Monitoring a Virus
More data needed to track the full implications surrounding the coronavirus crisis
by Julia E. Seaman and I. Elaine Allen
At the turn of the 20th century, the Spanish influenza pandemic claimed an estimated 50 million lives worldwide—including more than 450,000 in the United States. Just over 100 years later, lessons learned from the Spanish flu pandemic are being used to predict—and potentially corral—the spread of COVID-19, otherwise known as the coronavirus disease.
In the United States, for example, government institutions, cities, private companies and schools are taking divergent approaches to addressing the viral outbreak: Some are limiting social gatherings and having employees work remotely, while others still are watching and waiting for developments
In worldwide crises like these, data and data analysis can be powerful tools that will help address the inherent risk and potential impact of COVID-19, as well as influence the effectiveness of containment procedures. Thankfully, advancements in data collection, testing and responses should give governments and health agencies the upper hand in securing the right information needed to make critical decisions to combat the COVID-19 crisis.
Right now, there’s not a lot of data to share about the virus as the situation unfolds every day, but here’s a look at some of the numbers and other details that have been released about COVID-19:
COVID-19 is part of a large family of viruses. Its full name is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Other types of coronaviruses include the common cold (not influenza), and previous outbreaks such as SARS and MERS.
These viruses are positive-sense single-strain ribonucleic acid (RNA) viruses (in contrast to a retrovirus like HIV), in which the RNA is stored in a viral envelope made up of proteins. Most infections from coronaviruses include respiratory tract symptoms. The specific source and transmission for COVID-19 to humans is not yet known.
The spread of COVID-19
As of March 9, there were more than 110,000 COVID-19 cases worldwide, and 3,800 deaths. Measurement of the number infected is known to be conservative because individuals with mild symptoms may self-quarantine at home and may not be tested.
The case fatality rate (CFR) for COVID-19 is defined as the number of deaths divided by the number of confirmed cases. As calculated by the World Health Organization, this is close to 3.4%. That said, the global CFR likely will decline as the number of confirmed nonserious and/or asymptomatic cases rise through increased testing.
In the United States, where testing has been sparse and limited to highly symptomatic patients, the current CFR is 4.1% (22 deaths/540 confirmed cases), higher than the global rate. Based on published case reports, the CFR appears to vary by age group, with individuals over the age of 70 having a much higher CFR (11% in China, 16% in the United States and 23% in Italy).
When compared to the recent, headline-grabbing viral outbreaks of SARS and MERS, COVID-19 appears to be more contagious, albeit with a lower CFR (SARS at 10% and MERS at 50%). The current estimate for COVID-19 is that one person may infect 2.3 others on average, prior to or with mild symptoms.
If the virus continues to exist in a patient after the patient recovers from the symptoms, it is unknown whether the patient remains contagious or if reinfection is possible. With COVID-19, the greatest threat for infection spread is that a person may be infected and contagious without showing any symptoms, unaware that he or she is potentially infecting many others. Based on data at the time of testing from the Diamond Princess cruise ship, there were as many symptomatic and asymptomatic confirmed cases (301 vs. 318 out of 3,711 total tested).
While experts are reporting figures and case fatality rates to the best of their knowledge, these numbers are ultimately (very good) educated guesses. It is likely that the extent of the global infection only may be realized retrospectively—years from now. The true rate of infection and fatality may be detected through future surveillance studies, such as surveys of hospital health records and sampling populations for detection of antibodies to the virus, to reveal the full extent of the infection.
Tests for the virus have been in short supply in the United States, but many already have been deployed in other countries. All tests currently use real-time, reverse-transcription polymerase chain reaction assays (rRT-PCR) to quantify the presence of COVID-19 genes in a patient’s bodily fluids, most commonly using a respiratory sample.
rRT-PCR is a highly accurate, routine lab test for viral infections, and recommended for confirmation of suspected coronavirus infections. The Centers for Disease Control and Prevention recommends testing from multiple samples. A patient is considered negative for COVID-19 following two consecutive negative rRT-PCR tests on all specimens.
The current tests are estimated to have 95% sensitivity and 99% specificity. A test’s sensitivity shows how accurately it can correctly identify individuals with COVID-19, while the specificity shows how accurately it can rule out individuals who do not have the virus. If we assume that the test is eventually given to 100,000 infected people, there would be 1,000 false negatives. Those people could be free to spread the disease to the general public. On the other hand, in testing 100,000 individuals without COVID-19, there would still be 5,000 false positives—that is, patients put under quarantine needlessly.
Even highly sensitive and specific diagnostic tests are not perfect when used as screening tools. Indeed, there have been reports of individuals who have tested positive, then negative twice and were released from quarantine before testing positive again. These patients were likely false negatives rather than reinfections.
While the PCR assay itself is highly accurate, there are many aspects of the test that still need to be optimized, such as the timing and type of patient sampling. These tests can take many hours or days before delivering a result, though more commercially available options are available every day. (Quest Diagnostics was to start offering tests on March 9, and LabCorp announced availability on March 7). New tests giving results in just over an hour to less than 12 hours are being developed and tested at several university medical research labs.
Containment of COVID-19
The growth of COVID-19 cases outside of China (as of March 7) in Figure 1 matches the expected exponential growth of a viral infection pandemic, indicating that the infections are still in the growth phase.
During the Spanish flu in 1918-1919, there was considerable diversity in the pattern of deaths based mostly on the containment measures instituted in cities. Cities that instituted measures limiting transmission of the flu (for example, no public meetings, schools and theater closures) for longer periods of time (up to eight weeks) had fewer cases and fewer deaths.
In the United States, Philadelphia had the worst mortality during the epidemic: In September 1918, the city refused to cancel a parade in which 200,000 people gathered to celebrate success in the war effort. Schools and public gatherings were not cancelled until a week later, and only remained closed for 14 days.
In contrast, San Francisco had a very low mortality rate, having closed public places and schools for almost seven weeks and instituting a mask ordinance that saw arrests for individuals out in public without masks.
The Spanish flu virus abated during the summer of 1918. In the fall of 1918, however, the flu virus reappeared, having mutated into a more virulent form. Most of the deaths from the Spanish flu occurred during the fall of 1918 and the winter of 1919.
One of the worst-case scenarios is that a similar effect will occur with COVID-19, though there are no data to support this.
There are more known unknowns relating to COVID-19. These include transmission rate, overall spread, test and retest validity, case fatality rate, and the mutation rate of the virus.
Only with more data—and more complete data—can we start to better assess the implications of this growing coronavirus crisis.
Anderson, Roy M., Hans Heesterbeek, Don Klinkenberg and T. Déirdre Hollingsworth, “How Will Country-Based Mitigation Measures Influence the Course of the COVID-19 Epidemic?” Lancet, March 6, 2020.
Branswell, Helen, “We’re Learning a Lot About the Coronavirus. It Will Help Us Access Risk,” STAT, March 6, 2020, www.statnews.com/2020/03/06/were-learning-a-lot-about-the-coronavirus-it-will-help-us-assess-risk.
Bootsma, Martin C.J., and Neil M. Ferguson. “The Effect of Public Health Measures on the 1918 Influenza Pandemic in U.S. Cities,” Proceedings of the National Academy of Sciences, Vol. 104, No. 18, May 1, 2007.
Centers for Disease Control and Prevention, “CDC Laboratory Testing for Middle East Respiratory Syndrom Coronavirus (MERS-CoV),” https://www.cdc.gov/coronavirus/mers/lab/lab-testing.html.
Hatchett, Richard J., Carter E. Mecher and Marc Lipsitch, “Public Health Interventions and Epidemic Intensity During the 1918 Influenza Pandemic,” Proceedings of the National Academy of Sciences, Vol. 104, No. 18, May 1, 2007.
National Institute of Infectious Diseases, “Field Briefing: Diamond Princess COVID-19 Cases,” Feb. 19, 2020, www.niid.go.jp/niid/en/2019-ncov-e/9407-covid-dp-fe-01.html.
New York Times editors, “Coronavirus Map: Tracking the Spread of the Outbreak,” New York Times, March 8, 2020, www.nytimes.com/interactive/2020/world/coronavirus-maps.html.
Nogrady, Bianca “How SARS-CoV-2 Tests Work and What’s Next in COVID-19 Diagnostics,” The Scientist, www.the-scientist.com/news-opinion/how-sars-cov-2-tests-work-and-whats-next-in-covid-19-diagnostics-67210
Worldometer, “Coronavirus Cases,” March 9, 2020, www.worldometers.info/coronavirus/coronavirus-cases/#case-distribution-outside-china.
Julia E. Seaman is an associate director at Prescient Healthcare Group and research director of the Quahog Research Group. She earned her doctorate in pharmaceutical chemistry and pharmacogenomics from the University of California, San Francisco.
I. Elaine Allen is professor of biostatistics at the University of California, San Francisco, and emeritus professor of statistics at Babson College. She also is director of the Babson Survey Research Group. She earned a doctorate in statistics from Cornell University in Ithaca, NY. Allen is a member of ASQ.
Workers Trust Robots More Than Managers
More than 60% of workers surveyed said they have more trust in robots than their managers, according to a recent survey by Oracle and Future Workplace, a research firm.
Those same workers are clearly embracing new technologies and are excited and optimistic about where these workplace advancements could lead, the study said. In addition, artificial intelligence (AI) is challenging “old notions of what managers do best.” In other words, AI is reshaping managers’ traditional roles, and more individuals are making distinctions between what robots do best and what managers do best. Specifically, 36% of respondents said they think robots are better than managers at providing unbiased information.
“People are no longer afraid of the robots. They have experienced how AI and machine learning can improve the way they work in a very pragmatic way,” said Emily He, a senior vice president at Oracle. “And the more they use these technologies, the more excited they are about them.”
Results from the study, which involved surveying about 8,500 people in 10 countries, revealed how AI is changing “the relationship between people and technology at work,” researchers wrote.
The study also showed that survey respondents believe that new technologies will help them:
- Master new skills.
- Gain more free time.
- Expand their current role.
There are still worries, however, about complexity, data security and privacy that could be barriers to AI adoption in the workplace. To get the most from AI and machine learning technology, researchers wrote, organizations must explain how they are using AI ethically, as well as offer solutions to address security and privacy concerns.
To download the free report, titled “From Fear to Enthusiasm,” visit https://go.oracle.com/LP=86149.
Manufacturers to Invest $26.2B in Worker Training
U.S. manufacturers are planning to spend at least $26.2 billion this year on training to upskill new and existing employees to help address the shortage of available workers, according to the Manufacturing Institute.
As manufacturers shift to more innovative environments, new manufacturing jobs often require more advanced skills of factory workers, and many workers are expected to hold cognitively demanding roles.
“Manufacturers consistently cite the inability to attract and retain talent as their top concern, and as this survey underlines, they are taking strong proactive steps to overcome it,” said Carolyn Moutray, the Manufacturing Institute’s executive director. “Manufacturers are growing and investing significantly in the kind of workforce training programs that we know are so critical to combating the skills gap.”
According to the survey by the institute, the education partner of the National Association of Manufacturers, nearly 80% of manufacturers are expanding training programs. Three-quarters of respondents also said that this upskilling of the workforce already has helped improve employee productivity, promotion opportunities and employee morale.
Specifically, manufacturers are providing job-related technical skills training, cross-functional training, and new technology or equipment training, all of which will help improve the performance of workers in their daily tasks, the institute said.
Other training programs being offered include professional development, leadership development, soft skills development, formal mentoring programs and emotional intelligence training.
Another survey seems to jibe with the institute’s study. According to the “Future of Work Survey Report,” nearly 60% of employees said that their employers are indeed providing some degree of training and resources to help them keep current with changes in technology.
For more from the institute’s report, visit https://tinyurl.com/mnfg-inst-skill-gap.
Manufacturing Companies Lead in Sustainability
More than half of corporations recognized in an index of 100 most sustainable corporations in the world are manufacturing organizations.
The 2020 Global 100—spearheaded by the Corporate Knights, a Canadian financial research and information firm—includes 55 manufacturing organizations.
McCormick & Co. (No. 22), Tesla (No. 74), Intel Corp. (No. 81), Toyota Motor Corp. (No. 92) and Campbell Soup Co. (No. 93) were among the high-profile manufacturers recognized at the World Economic Forum’s annual meeting in Switzerland earlier this year.
To be on the list, an organization’s revenue must exceed $1 billion, and the amount of money it earns from its goods and services must have a direct, positive impact on society or the environment.
The Corporate Knights also considers factors such as an organization’s carbon emissions output, gender diversity, innovation capacity and the ratio of CEO to average worker pay.
To read more about this year’s top 100 corporations, visit https://tinyurl.com/2020-most-sustainable-orgs.
Survey Gauges Impact of ‘Inventor CEOs’
There’s a positive correlation between an organization having a CEO with a proven track record of high-impact inventions and the quality of an organization’s innovative output, a recent report suggests.
Researchers surveyed nearly 1,000 CEOs at high-tech companies in the United States and found about 20% were listed as an inventor on at least one patent, thus labeling them “inventor CEOs.” The report’s authors examined each organization’s history of patented technologies, looking at quantity and quality.
Researchers also found the volume and impact of the companies’ patents “significantly declined” after an inventor CEO’s departure.
The report, titled “Inventor CEOs,” was first published in the Journal of Financial Economics. For more information, visit https://tinyurl.com/CEO-innovation-survey.
Miata, Prius Models Get High Marks
Looking for some new wheels in 2020? It may be worth test-driving Mazda’s MX-5 Miata, and Toyota’s Prius Prime and Prius. Perhaps steer clear, however, of Chevrolet’s Colorado, Camaro and the Jeep Wrangler.
That’s the assessment from Consumer Reports, which published its top 10 most reliable models of 2020 late last year.
According to the nonprofit consumer advocacy group, the Lexus GX, Hyundai Kona, Mazda CX-3, Lexus NX, Toyota 4-Runner, Mazda CX-9 and Lexus GS rounded out its top 10 list of most reliable.
Others in the least-reliable roundup included: Alfa Romeo Giulia, Volkswagen (VW) Atlas, VW Tiguan, Acura MDX, Tesla Model X, Chrysler Pacifica and Chevrolet Traverse.
The Consumer Reports rankings were based on surveys of owners of more than 400,000 current-generation vehicles made within the past three years. Those owners evaluated safety systems, vehicle infotainment, engine performance and other aspects of the cars and trucks.
For more on the rankings, visit https://tinyurl.com/cr-reliability-cars.
2021 Board Candidates Announced
The ASQ Nominating Committee has announced the 2021 candidates for the positions of chair-elect, treasurer and two directors at large:
- Chair-elect: A. Blanton Godfrey, Joseph D. Moore distinguished university professor at North Carolina State University in Raleigh.
- Treasurer: Wayne Brown, retired aerospace executive and industry advisor/consultant at Embry-Riddle Aeronautical University, the University of Phoenix and the University of Arizona.
- Director at large: Jamison V. Kovach, professor at the University of Houston.
- Director at large: Paulo Sampaio, professor at the University of Minho in Braga, Portugal.
The term of office for the chair-elect and treasurer will be one year, from Jan. 1, 2021 to Dec. 31, 2021. The director at large positions will be two-year terms, from Jan. 1, 2021 to Dec. 31, 2022.
The declaration of the election of officers and directors will take place at ASQ’s annual business meeting, which will be held in conjunction with the World Conference on Quality and Improvement on May 3 in Columbus, OH.
Getting to know…
Current Position: Director of strategy and project management at Medtronic in Minneapolis.
Education: Doctorate in civil engineering with a major in project management from the University of Maryland in College Park.
What was your introduction to quality? While working as the only technical support person and quality professional on the graveyard shift at 3M in the mid-1980s, I learned about quality, leadership, influence management and technical skills, and started my journey to be a lifelong learner.
Is there a teacher who influenced you more than others? Why? Marty Walsh, a quality engineer at 3M, helped me start my career and my quality journey, and coached me for a few years. His first recommendation was to become an ASQ member back in 1988.
What is the best career advice you ever received? Network and continue to network throughout your career. Do not rest on who you know today.
Any previous noteworthy jobs? I started in the quality profession in 1986, and I still start all meetings with quality. I have been in the medical device profession for nearly 30 years. I have been fortunate enough to have worked in many different functions over this time, including quality.
What ASQ activities do you participate in? As an ASQ fellow, I have been involved in many activities, including acting as Medtronic’s corporate liaison (2015–2018) and current ASQ R&D contact. I also belong to several groups, including ASQ’s Minnesota Section; Food, Drug and Cosmetic Division; Biomedical Division; Design and Construction Division; Audit Division; Team and Workplace Excellence Forum; Quality Management Division; Human Development and Leadership Division; and Government Division.
Any recent awards? Recent accomplishments include receiving the Project Management Institute Educational Foundation Community Advancement Through Project Management Award; being named a fellow of the Association for Project Management; receiving the Biomedical Engineering Society’s Fellow Award; and receiving the American Society for Engineering Management’s Engineering Manager of the Year Award.
Personal: Married to my wife since 1991; one son.
What are your favorite ways to relax? Gardening, going on vacation and relaxing by the beach.
What books are you currently reading? Sun Tzu’s Art of War, Simon Sinek’s Start With Why and Harold Kerzner’s Innovation Project Management.
What was the last movie you saw? “Jumanji: The Next Level.”
Quality quote: W. Edwards Deming’s “Improve quality, you automatically improve productivity.”