What are the odds that I would finish writing a near-future viral thriller (The Lollipop Factory) just as 2019-nCoV was becoming entrenched in Wuhan? So, as it turned out, the first facts I wanted to know when I caught wind of the outbreak were things like the resource requirements for treatment, the average transmission rate per person, and whether transmission was asymptomatic. The sudden rush to build new hospitals answered the first question: 2019-nCoV was a resource intensive disease. As it turns out, some 18% of those with verified cases require intensive care. This fact became mind-boggling as more and more estimates of the transmission rate bubbled to the surface of the web: on average, investigators think 2019-nCoV is around twice as contagious as the seasonal flu. And if this weren’t bad enough, we now have solid evidence of asymptomatic transmission: as relieved as I was to learn that infected children weren’t getting sick, I understood the kind of epidemiological nightmare this represented. How do you contain a disease you can’t see?
So what’s the upshot?
2019-nCoV is more difficult to contain than the seasonal flu, and so, likely beyond containment short severe and sustained (ie, economic activity killing) restrictions on face-to-face interaction. Either way, we are likely at the beginning of the wildfire season, not the middle, nor the end.
The lethality of 2019-nCoV will be a function of the resources available to treat critical cases. If this reaches influenza pandemic proportions, then 2019-nCoV will likely be more, not less, deadly than SARS (which killed, given the resources available at the time, around 10% of those infected).
Personally, given the way Chinese authorities bungled the outbreak at the start, and given the alarming tendency of the WHO and CDC to communicate only the most optimistic appraisals of 2019-nCoV, I think this will be the biggest thing to hit humanity since World War II.
For the critically minded, most of the estimates referenced above can be found agreggated here. There’s countless caveats, of course, including the mutability 2019-nCoV itself, which could, like SARS, become less lethal over time. But don’t be lulled by calm-at-all-costs bureaucrats or the nothing-to-see-here Wall Street Bulls: the stakes may not be apocalyptic, but they are civilizational.
The General Director of the WHO, in addition to revealing the official name of the disease, Covid-19, has finally called on nations to treat it as “public enemy number one.” Markets reach record highs. Babies are kissed in New Hampshire.
Much of the latest cutting-edge research can be found here, expertly summarized no less. Ontario learned some hard lessons during SARS. Let’s all hope the good guys can delay this until spring. Maybe Africa, India, and Indonesia have no cases because they’re simply too warm for SARS-CoV-2 (the virus’s official official name). Better to suffer the nightmare next winter, once we’ve prepared.