China has declared a people’s war on the Wuhan virus. President Xi Jinping’s leadership is being tested, but so is the argument that a regime that at first underreacted now is overreacting. A young doctor who died after being interrogated for sounding the alarm about the virus has become a rallying symbol for reformers.
All this is true. Politics is in charge. A flu-like disease may be impossible to contain but a plausible victory might be to slow its world-wide spread until a vaccine can be developed. Then we’d be able to say, for all the misdirected political energy, it could have been worse.
Will we be able to say this? Probably not.
To summarize expert opinion, such a virus is unlikely to be stopped from going global. China is detecting only severe cases. Those with mild symptoms aren’t even being tested because of an overloaded medical system. The U.S. is blocking or screening travelers from China. This will have no effect on infected people from third countries (11 cases in France, Spain and the U.K. have been traced to a symptomless Brit who spent two nights in Singapore). Certain countries where infection is present may prefer to blame symptoms on the flu or the common cold to avoid travel bans and trade interruptions. (Don’t underestimate this caginess factor: A 2017 survey found that 10% of returning Ebola clinicians lied to screeners to avoid possible quarantine.)
The only good news is that the new coronavirus, for the U.S., is likely to prove no worse than a flu for which the wrong vaccine was stockpiled. How deadly the disease might be is unclear, but mortality is probably much less than the reported 2%. One mystery is why so many Chinese cases appear to be severe while outside cases are mild. Likely answer: underreporting by China of mild cases, which may number in the millions by now.
As with the flu, the elderly and chronically ill are at greatest risk. The 1918-19 influenza epidemic killed millions because of complications which today are easily treated. Still, heaven help less-developed countries when the Wuhan strain arrives. A million Chinese are estimated to be working in Africa, where health systems will not be up to keeping a check on secondary complications such as bacterial infections that can be the real killers.
If you’re wondering, the above summary is mostly gleaned from expert testimony before a House subcommittee last week. Witnesses included infectious-disease expert Jennifer Nuzzo of Johns Hopkins and Ron Klain, manager of the 2014 Ebola outbreak for President Obama.
Ms. Nuzzo’s bracing words: “The best evidence suggests that a lockdown of travel will at most prevent an introduction for perhaps weeks. That is not meaningful in the context of developing a vaccine. A vaccine could take a year or more.”
U.S. luck in identifying and isolating infected persons is likely to run out at some point. But we still have huge advantages over Wuhan, where the disease may have been spreading since November and the elderly and vulnerable never received warnings that would have allowed them to reduce their risks: Wash your hands. Avoid crowded places. Get a flu shot to reduce risk of an infection whose symptoms will have you thinking of the Wuhan coronavirus even if you haven’t been exposed.
Though partisan snippery was hardly absent from last week’s hearing, the most predictable note of disapproval concerned actions motivated by politics rather than strict medical justification. As foreshadowed in this column two weeks ago, much cited was 2014’s quarantine of returning medical helpers and others after the Ebola contagion in West Africa.
Nearly 30,000 were monitored, at considerable cost to the subjects themselves and public-health officials, with no infections discovered. And yet the political value of the measure, initially demanded by the governors of New York and New Jersey, is harder to judge or second-guess. At the time, local media were feasting on a returning doctor who rode the subway and dined with friends in a restaurant not knowing he was infected. New York City, which generates 7.5% of America’s gross domestic product, cannot function if fear of being sneezed upon has people refusing to use public transportation.
China teaches one thing: When a novel respiratory virus emerges, a free press is on balance an indispensable medical asset. The steps an informed public can take to protect itself are far more potent than any top-down action. Unknown is whether the new disease really originated in a meat market in Wuhan, as was first reported. But suppressing news of its outbreak once it was discovered was China’s most fatal mistake.