This is Not a Drill

The director-general of the World Health Organization (WHO) Dr. Tedros Adhanom Ghebreyesus warned governments that the global spread of the novel coronavirus is “not a drill” and called on them to take significant action if public health authorities are to contain the deadly outbreak. The novel coronavirus is a pervasive and resilient foe. Scientists have studied seasonal flu for decades, which has helped us learn a great deal about flu viruses and what to expect each season. But very little is known about the new coronavirus and the disease it causes, dubbed COVID-19, because it’s so new. COVID-19 is something of a wild card in terms of how far it will spread and how many deaths it could cause.[1]

World Health Organization Director-General Tedros Adhanom Ghebreyesus looks on during a press conference following an emergency talks over the new SARS-like virus spreading in China and other nations in Geneva on January 22, 2020. (Photo credit: Pierre Albouy/AFP)

An event of significance

The first case of the Coronavirus, scientifically known as COVID-19 was first discovered in Wuhan in the Hubei province in China on December 1st of last year. At the time of this writing the the virus has spread to over 115 countries and infected over 115,000 people. The spread of COVID-19 could be the most significant global event since World War II. A virus can be a greater threat to the world than war, famine and even terrorism. Those things can be controlled to some degree. We have not see this type of virus since the Spanish flu in 1918. The Spanish flu is estimated to have infected as many as 500 million people, and killed 17.4 million. Other estimates claim 50 million and as high as 100 million which puts the mortality rate at 10 and 20% respectively. The world was not prepared then and it is not prepared now.

This is Different

The Coronavirus is different, and for a number of reasons. Bill Gates believes this is the once in a 100 years virus we have been waiting for. COVID-19 has the ingredients to be the black swan event we’ve been dreading. We’re witnessing as Coronavirus wreaks havoc and disrupts the globe. Some believe this is only the beginning. Once the “second wave” begins, possibly when China allows its citizens to go back to work, cases will once again explode. Here are reasons COVID-19 will be different than SARS, MERS and H1N1.

Soldiers from Fort Riley, Kansas, ill with Spanish flu at a hospital ward at Camp Funston (Otis Historical Archives)

Fast moving

The modern world is is highly mobile and connected. What makes this virus so dangerous and difficult to fight is that its host can be asymptomatic, showing no symptoms while infected. The incubation period is said to be as much as 14 days, but most are up to 5 days. What this means is an infected person can infect many other people without knowing they have the virus. Many that contract COVID-19 will be unaware they are carriers until it is too late. Carriers with mild cases will spread it to others that are more vulnerable. While people over the age of 70 and with preexisting conditions such as chronic lung and cardiac disease, and diabetes are highly vulnerable, a recent study discovered the death rate for those over the age of 80 was as high as 15%.

Visitors to Grand Mosque in Mecca, Saudi Arabia have dwindled to dozens

High rate of transmissibility

The Coronavirus has high transmissibility. The reproduction number—R0 or “r naught”—simply refers to the number of additional people that an infected person typically makes sick. A transmissibility rate for the new coronavirus ranges from 2.0 to 3.1 people. That’s higher than influenza—1.3 to 1.8—but similar to SARS, which has a basic reproduction number in the 2 to 4 range.[2] So, coronaviruses are slightly more prone to spreading between people. You can catch it if you breathe in the particles from the cough of an infected person, but it also can be transmitted through hands, bus handles and cash when you touch your face after. That’s why washing your hands and sanitizing regularly is so important. A recent notice discovered pets can catch the virus and pass it on to their owners increasing the spread even further. the United States Centers for Disease Control (CDC) estimate between 3 and 11 percent of the US population gets sick with the flu every year.

A transmissibility rate for the new coronavirus ranges from 2.0 to 3.1 people.


Coronavirus is on par with SARS in terms of infectiousness. (Infographic credit: Sara Chodosh)

Dangerously high mortality rate

The seasonal flu has a low case fatality rate, at just 0.01%, but enough people get it every year that the CDC estimates as many as 30,000 Americans may have died from it between October 2019 and February 2020.[3] COVID-19 on the other hand was thought to have had a mortality rate of 2% but WHO recently announced it could was as high as 3.4%. That’s 34 times more lethal than the flu. People will want to be avoid large groups of people and some may choose to stay in the safety and comfort of their homes. We’ve seen this in China, South Korea and Japan where they’ve shut school and workplaces for hundreds of millions of people.

Source: Chinese Center for Disease Control and Prevention

A resilient foe

The virus can live on surfaces for up to 48 hours. This is a nightmare for public transit and agencies that have large groups of people. The virus has the potential to spread like wildfire. One source, a pole in a bus, a door handle, a table, your phone could infect multiple people. This matters because viruses don’t normally act this way. They have weaknesses. This virus looks to be so resilient and tough it seems unreal.

Coronavirus cells are more resilient than most diseases, capable of surviving on surfaces for up to 48 hours

An elusive predator

COVID-19 has been mutating. Two major strains have been identified in China, and there likely are e more. We don’t know the exact impact of this just yet, but it could make containment and slowing the spread of the virus more difficult. As a virus mutates it makes creating a vaccine and treatment more difficult. Further to this multiple strains could also lead to more cases and fatalities. Those that may have had resistance or survived one strain, could catch the other. Genetic analysis by Chinese scientists of 103 samples of the virus, taken from patients in Wuhan and other cities, suggests that early on two main strains emerged, designated ‘L’ and ‘S’. Research indicates the L strain is more aggressive, either transmitting more easily or replicating faster inside the body. This theory is speculative at this stage as there haven’t yet been direct comparisons to see whether people who catch one version of the virus are more likely to pass it on or suffer more severe symptoms.[4]

Patients are rushed between wards in a makeshift hospital in the Hubei province in China

Many that contract COVID-19 will be unaware they are carriers until it is too late.

A Global Web

The global economy is more connected than ever. This is a important for two reasons. If the virus becomes widespread it will affect more and more countries and areas. For examples, if a US company assembled and sells products made with parts made in China and Italy, and those parts stop coming in due to the factories being shut down, the company will eventually lose any ability to produce and generate revenue as the Chinese and Italian companies that create the components. And second, if economies are so intertwined, as companies stop producing, and essential products become unavailable, essentials anything from vehicle parts, medicines and even food stocks can become unavailable. Not only company revenue suffers, but the consumer. The disruption could be unprecedented.

The Piazza Duomo in Milan, a center frequently full of people is empty as Italy is on lockdown

Fire on the Whole

The areas with the greatest unpreparedness could be realized is in Africa, North America and South America. These regions from most medical professional’s perspectives appear to either be preoccupied with other viruses. Africa is at the end of a tumultuous bought with Ebola which could end up being a strength or a weakness. North America is either completely lost in a world of complacency or prepared. Many would placed bets on the former. And South America. Do they have any clue what’s going on? Perhaps ignorance is bliss. While Asia can rely on draconian measures for population control and quarantining, good luck with that in these three continents. When the virus breaks out in these regions it could be an absolute rampage or on the optimistic side, it could fizzle out like SARS. But whole world is at stake, not just a few cities this time. Better to be on the side of caution on this one, I reckon. 

Coronavirus Medical Staff with Patient in Wuhan, China

Putting Things Into Perspective

So far, the new coronavirus has infected nearly 115,000 and more than 4,000 deaths worldwide. But that’s small compared with the seasonal influenza which in the US has infected more than 32 million, 310,000 hospitalizations and 18,000 deaths this season, according to the Centers for Disease Control and Prevention (CDC).[4] But this virus is relentless and there are still so many unknowns. We don’t yet know whether the infected gain lasting immunity or whether the virus completely exits the body or remains. What is the actual mortality rate? Is it as low at 0.1% or as high as 7%? These are big questions that we hope the global science community can figure out, and soon.

A firefighter disinfects a traditional shopping center to help prevent the spread of the new coronavirus in northern Tehran, Iran, Friday, March, 6, 2020. A Health Ministry spokesman warned authorities could use unspecified “force” to halt travel between major cities. (Photo credit: AP/Ebrahim Noroozi)

Better than Before and Not

Some attempt to draw the comparison between COVID-19 and the Spanish flu in 1918. Things are different in a number of ways:

  • The scientific community was unaware it was a flu. They did not know influenza is caused by a virus. Scientists like Richard Pfeiffer had convinced most of the medical community that it was caused by bacteria. It wasn’t until 1933 that researchers proved conclusively that the flu is a viral infection.
  • Flu antibiotics were not yet discovered. Antibiotics capable of treating flu-related pneumonia infections (which are typically caused by bacteria) were 10 years from being discovered.
  • Antiviral drugs were not yet discovered. Antiviral drugs were many decades from being developed; the first came out in 1963.
  • Global health organization did not exist. There was no World Health Organization, and efforts to surveil and track the outbreak of new diseases were incredibly rudimentary.
  • Movement of information was slow. Most countries in Europe were under war censorship regimes that limited the spread of accurate, lifesaving information about the flu outbreak.[7]

What’s Next

Some estimate as many as 70% of the global population could contract some form of the virus.[6] That’s a big figure. We should keep in mind that more have recovered from this virus than are still infected. Although there are nearly 115,000 people that have been infected, according to World Meters nearly 65,000 have recovered. That’s over half. That’s good news, but we consider that nearly 6,000 are in critical condition.

Perhaps the most nerving part about all of this is the repercussions. Many analysts fear the Coronavirus is like the tip of the iceberg, and it could very well set off a chain reaction of events that will lead to many more challenges. In April and May companies will report quarterly results. These will be unsettling. The disruption COVID-19 has had on the global economy will be clear. As company debt has piled up, the highest in decades there will be defaults and some will go bankrupt. Many others will hobble along until the economy improves. The virus will result in hundreds of billions, if not trillions of dollars in lost revenue and losses. Companies that survive may be forced to cull 10 to 30% of their workforces to reduce costs. As income stops rolling in household debt which has been out of control for some time now will lead to defaults on home and vehicle payments. And the underlying impact of quantitative easing is still unknown, but this could cause further fallout.

Many analysts fear the Coronavirus will set off a chain reaction of events that will lead to more challenges.

But this won’t last forever. The spread of COVID-19 will only get as bad as the Spanish flu if we fail to adequately adopt measures like social distancing, aggressive testing, and quarantining. And that’s not likely to happen as government cooperation is set to improve in the months ahead. Once that happens recovery could happen quickly. As late summer approaches, communities could have a handle on the spread of the virus as we are witnessing in China now, people will begin to enjoy being human again, and out of their homes. Markets will come back, and new opportunities will emerge. And life will go on.

A major highway in Wuhan, China remains empty as the Coronavirus quarantine continues

References

  1. How does the new coronavirus compare with the flu? Live Science. March 6, 2020.
  2. Here’s how coronavirus spreads on a plane—and the safest place to sit. National Geographic. March 6, 2020.
  3. How does the new coronavirus compare with the flu? Live Science. March 6, 2020.
  4. Just how contagious is COVID-19? This chart puts it in perspective. Popular Science. February 20, 2020.
  5. Can a face mask stop coronavirus? Covid-19 facts checked. The Guardian. March 9, 2020.
  6. Coronavirus may infect up to 70% of world’s population, expert warns. CBS News. March 2, 2020.
  7. Why we should stop comparing the Covid-19 coronavirus outbreak to the 1918 Spanish flu. Vox Media. March 9, 2020.

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