Archive for March 1, 2020

Some Thoughts About the Ongoing Worldwide Coronavirus Outbreak

March 1, 2020 5 comments

Most readers might have read my previous posts (link 1, link 2) about the ongoing Coronavirus outbreak in China. Since then the outbreak has become a bigger issue outside China than within it. The growth in numbers of diagnosed, and suspected, international patients have surpassed those within China. So, ironically it is supposedly “authoritarian” China rather than the allegedly “free and competent” West that has done a much better job of controlling the outbreak. And you know something, this outcome is not surprising because the Chinese system actually gives a fuck about its own people as opposed to the western “free market” system which only care about the quarterly profit of corporations. As of today, the official government policy is still to test as few people as possible that way, they can pretend the outbreak is not a problem in this country. Of course, this would be hard to conceal once people start dying by the hundreds- but till then they can use a combination of incompetence and malice to pretend that there are no problem.

Now some of you might say- “didn’t you also write that this virus was far less serious than many were saying in the first few weeks of the outbreak”?. And to that I say- well, that is still correct from a medical and population statistics point of view. There are however two, or three, issues which will make this outbreak especially problematic in USA. Firstly, there are far more old people in assisted living facilities in this country than in China or most other Asian countries. In case you don’t know, these places are staffed with poorly paid precariat labor and known breeding grounds for all sorts of outbreaks- especially of respiratory and gastrointestinal pathogens. I can bet that people working in such facilities, who are usually young and poorly paid, are not going to call in sick if they have a ‘mild case of the flu’. Guess what, this scenario has already played out in Washington State. Did I mention that this cluster of infections was community acquired.

In case you are wondering, epidemics become hard to control once the microorganism starts circulating in the general population rather than being restricted to easily identified travelers and other high-risk groups. So far countries where community acquired infections account for the majority of cases include South Korea, Japan, Iran and Italy. While I can predict with reasonable certainty that these countries will be able to control them (Yes, even Iran), the same cannot be said about USA. A system which prioritizes the infliction of precarity on the masses over anything approaching rationality is bound to become a hotbed of community-acquired spread of COVID-19. Given that super-spreaders play an important role in the dissemination of this virus, imagine what all those poorly-paid people who work in restaurants and fast-food outlets could do for the spread of COVID-19 in USA. While I am not a sadist, there is something to be said for a country with almost no paid sick-leave policies getting fucked over because of them.

Another important issue, which has been still neglected by countries other than Japan (at this moment) is the role of children in spreading the virus. We know from available Chinese medical statistics that children under 10 and youth under 20 account for an unusually small percentage of cases who show symptoms (fever etc) or require medical intervention. Given that these are the two groups most likely to get community-acquired upper respiratory infections, it is odd that they are so poorly represented in the statistics for COVID-19. We cannot, therefore, rule out of the possibility that a far higher number of children and young adults infected with COVID-19 either experience an asymptomatic infection or one with minimal symptoms and then go on to recover completely, but are capable of infecting others just as readily as those with serious symptoms. So far, Japan is the only country to recognize this issue and close schools– though I suspect South Korea might follow soon. USA is unlikely to do this until it is too late.

One of the other unanswered questions about COVID-19 concerns why it seems to cause serious illness in old people with cardiovascular disease. While this has not been shown beyond doubt, having heart disease increases the risk of death even more than having pre-existing respiratory illness. If that is holds true, why? Also, what is the most common proximal cause of death in those who die. Is it respiratory failure, cardiovascular dysfunction, secondary infection from prolonged hospitalization or something else? Do any of the antiviral drugs shown to have activity against similar viruses in animal models effective in human beings? So far, initial reports suggest that Favipiravir has some therapeutic effect in patients with COVID-19. Remdesivir is another drug which has known efficacy in animal models of coronaviral infections. But, as of right now, we still don’t know how much these drugs affect the course of illness, morbidity, mortality and ability to infect others. Hopefully, this state of affairs will change soon.

Then there is the effect on global supply chain- with two major potential consequences. Firstly, could such a disruption have serious effects on the availability of essentials such a drugs, which are usually synthesized from ingredient chemicals made in China. While some disruption is inevitable, the post-1980 tendency of american companies to maintain “lean inventories” is likely to bite them (and all of us) in the behind. We also have to consider the effects of such disruption on the broader economy in an election year. Almost all of Trump’s re-election campaign is based on the narrative that he has not destroyed the economy. But what if the downstream effects of COVID-19 on the supply chain of almost every single industrial sector in USA cause an actual recession, rather than just a partial stock market crash. If this were to occur, the orange buffoon would find himself in a very bad position and likely lose the presidential election. Of course, I am sure that the democrat establishment will try to snatch defeat from the jaws of victory.

Another interesting question is whether a widespread outbreak of COVID-19 in USA, with all of its attendant morbidity and morality might make Bernie Sander’s plan for ‘Medicare for All’ plan an even more popular idea than it is right now. It would certainly make a lot of idiots who support the present system think twice about supporting the status quo.

What do you think? Comments?