Inside Covid-19: Hope soars for vaccine before year end; Percentages exaggerated? – Ep 7

In episode seven of Inside Covid-19 we feature an exclusive interview with the professor who is leading Oxford University’s team working around the clock to developing a vaccine. Prof Adrian Hill says one is now in sight and will probably ready for release before the end of the year. But the Ebola and malaria specialist frets that without changed behaviour, Covid-19 could wreak fearful damage in Africa. On a brighter note, numbers man Deon Gouws of Credo reckons infection numbers and mortality percentages are being exaggerated; and we close off with the #Staytheffhome campaign gaining ground in in the US. – Alec Hogg

In the Covid-19 headlines today:

  • Confirmed global infections rose 23% Saturday to just under 700,000 with deaths rising to just over 32,000. The United States has the most confirmed infections, at just over 125,000 with Italy at 92,500 – both still recording infections rising at over 20% a day. China’s infections remain static at just over 82,000 and Sunday it re-opened domestic flights to Hubei province, where the disease originated. At just over 10,000, Italy now accounts for around a third of the global deaths, with Spain at 6,500 now double that reported by China. There have been 2,200 deaths in the United States, with a third of those in New York City. The US’s top infectious disease official Dr Anthony Fauci warned Sunday that Covid-19 could kill up to 200,000 Americans. He urged New York City residents to not travel to other states. After floating the idea of isolating New York to contain the spread of the virus, US President Donald Trump backed away from imposing a quarantine.
  • South Africa’s confirmed infections rose in line with the 30% a day rate to 1,187 Saturday, around half of them in Gauteng and a quarter in the Western Cape. Among those infected are 13 health workers, a dozen doctors, six from Gauteng and five from the Free State. South Africa is one of ten countries that have confirmed participation in the World Health Organisation’s Public Health Emergency Solidarity Trial. The South African team of 30 academics, clinicians and researchers from eight universities is led by Wits University professors Helen Rees and Jeremy Nel. They will be testing the impact on Covid-19 patients of drugs identified by the WHO as the most effective so far – an Ebola trial drug Remdesivir, an HIV treatment drug Lopinivir and Chloroquine, which is used to treat malaria.
  • President Cyril Ramaphosa enjoyed an uplifting photo-op in Polokwane Sunday when he officially ended the quarantine of 112 South African citizens who had been airlifted from Wuhan, where Covid-19 originated. All of the evacuees tested negative. The country continues to gear up for an expected wave of infections with the six existing testing laboratories in academic hospitals soon to be supplemented by 47 mobile laboratories which will be able to test up to 30 000 tests daily by end April.

Over to London now and really nice to be talking to Deon Gouws who is the Chief Investment Officer at Credo. Deon, I was fascinated by a piece that you wrote about Covid-19 – not least because it’s very personal, your mother’s 93 years old so you could say in the highest risk group for this disease – but you unpacked it in some interesting ways. Just as far as your mum is concerned, is she okay?

Yes thank you Alec. I spoke to her this morning and she’s fine. She’s obviously concerned and has been for the last month or so, but all good.

So you’ve had a look at the mathematics of what we are being told about Covid-19 and they seem to be somewhat exaggerated.

Yes, I want to start by saying two things. One is I’m not a medical expert and I’m not really commenting on the disease in terms of how bad it is or might get. I fully respect that it is bad for many. The second point is – and I’m not making light of it, which is why I started by respecting my mother who is in this risk category – when it comes to the maths and the stats around it and the way that this is reported, I do think there’s a lot of hyperbole and a lot of misleading reporting and that’s what I tried to address in my piece.

Starting on the first one, the rapidity with which the disease is spreading. We know that from John Hopkins University, it’s now nearly 700,000 today from around 500,000 yesterday. So there is definitely exponential growth in this and I guess if one extrapolates that into the future the figures do look very scary.

Yes, but what I tried to say in my piece is these numbers – 500,000 a day or two days ago and 700,000 today – I don’t think that tells us much about how the disease is spreading. My assumption frankly, is that if we look at a global population of what we have – there’s probably several million people today, maybe tens of millions, maybe hundreds of millions of people who will have the disease or might have had it in the last month – so the fact that we go from 500,000 to 700,000 in a couple of days, is not a function of the spreading of the disease, it’s a function of the testing. We haven’t been testing till recently and now we’re going gangbusters. We’re testing all the time, we’re testing thousands of people per day in the UK and in other Western countries and that is why we’re finding these cases. Bearing in mind that the only people who do get tested in a place like the UK are people who present several symptoms and have done so for several days. If I have symptoms tomorrow morning, the NHS will tell me to self isolate for 7 days before I come back and before I qualify for a test. By the time people go for a test, there’s a very high chance that they will test positively and as I say, they are now doing tens of thousands of tests per day in each country in the western world.

Also read: Good Samaritans stepping forward – SA pharma donates chloroquine tablets for Covid-19 treatment

What is interesting is that we know that most people are asymptomatic so they don’t actually show anything more than perhaps just a very mild flu. In your piece you wrote about you perhaps also having had Covid-19 already without even knowing it.

Well, I did have quite a bad flu in January and I actually checked my log book this morning – because I’m a runner and I was training for the Two Oceans marathon – I missed 8 days running in January because it was the worst flu I’ve had in at least five years. I had all the symptoms that you read about in the newspapers today. It started with a sore throat and a fever and I felt quite bad for a day or two and then I had a horrible cough for about 7 days, after that a lingering cough for another few weeks. So is this the coronavirus? I don’t know and maybe I’ll never know. Maybe I’ve got the antibodies in my system now. What was interesting is on Tuesday the 21st of January, I got back to the office and a colleague sitting next to me – who’s following these things – was joking about it. That’s the first I heard of the coronavirus. I was probably a little bit late, but my colleague gets paid to be on top of these things, so he was already looking at the coronavirus. It was the week of the World Economic Forum and the news was just starting to come out. The first deaths were coming out in China and it started happening around that time.

It’s interesting that we are now hearing about famous people who’ve got the virus and I suppose – the point that you make again is – how come it’s missed the whole population and gone straight to the people like Tom Hanks and Prince Charles and so on.

Exactly. There was a tweet a couple of weeks ago that made that point. He said how can this virus affect the wife of the Canadian Prime Minister, Tom Hanks as you mentioned, Mikel Arteta – Arsenal’s manager – and now half the UK government. Maybe I’m exaggerating slightly but it’s got a few people in government and now some royalty – you’ve mentioned Prince Charles – and most of us don’t have it or we don’t know that we’ve had it. The point being that Tom Hanks, when he had his first cough in Australia, because he’s on a multi-million dollar acting gig, he gets a test every hour and then they find he’s got coronavirus and has to isolate for 2 weeks and recover. Thankfully he said it wasn’t that bad. But you and I were at the golf and we probably won’t get tested and it will come and go and hopefully we’ll be fine. I know it doesn’t come and go in all cases, once again I don’t want to make light of it, I know it’s a horrible disease for some – there’s been some horrific deaths – so I’m not making light of it, but for most people it really is not a killer disease.

But let’s talk about the mortality rates. What are you making about the reported figures?

Once again, people divide the number of deaths by the number of confirmed cases, so in Italy for example, the number might be about 9,000 – I haven’t checked it over the weekend – but there were something like 9,000 deaths and 900,000 confirmed cases. So take that 9,000 deaths divided by the 90,000 confirmed cases and it’s a 10% mortality rate. But that’s 90,000 confirmed cases. I am convinced – based on what I’ve said before on this call – that there must be hundreds of thousands perhaps a few million people in Italy, that had the disease or who may have the disease today. So you’ve got to divide the 9,000 by the million or more people that had the disease to get something more accurate in terms of the mortality rate. I’ve seen people model this. I’m talking about people who are epidemiologists and the estimate is that it could be a fraction of 1% ultimately. That’s on the low side, it could be more than that, we don’t know quite frankly. That’s something we need to recognise – nobody really knows what the number is – it’s too early to tell. Certainly the kind of numbers that do get reported – for the most part – are exaggerated and boil down to – not only bad reporting but – hyperbole.

The problem for South Africa is that a high percentage of the population have HIV/Aids or who are TB sufferers. If this virus were to get amongst them – that’s the theory anyway – we could have very high mortality rates here. What’s your take on that?

I think that is a real risk and that’s a real concern and there’s not much more I can add to that. Except to say that I think the lockdown in South Africa today unbalances a lot of the people that you are referring to – not those that are living in luxury homes with a big gardens – those living in informal settlements where they are living right next to each other perhaps sharing sanitation and the like and therefore I’m not sure that the lockdown is going to help them either. I think their bigger concerns are the TB and other things that you referred to but yes, once the virus does get hold of that sector of the population, I think it will be a concern. There’s no doubt about that.

We’ve also seen other countries really concerned about what’s been going on in Italy. Again, relatively speaking, there is a different demographic there than in South Africa.

Yes. The Italian population – as listeners will know – is one of the oldest populations in the world. More than 7% of the Italian population is over 80 years old and therefore we know that the coronavirus affects elderly people more than younger people and that’s part of the reason they’ve had a fairly high mortality rate. We will have to see this play out. The other countries – in terms of the maturity of the disease if you like – are China, but people don’t trust the numbers coming out of here, so it will be interesting to see Spain and France, which are closest to Italy in terms of timing. We should know within a week or 10 days how similar the experience is in Spain and France compared to Italy where the acceleration of the disease and the deaths seem to have slowed down. I’m not saying the crisis is over, but certainly it’s not growing exponentially anymore.

So, with your day job – as the Chief Investment Officer Credo – are you looking at these markets and the sell off that we’ve seen and believing that perhaps it’s been overdone. I know there’s been a huge bounce in the past week – supposedly that was the shortest ever bear market and we supposedly are back into a bull market – how are you reading that?

It’s very difficult to say. Markets are only ever obvious and easy in hindsight. So I’ll phrase it like this. I have no doubt that we are living through a very interesting period – not only in the world but certainly financial markets – and at some point, it may still be some weeks or months. I have no doubt that markets will have overreacted and we will in hindsight realise we had a once in a lifetime buying opportunity. Whether we are there now, whether we have seen the worst, I think it’s simply too early to say. The US is really only going into it now and I think with the kinds of news flashes we see coming out of the UK we can expect some turbulence and volatility. Who knows when the bottom will be or whether we’ve had it already. Only time will tell.