International COVID-19 Megathread

[parochial boy]

800 cases in Switzerland today, the number of cases per day is jumping around all over the place, which is apparently down to the cantons reporting individually and the fact that the OFSP (public health authority) is doing it's reporting using ... a fax machine... in 2020... in one of the richest countries on the planet...

I just don't understand where the stereotype that the Swiss are slow comes from.

At least here in the U.S., the medical and financial industries are the major users because they both deal with private data and it's a lot harder to hack fax machines than computers.

A planned upgrade had been shelved after the Swine flu crisis exposed similar flaws, and at one point this week they were apparently weighing test results to estimate case numbers as the fax machine wasn’t able to keep up. I’m pretty sure is was complacency about the pre-existing system rather than worries about privacy in this case.

[parochial boy]

Nice chart.

Could also be a ranking of how good a country’s healthcare system is.

https://twitter.com/justinwolfers/status/1241102311071645699

I don't think so. The differing death rates at the moment is something that really stands out. On the one hand, you have the likes of the Nordic countries, the Germanic countries or Switzerland where the death rate is hovering around 1% or below. And on the other, you have (forgetting Italy) the Spain, France, UK, the Netherlands a bit; where it is more lie 3% or higher. I mean for sure, the countries in the first groups are generally richer than the second group, but I don't think "healthcare systems" even comes close to making a difference of a factor of 4-5 in terms of death rates. The French system in particular, has always had a very good reputation. So there is clearly more going on here.

And for case numbers, there are obviously other factors at work. Ticino is part of Lombardy, geographically speaking - and hugely economically dependent on it. So Switzerland was always going to walloped from the moment it became obvious what was going on in Italy.

[parochial boy]

But, in an almost unheard of case of a Swiss politician doing something vaguely creative. Alain Berset, did an instagram thing... and now we've got Federer protecting us. All will be well.

[parochial boy]

On that cultural thing - I'm gonna Swisspost, but a funny one that has been picked up here is that within Switzerland it has been the "Latin" cantons that have been far harder hit than the German ones. Ticino obviously, but the French speaking cantons have had virtually half of the cases nationwide despite only 25% of the population. Slight parallels with the worst hit countries in Europe generally being the romance speaking southern European ones.

This has been explained, in the French speaking papers even, as being basically because the latins are crap at following rules and less inclined to "personal responsibility" (and also have a culture that is much more "huggy-kissy" compared to the reserved Germanics - I don't entirely buy this part as the Swiss-Germans absolutely adore organised fun); but also have a greater faith in the state. Which is why calls for the most restrictive measures have almost all come out of French and Italian Switzerland.

So, we're perfectly able to do the "cultural differences" thing even within Europe

[parochial boy]

On that cultural thing - I'm gonna Swisspost, but a funny one that has been picked up here is that within Switzerland it has been the "Latin" cantons that have been far harder hit than the German ones. Ticino obviously, but the French speaking cantons have had virtually half of the cases nationwide despite only 25% of the population. Slight parallels with the worst hit countries in Europe generally being the romance speaking southern European ones.

I think a another factor might be that there are far more Cross-border commuters (per capita in the affected cantons and overall) from France and Italy into Switzerland than from Germany, and the fact that the French and Italian departments/regions that border Switzerland are some of the hardest hit in the entire country while Baden-Württemberg is not really to the same extent.

Potentially, especially around the Basel area with regards to Alsace (and Ticino, obviously) - and there might be a degree of ski-resortism as has been the case with a lot of the Nordic/German cases (a Ski resort in the Valais, Verbier has actually been identified as a massive hot spot for infections). But otherwise, even accounting for differing test rates, Geneva is quite a bit harder hit than Ain or Haute-Savoie, which are the two major frontalier sources. Geneva has over 1'100 cases for a population of 500k; compared to 270 in Haute-Savoie, which has a population of 800k; or 130 in Ain. Vaud is even worse hit, with 1'900, and has much less intense cross-border activity than Geneva since Lausanne is quite far from the border and the actual Vaud-France border region is pretty remote.

And then, the spate of cases in Neuchâtel and the Jura have pretty strong links to that church meeting in Mulhouse. Neuchâtel has a lot of cross-border commuting, but isn't as hard hit as the two larger cantons, and the Valais which has been hit hard has nect to no frontaliers.

[parochial boy]

Another, "are the lockdowns effective?" post. Lodi went in to lockdown on the 24th February and Bergamo did on the 8th of March. Well, draw your own conclusions

[parochial boy]

Switzerland now recording the highest number of cases per capita in the world (but far more testing per capita than France/Spain/Italy so the stats are obviously misleading).

Big controversy here yesterday as it was revealed that both France and Germany have blocked big orders of face masks from China as both countries are blocking all medical exports, apparently including goods in transit. Amazingly, it was the EU that actually came to the rescue, telling Merkel and Macron to sort themselves out and stop bullying landlocked neighbours.

In a rare and unique development, Switzerland even appears to be coming out of this relatively well. While almost every other country in the world has banned medical exports, Switzerland hasn't. Switzerland also conveniently has one of the world's leading producers of artifical respirators - and despite public pressure to follow the Germans and others and ban exports, they are still, rather impressively, prioritising deliveries to Italy even while Switzerland is increasingly worried about a potential shortage of its own.  

[parochial boy]

Is there, um, some explanation of what exactly is going on with the London underground? It's hard not to come to the conclusion that Sadiq Khan is seriously fücking up here, given the now daily update of horrifying pictures of overcrowded tube trains.

[parochial boy]

900 new cases here today. Dropping below the 1'000 mark for the first time in 8 days, and slow pattern of declining numbers since last Friday. Both the OFSP and a few epidemiologists have expressed some cautious optimism that we might be around the peak right now - but it's much too early to be sure. Probably there's a massive surge tomorrow or something.

[parochial boy]

Nice that they can spare a test for a 55 year old middle manager with mild symptoms, but apparently don't have enough available for the NHS personnel at the front line.

[parochial boy]

Ha, surprising how mediocre Switzerland is on both the hospital beds and intensive care beds, despite having, by some distance, the most expensive healthcare system in Europe.

Maybe the private insurance model isn't all it's cracked up to be?

[parochial boy]

Italy down to 5'200 cases today. Hope...

[parochial boy]

Less than 700 cases in Switzerland today, the lowest number of new cases since the 18th of March, even despite testing having been ramped up to around 8'000 a day since then. Day to day numbers are still bouncing around, but there does seem to be some sign of a downward trend; and the authorities are starting to express some cautious optimism that we might be on the way to avoiding the sorts of scenarios that were feared. Not a single hospital is at capacity in terms of Intensive care beds, even in Ticino and Geneva; and there is now some hope that it might be possible to completely avoid that situation arising.

That said, when asked when the lockdowns might end Alain Berset and the OFSP chief Daniel Koch still basically said "It's still too early to make any sort of prediction". I kind of appreciate the honesty actually, unlike the authorities in other countries where people are pulling dates out of their hats and going "oh yeah, it'll be May/July/6 months/December 2023 etc...".

[parochial boy]

Switzerland is counting every COVID-19 related death, regardless of whether it was in a hospital, care home, or at home. Detailed data is being reported by the cantons individually though, which can make numbers seem a bit weird if one of the big ones is a bit behind, or not using the same methodology as the others.

On another note, back to the theme of "are China's numbers accurate?". It's interesting that right now, we have a number of European countries that are probably round about their peak: Italy; probably also Germany, Austria, Switzerland; maybe Belgium; hopefully Spain. All these countries are currently reporting data that jumps around day-to-day - individual days can seem better or worse than the previous, but the overall trend is a sort of straight line increase, or even a slow decline in case numbers and, slightly later on, deaths.

Compare to China, which recorded an almost perfect curve of increasing case numbers followed by a perfectly smooth, day-by-day consistent decline in cases down to almost zero. And this is despite changing their reporting methodology 7 times in the intervening period.

Suspicious much?

[parochial boy]

Switzerland is counting every COVID-19 related death, regardless of whether it was in a hospital, care home, or at home. Detailed data is being reported by the cantons individually though, which can make numbers seem a bit weird if one of the big ones is a bit behind, or not using the same methodology as the others.

On another note, back to the theme of "are China's numbers accurate?". It's interesting that right now, we have a number of European countries that are probably round about their peak: Italy; probably also Germany, Austria, Switzerland; maybe Belgium; hopefully Spain. All these countries are currently reporting data that jumps around day-to-day - individual days can seem better or worse than the previous, but the overall trend is a sort of straight line increase, or even a slow decline in case numbers and, slightly later on, deaths.

Compare to China, which recorded an almost perfect curve of increasing case numbers followed by a perfectly smooth, day-by-day consistent decline in cases down to almost zero. And this is despite changing their reporting methodology 7 times in the intervening period.

Suspicious much?

When do you think France's peak will be?

I did notice France does not appear on your list while virtually every other european country does

No idea, I'm just going with what media/government officials seem to be insinuating. France seems to have had few times where it looks like things are stabilising before another surge in cases. I've nowhere near enough knowledge or expertise to be able to judge what is going on there - like that big surge on Tuesday, could just be a degree of catch up with the EHPAD situation?

The UK's case numbers are still growing pretty rapidly. And the Netherlands data looks iffy, not many cases but lots of deaths - and I haven't heard anything about them having ICU capacity issues like has been the case in the other countries with higher seeming death rates.

[parochial boy]

Not sure if this has been getting coverage elsewhere - but there has been talk about this new cross European effort to develop a mobile app that could help end slow transmission, and eventually even help end the lockdowns and restore some semblance of normality. Apparently, it would allow people to report whether they were experiencing Covid symptoms, and would anonymously alert anyone who had been in contact with them over the last X number of days (based Bluetooth connections), who would then be able to self-isolate as necessary.

The thing is called PEPP-PT, is apparently GDPR compliant, and would be aimed to be released by the end of next week.

[parochial boy]

Pretty horrifying news out of the UK. Sounds like it could be turning into the next Italy or Spain. Possibly an even bigger display of political incompetence given they knew what was coming and yet still chose to sit on their hands for two weeks.

[parochial boy]

Big news in Berlin today is that the Trump administration orchestrated the theft of 200,000 face-masks destined for the Berlin Police department from Thailand. Swift condemnation by the mayor of Berlin (see tweet below). The state interior minister called it an act of piracy.

https://twitter.com/RegBerlin/status/1246076088578502659

I saw that too. Genuinely couldn't believe what I was reading. The French have actually been complaining about a similar thing today.

I think the absolute disgust that people have had towards the behaviour of the US during this crisis is going to have some rather interesting repercussions in regards to the US's global position and influence in the near future.

[parochial boy]

Love the collective outrage in Germany about this one. We did the same thing to the Swiss and Austrians, and nobody cared. Actually what we did was worse, because we were stealing shipments intended from China to Switzerland, while the Americans stopped one of their own firms from exporting. Turns our if we ban exports, other countries will stop their companies from doing it too. Sad!

Ahem, I complained at the time, and I'm not any less digusted by this

Big controversy here yesterday as it was revealed that both France and Germany have blocked big orders of face masks from China as both countries are blocking all medical exports, apparently including goods in transit. Amazingly, it was the EU that actually came to the rescue, telling Merkel and Macron to sort themselves out and stop bullying landlocked neighbours.

Big difference is that that stuff was transiting through Germany, and in a somewhat unusual case of me defending your country, at least the German customs could make some sort of excuse about it being an honest mistake over the confusion over the export ban stuff that was going on at the time. And the stuff was actually released in the end - surprised credit to the EU on that one.

This looks like a much more straightforward case of abuse of power and theft. If you want control of medical supplies made by your companies then don't build them abroad. Especially when the actual manufacturer was almost certainly something like 3M Thailand Inc, and a company actually registered in Thailand.

[parochial boy]

Meanwhile, Germany’s numbers on cases and deaths are becoming more and more comparable with ours on a per capita basis, if you divide them by 9.

(German growth rates are now slightly higher than ours on both measures, so they are „catching“ up.)

Switzerland on the other hand is more a mix of Germany/Austria and France ...

Done a lot more testing here, per capita. But also a less strict lockdown which was brought in a couple of days later and, for obvious reasons, Switzerland was far, far more exposed to the outbreak in Lombardy than either Austria or Germany, or basically anywhere else in the world for that matter. In particular Ticino, which is has only 4% of the population, but is also by far the oldest canton (23% over 65 years old - higher than Italy), and has 12% of the cases and over 25% of the deaths.

We also had a few hiccoughs at the start of the crisis when the insurers tried to refuse to pay for the tests, which led to some precious time being lost - yet another advantage of the miraculous "private insurance" system.

The important thing is that there are signs of a slow decline in case numbers and we are starting to see a decline in the number of people in intensive care - so there is a fair amount of optimism that we aren't going to have a French or Italian style situation where the healthcare system is overwhelmed.

[parochial boy]

First day under 600 new cases yesterday, and a drop on deaths too. A weekend effect, but the numbers are still well below the last two weekends.

We've started having discussions about "when do we open up" again, by which I mean the (who else?) SVP have been whining (what else?) about it. By which I mean, Magdalena Martullo-Blocher (Christoph's daughter, obviously), the Graubünden MP who refuses to live there, has been whining because the multinational she owns is losing money. There is, again, a cultural divide, the Romand politicians shooting down any attempts to open things up again. A Vaud UDC/SVP politician was even heard saying something along the lines of "those stupid Germans care more about their wallets than our health", so some divisions in that party bubbling up.

[parochial boy]

But these proposed "Corona-Bonds" are something else entirely. They are, yes, common Bonds guaranteed by all Euro countries, but they would not affect Debt currently held by Italy (which would remain their exclusive responsibility) nor would they affect any future debts incurred by the spending of their national governments (which would also remain their responsibility). The money borrowed would only cover healing the damage caused to Europe (esp. IT and ES) through this Virus, something those Countries would not be able to do, because Bonds guaranteed solely by their Governments would have unsustainable BBB or so interest rates, which they cannot afford. And, crucially, the Money would not be spent by their Governments, but by the EU commission, which is of course led by a conservative German woman. Germans will not trust Italian politicans, but we should be able to trust one of our own, surely? Lastly, one of the main reasons why many people here were unhappy about Eurobonds back in the day, was because it was seen as bailing out Countries, who (or rather who's politicians) were at least partially responsible for the mess they created. A view that probably had at least a degree of legitimacy. No one, I think, would suggest that this is the case this time round.  

Which really makes it quite hard for any sort of moral justification to oppose them. What's the issue for the Netherlands, really? A marginally higher interest rate on their own debt, coupled with the risk of eventually having to cough up for and Italian/Spanish bail out? I mean, what does Mr Rutte think the impact on his own economy that the break-up of the Eurozone, even the EU would be? Does he think that Amazon and Unilever and all those other nice companies that use his country to siphon money off to the Cayman Islands would be so happy and friendly if suddenly there were capital controls on money coming into the Netherlands from all of these much larger markets?

The thing that I am holding out on is that at least there has been some sort of an intellectual sea change on the question. When you have a guy like Michael Hüther publically revising his opinion; or even a newspaper like the Neue Zürcher Zeitung (not a friend of fiscal profligacy, or the EU for that matter), starting to criticise the frugal four then you are starting to run out of an intellectual justification for your insistance. At the very least, if Spain and Italy and France keep up the pressure then there might be some compromise over very low interest loans decoupled from any conditions.

[parochial boy]

Government here has said they will start to ease the restrictions starting from the 26th of April. They will be determing a plan to gradually ease things up next week. Is it too early? It feels a bit early, we'll see.

[parochial boy]

Just updating today's data with new predictive graphs. Sunday is pretty quiet, so I will do it again on Monday.

UK



April 11 UK Active Case Curve - Predicted peak of 77,072 Active Cases on April 18

First things first. I have added 8,200 recoveries to the UK data.

I looked at the 'Total Cases' 14 days ago on 28 March 2020 which was 17,089. Since then, these cases have either recovered or died. Given that 8,856 patients have died since 28 March, I have added the difference (8,200) as recoveries.

What does this say about the reported UK data?

It says the numbers are most likely missing something. It is highly unlikely that 50% of a normal population of cases tested on March 28 have died according to the data reported.

Hence the UK dataset needs to be looked at more carefully over time. My suspicion is that if the mortality numbers are correct, then:

• the initial reported cases are under-representative of wider community spread; and
• they are only testing really sick people.

One flaw with this logic is the underlying assumption that all of the deaths since March 28 are people who had tested positive by March 28. While it takes at least a couple of weeks from infection to death, it's a flawed assumption that you have two weeks from a positive test until death. Probably a lot of the deaths are people who got tested when already very sick and died within a few days of testing, if not almost immediately or even whose positive results weren't reported until after they died, which does improve the survival rate of people who had tested positive by March 28.

It is obvious that the UK is not testing anyone but very, very sick patients, though. I do question the logic of this; there doesn't seem to be much value to knowing whether a patient in the ICU in respiratory distress has coronavirus. At this point, it's basically guaranteed that they do. Testing should be focused much more on mild cases where the flu, the common cold, allergies, etc. are also plausible causes and oriented away from hospital emergency rooms. (This also goes for the US, where at least here in NYC the approach on testing is similar.)

I was told by an NHS doctor this evening that the UK is only testing patients who need to be hospitalized. They are also currently only counting hospital deaths, which makes a future catch up as happened in France likely at some point soon. And to top it off, the data on fatalities is already several days old by the time it is actually reported.

The UK’s political management of this has been alarmingly bad, which is all the more unforgivable seeing as not being so exposed to the Italian outbreak gave them a couple of weeks longer to prepare than most of Italy’s close neighbours did.

[parochial boy]

Looks like an exit plan has been prepared for Switzerland too, that will be formalised tomorrow:

 - Hairdressers, Physiotherapists, Garden Centres and DIY stores can open on the 27th April, providing they respect existing social distancing measures. Hospitals will start elective surgeries again

 - "partial schools re-openings" as well as markets and other shops on the 11th of May

 - libraries, museums and zoos should be allowed to re-open on the 8th of June.

There is still no planned date for the return of large public events, or when restaurants/bars can reopen, which could mean the summer festival season is stone dead.