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An Unusual Observation about Ongoing Coronavirus Outbreak in China

February 8, 2020 18 comments

As mentioned in the previous post on this topic, it is my opinion that the coronavirus outbreak in China is far more hype than reality. To be clear, I am not denying that a bit over 700 people are dead from this particular outbreak at the time of writing this post. Then again, a few thousand people die from influenza and its many complications in USA every single year- in a ‘good’ year. My point is that we should look at the actual evidence to make decisions and prognostications rather than let racism and stupidity make them. With that in mind, here is an odd feature of this current outbreak which sorta validates my initial assessment. It began with an observation about the prognosis of 2019-nCov infections outside China.

As some of you might have heard there are over a couple of hundred confirmed infections of this specific virus outside China, but only one death- thus far. So what is going on? Why is the death rate of patients outside China less than 1%? After posing this question on twitter, I got an interesting reply in the form of an attached table- based on available data from two days ago. Have a look at highlighted row- specifically the low death rate of patients in China (0.21 %) outside Wuhan and the province of Hubei. Note that this rate is rather close to that of cases outside China (0.39%). So, what is going on? Why does the fatality rate for this outbreak drop depending on your distance from Wuhan (4.11%), even in the province of Hubei (0.81%)?

Now let us consider and go through a few hypothesis which might provide an explanation for this unusual pattern. But before we do that, let me say something that is obvious but has to be stated for the benefit of delusional white racists. The numbers provided by Chinese government seem to be as accurate as those which would be provided by the american government under similar circumstances. This is bolstered by the fact that this outbreak seems to noticeably less deadly (on a percentage basis) than SARS. Let me remind you that SARS killed 43 people or almost 20% of the people who got infected in Canada and almost all nations with more than 10 cases ended up with mortality rates over 10%. On to the hypotheses..

1] Are people of Chinese ancestry more susceptible to infection by 2019-nCov and die from it? While the overwhelming majority of those infected and dead, so far, are of Chinese ancestry, the significantly lower death rates outside city of Wuhan (but still in Hubei) suggest that ethnicity and race are unlikely to be an important factor. Also, the majority of 2019-nCov cases outside China (to date) have occurred in travelers of Chinese ancestry from China. In other words, there is no real evidence that people of Chinese ancestry are somehow more susceptible to infection by 2019-nCov or die from it. They were just at the wrong place at a bad time.

2] The virus strain inside Wuhan is different, and more lethal, than the one outside that city? While its certainly possible that more than one strain of 2019-nCov is in circulation, the evidence we have so far suggests that all known isolates are extremely similar and have jumped into human hosts very recently. Having said that, it is common for RNA-based viruses such as Coronaviruses to mutate from more lethal strains into less lethal ones which spread more easily. Need I remind you that some species of coronaviruses are among the many which cause the common cold. In other words, it is possible – but there is a much more likely explanation.

3] In my opinion, the most likely explanation is as follows: there are far more milder infections in Wuhan than have been acknowledged. Imagine that only 1 in 10 or 20 patients have symptoms bad enough to seek medical attention. Now this will result in a 10-20 fold concentration of the worst cases in hospitals. If the infection has a death rate of 0.5%. and only the most ill 10% seek medical attention, the recorded mortality rate at hospitals will immediately jump from 0.5% to 5%. It is therefore likely that, over the next few weeks, we will find out that majority of infections caused by 2019-nCov are mild or asymptomatic and only a small percentage get ill enough to seek medical attention. Not sure if this soothes existing worries, creates new ones or both.

What do you think? Comments?