Wednesday, 15 April 2020

nCOV

nCOV

                                                                                                                                                               

IT STARTED IN CHINA



Probably the first record of a person having contracted COVID-19 from the novel coronavirus nCOV or SARS-CoV-2, that is now terrorising the planet, is that of a 55-year-old man from Hubei province on November 17, 2019 ( South China Post). So, that's a lot earlier than early January, which anecdotally is more generally taken as the start of the scourge; and it is not in Huwan, the capital city of the region and home of the infamous, highly unhygienic wet markets, selling fish, meat, poultry, live stock and wild animals. 

It takes a whole six weeks between this first case and a first report by China to the WHO of 41 cases of a new contagious viral infection in the city of Huwan . There have been other cases in between, and doctors who have flagged it could be a new and dangerous respiratory disease (not flu) have been silenced. The 41 cases are a cluster and the patients are all customers or vendors at the wet market. Six weeks and only 41 cases, and no further cases elsewhere in the province; the under-reporting or -identifying has started; not only in China, but undoubtedly everywhere, as nCOV spreads. (See Axios, a US electronic medium, for a full timeline).

It is a well-known fact that horseshoe bats are corona virus carriers. Other (earlier) outbreaks of corona viral infections in humans have all been picked up from one or other horseshoe species; however, not directly, as in all cases, an intermediate host species has been required. A virus has to mutate to become infectious for another host population, and in-one-fell-swoop from bat to man is difficult. For example, SARS-CoV (just plain old SARS to you and me) first infected the masked palm civet, which then zoonotically transmitted the disease to us. MERS-CoV (Middle East Respiratory Syndrome) idem ditto, via the dromedary camel.

The accepted current thinking is that in the case of nCOV, it is the scaly ant-eating pangolin that is the intermediate host. Anything is possible, but in northern climes, horseshoe bats hibernate in caves and other dark empty spaces, where pangolins don't go.

Where pangolins do go (or did) is the Huwan wet markets. China's very first action on admitting that the nCOV outbreak was severe was to close these down, but recently they have begun to re-open again, admittedly with a national ban on the sale and slaughtering of pangolins (and palm civits and other wild delicacies) in place since February 24.

However, pangolin meat retails at €500 a kilo (New York Times), and their scales, that have purported medicinal qualities, are also in demand, so, even the Chinese must realise that once a mass facility for this profitable trade can be availed of again, it will, ban or no ban. So, either they are not so worried about the pangolin as the carrier after all, or they have a vaccine ready or near-ready.
What the Chinese also did, of course, was to gradually shut Wuhan down (and three neighbouring cities). By January 23 this is complete. All flights in and out, and all public transport are cancelled, but not before 5 million people leave. Everybody is ordered to stay at home. A week later, all 16 cities in Hubei province have been 'closed', affecting c 57 million people, but another fortnight passes before other provinces and the rest of Hubei are 'closed', affecting c 230 million people. So, the idea that China acted rapidly and decisively, and hence prevented the worst repercussions of the disease is a myth.

According to the figures China reports to the WHO, the spread of nCOV started to slow down from the middle of February onward, after an anomalous (change in recording) spike of 20,000 cases over two days (12/2 and 13/2) had been reported. To-date (11/4) the total number of reported cases, deaths and active cases stands at c 85,000, c 3,300 and c 1,000 respectively, and the new cases run rate is about 50 per day on a total population count of c 1.5 billion.  In the meantime, the various movement and congregating restrictions (incl. on wet markets) have been relaxed. Things are almost back to normal.

Now, this makes no sense from a number of perspectives. First, let's take a look at how the epidemic panned out (pandemic, black pun) in Italy.

The first recorded case (cases, two) in Italy is that of two Chinese tourists in Rome on January 31. Flights to and from China are suspended immediately. A week later, a Milanese is also diagnosed to have contracted the disease; from where remains uncertain. Two weeks later, a cluster of 16 cases and another of 60 cases are reported in Lombardy (the province of Milan) and contiguous Veneto. The Italian authorities are again quick to take action. On February 22 eleven municipalities in Lombardy and Veneto are closed down – the 'red' zone. The cancellation of all sporting fixtures and public events quickly follows, but the disease equally quickly spreads across the whole peninsula and to the islands.

By March 11, the whole country is 'locked down'. A final measure on March 21 is the closing of all non-essential business and industry; everybody else staying idly at home. All to little avail, as the disease continues to rage, only starting to plateau at a rough rate of 5,000 new cases and 750 fatalities a day towards the end of that month. And to-date (Easter Sunday, April 12) there is only a faint glimmer of regression, with 4694 new cases and 616 deaths being recorded yesterday (admittedly a small bit of a spike above the rough rolling average of the last week of 5,000 cases and 600 deaths). The total toll so far: 152,000 cases and 19,500 deaths in a population of 60 million.

Put the two case reports side-by-side in a table and you'd wonder is it the same disease that is at work here at all; not for a minute suggesting it is not.


China
Italy
First Case (A.)
17/11/2019
31/01/2020
First Cluster (C.)
03/01/2020 (41 no.)
21/02/2020 (76 no.)
First Case to Cluster (A. - C.)
48 days
21 days
First 'Local' Shutdown
23/01/2020 (Huwan)
22/02/2020 (Lombardy)
Full Shutdown (D.)
14/02/2020 (Hubei mainly)
21/03/2020 (all Italy)
Time to Full Shutdown (B. - D.)
42 days
28 days
Reported Cases to-date
85,000
152,000
Reported Deaths to-date
3,300
19,500 (13%!)
Daily New Cases now
50
600
Active Cases today
100
100,000
Relevant Population
230 million (Hubei only, say)
60 million (whole country)
Deaths per million
15
325
The simplest and least controversial explanation for this enormous difference between the statistics is that for internal propaganda reasons, China is being economical with the truth. There would appear to be plenty of observed evidence for this.
In China the dead are cremated. Burials are banned. In Wuhan City there are seven crematoria with 84 ovens in total and according to LifeSiteNews, these mortuaries were advertising for additional staff to man night shifts and swing and weekend work from mid January onward, and lorry loads of urns (2,500 per lorry) were being delivered every couple of days. LifeSiteNews cites other 'very busy' indicators – no charge for cremations, no funeral services, no collecting of urns – from late January on till the end of March, but these could also all just be explained as fair and sensible in the circumstances of a deadly epidemic.
Tellingly, when the collection of the urns of deceased relatives was again permitted, over a window commencing March 23 and ending appropriately enough on Tomb Sweeping Day, April 4, 500 urns were released each day from the seven mortuaries (source: Radio Free Asia), so that is 42,000 urns. Subtracting the normal Chinese mortality rate of 0.7% per annum over say a two month period applied to the population of Hubei (60 million, same as Italy), the number of non-normal deaths comes to 35,000, a completely different figure to the 3,300 reported deaths for China as a whole to-date. Let's just sense-check: 84 ovens, 2 hour turnaround, 24 hours gives a theoretical daily capacity of 1,000 cremations a day; so 42,000 urns is six weeks output, working 24/7.
But we don't have to rely on just the speculations of a Canadian reactionary conservative, opinion-forming and therefore unlikely to be unbiased website like LifeSiteNews to make us wonder; Bloomberg and The Guardian too are happy to cast doubt on the Chinese numbers, citing leaked US Intelligence. Amazingly, The Donald doesn't put the boot in simply shouting fake news, but much more coyly simply suggests the numbers seem a little light. No need to shout? Must be true then.
And then there's common sense. The place is a dictatorship and the democratic rule-of-thumb familiar to us in the West of "do what you must to assure re-election" does not apply to its leadership. So, why would you take such completely economically devastating measures to save a few thousand or ten thousand lives, given you control the lives of 1.5 billion inhabitants and the long-term goal is world domination?
Let's say with inadequate/overrun healthcare the death rate of those who contract nCOV is as much as 5% (the WHO says it's no more than 2%). Dictatorially rationally, you'd have to be convinced that unchecked and before a vaccine can be developed (say 12 mo, I'm assuming the Chinese are ahead, see later) nearly everybody will catch it, before you'd decide to take measures that will reverse your annual economic growth from 6% or 7% to zero.
You can see a very simplified model of the two options below. Chinese population, GDP and growth numbers in 2019 are rounded to big figures and approximate for illustration purposes, and my 2020 base forecast before nCOV is also in rounded numbers. Population growth in China is actually 0.5%,and forecast GDP growth… well my estimate is as good as the next.

Population (m)
Population growth
GDP/cap. ($)
Prod'ivity growth
GDP
($ m)
GDP growth
2019 (approx.)
1,500
10,000
15,000,000
2020 (a forecast)
1,515
1%
10,500
5%
15,907,500
6%
2020 (1/ shutdown)
1,515
1%
10,000
0%
15,150,000
1%
2020 (2/ do nothing)
1,470
-2%
10,500
5%
15,435,000
3%
Underneath the 2020 base forecast then, you have the two nCOV response strategies:
1/ shutdown, which will leave population growth largely unaffected, but eliminates productivity growth for the year (if you don't work, there is no productivity), resulting in 1% GDP growth;
2/ do nothing, resulting in 2% population decline (1% growth less say 3% 'disparition' as the French call it – i.e. only 60% catch it before the vaccine is available), but no decline in productivity (everybody who stays alive and does work, keeps working) and thus GDP growth falls back from the base forecast, but is only halved to 3%, rather than decimated to 1%.
Yes, there are a ton of challenges you could make to this awful, simple model, not least of which is that productivity growth will return and in fact be stronger after the year of 'shutdown'. It probably will return, but will it be stronger? The disruption of complex supply chains and global business relations will be badly damaged. Things won't just start-up again as if nothing has happened.
On the other hand most of the people who will die will be pensioners (anecdotally: 90% of the deaths in Ireland to-date are over-65s; the median age of the deceased in Switzerland to-date is 83), so equating a 'do nothing' cull (which is what it would be) to a same fall in productive capacity is very pessimistic. I am 66, so I am not making these points lightly, and I am of course writing about the choices facing an autocratic regime.
I think then you have to conclude the Chinese leaders had reason to expect the very worst if they had taken the 'do nothing' option. Why would that be?
Let's go back to why they might have gone light on reporting the numbers, again. A more conspiratorial reason, than the great Chinese cause of internal propaganda, could be an international economic political one. "We caught a bad cold, and it is truly terrible; let's make sure our rivals catch pneumonia, by pretending our cold wasn't much." Especially since we know what really caused it, and we should have a vaccine to combat it soon. A global mass market opens up.
Scurrilous speculation of course, but there is reason to think they know more about wat is going on than they are telling. I'll refer to two separate publications:
1/ a paper by Pradhan, Pandet et al of the Biological Sciences school at the New Delhi Institute of Technology, with no particular axe to grind, about the microbiology of the virus, now retracted but still out there.  
2/ a report by an unidentified Professor of Neurobiology at Pittsburgh State in collaboration with Dr. Karl Sirotkin, a retired scientist with 30 years of experience in genomic sequencing at the Theoretical Biology Division of the Los Alamos National Laboratory and a former NSA counterterrorism analyst, i.e. by a less neutral team. The report has been widely published i.a. on Harvard to the Big House, on Simple Life, and on Your News. All of these on-line websites have an agenda, but not a particularly anti-Chinese one.
Pradan and Pandet's stuff is very bio-technical, but the essence is that nCOV is quite different from its sister corona viruses and from those hosted by the horeshoe bat. The jump from its known possible ancestors to the nCOV that is infecting humans is too big to have simply happened in the time available. I guess there should have been intermediate steps. Moreover, they suggest that nCOV has four 'inserts' similar to those in HIV-1. These 'inserts' improve the performance of the 'spikes' (the pointy bits sticking out from the spheroid shape in the pictures that then burrow into your cells). They insinuate no more than this, but it has to be said, many of their peers are quite scathing.
Karl Sirotkin is more of a secret agent than a biologist. Wuhan, of course, is home to the only BSL-4 virology laboratory in China. BSL-4 stands for Biosafety Level 4, the highest. Sirotkin reports that the lab's staff members Zhengli Shi and Xing-Yi previously worked at an American lab which had already bio-engineered an incredibly virulent strain of bat coronavirus. Zhengli Shi has a history of interest in corona viruses. A project of particular interest is the use of coronaviruses as a vector for an HIV vaccine. Sirotkin speculates that Zhengli Si may have been working on such a project in Wuhan and if not, more generally on what are called dual-use gain-of-function research. Dual-use means for good or evil.
Zhengli Si's track record in the US, according to Sirotkin, was less than meticulous when it came to hygiene and safety. Additionally, the Wuhan lab is known for "sloppy field research methods" and, as late as mid February 2020, the Chinese Ministry of Science "sent out a directive to all its labs emphasizing the importance of carefully handling bio-infectious agents, alluding to slack oversight and past lapses, mentioning coronaviruses specifically." There is loads more in Sirotkin's report, but you get the picture.
So, there you have it:
·         The horseshoe bat hibernates.
·         The Chinese authorities have left the Wuhan wet markets re-open.
·         People haven't stopped eating pangolin.
·         Wuhan's BSL-4 viral laboratory works on corona virus research (it's the main game in town).
·         The lab and two named employees have an imperfect record on hygiene and safety.
·         The new nCOV virus is an unusual/unlikely natural mutation.
·         The reported Chinese numbers on the nCOV outbreak seem light.
·         The autocratically rational response if the likely death toll is light (2%) is not to shut down.

It started in China.

1 comment:

  1. So my query. 🤔
    Of all the viruses we have lived through and some were major killers why has this virus got us locked down in our homes in fear, locked away from our loved ones, out of jobs, not able to move freely, not allowed out of our Country.
    Would be interested in your opinion.

    ReplyDelete