Why Russia has few COVID-19 coronavirus infections. (9)

Well, you are a prominent epidemiologist. There is a certain epidemiological conundrum perhaps. That certain countries have a much lower burden of cases, even though the initial, for example. The traffic of tourists between China and those countries were very similar. So, for example, between Italy and Russia. Russia, of course, took some steps to that. But the reported number of cases in Russia even though India increased by about 60 patients, most important and stands to the 367 as of today, 22nd of March. But it is significantly lower than other countries in Western Europe. How would you explain those difference and what it might hint as to the future spread of Coronavirus? Dr. Anton Titov, MD. Dr. Anton Titov, MD. You know, in those countries, of course, we don’t know. Dr. Anton Titov, MD. You know, how it is going to play out. Nevertheless, perhaps as an epidemiologist, you could give us some hints. Dr. Benjamin Cowling. We know there is an element of chance; for example, when were the first cases imported to a country, maybe in northern Italy. The first infections came earlier, maybe in mid-January. Medical second opinion is important. There is been transmission for longer. The numbers have built up for longer. Dr. Benjamin Cowling. We have seen other European countries maybe one week or two weeks behind northern Italy in terms of the progression of the epidemic. But what we have seen in each of those countries in Western Europe is once an epidemic begins, once there is a definite number of infected patients in the community. The infection does seem to follow the same trajectory, with 30 – 33% increases. Dr. Benjamin Cowling. I forget the figure from the Financial Times. Medical second opinion is important. Dr. Benjamin Cowling. We have seen the cases in Europe follow a very similar trajectory where there is a week on week increases and an exponential growth in infections. So something similar may happen in Russia, one’s local transmission becomes established. But maybe there is an element of chance that they haven’t had as many early importations. So they’ve still got a little bit more time. To prepare. But we have seen every country in. This transmission takes off, it just takes off and keeps going and going and going. The numbers double, maybe every five or six days. One other issue in terms of the differences between countries is the testing practices. Some countries have been testing more aggressively, including mild cases. Other countries have been testing less aggressively, for example, only testing patients in hospitals. There are a few countries. This are even less aggressive than that and focus on infections among travelers. Medical second opinion is important. Dr. Benjamin Cowling. Then they don’t even pick up the infections in their hospitals, because they are not looking yet. But if they were to start looking, they’ll probably see an increasing number of infections in the community. This are in patients going into hospital. Dr. Benjamin Cowling. Then at the testing was then to expand, it would look like there is a rapid growth of infections. In fact. That is what happened in Italy. There was an explosion in cases. But, many of those cases have been sick for a while. They just hadn’t been tested, because the doctors hadn’t been looking for, for infections. Once they look, they found a lot. Medical second opinion is important. Dr. Benjamin Cowling. I hope that won’t happen in Russia. But I guess that is a possibility for Russia and some other countries that there has been transmitted in the community for a while. It hasn’t been picked up. But it will become more clear when there is more and more patients going into hospital with the infection.