We don’t yet know the full ramifications of the novel coronavirus:
But three crucial facts have become clear in the first months of this extraordinary global event. And what they add up to is not an invocation to stay calm, as so many politicians around the globe are incessantly suggesting; it is, on the contrary, the case for changing our behavior in radical ways—right now.
The first fact is that, at least in the initial stages, documented cases of COVID-19 seem to increase in exponential fashion. On the 23rd of January, China’s Hubei province, which contains the city of Wuhan, had 444 confirmed COVID-19 cases. A week later, by the 30th of January, it had 4,903 cases. Another week later, by the 6th of February, it had 22,112.
The same story is now playing out in other countries around the world. Italy had 62 identified cases of COVID-19 on the 22nd of February. It had 888 cases by the 29th of February, and 4,636 by the 6th of March.
Because the United States has been extremely sluggish in testing patients for the coronavirus, the official tally of 604 likely represents a fraction of the real caseload. But even if we take this number at face value, it suggests that we should prepare to have up to 10 times as many cases a week from today, and up to 100 times as many cases two weeks from today.
The second fact is that this disease is deadlier than the flu, to which the honestly ill-informed and the wantonly irresponsible insist on comparing it. Early guesstimates, made before data were widely available, suggested that the fatality rate for the coronavirus might wind up being about 1 percent. If that guess proves true, the coronavirus is 10 times as deadly as the flu.
But there is reason to fear that the fatality rate could be much higher. According to the World Health Organization, the current case fatality rate—a common measure of what portion of confirmed patients die from a particular disease—stands at 3.4 percent. This figure could be an overstatement, because mild cases of the disease are less likely to be diagnosed. Or it could be an understatement, because many patients have already been diagnosed with the virus but have not yet recovered (and may still die).
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Meanwhile, the news from Italy, another country with a highly developed medical system, has so far been shockingly bad. In the affluent region of Lombardy, for example, there have been 7,375 confirmed cases of the virus as of Sunday. Of these patients, 622 had recovered, 366 had died, and the majority were still sick. Even under the highly implausible assumption that all of the still-sick make a full recovery, this would suggest a case fatality rate of 5 percent—significantly higher, not lower, than in China.
The third fact is that so far only one measure has been effective against the coronavirus: extreme social distancing.
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As the [1918 flu] was spreading, Wilmer Krusen, Philadelphia’s health commissioner, allowed a huge parade to take place on September 28; some 200,000 people marched. In the following days and weeks, the bodies piled up in the city’s morgues. By the end of the season, 12,000 residents had died.
In St. Louis, a public-health commissioner named Max Starkloff decided to shut the city down. Ignoring the objections of influential businessmen, he closed the city’s schools, bars, cinemas, and sporting events. Thanks to his bold and unpopular actions, the per capita fatality rate in St. Louis was half that of Philadelphia. (In total, roughly 1,700 people died from influenza in St Louis.)
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For a few days, while none of your peers are taking the same steps, moving classes online or canceling campaign events will seem profoundly odd. People are going to get angry. You will be ridiculed as an extremist or an alarmist. But it is still the right thing to do.
You can’t trust any of the stats on this, at all. For one, the Chinese have been lying since day one and even before, and two, since they’re not doing mass testing, we don’t know what the actual number of cases is. With the low-level asymptomatic cases that are going on, I strongly suspect that the MO for this virus is a lot more low-key than we think, and the severe cases/deaths stem from some other unknown triggering feature when it hits vulnerable victims.
Honestly, I’m pretty sure it’s been endemic here in the Pacific Northwest since sometime in early January. Too many people around here have had symptoms of something that damn sure mimics what’s been released already about COVID-19 symptoms, and if they start doing retro-studies to see who has had it, I think we’re going to be in for a hell of a surprise.
This is one of those diseases that you look at and have to wonder if it wasn’t almost tailored to be hard to catch before it blew up into a pandemic. SARS had relatively early onset and good symptoms to use for identifying people who had it. This stuff? I’m almost certain it uses asymptomatic carriers to spread, most of whom don’t show severe enough symptoms to screen for. I’d almost plump down for saying it’s a two-stage disease, and that there’s something else that triggers the secondary severe stage, maybe an interaction between variants. Could be that the COVID-19 sufferers who are getting really sick are somehow like AIDS patients in that their immune systems are getting compromised by something else, or an atypical interaction with the COVID-19 virus itself.
I agree. One of the reasons the death rate seems to vary is likely a bunch of co-factors. China is hugely polluted, and nearly everyone smokes, and the population skews elderly, and so seems to have a higher death rate (even controlling for bullshit stats, South Korea seems to have a lower death rate). Italy seems to be suffering, but they also have the oldest population in Europe, so that may be a factor in the greater severity in Italy compared to the rest of Europe.
I suspect the death rate is actually lower than we think, because we are counting the deaths of those diagnosed and hospitalized who died, compared to those actually diagnosed. We actually have no idea how many people have had it, and recovered and never even knew they had it.
I think that rather like SARS, we will find out more once it is over.