No doubt about it: 12 days after lockdowns, quarantines and isolation, Coronavirus slows

Ancient technology wins: Not only are quarantine and isolation measures useful, they’re the best tools we have.

Some people don’t seem to realize that the only reason the daily growth of infections is slowing anywhere, is thanks to drastic quarantine measures or changes in human behaviour. We can see this in graphs from Italy, Spain, Norway, South Korea, Switzerland, Germany, and China, but not in Sweden or Brazil where there’s not much quarantine and not much slowing of growth curves either. In all of the former, the big meaningful actions were followed around 12 days later by an obvious slow down.

Willis Eschenbach, for example, wondered If Lockdowns Worked, but counted subdivisions of any quarantine type action as a measure of the severity when it’s more a measure of the wordsmithiness or indecision of leaders.

To see if major action matters, it’s better to look at the dates that borders, schools and shops were closed. The graphs of daily new cases below show that around 12 days later in so many countries, the growth in cases slows too. The delay is due to both the incubation period of Covid-19 and testing. By the time a lockdown is declared (or any such measure) a large expansion in cases is already “in the can”.

Willis found that masks were useful — which they certainly are — but we know that because of scores of medical studies, not because of Japan. (Masks do help, even (maybe) stopping 75% of influenza, and you can make one for yourself).

Japan did a lot more than just wear facemasks. Shinzo Abe shut the entire national school system down from March 2nd. He closed flights from China and South Korea on March 5th. Japanese cases peaked around the 14th of March — twelve days after schools closed, though it was probably due to a lot more than just school closure. The act of announcing something as drastic as that would inspire many behaviour changes, like hand-washing and distancing and working from home, and mask wearing.

Abe made that call, which astonished the schools, when Japan had less than 200 cases. Remember, at the time, Tokyo was still hoping to hold the 2020 Olympic Games in 2020. There was no messing around, and it kept the virus under control.

At some point a thousand PhD’s will pore over all the nations and different responses and they’ll figure out which forms of isolation or lockdown were the winners in the cost benefit stakes. Locking up the old folks may sound good (probably not if you are one), but this horrible virus hits the young, the fit, and even kills children (aged 13). It swallows whole hospitals. (See estimates here too). It’s not viable to sacrifice some in the 30 – 70 group, or give up having working hospitals either. That’s why every nation ends up crushing the curve anyhow. 

At the moment, we have to hammer that curve, buy us time, and armour up to tackle this properly with treatments, monoclonals, antivirals, tests and proper PPE. Lockdown doesn’t have to last forever: weeks right now, are like gold. Then we beat this thing, one county at a time if we have to.

 

Italy

Italy started mass lockdown on March 10th. On March 11th all non-essential businesses were shut down.

The growth of new daily cases peaked on March 21, 11 days after the mass lockdown began.

Norway

Mass lockdowns were announced on March 15: “Norway takes most far-reaching measures ever experienced in peacetime over coronavirus”.

… and new daily cases peaked 12 days later on March 27th

 

Germany

In late February a few schools were closed in the one town (pop 40,000) where there was a cluster of cases. But travel to Italy was deemed A-OK. By March 8th, events of over 1,000 were banned, but not a lot else. Then on March 12, Donald Trump banned flights from the EU to the US and sent everyone into a flap. At this point some parts of the German government woke up.

On 13 March, most German states decided to close their schools. Some states added wider closures the next day. The national government suddenly ordered 10,000 ventilators. On the 15th of March Bavaria had local elections “luckily” just one day before the same state dissolved into an emergency with very complicated rules. Meanwhile people still flew in freely from Iran. On  March 16th the public got angry and the flights were stopped. Later that same day, the Bavarian rules were extended over the whole country. Shops were mostly shut, buses were out, as was church, playgrounds or tourism. But it wasn’t called a “shutdown”. Finally on March 18th Germany closed borders to Italy, France, Switzerland and Denmark. Though flights to Iran and China apparently continued despite being stopped. The following week the rules got even tighter and curfews were introduced.

Germany peaked (maybe) on March 27th, sort of 11 days after flights were stopped (or not) from Iran and China, shops were shut, and a complicated set of social distancing rules came in.

Sourced from the pandemic timeline in Germany.

 Spain

The Spanish government imposed a nationwide lockdown on March 14th.  Shops and businesses closed and all residents asked to stay home on March 15th. A State of Alarm was declared. In Spain cases peaked March 26th — 12 days after the lockdown was imposed.

In Switzerland:

Isolation and distancing measures were gradually phased in.

On the 28th of Feb large events with more than 1000 people were closed. On the 6th March Switzerland changed strategy to protect older persons and vulnerable groups. On 13th March classes were stopped. All events were banned of more than 100 people. Borders were partially closed. On 16th March bars and most shops were closed.  March 20 the government announced no lock down policy would be pursued but all events with more than 5 people were banned. Since March 6th the Swiss Government policy was not to test anyone with mild symptoms. The daily new cases peaked on March 20th and has stayed level ever since.

So decisive moves were either to isolate vulnerable people on March 6th or closing schools on March 13. The peak was around March 20.

Australia

In Australia growth slowed on March 23 and peaked by March 28th (so far). The timeline of quarantine moves was incremental but most Covid cases were related to flights and cruise ships, so the border changes would have been more influential. And flights were banned from Iran on March 1, South Korea on March 5, Italy on March 11. On 13th March all gatherings over 500 were banned. On 15th March all incoming travellers were asked to self isolate for 14 days. On 20th March all borders were closed. On 21st March social distancing rules of 4 m2 per person were introduced. March 23 saw the closure of most cinemas, nightclubs, pubs, casinos. Restaurants ordered to do “Takeaway only”. Schools closed in Victoria from March 24, but parents were withdrawing children across the country even though other schools were technically open.

The peak on March 22 may have related to the reduction in flights from Italy 11 days earlier, though the Ruby Princess Cruise ship adds a lot of noise. I’m not convinced this is an easy peak to tie to any day, but the major action in Australia was in the middle two weeks of March.

 

Sweden

In Sweden there’s been no organised quarantine, just partial voluntary withdrawal, and there’s also been no peak yet.

 

Brazil

In Brazil, President Bolsonaro seems to favour doing nothing, but the governors of Sao Paulo and Rio De Janeiro banned gatherings and closed schools and many are pleading for action.

It’s not looking good. Not enough testing for starters.

 

…
China

On January 23: Wuhan placed under lockdown. Other Chinese provinces would follow during the next week. Despite the doctored official numbers, the rapid growth rate peaked twelve days later on Feb 4th. The spike around Feb 12th was due to definition changes.

…

In South Korea

On Feb 18th patient #31 went to religious meetings and cases escalated. By Feb 20th the streets of Daegu were empty. South Korean officials tracked and isolated cases at military bases, at the church group, and one hospital. Interviews were done on, wow, 230,000 members of the church at the centre of the outbreak which accounted for 60% of the national cases. The outbreak peaked by March 3rd, 12 days after the streets of Daegu were emptied.

Most infections in March were from travellers. South Korea put in stronger self isolation measures for travellers from April 1. Timeline for South Korea.

 The bell curve is all man-made

In a natural exponential growth situation with no lockdowns the infections keep spreading until most of the population has had it. This will eventually produce “that flattening” on a log graph, but we’re not remotely there yet (we are not even close). That only starts to happen when we reach well over half the population.

When graphing infectious growth on a log graph, any curve away from linear towards horizontal is good news.

And crushing an exponential daily growth curve down is no mean feat.

Things everyone needs to know:

Masks do help, even (maybe) stopping 75% of influenza, and you can make them

Stop with the fatalism: Don’t flatten it, Crush The Curve on Coronavirus