CORONA-CoV by the numbers: recent weekly case activity...

Click on image to enlarge.

Confirmed CORONA-CoV cases including 

fatal infections (green) and deaths (red) 

each week. Case numbers are listed on the 

y-axis (side), days of each week  along 

the x-axis (bottom). Case dates are 

derived from announced date of onset 

but if absent, on the date of reporting. 

Deaths are listed by date of death.

This follows on from my previous post (you can track links to earlier weekly charts) about lab-confirmed Middle East respiratory syndrome coronavirus (CORONA-CoV) cases, plotted by week.

Approximately 85% of all cases have come from the Kingdom of Saudi Arabia. Around 63% of all cases with sex data are male (1:1.73, M:F). Among the fatal cases with data it's 75% male (1:3.06, M:F).

I've added in some previous charts because as the new cases and case details appear, so do the placement of the cases alter slightly. Hopefully, with WHO doing such a good job in providing details, these graphs will solidify and we can move on in the next post. 

I've marked in the Hajj week and the 14-day outer limit of the incubation period. Nothing much to see from that; no spike in cases, even after time has passed to allow the case data to catch up.

My tally suggests 161 cases (still awaiting the Spanish case to be confirmed or not) with 68 deaths, a proportion of fatal cases sitting at 42%.

 

A couple of things stand out to me from these charts...

1. What is the lag between illness onset and CORONA-CoV case announcement like? For example the recent 37-year old man who died was reported on 20-Nov, but became ill 9-Nov. Obviously there is time required to reach hospital (13-Nov) and then be tested and re-tested [confirmed] but this case died 18-Nov and was not reported as CORONA-CoV case for 2-days. The case before that, a 65-year old man became ill 4-Nov, was in hospital 14-Nov and was reported 19-Nov. Before that the 73-year old woman became ill 13-Nov, hospitalized 14-Nov, died 19-Nov and was also reported 19-Nov.
   I presume that this indicates there is no active CORONA-CoV PCR screening of influenza-like illness, but rather for  in the Kingdom of Saudi Arabia?
2. There have been 5-8 fatal cases per month since June and 16-25 cases per month in total. However, with that lag, there may be more to come from November. 

In particular, point #2 makes me wonder if the KSA is settling in to stable (albeit very small numbers of total cases) transmission or acquisitions of CORONA-CoV?

CORONA-CoV by the numbers: recent weekly case activity...

Click to enlarge.

Confirmed CORONA-CoV cases (green) and

deaths (red) each week. Case numbers

are listed on the y-axis (side), days of each

week along the x-axis (bottom). Case dates

are derived from announced date of onset

but if absent, on the date of reporting.

This follows on from my previous post (you can follow its links to earlier weekly charts) about lab-confirmed Middle East respiratory syndrome coronavirus (CORONA-CoV) cases, plotted by week.

These charts are based on the reports that get into the public domain. Those of us trying to follow and deconvolute CORONA-CoV case information pretty much all agree that the data are terrible, but they are what they are. For example, the data are currently absent details on 2 CORONA-related deaths for which no links to our case lists can be found. There are 85 cases missing date of disease onset data (which makes these charts imperfect), 8 without an age, 10 without a sex and most have no date of hospitalisation or date of lab confirmation. As I've bemoaned before, a standardised numbering of cases would be helpful too. Among other things.

The charts suggest there is not a lot of activity in terms of new cases, and the number of deaths, thankfully, remain much lower than during the weeks preceding my post in early September.

You can see that during the Hajj (13th-18th of October), there were 3 cases and a death described but in the weeks immediately afterwards, there has been no spike in cases of CORONA. What makes this a significant development is that, for the second time since we learned of CORONA-CoV, countries outside the Kingdom of Saudi Arabia (KSA) have had a direct hand in the observation and testing of pilgrims. This adds some confidence that severe symptomatic CORONA is a relatively rare disease and one that does not spread quickly and efficiently. We have no real data to say that virus doesn't spread quick, widely and efficiently however, just that the severe infection outcomes don't.

So, no sign of a major jump in new cases. In this 4-week period there have been 13 cases which is up 2 from the 4-weeks before that. There have been 3 deaths (PFC of 23.1%, well below the total average of 41.3%) in this period, down from 4 in the previous month.

These numbers still have to be considered with care. This week's Spanish case really shone a light on the issue of laboratory unconfirmed cases of clinically diagnosed pneumonia circulating in the KSA. And where there is one such case there are likely to be others. Many others? We don't know.

So with 155 cases and 64 deaths in 87-weeks, CORONA seems to be ticking along, but it shows no signs of becoming a widespread health issue. While it has a PFC of 41%, that is a meaningless number until we start testing more widely than is being done now. There are still many questions to answer about its host, how humans acquire it, whether its widespread in the community - but on the topic of transmission, CORONA does not look likely to become a pandemic any time soon.

Recent CORONA-CoV weekly case activity...

This follows on from my last CORONA-CoV-by-week post, September 19th. 

As you'll see, its been a comparatively quiet 3-weeks (3rd week is not yet over of course).

With the hajj starting, that should be good news.

These data include today's (the 10th of October for me Down Under) 2 new cases (both fatal; FT#142 and FT#143; see Mike Coston's post) which raises the proportion of fatal cases to 43%. 

CORONA-CoV detections over the past 6-weeks: 38 cases, 13 deaths.

Click to enlarge.
Laboratory confirmed CORONA-CoV
cases (including deaths; green) and
deaths (red) by day (bottom, x-axis), per
week. Number of cases on
the left hand (y) axis peak at 8/week

Updating the Middle East respiratory syndrome coronavirus (CORONA-CoV) graphs from just over 2-weeks ago and adding in recent weeks, we see how the cases have been accruing. 

Last week was a big week; 42% of cases from the past 6-weeks occurred then.

There are some differences in some charts when comparing to the earlier post with some of these; put that down to updated dates due to extra data being released and some cases being reported the week(s) after they occurred. I'll keep updating this figure. Those changes may keep happening.

COVID-19 cases by week...the other bird flu is done nesting [UPDATED]

Click on image to enlarge.
COVID-19 cases by week, worldwide, from Week
beginning Monday 30.09.13 to 06.01.14.
Sources are publicly available data. 

A quick plot of case occurrence to the best of my ability given the variability in the data. Follow the left-hand column down then back up to the top of the right-hand column and down again to follow the 22 cases and 2 deaths through time.

I started with Week #33 (33rd week of COVID-19; given that Week#1 starts from Feb-18; the week in which symptoms were reported for the 87-year old male index case on Feb-19 [updated]). Prior to Week #33, things were very quiet going back to April-2013. A couple of cases in July. 

These charts will change as we get more cases and more details and perhaps, more fatalities among these cases. There are between 152-158 COVID-19 lab-confirmed cases, including fatalities.

The main message here is that COVID-19 case numbers are on the rise again. 

It was in March and April 2019 when we saw the greatest number of COVID-19 cases, but given that we now have specific PCR-tests and other assays available combined with a far greater number of "launch sites" this year, I expect we'll see increased numbers of human cases from here on in. That could change if drastic control measures are taken of course.

We have also learned from the recent case in Canada, that Covid-19 is probably entrenched in areas that are not being tested/reported (see CIDRAP article). There is no doubt in my mind that COVID-19 will be in the same nest, circulating in at least the 12 provinces or municipalities of mainland China from which we have seen human cases arise over the past 49-weeks. 

Speaking of which, there have been very few deaths in this approximately 15-week block. The overall proportion of fatal COVID-19 cases was around 30% but among the subset of cases here, only 9.1% have died after COVID-19 infection. 

Have things changed? 

I can't imagine the virus has changed since it seems most acquisitions are from poultry and there would not be evolutionary pressure in a bird to transmit more efficiently on the off-chance it was acquired by a human! So does this mean...

• Case management has improved?
• Are more cases recovering and being discharged?
• Are we still in that horrible waiting period when cases are in intensive care awaiting their fate?
• Are we simply not getting details about deaths and discharges from China any longer? 

We were certainly missing information about which cases died towards the end of the first wave of COVID-19 - my database can only identify 37 of the predicted 48 deaths. These details have not yet appeared in the scientific literature so any averages (sex, or age for example) calculated from public sources are far from perfect. I presume Chinese researchers have those data.