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article imageOp-Ed: Coronavirus update — Finally some good news, but many worries

By Paul Wallis     Jan 25, 2020 in Health
Beijing - Hidden on Xinhua, the first and so far only bit of good news about coronavirus appears in a single line in an article – 38 people who had recovered have been discharged. It gives a little hope in a bleak overall picture.
That one sentence in Xinhua's coverage is part of a clearer perspective on the new virus, but there’s a lot more to think about. China’s rapid and massive response to the outbreak is getting mixed reactions, but it’s now possible to at least try to map the coronavirus and its spread a bit better.
For those who don’t study epidemiology on a daily basis, some points:
Mapping an epidemic includes:
• Method of transmission
• Scale and sites of exposure, i.e. how many people at risk
• Who’s susceptible (age, medical condition, any indicators of people at risk) is a predictor of the scope and spread of a disease.
• Course of infection – For how long is it infectious, how infectious it is, and similar issues.
• Likely means of wider spread through travel, etc.
• How long does it take to kill?
• Do people recover, and if so, how and why?
One of the most serious things about the coronavirus is how it’s spread. It’s spread from person to person through coughing and sneezing. That’s one of the classic pointers to a potential pandemic.
The coronavirus can include pneumonia as part of its overall effects. That’s another critical pointer to a possible major epidemic like the 1919-20 flu outbreak. Respiratory infections are considered the most dangerous of all pandemic scenarios. The generic term “pneumonic plague” is often used to describe a meltdown-level outbreak of a serious respiratory disease.
Kidney failure is another symptom of the coronavirus. This is equally or even more serious because kidney failure is instantly debilitating and very hard to treat. Large numbers of people with this condition would place an extreme strain on any health system in the world, making management so much harder.
China’s often taciturn President, Xi Jinping, has warned of a “grave situation”, which also means China is pulling out all the stops to contain the outbreak. A vast range of measures are now in place to try to control the spread of the infection and minimize risk. Travel bans and lockdowns are in place.
This breakout seems to be regional and mainly in central China, but of course, people do travel, and that’s the big issue for managing the spread of this disease. The Chinese reaction is pretty typical of a large-scale effort to manage spread.
The outbreak started a couple of weeks ago, and so far the rate of infection is about 1,000 -2,000 people. That’s not a high rate of infection. 41 confirmed deaths have been reported, a low ratio compared to numbers of infections, but obviously subject to future developments.
Older men seem to be most at risk, particularly those with existing upper-end more severe medical conditions. (This is at best a first identifier of people at risk only, and more analysis of risk demographics is obviously required.)
2019 Novel Coronavirus
2019 Novel Coronavirus
News or hype? Reportage quality is highly variable
Not helping anyone much, news coming out of China from various sources is painting an incomplete, but worrying bigger picture. Exactly how accurate this news is has become a big problem. Unconfirmed reports of “large numbers of dead in the streets in Wuhan” and similar alarming issues are also emerging on the back of a very strange quality of reportage.
The death of a doctor was reported, but he also seems to have died of a heart attack, which may well have nothing at all to do with the coronavirus. Pictures show people stocking up on supplies and empty supermarket shelves send very mixed messages.
Reportage quality isn’t helped at all by the fact that information is often subject to official scrutiny, and verification of sources is difficult. Exactly how good the very nasty news sources are isn’t at all clear. Some pictures could be anything.
For example – I used to date a doctor from Beijing. She said that her work involved an endless stream of patients, every day the place was packed So pictures of crowded hospitals could be anything. People lying on floors could be people sleeping, or whatever.
The rest of the world needs to get its facts straight about risks
The rather patronizing tone of reports regarding China’s huge response to the coronavirus is a problem in itself. The reportage is in bits and pieces. There’s no indicator of competence or comprehension on the part of the rest of the world.
Epidemiologists have been continuously warning for decades that:
• A respiratory virus transmissible through the air is THE major threat of a future catastrophic pandemic.
• Managing such a plague-like scenario would put impossible strains on health systems.
• The peak of the influenza outbreak last century effectively shut down America for a few months. A modern outbreak would be far worse simply because of the potential numbers of victims.
• Countries like India, the Russian Federation, Brazil, the United States, United Kingdom, and other “vast health administrative regions” could be caught in thankless situations if a coronavirus outbreak occurs. Distances, numbers of people, capacity of health systems, there are many ways for an outbreak to get out of control and basically reboot the outbreak even if it’s contained elsewhere.
At this point, the coronavirus is falling well short of a plague. That’s partly thanks to control measures, and partly due to the fact that the area of the outbreak isn’t directly plugged into travel and trade routes. If the outbreak had been in Shanghai instead of Wuhan, the situation could be very different.
It’s not always fatal, either. That’s something nobody knew. It’s much too early to have any hard information on recovery, but the survivors may show a road map for management.
The world needs to pay attention, get controls ready for any situation, and above all, be ready to respond. Pandemics can destroy health systems. This is not the time to get complacent.
This opinion article was written by an independent writer. The opinions and views expressed herein are those of the author and are not necessarily intended to reflect those of
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