I am not a doctor, epidemiologist, or indeed a statistician. Those who read my posts realise my aversion to “Monday Maffs” is bordering on the pathological. I do however have one skill-set that allows to me to have a reasonably objective and sane outlook on the current “Coronavirus” scenario. Having spent many years dealing with disaster recovery, risk management, 24/7 critical systems and emergency planning, I have learned from bitter experience how to separate hype, panic and doom-mongering from a black swan event that will have disastrous consequences. As Donald Rumsfeld put so succulently, there are “known knowns” and “known unknowns”. Or to put it another way, prior preparation prevents piss poor performance.
I have on my bookshelf a copy of the 1994 book, The Coming Plague by Laurie Garrett. A balanced and extremely well cross referenced book, it essentially posits that uncontrolled migration, war, unsanitary conditions and antibiotic resistance are the major precursors to epidemics, pandemics and a potential forthcoming global viral catastrophe. While it focusses very much on medical and scientific evidence, it only cursorily considers the impact of insecure bio-labs or a deliberate attempt at engineering a bio-weapon based on racial or eugenics principles, something that has probably been undertaken in secret by many nations despite a public face of denial. Smoking gun evidence of such crimes is available for those with eyes to see, and the patience to go digging through mountains of frequently redacted research material. Many nations have a documented history of experimenting on the general populace without their consent, mainly in the interests of “Protecting all” in the case of a biological attack from a hostile power, and conveniently covered by an “Official secrets act”. The horrors of the concentration camps, at least when it comes down to experimenting on human beings without their consent, did not suddenly cease at the close of Auschwitz. In these febrile times, especially in the light of the recent Skripal debacle, it would be wise for me not to elucidate too much further.
All of that said, before we look at 2019-nCoV, the proper name for the virus the media has loosely termed “Coronavirus”, I want to take you back to ‘80’s and the AIDS epidemic. At the time I was fortunate in having a very wide and eclectic social circle, doctors, nurses, clergy and gay people among them. Living in London at the time, I was very well connected and I didn’t know what was going on by reading newspapers. I was far too busy for that, and the social whirl I was engaged in offered me the benefit of hearing from the horses mouth so to speak, exactly what was happening in the corridors of power. And here follows a truth that few realise, while in public most professionals take a vow of silence and only say what the official line may be, in private, it is a totally different matter. Win the confidence of these groups, and a panoply of knowledge and indeed understanding will be your reward. Without breaking any confidences, I can tell you the medical community at this particular point in time was more scared by HIV-AIDS than a patient consuming a bowel evacuation medication prior to a colonoscopy. Why? Put very simply, the pathology of the virus did not meet the standard criteria of “evolving” virii. Even 40 years down the road, you will stimulate much argument amongst those in the know (off the record of course), if AIDS was a naturally occurring phenomena due to natural evolution, something born of a mad and corrupt scientist or a lack of security in some “secure” bio-lab somewhere. Gregor Mendel proved conclusively that evolutionary change is but a slow and incremental process, often taking generations. HIV-AIDS jumped the shark so to speak, in that regard. Be it a naturally occurring mutation or something more sinister, what is indisputable, is that we have had some really strange bugs appearing on the landscape in the past 50 years or so.
So let us clear up some misunderstandings at the microscopic level. Bacteria have pretty much bowed the knee when it comes to man dominating the environment. Antibiotics and good hygiene tilt the balance of power very much in favour of man, unless of course we are talking about antibiotic resistant strains which are becoming more prevalent. Bacterial infections, while not pleasant, are rarely fatal these days, but that is no reason for complacency. Introducing antibiotics into the food chain is not a good idea, while it might increase the profitability for the farmer, the risk to the consumer is clear. Direct infection with resistant bacteria from an animal source, sustained transmission of resistant strains and transfer of resistant genes being amongst the most contentious vectors. Like the “nature” versus “nurture” debate over AIDS, the science is not settled. Viral infections on the other hand, all we have in our arsenal is our natural or artificial immunity (via immunisation), good nursing care and prayer. While there are a number of antivirals on the market, they are very expensive and have the same efficacy as cancer treatments, which should not surprise anyone, as cancer acts like a virus in certain respects. Don’t believe me? A successful cancer virus was developed in the ‘60’s, mainly as part of the drive to rid the US of Fidel Castro.
Most worryingly though, is the impact that a virus can have on our own immune system long term. Like cancer, one of a viruses nastier tricks is to fool the immune system into ignoring the foreign RNA of the invader. One of the even nastier strategies a virus can adopt is to use the immune system against itself, either through overload or to attack healthy cells. This was the fear on the fevered brows of the medical professionals in the ‘80’s. Lab results do not lie, and seeing the total collapse of patients immune system before their eyes was a sobering observation. Under such circumstances, a common cold, or any simple secondary bacterial infection is a potential killer. The body is so overwhelmed that even the best medical care money can buy will not help you. You need a new immune system programmed accordingly, and medical science is not there yet. While antivirals mean AIDS is not an automatic death sentence as it was then, you will live your life out on expensive medication with many medical complications.
And so to analyse the latest threat to humanity amongst Brexit, Donald Trump and the melting ice caps. 2019-nCoV certainly offers a closer personal and more intimate encounter with the grim reaper than the aforementioned, but I would suggest at this point in the game it is difficult to tell if this falls into the category of flash in the pan, epidemic, pandemic, or global catastrophe. Certainly, the pedants in the house will suggest that the third scenario is on the cards, but I would urge caution here. A classic pandemic in the eyes of your average man in the street involves something akin to a “28 Days” scenario and an emerging zombie apocalypse where shotguns and machetes are essential for daily survival. We are nowhere near that point. To be truthful and to skate around the hype and hysteria, we need to look at the important characteristics of a disease outbreak, Infection Rate (R0), Mortality Rate, Mortality Complicator, Incubation Period and Curability.
The latter we have already covered, and until there is some of form of vaccine made available, we can consider this pathogen incurable by any generic, non-patented medication. The non-peer reviewed studies I have looked at so far suggest that antivirals are effective, but these are proprietary, expensive and not as readily available as generics.
Mortality Rate I will cover next, as this is the first question a patient will ask when stricken with the bug. Depending on who you ask, this varies wildly between 2-15%, the Western cases being minimal and the Eastern cases maximal. Unfortunately, my ongoing qualified US university source for this metric has gone offline, no doubt due to the amount of sustained internet traffic. Provided we do not hit a crisis point in intensive care units, or the virus doesn’t mutate, I would expect this figure to remain lower in the West. The third world and developing countries will naturally take a bigger hit, as the corresponding poor infrastructure, government and hygiene levels will negatively contribute to that figure. Seasonal flu has a 1% mortality rate tops, if you take into account secondary infection and true cause of death. More often than not in the West it is the secondary infection or complications that gets you, rather than the disease itself. Viral or bacterial pneumonia is the real killer, as any coroner will tell you. So in comparison with SARS (11%) and Spanish flu (10-20%), on the statistics so far, we are not looking at a major global killer. HIV-AIDS in its initial disease cycles had a mortality rate of 100%. Ebola and haemorrhagic fevers are around 60-80%. So I am optimistic this figure will lie well below 5% here, affecting mainly those with prior medical conditions, provided a robust isolation and care regime is in place.
The Mortality Complicator is an interesting variable. Once infected with XYZ, do our bodies become more susceptible to other lethal agents or secondary infection? Much ridicule has been voiced over the fact that 5G has been rolled out recently in Wuhan, and this may or may not be a contributory factor in the disease epidemiology. I would refer the scoffers to the fact that it has been known for generations that microwaves boils your balls, place a man in a high-energy microwave field and their sperm is genetically damaged or they will become infertile. While intense microwave or nuclear radiation causing mutation is the staple of science fiction, yet science fact uses ultraviolet radiation further down the spectrum to kill simplex bacteria and viruses. There are too many variables to qualify the possible outcomes here, even less decent statistical facts, so let’s just say that 2019-nCoV won’t do you any good in the secondary infection stakes, microwaved or not. Without post mortems, further research, extensive testing and medical histories on a significant scale, it will be difficult to identify the risks accurately other than a wet finger in the wind. Currently there is too small a sample to realistically and immediately identify a figure here.
Incubation Period is one of the worrying factors here. 2019-nCoV, being asymptomatic, is infectious before you have any symptoms and after you are ill for a yet unknown period of time. Looking at the German infection scenarios, the first German national was infectious before and after his illness, according to virology performed on his sputum. What is more concerning is that he was allowed back to work despite showing a positive sample. Clearly the Germans don’t kiss or spit much. This suggests a minimum period of at least 3 days either side of the illness as being an appropriate level of isolation to prevent spread of the disease, if we accept that it took three days before he was infected to show symptoms. While we cannot realistically monitor the asymptomatic period prior to infection, this will have significant economic impact post infection, if serious isolation controls are required before a patient is totally clear and non-infectious. Your average vomiting and diarrhoea bug is given 48 hours after symptoms before you are considered safe in the catering industry. We have a “Typhoid Mary” scenario here, both prior and post infection.
Infection rate (R0) is the one parameter that has got the media twitching. Those suffering the flu, statistically, might infect 1.28 people in a room if they were a carrier. SARS, approaches 3.0. HIV-AIDS, unless you had intimate physical contact, approaches 0.0. 2019-nCoV, depending on who you believe, floats between 2.5 and 4.0, which makes it more infectious in comparison to flu, but as viruses go, fairly innocuous. The Spanish flu only manages an R0 of 2.8, whereas measles hits a spectacular 12.0-18.0. Ebola kills the patient rapidly, so the cross infection rate is fairly low at 2.0. This is where the Chinese leadership has missed a trick. Rather than attempting to isolate cases early, something in a Communist regime it would in reality be far better prepared for than many Western nations, it stuck its head in the sand, silencing and imprisoning the doctors who were the canaries in the coal mine. Sods law was a clear player here, the Chinese New Year massively exacerbated the spread. Western governments take note – if you want to get a grip on this outbreak, early and efficient containment of suspected infected individuals is critical. I hope someone is keeping a close watch on the bus drivers who ferried the UK nationals to quarantine.
For the statisticians, taking into account a very conservative model of R0 (2.04), an incubation of period of 3 days, a mortality rate of 2.6%, and 10% developing fatal complications, we are looking at this virus peaking in mid March with a total fatality count of just under 210K worldwide, the majority of victims being in the third world. In comparison to the Spanish flu, which killed 50 million, 2019-nCoV, while serious, appears relatively benign. These preliminary figures are based on the single documented German incident, unconfirmed non-peer reviewed medical papers and assume the initial outbreak in Wuhan occurred in mid-December. According to the US CDC 8,098 people worldwide became sick with SARS during the 2003 outbreak and 774 died. Currently, we have passed that number of infections (> 14,628 at time of writing), with approximately half the fatalities of SARS. The reason for the major difference? SARS was symptomatic and easily isolated, i.e. a high temperature was an immediate indication of infection and potential for cross infection, something 2019-nCoV hides up its sleeve with zero symptoms prior and post illness. The good news, unless the figures are being seriously manipulated, is that 2019-nCoV is nowhere in the same morbidity league as SARS or Ebola. The bad news is that it will affect many more by a considerable factor, so the impact at first glance will be more economic than a complete breakdown of civilization. Saying that, the more data we have and the longer the virus is active, the more accurately we can predict the true outcomes. This is especially true, as we don’t know yet how long a patient remains infectious post sickness, nor what further complications may occur weeks or months later as a result of infection. Until the outbreak is over, we cannot know the full statistical truth.
If I was still in my emergency planning role, I would not be panicking. There are measures in place that few of the general public are aware of, both from an infrastructure and legal perspective. From a human perspective, I don’t see a zombie apocalypse immediately on the horizon. If you are suffering from ill health already, I would be very cautious about socialising too much if cases are reported in your locality, particularly if you suffer from respiratory or immune system illness. Everyone needs to wash hands regularly, especially after being in public places, and if you so feel the need, wear a tight-fitting face mask. Don’t forget though, the virus will live on surfaces for a period of time, as of yet unascertained. Air travel is best avoided, as the cabin air is recirculated, and I would not be surprised if this outbreak tips a few carriers over the financial edge. If you are serious, wear wrap round glasses, as the virus can enter via the eyes. Provided the number of infections doesn’t outweigh our national ICU capability to deal with serious complications like ARDS (Acute Respiratory Distress Syndrome) etc., we will be OK. If it reaches that point or beyond, we are in deep merde. I would hope that long before that point, our government would put in place strict isolation and civil contingency measures. If not, they are as short sighted as China has initially shown to be, to their cost.
So yes, 2019-nCoV is a nasty piece of work. In comparison to the Spanish flu, it potentially has a higher infection rate, while based on current figures, the mortality rate is comparatively low. In our favour though, we have better medicine, technology and communication than was available then, and we are not amidst a world war. As always, getting to the kernel of truth is always difficult, and this post is based totally on non-peer reviewed papers and generalisations, as that, realistically, is all that is currently available. For those who consider my opinion valid, I don’t think this is the “Global killer” that the population reductionists want. Yes, I would put money on the fact that like HIV-AIDS, it probably came out of a lab somewhere. According to some reports, 2019-nCoV shares a similar genetic core to HIV-AIDS (Ed. Which if you read the comments below the paper does not appear to be true. Also from the comments the paper is currently withdrawn. Confirmed at Forbes). Personally, the fact that the Chair of Harvard University’s Chemistry and Chemical Biology Department and two Chinese nationals have been charged (28/1/20) in connection with passing secrets, including 21 vials of biological research to the PRC, speaks volumes. The close proximity of a level 4 bio-lab to Wuhan smacks one in the face with the same irony as the Skripal affair and the proximity to Porton Down. Cock up, conspiracy or evolution? We may never have anything more than circumstantial or anecdotal evidence to consider, unless a trusted whistleblower comes forward.
That said, there is too much evidence to ignore that there are some very powerful players on the world stage that are demanding a major cull or population reduction, if humanity is to prosper in their wicked eyes. The Georgia Guidestones is but one, the Green and abortion agenda others. I don’t think 2019-nCoV is “It” though. Far better soften up your adversary first, and let nature, or something else, do the power lifting and then rest in the warm embrace of plausible deniability. Certainly, that seems to be the current modus operandi. The wicked, and indeed, leopards, don’t change their spots.
Andy at Corona Virus Prediction Tool, whose spreadsheet was invaluable in helping this statistical ignoramus make sense of the panic.
© Rookwood 2020
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