Via Johns Hopkins

On 26 January I wrote a bit about 2019-nCoV, the novel coronavirus originating in Wuhan, and opined that we’d know more in 10-14 days. Here’s an update in two parts:

1. The current situation, that is, what I know today (6 February) and what might reasonably be inferred—though with the caveat that information is always changing and its transmission is imperfect.
2. Speculative fun, that is, how I would use all this to write a novel about the fall of civilisation.

Current situation

• confirmed cases 31,439
• serious condition 4,826
• of which, critical condition 985
• dead 639
• recovered 1,564

Using these numbers, the worldwide fatality rate is now just a little over 2%, and falling. (Mostly. The story is more complicated than that, because in Hubei province it is 4.1%, and only 0.17% in the rest of the world—at least the parts of the world that are reporting.) This is good news, and it’s the result of improved reporting. (But, oh, so many places are not reporting, and as these are places with fragile healthcare systems I do not trust this data.) As the quality of data continues to improve, my hope is that we’ll see that figure continue to fall. I honestly have no idea of the latest R0 (R-zero, or R-nought, that is, the rate of transmission) but just looking at the numbers I’d guess that has not fallen.

I want to emphasise, again, that this data is not very reliable. The number of cases, for example, is certain to be wrong. I’ve seen figures ranging from 100,000 to 200,000 mentioned as a more likely  number, and I think this is much closer to the mark. (What’s going on in North Korea? How about Indonesia? Then there are all those countries in Africa where Chinese engineering projects have necessitated vast in- and outflows of Chinese labour.) The reason we don’t know about many of the unreported infections, though, is that their symptoms are very mild. In other words, the virus might not be nearly as deadly as we first thought. At least at the moment. I also suspect that there will be deaths that should be attributed to the virus but weren’t because the infected person was asymptomatic and so never tested.

Viruses mutate all the time. This virus will, too. It may become less infectious or more infectious. It may become more deadly or less deadly. We don’t know. But it will mutate; it’s what viruses do.

The virus is very close to being a pandemic if it’s not already. Pandemic just means an infectious disease has reached epidemic proportions on more than one continent. Flu, for example, is a global pandemic but most of us aren’t that afraid of it because we know fatality rates are generally less than 0.1%—often quite a bit less. The common cold (another coronavirus) is also pandemic—so pleased don’t be alarmed by the word.

Coronaviruses rise and fall with the weather. Like the common cold, it’s entirely possible that in the northern hemisphere, the 2019-nCoV will start to die down in spring—but really rev up in the southern hemisphere as things begin to cool down. It’s also entirely possible—I’d go so far as to say likely—that there will be a resurgence of infection at the end of the year coinciding with autumn and the onset of winter

So how do you protect yourself against it? I’m not an expert so this is not medical advice. I can only tell you what I plan to do, which is to behave as though I’m on book tour, meeting a lot of people in the middle of flu season. The most important thing is to wash your hands, a lot. If you can, use warm water, and wash thoroughly with soap—not a quick rinse under the tap but a through sudsing. Hand sanitiser is also very effective. Don’t stand right next to someone coughing and sneezing. Wipe down surfaces if someone with symptoms has been in a space for five or more minutes. (Experts suggest at least 10 minutes, but hey, precautions are our friend.) And if you do test positive for the virus, wear an anti-viral surgical mask to prevent spreading infection. Do we need any more precautions than that? I don’t think so, not unless the virus mutates in terms of transmissibility and/or deadliness. For more info, see a variety of advice, for example from The Guardian. And the Wold Health Organisation has a decent video.

Those people who are dying from 2019-nCoV are doing so from lung injury; most seem to have co-morbidities. So if you already have health issues, like me, and/or a weak respiratory system, start washing your hands a lot.

What treatments are there? Nothing that’s proven to help. Though there are indications that some of the therapies used to combat HIV—a combination of anti-virals and interferon, which signals to the immune system to rev up—might help. And there are several teams in various parts of the globe working on a vaccine. The virus has already been sequenced and people know roughly how to knock out specific important bits to prevent or reduce replication. So I’m guessing there will be some kind of vaccine in 15-18 months.

But remember what I said about mutation? I suspect 2019-nCoV will be like influenza: seasonal, and variable, and sometimes vaccines will be more effective than others.

So meanwhile, people, wash your hands and keep yourselves informed. The two best sources I’ve found so far are BNO News (for latest numbers) and WHO for thoughtful Situation Reports. Johns Hopkins has a nifty Dashboard, but I find they sometimes lag a bit, and the Guardian does great live updates, and has useful tips based on changing info, but that links is always changing, so it might be best to go do a search.

Here is where I move into speculative territory. If you are of a fretful disposition I’d stop reading now. If you continue reading please remember I’m just playing, making shit up for for fun. It’s not researched; it’s guesswork, pure and simple. You’ve been warned.

Speculative fun

Coronaviruses are tricky bastards. Not only do they mutate with astounding ease, they don’t play fair: they do not confer protective immunity on their host. In other words, you could get 2019-nCoV, fight it off over a two-week, life-or-death struggle, emerging weak but triumphant, only to get it again. Just like getting the same cold twice in winter, only this time you die.

Vaccines won’t be much use against an endlessly metamorphosising opponent. As with flu, you’ll often be in the position of bringing a knife to a gunfight. So don’t even think about feeling safe.

Coronavirus is, essentially, already a pandemic. Like seasonal flu and the common cold it will wax and wane with the seasons—you might think you’ve got it corned but, eh, no, it’s just gone skiing in New Zealand and will be back refreshed, and ten times deadlier, just in time for Halloween. Then factor in that many, many countries are not reporting infections and I’m pretty sure this thing cannot be contained.

But all that’s for later. What’s happening now?

Factories in Wuhan and surrounding areas are closed. Manufacturing is halted. It’s likely this will spread to other regions. This will trigger a series of chain reactions.

First, demand shock: idled manufacturing plants don’t use energy; oil prices will tumble. Entire economies—often of politically volatile polities (Russia, Saudi Arabia, Venezuela, Nigeria, Sudan)—will implode. Add this to mass migration already underway because of climate change and there will be increased instability, unrest and conflict. Worst case: war, lots of war, with collapse of local, regional, national, and even international society.

And that’s just oil. Now think about what those idled factories are actually manufacturing: car parts, washing machines, iPhones, hammers and drills, industrial piping, steel, aluminium… The list is almost endless. China’s economy is nearly 10% of global GDP (and its exports well over 12% of global trade) and most it is not services. What do you think happens when you can’t get an engine part used for manufacturing in, say, Korea or the US? Manufacturing in Korea or the US stops. This is already happening to Hyundai in South Korea. Multiply that a zillion-fold and include parts necessary for refrigeration, electrical switching… And boom, down it all goes.

We are living in an unprecedentedly globally interconnected society. As its complexity increases, so does its vulnerability. We only need one part of one grid to go down and a cascade of failures will follow. And as most of the industrialised world is only 3 days from starvation, if grids go down and transport fails then, oof, it is not going back up. Not just ‘not for a while,’ but not ever. If that happens? Billions die.

But imagine nothing goes down, just a series of things closing. So factories are idle. All those workers aren’t getting paid. Starbucks and other big US corporations have already shut many Chinese branches: their profit goes down; their stock goes down; other stocks go down. The next thing we know: global recession. Unlike the last Great Recession, though, central bankers have no shots left in their lockers: they can’t bring down interest rates enough to make a difference. The recession becomes a depression. A depression in a globally interconnected world? Nightmare. Millions die.

And all this is not folding in factors such as police and medical professionals being too ill to work. Or the tools of their profession—medications, ventilators, ammunition—being in short supply because of global supply chain failure.

But let’s change tack and imagine a Happy Fairytale and do some best-case speculation. Imagine there’s no interruption of the supply chain. Imagine no recession. Imagine no political unrest. Then imagine the virus fatality rate drops by half. Assuming the transmission rate does not increase—-but assuming the virus can’t be put back in the box, and we’re already heading for global pandemic—we’re still looking at the death of at least a hundred million people.

So, yep. Buy a mask, buy soap, and wash your hands. All the time. If nothing else, it’ll cut down your chances of getting flu.