The CODE Update – Introduction

Priscilla Robinson

The CODE Update is a new regular feature on the Intouch blog to keep readers informed of COVID-19 developments around the world.

The CODE update originally began at the start of the SARS CoV-2 pandemic as a way of explaining it to my friends and family who happen to live all over the world, and who were being bombarded with information and misinformation in their own countries. The CODE Update provides links to practical materials and papers written for people who are not versed in the language of outbreaks and epidemic curves. It is sent out every week, and includes a short commentary to provide context to the numbers included in the spreadsheets.

Note: Whilst every attempt is made to transcribe all data faithfully, every now and again mistakes are made and not noticed until the next update. Also, on occasion numbers are revised after posting at the source databases.

Spreadsheet data:

The data contained in the spreadsheets come from four main sources:

• COVID case and fatality numbers from the Johns Hopkins and WHO websites
• Population data from Worldometer
• Australian data from the federal government COVID website.

The links for these can also be found on the relevant part of the spreadsheets.

COVID data are transcribed from these most days, and for the Snapshot, Africa, SEARO, and WPRO sheet on Wednesday each week.

The spreadsheets show the population sizes (total and 100,000s as those are the indicators used to compare rates of any disease); the total number of notified positive cases and the population attack rate per 100,000 people; deaths and death rate (%); and in the final columns, the proportion of the world’s population, the proportion of cases and deaths contributed by each listed country. The first 20 countries are those which are highest on the WHO notification lists.  A quick look will tell you that the top two countries with COVID burden – India and the USA – include almost 22% of the world’s population, but 35% of cases and nearly 30% of notified COVID deaths.

The Snapshot provides a week-by-week comparison of progress in the six WHO regions, so that over time rises in cases and fatalities are less subject to day-to-day surges in notifications – for example, some countries never report any cases on Mondays and Tuesdays, and then several thousand on Wednesdays.

The data are transcribed rather than downloaded, so occasional errors do occur (but not too often). Sometimes individual countries also revise their notifications – once the Johns Hopkins site carried the annotation ‘XX cases recovered’ when their fatalities were revised downwards. In addition, there are differences in the ways in which each country records cases and fatalities. However, over time the patterns of notifications for these countries has remained quite consistent.

So, whilst these data are not perfect, they are consistently imperfect for each included country.

We hope you will find these updates to be a helpful tool, and the links to current information useful.

The CODE Update – third week of February, 2021

View the most recent spreadsheets 

This week the news is mainly positive, with both cases and fatalities continuing to fall (and I am very glad that WHO agrees with me – how about that?!) . There are of course pockets where that is not the case, but overall globally things are looking up, at least for this week. It is much too early to attribute this to the introduction of vaccines yet, although by now it will be starting to make some differences. Here is the current WHO epidemic curve since the start of the pandemic:

There has been a lot of news reporting about ‘new strains’, which is worth a mention. There are new COVID variants in the UK, South Africa and Brazil – and probably other places too.

The spreadsheets tell us a great deal about overall rates, but noting at all about how infections happen in clusters within communities. So a 10% overall rate in a population – as in Chechia, and almost as high in the USA – does not mean these cases are evenly distributed throughout a population, but occur in clusters (family groups, work places etc.). Therefore these groups are no longer able to be infected, and will have some immunity. Viruses always change a little as they progress, and these new strains are also finding homes in people who have not already developed protective antibodies, so of course they will become the dominant strains, probably all slightly more ‘infectious’ but also a little less fatal – that’s what usually happens as outbreaks progress. The R-rate for the new UK strain seems to have risen from 1.4 to 1.7 – not really a great increase despite the news reports (interpreted this as a 30% increase, which it certainly is not!!)  – but as I always say, I am happy to stand corrected if I find evidence to the contrary.

The vaccines still seem to be protective against these strains (PLEASE NOTE that the evidence from South Africa about a lack of protection was based on a very odd and tiny study of 20 people). This is not a good reason to not be vaccinated.

I came across this cartoon video from the wonderful Johns Hopkins: I’m a Vaccine — How a Hypothetical COVID-19 Vaccine Came to Be – clearly designed for general use. It would be very helpful for explaining how the various stages of clinical trials work to people who are worried about vaccine (and other pharmaceuticals) safety. I also commend the WHO COVAX project for continuing to promote the need for equity of access to vaccines for all countries, wealthy and poor, to manage this pandemic.

About Dr Priscilla Robinson

Dr Robinson is a public health epidemiologist with particular interests in international health and communicable diseases, and public health competencies. She has worked in health departments in England and Australia, has managed public health teaching programmes, and taught and researched many aspects of public health epidemiology and policy in many countries. She is an adjunct Associate Professor at LaTrobe University, and to stop herself being bored is an editor of PHAA’s journal ANZJPH, and holds board positions (almost all unpaid) on various NGOs, journals, and at her local hospital. Otherwise, 10 acres of untamed bushland on a hill in South Gippsland makes weight-bearing gym exercise and strength training a bit redundant.