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Saturday, March 28, 2020

Coronascape – a look around

First, the cheerful news: according to Dr John Campbell’s exposition , 85% of the over-80s in China who contracted Covid-19 pulled through; in Italy, over 80%, for the same age group; so the prognosis for sufferers is good for the old, rising to excellent for the young. Accordingly, ‘as of 19 March 2020, COVID-19 is no longer considered to be a high consequence infectious disease (HCID) in the UK.’

Some say that the curfew should stop because the pandemic model has been revised optimistically; it hasn’t, it remains the same. The new forecast of 20,000 fatalities (or fewer) is because public policy and behaviour have changed; without that, says Professor Ferguson, the original prediction of half a million dead would still stand. If anything, the potential danger is worse than originally assumed: the estimated ‘reproduction rate’ (for onward transmission of the sickness) has risen from 2.5 to 3.
Another meme is that it’s all a fuss about nothing, since the oldies who died had other things wrong with them, so they were doomed anyway. Not so: most old people have some health condition or other, but we should remember that they are, by definition, survivors – the average 80-year-old man has a 35% chance of living ten more years, and even at a hundred has a 65% probability of seeing out another twelve months. We got a note last week from an old drama pal who is well into his nineties, saying he’s moved to a care home and hopes we are well!
However, reassuring statistics aren’t personal guarantees. Only 10% of British soldiers on the Western Front in WWI were killed, but any squaddie who stood up in the trench waving his arms and shouting ‘Oi, over here, Fritz!’ would have found his own odds shortened; which brings us to (for example) the morons who recently took up the toilet-bowl-licking challenge . We are in (sort of) lockdown because many people can’t tell the difference between ‘unlikely’ and ‘impossible’ consequences and keep taking risks, including gathering in large groups (£ ) . As one Twitter user has said, ‘I absolutely hate that my chances of survival during this period are inextricably linked to other people having common sense.’
Stupidity alone hardly explains the teenagers who smashed up Kidderminster Hospital a few days ago , or the gang (including adults) who, claiming to be carrying the coronavirus, coughed at NHS staff. I assume they had no inkling that very sadly, though it rarely happens, even young people can contract viral pneumonia. Besides, there could be many other reasons why youngsters might need emergency treatment, which could be unavailable to them if the hospitals were already fully employed tackling a pandemic: ‘tough luck, kid, your motorcycle can be fixed but you’ve had your chips, shame the ventilator was vandalised.’
Not that ventilators are necessarily the answer. It’s good for many other cases that production of these machines is increasing, but writing in the Spectator magazine , Canadian critical care physician Matt Strauss says ‘up to 90 per cent of Covid-19 patients who go on life support will die.’ In any case, inundated with medical emergencies, Italy has stopped intubating patients aged over 60. A review just published in the Lancet of Wuhan’s coronavirus patients also suggested respirators were of little use, concluding that old age and indications of vulnerability to sepsis were significant factors in predicting a failure to survive. Aeration was of far less use than antibiotics and antiviral drugs.
That last highlights another vulnerability that the West has allowed to develop. In December 2019, during trade negotiations shortly before the coronavirus crisis arose, the US was beginning to worry about its dependence on China for the production of around 80% of America’s supplies of antibiotics. This month, according to Fox News, Chinese media agency Xinhua hinted dangerously at restricting its exports of drugs to the US, plunging the latter into "the mighty sea of coronavirus."
Microsoft founder Bill Gates warned of viral pandemic in a TED talk in 2015 , a year after Ebola had broken out in West Africa . He said how air travel could spread a sickness across the world in a short time, and how we should be making plans to coordinate medical and military resources to tackle pandemics fast. Within months, the Bill and Melinda Gates Foundation helped to set up and fund the Coalition for Epidemic Preparedness Innovations , in partnership with others including the pharmaceutical research giant Wellcome Trust. The business potential for a vaccine needed to combat an illness that is destined to become a permanent feature, like seasonal influenza, is huge; but if it is found, it will take a long time yet to come to market, and there are those who say that mass vaccination has never been proved to be safe and effective.
Again, many contrast Covid-19 with influenza, saying that the latter claims many more victims. Oddly, that number varies very widely from one year to another. In 2014/15 28,330 are estimated to have died from flu (such figures are always educated guesses because of the variety of factors in a death) in the season [see Table 7, p. 51 here ], defined as week 40 of one calendar year (October) to week 20 of the following (May); yet with only five weeks before end-season 2018/19, flu had taken a mere 1,692 lives – so say 2,000 by week 20? If that is so, within less than one month , Covid-19 is already half-way to matching the toll of the whole of last year’s flu season.
While we wait in hope of a ‘magic bullet’ for coronavirus, Doctor Strauss argues for allowing those who are at very little risk of death to catch and overcome the illness while secluding the most vulnerable, so that when the latter come out into society they will be surrounded by people who have been through it and are no longer infectious. The difficulty with this idea – attractive though it is for us enforced homebodies and for all of us who want the economy to recover – is that absent mass testing, we don’t know how many people have had Covid-19. This is crucial because the more easily a virus spreads, the higher a percentage of the population that must be vaccinated or otherwise immune to establish that ‘herd immunity.’ In the case of measles, which has a reproduction rate 4 – 6 times higher than Covid-19 , Strauss says we need around 95% to be immune; for a ‘firewall’ against coronavirus, he estimates two-thirds. How will we know when that target has been reached? Some days ago, President Trump was talking of sending people back to work by Easter, because the pain of economic standstill was worse than the disease, but has since started to row back as advisers warned of a fresh escalation of cases.
Western leaders are between a rock and a hard place. In the UK, even as we are mostly confined to our houses, the planes are still coming in from Italy and China. We are so globally connected that we don’t know how to stop without blowing up the machine. We at the start of a time for building resilience rather than maximising profits.
Even when we think society is safe, surprises can happen: the last naturally-occurring case of smallpox was in 1977, in Somalia , yet in 1978 a 40-year-old medical photographer in Birmingham, England, vaccinated against it twelve years before, contracted the disease and died. It turned out that she had been working above a laboratory that was researching the virus.
This leads us to the blame phase of the current disaster. Some say the outbreak started with infected animal meat in Wuhan’s market – though a British teacher working in Wuhan, who caught the disease, denies seeing exotic meats there ; some hint darkly at a viral escape from the Grade 4 (highest security) bio-research lab in the city (the earliest tip I have seen was from a military spook in a Near Eastern country who contacted the Washington Times .) Already there are calls for China to pay damages for the consequences; but, says veteran blogger John Ward , China has responded by pointing the finger at a large US military sports team that stayed near Wuhan’s fish market, had come into contact with what turned out to be the first seven Chinese victims, and had previously trained at Maryland’s Fort Detrick, a germ research lab shut down in August 2019 over safety concerns. Ward goes on to say:
‘The Beijing Government’s Foreign Minister Wang Yi, on releasing this information, formally asked US Secretary of State Mike Pompeo for an explanation.
‘Immediately afterwards Pompeo went over Wang’s head and phoned Yang Jiechi, Chinese state councillor in charge of foreign affairs. Pompeo “begged” Yang not to release the details shown above. They have since been leaked. Pompeo has yet to respond.’
American lawyers must be fainting with greed at the distant prospect of the world’s largest compensation case ever.
Meanwhile, what do we do? Accept the precautionary principle. Our government may be mistaken, but they’re certainly not doing this for a joke, even though April the First is near.


James Higham said...
This comment has been removed by the author.
James Higham said...

Taking a second look at this comprehensive summary. Shall link.

Sackerson said...

@James: thanks for the mention!