One disease, two phases. Or three.

COVID-19 started in Wuhan, China in late Dec 2019.  Panic, which I was more worried about in Jan 2020, has become a reality all over the world.  I’d never had thought I would see so many empty shelves in so many stores for a week now in the US.  

The disease has, so far, two distinct phases.  The first is to about Feb 20.  The second is till now, and ongoing.

The first phase is more or less like SARS in 2003.  Most cases were in China, with the most restrictions applied.  In 2003, when it was over in China, it was all over in the world, and we haven’t seen SARS since.  For almost two months COVID-19 seemed to be on the same but faster trajectory.  China had 75000 cases, 2500 deaths, while most other countries had single- or low double-digit cases.  By Feb 20, China had clearly turned the pages, with significant, overall drops of new cases, and many provinces 0 or close to 0.  Compare this to the 2003 SARS struggle lasting 6 months.  

The second phase started with the dramatic new cases in South Korea, then Iran and Italy.  By Mar 1, the US and many other European countries.  At this moment, no end in sight.

Humans have always had pandemics.  Cholera, influenza, AIDS, and many others.  Is COVID-19 any different, or how is it different from or worse than its relative, SARS?  There are three major contributing factors.  The first is that COVID-19 is milder than SARS, yet many patients have few symptoms but are still infectious.  This makes it harder to identify and sequester.  The second is that the degree of globalization is higher than in 2003.  But humans had had pandemics before, throughout history.  The third is political: China and US have a much worse relationship now than in 2003.  In 2003 the US and the West were preoccupied with wars in Iraq and Afghanistan.  In 2020 the US has been waging an economy and propaganda war against China for three years.  So when COVID-19 broke out in China, the media and politicians in the US and the West so dutifully and gleefully watched a horror movie and bashed from afar that they forgot to prepare for it.  And then when it hits, of course it is still China’s fault.  The current panicking is more a consequence of these governments’ actions than of the virus itself.   Strongest evidence?  See when exactly the stock markets started to drop precipitously.

Clearly there are blames all around.  For China, the first mistake is why subsequent research has been so lacking after SARS.   An excuse is that SARS is gone since 2003, and MERS didn’t affect the mainland.  Still, we know other coronaviruses cause problems, and new viruses can jump to humans.  More focused research could have yielded better diagnostics, drugs, or broad-spectrum vaccines.  The second is regulation of wet markets.  But this problem is more complex than most people realize: a blanket ban of eating wild animals?  I don’t know of any country where no wild animals are not consumed.  How does one define “wild animals” anyway?  Fish you caught, wild ducks you shot, deer?  The list is endless.   The third is whether the Chinese government could have acted quicker, say imposing restrictions earlier than Jan 23.  Much documentation about it has long been in the public domain, and my earlier blogs had elaborated on it extensively.  The fourth is whether the lockdowns in Wuhan and other places are worthy.  Nobody can dispute its result of shutting down virus transmission, but how about the cost?  This could have been the end of the story, except COVID-19 is no SARS, and we are now in phase two. 

In phase two, many of the affected countries are more medically or technologically advanced than China, and have a lower population density.  Most importantly, they have more than one month’s time and all the knowledge needed to prepare.  Since Jan we have known what the virus is, the symptoms, carriers, transmission, treatments, and one unprecedented example of how to contain it.  The only things left to discover is whether we can identify better drugs, treatments, vaccines, and whether a less harsh way than the Wuhan lockdown will suffice.  Indeed, measures adopted by other provinces in China soon after Jan 23, less drastic than in Wuhan and Hubei, were able to contain COVID-19 and keep the fatality at 0.9%.   Unfortunately, much of this was oblivious to most Western countries.  First they failed to test and identify potential carriers since late Jan when they reported their first cases.  This was actually in retrospect where Wuhan failed in the first half of Jan, although much of it was due to not knowing the virus and the disease characteristics then.  Because of prevailing attitudes of the media and politicians, who were and still are more than eager to blame others, ordinary citizens thought it was merely a problem unique to China, and that would never happen here.  And then one month later, everybody was stunned, but should he really be?  

All the negative descriptions of China over the years, especially the last three years, by the politicians and media, have not swayed China, but have succeeded in poisoning the well in the West.  Public opinion is that China can do no right.  Cover-up is default.  Lockdown is just another attempt to repress human rights.  Which of course will never happen here.  It is mind boggling that the tremendous efforts and tolls in China since Jan 23, 2020 failed to ring a bell for a majority of people.  This political and media virus is now having its invisible but much bigger toll.

One thing is clear: COVID-19 can be contained.  For most of China, except Wuhan and imported cases, COVID-19 is effectively over.  As written in my Mar 5, 2020 blog, even though the same lockdowns in China are not applicable everywhere, many countries have their own advantages in infrastructures.  So all hope is not lost.  But the real danger lies in politics and panics created by the actions of these governments and citizens.  It is now believed that reactions after 1929 made it worse and longer.

There will be phase three of COVID-19.  It is not going away, at least not like SARS.  It will spring up here and there from now on.  Without a vaccine, humans will have to live with it.