Random Analytica

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

Tag: H7N9

Random Analytics: H7N9 Infographics (to 15 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 16 May 2013 CET/EST *****

1 - H7N9_Infographic_130516

Infographic Details

Between 12 – 16 May there have been no new reported cases of H7N9 and a drip feed of case and fatality details. To date the totals for China are 131-cases including 36-deaths and Taiwan 1-case without loss of life. Two deaths were confirmed on 13 May without details and the first confirmed fatality from Hunan was reported on 15 May. Note that all totals include asymptomatic cases.

To date 27.3% of all known cases have been fatal, or more than one in every four afflicted by H7N9. For context the Case Fatality Rate of SARS was 10.9%.

The Ministry of Health and Chinese media confirmed that to 15 May there have been 61 patient discharges (46.2%). Asymptomatic cases remain at one (0.8%).

The most recent fatality (with details) reported by the Chinese media was on the 15th May 2013 via Xinhua.

2 - CasesbyRegion_130516

Cases by Region (including Taiwan)

Along with a decline in cases there has been a drip-feed of case details that have flowed through during the week. Note: I have two confirmed deaths that I cannot add as the province has not been disclosed.

The last confirmed onset that I could see has moved from Fujian to Jiangxi and it’s more than a week old in the regional extremities of the outbreak. Shanghai, the region which hosted the outbreak in mid-April announced during the week that it had not had a confirmed case in more than 20-days and was in the process of dismantling its emergency level response to H7N9.

Note: I have created this infographic using Tableau Public software which can be viewed here.

3 - CasesbyEmployment_130513

Cases by Job-Title

Here is another look at the cases by employment.

Given that more than 44% of cases were in patients over the age of 65 it’s no surprise that 35 (28.8%) of job titles are ‘Retired’.

To tenuously back the avian link the next largest job title was ‘Farmer’ with 26 confirmed at 19.7% of all cases. If you include those job-titles with linkages to farming, poultry production and food preparation that number would increase to 38 making it the most dominant employment type at 28.8%.

Of the 31 unknown job titles, 12 (9.1%) are represented by people over the age of 65, thus would predominately fall into the ‘Retired’ or ‘Farming’ employment types depending on whether they are rural or urban based.

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 8 May 2013)

Updates (13/05/2013)

  • Confirmed two additional job titles (1x Builder and Farmer) so updated both the infographic and Cases by Job-Title.

Updates (14/05/2013)

  • Updated the main infographic after a further 2 fatalities and 15 recoveries were confirmed via Xinhua.

Updates (16/05/2013)

  • Updated the main infographic and Cases by Region map after a fatality was confirmed via Xinhua and a further four recoveries were announced via CCTV News. The most recent Xinhua announced fatality link was also updated.

Random Analytics: H7N9 Infographics (to 8 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 9 May 2013 CET/EST *****

1 - H7N9_Infographic_130508

Infographic Details

In the past 48-hours of reporting there has been one new case of H7N9 and one retrospective fatality. This brings the total for China to 131-cases including 32-deaths and Taiwan to 1-case without loss of life. Note that all totals include asymptomatic cases.

To date 24.2% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

The Ministry of Health also confirmed that to 6 May there were 42 discharges. That keeps the recovered total to 42 (31.8%) and asymptomatic cases at one (0.8%).

The most recent fatality (with details) reported by the Chinese media was on the 3rd May 2013 via Xinhua.

Economic Impacts of H7N9: Direct Costs and The Poultry Industry

According to the World Bank, China’s Gross Domestic Product hit $7.318-trillion USD in 2011, making it the second largest economy on the globe. Back in 1982 China had a GDP of $203-million, a mere 1/36th of its current size, thus an economy that has doubled in size more than six times.

Last year China’s economy grew by 7.9%, the weakest result since 1999 and below expectations.

The first quarter of this year was expected to see growth rates return to 8% or greater. This would be driven by internal consumer consumption over exports. However the first quarter of 2013 disappointed with GDP growing by 7.7%, again under expectations.

Although the avian influenza A(H7N9) virus is not the reason the Chinese economy has been soft it is a contributing factor. Some considerations when considering direct costs:

  • Effecting flu controls on the human and fowl populations such as the additional ¥303M ($48.6M USD) which was put up by the Chinese Ministry of Finance in late April;
  • Subsidizing the poultry industry as it struggles with the outbreak, like the ¥90M ($14.6M) from the Beijing Municipal Bureau of Agriculture again in late April;
  • Additional medical costs and insurance for regional populations costed to the Ministry of Finance, and;
  • One of the biggest direct costs of the H7N9 outbreak is the loss suffered by the poultry industry. By mid-April that agriculture component stated that it has lost approximately ¥10Bn ($1.6Bn USD) as chicken consumption halved and chicken/egg prices collapsed.

If the figures are not overstated then the impact to the first and second quarter GDP figures would be at a cost of between 0.1 and 0.15% with a work-in-progress cost to the economy of between 0.2 – 0.3% over the calendar year. Although future poultry losses would not be of that magnitude (as the poultry industry ramps down production and concentrates on protecting its breeding stocks) that number will still likely increase to some degree over the coming months. The standalone poultry industry losses to mid-April alone could account for the 0.3% minimum underperformance of the Chinese economy.

Looking at this from a different angle there is also currently an unrealised loss in terms of the overall chicken population value.

In brief, the Chinese chicken population in 2009 was 4,680,000,000. Here’s a great infographic via The Economist:

2 - CountingChickens_110727

Prior to the outbreak becoming known in China the national average broiler price (chickens raised purely for meat production) was ¥9.37 (source: Beijing Shennong Kexin Agribusiness Consulting). At publication date the average price of broilers across Liaoning, Shandong, Henan, Hebei and Jiangsu was just ¥4.07 (source: www.chinafarming.com), effectively a 56% reduction. Eggs have had a similar price decline and broiler chicks around 75% as agribusiness pends new stock purchasing and waits out the virus .

Now I know that not all chickens are broilers (being an owner of nine-chickens and a rooster myself) but with a huge appetite for chicken which is on-hold and an approximate 10-week lifespan of broilers the short-term price impacts of such a decline are a huge drag on first and second quarter Chinese GDP growth numbers.

Another consideration: Taking the 2009 chicken population number of 4,680,000,000 as a base, the bulk of chickens across the country would now be worth, on average, ¥5 less. Thus the national stock, minus protected and virus free breeders could be worth as much as ¥23.4Bn (approx. $3.74Bn USD) less than it was two months ago. If not for other inputs (such as an increase in vegetable prices against the gains in chicken import prices) then the possible impact on GDP could be doubled or even tripled.

In summary, the impacts of the current H7N9 outbreak on the economy are still short-term. Prices always recover when there is a market but by the time the virus passes and confidence returns to the poultry industry the national stock will have decreased, poultry producers have gone out of business and outside of imports the industry will take at least 3-months to re-stock. This will drive up prices in the short-term and those direct impacts will flow through the economy.

Much like the medical unknowns still in play the economic impacts can only be forecast.

Unlike the medical impacts which are tracked on a daily basis and could disappear overnight the negative economic impacts of the virus could be sustained for many months.

 

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 6 May 2013)

—————————–

Update: (30/07/2013)

  • World Poultry published an article on 29 Jul 2013 stating that:

“The total losses of poultry-related companies all over the country up until the end of June exceeded 600 billion yuan ($92.2 billion) since the first case of H7N9 virus was discovered by the authorities at the end of March, according to the latest statistics from the National Poultry Industry Association.”

In my article I envisaged that the loss for the first and second quarters of Chinese GDP would be between 0.1 and 0.15%. The National Poultry Industry Association total would equal 1.26%. Industry bodies tend to overstate the loss in a crisis so I am still confident in my original forecast but happy that the first numbers to be discussed fell well within a reasonable range of error.

Random Analytics: H7N9 Infographics (to 6 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 7 May 2013 CET/EST *****

1 - H7N9_Infographic_130507

Infographic Details

In the past 24-hours of reporting there has been one new (retrospective) case of H7N9 and confirmation via the Chinese Ministry of Health 4 additional fatalities. This brings the total for China to 130-cases including 31-deaths and Taiwan to 1-case without loss of life. Note that all totals include asymptomatic cases.

To date 23.7% of all known cases have been fatal (an increase of 2.9% from yesterday’s data). For context the Case Fatality Rate of SARS was 10.9%.

The Ministry of Health also confirmed that to 6 May there were 42 discharges. With that update the recovered total now moves to 42 (32.1%). Asymptomatic cases remain at one (0.8%).

The most recent fatality reported by Chinese media was on the 3rd May 2013 via Xinhua.

2 - CasesbyRegion_130507

Cases by Region (including Taiwan) to 6 May 2013

I usually don’t repeat the second infographic from one night to the next, however some data came in via the Chinese Ministry of Health which included four new deaths confirmed by province (although not down to case level at this stage). Two additional fatalities were reported in Jiangsu and one each in Zhejiang and Anhui.

Although recoveries have been revised upwards I cannot confirm to case level the details of 14-cases and 5-cases cannot be confirmed to province or municipality level.

Two other changes with this infographic. The first is a colour scale to reflect the number of cases in each region. Secondly, I have created this infographic using the excellent Tableau Public software which can be viewed here. (Note: I have no commercial or personal relationship with Tableau).

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 5 May 2013)

Random Analytics: H7N9 Infographic (to 5 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 6 May 2013 CET/EST *****

1 - H7N9_Infographic_130506

Infographic Details

In the past 48-hours of reporting there has been one new case of H7N9 with no new fatalities. This brings the total for China to 129-cases including 27-deaths and Taiwan to 1-case without loss of life. Note that all totals include asymptomatic cases.

To date 20.8% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

There were 2 discharges over the past 24-hours, both from Shanghai. With the additional two discharges the recovered total now moves to 38 (29.2%). Asymptomatic cases remain at one (0.8%).

The most recent fatality reported by Chinese media was on the 3rd May 2013 via Xinhua.

2 - CasesbyRegion_130505

Cases by Region (including Taiwan) to 5 May 2013

Here is a look at the Cases by Region data which closes out Week 11 of the avian influenza A(H7N9).

Zhejiang continues to have the most cases (46) with 19 recovered and six deaths.

With 33-cases and 13-deaths Shanghai has the most deaths and the highest Work-In-Progress Case Fatality Rate, currently 39.4%. That municipality also had the first case.

Beijing still has the only confirmed asymptomatic case.

Taiwan has the only non-mainland China case, that of a man who was working in Jiangsu and flew home before displaying any symptoms.

Fujian had the most recent confirmed case.

Lastly, for the first time since the H7N9 became a known issue there are now more case outcomes than there are patients being treated. Of note is that positive outcomes outweigh negative outcomes.

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 3 May 2013)

Random Analytics: H7N9 Infographic (to 3 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 4 May 2013 CET/EST *****

1 - H7N9_Infographic_130504

Infographic Details

In the past 24-hours of reporting there have been no new cases of H7N9 and no new fatalities, although the 27th fatality (without specifics) was reported by Xinhua. This brings the total for China to 128-cases including 27-deaths and Taiwan to 1-case without loss of life. Note that all totals include asymptomatic cases.

To date 20.9% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

There were 10 discharges over the past 24-hours, all from Zhejiang and just 17-hours after I discussed the lack of detail from that province. Although Xinhua detailed the case of Cao it didn’t provide any detail of the 9 other outpatients discharged today. With ten H7N9 cases cleared that would bring the total recovered to 36 (27.9%). Asymptomatic cases remain at one (0.8%).

The most recent fatality reported by Chinese media was on the 3rd May 2013 via Xinhua.

2 - CumulativeCases_Zhejiang_130504

Zhejiang: 17-hours later

Yesterday I looked at cumulative cases for Zhejiang, the most impacted to date by H7N9.

At that time there were 46-cases with 6-deaths and 6-recoveries and no new reported cases in 14-days.

How 17-hours can make a difference.

There have been only two Xinhua H7N9 stories released in the past 24-hours. The first confirmed the 27th fatality but did not provide details of the two most recent victims. The second story detailed the recovery of Cao who had recovered from the severest of symptoms thus far.

It also stated:

Nine other H7N9 patients were also discharged on Friday from the First Affiliated Hospital of Zhejiang University.

I have updated yesterday’s chart with the data input provided. I’d advise that this is a look at the cases, fatalities, recoveries and Work-In-Progress (WIP) Case Fatality Rate (CFR) for Zhejiang only and might be useful. Given the percentile of known H7N9 cases for Zhejiang are very low and those still receiving treatment remains above 50% the CFR should be seen as a useful guide only. Also of note is that Zhejiang has had no reported asymptomatic cases and as shown in the daily infographic we still have a ‘Fog of Flu’ or a lack of data around three-deaths and 12-recoveries which may impact this chart.

No data points jump out at me, but…

A long time ago I was a soldier, a communicator and a Cold War warrior who trained up against the best the Soviets were still pumping out in 1989/90.

I always remember my first ‘operational active’ exercise where I watch the Vladivostok fishing vessels trailing our combined fleet and being told that though most of this peace time force would be going through the motions, my efforts were real.

I was told that everything communicated was tracked, analysed and would be brought up in future operations. There were no ‘co-incidences’ in data…

Zhejiang had no new data for 2-weeks as of yesterday. It has some today.

Coincidence?

I’ll not leave it on a semi-pseudo conspiracy theory. I had a fantastic 3-tweet conversation with Crawford Kilian today. He stated that I was more literate but I would counter that he has a unique ability to be a superbly interesting chap on Twitter.

3 - @Crof

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 2 May 2013)

Random Analytics: H7N9 Infographic (to 2 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 3 May 2013 CET/EST *****

1 - H7N9_Infographic_130503

Infographic Details

In the past 24-hours of reporting there have been no new cases of H7N9 and as many as two fatalities, although only one death was fully reported via Xinhua. This brings the total for China to 128-cases including 26-deaths and Taiwan to 1-case without loss of life. Note that this includes asymptomatic cases.

There have been a number of reports, supported by organisations such as CIDRAP and FluTrackers.com which put the number of fatalities at 27. Given that only one fatality was identified on the 2nd May and the numbers seem to be including that person on top of the 26 announced via  Xinhua in a weekly update I am going to keep my number at 26 until further information can be verified.

To date 20.2% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

Although there were no new announcements on discharges today a weekly report stated that 26 people had recovered from the disease. That would increase the recovery number to 26 (20.2%) and asymptomatic cases at one (0.7%).

The most recent fatality reported by Chinese media was on the 2nd May 2013 via Xinhua.

2 - CumulativeCases_Zhejiang_130503

Cumulative Cases (Zhejiang)

Yesterday I looked at cumulative cases (just cases and deaths) across the entire H7N9 dataset.

Today I thought a look at the cases, fatalities, recoveries and Work-In-Progress (WIP) Case Fatality Rate (CFR) for Zhejiang only might be useful. Given the percentile of known H7N9 cases are very low and those still receiving treatment remains just below 70% the CFR should be seen as a useful guide only. Also of note is that Zhejiang has had no reported asymptomatic cases and as shown in the daily infographic we still have a ‘Fog of Flu’ or a lack of data around two deaths and three recoveries which may impact on this chart.

Two data-points jump out at me.

Firstly, would be the lower WIP CFR of 13%, much lower than the entire disease average which stands at (20.2%) today.

The second and more interesting data-point is that after a sharp rise in cases between 2 April and 18 April (where new cases reported averaged 2.3 per day) there have been no cases reported now for 14-days.

I have always thought that data that is 100% correct or 100% absent is unusual and worth looking into further.

The fact that there has been no data from Zhejiang for two weeks is ‘unusual’.

Note: My previous post on H7N9 can be found at Random Analytics: H7N9 Infographic (to 1 May 2013)

Updates (3/05/2013)

  • Updated Infographic section with note about 27th fatality.

Random Analytics: H7N9 Infographic (to 1 May 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 1 May 2013 CET/EST *****

1 - H7N9_Infographic_130502

Infographic Details

In the past 24-hours of reporting there has been one new case, reported from Hunan Province and for the second consecutive day, no new fatalities. This brings the total for China to 128-cases including 24-deaths and Taiwan to 1-case without loss of life. Note that this includes asymptomatic cases.

To date 18.6% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

There were no new announcements on discharges today. With no new data the current count of recoveries remains at 25 (19.4%) and asymptomatic cases at one (0.8%).

The most recent fatality reported by Chinese media was on the 29th April 2013 via Xinhua.

2 - CumulativeCases_130502

Cumulative Cases

Here is a look at the cumulative cases, fatalities and current Case Fatality Rate (CFR). Given the percentile of known H7N9 cases are still receiving treatment remains above 60% the CFR should be seen as a useful guide only.

Two interesting data-points from this chart. The first is that the cumulative cases have only increased by 10 over the past five days, averaging just 2 a day over a territory larger than South Africa and a population of more than half a billion.

The second item is that since mid-April the Case Fatality percentile has remained steady between the ranges of 18.3% – 22.2%.

What will tomorrow bring?

Note: My previous post on this can be found at Random Analytics: H7N9 Infographic (to 30 Apr 2013)

Random Analytics: H7N9 Infographic (to 30 Apr 2013)

***** Please note that the infographics/charts of the Avian Influenza A(H7N9) virus presented were updated with public source information to 0001hrs 1 May 2013 CET/EST *****

1 - H7N9_Infographic_130501

Infographic Details

In the past 24-hours of reporting there has been one new case, reported from Fujian Province and no new fatalities. This brings the total for China to 127-cases including 24-deaths and Taiwan to 1-case without loss of life. Note that this includes asymptomatic cases.

To date 18.8% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

There were no new announcements on discharges today. With no new data the current count of recoveries remains at 25 (19.5%) and asymptomatic cases at one (0.8%).

The most recent fatality reported by Chinese media was on the 29th April 2013 via Xinhua.

2 - RecoveryByAge_130501

Recovery by Age Cohort

A lot has been made in recent weeks of the concentration of older victims of H7N9.

The average age of those who have died has been 65 but looking at it from a different angle, the average age of those who have recovered currently stands at 45.9.

Today’s additional chart looks at those patients who have been discharged from hospital and where we have their age data. It should be noted that I’ve included Meng, the two-year old from Shanghai as a boy even though his or her gender has not been confirmed.

Whereas 56.5% of the H7N9 deceased have been aged 65 or greater only 29.2% of those who recovered are in a similar age cohort. If you make a similar comparison of those aged 55 or above then its 73.9% fatalities against 45.8% recoveries.

To date, no one aged below 25 has died of the disease.

Note: My previous post on this can be found at Random Analytics: H7N9 Infographic (to 29 Apr 2013)

Random Analytics: H7N9 Infographic (to 29 Apr 2013)

***** Please note that this infographic of the Avian Influenza A(H7N9) virus was updated with public source information from late 29 Apr to early 30 April 2013 CET/EST *****

1 - H7N9_Infographic_130430(U)

Infographic Details

In the past 24-hours of reporting there have been no new cases but one new fatality. This brings the total for China to 126-cases including 24-deaths and Taiwan to 1-case without loss of life. (It should be noted that I from today I will be including asymptomatic cases, including that of a 4-year old Beijing boy which was confirmed in April. Asymptomatic cases will be represented by green figures).

Interestingly, the very late reports of the Fujian and Shandong cases from yesterday are being repeated today, thus some are discussing two new cases. Thanks so much to Crawford Kilian (@crof) for his constant updates.

To date 18.9% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

I was able to update my database today against provincial hospital announcements and have increased my known discharges by 5. This includes the most recent discharge, as reported by Xinhua, from Henan reported today. This brings the current count of recoveries to 25 (19.8%) and asymptomatic cases to one (0.8%).

The most recent reported fatality was on the 29th April 2013 via Channel News Asia.

2 - TwoHalves_130430

A Look at Two-Halves

When I saw that the total recovered had moved ahead of the total fatalities, I thought that in itself might make a good graph, however I have noticed a pickup in discharge announcements recently so I wanted to have a look that in a bit more detail. When I cut the data in half, that is had a look at the first 63 symptomatic cases against the following 63-cases, I found two interesting data points.

The first point is around fatality figures. For the first half 28.6% of cases have been fatal, while for the second half its currently 9.5%. Although this is interesting there is a strong possibility that these percentiles will increase as more data comes in. This brings me to my second interesting data-point.

The trajectory of discharges against deaths is increasing as we see improvements in response to the H7N9 outbreak. To be more specific, to reach 12 discharges (or 19.7% of 63) it took 18-deaths for the first 50% but only six for the last 50%.

I know it’s a bit early to make too much of this split but hopefully it means we are moving in the right direction against H7N9.

Note: My previous post on this can be found at Random Analytics: H7N9 Infographic (to 28 Apr 2013)

Updates (30/04/2013)

  • After much deliberation I finally added the Beijing asymptomatic case to my dataset and adjusted the infographic and percentiles accordingly. Many thanks to Helen Branswell (@HelenBranswell) and CIDRAP (@CIDRAP) specifically Lisa Schnirring for convincing me of my error.

Random Analytics: H7N9 Infographic (to 28 Apr 2013)

***** Please note that this infographic of the Avian Influenza A(H7N9) virus was updated with public source information from late 28 Apr to early 29 April 2013 CET/EST *****

1 - H7N9_Infographic_130429(U)

Infographic Details

In the past 24-hours there have been 5 new cases (2x Jiangxi, 1 Zhejiang, 1x Fujian and 1x Shandong) with no new deaths reported. This brings the total for China to 125-cases including 23-deaths and Taiwan to 1-case without loss of life. (It should be noted that I do not include the asymptomatic Beijing case in my count).

To date 18.3% of all known cases have been fatal. For context the Case Fatality Rate of SARS was 10.9%.

There were no confirmed discharges in the past 24-hours, thus the current count of recovered remains at 20 (15.9%). Note: Prior to today when a four year old was confirmed with avian influenza A(H7N9) all known paediatrics and children had recovered.

The most recent fatality reported was on the 26th April 2013 via Jiangsu Health (in Chinese).

Final Thought

If the China Animal Agricultural Association numbers are to be believed the chicken industry will ‘in the hole’ a further ¥14,000,000,000 or according to Xinhua’s calculations would have experienced around $2.273-billion in direct losses (feeding of chickens that no one is buying, culling of chickens, lost productivity, maintenance and loss of breeding stock).

Xinhua reported that vegetable vendors are doing very well as customers change their purchasing habits to avoid chicken.

I’d also suggest that the European breed stock owners will be doing very well once the crisis is over as it sounds like the Chinese will need to do a lot of stock rebuilding.

Note: My previous post on this can be found at Random Analytics: H7N9 Infographic (to 27 Apr 2013)

Updates (29/04/2013)

  • Added another two cases (1x Fujian & 1x Shandong) which were reported by Xinhua at 23.55CET.