- The document provides a daily analysis of the COVID-19 pandemic from the perspective of an international public health specialist based in China. - Key points covered include the situation in various regions and countries, with China taking strict measures to prevent a second wave, concerns about Africa's ability to respond, and the US now reporting the most new daily cases. - Worldwide, the number of cases is doubling every 4-5 days, with over 260,000 active cases across 5 major outbreak zones. The pandemic is developing rapidly.

1. About 50% of the world's confined
population: Africa, India, Europe, 40%
of the United States, etc...
PREAMBLE
Our Covidminute.com team is made up of volunteers (apart from computer scientists!) And aims
to:
● help decision makers make the right decisions
● reassure the population by providing technically flawless and "ahead" information on the
media (more than the current trends and trends)
We had since the beginning of the epidemic “reassured” the French community by a daily
newsletter distributed since January 28 on the Chinese messaging WeChat. First with a few
hundred people, to reach more than 4,000 followers after 3 weeks.

2. The Chinese authorities having prohibited the dissemination of any Covid analysis in early
March, we have migrated to a site and a mobile app which is ready ("all in one").
If by chance, you had openings (public funding, patron or sponsor, ...), to help us improve,
maintain and disseminate this application, do not hesitate to contact me:
guillaume@covidminute.com.
We offer an “all in one” application, including a minute analysis for breakfast, because we are
legitimate (I have been producing this daily report for 58 days!), Have technological skills (see
mapping, ...), and have the more often a step ahead of the understanding of the situation and the
challenges due to our experience of the epidemic in Asia.
The whole team (Dr Athmani, Carole Gabay, Mathieu Bouquet, Stephane, Laetitia, Marie, ...)
thanks you for your many encouragements.
Dr Guillaume Zagury
A. China : a great wall to avoid the “second wave”
1. Gross and relative figures
About 50 new cases per day (average) in Shanghai and Beijing, or about 800 cumulatively.
2. Know how to read curves
● Emotional vision: the first reading of the curve of imported cases can cause some
panic. The numbers seem to be exploding.

4. rational vision: there are approximately 27,000 daily arrivals from abroad, and around
50 cases detected, most often at an asymptomatic stage.
The accumulation of cases certainly gives an impression of explosion, but the daily
number of these new cases has been relatively stable for several days, and they are
well identified and managed (as well as those around them).
3. A process well in place
From 7 to 23 hours of procedures between landing and leaving the airport: questioning of
recent trips, examination (temperature, ...), often “nasal swab” test, administrative process,
...
4. Regulations that are constantly adapting
● The control measures have gradually tightened over the past 2 weeks.
● Planes bound for Beijing are redirected to airports in the periphery or to Tianjin for
passenger screening.
● In the region: closure for 15 days of Hong Kong and Singapore airports to non
residents since yesterday
The following testimony from my friend Mathieu is quite
eloquent
China is taking precautions and using technology.
● Since Wednesday, all new arrivals are subjected to the screening test, and they are
more and more to have to carry out quarantine in a dedicated hotel (at their
expense). These measures are in addition to the investment that China is making to
avoid a resurgence of contamination. As a reminder, all new recent cases in China
are imported cases.
● Entrance door remotely controlled by the police. The police have just passed by and
equipped me with new equipment. My apartment door is now equipped with a motion
detector (see photo below, equipment marked with China Telecom, probably with a
SIM card inside) which sends this information (opening / closing of the door) to the
police.
● Whenever I go out to collect packages or throw out trash (space dedicated only to me
to avoid sharing my trash with people who have not traveled abroad recently), I have
to do more share of each door opening on Wechat to the local police in a WeChat
group created for the occasion with 8 other people who return from abroad and live in
the same residence.
● As a reminder: I do not cough, I do not have a fever, I have absolutely no symptoms
but simply, I come back from France and the government of Shanghai does not want
to take any risk.

5. ● If we calculate the cost that this represents for the Chinese government, the total of
my return to China cost at least 300 euros in terms of time, material, allocation of
means of transport, etc., without counting the fixed costs to install the organization
and planning. And we are thousands or tens of thousands to return to China in the
past week.

6. 6. Technological innovations
Dans les jours à venir, nous vous montrerons comment les innovations technologiques ont
complètement bouleversé la prise en charge épidémique.
B. “Crash test” : Africa (monitoring)
For lack of means, the war will be above all epidemiological (closing
of borders and confinement). If people don't move, the virus won't
move!
● Together with my colleague, Dr Bachir Athmani, we assess a health system every
day when faced with potential massive influxes of patients.
● Remember that in the current state of knowledge, 15% have severe forms requiring
hospitalization and 5% a stay in medical intensive care for 1 to 2 weeks generally),
based on experience in China ( including more than 90% of cases in Hubei).
1. The virus is geographically present in 80% of African
countries
Cases have been detected in 44 of the continent's 54 countries, but the virus has apparently
not yet spread. The number of cases detected is still quantitatively low: 1,800 cases,
including 57 deaths, or around 3% of lethality.

8. 2. Figures and analysis
● Spatial vision: ​Egypt (294 cases detected / 8 deaths), Ethiopia (9), Algeria (139/11),
Senegal (56), Ghana (21/1), Morocco (109/3), Tunisia (60/1) , Burkina Faso (75/3),
Togo, Côte d'Ivoire (14), Guinea (2), Mauritania (2), Gabon (3/1), Kenya (15),
Rwanda (17), Uganda (1) , Sudan (2/1), Cameroon (27), Namibia (3), Congo (23/1),
South Africa (240), Central African Republic (3), Equatorial Guinea (6), Benin (2),
Liberia ( 2), Somalia, Djibouti, Nigeria (22), Gambia, Zambia (3), Niger (2), Chad,
Angola (2).

9. ● Vision temporelle :​ une évolution prévisible depuis 1 semaine
3. Continent at risk for multiple reasons
● Who says war (Central Africa,…) says epidemic.
● Difficulty enforcing social distancing: living conditions (30% of the population lives in
shantytowns, places of worship very crowded, megacities like Lagos, etc.)
● Prevalence of AIDS-type comorbidities: South Africa has the most Covid patients -
402 cases - coupled with one of the highest AIDS rates in the world.
4. It is illusory to play on the therapeutic side
● Developed countries like Italy and France are often already saturated.
● The medical network is insufficient: 20 times less general practitioner per inhabitant
than France
● Technological equipment (intensive care units, etc.) is also insufficient: I was
discussing it yesterday on Tunisian TV. Tunisia has 350 resuscitation beds for 11
million inhabitants, 3 times less per capita than France.
5. The only solution will be preventive
● The majority of countries have understood this, and are adopting the only weapon at
their disposal: prevention by confinement (allow 3 weeks to see its effects) and the
closing of borders.
● The example of Italy seems to have made a big impression.
● The term confinement is still variable geometry: schools, curfew, threshold of
meetings, ...)
● Some countries to salute having taken rapid preventive measures and which it will be
interesting to follow: Rwanda, Mauritius.
6. An important advantage: youth

10. The continent's population is young, while the severe forms of the disease and mortality
primarily affect the oldest (65 years and over).
C. France – Living with D20, confinement D9
Period of uncertainty after a week of confinement: if some "furry" have spent 4 years in the
trenches, we can try to spend 4 weeks (between 1 and 6 weeks) at home.
1. Incidence: + 2,450 new confirmed cases (3,200 yesterday)
We are still in the epidemic growth phase.
2. Prevalence: 17.9 k in observation (16k yesterday)
● The doubling time remains stable at 5 days.
● Note that the figure of 22,000 total cases reported by the media is, in my opinion, not
a relevant indicator, since it includes the historical cases healed, the deaths and the
cases currently under observation.
● So if I say that: China presents 88,000 cases ... this is true cumulatively, but 98% are
cured and there have been no indigenous cases for several days !
3. Comparative dynamics (/ Italy): France seems to be
deviating slightly from Italian development over the past three
days
● The average trend for the last 3 days is to slow down compared to Italy a week ago
(see graph below).
● However, be careful with the data and compare what is comparable: the Italians now
have a more case-oriented strategy, whereas we are much less so. Thus, according
to some, but to be confirmed, France has tested approximately 2 times fewer people
than Italy at the same stage of the epidemic.

11. 4. Geographical distribution and health system: +/- 10% of
cases in intensive care
● Key figure released yesterday, concerning the distribution of mortality which joins the
data observed in Wuhan: in France, 85% of deceased patients are over 70 years old.
● Resuscitation and intensive care: 2,500 cases, a third of which are less than 60 years
old.
● Over 1,000 deaths (1,100) including 186 yesterday in 1 month, but which does not
take into account deaths in nursing homes possibly linked to the virus.
● France, like many European countries, is not in the lead in terms of protective
equipment and screening tests. So let's welcome the order for around 30,000 kits for
the weekend.
● Mulhouse, the “French Bergamo”, where the President did well to go to come into
contact with the carers, for the extraordinary work provided.

13. 5. Regional analysis
6. To note
● Interesting to follow the case of Morocco, which made the decision to treat all
hospitalized cases with Plaquenil, for 4 days: equivalent to a large-scale clinical trial.
● Paradoxically, the hexagonal plant producing Plaquenil (chloroquine), potentially in
receivership, will perhaps benefit from a second chance (orders by Sanofi, ...)
● The French overseas departments and territories are also affected: 23 cases
detected in Guyana, and Cayenne raises the tone in the fight against the
coronavirus. Like several cities in France, the administrative center institutes a night
curfew from this evening (March 24, 2020). Decision motivated by the excessive
number of sprains to the limitation of displacements. Note also that close Haiti
observed 2 cases yesterday.
D. Incidence worldwide: the United States takes
over, slight improvement in Italy on D14 (see
03/10/2020)
Thanks to Stéphane, a companion from the start, for his participation.

14. 1. Incidence: 40k new cases diagnosed - Acceleration of the
pandemic
These are very important levels since in Wuhan, the number of new cases notified daily was
around 3,000 (although there was a likely underreporting due to the limited number of tests
available)
2. Chronological vision
3. Geographic vision
● Global vision by country

15. ● Vision by continent: the Americas
● Country vision: top 7
○ United States 11,100
○ Italy 5,200
○ Spain 4,700
○ Germany 4,000
○ France 2,400
○ Iran 1,800

16. ○ United Kingdom 1,400
● Italy: the number of new cases detected has not decreased like the last 2 days, but
the trend confirms a slowdown on D15 (we will see tomorrow, if the containment
produces the expected effects). Bergamo is the most affected city, some invoke the
sold-out international European Cup soccer match Atlanta-Valencia as a focal point.
● The United States is now firmly established as the country with the highest number of
new cases daily.

17. D. World: prevalence, 260 K active cases (379 K
cumulative) - Faster doubling time
WHO Director-General Tedros Adhanom Ghebreyesus made the following observation
yesterday:
- 67 days to reach the first 100,000 prevalence cases
- 11 days for the next 100,000 cases
- 4 days the following 100,000 cases
1. Time vision (chronological)
● Figures to be taken with caution given the disparity in testing strategies: the epidemic
can spread without it being reflected in official figures, if patients are not screened
biologically.
● At the current rate, doubling of cases worldwide every 4-5 days (stable).
2. World space vision
● The map of the day shows us 5 outbreaks: Western Europe, United States and
Central America, Middle East and to a lesser extent (but to be considered with
caution because the means of detection are weaker) West Africa.
● Top 6 countries:
○ Italy (54K active cases)
○ USA (52k)
○ Germany and Spain (33k)
○ France (18k).

18. ● At the continental level: a quarter of the current cases are in North America.

19. F. Geopathology: a world in turbulence awaiting
therapeutic solutions ...
1. Postponement of the Olympic Games
It is the first time that the Olympic Games have been postponed in peacetime (the previous 3
in 1916, 1940 and 1944 were due to the war). The Tokyo Olympics are likely to take place
next year, but will still be called "Tokyo 2020".
It should be noted that the Paralympic Games could not have taken place anyway, due to
the too high risks for patients of the cystic fibrosis or myopathy type.
2. European Union: Europe, yes but which Europe?
● This health crisis is the third crisis that is shaking our European space (after the
financial crisis of 2008 and the migrant crisis of 2015).
● It revealed the current limits of the system, because health Europe (like military
Europe) did not work: stocks (masks, tests, ...), no common policy, ...
● Take the example of Italy, which has received almost no material support (aid came
from China, Cuba and Russia / even if it is mainly communications operations).
3. Historical rise for Wall Street
This record jump in the Dow Jones index has never been seen in 90 years. It arises because
optimism has returned to stock market circles, following the announcement of a massive
American stimulus plan ($ 2,000 billion should be allocated soon).
4. United States: what is the dollar cost of human life?
● For President Trump, a shutdown beyond 15 days would be unreasonable and it will
quickly return to "business as usual".
● According to some of these advisers, a severe economic recession would be more
dangerous than maintaining the shutdown.
● Even in health terms: mental health (and its corollary of suicides), delayed diagnoses
(oncology, etc.), etc.
● This reminds me of the Prime Minister of Singapore's 2003 statement: "We will not
die from SARS, but from its economic consequences"

20. Coming tomorrow
● Probably a video: we are equipping ourselves
● The impact of new technologies
● A “stress test” on Russia
● Monitoring: Morocco (use of chloroquine), India, Thailand
Keep in mind the “3M reflex” (Hands-Masks-Meter) to protect yourself… but above all to protect the
most vulnerable.
Trust and solidarity for this collective fight
Dr Guillaume ZAGURY
Specialist in International Public Health
Consultant in “Health Innovations” ​
HEC
In China since 2000.
“All success is collective”, thanks to:
● the whole “Back Up” team (Mathieu Bousquet, Carole Gabay, Flavien, Marie, Laetitia,
Anne-Sophie, ...), without whom this project would not have been possible.
● all the “Medical” team (Dr Bachir Athmani, Dr Ibrahim Souare ,, Dr Taieb, Dr Viateur ...) who
allow this project to exist,
● all historical financial sponsors (Jerome, Benjamin Denis & B Square, Benoit Rossignol,
Arnault Bricout) who work for “Citizen Actions”
If you feel like a patron or of partners to finance IT development, don't hesitate to contact me
(guillaume@covidminute.com).
Also, even if part of the team is based in Shanghai, do not hesitate to come and join us, because
there is no shortage of work :-)