Analysis


Below are some of the exclusive analyses written by our editors on the coronavirus outbreak. These are personal interpretations and are meant to be understood as opinions rather than facts.

 

 ANALYSIS: Comparing hospital demand in Europe

March 19th 2020

Back in February, when the Coronavirus was starting to spread in Europe, health authorities in Europe and the United States were stating they have the best medical institutions and that there was no reason to panic as the mortality rate of the Coronavirus was not very high. Already back then, I pointed out that we should not take things for granted:
- COVID did not have a high fatality rate in Asia, but in places where hospitals were overcrowded (e.g. in Wuhan) the fatality rates were way higher. (See also, this publication in medical journal The Lancet.


- China was able to send in around 40000 medical specialists from all over the country to Hubei province to relieve the health care system in the epicenter, while enforcing strict lockdowns on its population. If they wouldn't have, the fatality rate would have been higher as well. Europe will not have those numbers of medical forces.
- There is a limited amount of Intensive Care Units and ECMO-machines. Once these are all in use, then almost every critical case will end up as a fatality.

Because of the above, and the news reports that hospitals in Italy are already overwhelmed, I decided to compare the people currently on intensive care with the intensive care capacity a country has:



The above chart gives an indication in where we are standing at this moment. It shows the current amount of COVID patients per European country both in current numbers (white text) as in a percentage of total available intensive care units in this country. Note: The X-axis only ranges to 50%, but this is also a decent estimate for the percentage of ICU already in use for non-COVID patients.
by G. Hoeberigs



 Comparing confirmed cases in South Korea and Europe

March 10th 2020

Today I came up with an idea to use existing data in a new way, and I'll start with my findings right away: European countries are not detecting the vast majority of COVID-19 cases. The actual amount of cases in Europe is likely 3 to 7 times higher. I'll explain why I think so.

What I did is calculate the current ratios for South Korea, Italy, France and Spain, in three categories:
1) Confirmed cases (=people infected with COVID-19) / people on intensive care
2) People on intensive care with COVID / people who died due to COVID
3) Confirmed cases / COVID deaths



When visualizing the data in a 3D radar chart, it's easy to notice how the South Korean ratios which includes the amount of confirmed cases is way off, compared to Italy, France and Spain. The ratio of COVID-19 patients on intensive care/deaths is similar in all countries though.



Now, it's quite easy to detect COVID-19 persons who have died or are on intensive care and submit them to a labtest.

It's much harder however to detect all mild COVID-19 cases.

This too implies the reported number of deaths and ICU are more likely to be correct than the number of cases.

Finally, both data and logics point me to one and the same observation. To get the same ratios as South Korea (assuming the virus is the same in Europe and Korea), the number of confirmed cases in Italy, Spain, France have to be THREE to SEVEN times higher than currently reported.


For the record, there is a very logical explanation why South Korea has a high number of confirmed cases compared to Southern Europe.

They test A LOT. They have drive-in/drive-through screening centers where you get diagnosed without leaving your car and get the result by text message.



In total S. Korea tested 191692 people as of March 10. The effect of their huge testing system is also found by studying the breakdown to age of confirmed COVID-19 cases. Compared to China, Korea has way more confirmed cases among young persons, which are more likely mild cases.
by G. Hoeberigs



 Forecasting the Wuhan Coronavirus

February 6th 2020

This article is quite a long read, but it's important and very relevant, not only for investors and traders.

First, I'll explain why stocks in Europa and US are going up, almost ignoring 2019-nCoV, and second I'll explain what the investors are missing.

All market research firms are following the coronavirus very closely and many of them are expecting the coronavirus to slow down. They do this by studying the actual reported numbers (just like I'm doing here), rather than going by R0-models.



As discussed before: this is very good in my opinion, because using Basic Reproduction Numbers (or the R0) has turned out to be unreliable (the actual transmission numbers are due to many other factors: R0 isn't a good indicator) for predicting the future numbers of nCoV-infections.

The mathematicians doing these calculations also look to the speed of daily increases (this is just like what I have been doing), which is the derivative of the acceleration: also known as the 'jolt'. Below I've made a new chart to show my version of the 'jolt' of Chinese reporting nCoV data.



Based on these mathematical (in my opinion accurate) approaches, market research firms like Gavekal conclude (as quoted by Bloomberg) that the virus will peak early March.
However, these market research firms and institutional investors are forgetting one very important point..

Their estimates are very useful if the 2019-nCoV would be an outbreak with homogeneous infectivity conditions. That is however certainly not the case. Thailand or India will not be able to handle the virus like China is doing (lockdowns, mass surveillance, or ordering a pizza and getting a note with the temperature of the cook, the delivery guy and the waiter).



If you don't take into account the heterogeneity of the infectivity conditions, exponential growth in infections in future epicenters (e.g. Thailand or India) will not be flagged, if China is able to contain it within their borders (which is currently 99% of infections).

That's why I have been looking to growth in infections and infection rate in subsets of China and I will do so in the future (once there's enough data) for outside China. E.g. looking to growth in China, excluding the epicenter, or looking to three megacities (see below)



Summarized: yes the containment of the coronavirus is definitely looking good in most places in China, outside the epicenter. However, new exponential growth in China-neighbouring countries is likely, in which case the virus peak will turn out to be far beyond March 2020.


Added on March 8th, 2020:
To visualize what I had been saying since late January, I have added the following two charts. It illustrates how future epicenters will not be flagged when only studying the totals, as mentioned above.



by G. Hoeberigs
 


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