Relative Joy

The Novel Coronavirus (NCoV) that has caused concern among people and the health experts has overtaken all other causes of global calamity (natural and political).

What started out as a a “potential” SARS-like illness from Wuhan, China in December 2019, has, as of this writing, become a story that looks like it was written for a Netflix series.

Less than a month into the lockdown in Wuhan (and expanded to other cities in the central province of Hubei), the Chinese authorities have now, according to the New York Times, “resorted to increasingly extreme measure on Thursday to try to halt the spread of the deadly coronavirus, ordering house-to-house searches, running up the sick and warehousing them in enormous quarantine centers. The urgent, seemingly improvised steps come amid a worsening humanitarian crisis in Wuhan, one exasperated by tactics that have left this city of 11 million, with a death rate from the coronavirus of 4.1% as of Thursday – staggeringly higher than the rest of the country’s rate of 0.17%”.

In early December, Dr. Li Wenliang, a physician at Wuhan City Central Hospital had warned of the outbreak – but was reportedly silenced by the police for it. In a country whose government is known to be shrouded in secrecy in order to keep social and political norms at bay, public anger is simmering and unrest and disorder at the brink of concern for the Communist Party, who are reportedly trying to stifle news organizations and local social medial platforms on criticisms related to how the government in general and President Xi Jin Ping in particular are handling this medical crisis. The death of Dr Li from this novel coronavirus was likewise shrouded in so many speculations before the news was finally released that he had indeed died from the viral infection.

While there are now 31,481 confirmed cases, 635 deaths, and 28 countries affected (as of this post) giving an overall case fatality rate of 2.01%, the numbers may not reflect the actual case fatality rate of the disease (worldometers.info/coronavirus). That’s because all except for 2 deaths are concentrated in China. The epicenter Wuhan has the most number of cases – 22,112 (72% of all the cases in the world) and the most number of deaths – 470 (of the 633 deaths in China alone, or 74% of all deaths). According to the National Health Commission of China (based on a press conference last February 4, 2020):

1. The national mortality rate is 2.1% of CONFIRMED cases,
2. Mild cases are usually not reported
3. 97% of the total deaths in China were in Hubei Province. Mortality rate in Wuhan was 4.9%, while the fatality rate in other provinces at 0.16%.
4. Most of those affected are males (around 70%) and the elderly with co-morbid conditions have higher fatality rate.
5. Infectivity period can be anywhere between 2-14 days (average is around 5.2 days), ASYMPTOMATIC transmission is possible (hence the rationale for a 14 days quarantine or medical observation period for the pathogen).

While this global medical problem isn’t going to go away anytime. It comes at a time when the cooler temperatures and viral upper respiratory infections are common complaints seen in the various clinics, making managing respiratory problems a more difficult and fearful one.

The graph below shows the data culled from worldometers.info/coronavirus on the trend of daily new cases. While preliminary data is encouraging on the present statistical trend, the health authorities should not keep their guard down on this pathogen.

At the pinnacle of the outbreak is a country whose leadership and culture are being tested and challenged. China should change its paradigm on its approach to novel diseases and outbreaks emanating from a region whose 1.4 Billion people are at the forefront of travel, migration and economy. The SARS story in 2003 must have made China learn its lesson – that diseases like these cannot be swept under the rug. Seventeen years ago, social media and travel driven by advances in technology evolved dynamically into an industry in itself. Not even a highly restricted state media can control how people provide accurate information and react to life and death situations in the real world. We begin to realize that no one individual is worth protecting – even if he is the anointed president for “life”. No one is worth the sacrifice, if only to keep the notion that “business is as usual” and the “economy” of the world’s number 2 nation is at risk. This kind of mindset is archaic and the hierarchical type of governance is detrimental to the health of a nation.

We are not at that point in medicine where man will ever be ready for the microorganisms that roam the same planet we live in. Only fools would make that conclusion. Even as new threats emerge (they’re called emerging diseases in infectious medicine), the old scourges like TB, polio, cholera, the plague, to name a few, are still very much around and flare up with disturbing regularity. Former US adviser on public health emergencies Richard Hatchett nails it in his opinion that “we’ve created an interconnected, dynamically changing world that provides innumerable opportunities to microbes. If there’s weakness anywhere, there’s weakness everywhere.”

The coronavirus (or any infectious disease pathogen for that matter) will not distinguish a head of state from a common citizen. It knows no nationality or boundaries. Hence, it is the mandate of every leader to make sure that none of its citizens suffer or die because he/she prioritized personal, political and economic gains for the lives of a few.

Muhammad Ali Pate, global director for health, nutrition and population at the World Bank, correctly points out that “the foundation for better preparedness is investing in stronger primary health care systems which provide surge capacities that can be mobilized for effective response to contain outbreaks.”

It takes political will to go out in front of an epidemic. Yes. At some point, the outbreak will end. And that’s the problem. We mourn, grieve and bury the dead. And the world will move on. And so will the microbe. They stay quiet. Mutate. Resurge while we’re sleeping.