The Good News About the High Rate of Infection of the Chinese Virus
Despite being more transparent than it was with SARS, there is no way to clearly rely on the official Chinese figures about the number of infected with the new 2019-nCoV virus, or the number who have died as a result.
Pointing out this fact publicly is seen as making the Chinese to lose face, which may shut down the information flow even more, so most Western media just report the official numbers, knowing they are fiction — especially since they have so few other numbers to report.
The Chinese may be signaling a willingness to be more truthful about the numbers, preparing the world for high infection numbers. China’s Health Minister, Ma Xiaowei recently said: “The transmissibility shows signs of increasing and the ‘walking source of infection’ [where patients have few signs of disease] has made it difficult to control and prevent the disease.”
The recent news from the BBC that the virus “spreads before symptoms show” illustrates that in addition to quarantining people and cities in China, the Chinese are quarantining two essential pieces of information: the number who are infected, and the number who have died as a result. Further confusion reigns on this key point, as the Guardian reports today: “It is not clear whether patients who are asymptomatic can also transmit the disease.”
If it is true that the virus spreads before symptoms appear then it’s (obviously) too late for China to quarantine itself out of this outbreak. (I called their quarantine when they announced it, a “cute notion.”)
Even historians of epidemics are skeptical of quarantines in general, and this Chinese attempt specifically: “as a historian of quarantines and epidemics — one who has read, seen or written similar sad stories too many times — I am not terribly optimistic it will turn out well.” Or, as Jeremy Konyndyk, the senior policy fellow at the Center for Global Development and former head of Global Disaster Response at USAID told Wired, “the horse has probably already left the barn.”
The point about the quarantine being a “cute notion” is further borne out by the Mayor of Wuhan’s recent statement that “5 million residents had left the city before it went into lockdown, due to the virus and the lunar new year festival.” “Due to the virus,” well, that’s clear — 5 million ran for it before the quarantine was imposed and the quarantine being instituted is merely closing the barn door after the horse has left.
The West first received reports about the new Chinese virus causing pneumonia in late December. The Chinese quarantine efforts began almost a month later.
We can assume the first reports of the virus in the West were at least ten days after the virus infected the first human, meaning the virus has likely been circulating since the second or third week of December, or earlier, unnoticed and gaining traction out of a seafood market near Wuhan’s central train station.
One nurse, who recently broke China’s information quarantine, lamented the helplessness health care workers feel, that more than 100,000 are infected, and there is no way for the government to help — it’s out of supplies, the health care system is overwhelmed and citizens are on their own.
This is exactly as you would expect with a pandemic.
But the question is, what is the mortality rate?
Some British scientists estimate at least 11,000 infected as of four days ago, while other scientists put the number of infected at closer to the brave nurse’s estimate of 100,000.
Furthermore, the size and scope of the Chinese government’s quarantine of nearly 60 million people indicate many more are infected than are being officially reported.
So what is the good news about any of this news?
First, the high infection rates of 11,000 or even 100,000 means that in event that the official death toll is 56, then the mortality rate of this new virus is much lower than the 2.5% to 3.0% indicated by the government stats of 2,000 people infected, which is about the mortality rate of the Spanish flu.
11,000 infected with a death toll of 56 means 56/11,000 x 100 = 0.5% mortality rate, meaning 99.5% of people infected survive.
100,000 infected with a death toll of 56 means 56/100,000 x 100 = 0.056% mortality rate, which would be lower than the annual deaths from the flu.
The wide variance in the projected or actual mortality rate is keeping uncertainty alive around this outbreak.
Is the mortality rate of this Chinese virus in the same low-end range of the estimates of the mortality rate of the 1918 Spanish flu (2.5% to 3.0%)? Or, is it slightly higher than the mortality rate of influenza in the West today?
Or. is the Chinese virus mortality rate less than the Western mortality rate of the flu?
Here is how University of Michigan Professor of Medical History Howard Markel put it in his piece in The Washington Post:
The case fatality rate, a very important statistic in epidemiology, is calculated by dividing the number of known deaths by the number of known cases. At present, the virus appears to have a fatality rate of about 3 percent, which mirrors that of the influenza pandemic of 1918.
But what if there are 100,000 Chinese citizens in Wuhan with mild infections that we do not know about? That would lower the case fatality rate to a mere 0.02 percent, which comes closer to seasonal flu death rates. If that’s the case, a major disruption like the Chinese quarantine would seem foolish and cost a fortune in terms of public health efforts, interrupted commerce, public dissonance, trust, good will and panic.
Until we have a clear sense of the two numbers that matter, the number of infected Chinese and the number who have died, the good news about the fact that the virus is spread easily may mean we are dealing with a virus that is making people sick and overwhelming the Chinese health care infrastructure but has a low mortality rate, equal or less than the Western mortality rate of the flu. Right now, that’s my best guess.
After all, this American doctor who is the spokesman for a Texas hospital caring for a patient from China who likely has the virus said most who become infected have mild symptoms and recover.