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Tuesday, February 11, 2020

Coronavirus: a storm in a teacup?

Are we making too much fuss over the new virus? To date 910 people have died, which is less than half the annual toll from road accidents in the UK alone.

Provisionally, ‘2019nCoV’ seems much less deadly than SARS. Within China, the mortality rate is running at about 2.3% of the 40,195 infected; the two who died out of 378 cases abroad represent a rate of only 0.5%, though small figures are more likely to be statistically misleading. However, as business site Quartz warns, it’s too early for complacency: during the 2003 SARS epidemic the World Health Organisation (WHO) initially estimated a SARS fatality rate of around 3%, which later had to be revised to almost three times higher. Remember, 89% of coronavirus cases have so far neither died nor recovered.

Still, only two deaths have happened outside mainland China. It would be nice to reassure ourselves that ‘it can’t happen here’ and there is a suggestion that some ethnic groups may be more susceptible. Russia Insider cites a Chinese scientific study on the 2009 ‘swine flu’ pandemic that felt ethnicity might be one of the factors determining vulnerability to the H1N1 virus; and a new piece of research has tentatively (awaiting peer review) indicated that the alveoli (lung cells) of ‘Asian males’ have more receptors to which 2019nCoV can bind, so making those people more likely to succumb.

However, there may be other and possibly more significant predictors. A 30 January paper in The Lancet, looking at 99 ‘Wu flu’ patients in Wuhan’s Jinyintan Hospital, noted that they tended to be older (average age 55 years) and predominantly (two-thirds) male; and half of the sufferers had existing chronic illnesses. The risk pattern resembled that for viral pneumonia generally, and as with the latter, smoking may be a factor (52% of Chinese men smoke; among women, only 3% but they are often exposed to second-hand smoke.) Anybody here fit the profile?

The spread into the rest of the world is in its early days. The symptom-free incubation period is said to be about two weeks and although it’s currently thought that the virus can’t be passed on during this stage we are still learning. Besides, when exactly does one move onto the infectious stage? Charles Hugh Smith, who was predicting a pandemic a week ago, repeated his warning on Sunday, suggesting that governments are concerned to pretend for the sake of economic stability that everything is under control. In that context, it seems both understandable and yet near-insane that the WHO should urge that travel restrictions not be imposed.

Smith’s article gives reasons to disbelieve official assurances. It’s also worth noting that part of the Chinese strategy for containment was to extend the Lunar New Year holiday to 10 February in many local areas, so what happens now the great back-to work has begun? Many people must be desperate to start earning money again and so they have an incentive to ignore a ‘bit of a sniffle’.

Even if the fatality rate is indeed relatively low, the rate at which infection can spread appears to be high, so that a small percentage of a large number could result in a high victim count. In this country we have very good medical facilities but even the best could be overwhelmed by demand, as happened in Wuhan. The UK Health Secretary Matt Hancock is therefore right to label the risk to Britain as ‘serious and imminent’ – a declaration that empowers him to use force if necessary to prevent individuals absconding from 14-day quarantine, as one of them was reportedly threatening to do.

A stitch in time… if the crisis got out of hand stringent measures would demand to be employed. There are allegations that the quarantine effort in China extends to welding sufferers’ house doors shut, and herding others into guarded camps with inadequate medical care, just to stop the viral wildfire spreading. One Twitter user claims that a Hubei woman was shot dead while trying to get through a protective blockade. What would we do?

Let's do whatever we can not to have to find out.

4 comments:

Nessimmersion said...

Interestingly the table below lifted from Frank Davis's blog indicatws that the majority of sufferers were never smokers. So could smoking have a protective effect?
https://cfrankdavis.files.wordpress.com/2020/02/1099_ncov_patients.png

Sackerson said...

Fair comment - we have to go by research not prejudice. I heard or read many years ago that the mortality risk of smoking was uneven - most people not much difference, but a quarter die c. 20 years early. Perhaps it would be helpful to make some test that told you if you were in the most vulnerable group.

Having said that, there appears to be some statistical correlation between smoking and premature death, and this was established when doctors looked at their colleagues!

I'm not against smoking per se - so many pleasures carry a risk, and I like the smell of pipe and cigar tobacco.

I also feel that there could be much more mutual flexibility - what was wrong with smoking rooms or bar 'snugs'?

David Hockney said recently he's had 3 doctors in the last 40 years, all told him to quit smoking and they're all dead. I suppose he's one of the 3/4.

Paddington said...

A couple of quick comments:

1. The incidents of welding doors shut and shooting patients seem plausible, given the concrete nature of Chinese thinking, bizarrely combined with a strong belief in magic. I would suspect that such things are the result of local decisions.

2. While some smokers do not drop dead from their habit, almost all develop some form of COPD eventually.

Name said...

I have little doubt that this virus cannot be contained and will be coming to an outlet near you soon. It will join the list of scourges of mankind along with cold, measles and flu. A cruise ship anchored off Yokohama knew it had 10 cases when it went into lock-down with 10 cases. Now 110 cases on board. A microcosm of the world that could not contain it in this lab test where elaborate precautions were taken. I live in remote rainforest in Australia with my nearest neighbour 4 km away. Just 2 hours ago I was speaking with guests of my B&B and they work in tourism and had recent clients from Wuhan. I took a couple of steps back and they laughed. But the reality is that we live in a world of less than 7 steps of separation. I will get it, you will get it. I wish you mild symptoms, but hey, that will make you a super-carrier