When making sense of an epidemic, we want to know how fast it is likely to spread, and how many cases of the infection are likely to die from the disease. In the case of the recent China virus, these numbers tend to vary — making it more difficult to settle on an optimum policy of containment for all regions of the globe.
… in the early stages of the outbreak the risk of death from COVID-19 reached 12.2% in Wuhan, China, the disease’s epicenter.
… Mass testing, tracking, social isolation, and containment, as we’ve seen in South Korea and Singapore, can cap the number of cases at manageable levels and keep the death rate at 1% or lower.
… For someone in Wuhan with the disease today, their risk of death is now likely comparable to the risk of death for someone living outside of Hubei Province in China, which stood at 0.9 percent or lower as of a month ago.
Death rates in Italy and Iran seem quite high. If we are dealing with two different strains of Wuhan Coronavirus, some of the variation in observed virus behavior makes more sense.
Rate of Spread
The “reproduction number of a virus, R0, gives us an estimate of how quickly the virus will spread from person to person. The Wuhan virus has an R0 higher than seasonal influenza, but lower than that of the highly contagious measles virus.
The rate at which the viral infection spreads depends on intrinsic properties of the germ but also on what kind of chance societies give it to spread. Every virus has what’s called a basic reproduction number (R0, pronounced “R-naught”), a measure of how many additional people one affected person will infect. __ https://www.technologyreview.com/s/615364/coronavirus-covid-19-deaths-projections-united-states-italy/
Both of the above numbers are very important when attempting to predict the course of the pandemic using infectious disease models, or advanced disease simulations.
Meanwhile, the death toll in places such as Iran or northern Italy has been horrific. Both outbreak sites had direct ties to viral carriers from Wuhan.
Raging Storm in Iran
Iran has very close business and military ties to communist China, and is experiencing some of the blowback from those close ties.
Iran’s official news agencies are reporting that the disease has taken a grim toll on the nation’s governmental and security apparatuses. “Iran’s senior vice president and two other Cabinet members have contracted the new coronavirus,” Iran’s FARS news agency reported this week. “Among the dead are five of Iran’s elite Revolutionary Guard members and an unspecified number of the Guard’s volunteer Basij force,” Iran’s health ministry revealed.
“The economic depression is far more pervasive and contagious than the virus itself,” said one Iranian business owner. Iran’s economy is already estimated to have contracted by almost 10 percent in 2019 as a result of international sanctions, and the reduced domestic economic activity and trade with its remaining partners will only exacerbate these conditions. Perhaps more urgent for Iran, the efforts by Saudi Arabia and Russia to ramp up energy production have sent global oil prices into a tailspin.
… It is hard to avoid the conclusion that the level of risk the Iranian regime is prepared to accept is directly proportional to the economic hardships it endures. And for Tehran, the threat posed by a global Coronavirus pandemic alongside the collapse of global oil prices is a perfect storm. It’s reasonable to assume, then, more violence in the Middle East will be forthcoming. __ https://twnews.us/us-news/iran-rages-against-the-perfect-storm
More details on why Singapore, Taiwan, and Hong Kong are doing better than China, so far.
There May be A Million More Viruses Where That One Came From
Bats seem uniquely suited to act as hosts to a wide range of viruses. The Wuhan Coronavirus is not the worst virus that has come to infect humans by way of bats. There have been many in the past, and there are likely to be many more in the future:
Bats carry and transmit some of the world’s deadliest zoonotic viruses: Ebola, Marburg, Nipah, and the pathogen behind severe acute respiratory syndrome, SARS coronavirus, to name a few. What has puzzled researchers for a long time is why bats don’t appear to get sick from their unusually high microbial loads. The question has been nagging Peng Zhou, a virologist at China’s Wuhan Institute of Virology, for more than a decade, ever since he took part in a survey of bat populations in southern China. Zhou and his colleagues were looking for the strain of the SARS coronavirus responsible for the 2003 outbreak that sickened more than 8,000 people worldwide and killed nearly 800. “We started to think, why bats?” he says. __ https://www.the-scientist.com/notebook/why-bats-make-such-good-viral-hosts-64251
Another virologist at the Wuhan Institute of Virology, Shi Zhengli, has also been at the center of the search for SARS-like viruses in Chinese bats. She warns that there are a lot more viruses out there in those bat caves.
Is the Reaction to the Virus Worse than the Disease?
We have seen what can happen to health care infrastructures when they are overwhelmed by a rapidly spreading viral outbreak like the Wuhan Coronavirus. The collapse of health care systems in Hubei province, in Iran, and in northern Italy, all testify to the devastating effect an exponential increase in the number of serious infections can have.
To avoid a crisis at overwhelmed hospitals, health authorities say it’s essential to slow the spread—what has become known as “flattening the curve.” While in the end most people might still get infected, spreading the problem out over time will save lives, because it will allow people to get the best care. Countries struggling with a burst of cases, like Italy, have much higher death rates, as hospitals fill up their intensive care units and run short of the equipment, like ventilators, needed to treat the critically ill. __ https://www.technologyreview.com/s/615364/coronavirus-covid-19-deaths-projections-united-states-italy/
But we are also beginning to see economic devastation from the reactions to the epidemic, when large parts of economies are shut down proactively to slow the rate of spread. In time, we will see if shutting down an economy is either helpful — or even necessary — in order to minimize the long term effect of being touched by the China pandemic of 2020.
One dirty secret of “social distancing” and “self-isolation”: a lot of people will not take either measure seriously. I have already heard of cases in the US where persons infected with Coronavirus go for treatment at the ER, and deny having traveled — despite having only returned from Europe (or China or Iran) a few days earlier. I have read of other cases of persons staying in “quarantine hotels” who slip out of quarantine to go to convenience stores and other public places, then return for the night. One can also read about college students on the eve of college shut-downs, who get together for one last “going home party,” before they disperse for the rest of the semester to the four winds. Such behavior is probably more common than thought, particularly among persons with poor executive functions and high impulsivity — both of which can be highly heritable, or at least age-related.
A lot of people almost seem to be intentionally trying to spread the infection. Be responsible for yourself, but also avoid putting others at risk unnecessarily.
This pandemic continues to serve as a test of preparedness, and a test of competent response. One thing is clear: when the US CDC spends more time worrying about obesity than it spends time preparing for infectious disease pandemics, the upper echelons are in bad need of cleaning out (draining the swamp).
What’s more, supply chains and manufacturing sites need to be moved out of China as quickly as can be done.
One can also read about college students on the eve of college shut-downs, who get together for one last “going home party,”
The question is — Are those students being irresponsible by getting together? Or are the bureaucrats being foolish by trying to impose unnecessary & unenforceable rules of conduct?
If we allow that the students can read & analyze, they know that the Panic Virus is currently several orders of magnitude below ordinary flu in terms of infections & deaths. They know that about 80% of the passengers & crew given a very high exposure to the virus on the Diamond Princess cruise ship did not catch the disease. They know that most of the morbidity is associated with limited life-shortening of people who were already very old and/or suffering from other medical problems, i.e. not the kind of people most students spend time with.
Now that the virus has clearly escaped containment, a rational analysis would say that the bureaucrats would be better to focus our limited resources on helping the relatively small ‘At Risk’ part of the population to self-isolate, instead of trying vainly to impose sweeping restrictions on everyone. The Chinese government can impose certain measures because of a very high urban population density and a culture which is generally respectful of authority. In contrast, San Francisco’s government cannot even stop people defecating in the streets.