(Hong Kong, Shanghai, 30 March 2020) Ping An Insurance (Group) Company of China, Ltd. (hereafter “Ping An”, the “Company” or the “Group”, HKEX: 02318; SSE: 601318) announced that according to an analysis by Ping An Macroeconomic Research Institute and Ping An Healthtech Research Institute, Europe and the U.S. could see the turning point, peak of new confirmed cases per day, of the COVID-19 pandemic by this week / early April.
Ping An’s disease transmission analysis focuses on seven of the most affected countries, considering factors such as quarantine controls, public sentiment analysis, population density, medical resources and size of the elderly population.
The analysis suggests that different countries will reach the turning point at different times: Italy – Mar. 21-25, which is probably at the peak period now; Germany – Mar. 27-31; France – Mar. 27-31; Spain – Mar. 28-Apr. 1; U.S. – Mar. 30-Apr. 3; and Iran – Mar. 31-Apr. 4. It appears South Korea has already passed the peak point, as has China, where disease prevention and control efforts are shifting to preventing imported cases from the U.S., Iran and European countries.
1. Analysis on disease transmission model
Most countries will reach peak in new cases around March 27-April 4, according to Ping An’s analysis. Most of the countries are likely to see a slowdown in the rate of new cases each day between Mar. 21-Apr. 4, according to Ping An’s analysis. Italy appears to have had the peak of new reported cases on March 22, and has now started to decline. The U.S. is forecast to reach the peak of new reported cases per day between Mar. 30-Apr. 3.
Late controls can result in infection rates 10 times higher than countries with early controls. The number of people affected in a country depends critically on how quickly the separation/control measures are implemented. We see three models:
1) Early control models, such as South Korea, which is expected to have 0.02% of population being affected.
2) Mid-term control models, such as the U.S., France and Germany, which are expected to have 0.1% of population affected, i.e. about 300K people in U.S.
3) Late control models, such as Italy and Spain, which are expected to have more than 0.2% of population affected.
Fatality rates range significantly between 0.9% to 14%, depending on the level of intensive care unit (ICU) beds. While the COVID-19 virus itself is much less deadly than even SARS (Severe Acute Respiratory Syndrome, which appeared in 2003) or MERS (Middle East Respiratory Syndrome, which appeared in 2012), about 20% of diagnosed cases require hospitalization, so the number of ICU beds is critical to determining the mortality rate.
- Adequate healthcare resources would likely result in lower mortality rates of 1-2%. If the number of new confirmed cases in a seven-day period is less than twice the number of ICU beds, then there should be sufficient healthcare treatment capacity in the country. The expected fatality rate would be low, in the range of 1-2%. The models suggest mortality rates in Germany and U.S. to be about 1.1%-1.4%, similar to South Korea at 1.8%.
- Inadequate healthcare resources would likely result in higher mortality rates between 10%-14%. If the number of new cases in a seven-day period is much higher than twice the ICU bed capacity, then our models show that the mortality rates would be significantly higher. The models suggest mortality rates in Spain to be about 9.7%, Iran 11.7%, and Italy 13.3%.
Public sentiment is positively correlated with the intensity of preventive and control policies, ahead of the pandemic turning point. It appears that public sentiment is slightly leading control policies and the pandemic turning point. Shifts in public sentiment encourage governments to reinforce its disease prevention and control efforts, and therefore have an impact on how the pandemic will evolve. For example, as the public sentiment about taking measures to control the outbreak soared in South Korea, the government put the country on its highest alert for infectious diseases on Feb. 23, which led the peak of its pandemic curve by five days.
The speed of disease transmission is affected by population density. As the COVID-19 is an infectious respiratory disease, countries with high population density are likely to have a quicker pandemic spread. There are 275 people per square kilometer in the U.K., 237 in Germany and 205 in Italy, compared to 122 in France. The spread in France appears relatively slower than in Italy, Germany and the U.K.
Countries with large aging populations are greatly impacted by the pandemic. Countries where population aging is advanced are more being severely hit by the pandemic. In Spain, 19.4% of the population is aged over 65, in Italy, 22.8%, and in France, 20%. The crude death rates of the outbreak (accumulative deaths/accumulative confirmed cases) are 4.47 % in Spain, 8.34% in Italy, and 2.89% in France. Considering that the pandemic has only recently reached France and is still spreading, the analysis suggests the situation in those countries with large elderly populations will get worse.
The turning point for the pandemic in European countries and the U.S. is expected to arrive this week / early April, while the pandemic will continue spreading till the end of April or early May. The evolution of the pandemic can be divided into the following stages: outbreak, initial control, mitigation and plateau. Currently, only China is at the stage of plateau, South Korea is at the stage of mitigation, and the other countries with serious outbreaks are at the stage of initial prevention and control. It is estimated that the turning point of the pandemic for different countries will be:
- Germany – Mar. 27-31
- France – Mar. 27-31
- Spain – Mar. 28-Apr. 1
- U.S. – Mar. 30-Apr. 3
- Iran – Mar. 31-Apr. 4
Italy is currently at the peak period and South Korea has already passed the peak point.
According to the analysis, the estimated total confirmed cases in each country will be: U.S., 300,000 people; Italy, 150,000; Spain, 120,000; Germany 95,000; France, 72,000; Iran, 64,000 and South Korea, 10,000.
2. Pandemic trends in major countries
Observing the pandemic trends in different countries, our analysis found a correlation between early quarantine measures and lower infection rates. Countries can be classified into three modes of pandemic evolution based on the total number of confirmed cases per million population:
- Early prevention and control – at the time the emergency response is activated, the number of per million confirmed cases is between 0 to 20
- Mid-stage prevention and control – at the time the emergency response is activated, confirmed cases are between 20 to 60 per million
- Late-stage prevention and control – at the time the emergency response is activated, confirmed cases are above 60 per million
We will analyze the pandemic evolution in different countries using these three modes.
1) Early prevention and control: South Korea
Countries that implement prevention and control measures before the outbreak of the pandemic appear to reach a turning point within 10 days and the number of infected cases per million people is less than 500. South Korea is a case in point. On Feb. 23, South Korea initiated an emergency response to deal with the pandemic. At that time, the number of accumulative diagnoses per million people was 11.74, and the final number is estimated to be lower than 200 per million people. On Feb. 29, South Korea saw its peak of 813 newly confirmed cases, while it is estimated that the final total number of confirmed cases will be around 10,000.
2) Mid-stage prevention and control: U.S., Iran, France, Germany
Countries that take mid-stage prevention and control measures appear to reach the turning point after 10 to 18 days. In these cases, our analysis suggests about 1,000 people per one million people will get infected. Countries like the U.S., Iran, France and Germany can serve as examples. Iran took urgent responses to deal with the pandemic on Mar. 5, when there were 34.78 infected cases per one million people. France initiated responses on Mar. 14, with 56.1 confirmed infections per million, and Germany initiated responses on the same day, with 43.9 confirmed diagnoses per million people. In the U.S., prevention and control measures were taken on Mar. 13 when only 5.4 people per million were diagnosed there. We list it under the category of mid-term prevention. It is estimated that the aggregated diagnoses will reach about 910 per million in the U.S., 800 per million in Iran, 1,100 per million in France, and 1,200 per million people in Germany.
We predict that the newly added diagnoses in the U.S. will peak on between Mar. 30 and Apr. 3 at about 28,000 cases, and the cumulative total will be around 300,000.
We predict that the newly added diagnoses in Iran will peak between Mar. 31 and Apr. 4 at about 3,000 cases, and the cumulative total will be around 64,000.
We predict that the newly added diagnoses in France will peak between Mar. 27 and 31, at about 4,000 cases, and the cumulative total will be around 72,000.
We predict that the newly added diagnoses in Germany will peak between Mar. 27 and 31 at about 7,000 cases, and the cumulative total will be around 95,000.
3) Late-stage prevention and control: Italy, Spain
Countries that implement prevention and control measures at a late stage will likely reach their turning points more than 14 days after measures were first taken. Consequently, more than 2,000 people per million will get infected. For example, Italy initiated urgent responses on Mar. 8, with 97.29 infection per million at the time. Spain followed on Mar. 13, with 67.30 infected per million people. The accumulative diagnoses are expected to be 2,500 and 2,100 per million respectively.
Italy is currently at the peak period of newly confirmed cases with about 6,500 people listed as newly infected. We expect the cumulative total will reach 150,000. Our analysis suggests that if prevention and control measures had been implemented one week earlier, the confirmed cases would have been reduced to 80,000, nearly half of the current estimates.
For Spain, we forecast the peak of newly confirmed cases to be between Mar. 28 and Apr. 1, with about 9,000 people listed confirmed as newly infected, and the cumulative total will be around 120,000.