COVID-19: going global?


28th February 2020


COVID-19 isn’t going away quickly, and the developments over the next two weeks will move towards either a pandemic or global containment.

There are now almost 84,000 cases reported worldwide, with around 5,000 outside of mainland China. Aside from China, there are now established transmission clusters in several different countries including Japan and northern Italy. Cases are popping up in many European countries, and there’s a sense that we’re moving towards a pandemic. On the other hand, WHO are making positive noises about containment, which seems to be their strategy currently.

There’s been an explosion of science around COVID-19, with hundreds of papers now published – that’s not to mention all the good stuff out in the public domain on pre-print servers. A key paper published recently is a clinical overview from more than 72,000 patients with COVID-19 in China. This paper cites a case-fatality rate (CFR) of 2.3% overall, but a considerably higher CFR in certain patient groups (e.g. 15% in those aged over 80).

We are learning a lot about the transmission dynamics of COVID-19 from the cruise ship outbreaks. For example, this paper performs a near-real-time modelling study to predict the outcome of the COVID-19 outbreak aboard the Diamond Princess cruise ship. In the end, 705 of the 3,711 people aboard (almost 20%) contracted the virus aboard the ship, which certainly questions the decision to quarantine those aboard.

Overall, the evidence suggests that COVID-19 is less deadly but more transmissible than the SARS coronavirus. It’s difficult to predict where this outbreak will end – but there’s a well-written piece in The Atlantic making the case that the SARS-CoV-2 (the virus that causes COVID-19) is likely to become one of the common circulating coronaviruses and most of us will become infected at some stage. Whilst this is a scary thought, most cases are mild and many asymptomatic.

COVID-19 isn’t going away quickly, and the developments over the next two weeks will move towards either a pandemic or global containment.

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