Random Analytica

Random thoughts, charts, infographics & analysis. Not in that order

Category: Health

Random Analytica: Australia COVID-19 cases by day

Here is a look at the total Australian cases by day since the 100th case was recorded on the 10th March 2020.

As at 6.00am on the 9th April 2020, there have been 6,052 confirmed cases of COVID-19 in Australia, including 50-deaths. The Case Fatality Rate (CFR) based on those numbers is 0.83%.

200409_Chart_CasesByDay_Australia

Key Dates:

28th March: Travel restrictions imposed. All travellers entering Australia must undergo 14-days of isolation.
16th March: Social distancing measures adopted across all States and Territories.
13th March: Tom Hanks and Peter Dutton confirmed as having COVID-19. Measures to prevent spread tightened including social distancing measures.
18th February: Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19) launched.

Table: Total Cases by State

200409_Table_TotalCases_Australia

Random Analytica: Jakarta (Indonesia) COVID-19 cases by day

Jakarta is emerging as another COVID-19 pandemic hotspot. Unfortunately the data is really problematic to find prior to the 19th March. What is officially available is limited due to a lack of testing capability (among other issues). As an example the data available had Jakarta cases totalling 77 (to the 18th March), then a big jump of 133-cases (19th March) then hardly any cases with just five. This very low amount occurred on the 20th March which was also hari Jumat/Friday.

On the official numbers.

As at the 11th April 2020, there have been 1,949 confirmed cases of COVID-19 in the city of Jakarta, Indonesia, including 159-deaths. The Case Fatality Rate (CFR) based on those numbers is 8.16%.

200411_Chart_JakartaCasesByDay

Here is a look at the official numbers for COVID-19 deaths in Jakarta.

200411_Chart_JakartaDeathsByDay

** Special thanks to Anne Barker (ABC) for her assistance and Pak Agus Wibowo for his data tweets.

Key Dates:

10th April: Australia’s ambassador is withdrawn due to COVID-19.
31st March: Indonesia implements a ban on foreign visitors.
23rd March: Via the ABC. Coronavirus COVID-19 death rate in Indonesia is the highest in the world. Experts say it’s because reported case numbers are too low.
6th March: Indonesia restricts visitors from Iran, Italy & South Korea.

Random Analytica: NSW COVID-19 cases by age (to 25th March 2020)

NSW COVID-19 cases hit 1,029 today. I was interested enough to have a quick look into the NSW Health’s excellent web-page. Although they supply a lot of data and charts I couldn’t see a ‘bee hive’ graphic or the age pyramid. Given NSW has just topped 1,000 cases I thought it might be worthwhile doing the chart on their behalf.

My big take-outs from looking at the chart is the uniformity of cases from ages 20 – 29 to 60 – 69 for both men and women. That’s your core working age cohort. That’s when most people travel for work and pleasure. Looks like this disease will predominately target workers in its first wave.

Second takeout. There are just two children aged 0 -9 yet eleven people aged 90 or more. Children obviously less likely to present with COVID-19. I’ll let better minds than mine figure that one out.

Chart below: NSW Age Pyramid of NSW COVID-19 cases to the 25th March 2020 (n = 1,029).

200325_Chart_NSWxAge

Source: NSW Health

200325_Screenshot_NSWHealth

Random Analytica: Australian Coronavirus (COVID-19) cases by calendar week

The daily COVID-19 numbers are escalating quickly. If you think the daily numbers are worrisome take a step back and consider the weekly new case numbers.

In the past week the new cases increased almost five-fold.

Chart below: Australian cases by week. My chart time period commences from Monday 20th January 2020 with the first confirmed COVID-19 presentation on the 25th January.

200324_Table_AUSStatesWkNo

Random Analytica: Australian Coronavirus (COVID-19) cases by day (to the end March 2020)

Here is a look at the Australian cases by day since the first known case which presented on the 25th January 2020.

As at 6.30am on the 31st March 2020, there have been 4,359 confirmed cases of COVID-19 in Australia, including 18-deaths. The Case Fatality Rate (CFR) based on those numbers is 0.41%.

200331_Chart_AUSCasesByDay_FINAL

Via the Australian Department of Health. Coronavirus (COVID-19) health alert. Notes with a table detailing cases by location:

As at 6:30am on 31 March 2020, there have been 4,359 confirmed cases of COVID-19 in Australia. There have been 266 new cases since 6:30am yesterday.

Of the 4,359 confirmed cases in Australia, 18 have died from COVID-19. More than 230,000 tests have been conducted across Australia.

200331_Table_AUSStatesCaseNo_FINAL

* Note that under National Notifiable Diseases Surveillance System reporting requirements, cases are reported based on their Australian jurisdiction of residence rather than where they were detected. For example, a case reported previously in the NT in a NSW resident is counted in the national figures as a NSW case.

** Includes Diamond Princess repatriation cases: QLD (3), SA (1), VIC (4), WA (2, including 1 death)

Random Analytica: Early days of the Wuhan Coronavirus

I’m in the process of building a timeline infographic that tracks the progress of the still to be named Wuhan Coronavirus. It’s early days and I’ve a bit to research but here is a preview of where we are at with the virus in the early hours of the 21st January 2020.

200121_Infographic_WuhanCoronaVirus

Sources:

FluTrackers.com. 2019-nCov Confirmed Case List by Country and Province – Total = 222 (as of 8am ET)

Random Analytica: Samoa Measles Outbreak (2019)

The Samoan Government declared a State of Emergency on the 15th November 2019 and has subsequently extended that period until the 29th December. Via the Samoan Government. National Measles Response and Recovery Appeal 6 December 2019. Excerpt:

The Samoa Ministry of Health declared a national measles outbreak on 16 October 2019. There is widespread community transmission, with the outbreak strain the same as that causing the current outbreak in New Zealand. The Government of Samoa declared a state of emergency on 15 November 2019. Under the new Orders of the State of Emergency the Government has made vaccination mandatory for priority groups. Samoa activated its National Emergency Operations Centre (NEOC) on 15 November which meets daily to coordinate the emergency response and provides updates on the situation. Under the national order, various restrictions have been implemented including limitations on inter-island travel for all individuals below 19 years of age; temporary closure of schools, and strongly advising children not to attend public gatherings or attending any medical facility, unless they require medical attention. Immunised pregnant women are further restricted from attending their place of employment (public and private sector).

Infographic updated with data to 24th December 2019 via @samoagovt.

191224_Infographic_SamoaMeasles

Random Analytica: Mefloquine – Colonels & Generals

Mefloquine wasn’t just given to Diggers [Australian slang for Other Ranks]. Colonels and Generals got it too. They get sick and they die. They don’t believe the diagnostic overshadowing of PTSD makes any sense either. Some are even voicing their concerns.

Here is a list of Colonels and Generals who either received Mefloquine on Operations OR (more telling) refused to take it. Correct as at 20th October 2019. I’ll update accordingly.

 

Confirmed Mefloquine Exposure and Symptomology

18th October 2019 (Canada): Lieutenant-General Roméo Antonius Dallaire. UNAMIR (Rwanda 1993/94). Via W5. Romeo Dallaire joining lawsuit against government over anti-malaria drug. Excerpt:

In a W5 exclusive, Dallaire announced that he is joining a lawsuit against the Canadian government and Defence Department over an anti-malaria drug that he, and other soldiers , were forced to take on missions to Rwanda, Somalia and Afghanistan.

Dallaire, who led the international peacekeeping mission in Rwanda in 1994, has become the highest ranking soldier to join an unprecedented legal action by veterans over the use of the anti-malaria drug Mefloquine. He joins nearly 900 other veterans who claim the Canadian government and Department of National Defence “willfully ignored and concealed the risks” of the drug, which is marketed under the brand name Lariam.

Dallaire has been hailed a hero, both for his attempts to stop the genocide in Rwanda, but also for his outspoken admission that he struggles with Post-Traumatic Stress Disorder.

30th January 2019: Colonel Timothy Dunn (USA). Deployed (Sep – Dec 2006). Via the Military Times. ‘I plead with you to look at this very closely,’ retiree tells panel studying health effects of anti-malarial drugs. Excerpt:

Timothy Dunn, a retired Marine Corps colonel, was among those who told the committee they’d be willing to provide information.

” I open my self, my heart and soul and medical records to you,” Dunn said. “You have to do something to look at this closely and make a fair and just determination … there are many more than I who have had this problem.”

Dunn said he still suffers from insomnia, anxiety, depression, ringing in the ears, and dizziness.

22nd May 2016 (UK): General David Julian Richards. Operation Pallisar (2000). Via the Independent. British armed forces set to ban most prescriptions of controversial anti-malarial drug Lariam. Excerpt:

Lady Caroline Richards, the General’s wife, had also taken a keen interest in matter for a long time. She added “Wives and partners of people who had been affected by the use of Lariam approached me and described what had happened. There were some terrible, sad stories of trauma, of relationships ending, psychological problems. We heard about other forces which have stopped using Lariam, so this is obviously something which needed looking into.”

23rd November 2015 (UK): Major-General Alistair Duncan. Sierra Leone (1999). Via the Daily Mail. Has this highly decorated hero been driven mentally ill by an anti-malaria drug tourists are still given? Excerpt:

Today, however, he is locked up in a secure psychiatric unit near his home in Somerset. Tragically diminished, he has been incarcerated for ten months. He has lost the capacity to read and write; outbursts of aggression are punctuated by periods of torpor. He can be sweet-tempered and affectionate; remote and belligerent by turns. His wife, and a growing body of expert medical opinion, believe his psychiatric disorder has been caused, in part, by the controversial anti-malarial drug mefloquine, or Lariam, which he was given for six months in 1999 before being deployed to West Africa.

The Abstainers

31st August 2016 (UK): General Francis Richard Dannatt. Refused Mefloquine. Via The Guardian. Ex-army chief apologises to troops over anti-malaria drug. Excerpt:

Lord Dannatt, who was chief of the general staff between 2006 and 2009, told BBC2’s Victoria Derbyshire programme he would not take the drug because of his son’s experience with it.

Dannatt said his son Bertie had suffered mental health problems after taking two doses of Lariam before visiting Africa in the late 1990s. He was not in the armed forces at the time but had been prescribed the drug by his father’s army doctor.

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

Random Analytica: A ‘Soldiers-Five’ [trans. Basic Reading Guide] on Mefloquine

An old ‘soldiers-five’ on Mefloquine. When I first thought I was given Mefloquine I wasn’t sure where to look first. I initially got some good and some bad information. I’m not the tree of knowledge on Mefloquine but here is a suggested reading list and resource guide concerning Mefloquine. I’ve focused on veterans because that is my lived experience. Remember, this is a guide only. Consult your doctor.

Last updated 7th October 2019

World Health Organisation

8th August 1989: World Health Organisation. The original warning from WHO way back in 1989.

Consumer Medicine Information

9th October 2017: The Consumer Medicine Information guide for Lariam (linked here: 171009_ConsumerMedicineInformation_Roche_Lariam). A veteran mate has underlined the important health warnings.

Mefloquine Articles (non-specific)

27th April 1996: New Scientist.  Malaria pill stands accused – Lariam fends off malaria more effectively than any other drug, but growing evidence of disturbing side effects may soon land its manufacturer in court (via 960427_Article_NewScientist_Mefloquine). Thanks to the veteran mate who sent this through. He was given Lariam in 1994 and 1999 without the serious side-effects.

Mefloquine Articles for Veterans

27th January 2003: CBS News. The Dark Side Of Lariam. How Dangerous Is It? One of the first ‘deep-dives’ into mefloquine by a news outlet. Discusses the Fort Bragg suicide cluster where mefloquine was a factor.

19th September 2013: CBS News. Elite Army units to stop taking anti-malarial drug. The US Army’s Special Forces banned from using mefloquine in 2013.

25th September 2013: Huffpost. Mefloquine: The Military’s Suicide Pill. Dr Remington Nevin writes about mefloquine including the 2013 FDA’s ‘black-box’ warning. The world is waking up to the dangers of mefloquine. Dr Nevin is one of the leading experts in the field.

12th October 2014: Army Technology. Mefloquine – the military’s deadly malaria treatment. Dr Remington Nevin discusses the downside to mefloquine including his own personal deployment experience with the drug.

11th August 2016: Military Times. Malaria drug causes brain damage that mimics PTSD: case study. A different take on mefloquine exposure from the USA.

22nd August 2016: Australian Broadcasting Corporation. Defence force admits soldier shouldn’t have been included in East Timor anti-malaria drug trial. One of the first articles I read. Also includes a link to a 2016 7.30 Report about the Australian mefloquine/tafenoquine trials.

30th August 2018: The Irish Times. Vivid nightmares and suicidal thoughts – ex-soldiers blame drug for destroyed lives. An Irish perspective. With a standing Army of approximately 10,000 they have still administered Lariam to approx. 5,500 – 6,000 over the years.

Podcasts

12th June 2019: The Medical Republic. TMR podcast: Can this anti-malarial drug really cause “brain damage”? Thanks to my GP, Dr Mary Lamond for sending this to me. Along with other subjects the podcast covers mefloquine/tafenoquine exposure and its risks in simple language.

Books

23rd January 2014: ‘The Answer to the Riddle Is Me’ by David Stuart MacLean. The Washington Post book review can be found here.

Official Mefloquine Sites (Information & Policy)

Last accessed 7th October 2019: Department of Defence (Australia). Mefloquine. An excellent resource. One of the first sites I visited. Mefloquine Loading Doses are also explained.

Experts

Dr Remington Nevin (USA). Possibly the leading expert in the field of Quinism in 2019 when I suspected my exposure. US Army (Major – Retired). A Vermont-based physician epidemiologist and expert consultant in the adverse effects of antimalarial drugs, particularly mefloquine and tafenoquine.

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.

Random Analytica: Mefloquine Use by the Australian Defence Force (1990s)

I’m ready to heal yet I still need to count the cost. Others have made the attempt and fallen short. It might be my most important piece of epidemiology to date. It might pan out to be nothing. At least now I can do it systemically and at a slower pace.

It’s personal for me.

191112_MefloquineUseByADF90s (UPD)

The chart above is still a work in progress. I’m starting to get some good feedback from other veterans… If you want to add to this chart please reach out.

Last updated 12th November 2019

Notes:

191112_MefloquineNotes (UPD)

 

990910_Photo_JMolan_OpSpitfire

10th September 1999. Brigadier Jim Molan & Ian Martin directing the evacuation of Dili, East Timor. Source: Twitter (John L. Gould)

 

If you or someone you know needs help, please phone Lifeline on 131 114, Kids Helpline on 1800 55 1800, Beyond Blue on 1300 224 636 or Open Arms on 1800 011 046.