China shows a future of the epidemic and the world

Summary:  The findings of the experts sent to investigate the COVID-19 epidemic in China not only tells us about the epidemic (an antidote to the misinformation pandemic) but also gives hints about the future of the world’s economy and politics. Also, China shows what can be done when the need is clear and the clock is running. It’s a model for responding to future threats, such as climate change.

Pandemic

Before looking at the epidemic in China, look at a different infection in America. Discussion about the epidemic in China often describe its government and society in ways similar to 19th century Brits describing central Africa: dark, primitive, untrustworthy, lesser than us. No surprise since for a decade US elites have demonized China – as it has become a serious commercial and geopolitical rival to America.

Much the same paranoia, insularity, and ignorance has infected discussions in America of Russia, again the result of propaganda serving the interests of America’s elites (better that the proles focus on foreign foes than our own corrupt leaders).

Perhaps this epidemic will help break this lock on our minds. China’s efforts to contain the epidemic have been innovative and unprecedented, with many lessons America should learn.

Press Conference reporting about results of

the WHO Joint Mission to China on COVID-19

Excerpts; see the full transcript here.

Slightly paraphrased for clarity. Emphasis added.

Liang Wannian.

Head of the COVID-19 Response Panel of the China National Health Commission (NHC), also Director-General of Health Care Reform for the NHC.

Let me begin with {our} purposes and the findings …The joint team was composed of 25 international and Chinese experts in fields including epidemiology, virology, clinical management, and public health. {These} experts gained a comprehensive and thorough understanding of the epidemic situation, prevention and control measures, health care services, and scientific research …across China. During the mission, the Joint Mission held detailed discussions and consultations with government officials, emergency response teams, senior scientists, front-line health care staff, and the general public. …Here I will briefly introduce the major findings of this mission. …

(2)  Epidemiological characteristics of the epidemic.

In terms of demographic characteristics, the average age of the confirmed cases was 51 years old, and nearly 80% of these patients aged 30 – 69 years. As of February 20, about 78% of the confirmed cases were from Hubei Province. …

Editor’s note: That’s important. Many doomsters say that this is a devastating epidemic across all of China. I doubt that most of them could find Hubei Province (Wikipedia) on a map. It has not taken hold in China’s other 30+ provinces and other units.

(4)  Routes of transmission.

Familial clustering of COVID-19 has been identified, especially in Guangdong and Sichuan, where up to 78% – 85% of the confirmed cases were from familiar clusters. The familial clustering just reflected that the prevention and control measures in these two provinces are highly effective. Thanks to these strict prevention and control measures, the only second-generation cases and clusters occurred inside families (i.e., other than the imported cases). No continuous community spread was found.

Close contacts are closely managed nationwide, and they are now tracked and medically observed. Approximately 1% -5% of the close contacts {of the infected} have been laboratory confirmed as COVID-19 patients. …

About COVID-19.

The current data have indicated that the disease are mild and can be cured in most cases. The proportions of mild, severe, and critically ill patients are about 80%, 13%, and 6%, respectively.

Some asymptomatic patients have been found. However, whether such cases are patients with asymptomatic infections or carriers whose virus is still in the incubation period warrants further study. It is unclear whether the asymptomatic carriers can also spread the disease.

The case-fatality rate is estimated at …about 0.7% …outside Wuhan. …According to the currently available data, the average time from symptom onset to recovery is two weeks for mild cases and three to six weeks for severe patients. …

Ed’s note: The fatality rate outside Wuhan (i.e., provinces with adequately functioning health care systems) is estimated to be 0.7%. Not the 2 – 3% commonly cited by doomsters (who also mention that the fatality rate in developed nations will probably be lower than China’s). For comparision, the Spanish flu was also highly infectious, but with a fatality rate of over 2.5% (see more about it here and here). The usual rate for influenze pandemics is <0.1%).

Dr. Bruce Aylward (bio).

…So first, what has China done? In the face of a previously unknown disease, China has taken one of the most ancient approaches for infectious disease control and rolled out probably the most ambitious, and I would say, agile and aggressive disease containment effort in history.

China took old-fashioned measures, like the national approach to hand-washing, the mask-wearing, the social distancing, the universal temperature monitoring. But then very quickly, as it started to evolve, the response started to change. And it moved from this sort of one-size-fits-all approach to a science-and-risk-based approach, which was tailored to use different containment approaches and measures, depending on the context, the capacity and really the nature of the coronavirus circulation. So they refined the strategy as they moved forward, and this is an important aspect as we look to how we might use this going forward.

They took this old approach and then turbo-charged it with modern science and modern technology in a way that was unimaginable even a few years ago.

Just a couple of small examples. As they cleared these giant hospitals to make space for overwhelming numbers of COVID-19 cases, they moved a huge amount of the routine provision of medical services onto online platforms and other mechanisms that they’ve really come to a cutting edge with. When we were in Sichuan …they showed us a 5G platform so they could do real-time contact, support. In two minutes they contacted an epidemiological investigation team in the field that was having problems, and was getting walked through it by the top experts from the province. It’s fundamentally different from the way most people approach a dangerous respiratory pathogen in the modern era.

The second issue: how did they make it happen? This was only been possible because of tremendous collective commitment and will of the Chinese people from the most bottom-level community leaders to the governors at the top. It was an extraordinary all-of-government, all-of-society approach. …

Is it working?

It’s the opinion of the joint mission …that China’s bold approach to the rapid spread of this new respiratory pathogen has changed the course of what was a rapidly escalating and continues to be deadly epidemic.

There’ve been challenges with statistics that come out of China, the changing numbers. We looked carefully at different sources of information, and can say with confidence that this is declining.

When you get out into the field, there is a lot of compelling data and observations to support this decline. …First, we saw a steep decline in visits to fever clinics. In one province that we went to, it dropped from 46,000 at one point for the whole province down to 13,000, so dropping very quickly despite a heightened awareness of push to get people in and get them tested.

Second, when we spoke to physicians in Wuhan, they said that hospital beds are opening up – so we can move people in. This was the first time in weeks that they found there was more than enough capacity. …

I know people look at the numbers and ask what is really happening. …I work for the WHO. But I have 12 people with me who work for the best research and public health institutions around the world. …multiple sources of data pointed to the same thing. This is falling and it’s falling because of the actions that China has taken.

{He presented graphs of the data they collected.}

The last point is what happens next as China is already preparing to reopen businesses and schools in the near future, maybe some weeks. They want to get society back to a more normal semblance – a new normal, because this virus may be around for months. …Also, it could come back again as the shops open, restaurants open, schools open. That risk is being managed very carefully. …

To show you how quickly China is adapting, seven weeks into this outbreak China is already on the 6th edition of its clinical guidance. China didn’t approach this new virus with an old strategy from other diseases. It developed a new approach to a new disease. It turned around this disease with strategies most of the world didn’t think would work. …

This brings us to the 3rd finding in terms of the global response, probably the biggest challenge. The global community is simply not yet ready in mindset or with the materials to implement the measures that have been employed in China, the only successful measures we know so far to contain COVID-19 as it has here in China. …There’s an ambivalence to using what we call non-pharmaceutical measures. We don’t have a vaccine, we don’t have a therapeutic. China said, OK, we don’t have those. Let’s get out the old ones. Let’s adapt them. Let’s innovate and let’s stop this virus and save lives. And that’s what they’ve done. …

Important recommendations.

it’s important that other countries think about …a rigorous approach, is because they are now the second line of defense, before this virus gets into the low-income countries – that have weaker capacity to deal with this. This little bit of time could be important. It’s only seven weeks since a new disease was described. We have diagnostics, we’re trying antivirals, we are probably within months trying vaccines. The situation could be very different with just a few gained weeks.

That brings us to the last point, in terms of the global response, we will gain a bit of time, but we have to be using that time better than we are today. …

The single biggest lesson is speed. Speed is everything. And what worries me most, sorry, I didn’t catch it in, but what worries me most is that has the rest of the world learned the lesson of speed? …The most important message is don’t be complacent. …It can come back up and that would require really rapid work again. Sometimes when we’re used to dealing with a virus, we get complacent. That is always the single biggest risk. …

Liang Wannian.

The overall judgment is that Wuhan is still the epicenter of the epidemic in China. The current situation is still grim and complex, but to a certain extent, we are now at the most critical period that determines whether the epidemic prevention and control efforts will prevail.

  • The number of new cases per day is decreasing,
  • the number of reported cases is declining daily,
  • the proportion of severe and critically ill patients is declining, and
  • the mortality rate of confirmed cases is declining.

This is good news. {But} the epidemic has not yet been completely contained by us. However, our judgment is that the epidemic in Wuhan has been effectively contained. …

Bruce Aylward discusses the numbers

People keep asking me to explain why is the numbers {keep changing}. In any crisis like this, especially for a new disease, you’re trying to figure out what is the case definition. What are the characteristics of every confirmed case? You’re trying to be as efficient as possible so you can get people into treatment. It takes a while to figure out. It’s not unusual that numbers bounce around. What I’m always interested in are the trends. …If we go back and look over time with China, with all the different information, the trends have been incredibly clear and consistent.

——————————-

Important info from the Director of WHO

Excerpt from his press briefing on February 26.

“The key message that should give all countries hope, courage and confidence is that this virus can be contained. Indeed, there are many countries that have done exactly that. 14 countries that have had cases have not reported a case for more than a week, and even more importantly, 9 countries have not reported a case for more than two weeks: Belgium, Cambodia, Finland, India, Nepal, Philippines, the Russian Federation, Sri Lanka and Sweden. But that doesn’t mean that cases may not come back to these countries. But the cases that made it before have been contained. …

“For the moment, we are not witnessing sustained and intensive community transmission of this virus, and we are not witnessing large-scale severe disease or death. China has fewer than 80,000 cases in a population of 1.4 billion people. In the rest of the world, there are 2,790 cases, in a population of 6.3 billion.

“Do not mistake me: I am not downplaying the seriousness of the situation, or the potential for this to become a pandemic, because it has that potential. Every scenario is still on the table.”

Editor’s afterword

China’s response has been fast and astonishingly innovative. That’s the response to a crisis of a nation capable of doing great things in the 21st century. China shows the scale of response possible for a well-managed nation when the dire need is clear and the clock is running. It could be a model for dealing with future threats, such as climate change.

When comparing the statements of these experts and WHO to those of the doomsters, remember the difference. These people and institutions have reputations to preserve. Doomsters are almost always wrong, but their audiences do not care – and follow them anyway. So doomsters’ incentives are to provide sensational stories – clicks for money and fame.

It’s easy to follow the coronavirus story

The World Health Organization provides daily information, from highly technical information to news for the general public.

Posts about the coronavirus epidemic.

For More Information

Ideas! For some shopping ideas, see my recommended books and films at Amazon. Also, see a story about our future: Ultra Violence: Tales from Venus.

Please like us on Facebook and follow us on Twitter. Also, see these posts about epidemics…

  1. See the ugly cost of the next big flu pandemic. We can do more to prepare.
  2. Stratfor: The superbugs are coming. We have time to prepare.
  3. Posts debunking the hysteria about the 2009 swine flu in America.
  4. Posts debunking the hysteria about the 2015 ebola epidemic in America.
  5. Important: A vaccine against the fears that make us weak.

Films about scientists responding to global threats

In these films, we see scientists behaving according to their and our highest ideals.

When Worlds Collide (1959) – The world will end. Scientists band together to warn the world and build an ark to carry humanity to another home. It is a great film! The 1933 book by Philip Wylie and Edwin Balmer is even better than film.

Contagion (2011). – This shows the progress of a pandemic from its start with Patient Zero, through the global devastation, to an eventual victory by the world’s scientists.

When Worlds Collide (1951)
Available at Amazon.
Contagion (2011)
Available at Amazon.

 

23 thoughts on “China shows a future of the epidemic and the world”

    1. Gerard,

      That’s a great point. With no vaccine and treatment, quarantines are the most effective response. As this WHO report says, developed nations are not used to relying on these low-tech methods.

      Worse, the strong individual rights West probably will find the strong quarantines more difficult to enforce than those with communitarian cultures.

  1. “only the second-generation cases and clusters occurred inside families after the occurrence of imported cases”

    Well, this is maybe the most encouraging thing. That and the reported decline in new cases of course. If this is right, they really have limited it.

    But also we have to consider that in a country like Iran, the chances of them effectively implementing the same measures are few and none.

    So China could get it more or less under control, but it still explode in the rest of the world. The Italians seem to be implementing similar measures to the Chinese, and the UK appears to have similar measures in planning. Its clear from the conference that you have a limited time to act very vigorously. Once it gets away from you its over.

    We shall see. I agree that the global response has been remarkable, and assuming these numbers are correct at least regarding the trend, to have contained a disease with an R0 of between 2 and 3 is very different from anything that’s been managed before.

  2. If it is not contained, there will be a Darwinian ratchet. This will include social and societal entities.We should be thankful that WHO and China have given us insights on how to slow down, if not contain, this virus. One thing all the experts agree is that time is one of the crucial elements in control and eventual procedures for our adaptation and mitigation of this disease.

    Another one of the other areas that experts agree, the need to use the time we have wisely. Panic does not help. It not only increases the difficulty of control from such human activities as hoarding and personal contact, it can serve as an uncontainable disease vector with far reaching effect both socially and geographically.

    As indicated in the name Risk Control, the ability to control is a front line defense to catastrophe. Panic is the opposite of control. The response by China, in closing down such things as live markets, indicates control that the fear mongers and China bashers are not counting. Innumeracy is the fear monger’s friend. Fear mongers are part of the problem in emergencies.

    1. John,

      “If it is not contained, there will be a Darwinian ratchet.”

      Why? Do you believe it would be worse than the “Spanish” Flu?

      The WHO investigative team estimates the case fatality rate of COVID-19 at 0.7% in China. The Spanish flu was probably as or more infectious, with a fatality rate of over 2.5%. (The general rate for influenza epidemics is <0.1%.) It killed at least 50 million people, perhaps 100 million. It did not have a Darwinian effect.

      1. With modern communications, knowledge will be available. That is the part that will ratchet social and societal entities. Those who don’t use the correct procedures will provide us with information. But also may well provide us with the most effective generational ratchet.

        Deadly infectious diseases almost always enable generational ratchets.

        Most coronavirus mutate. The ratchet there will tend to be dual with humans and the virus. The humans exposed to weaker strands will be more likely to spread the weaker strands to others giving partial immunity because of delayed or reduced frank symptoms. Humans that survive, even the strongest variant, will tend to generationally spread their genes.

        Perhaps our differences are you are looking at one virus, and one variation. Ask your self what happened to Spanish flu which “was probably as or more infectious, with a fatality rate of over 2.5%.” In Biology, we were taught that extremely deadly diseases tend to select themselves and humans. The reason is due to capability and opportunity. If too quick and deadly, the disease burns itself out. If the virus does not mutate, then humans will be selected by a Darwinian process. If the virus mutates, it will go through its Darwinian selection process.

        I think the success story from China showed a ratchet that involved communications, knowledge and response. This is what your selection of quotes indicate. As this spreads, to contain will require the same or similar steps. China has done us a great service. They have highlighted winning procedures for containment, which we can implement faster, and perhaps better, since the discovery, determination, and working procedures have already been done: the social and societal entities.

      2. John,

        I believe the giant “Spanish” flu had almost nil effect on nations and the flow of history, and will be a minor footnote in specialist history & epidemiology books about the 20th C – and forgotten by everybody else.

        COVID-19 would have to be far larger to have any of the effects you describe.

        As for the effects on China, it is too soon to say – but might have accelerated its cohesion into a superpower – and realization of their strength. Both would have happened, eventually. A historical analogy would be the retreat of the ten thousand Greek mercenary soldiers (401 BC) as told by Xenophon in Anabasis.

      3. This is more trivia ABOUT the spanish flu, but it almost overnight mutated into something that was far less lethal. In Philadelphia they went from hundreds of deaths one week to a handful the next. And it wasn’t that people stopped getting the flu, it was just suddenly less lethal.

        Of course diseases tend to get less lethal, or at least less quickly lethal, over time.

      4. Grant,

        That is an old number, based on the fatalities in Hubei Province of China – a poor country, where the province’s health care system collapsed.

        For the developed world, current estimates of the fatality rate run under 1%. The Diamond Princess is a test case, with a ~1% fatality rate for its largely older population.

        The fatality rate is not a constant (there is no one “fatality rate”), as it varies by many factors (see this post for details). Much depends on how the epidemic develops – where and on what scale.

  3. Thank you for this report, it really should be front page news in Europe as well as here.

    Xi recognized that this disease was a potential social bomb and put himself and the Chinese CP system on the line for solving it. They took extreme measures, but if the effort has indeed been effective, it very much legitimizes his approach.

    What is less clear is whether there is any willingness to learn from this in the Western world. Juxtaposing a Chinese success against a failed response elsewhere will greatly reorient opinion, to China’s benefit. We may be witnessing a passing of the mantle of global leadership.

    1. What is less clear is whether there is any willingness to learn from this in the Western world.

      Well I have heard some of our own elected officials here in America getting on TV to suggest darkly that this was a bio-engineered weapon, so that’s where we seem to be at. I’d like to say, “but they are probably a small number of cranks and fools,” but the cranks and fools seem to be in the catbird seat lately.

  4. rawdawgbuffalohttp://wsenmw.blogspot.com/

    Great presentation. For me, I think (my bias showing) that work on a vaccine should happen but it shouldnt be rushed. This will lead to either wasted spending on big pharma (which we are trying to address currently) and efficacy testing on vunerable populations. If it was my lab or funded research, I would focus on antiviral development that addresses the s-segment of the RNA near the 5-prime end of both Alpha and beta coronaviri. Logic being is if you can control the receptor binding domain of the virus – especially at the level of epitheial cells that are in the lungs and find this out and the specific proties/enzymes that are impacted, you will have something that will really serve to reduce future similiar pandemics. I dont care where it came from because as of now it is here and any descent scientist wouldn’t care about that when compared to solving the problem.

    Rawdawgbuffalo

    PS: I was banned perm. from twitter last Jan. 2019.

    On my blog I post some articles (news and scientific papers) daily. I dont trust any news meia or politician when discussing science.

    This is the one from today

    Coronavirus (COVID-19) Update 2.26.2020
    http://wsenmw.blogspot.com/2020/02/coronavirus-covid-19-update-2262020.html

  5. We shall find out shortly what the China situation really is. If Larry and the WHO are correct, they are over the worst, China new cases will continue to fall, deaths will fall, business activity and travel will resume, and they will have no more than small local outbreaks which they will contain. In about a year there will be effective and safe vaccines, and it will all be over.

    ZH will find something else to apocalypse over. Well, it will probably do that anyway!

    If ZH and the other doomsters are correct, new cases and deaths will continue to increase but the reports will be faked. But at some point, probably in the next few weeks, fuelled by returns to work and lifting of travel restrictions, this will reach a point where it can no longer be concealed, and at that point we will have a huge number of cases all over the country, a huge number of deaths and a political crisis in China.

    The Chinese regime isn’t stupid, its hard to see them heading into that, as it would be, knowingly. They are much more likely at this point to err on the side of over-vigorous quarantine, and they must surely see, because its so obvious, that any deliberate understatement of incidence is counter-productive, both politically and in terms of managing the epidemic itself.

    We shall see. I am encouraged by ZH’s track record of consistently being entertainingly and apocalyptically wrong about almost everything. But epidemics can wrong foot us.

    The other ZH topic I’m following with interest and amusement is their war on Tesla. So far they are losing. We shall see…

    1. There is a wonderful post here:
      https://www.chinafile.com/reporting-opinion/viewpoint/dear-chairman-xi-its-time-you-go
      which clearly delineates the issue.
      If Xi is right and China has solved the corona challenge, they will ‘inherit the earth’ imho.
      ZH believes that they are mistaken. Sadly, if ZH is correct, much of the global economy will disappear as well.
      Look at sites such as http://www.maritimebulletin.net they offer a worms eye view of current business reality. Pressures on safety and fuel type can kill a business just as easily as war and taxes.

      1. Etudiant,

        “If ZH” is right is humor only, info only for the exceptionally gullible.

        The info it presents from reliable sources is of use, but it’s buried in the chaff. They unwary are made dumber by reading ZH.

        You appear to have forgotten their mindless hysteria about Ebola, or the mockery and sustain the have to economist which said the economy was recovering in 2010, 2011, and god only knows for how long after that.

        Or their frequent announcements that hyperinflation was imminent.

        I would be surprised in Xi says China has “solved” Covid19. But there is ample evidence that they have contained that. As many experts have said, however, the situation is fluid and could change.

      2. That is quite a letter. But he has now been captured, so its probably the last we hear from him for some time, maybe ever.

        We must hope ZH is wrong. If ZH is even partially correct, we are about to see China’s system really stress-tested.

        From their history in the 20c its not a prospect that cheers one. Like the Germans they are a great people. And like the Germans they have demonstrated a capacity to go totally off the rails into an orgy of mass murder.

        The flash point will come, if it does, when the security services lose faith. We shall see.

      3. etudiant,

        Re: the letter

        I am no China expert (I doubt there are any commenting here). His comments about the epidemic are nonsense. There have been uncounted epidemics in history. The first steps are almost always “bungled” – in the minds of people on the sidelines with perfect hindsight. It looks so easy!

        This is, I’m sure, a waste of time – but I suggest you pay more attention to the conclusions of the multi-national team of experts that just returned than to a disgruntled foe of Xi.

        “If Xi is right and China has solved the corona challenge,”

        I hope you can provide a factual basis for that statement. I would hate to think you are making stuff up, or relying on bogus sources (like ZH).

      4. Larry,

        I think there’s nothing wrong with reading ZH, if only to get an idea what sort of wild stories have some level of credibility within the US Internet news reading population.

        But as to the likelihood of their being even close to the mark on this one, its maybe not quite zero, but its falling rapidly with every day that goes by and the predicted disaster fails to materialize.

        If they are right, there should, by now or pretty soon, be large scale spreads to other ares of China, too big to be concealed, and also a situation in Wuhan that becomes clearly inconsistent with the WHO account.

        There is no sign of either.

        I have read suggestions of Russian funding of ZH. But maybe that is just more of their own kind of thing being turned back on them.

  6. Pingback: COVID-19 Coronavirus

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