Anybody with a rudimentary understanding of infectious disease should have understood by the start of February or earlier that the coronavirus outbreak had not been contained to Wuhan or wider China.
While the Chinese Government has come under fire from some quarters for not acting quickly to report the outbreak and to enact containment measures, on the one hand I understand that the political considerations that they faced are not unique to their autocratic country, and on the other hand I am amazed by the speed and intensity of their actions once the political decision was made to respond.
Having worked for a period in biosecurity policy development in Canberra, I have seen first-hand how the tentacles of politics extend throughout all functioning of Government even those areas that are apparently fire-walled off from interference by the existence of Global agreements (as in the rules governed by the World Trade Organisation with respect to biosecurity of trade) or intra-Government agreement (as in the Reserve Bank of Australia).
I am very prepared to point out the inadequacies of autocratic Government, as is clear on my website, but when it comes to China’s response to the coronavirus outbreak I consider criticisms largely unwarranted and in this essay I will show how they have responded better than many other Governments have and likely will in the near future.
Before moving on, though, being a humanitarian, I do have to say that I have some concerns about the rights of people infected by a virus. Then again, this is an issue that humanity has struggled with throughout our history and that is a very vexed question to answer when faced with the crisis that China has faced, and that Japanese authorities faced with the Diamond Princess passengers. It will be interesting to see how other countries handle it.
First I will discuss China specifically.
The details of how this virus jumped species into humans is yet to be determined. I would assume that my friend Dr Shi Zhengli is already working very hard to determine those very specific details.
The point is this. Those likely 100,000+ infected people in Wuhan that have been infected to this point of the outbreak – note that the total number of infected people will be much higher than the official figure because many infected people remained subclinical before losing the infection – spread from a single or very low number of original cases where the virus jumped to humans.
I think you get the picture… the epidemic in China blew up from a single or very low number of events of the virus jumping into humans. That is how epidemics work – the number of cases increases exponentially until the pathogen either attenuates to be less virulent or transmissible, or it runs out of new hosts to infect. Biosecurity aims to work on that latter factor, but it has to be eliminated from those that were infected, and it needs to be prevented from being reintroduced to those that were not infected, for biosecurity containment to work.
China has enacted truly extraordinary measures, and even beyond that the Chinese people began implementing their own measures of reducing social contact early in the outbreak. Clearly the memory of the SARS outbreak in 2003 remained strong in their conscious thoughts. The footage on Bloomberg of their presenter walking alone in Beijing hotels and shopping malls is truly astounding.
It is an enormous feat that virus’ spread has been slowed in China to the degree it has, but any reasonable person must question whether it can be maintained and at what cost. We are, afterall, talking about a population where there is a great deal of inequality and the majority of citizens need regular income for the necessities of life due to low accumulated wealth and weak social safety networks.
China has managed to put a lid on the outbreak but how can it keep this up without crippling its economy?
Without testing every single person in China, with a test that is 100% accurate (which they never are, either in terms of obtaining samples with the virus and then detecting the virus at low levels or with other complications), to ensure that the virus was eradicated, once these extraordinary measures are eased so that workers can begin to restart the wheels of commerce, then more people are going to become infected and the outbreak will start all over again, but likely all throughout the country. And here is the thing – even if by some miracle it had been eradicated in China, now that it is gaining a foothold in neighbouring countries, no doubt especially in poorly developed countries, but also in highly developed ones like Japan and South Korea, how can China prevent the reintroduction of the virus without effectively closing its borders (especially when it has complained about other sovereignties closing their borders to Chinese people.)
Hopefully the reader is beginning to understand the reality of this situation.
I have to admit to being flummoxed by the response of markets, the media and by most people that I speak with about this outbreak. I cannot understand why everybody is so slow to understand the rather obvious realities of the situation and the serious implications. It really does seem to me that the movie “Idiocracy” is not a Sci Fi but a work of non fiction and one would have to have travelled forward 50 years in a time machine to the present day to realise it. Is it that humans, when faced with a scary situation just cannot accept that it is real? Is it that our arrogance has reached such heights that we really believe nothing from nature can genuinely affect us until after the event?
Before I move on I will make a few comments on how I think China will respond going forward. I suspect that the very top of the CCP will have decided that the costs to the economy, because of the consequent risk to the stability of their leadership, will be too great if this very high level of biosecurity measures are maintained. So, even though loosening of measures will undoubtedly result in there being more cases throughout China and deaths, I expect that a plan will be developed to bring back on-line industrial production while at the same time increased propaganda will be used to airbrush over the reality of increased mortalities in their general population, as was done at other times in their history such as the Cultural Revolution. Xi’s recent move to centralise even more power would fit with the game plan.
Next I will discuss the situation in Australia.
I am of the view that there may be hundreds of people infected by the coronavirus in Australia as of the time of writing, that being 21 February 2020. (Note I always state such opinions beyond the first few paragraphs of my writing because I know the superficial masses will have stopped reading paragraphs earlier.) To make myself accountable, I will say that I will be very surprised – and wrong – if there are no reports of people ill with coronavirus in Australia by 7 March. And I would expect that many who present as unwell with coronavirus throughout March have not been to China.
That is what I meant when I said that by early February it was clear that containment in Wuhan, and broader China, failed.
How can that be the case when we have not seen any cases reported from the general population in Australia to this point?
Well just look at what is happening in more proximal countries with good health care systems like Japan (not including the specific case of the Diamond Princess passengers) and South Korea. Beginning only a few days ago, cases are surging in these countries and the sources of original infections coming from China are now unknown for most. One couple in Japan returned from a holiday in Hawaii! And today The Guardian has a story on possible infections in Papua New Guinea in two villages which are so remote that they can only be accessed via boat. Clearly very specific circumstances were required to spread the virus, if it is confirmed, to such a remote locality, but the odds are very high that very open localities with much movement of international travellers has many infections already, that will be spreading, that will come to light in the near future.
Surely the epidemiologists providing analyses to Government have been saying that for weeks now. It is clearly articulated by the WHO where the plain language for several weeks infers a certain level of inevitability to the pandemic. For instance, at the Munich Security Conference the Director General of the WHO, Dr Tedros, praised China saying:
“We are encouraged that the steps China has taken to contain the outbreak at its source appear to have bought the world time, even though those steps have come at greater cost to China itself. But it’s slowing the spread to the rest of the world.”
He does go on to specify some encouraging developments, but in my very first post on the outbreak “Social Cohesion: The Best Vaccine Against Crises” I stated that the WHO was working on slowing the spread of the pandemic, not containment, and the comment above confirms that view.
So let us next look at a very basic cost benefit analysis for Australia in responding aggressively to this pandemic.
In my “Coronavirus Outbreak” update on 11 February I said:
Presently every developed country will be asking themselves these questions:
– what is our capacity to test everybody displaying flu-like symptoms and at what point do we start and at what point do we stop (and devote resources elsewhere)
– at what point will we stop large public gatherings (sports events, conferences, concerts)
– at what point will we close schools
– at what point will we stop public transport and encourage employers to ask employees to work from home
– how will we ensure that we can continue vital services such as health, water, electricity
– at what point do we close the borders completely to all non-citizens or residents
I could understand if Australians looked at that list and thought I was “off my rocker”, these measures must have seemed so alien to them. But if careful consideration is given to the situation and what is occurring in other countries nearer to the outbreak it quickly becomes clear that this is just standard response to a severe disease outbreak.
Now over the years that I have been blogging and in my submissions to Government inquiries, and most recently on MacroEdgo.com, I have stated my serious concerns about the structure of the Australian economy, specifically an over reliance on household wealth from high house prices relative to incomes and consequently high household debt (both world records according to some analyses).This has left our economy incredibly vulnerable in its own right, highlighted by the pressure that the recent brief fall in house prices placed on the national economy, but consequently especially susceptible to an external shock.
There is no doubt that that external shock is now here in the form of the coronavirus pandemic. Already the effects on Australia via the China channel is showing and it has only just begun as my analysis above shows. However, the pandemic will begin to have direct impacts on the Australian economy in the near future, regardless of which or whether any of the measures mentioned above are enacted in Australia locally in response to focal outbreaks or nationally.
The sooner these measures are enacted the greater the chance of limiting the human impact on Australians, and, in fact, playing a role in preventing the spread throughout broader human populations. However, the politics of these actions are significant and even the WHO can not avoid them in that they did not recommend the closing of borders with China even though they knew that not doing so would lead to increased dispersion of the virus.
On the other hand, the sooner these measures are enacted the greater the impact on the Australian economy and especially some specific businesses. And economic impacts certainly do have society and human impacts.
I want to be clear – I am in no way qualified to make these calls on how the cost/benefit of economic impacts to actions can be weighed against human and societal impacts. Then again I do not really believe that anybody is qualified. Sometimes people find themselves in extraordinary situations and they need to make a call not knowing whether it is even likely to be the right one. Sometimes in life decisions just need to be the best that can be made at the time.
Even if we do strip things down to a bare cost/benefit analysis for society – if it were ever possible to totally eliminate politics, both broad systematic politics and interpersonal, social politics (essentially of egos) – how does one weigh up the costs and benefits of a certain level of economic activity versus a certain level of deaths amongst a society. And even then there are cross-contaminating issues, where economists will quickly point out that the stress of economic hardship results in costs to the health of populations and then to deaths.
I just wish that I had witnessed behaviour worthy of faith and trust in the political leadership of this country instead of a continual erosion of it over the last two decades…
Gained value from these words and ideas? Consider supporting my work at GoFundMe
© Copyright Brett Edgerton 2020