Photo credit : Ahmed Zarrouki

As a disclaimer, I’m not an epidemiologist and not even remotely connected to the medical field. My observations below are based on collecting public data and applying them to the specific context in Tunisia, and using some of my training as a data scientist and predictive modeler. Below I’ve provided graphics, data, and alternative models in response to some pressing questions:

  1. How far are we from the significant outbreak?
  2. How many real cases of Coronavirus are in Tunisia?
  3. How ready is the Tunisian health care system to handle the upcoming outbreak?
  4. How can we reduce the mortality rates?

My aim here is to assess whether all the hype regarding the Coronavirus is justified, or if it has been sensationalized. Unfortunately, what you will most likely conclude is that:

  1. Tunisia’s has already entered the critical inflexion point for inverting
  2. The spread of Coronavirus has already taken place and the current number of case statistics are very misleadin
  3. World healthcare is not ready for this pandemic, and Tunisia’s health care system is likely to be overwhelmed and to crumble
  4. Given the dire state of Tunisia’s health care system, some hard decisions will need to be made, such as who will be given oxygen and who will be left to die
  5. Inverting the Coronavirus is still possible, but it takes immediate action now; currently social distancing is the only way to slow down the virus

1- What is the likely true number of cases in Tunisia?

Since the initial diagnosed case in Wuhan, China on December 1, 2019, the total number of cases grew exponentially until China contained it by enforcing a very aggressive lockdown. Outside China, the virus was very slow to appear initially, until the end of February 2020. However, given the lack of public awareness and immediate action, the situation spiraled out of control very quickly in less than three weeks, as the number of confirmed new cases almost doubled, and governments around the world were very tentative in their confinement and containment strategies. Unfortunately, COVID-19 is now a pandemic with no near end in sight. China and most other Asian countries are now reporting low diffusion of the virus, whereas Europe (Italy, France, Germany, and Spain leading the way) and increasingly the US are becoming the epicenter of the virus.

Coming back to Tunisia, the situation may not seem critical now, but we cannot ignore the recent historical data on the spread of COVID-19. On March 20, 2020, the number of cases in Tunisia surpassed the seemingly benign threshold of 50 confirmed cases, and on March 18, 2020 the first death due to COVID-19 was reported. As I will show later, this number is much more worrying than it seems.

Chart 3 shows the evolution of confirmed cases since they numbered 50. It is clear that 50 represents a critical thresholds beyond which the daily growth of number of cases nearly doubles. It is thus fair to say that the number of confirmed cases is likely to grow in two weeks to as much to 6,000 if we look at comparable examples such as Italy, France, and Germany.

The only countries that seem to have very successfully contained the virus since exceeding the 50-case threshold are Singapore,South Korea and a few other Asian countries. This was achieved by very exhaustive and decisive containment policies early on.

Conversely, there are very good reasons to be concerned with the delayed response in Tunisia. For instance, flights to and from high risk areas such as France, Italy, and Spain were not suspended until very recently. Similarly, there are numerous reported violations of the self-quarantine period and of rules for Tunisians and foreigners entering Tunisia. Lastly, some of the basic tools and equipment needed to slow down the spread (such as face masks and hand sanitizer) are not available.

Understanding the nature of the spread of the Virus – Study of the timeline of events in Hubei, China