As the UK, along with most of Europe, comes slowly out of lockdown it is sobering to look back to the time when the pandemic was, with hindsight, just beginning. In those initial days and weeks I was only writing a few lines at a time about this emerging virus for the sponsors of this blog, DHClamp Ltd. (1)
By March 2020 it was clear that things were rapidly accelerating and the blog was born out of a need for more detailed pieces which could also be tailored to client requests.
In Part 1 of this look-back I will compare those first pre-blog predictions with what we now know. In Part 2 I will revisit some of the earlier blog pieces to see how much, or little, has changed since they were written.
Prediction - Written on 18 January 2020
China has implemented travel restrictions across Wuhan and four nearby cities because of a new coronavirus illness. The WHO is meeting for a second day to discuss the ongoing outbreak. (2)
The death toll currently stands at 17 although all deaths so far have occurred in people who had other serious, underlying health conditions.
For many, infection with the virus causes only a mild illness. However lessons learnt from the SARS outbreak in 2002/3 have ensured that this outbreak is being dealt with robustly.
Scientists believe the virus may have been transmitted by snakes on sale in the Wuhan wildlife market.
It is possible that the WHO will declare a public health emergency of international concern within the next 24 to 48 hours.
Reality - 7 July 2020
The current death toll from COVID-19 now stands at 537,616 worldwide. Although the elderly have been disproportionately represented in the death statistics people from every age group, and people with no underlying heath disorders, have died from the disease. (3)
The origins of the virus have been traced to the wet markets in Wuhan, China, the original epicentre of the outbreak although it remains unclear exactly which animals were the link the virus used to cross into humans. (4)
World leaders have been apportioning blame on each other for the outbreak and conspiracy theories about the virus's origins have claimed it was man-made. (5)
However, scientists have ascertained that the COVID-19 virus is a naturally occurring member of the coronavirus family with no unusual characteristics to suggest it has been manufactured. (6)
At this stage the WHO did not consider it necessary to declare a public health emergency, a decision we now know that would be overturned.
Prediction - Written on 28 January 2020
The latest news is that Hong Kong is to restrict cross-border travel with mainland China as coronavirus continues to spread across the country: more than 100 people have now died in China, with confirmed infections more than 4,500. (7)
16 other countries have confirmed cases but so far no deaths. UK health services have tested 52 people and found no cases of infection.
In The Guardian, Professor Neil Ferguson of Imperial College, said his "best guess" is that 100,000 could become infected globally and said, "Sooner or later we will get a case [in the UK]. There are very large numbers of Chinese tourists across Europe right now. Unless the Chinese manage to control this, and I’m sceptical about whether that is possible, we will get cases here.” (8)
Although a "best guess", the figure is likely to be accurate as people are infectious during the incubation period of up to 10 days (when they will not have any symptoms and not realise they are infected) and the fact that cases are increasing exponentially despite quarantine measures is concerning.
The WHO is expected to meet in the next few days to reassess if a PHEIC (Public Health Emergency of International Concern) needs to be declared.
Reality - 7 July 2020
China has officially declared 83,577 cases and 4,634 deaths since the start of the pandemic. Although more than the figures noted on 28 January the true figures for China are likely to be much higher with many countries sceptical about the numbers they have released.
(9) (10)
Professor Ferguson was correct when he said that "sooner or later there will be a case in the UK". However the projection that up to 100,000 people globally could be infected turned out to be woefully too small. The current total number of cases worldwide is 11,598,150 and still climbing. (3)
Again, the WHO were still questioning if it was necessary to make a public health declaration about COVID-19 but felt it was not necessary.
Prediction - Written on 30 Jan 2020
Further to our last update, the UK raised its threat level from low to moderate for the Wuhan coronavirus outbreak last night (Jan 30th) after the World Health Organisation declared the outbreak a global health emergency.
The first two cases were confirmed in the UK today: they are being treated in a specialist unit in Newcastle. (11)
The World Medical Association called for the establishment of an international supply chain of medical supplies amidst warnings of growing shortages in the Asian countries affected by the outbreak. (2)
The Wellcome Trust also warned of the impact on "fragile health systems" in poorer countries. Director Dr Jeremy Farrar said: "This virus has spread at unprecedented scale and speed, with cases passing between people in multiple countries across the world.” (12)
The WHO reports that in China there are more than 7,000 confirmed cases and 12,000 suspected cases with 213 deaths. Outside China there have been 98 cases in 18 countries. (2)
In the wake of rising public panic Professor of Virology at Reading University Ian Jones urged people to remember that "For the majority of those who contract this virus, the outcome will be a mild respiratory illness from which they will recover." (13)
Reality - 7 July 2020
The WHO declared a PHEIC (Public Health Emergency of International Concern) on 30 January 2020. (2)
At the start of the outbreak individual cases were reported in the media. British nationals returning from Wuhan were taken to specialist quarantine facilities in a bid to contain the virus.
None of them tested postive for the virus.
The first two confirmed cases of coronavirus in the UK were on 29 January 2020 when two Chinese nationals fell ill in York. Treated in Newcastle, they both recovered. (14)
On 5 February 2020 a cluster of cases in the UK were linked to a British man who had contracted the virus in Singapore. (15)
Meanwhile on 4 February 2020 the British registered cruise liner "Diamond Princess" was quarantined in the port of Yokohama in Japan when it became clear it was experiencing a COVID-19 outbreak traced back to a passenger who had disembarked on 25 January 2020 in Hong Kong and subsequently found to have the virus. The ship would remain quarantined until 1 March 2020.
From a total number of people of 3,711 (2,666 passengers and 1,045 crew) there were 712 cases and 14 deaths from COVID-19. All 14 deaths were passengers. (16)
What would become a worldwide shortage of PPE (Personal Protective Equipment) was acknowledged at the stage when 18 countries had recorded cases.
There have now been 213 countries and territories affected by COVID-19.
Prediction - Written on 11 February 2020
Figures released from China yesterday showed a possible decrease in the number of new cases of COVID-19 being reported. (17)
This would be welcome news, but it may reflect that access to testing is becoming increasingly difficult and videos on social media of people being forcibly removed from their homes may have caused many to decide not to seek medical help when ill.
Watching countries outside China may be a better marker of disease spread. Cases in Thailand and Singapore are rising at the present time.
If cases in other countries are all linked to imported cases from China, with a clear chain of transmission, then this would suggest the virus may be containable.
However if sporadic cases emerge outside China in people with no known links to the country, then person to person transmission may be occurring with the potential for an upsurge in cases elsewhere in the world.
Reality - 7 July 2020
There is now worldwide scepticism in both the lay press and the scientific community about the official figures released from China.
The possible decrease in case numbers reported by China five months ago gave false optimism allowing hope that if all cases of COVID-19 could be traced directly back to China then the virus may not spread elsewhere, a hope that was not to be realised. (9) (10)
Prediction - Written on 25 February 2020
There is growing consensus from the medical community that there is gauged to be less than 10% chance of containment of the spread of COVID-19. Whilst Singapore appears to have contained the virus' spread, further "hotspots" are developing in Italy, which currently has reported 78+ cases. Concerns remain over the contradictory numbers released by Iran, while statistics from China over the spread of the virus are seeing a lengthening time between reports. (18)
Further developments are likely to come from the detection of cases in Africa, and whether half term visits to Italy, or sports events such as the Six Nations, could see a growing significance.
The fact that the spread to Europe has been facilitated by business travellers, some of whom were infected at trade events and other meetings, should be a serious concern for those planning and authorising business travel. This is further highlighted by the recent cancellation of major trade and cultural events in Italy and Spain.
Reality - 7 July 2020
On 11 March 2020 the WHO declared the COVID-19 outbreak a pandemic. (19)
Doctors in the UK were realising that the chances of containing the virus were very slim and hospitals started preparing for the expected onslaught of cases. (20)
Italy, first noted to have several "hotspots" of infection, became one of the worst affected countries in Europe with 241,819 cases and 34,869 deaths. France, Spain and the UK joined it as their cases and deaths rapidly rose. The UK has now had the highest number of deaths in Europe although it should be noted that countries do not always register deaths in the same way.
Northern Italy began to lockdown on 21 February 2020, the whole country went into lockdown on 8 March 2020. Spain followed on 14 March 2020 and France on 14 March 2020. (21)
Prediction - Written on 12 March 2020
Downing Street has today announced the latest measures which will be implemented in the fight against Covid-19.
The aim is to delay the peak incidence of cases for 4 to 6 weeks by which time seasonal respiratory illnesses such as flu will have tailed off and the NHS will have an increased capacity to cope.
All those with a new cough and/or temperature are asked to self-isolate at home for 7 days, not just people who have travelled to affected areas or been in possible contact with the infection.
Schools are advised to cancel all trips abroad and the elderly and those in poor health advised to avoid cruises.
The key way to protect yourself from infection remains frequent handwashing as the mode of infection is primarily through touching contaminated services.
At the present time schools are remaining open and public gatherings continuing with the exception of Scotland who are banning meetings of more than 500 people. (22)
Reality - 7 July 2020
On Monday 16 March 2020 people in the UK were told to avoid pubs, clubs, restaurants and theatres, stop all non-essential contact and travel, and work from home if they could. The phrase "social distancing" was used to describe how we all now needed to interact with each other.
These measures were announced on the day the death toll of people from COVID-19 in the UK reached 55. (23)
Prediction - Written on 16 March 2020
As new measures were announced yesterday on the UK response to COVID-19, scientists at Imperial College have released the research which has helped form current policy - attached in the comments.
Without social distancing, particularly of at-risk groups, mathematical models predicted up to 260,000 deaths. With the new measures there is the potential to reduce this number to 20,000. (24)
Reality - 7 July 2020
The UK went into full lockdown on Monday 23 March 2020. Schools, pubs, clubs and restaurants closed the preceding Friday. The nation was told to leave home only to shop for essential items such as food and medications, only keyworkers continued to work outside of the home and people were only allowed to leave home for exercise once a day with household members only. (25)
Whilst the number of deaths is currently well below the predicted 260,000 if measures were not taken to limit the spread of the virus, at 44,236 the number is now more than twice the 20,000 hoped for as a maximum. (26)
Conclusion
It is easy to forget that just a few short months ago most people had not heard of the coronavirus family and COVID-19 itself was unknown. Those initial posts and their predictions were not my random thoughts but based on the science available at the time. There is much we still don't know about this virus but with each passing day our knowledge increases. With the pandemic still accelerating in many parts of the world it is vital that it does.
(12) https://wellcome.ac.uk/news/wellcome-pledges-10-million-tackle-novel-coronavirus-epidemic-covid19
