dotlah! dotlah!
  • Cities
  • Technology
  • Business
  • Politics
  • Society
  • Science
  • About
Social Links
  • zedreviews.com
  • citi.io
  • aster.cloud
  • liwaiwai.com
  • guzz.co.uk
  • atinatin.com
0 Likes
0 Followers
0 Subscribers
dotlah!
  • Cities
  • Technology
  • Business
  • Politics
  • Society
  • Science
  • About
  • Society

How Big Will The Coronavirus Epidemic Be? An Epidemiologist Updates His Concerns

  • March 11, 2020
Total
0
Shares
0
0
0

The Harvard historian Jill Lepore recounted recently in The New Yorker magazine that when democracies sink into crisis, the question “where are we going?” leaps to everyone’s mind, as if we were waiting for a weather forecast to tell us how healthy our democracy was going to be tomorrow. Quoting Italian philosopher Benedetto Croce, Lepore writes that “political problems are not external forces beyond our control; they are forces within our control. We need solely to make up our own minds and to act.”

A security guard wears gloves while holding a basketball during halftime of an NBA game in Houston on March 5, 2020. The NBA has told players to avoid high-fiving fans and to avoid taking any item for autographs. AP Photo/David J. Phillip

And so it is with the coronavirus epidemic. How big will this epidemic be? How many people will it infect? How many Americans will die? The answers to these questions are not written in stone. They are partially within our control, assuming we are willing to take the responsibility to act with commitment, urgency and solidarity.

I am an epidemiologist with eight years of field experience, including time on the front lines of the isolation and quarantine efforts during the 2009 swine flu pandemic. One month ago, I was under the impression that the death reports due to COVID-19 circulation in China were giving us an unfair picture of its mortality rate. I wrote a piece saying that the death rate of an emerging disease always looks bad in the early stages of an outbreak, but is likely to drop once better data become available. After waiting for eight weeks, I am now worried that these new data – data indicating that the virus has a low fatality rate – may not arrive.

Young passengers wear masks on a high-speed train in Hong Kong, Wednesday, Jan. 22, 2020. At that time, it was hard to know how dangerous the virus would be. (AP Photo/Kin Cheung) AP Photo/Kin Cheung

Case fatality rate and infection fatality rate

By Jan. 31 2020, China had reported a total of 11,821 cases of COVID-19 and 259 deaths; that’s about a 2% case fatality rate. Two weeks later, the tally had risen to more than 50,000 cases and 1,524 deaths, corresponding to about 3% case fatality (the rise in the case fatality is expected as deaths always get counted later than cases). For an easily transmissible disease, a 2% or 3% fatality rate is extremely dangerous.

However, case fatality rates are computed using the officially reported numbers of 11,821 cases or 50,000 cases, which only include individuals who (a) experience symptoms; (b) decide that their symptoms are bad enough to merit a hospital visit; and (c) choose a hospital or clinic that is able to test and report cases of coronavirus.

Surely, there must have been hundreds of thousands cases, maybe a million cases, that had simply gone uncounted.

First, some definitions from Steven Riley at Imperial College. The infection fatality rate (IFR) gives the probability of dying for an infected person. The case fatality rate (CFR) gives the probability of dying for an infected person who is sick enough to report to a hospital or clinic. CFR is larger than IFR, because individuals who report to hospitals are typically more severely ill.

If China’s mid-February statistic of 1,524 deaths had occurred from 1 million infections of COVID-19 (counting all symptomatic and asymptomatic infections), this would mean that the virus had an infection fatality rate of 0.15%, about three times higher than seasonal influenza virus; this is a concern but not a crisis.

The IFR is much more difficult to estimate than the CFR. The reason is that it is hard to count people who are mildly ill or who show no symptoms at all. If you are able to count and test everybody – for example, on a cruise ship, or in a small community – then you may be able to paint a picture of what fraction of infections are asymptomatic, mild, symptomatic and severe.

Scientists working at the London School of Hygiene and Tropical Medicine, Imperial College London and the Institute for Disease Modeling have used these approaches to estimate the infection fatality rate. Currently, these estimates range from 0.5% to 0.94% indicating that COVID-19 is about 10 to 20 times as deadly as seasonal influenza. Evidence coming in from genomics and large-scale testing of fevers is consistent with these conclusions. The only potentially good news is that the epidemic in Korea may ultimately show a lower CFR than the epidemic in China.

A quarantined cruise ship in Japan at the Yokohama Port in Yokohama, near Tokyo, Feb. 9, 2020. Cruise and airline bookings are down as a result of the coronavirus. AP Photo/Eugene Hoshiko

Impact of the epidemic in the US

Now that new COVID-19 cases are being detected in the U.S. every day, it is too late to stop the initial wave of infections. The epidemic is likely to spread across the U.S. The virus appears to be about as contagious as influenza. But this comparison is difficult to make since we have no immunity to the new coronavirus.

On balance, it is reasonable to guess that COVID-19 will infect as many Americans over the next year as influenza does in a typical winter – somewhere between 25 million and 115 million. Maybe a bit more if the virus turns out to be more contagious than we thought. Maybe a bit less if we put restrictions in place that minimize our travel and our social and professional contacts.

The bad news is, of course, that these infection numbers translate to 350,000 to 660,000 people dying in the U.S., with an uncertainty range that goes from 50,000 deaths to 5 million deaths. The good news is that this is not a weather forecast. The size of the epidemic, i.e., the total number of infections, is something we can reduce if we decrease our contact patterns and improve our hygiene. If the total number of infections decreases, the total number of deaths will also decrease.

What science cannot tell us right now is exactly which measures will be most effective at slowing down the epidemic and reducing its impact. If I stop shaking hands, will that cut my probability of infection by a half? A third? Nobody knows. If I work from home two days a week, will this reduce my probability of infection by 40%? Maybe. But we don’t even know the answer to that.

What we should prepare for now is reducing our exposures – i.e., our chances of coming into contact with infected people or infected surfaces – any way that we can. For some people this will mean staying home more. For others it will mean adopting more stringent hygiene practices. An extreme version of this exposure reduction – including mandatory quarantine, rapid diagnosis and isolation, and closing of workplaces and schools – seems to have worked in Hubei province in China, where the epidemic spread appears to have slowed down.

For now, Americans need to prepare themselves that the next 12 months are going to look very different. Vacations may have to be canceled. Social interactions will look different. And risk management is something we’re going to have to think about every morning when we wake up. The coronavirus epidemic is not going to extinguish itself. It is not in another country. It is not just the cold and flu. And it is not going away.

The Conversation

Maciej F. Boni, Associate Professor of Biology, Pennsylvania State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Total
0
Shares
Share
Tweet
Share
Share
Related Topics
  • Coronavirus
  • COVID-19
  • SARS
  • SARS-CoV-2
majulah

Previous Article
  • Cities
  • People

What Do Smart Cities Mean For Healthcare And Nursing?

  • March 11, 2020
View Post
Next Article
  • People
  • World Events

How Big Will The Coronavirus Pandemic Be? An Epidemiologist Updates His Concerns

  • March 11, 2020
View Post
You May Also Like
View Post
  • Cities
  • Lah!
  • Society

NUS Computing Establishes Sea Olympiad Scholarship To Attract And Nurture Top Talents In Computer Studies

  • dotlah.com
  • February 27, 2022
View Post
  • Cities
  • Lah!
  • Society

Joint Study: Diverse Leadership Brings Better Firm Performance

  • dotlah.com
  • February 23, 2022
View Post
  • Lah!
  • Society

Community And Mentorship Help Women Entrepreneurs Thrive

  • dotlah.com
  • November 23, 2021
View Post
  • Lah!
  • Society

ST Engineering Champions Employee Wellness, Raises Funds For Charity And Launches Women Support Group

  • dotlah.com
  • November 14, 2021
View Post
  • Lah!
  • Society

NUS Honours 40 Alumni For Outstanding Contributions To Alma Mater And Society

  • dotlah.com
  • November 7, 2021
View Post
  • Cities
  • Lah!
  • Society

The COVID-19 Pandemic Has Made Many Singaporeans Adopt Better Financial Habits

  • dotlah.com
  • November 3, 2021
View Post
  • Lah!
  • Society

A Cleaning Revolution: How JCS-Echigo Partnered A*STAR To Clean Faster And Smarter

  • dotlah.com
  • October 16, 2021
View Post
  • Lah!
  • Society

Singapore 100 Women In Tech 2021

  • dotlah.com
  • October 16, 2021


Trending
  • 1
    • Technology
    5 New IMDA Initiatives You Should Know About
    • March 24, 2020
  • 2
    • People
    • World Events
    How To Cope With The Mental Health Effects Of Social Distancing For COVID-19
    • April 4, 2020
  • 3
    • Technology
    NTUC Income Launches SNACK, Singapore’s First Bite-sized, Stackable Insurance That Seamlessly Integrates Into Daily Lifestyle Activities
    • June 16, 2020
  • 4
    • Cities
    • Lah!
    Three-Door Buses To Roll Out In The Streets of Singapore
    • May 4, 2019
  • 5
    • Society
    How Can We Actually Create Happy Societies?
    • December 17, 2019
  • 6
    • Lah!
    • Technology
    Age Is No Barrier To Digitalising
    • June 23, 2021
  • LunaRing 7
    • Gears
    • Technology
    Noise Unveils Next-Gen Wearables at CES 2025; Showcases Luna Ring Gen 2 and Noise ColorFit Pro 6 Series
    • January 7, 2025
  • driver-car-dog-cdc-A82PSKGx9cI-unsplash 8
    • Cities
    4 Tips To Help You Prepare For Your Driver’s License Test
    • October 30, 2021
  • Cloud platforms among the clouds 9
    • Computing
    • Public Cloud
    • Technology
    Best Cloud Platforms Offering Free Trials for Cloud Mastery
    • December 23, 2024
  • 10
    • Lah!
    • Society
    Singapore And Brunei Successfully Conclude 24th Edition Of Exercise Maju Bersama
    • February 8, 2020
  • 11
    • Cities
    • Technology
    UOB Gears Up Green Financing With U-Drive, An Integrated Value Chain Solution For The Electric Vehicle Ecosystem
    • September 19, 2021
  • 12
    • Cities
    NParks completes Phase One Of The Round Island Route With 75km Of Recreational Connection Stretching Across Eastern Half Of Singapore
    • January 31, 2022
Trending
  • Smart Watch 1
    Best Smartwatches, Your Gateway to Health Monitoring and Everyday Use
    • October 5, 2025
  • Cooking pots and pans 2
    Best Pots and Pans 2025: All-Season, All-Purpose Picks for Every Kitchen
    • September 23, 2025
  • 3
    Politicians love comparing NZ’s economy to Singapore or Ireland – but it’s simplistic and misleading
    • September 21, 2025
  • Kitchen Knives - Best All-Around Picks in 2025 4
    Kitchen Knives : The Surgeons of Cooking – Best All-Around Picks in 2025
    • September 15, 2025
  • 5
    Apple unveils iPhone 17 Pro and iPhone 17 Pro Max, the most powerful and advanced Pro models ever
    • September 9, 2025
  • 6
    Apple debuts iPhone 17
    • September 9, 2025
  • Fruits and vegetables for cooking. For food processors. 7
    Food Processor: The Swiss Army Knife of the Kitchen – Best All-Around Picks in 2025
    • September 8, 2025
  • 8
    Meet Samsung Galaxy Tab S11 Series: Packing Everything You Expect From a Premium Tablet
    • September 4, 2025
  • 9
    Malaysia’s ‘ASEAN Shenzhen’ needs some significant legal reform to take off — here’s how
    • August 25, 2025
  • French Fries 10
    Air Fryer: The One Cooking Appliance to Rule Them All – Best All-Around Picks in 2025
    • August 22, 2025
Social Links
dotlah! dotlah!
  • Cities
  • Technology
  • Business
  • Politics
  • Society
  • Science
  • About
Connecting Dots Across Asia's Tech and Urban Landscape

Input your search keywords and press Enter.