Leader of WHO’s new pandemic hub: Improve data flow to extinguish outbreaks

Former Nigeria CDC leader Chikwe Ihekweazu talks with Nature about the COVID crisis, and strengthening global response to future public-health emergencies...

What are the biggest problems you hope to fix — and why do you want to solve them at the WHO?

‘I want to make the mechanics of reporting disease-related information easier, and also demonstrate that the WHO can use that data to help countries that share it. One way to do that is to enable countries to derive value from their own data.

‘I wouldn’t want to do this at a venue other than the WHO. I know that different countries are creating hubs, as are some big donors. They may be able to analyse publicly available data, but they won’t have the same access to information from countries that the WHO does. Speaking as the current director of the Nigeria CDC, I can tell you that I wouldn’t share my data openly with a hub located in another country. We share our data with the WHO without worry because the WHO belongs to us and other countries as a member-state organization, and has a mandate from countries to monitor health risks and coordinate the response in health emergencies.’

Read here (Nature, Sept 21, 2021)

WHO starts data-sharing effort to prevent pandemics. Will nations cooperate?

‘WHO Hub for Pandemic and Epidemic Intelligence opens in Berlin backed by initial US$100 million from Germany. It aims to pool global disease data, and produce tools to predict outbreaks – but is reliant on countries taking part.’

Read here (South China Morning Post, Sept 3, 2021)

Three new estimates of India’s all-cause excess mortality during the Covid-19 pandemic

‘India lacks an authoritative estimate of the death toll from the COVID-19 pandemic. We report excess mortality estimates from three different data sources from the pandemic’s start through June 2021. 

‘First, extrapolation of state-level civil registration from seven states suggests 3.4 million excess deaths. Second, applying international estimates of age-specific infection fatality rates (IFR) to Indian seroprevalence data implies a higher toll of around 4 million. Third, our analysis of the Consumer Pyramid Household Survey, a longitudinal panel of over 800,000 individuals across all states, yields an estimate of 4.9 million excess deaths. 

‘Each of these estimates has shortcomings and they also diverge in the pattern of deaths between the two waves of the pandemic. Estimating COVID-deaths with statistical confidence may prove elusive. But all estimates suggest that the death toll from the pandemic is likely to be an order of magnitude greater than the official count of 400,000; they also suggest that the first wave was more lethal than is believed. Understanding and engaging with the data-based estimates is necessary because in this horrific tragedy the counting—and the attendant accountability—will count for now but also the future.’

Read here (Centre for Global Development, Jul 20, 2021)

What we should do to get a good grip on Covid-19 – P Gunasegaram

‘Can the reported number of Covid-19 cases be manipulated? Is it being done? The short answer to the first question is, yes. For the second question, you get to decide after looking at the data. But whichever way you vote, there can be no argument against keeping politics out of Covid-19 – that is absolutely essential for success in beating back the pandemic.

‘Given the constantly high number of daily Covid-19 cases, it is not at all surprising that the movement control order (MCO) has been extended. But what is surprising is that the numbers have stayed steadily well above 5,000 infections per day despite a lockdown of nearly four weeks. Why is that?

‘What the strict MCO over four weeks has done is severely restrict movement within the community, but daily infections are still resistant to moving below the 5,000 figure. That is a clear indication that the source is elsewhere than the broad community – perhaps factories and the manufacturing sector, which are still allowed to operate? Some are pointing to easy approvals for some industries to open.’

Read here (The Vibes, July 8, 2021)

Why the pandemic experts failed: We’re still thinking about pandemic data in the wrong ways

‘Not until early May, when the CDC published its own deeply inadequate data dashboard, did we realize the depth of its ignorance. And when the White House reproduced one of our charts, it confirmed our fears: The government was using our data. For months, the American government had no idea how many people were sick with COVID-19, how many were lying in hospitals, or how many had died. And the COVID Tracking Project at The Atlantic, started as a temporary volunteer effort, had become a de facto source of pandemic data for the United States.

‘After spending a year building one of the only U.S. pandemic-data sources, we have come to see the government’s initial failure here as the fault on which the entire catastrophe pivots. The government has made progress since May; it is finally able to track pandemic data. Yet some underlying failures remain unfixed. The same calamity could happen again.

‘Data might seem like an overly technical obsession, an oddly nerdy scapegoat on which to hang the deaths of half a million Americans. But data are how our leaders apprehend reality. In a sense, data are the federal government’s reality. As a gap opened between the data that leaders imagined should exist and the data that actually did exist, it swallowed the country’s pandemic planning and response.’

Read here (The Atlantic, Mar 16, 2021)

Multitude of coronavirus variants found in the US — but the threat is unclear

‘For the scientists who have spent the past year poring over hundreds of thousands of coronavirus genomes, the United States has been an enigma. Despite having world-leading genome sequencing infrastructure and experiencing more COVID infections than any other country, the United States has until recently lagged far behind in sequencing coronavirus genomes and spotting worrisome variants.

‘But in recent weeks, US researchers have identified a host of new variants, including in California, New York State, Louisiana and elsewhere. And they are continuing to ramp up SARS-CoV-2 sequencing efforts.

‘That has brought another challenge: making sense of the variants that are discovered. They carry potentially worrying mutations and might be becoming more common, but a dearth of data on how the variants are spreading means the threat they pose is unclear.’

Read here (Nature, Mar 6, 2021)

Peter Doshi: Pfizer and Moderna’s “95% effective” vaccines—we need more details and the raw data

Peter Doshi: Pfizer and Moderna’s “95% effective” vaccines—we need more details and the raw data 

‘Five weeks ago, when I raised questions about the results of Pfizer’s and Moderna’s covid-19 vaccine trials, all that was in the public domain were the study protocols and a few press releases. Today, two journal publications and around 400 pages of summary data are available in the form of multiple reports presented by and to the FDA prior to the agency’s emergency authorization of each company’s mRNA vaccine. While some of the additional details are reassuring, some are not. Here I outline new concerns about the trustworthiness and meaningfulness of the reported efficacy results...’

Read here (BMJ, Jan 4, 2021) 

Spain to keep register of those who refuse Covid vaccine

‘Spain is to set up a register of people who refuse to be vaccinated against coronavirus and share it with other European Union nations, the health minister has said. Salvador Illa said the list would not be made accessible to the public or to employers. He said the way to defeat the virus was "to vaccinate all of us - the more the better".

Read here (BBC, Dec 29, 2020)

Coronavirus antibody tests have a mathematical pitfall

‘...such [antibody] tests have been proposed as a way for individuals to find out if they have already been infected with the novel coronavirus. But a mathematical wrinkle makes these tests—and in fact, all screening tests—hard to interpret: even with a very accurate test, the fewer people in a population who have a condition, the more likely it is that an individual's positive result is wrong. If it is, people might think they have the antibodies (and thus may have immunity), when in fact they do not.

‘A positive screening test result for other diseases usually prompts follow-up testing to confirm a diagnosis. But for COVID-19 screening, such follow-up has been rare because testing resources are scarce or because other testing methods are prioritized for the sickest patients. Here's a look at the massive impact infection rates can have on the predictive value of these tests for individuals.’

Read here (Scientific American, July 2020, pre-published in June 19, 2020)

What is the true death toll of the pandemic?

‘At least another 130,000 people worldwide have died during the coronavirus pandemic on top of 440,000 officially recorded deaths from the virus, according to BBC research. A review of preliminary mortality data from 27 countries shows that in many places the number of overall deaths during the pandemic has been higher than normal, even when accounting for the virus.’

Read here (BBC, June 19, 2020)

K number: What is the coronavirus metric that could be crucial as lockdown eases?

‘K sheds light on the variation behind R. “Some [infectious] people might generate a lot of secondary cases because of the event they attend, for example, and other people may not generate many secondary cases at all,” said Dr Adam Kucharski, an expert in the dynamics of infectious diseases at the London School of Hygiene and Tropical Medicine. “K is the statistical value that tells us how much variation there is in that distribution.” But unlike R, K numbers are not intuitive. “The general rule is that the smaller the K value is, the more transmission comes from a smaller number of infectious people,” said Kucharski.’

Read here (The Guardian, June 1, 2020)

Nobel laureate Michael Levitt on the lockdowns: “I think it is a huge mistake”

‘Q: What’s your view of the lockdown policy that so many European countries and states in America have introduced?

‘A: I think it is a huge mistake. I think we need smart lockdowns. If we were to do this again, we would probably insist on face masks, hand sanitizers, and some kind of payment that did not involve touching right from the very beginning. This would slow down new outbreaks and I think that for example they found as I understand, that children, even if they’re infected, never infect adults, so why do we not have children at school? Why do we not have people working? England, France, Italy, Sweden, Belgium, Holland, are all reaching levels of saturation that are going to be very, very close to herd immunity — So that’s a good thing. I think the policy of herd immunity is the right policy. I think Britain was on exactly the right track — before they were fed wrong numbers and they made a huge mistake.’

Read here (AIER, May 31, 2020)

How fear, groupthink drove unnecessary global lockdowns

‘New York City reached over a 25% infection rate and yet 99.98% of all people in the city under 45 survived, making it comparable to death rates by normal accidents. But of course the whole linchpin of the lockdown argument is that it would have been even worse without such a step. Sweden never closed down borders, primary schools, restaurants, or businesses, and never mandated masks, yet 99.998% of all their people under 60 have survived and their hospitals were never overburdened. Why did we lock down the majority of the population who were never at significant risk? What will be the collateral damage? That is what this series will explore.’

Read here (Real Clear Politics, May 21, 2020)

Unusual symptoms of coronavirus: What we know so far

‘While most people are familiar with the hallmark symptoms of COVID-19 by now—cough, fever, muscle aches, headaches and difficulty breathing—a new crop of medical conditions are emerging from the more than 4 million confirmed cases of the disease around the world.

‘These include skin rashes, diarrhea, kidney abnormalities and potentially life-threatening blood clots. It’s not unusual for viruses to directly infect and affect different tissues and organs in the body, but it is a bit unusual for a primarily respiratory virus like SARS-CoV-2, which is responsible for COVID-19, to have such a wide-ranging reach in the body.’

Read here (Time Magazine, May 19, 2020)

How has Vietnam, a developing nation in South-East Asia, done so well to combat coronavirus?

Key points: Despite sharing a border with China, Vietnam has reported less than 300 cases. Experts believe that Vietnamese coronavirus caseload statistics are accurate. Success has been attributed to aggressive testing, contact tracing and public messaging

Read here (ABC News, May 13, 2020)

Global coronavirus death toll could be 60% higher than reported

‘To calculate excess deaths, the FT has compared deaths from all causes in the weeks of a location’s outbreak in March and April 2020 to the average for the same period between 2015 and 2019. The total of 122,000 amounts to a 50 per cent rise in overall mortality relative to the historical average for the locations studied.’

Read here (Financial Times, April 26, 2020)

Coronavirus is accelerating eight challenging mega trends

‘...be in no doubt, as the long days at home seem to pass ever so slowly: in its effect on societies, politics and the distribution of power in the world, COVID-19 is on track to be the Great Accelerator.’

1. Eurozone existential crisis: ‘To put it crudely, Italians will not work as productively as Germans, and Germans will not agree to pay off the debts of Italians.’ 
2. Trans-Pacific tensions: ‘...the process of “deglobalisation” - more of what we consume being made closer to home, even if it is more expensive - will accelerate.
3. Greater rise of the Asian tigers: ‘[Asia] was already going to account for 90 per cent of new middle-class people in the next decade. Perhaps we can revise that up to 95 per cent now.’
4. Oil price volatility: ‘Countries dependent on oil production already faced forecasts that petroleum demand would peak and fall before 2030.’ We have in recent days seen negative oil prices.
5. Politics of inequality: ‘It will push to the forefront of politics fundamental issues about the taxation of wealth, the case for basic incomes provided by governments, and the responsibility of companies for their employees.’
6. Debts: ‘Political parties will campaign for debt forgiveness and write-offs, and for the cancelling by central banks of money borrowed by governments, with inflationary consequences.’
7. Data: ‘Once we are all carrying around an app on our phones to show where we have been and who we have met, pressure will grow to use that information for other purposes.’
8. Crisis as the mother of innovation: ‘More optimistically, they have one positive companion - the massive incentive this crisis provides for innovation’

Read here (The Age, April 21, 2020)

China to reveal a key virus data point: People with no symptoms

‘China’s government indicated it will start releasing data on how many people are infected with coronavirus but don’t have symptoms, seemingly responding to a growing chorus of domestic and international criticism of China’s data on the outbreak.’

Read here (Bloomberg, March 30, 2020)

South Korea amassed the world’s most comprehensive coronavirus data. What it’s taught us so far

“South Korea’s data is valuable, in part, because it provides a stark warning to the world that there are likely far more young and asymptomatic carriers of the coronavirus than are currently being tallied, especially in countries like the U.S. that are suffering from ongoing testing shortages.

“As of March 14, South Korea reported that nearly 30% of its confirmed coronavirus cases were in patients ages 20 to 29. In Italy, by comparison, 3.7% of coronavirus patients fell into that age range, according to a report from Andreas Backhaus, a research fellow at the Centre for European Policy Studies.”

Read here (Fortune, March 19, 2020)

Coronavirus: Why you must act now -- Politicians, community leaders and business leaders: What should you do and when?

This article by Tomas Pueyo, which has received over 40 million views, and translated into over 40 languages as at March 19, begins with the following:

‘With everything that’s happening about the Coronavirus, it might be very hard to make a decision of what to do today. Should you wait for more information? Do something today? What?... Here’s what I’m going to cover in this article, with lots of charts, data and models with plenty of sources: (1) How many cases of coronavirus will there be in your area? (2) What will happen when these cases materialise? (3) What should you do? (4) When?’

Read here (Medium, updated March 19, 2020)

List of prominent people who have endorsed or shared his article. Read here