Covid-19

Today the University at which I work, along with a host of other Universities in Australia, announced that it will be suspending all teaching for a period of four days in order, wherever feasible, to transition teaching to an online mode. I work in a Faculty of Arts and Education that includes the creative arts disciplines which means that we will be looking, for example, at how to transition a dance studio to an online environment. We will also be looking into how to transition photography units online. Virtual darkrooms perhaps.

Given my role at the University, which has always included a significant component of supporting academic staff to develop courses for online delivery as well as converting existing face to face courses for online delivery, I find myself somewhat busy at the moment. However, from a purely selfish perspective, I imagine that I will be in gainful employment for years to come because once this virus has run its course, universities will put a central focus on ensuring that just about any course can be taught both face to face and online. So, you know, hurrah for me.

Staff at my university have been advised to work from home and so things just keep getting better for me. My attendance at my place of work has always been somewhat intermittent but now I can work from home with impunity and it appears that this state of affairs might continue for months. My days have always been defined by living a peaceful and contemplative life of solitude away from the FaceBook stupidity that defines the lives of the masses and so the fact that social isolation and social distancing measures are firmly in place in Australia, means that my life will be rather idyllic as solitude more than suits me.

Just in case you are thinking that I am a somewhat selfish and self-centred person, take a moment to consider two reports about panic buying that defy belief. In the first report, a woman in a wheelchair was pushed out of the way as she reached for the last pack of toilet paper on the supermarket shelf. The offender then walked off with the toilet roll. The partner of the person in the wheelchair followed the perpetrator of this heinous act to discover that she had thirty five packs of toilet roll in addition to the one that she had grabbed. In a second news item, a blind woman reported that someone had stolen her toilet roll out of her shopping basket. I am honestly at a loss for words regarding these two stories because I just cannot comprehend people behaving in such an inhumane manner.

In a third news item a male shopper verbally abuses a supermarket employee who is handing out toilet rolls in an effort to ensure a fair distribution process. Lastly, a man was tasered by police after he became aggressive over, you’ve guessed it, toilet paper supplies in a supermarket. At some point I will conduct some research into just why it is that people are so fixated on toilet paper supplies and the answer will likely not be the obvious one that they are concerned with their personal cleansing habits. There is something far deeper here, something rooted in the human psyche that is manifesting itself in this current obsession. Perhaps people are looking for the illusion of control.

This morning, as I was having a lovely time sitting in my garden drinking my first coffee of the day and smoking numerous cigarettes, my mind turned to the history of pandemics in my lifetime and I realized that I possessed scant knowledge with respect to past pandemics. Bird Flu came to mind because I had travelled to Vietnam during that pandemic. Someone at my fitness centre had mentioned Ebola and I wondered about HIV / AIDS. My early morning interest lay in wanting to contextualize what is happening with the Covid-19 virus, particularly in terms of having a think about whether we are all overreacting to the current situation. So I did a Google search on my phone for the history of pandemics in the twentieth century and I did a further search this evening on my laptop.

The Australian Department of Health Website lists 4 Influenza pandemics in the 20th Century as does the Centre for Disease Control and Prevention website. These pandemics occurred in 1918 (estimated 50 million deaths worldwide), 1957-1958 (estimated 2 million deaths worldwide), 1970 (estimated one million deaths worldwide), and 2009 with the pandemic colloquially known as “swine flu” (original estimates by the World Health Organization at around 18,500 deaths worldwide but now considered to be a much higher figure, possibly around 400,000 deaths worldwide). Severe Acute Respiratory Syndrome (SARS) was a Coronavirus with cases of infection occurring for the most part in China, Hong Kong, Taiwan, Canada and Singapore. As reported by the World Health Organization, the total number of SARS cases from 1st November 2002 to 31st July 2003 was 8096 with 774 deaths giving a fatality rate of 9.6%.

At the time of writing, real time figures for the Covid-19 virus give the total number of global cases as 183,249 and the total number of deaths as 7,164 giving a fatality rate of 3.9%. There are of course other estimates of the number of cases and numbers of deaths but the figures are not so significantly different as to be worried about them in this piece of writing. As I continued with my research I came across Middle Eastern Respiratory Syndrome (MERS), a syndrome that fits into the coronavirus family. There have been 2,494 cases of MERS since September 2012, with 858 deaths in the same period meaning that 35% of those who contract MERS have died. The fatality rate is, therefore, far higher than the fatality rate for SARS.

We also have Avian Influenza or “Bird Flu” first reported to the World Health Organization on 5th January 2017. On the 9th January 2017, 106 cases of Avian Influenza, were reported to the World Health Organization. Of those 106 cases all of which were confined to China, 35 people died giving a fatality rate of 33%. Earlier I mentioned the Ebola virus which has had outbreaks in 1976, 2014-2016 and 2018-2019. Fatality rates for this virus can be incredibly high. For example, for January to April 2003, Zaire had 143 cases and 128 deaths giving a fatality rate of 90%. Lastly, let’s turn to the HIV / AIDS pandemic which produces some staggering statistics. For example, in 2018 there were approximately 37.9 million with HIV/AIDS with an estimated 1.7 million people worldwide becoming infected with HIV. In 2018, around 770,000 people died from AIDS-related illnesses worldwide, compared to 1.2 million in 2010 and 1.7 million in 2004.

I could have gone back far earlier with the history of pandemics, to the Black Plague or the Plague of Justinian with fatality figures from the Black Death possibly as high as 200,000,000 and fatality rates from the Plague of Justinian at around 75,000,000. The figures are sobering but they don’t really help to contextualize what is happening now because our current circumstances are so vastly different from circumstances in the 14th Century (Black Death) and the 6th Century (Plague of Justinian). So, remaining in the present there are two questions that we might ask with respect to whether or not we are being alarmist. First, how contagious is the Covid-19 virus i.e. how many people are likely to become infected worldwide. Secondly, what fatality rate can we expect? And third, in virtue of answering the first two questions, how concerned should we really be with respect to the Covid-19 virus.

In terms of answering the first question regarding just how contagious the Covid-19 virus might be, it is worth taking a quick look at the origin of this virus, along with the other viruses that we have considered. The Covid-19 virus likely originated at a market in Wuhan when the virus “jumped” from an animal to a human and not, as the Chinese would like us to believe, with a U.S soldier visiting the market in Wuhan. The 2009 Swine Flu originated in the United States with the virus likely coming from contact with pigs. SARS originated in China as a result of what is referred to as a “zoonotic event” or the virus jumping from an animal to a human. MERS originated in Saudi Arabia and, yes you’ve guessed it, was the result of the virus jumping from animals to humans. Avian Flu or Bird Flu again originated in China and again the source of the infection was a market, this time a wet poultry market. Finally, the Ebola Virus originated in West Africa with a single person likely infected by a bat.

These points are interesting – more than interesting given that transmission of viruses from animals to humans through unsanitary conditions in marketplaces is entirely preventable – but the really sobering point for now is that, “the novel coronavirus’ affinity for entering human cells is 10 to 20 times higher than that of other coronaviruses. These habits mean the new coronavirus can more easily hitch a ride via coughs and sneezes, and they may explain why people become contagious before displaying full-blown symptoms“. So, yes the Covid-19 virus is highly contagious which means that we should be extremely concerned about the virus because there is a significant potential that the virus will spread across significant proportions of the population.

The caveat that we might add is that the risk of catching the virus is high under certain conditions e.g. when in close proximity to people who have the virus and when people are not engaging in good hygiene practices. In both cases, we should feel concerned for a host of reasons. For example, travel bans were, minimally, not as effective as they might have been and so the virus spread. People were not honest with respect to whether or not they might have been exposed to the virus with an estimate that only one in four travellers answered questions honestly. With respect to hygiene standards, I do not need data. If you do what I do, sit and people watch for long periods of time, then you will be able to gauge whether or not people are practicing good hygiene. The majority are not doing so.

The question of the fatality rate seems trickier to answer. I don’t mean that there is a lack of data with respect to the fatality rate. There’s tons of data showing the total number of global cases per country along with total number of fatalities worldwide and total number of recovered cases. Since its identification was first announced on 16 January, the numbers of suspected and confirmed coronavirus cases have risen sharply. As of today 19th March 2020, China still has the highest number of cases and the highest number of fatalities with 80,860 cases and 3,213 deaths. However, the number of cases in Italy along with the number of fatalities has risen at what can only be referred to as an alarming rate with 24,407 cases and 1,809 deaths in Italy.

If you look at a graph representing roughly a two month period from the original infections to the present day then, again, it looks like there is cause for concern. On January 20th, 2020 there were 220 cases. By 15th March 2020 there were 201,634 cases. In the same period, fatalities have risen from 17 to 7,905 with the highest number of deaths being in China, although it is noted that underlying health conditions may account for the high number of deaths in China. This brings us to another point about whether we should be concerned with the fatality rate per se or with a more nuanced understanding of the fatality rate. The answer is that we should be concerned with a more nuanced understanding of the data because the fatalities seem to be correlated with particular demographic groups.

For example, in China deaths have mainly occurred in those aged between 30 and 79. This article with respect to data from China goes on to say that, “the fatality rate was 14.8% in people 80 or older, likely reflecting the presence of other diseases, a weaker immune system, or simply worse overall health. By contrast, the fatality rate was 1.3% in 50-somethings, 0.4% in 40-somethings, and 0.2% in people 10 to 39“. So you get the picture. To put it bluntly, from a statistical perspective, whether or not you are “likely” to die from the virus seems to have a lot to do with your age and your state of health. In this respect teenagers and younger people in China were least likely to contract the virus, possibly because exposure to other Coronaviruses had strengthened their immune systems. Kind of ironic really.

An alternative data source paints the same picture. The older you are the more at risk you are and if you have pre-existing medical conditions of particular types then you are more at risk. Thus, whilst the World Health Organization has reported that people of any age can catch the virus, the fact is that some people are more susceptible than others to dying from the virus. So, are we being alarmist? Absolutely not. Should we be very worried? Yes. The virus is highly contagious. Initial travel restrictions were fatally flawed and did not work. Airport screening was never going to catch even a minority of the Covid-19 cases. People cannot be relied upon to be honest, to self isolate or to engage in good hygiene practices. We have a perfect storm for virus transmission and the subsequent fatalities.

First Published March 18th, 2020

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