1. The number of new cases is gradually declining.
As you can see in the chart above, the number of new cases has been steadily decreasing since February 4th (the one sudden increase is due to the change in the diagnostic method introduced by the Hubei province, and not to the actual increase in the number of cases). The total number of suspected cases is also falling. From these two tendencies, it can be concluded that the authorities' efforts to limit the spread of the epidemic are finally beginning to bear fruit and the epidemic is slowly entering the phase of decline. This tendency seems to be noticed by the authorities of Zhejiang Province (one of the most affected by the outbreak), because in many cities in that province, quarantine conditions have been relaxed starting from February 19th. For the last two weeks, the citizens have been locked in their homes and could only go out once every two or three days to shop. The number of exits and body temperature were checked at the exit of their housing estates / buildings (a special form had to be provided on which each exit from the apartment had to be recorded). There was also no public transport (at least buses), and all restaurants, cinemas, etc. were closed. My friends who got stuck in such quarantine in the cities of Hangzhou, Wenzhou and Lishui said that they could finally leave the house yesterday. Local news say that some shops and restaurants have finally opened and the first buses have appeared on the streets. The citizens are cautiously optimistic. People are still afraid, but for the most part the desperate boredom after 2 weeks of house arrest, seems to outweigh the fears.
I must point out however, that while the number of new cases is decreasing in all provinces, the total number of cases in the Hubei province is so high (over 61 thousand cases) that there are still very strict restrictions. Relaxed quarantine measures can be seen in provinces that are not facing such an overwhelming number of cases.
2. Case fatality rate is clearly dependent on the region.
Currently, mortality from the new coronavirus (Covid-19) is estimated to be slightly above 2% on average (data from the Chinese CDC). However, if you look at the case-fatality rate in different territories, there is a very clear relationship:
- Wuhan (the epicentre of the outbreak) – mortality at around 4% (data from Chinese CDC)
- Hubei (Wuhan is in that province) – about 3% mortality (according to data from the government application that monitors the progress of the epidemic 1921 deaths / 61 682 cases – data from 19.02.2020).
- Outside Hubei – mortality around 0.7% (88 deaths / 12,608 cases).
Why such a discrepancy?
One can only speculate, but two explanations are likely:
- In the Hubei province, where up to February 19th 2020 over 61,000 cases have been diagnosed, there are simply no means to provide adequate medical care to such a number of patients. In the first weeks of the epidemic, dramatic testimonies of people appeared in Chinese social media, telling how they tried to find a place in the hospital for their sick relatives and were sent away empty-handed due to the lack of hospital beds. In the remaining provinces, where there are a few to a few hundred cases per city, a whole team of specialists hovers over each patient. In Zhejiang Province, for example, no deaths have been reported so far (until February 19th), even though the number of patients exceeded 1,100. It is worth noting that this is one of the richest (if not the richest) province in China.
- In Hubei, they may not diagnose mild cases (not everyone gets pneumonia from this virus). With thousands of patients, testing everyone with fever for viral RNA is simply impossible. Hence the total number of cases in this province may be underestimated.
General data from the Chinese agency for infectious diseases also indicate that about 80% of fatalities are people over 60 years of age, and 75% suffered from some additional diseases.
One more comment about fatalities, because this is what media use to make the news more catchy, which in result is driving worldwide hysteria.
- So far, 2122 people have died from Covid-19 (data from February 20th). This of course is a terrible tragedy, but we should be aware that at the same time about 10,000 people have already died of influenza in the US (CDC data).
- Influenza fatality rate is reported at about 0.13%.
- Coronavirus mortality outside of Hubei province is around 0.7% so far.
- Mortality rate of SARS, to which the new coronavirus is often compared, is 15% (so it is 20 times higher).
3. The highest incidence and mortality occur among men.
One of the first published reports (when the number of cases did not yet exceed one thousand) showed the number of patients broken down by gender. Surprisingly, over 70% of people diagnosed with Covid-19, are men. Statistically, this is a huge difference. Unfortunately, none of the later reports provided statistics by gender (at least I could not find any).
Again, one can speculate why such a discrepancy in numbers. From what I read, in the case of SARS and MERS (which belong to the same family of viruses as Covid-19) a similar relationship was observed; however, it has not yet been clarified why it occurs. It seems to me that, at least in the current epidemic, a large epidemiological role plays the fact that in China (where most cases occur) the vast majority of men are smokers. Cigarette smoking is culturally grounded. At each official dinner, the host treats guests with cigarettes, and, as expected, it’s not proper to refuse the host. Personally, I know very few Chinese men who don't smoke. However, smoking is rather rare among women, because in China it is perceived as inappropriate for a woman to smoke.
Phew, okay. It was a lot of data. My analytical mind feeds on numbers, so I just had to vent these analyses. As a comment or summary, I will repeat:
- The number of new cases is falling. The epidemic seems to be on the decline.
- Some cities in China (outside Hubei province) are slowly coming back to normal life.
- Covid-19 is not as dangerous as television presents it to be. You must not underestimate the virus, but there is no need for hysteria.