covid 19 performance march 15 to april 21st 2020€¦ · digit ltd, brunel business school, gpi...

Covid 19 Performance

March 15 to April 21st 2020

Dr.Andrew Black,

Digit Ltd, Brunel Business School, GPI

April 2020 ,

Digit Ltd & Brunel Business School 1

Covid 19

Situation Report March/April 20th 2020:

by Dr. Andrew. Black

Digit Ltd & GPI London 2

• These slides provide a global overview of the

development of COVID 19, the number of

cases, the number of fatalities, and fatality

rates.

• These are shown for 7 main regions.

• Data is from John Hopkins Covid data archive

Digit Ltd & GPI 3

Introduction

Broad Conclusions I

• March saw the explosion of Covid out of its original area, China, and into Europe.

• Since then Covid has infected the USA. The US now has the largest number of cases of a single country.

• The first week of April saw a substantial deterioration in fatality rates. This is largely a function of the rate of infection, and the type of patients infected

• Infection rates are higher than originally expected, with a r (reproduction rate) of between 2.5 and 3.2 (Imperial College).

• The main centres continue to be Europe , N.America. And China.


Broad conclusions II

• Regions such as Africa, S.Asia and S.America

still have small numbers of Covid19 patients

• Their numbers are growing very fast,

• The rate of increase in the number of cases is

starting to fall in some regions (Europe,

N.America)

• The absolute number of new cases continues to

rise, or is stabilizing at a high level


Broad Conclusions III: Fatalities

• There are substantial differences in the performance of fatalities. The worst performing countries are Spain, Italy, Britain and France.

• Some countries have markedly better fatality performance, particularly Germany, Finland, S.Korea, Taiwan and Singapore

• This is due to a combination of better social control methods (including testing), and partly due to better legacy medical systems with better equipment levels and standards


Covid Stages:

Suggested Sequence • The disease is spreading out from its ground zero, China/Hubei province/Wuhan.

• Stage 1: Few cases, mostly contained. Few fatalities. Virus appears to be under control and is “trapped”. Person to person transmission relatively low

• Stage 2: Escape. Covid infects others outside of original areas. Infection clustes occur in densely populated cities and areas with many vulnerable people (the elderly and those with existing medical conditions). Very rapid growth occurs. Daily growth rate in new cases 30% plus per day

• Stage 3: Lock downs and introduction of other social measures. Infection rates come down as a proportion of total cases. However, in absolute number the daily increase can still be rising

• Stage 4: Stabilization. Lock down starts to work. More testing and protective equipment reduces cases/fatalities. There is still some overall growth in cases, fatalities stabilize

• Stage 5: Declines in the number of new cases. Declines in the number of fatalities. Probably accompanied by reduction in severity of social control measures.

• Stage 6: Relaxation of social control and distancing measures. Introduction of measures to proect the vulnerable. Danger of a further second or tertiary infection wave.


Overall Situation

April 21st 2020

• 2.469 million Covid Cases world wide

(0.032% of the global population)

• 169,961 fatalities

• A fatality rate of 6.9 % - rising steadily

• Significant variation in fatality rates:


High Fatality Countries

Fatalities % Confirmed Cases Apr 06 and Apr 20

Digit Ltd & GPI London 9 0.00% 2.00% 4.00% 6.00% 8.00% 10.00% 12.00% 14.00% 16.00%

Algeria

Antigua and Barbuda

Bahamas

Belgium

Congo (Kinshasa)

Egypt

France

Guyana

Honduras

Hungary

Indonesia

Italy

Liberia

Mexico

Netherlands

San Marino

Spain

Sudan

Sweden

Syria

Togo

Trinidad and Tobago

United Kingdom

Zimbabwe

Bangladesh

Colombia

Mali

Antigua and Barbuda

Honduras

Highest Fatality Rate Countries

Apr 06 and Apr 20th Compared

Fatality Rate Apr 06th Case-Fatality 20 Apr

High Fatality Countries

(Death traps)

• Many of them have fatality rates over double the global average

• European countries perform badly – higher proportion of elderly patients ?

• List is not stable. During April most European countries in this group performed worse

• Some developing countries dropped out of this list, e.g. Bangladesh, Colombia

• Most of the new entrants are from outside of Europe.


Low Fatality Countries (Less that 25%

of the global fatality average):A varied list. • Australia

• Israel

• Chile

• Kuwait

• Latvia

• Malaysia

• New Zealand

• Russia

• Singapore

• Taiwan

• Thailand

• Some are at early stages

• Some have better social control systems

• Some have poor records

• AsiaPac countries well represented.

• Experience with SARS and MERS acted as a wake up call.


During March shift in centre of Gravity away from AsiaPac,

towards Europe & N.America

• A big rise in share of

N.America.

• Europe remains the hot

spot: its relative share

declined slightly in early

April

• AsiaPac share fell steadily

• Numbers in Africa and

S.Asia still low, rising

very rapidly


0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

s.Asia Europe MENA AFRICA S.AMERICA CIS ASIAPAC N.AMERICA

REGIONAL SHARE COVID CASES

MARCH/APRILS 2020

Share March 15

Share March 31

Share April 20

Fatalities lag the new cases:

Europe still the main centre for fatalities


0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%


REGIONAL SHARE COVID FATALITIES

MARCH/APRILS 2020

Share March 15

Share March 31

Share April 20

After initial high volatility, daily

growth rates of new cases settling down

AsiaPac cases still growing


CIS

AsiaPac

Eur

N.Amer

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00% Daily Compound Growth Rates

COVID cases by Region: Major Regions

Europe MENA ASIAPAC N.AMERICA

Daily growth rates in higher

income regions are decelerating

• Daily Growth rates of new cases are falling

• They are still in the region of 5% per day,

which is still a high rate

• This will keep pressure on health systems


Daily growth in new Cases

around 10% in lower income regions


0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%Daily Compound Growth Rates

COVID cases by Lower Income Regions

s.Asia MENA AFRICA S.AMERICA CIS

Daily growth rates in new cases

now higher in the lower income regions

• Still some volatility in the growth rates

• Unclear whether the lock down measures are

working. Many countries still at stages 1 and 2

of the cycle


Number of New Cases Still Growing

Very Fast. Between 20 and 30k per day

in Europe and N.America. On the ground the crisis persists

0

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r-2

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DAILY INCREASE IN COVID CASES BY REGIONMARCH/APRIL 2020

s.Asia

Europe

MENA

AFRICA

S.AMERICA

CIS

ASIAPAC

N.AMERICA


Crisis severity unequal around the

world

• Europe and N.America are both experiencing around 30k new cases per day

• Covid 19 has essentially “escaped” in these regions.

• Their experience very differnt from that of AsiaPac (China)

• Lower income regions are experiencing growth in new cases less than 10k per day

• There are signs that the absolute number of new cases is still accelerating in CIS and S.America.


AsiaPac eclipsed by Europe and N.America

in terms of Share of Covid Fatalities


0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%


REGIONAL SHARE COVID FATALITIES

MARCH/APRILS 2020

Share March 15

Share March 31

Share April 20

Covid Fatalities

(mid April 2020)

• Europe the global hot spot, followed by

N.America

• AsiaPac and MENA shares are falling steeply

• S.America, S.Asia & CIS likely to be entering

accelerating growth phase

• Africa may be the last continent to experience

rapid increase in Covid cases & fatalities

• Fatality numbers lag the number of new cases


Comparisons with Spanish Flu

• Estimated that 25% of the global population caught the Spanish Flu. Global population then was just over 1 billion.

• Today’s global population is 7.8 billion.

• If Covid infection rate similar to Spanish flu, this could lead to as many as 1.95 billion cases

• If fatality rates remain at current levels (4.84%) , this would then lead to 93.6 million fatalities

• If the fatality rate is closer to 2%, then the expected number of fatalities would be in the region of 49 million.

• That is the potential scale of the problem.


Following slide shows

changes in fatality performance by countries

to April 6th compared with March • Many more countries show a deterioration in

fatalities.

• Improving performance on relatively small countries. Trends are volatile and will change.

• Countries included only where there is a a continuous record of fatalities since early March.

• Global fatality rate continues to rise.

• National fatality rate variations substantial. Some are considerably more effective in saving lives than others.



COUNTRY

Most Recent Fatality

Rate worse or better

than average

COUNTRIES BETTER 18

COUNTRIES WORSE 61

Afghanistan BETTER

Albania WORSE

Algeria WORSE

Andorra WORSE

Argentina WORSE

Armenia WORSE

Aruba

Australia WORSE

Austria WORSE

Azerbaijan BETTER

Bahrain BETTER

Bangladesh BETTER

Belgium WORSE

Bosnia and Herzegovina BETTER

Brazil WORSE

Bulgaria WORSE

Burkina Faso WORSE

Canada BETTER

Chile WORSE

China BETTER

Colombia WORSE

Costa Rica BETTER

Croatia BETTER

Cuba WORSE

Cyprus BETTER

Czech Rep WORSE

Dem Rep of Congo WORSE

Denmark WORSE

Diamond Princess WORSE

Dominican Republic WORSE

Ecuador WORSE

Egypt WORSE

Finland WORSE

France WORSE

Germany WORSE

Ghana BETTER

Greece WORSE

COUNTRY

Most Recent Fatality

Rate worse or better

than average

Hungary WORSE

Iceland WORSE

India WORSE

Indonesia BETTER

Iran BETTER

Iraq BETTER

Ireland WORSE

Israel WORSE

Italy WORSE

Jamaica WORSE

Japan BETTER

Lebanon WORSE

Lithuania WORSE

Luxembourg WORSE

Malaysia WORSE

Netherlands WORSE

North Macedonia WORSE

Norway WORSE

Pakistan WORSE

Panama WORSE

Paraguay BETTER

Peru WORSE

Philippines BETTER

Poland WORSE

Portugal WORSE

Romania WORSE

Russia WORSE

San Marino WORSE

Serbia WORSE

Singapore WORSE

Slovenia WORSE

South Korea WORSE

Spain WORSE

Sweden WORSE

Switzerland WORSE

Taiwan WORSE

Thailand WORSE

Tunisia WORSE

Turkey WORSE

UK WORSE

Ukraine WORSE

United Arab Emirates BETTER

US WORSE

Infection Rates &

Cumulative Covid cases

Hypthetical Pandemic Cycle


0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

4,000,000

-30.00%

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0.00%

10.00%

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Start po

int

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Number of new casesper day

DailyGrowth

Rate

(Assumed)

Time (Days)

Assumed Daily Infection Rates Covid (LHS)and Cumulative cases (RHS)

Assumed Infection Growth rate (LHS)

Cumulative Net number of cases RHS

Summary & Comments

• Model assumes daily growth rates rising to 40%, before dropping back, fairly quickly to lower daily rates (blue line).

• Red line shows the number of new daily cases of Covid.

• Even as the rate of infection declines, so the absolute number of new cases continues to rise

• The situation only improves when the rate of new cases goes to zero, and then starts to fall.

• Note, there are still new cases appearing in China – at a very low rate.

• Negative rates can be thought of as recovery of survivors reducing the overall number of cases


Relevance to actual Covid

• Daily rates of new patients have been in excess of 25%

• This example creates a peak number of patients/cases as 3.5 million

• This is the equivalent of 4.5% of UK’s population. If achieved this would be a good result.

• This scenario plays out over 11 weeks.

• The zig-zag rate of decline is a function of the reducing daily rates.

• Following chart shows development of the cumulative number of cases over the same time period


Regions Defined

• N.America: USA & Canada

• S.America: S.America + Caribbean+Mexico

• Europe: East and West Europe

• CIS: Russia, Ukraine, former parts of the USSR, the “stans” in central Asia, Mongolia

• MENA: Middle East and North Africa. Includes Turkey, Saudi Arabia, Iraq, Syria+ N.Africa

• AsiaPac: All of Asia, and Pacific region. Includes China

• S.Asia: India, Pakistan, Bangladesh, smaller nations in region + Indian Ocean islands

• Africa: Africa south of the Sahara.


On-going issues

with data quality • Most countries have reported Covid cases. Not all of

them have reported consistently (on a daily basis)

• Reporting on fatalities much worse than for the number of cases.

• Difficulties with definitions even in advanced countries. Are COVID deaths outside of hospital included ? Should the right measure be the number of deaths from pneumonia ?

• Are deaths being “correctly” ascribed to Covid 19?

• It is highly likely that both the number of cases and the numbe of fatalities are under-estimates. The true picture is worse than that shown here.


covid 19 performance march 15 to april 21st 2020€¦ · digit ltd, brunel business school, gpi...

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