Technology

Coronavirus: How Fast to 100,000 Infected?

What exactly is this new infection epidemic called the coronavirus and could it spread to many other countries causing a pandemic where hundreds of thousands or even millions are infected and potentially die?

Well that's a big unknown right now. Before we get all worked up and worried, let's build some important facts around the news reports.

According to the US Centers for Disease Control and Prevention (CDC), coronaviruses are a group of viruses that cause diseases in many species of mammals and birds. Rarely, these coronaviruses can evolve and infect humans and then spread between them. Recent examples of this include SARS-CoV (Severe Acute Respiratory Syndrome) and MERS-CoV (Middle East Respiratory Syndrome).

While four older human coronaviruses commonly cause mild to moderate illness in people worldwide, the two newer human varieties, MERS-CoV and SARS-CoV, have been known to frequently cause severe illness. Coronaviruses are named for the crown-like spikes on their surface.

In cows and pigs coronaviruses typically cause diarrhea, while in chickens it can cause an upper respiratory disease. In humans, the virus causes respiratory infections which are typically mild including the common cold, but again, rarer forms like SARS and MERS can be lethal. There are no vaccines or antiviral drugs that are approved for prevention or treatment.

The incubation period of the virus (from exposure to symptoms) is between 2 and 10 days and it remains contagious during this time. Symptoms include fever, coughing and breathing difficulties and it can be fatal.

A Severe Health Crisis for China

The newest coronavirus, designated 2019-nCoV, was first identified in Wuhan, a city of 11 million in the Hubei province of China, after people developed pneumonia without a clear cause and for which existing vaccines or treatments were not effective.

The virus early on showed evidence of human-to-human transmission via coughing as it could be found in respiratory fluids. The rate of infection quickly escalated this month, with several countries across Europe, North America and the Asia-Pacific reporting cases. As of January 29, there were still only five known cases in the US: Chicago, IL; Everett, WA; Maricopa County, AZ; and two in Los Angeles.

As of January 29, approximately 6,000 cases of infection had been confirmed across China. The first death from the infection occurred on January 9 and since then over 130 deaths have been confirmed.

Easily 40 million people have been placed under what might be called "soft" quarantine in Wuhan and 15 other cities in the surrounding Hubei province, involving the termination of all public transportation and obviously all outward transport by train, air and bus. Wuhan is racing to build two dedicated hospitals with over 2,500 beds for those infected.

Geometric Infection Spread?

The number of cases in China now exceeds the approximate 5,500 infected with the SARS coronavirus that killed about 800 people globally in 2002 and 2003. The rate of spread is probably of concern to officials in China and in the West, though the World Health Organization (WHO) has stopped short of declaring it a global health emergency.

According to Bianco Research in Chicago, based on official China National Health Commission data, the geometric rate of transmission (about 53% daily) where every infected person can infect 2 to 2.5 people, we could be looking at 88,000 sick by February 3 and 315,000 ill by Feb 6.

Jim Bianco, president of the eponymous research firm, asked "Does the mkt understand this growth rate? Or will it freak?"

If you follow Jim Bianco on Twitter at @BiancoResearch, you'll get to see more data modeling like that. On January 27, he built a graph with the "hard" quarantined number at just over 44,000 and posed the question "Are people under quarantine the inventory for future infection growth?"

This harder definition of quarantine from China is those with flu symptoms isolated and monitored. It was up over 30X in just a week, from 1,400 to 44K! "This is the inventory that will feed the continued geometric of infection rates," Bianco tweeted.

During the same period, Jan 21-27, reported infections were up over 10X to cross 4,500. With the "inventory" growing faster than the confirmed cases, this could explode to pandemic spreading levels very quickly. Over 100K infected next week equals nearly 10 million by Valentine's Day.

Again, these are not predictions but simply mathematical projections based on the current rates of acceleration in confirmed cases and those with symptoms. If these slow down, the picture becomes much more optimistic.

When confirmed cases grew to 5,974 as of Jan 28, slightly less than the model projected, Bianco surmised "China Health might be underreported as some areas are running out of testing kits."

But the math of the geometric expansion still speaks, with quarantined "inventory" rising to 60K on Jan 28 and infection cases doubling every 1.7 days. If these numbers don't slow down, the WHO may have to update their classification.

In Search of Data and a Vaccine

For a broader perspective on the data and to stay up-to-date on the latest information, here is the CDC homepage on Coronavirus with many resources and references.

Another resource I recommended on my Mind Over Money podcast on Tuesday is STATnews.com for their excellent medical and biotechnology reporting. They are offering all coronavirus-related articles in front of their pay-wall at this time to help as many people as possible understand the disease and the latest assessments of the crisis.

In an article I share from STAT by Sharon Begley, she talks about the advantage scientists and public health officials have now that they didn't two decades ago: fast and affordable genome sequencing power from equipment like that built by Illumina ILMN.

In the video that accompanies this article, I also glance at some of the companies who might be involved in an eventual vaccine. Early in the week, the Wall Street Journal reported that shares of companies including Inovio Pharmaceuticals INO, Moderna MRNA, and Novavax NVAX were surging as the coronavirus spread further.

The rallies were sparked last week when the Coalition for Epidemic Preparedness Innovations (CEPI), a public-private nonprofit based in Norway, announced that it would provide as much as $11 million in funding to Inovio and Moderna to develop vaccines against the coronavirus.

The CEPI aims to derail epidemics by speeding up the development of vaccines. But Jefferies analyst Jared Holz threw some cold water on the big buzz in these small companies in a research note on Monday where he wrote, "Companies stating their interest in development vaccines for coronavirus are likely too late, as we saw similar commentary around SARS and other similar situations."

Pandemics: The Black Death and The Spanish Flu

In my podcast Coronavirus: Epidemic or Pandemic?, I thought it would be interesting to look at past pandemics to see what is possible and probable. Even though developed nations have historically robust levels of sanitation and disease control that prevent flu epidemics, the pace of spreading for 2019-nCoV is clearly on its way to exceeding prior epidemics like Ebola and SARS.

According to the WHO, a pandemic is the worldwide spread of a new disease. An influenza pandemic occurs when a new "flu" virus emerges and spreads around the world, and most people do not have immunity. Viruses that have caused past pandemics typically originated from animal influenza viruses.

The last great pandemic that killed tens of millions was the 1918 influenza pandemic, commonly known as the Spanish flu. It was the first of the two pandemics involving H1N1 influenza virus and infected 500 million people around the world, killing an estimated 50 million and possibly much more. This death toll would have been three to five percent of Earth's population at the time, making it one of the deadliest epidemics in human history.

Most influenza outbreaks disproportionately kill the very young and the very old, with a higher survival rate for those in-between. However, the Spanish flu pandemic resulted in a higher than expected mortality rate for young adults. (Source: 2013 research paper linked on Wikipedia page for Spanish flu, "Age-specific mortality during the 1918 influenza pandemic: Unraveling the mystery of high young adult mortality").

For a great 5-minute video on the highlights of the Spanish flu, check out History.com.

The Greatest Empire of 1400

Did you know that the "big daddy" of pandemics, The Plague of the 14th century, originated from China? Killing anywhere from 75 million to 200 million, the Black Death probably came cruising along the Silk Road after the Mongols and Marco Polo got traffic and trade rolling to connect East and West.

But let's try to end on a good note about China today. In last week's Cook's Kitchen video Tesla to $6,000 and SpaceX to the Moon?, I showed off a great new book I'm reading by SpaceX mission manager Andrew Rader. His Beyond The Known: How Exploration Created the Modern World and Will Take Us to the Stars is a blast because to make his argument for colonizing space he first gives us a 220-page tour of history's great explorers including the Polynesians, Phoenicians, Vikings, Italians, Chinese, Spanish, Dutch, Portuguese, and British.

Upon further progress in Rader's book this week, I am reminded of what a great power China was in the early 15th century with the largest city, Beijing at almost a million, and the largest and most advanced navy in the world. Rader makes a long list of Chinese inventions including the magnetic compass, various ship rudders, crossbows, flush toilets, dental fillings, hot-air balloons, hydraulics, negative numbers, paper money, and the printing press, which they never found much use for with over 25,000 characters in the language.

Rader writes, "In stark contrast to the opulence of China, Europe at the time was a miserable backwater still recovering from the ravages of the Black Death, which had recently reduced the population by a third."

He goes on to suggest that the idea an isolated and impoverished Europe would eventually come to dominate the world would have seemed crazy at the time. "China, far more than Europe, was poised to discover, settle, and conquer the world." To learn why they didn't, be sure to grab Rader's book!

Complexity Science: Climate, Population, and Space

In the Coronavirus podcast, since we are talking about global populations potentially affected by a disease pandemic, I found that Rader's book is the perfect jumping off point for all discussions about why we need to explore and colonize the solar system as soon as we can (I'm talking in decades here).

With projections of 9 billion plus on the planet in three decades by 2050, things are going to get tighter from resource, food, and land perspectives. Getting ready and having options on the moon and Mars is our natural, no-brainer destiny as explorers.

Coincidentally as I'm reading Rader, I came across Dr. Jane Goodall's comments at the World Economic Forum in Davos where climate change and global warming were the hot discussion topics. The wonderful primatologist "remarked at the event that human population growth is responsible, and that most environmental problems wouldn’t exist if our numbers were at the levels they were 500 years ago," according to TheConversation.com.

This conclusion seems somewhat self-evident, almost tautological by definition. So, then, here we are. Humans do what we do and we can't stop breeding any more than inventing and exploring. Carry on. To Mars... and beyond.

Competition: A New Science?

Finally in today's video, I introduce an important 2007 book I would bet 99.5% of my audience -- or the USA, whichever is bigger -- has never heard of. Applied mathematician James Case wrote Competition: Birth of a New Science to tackle the preposterous assumptions and predetermined certainties (not subject to testing) of pseudo-sciences like economics.

It's fascinating to me that he published the same year as my other favorite econ-dismantling book The Black Swan by Nassim Nicholas Taleb. Both credit Benoit Mandelbrot, author of 2004's The (Mis)Behavior of Markets, for his original ideas about the limitations of standard deviation in markets and Modern Portfolio Theory models.

He opens with the 1997 victory by IBM's IBM Deep Blue computer over world chess champion Garry Kasparov, handing him his first professional defeat. And then he puzzles over how hard it might be to "crack the code" to play Go and beat a human champ.

Little did he know that companies like Google, DeepMind, and NVIDIA NVDA would soon be building the foundational parallel processing essential to machine learning and eventually bring more complex games like Go and Texas Hold'em poker under control.

Case is also a big fan of physicist Richard Feynman and I share some of his observations about the quantum maverick's 1974 commencement address to the graduates at CalTech. My favorite Feynman-ism is this...

“I have approximate answers and possible beliefs and different degrees of certainty about different things, but I'm not absolutely sure of anything.”

And Case plucked this gem from the 1985 book by Ralph Leighton, Surely You're Joking, Mr Feynman!...

"After you've not fooled yourself, it's easy not to fool other scientists. But not fooling yourself is far from easy because, liking your own ideas, you are the easiest one to fool."

Kevin Cook is a Senior Stock Strategist for Zacks Investment Research where he runs the Healthcare Innovators service. Click Follow Author above to receive his latest stock research and macro analysis.


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