pro-active sampling testing.

We ought to start sample testing of the population in sufficient numbers to be able to detect the true rate of infection in the UK. At moment we are starting to test people who have symptoms and show up at GPs, but that is not nearly enough. We need to go out into the community and check people in large enough numbers to find it even where the symptoms are too mild to seek medical advice.

The second stage of this would be 100% testing in any “hot spots” that are located. For obvious reasons, that will be a huge strain if the areas are too large, which is why we need to start with a lot of monitoring.

Quarantine

To put it simply, any area (or group of people) where there is any detection of coronavirus must immediately be put into 100% quarantine, no ifs no buts. The only people who can move around in these areas must be 100% protected and they also must be routinely screened for coronavirus.

Shooting of politicians

No, I’m not really suggesting shooting politicians, yet. But let’s be honest, if we get scense like China I’m sure people will be demanding heads roll. It’s a huge job planning for quarantine, even if we started now with zeal, it will be chaos, and the UK politicians still seem to have the mad belief that coronavirus will somehow go away. Let’s hope they are right, but I strongly doubt it.