The Corona Cockpit

10 ways to control and monitor the corona virus outbreak

Although I’m not a virus expert the last couple of weeks I’ve read a lot about pandemics: the main causes and most effective strategies for countries to control and prevent outbreaks. It's amazing how much scientific data already is available. With this knowledge I was able to design the Corona Cockpit and discovered how much we learn from outbreaks, when a corona vaccin can be expected and how to monitor the corona outbreak on short and on the long term. Most data is provided by official research institutions and all 50 sources are fully referenced below this article.

SUMMARY

The Corona Cockpit presents ten ways to control and monitor the corona pandemic on short and long term and shows how the world, Europe and Netherlands currently are performing based on research from leading institutes and researchers. Six out of ten indicators are pointing at "no control", with 3 indicators at "some contol" and 1 indicator at "in control". Each indicator has an index from 0-100% and the worldwide index for corona control per 1st of May 2020 resulted in: 25% (no control area is from 0-33%). Main concerns: corona cases globally keeps on rising on a high level, the virus is as deadly as the Spanish flu and there's no vaccin yet. Positive signs: one third of patients recover, global lockdowns were somewhat effective and the immune system of people in effected countries is supported by a high level of happiness.

Results of the Corona Cockpit - 1st May 2020

• Containing: No control. The amount of corona cases worldwide keeps rising, with 91k+ on May 1st 2020 the second highest rise of cases since the start of the pandemic (no control), Europe and Netherlands see slowing down of new cases (some control).
• Surviving: No control. Four months after the first case and with 7% deaths of all corona cases worldwide, 9% deaths of European cases and 12% deaths of all Dutch cases the corona virus is as deadly as the Spanish Flu (10%).
• Recovering: Some control. One third of corona patients worldwide and in Europe are reported recovered (some control) and 9% in Netherlands (no control).
• Securing: Some control. Streets are not safe because of the high fatality rate of the corona virus in combination with only partly reduced community mobility in countries: -60% worldwide, -66% in Europe and -43% in the Netherlands.
• Curing: No control. With only 8 potential vaccin candidates in clinical testphase (virologist: 90% chance on fail in this phase) and more than one year to go (experts estimates 1,5 yrs lead-time for a successful roll-out of a corona vaccin).
• Learning: No control. We're not learning from virus outbreaks: still 8 active outbreaks worldwide (e.g. corona, ebola, HIV/Aids and cholera active on a global scale) and there's an increasing amount of pandemics: Black Death, 502 years later: Third Plague, 63 years later: Spanish flu, 61 years later: HIV/Aids, 38 years later: corona (COVID-19).
• Preventing: No control. With 6 out of every 10 infectious diseases in people are zoonotic, caused by human infections of animal origin, intensity of contacts between animals and humans is very high (caused by e.g. bio-industry and wild-life markets) while globalisation (caused by global trade and tourism) is also very high.
• Transforming: No control. Human life on earth is way out of balance with nature and animals according to the Sustainable Development Goals of the UN: only 16% of global goals 2015-2030 are met in 2020.
• Investing: Some control. Investing in vaccins, protection materials and Intensive Care Units is relatively low seen the increasing amount of complex and unpredictable viruses: $1.000 per capita worldwide, $3.000 per capita in Europe and $5.000 per capita in the Netherlands.
• Smiling: In control. Global happiness scored 70% in 2020 with 88% for Europe and 95% happiness score for the Netherlands. There's much proof of the happiness-health connection meaning that less stress will improve the immune system.

Explaining the Corona Cockpit

The Corona Cockpit presents 10 calculated indexes to control and monitor the corona virus outbreak. When an index reaches 100% there's maximum control of that aspect (e.g. no new cases) of the virus and 0% means no control. Four indexes are focused on short-term aspects of the outbreak (e.g. amount of deaths) typically monitored on a daily basis by governments in crisis. Six indexes are more long-term related (e.g. developing a vaccin) taking months or years to reach 100%.

1. Containing

Why this kpi? To monitor the amount of new corona cases for containing the virus, halt the spread and flatten the curve (reference 31 & 32) as an indication of the reproduction number (R0), pressure on the healthcase system and effectiveness of measures like social distancing, self-isolation (specially the most vulnerable people), actual quarantine, lockdowns and use of protective care materials, corona testkits and corona tracing apps. A great graph by Visual Capitalist (reference 47) with actuals per country can be found here.

How it is measured? World Health Organisation is reporting the official amount of new corona cases on a daily basis (reference 1, below this article). The Corona Cockpit calculates an index based on:

• 0% stands for a day with maximum of new cases during start of the crisis (day of the first case)
• 100% stands for a day with zero new cases.

In perspective. Reported corona cases are expected to be much lower than actual caused by the lacking of test-kits and people with mild corona symptoms who did not call a doctor for a test. Italy for example is expected to have ten times more corona cases than officially reported (reference 33).

2. Surviving

Why this kpi? To monitor how many people are surviving given the amount of corona cases.

How it is measured? World Health Organisation is reporting the official Case Fatality Rate: amount of deaths divided by amount of cases (reference 1). The Corona Cockpit calculates an index based on:

• 0% stands for Case Fatality Rate (CFR) of 10% or higher (world's last devastating pandemic Spanish flu with 50 million deaths had a CFR of 10%).
• 100% stands for a Case Fatality Rate of 0,1% (the yearly influenza has a CFR of 0,1%).

In perspective. The Case Fatality Rate of coronavirus changes with age (reference 34). For example the average fatality rate may be 2.3%, but rises to nearly 15% among those over 80 years old. Since the Case Fatality Rate is based on the amount of officially reported corona cases and deaths, the actual CFR might be lower (more cases in reality than reported) or higher (more deaths than reported, e.g. when old people in nursing homes are not tested and counted as corona deaths).

3. Recovering

Why this kpi? To monitor how many people are recovered from the corona virus as an indication for group immunity.

How it is measured? Worldometer (reference 2) and Microsoft's Bing COVIC-19 tracker (reference 23) are publishing corona recovery data on a daily basis. Worldometer uses global and European data from official reports, directly from Government's communication channels and is trusted by Johns Hopkins, Financial Times, New York Times en BBC. Bing is also publishing Dutch data on people recovered from corona.

• 0% stands for nobody is recovered
• 100% stands for everybody is recovered

In perspective. Some countries like Netherlands do not report recovered corona patients while in reality many patients do recover from the virus. Also there's discussion (reference 35) going on if people can get reinfected: in South-Korea 163 recovered coronavirus patients are testing positive again.

4. Securing

Why this kpi? To monitor how safe the streets are. This can be achieved by a high % of lockdown or a low Case Fatality Rate of the corona virus or an optimum combination of both.

How it is measured? The securing index of the Corona Cockpit is based on the lockdown data index (weight 50%) and the Case Fatality Rate index (weight 50%). Google (reference 5) reports data of changes of mobility in retail & recreation compared to their baseline via community mobility reports from Google Maps. Other lockdown sources are citymapper (reference 11) and World Economic Forum (reference 15). World Health Organisation (reference 1) is reporting the official Case Fatality Rate (CFR).

• 0% stands for no lockdowns and CFR=10%
• 100% stands for total lockdown and CFR=0,1% 

In perspective. Many countries have different definitions and levels of a lockdown or stay-at-home order. In some cases, outdoor activities are allowed and nonessential businesses comply with social distancing rules while in other cases people have to stay at home and need special permissions to go outside. Lockdown data via community mobility data of Google Maps is indicative: although 1B people are using it frequently (reference 36) still 6 billion people are not using it.

5. Curing

Why this kpi? To monitor how near we are in finding a cure and global immunisation with a corona vaccin.

How it is measured? The curing index is calculated by multiplying "vaccine chance" (50% weight) and "vaccine readiness" (50% weight) of a successful corona vaccine.  The factor "vaccine chance" is based on the amount of days left to the moment of 1,5 years (547 days) after January 1st, 2020. On that day China alerted (reference 26) the WHO to several cases of unusual pneumonia in Wuhan. BBC reported (reference 25) that most experts think a vaccine is likely to become available by mid-2021, about 12-18 months after the new virus, known officially as Sars-CoV-2, first emerged. The factor readiness is calculated by dividing the amount of corona vaccins candidates by 235 as reported by WHO (reference 16) and Artis ventures data (reference 24). The amount of 235 candidates is based on the current amount of 102 vaccin candidates which resulted in 8 candidates in clinical phase (235 may result in 20 candidates). According to the Dutch virologist Hanneke Schuitemaker of Janssen Vaccines (Johnson & Johnson) 90% of the clinical candidates will fail (reference 46), so out of 20 vaccin candidates possibly 2 may be successful.

• 0% stands for 547 days (1,5yrs) to go AND zero candidate vaccins (vaccine chance x vaccine readiness)
• 100% stands for 0 days to go AND 235 or more candidate vaccins (vaccine chance x vaccine readiness)

In perspective. A traditional vaccine development pathway including development phases, innovative regulatory processes and scaling manufacturing capacity takes on average over 10 years and an accelerated pathway (first Ebola vaccine) 5 years according to Nature (reference 27). Currently there's also little known about how many corona vaccine candidates you need in the pipeline to have one successful vaccine. On the other hand: researchers at Oxford (reference 38) are optimistic that the first few million doses of their vaccine could be available in September 2020, 9 months after China alerted the WHO. 

6. Learning

Why this kpi? To monitor how much we are learning from the amount and frequency of former pandemics.

How it is measured? The learning index is based on wikipedia published official WHO data (reference 17 & 18) on the amount of active outbreaks with more than 1000 deaths (50% weight) and the number of years between pandemics (50% weight).

• 0% stands for 10 active outbreaks and 10 yrs between pandemics
• 100% stands for 0 active outbreaks and 1000 yrs between pandemics 

In perspective. According to a large group scientists IPBES (reference 40) we ain't seen nothing yet: "1.7 million unidentified viruses of the type known to infect people are believed to still exist in mammals and water birds and future pandemics are likely to happen more frequently, spread more rapidly, have greater economic impact and kill more people". Still the frequency of pandemics are hard to predict and however pandemics of centuries ago are well described (reference 28) the detailed facts remains unclear of what exactly really happened why and how. That's why this kpi is for 50% also based on the amount active outbreaks with more than 1000 deaths.

7. Preventing

Why this kpi? To monitor how we are preventing outbreaks by reduction of the intensity of contacts between animals and humans, and humans between humans. This kpi is relevant since human infections of animal origin – has accelerated in recent decades caused by the global, human-dominated ecosystem (reference 29) and six out of every 10 infectious diseases in people are zoonotic (reference 30). Public health scientists from multiple countries overwhelmingly conclude that this coronavirus originated in wildlife (reference 45). 

How it is measured? The preventing index is based on the amount of vegans (50% weight) in countries and level of globalization (50% weight). Nederlandse Vereniging van Veganisten (see reference 6), CBS (reference 7), Friends of the Earth Europe (reference 12), Worldometer (reference 13 & 20) and Veganbits (reference 19) are reporting on the amount of vegans (humans not eating or using animal products) in respectively Netherlands, Europe and the world. The KOF Swiss Economic Institute (reference 8) yearly measures the economic, social and political dimensions of globalisation via the Globalisation Index.

• 0% stands for nobody is vegan AND globalization score = 100
• 100% stands for everybody is vegan AND globalization score = 1

In perspective. Still 40% of infectious diseases are not zoonotic and a vegan lifestyle probably will never reduce all contacts between animals and humans: people will have pets, there will be veterinarians needed and people will have contacts with animals - like insects - in nature. Although animals seems to be strongly related to the coronavirus outbreak other events like laboratory accidents (reference 43) and also air quality are related to the corona outbreak. A recent study by the World Bank (reference 42) showed that atmospheric particulate matter with diameter less than 2.5 is a highly significant predictor of the number of confirmed COVID-19 cases.

8. Transforming

Why this kpi? To monitor how we are transforming human life on earth (like good health and sanitation for everybody on the planet) in balance with nature and animals on the long term via the 2015-2030 Sustainable Development Goals of the UN (Global Goals).

How it is measured? The transforming index is based on the global achievements in reaching the 17 global goals set by the UN (reference 37).

• 0% stands for no achievements in reaching the 17 global goals
• 100% stands for all 17 global goals are met

In perspective. The Global Goals are forming a very broad 2015-2030 UN agenda covering goals in different areas: climate action (goal 13), reducing inequalities (goal 10), decent work & economic growth (goals 8), life on land (goal 15) and life below water (goal 14). Not all 17 goals are having direct or indirect impact on corona virus outbreak.

9. Investing

Why this kpi? To monitor how much we are investing in vaccins, protection materials and Intensive Care Units to cope with the increasing amount of complex and unpredictable viruses.

How it is measured? The investing index is based on the health expenditure per capita as published by OECD, Organisation for Economic Co-operation and Development (reference 9 for Dutch data & reference 14 for European data) and WHO, World Health Organisation (reference 21 for global data).

• 0% stands for $0 health expenditure per capita
• 100% stands for $10.000 health expenditure per capita

In perspective. In the first months of the corona crisis (jan-apr 2020) countries with the highest health expenditure per capita, like USA and Europe, experienced the highest number of corona cases while - for example - African countries had much lower amount of corona cases. This may change over time. Also USA and Europe were confronted by many shortages of protection materials and Intensive Care Units despite their relatively high health expenditures (EU: $3.000 per capita). Probably much more expenditures are needed to have sufficient care materials and effectively cope with outbreaks. According to a group of scientists who led the most comprehensive planet health check ever undertaking (reference 39) we need a global “One Health” approach: “The health of people is intimately connected to the health of wildlife, the health of livestock and the health of the environment". 

10. Smiling

Why this kpi? To monitor how many happy people we have with good reason for smiling - figuratively - and with less stress to improve of their immune system. Happy people are spreading positive energy and their mental health can support them to prevent depressions and overcome lockdowns. Researchers from Harvard University (reference 41), University of California (reference 48), University of Utah (reference 49) and Pulitzer price winner and New York Times journalist Matt Richtel (reference 50) supports the connection between happiness and health. 

How it is measured? The smiling index is based on The UN yearly publishes the World Happiness Report. Reported key variables for happiness are GDP per capita, social support, healthy life expectancy, freedom to make life choices, generosity, and freedom from corruption.

• 0% stands for 2567 points, minimum score by least happiest country (Afghanistan)
• 100% stands for 7809 points, maximum score by the most happiest country (Finland)

In perspective. John F. Helliwell, an editor of the annual happiness report, according to the New York Times (reference 44): "happy people wouldn’t have the highest smile factor. They do trust each other and care about each other, and that’s what fundamentally makes for a better life.

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