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Friday, January 31, 2020

Coronavirus

Should we panic over the novel coronavirus strain from Wuhan, China (hereafter: nCoV)?

Short answer: I don't think so. At least not yet.

Longer answer (in no particular order):

1. The vast majority of cases and deaths are and still remain in China. At last count, I think the US has 6 cases from nCoV. Canada has 3 cases. Johns Hopkins is tracking the epidemic in real-time. See here for the map.

2. Coronaviruses are nothing new. We've known about them for like 50 years or more. Coronaviruses can cause the common cold, but (more worrying) they caused SARS and MERS. In fact, MERS was deadlier than SARS but not as well reported in the media. SARS had approximately 8,000 cases and approximately 800 deaths from 1 major outbreak in China (likely source is bats), whereas MERS had approximately 2,500 cases and approximately 850 deaths from 10 major outbreaks mainly in Saudi Arabia (likely source is camels).

3. For a while now, major medical organizations (e.g. WHO, CDC) have been predicting a coronavirus from China/Asia would likely cause an epidemic and have been preparing for it too. It's not like the Ebola epidemic in W. Africa which caught medical professionals by surprise when they had originally thought it was cholera.

4. E. O. Wilson once said something like: there's more genetic variety among viruses than in the rest of life combined together. Viruses have tremendous genetic variety. Hence why it's relatively "easier" for viruses to jump from species to species. It doesn't help that Chinese markets are often rife with poor hygiene practices and the like. That's unlike the US where we have better food safety regulations which most follow.

5. Statistically speaking, we're far more likely to get sick from and even die from the flu than the nCoV. Especially considering the recent flu that's afflicting a lot of Americans is thought to be a re-emergence of the H1N1 from 2009.

6. The US has learned to deal with outbreaks better ever since SARS. Sure, we can't quarantine entire cities like a communist government can, but we don't have to since we're not ground zero and since the outbreak doesn't threaten to overwhelm us. We primarily need strict controls over entry/access points to the US from travel from Wuhan, China at this point (which we've already implemented in places like LA, SF, and NYC), isolate and treat individuals suspected of carrying the virus, and otherwise continue to track emerging trends.

7. In the main, people don't die from coronavirus, but from complications like ARDS. Most who contract coronavirus can overcome it without hospitalization. A minority are hospitalized. And an even smaller minority end up in the ICU. That's when it becomes more life-threatening. Yet, even still, a majority make it out of the ICU. In fairness, this is a novel virus, so things could differ.

8. In the US, we have better trained medical professionals as well as better medical equipment than widely available in China (e.g. ECMO machines).

9. There are several organizations (public and private) including the NIH and Johnson & Johnson working on a vaccine for the nCoV. I think I read somewhere the NIH is even saying the vaccine could be ready within 3 months, which, if so, would be just in time for the disease to peak.

10. To be fair, SARS was severe but could (for the most part) only be spread if a patient is symptomatic, whereas the flu is (relatively) mild but could be spread if a patient is asymptomatic. The concern with nCoV is that it can spread asymptomatically and it may be quite severe. So that's a legitimate concern.

11. In short, though there are some concerns on the horizon, there's no need for Americans and most others in developed nations to panic at this point. However, that doesn't necessarily mean the situation won't worsen. Medical experts including epidemiologists are predicting the nCoV will reach its peak at about the 3 month point. Time will tell.

However China might well be justified if it "panics". Certainly the Chinese government or Chinese communist party since they seem to be having difficulties. It also doesn't help that they're obfuscating certain problems and refusing to let Western nations like the US see all the relevant data. I guess they're doing better than when SARS broke out, but they're still not entirely transparent, which would better help medical experts combat and stem the epidemic.

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