Whack a mole

My 7/30/2020 blog compares SARS vs COVID-19 outcomes.  My earliest predictions about COVID-19 were also heavily influenced by the SARS experience, e.g., reflection in the 3/15/2020 blog.  Curiously, whenever I tied COVID-19 to SARS, the predictions would turned out wrong.  Like thinking COVID-19 tolls would be lower than SARS (wrong by early Feb), or the West would contain COVID-19 better than China (wrong by mid Mar).  But when I contrasted COVID-19 to SARS, the predictions would stand.  Like the fatality rate, and COVID-19 being long-lasting.  A separate, early notion was that Wuhan lockdown was too harsh.  As reviewed in the 5/2/2020 blog, rollout of the lockdown and the ensuing panicking was undoubtedly flawed and undesirable, but it was a new situation, and nobody had any experience. 

In a typical fashion the West has bashed the Chinese response to COVID-19, although no criticism has cut the mustard (6/3/2020 blog), unless one demands that China must be perfect or a saint (7/18/2020 blog).  But misinformation is widespread and considered gospel, even among people who should have known better.  For example, even though the left, and most scientists and doctors, probably don’t believe, like the right-wingers do, that COVID-19 was made by the Chinese lab, they still tend to think China was hiding sth early on.  The Lancet editor-in-chief, Richard Horton, has consistently praised the Chinese actions and strongly criticized COVID-19 situations in the UK and US from the beginning.  He obviously knows the history, as the earliest and most influential papers on COVID-19 have been published in Lancet, by the Chinese, by late Jan or early Feb.  But even he thinks Dr Li Wenliang was an example of Chinese hiding sth.  Anthony Fauci likewise has similar misgivings.  In a sense they are victims of the Western media, because whenever sth is not scientific in nature, they lack the ability to judge.  They don’t read Chinese, while the Western media has a narrative and format to filter and tell stories about China.  The Western news crew in China doing an awful job is no secret.  It is well-known that some staff don’t even speak Chinese, or if his Chinese is merely passable, he often doesn’t understand the subtle meaning in Chinese.  No wonder a lot of mistakes translating Chinese to English or else.  And they never report Chinese news without filters in real time (who can trust the Chinese media, right?), so what their audience see is almost always late, incomplete, and distorted, enforcing preexisting perceptions, because otherwise it is not China.  Even when one has a good understanding and reporting, how will his editor in the West react?  Can one say something good about China without being labeled a Chinese mouthpiece or worse?

The misinformation about Li Wenliang can be parsimoniously explained by most people in the West not reading Chinese and easily manipulated by the media in their own countries.  If one followed the Chinese news in real time, including Li’s own words during interviews and on social media, he would know it was a minor incident that had no bearing on how China dealt with COVID-19 (3/16/2020 blog).  Li was given a warning by the local police because one of his private WeChat posts was made public, which said it was SARS.  Don’t we all wish it were SARS!   But even if one doesn’t read Chinese, he can still dimiss the hide-sth claim, considering all the well-publicized events.  The Wuhan Health Commission issued an alert to all Wuhan hospitals on Dec 30, 2019.  Various Chinese media reported it on Dec 30 and 31.  Li’s SARS post was on Dec 30, and he was warned by the police on Jan 3, 2020.  One can debate whether the police should have done that or not, but the fact remains: Li’s post might be seen by a few hundred or thousand people, while the Chinese news reached hundreds of millions of people.  That the local police censored Li in order for China to hide COVID-19 is beyond absurd.  I heard of the disease before the New Year, but not Li until late Jan.

Another beef is that China was too slow to warn the world, like wasting a grand total of 6 days(!!!) about human-to-human transmission (4/15/2020 blog).  This is more complicated than Dr Li’s story, because it involves certain professional knowledge, although the conclusion is no less clear-cut.  All dissected in 6/2/2020 blog: much of the “delay”, if any, merely shows that scientific discovery takes time.  Give an example in human history that a brand new disease has taken fewer days to characterize than COVID-19.  Answer: None, not even close.  Importantly, the Chinese timeline is consistent with the careful studies required (6/2/2020 blog), and information reported by the Chinese has been proven correct and formed the bedrock and gold standards of COVID-19 control and research around the world since then.  The more one thinks about it, the more one appreciates the work: it all happened during the height of the cold/flu season, when at least until late Jan most patients had just common cold or flu.  Hindsight or hunches are meaningless to diagnose COVID-19 on the fly: one needs real evidence.  And blaming China is holding China to a higher standard than anybody else: how many days did the West, like the UK or US, waste?  Draw an easy red line on Jan 23: because of the historic Wuhan lockdown, the UK or US should have known about COVID-19 by Jan 23, even if they knew nothing before Jan 23 due to the supposedly Chinese "coverup".  What did they do from Jan 23 to mid March?

But how about those dreadful Chinese travelers?  My 7/18/2020 blog analysis showed that it is pure red herring: there is no evidence Chinese travelers caused any lasting COVID-19 transmission in the West.  Early cases were identified and contained, by the low hundreds, from mid Jan to early Feb.  By late Jan or early Feb many countries had already banned Chinese entry.  The West experienced outbreaks only in late Feb, and their genomics finds no trace of the first COVID-19 viruses from Wuhan.  No one is sure the outbreaks have zero link to Wuhan, but clearly there was many weeks’ of time for the West to prepare for COVID-19.  Yet perhaps the most decisive rebuttal, which the West likes everybody to forget, is the fact that 99.9% of the people from Wuhan traveled to the rest of China.  Why didn’t the whole China blow up?

Rumors exist no matter what, and whack-a-mole, even if necessary, is ineffective.  COVID-19 is also persistent, but whack-a-mole is the new way to suppress low-intensity COVID-19, as many countries are now experiencing.  

China has been using this strategy against domestic COVID-19 outbreaks since March.  More targeted lockdowns, and intense testing.  In April it happened in the Heilongjiang province (https://wwwnc.cdc.gov/eid/article/26/9/20-1798_article).  The origin was traced to an importation from the US, and led to ~ 90 cases.  In May it was the Jilin province, ~50 cases.  In June it was Beijing, ~ 400 cases, link to the Xinfadi Wholesale Market.  In July, it was Dalian city, ~ 100 cases, originated from a seafood company, and Xinjiang, ~800 cases, from a wedding.  The origins of Jilin, Beijing, Dalian, and Xinjiang outbreaks are unknown.  Genome sequencing indicated that the viruses were first reported in Europe.  The Beijing and Xinjiang viruses are the same, suggesting that a carrier traveled from Beijing to Xinjiang, although other possibilities remain.  An interesting aspect is that the seafood connection: the Wuhan Huanan Seafood market in Dec 2019, Beijing Xinfadi, whose seafood (often imported) section revealed viral RNA, and the Dalian seafood company, which processes seafood.  At this point it is hard to draw a conclusion.  Packaging from imported seafood sources has been tested positive in China.  Infections at the Dalian seafood company might be similar to those of meat processing plants around the world.  Also, maybe the virus likes the cold environment, and people get infected more under the condition.  But one is quite certain now that the Wuhan market is the site of the first known superspreading event.  

Nobody can completely eliminate COVID-19; the job is when sth comes up, trace and isolate a lot of people quickly, to keep the level of infections manageable.  Whack-a-mole is better than whack-many-moles at once.  Today’s Chinese response is different from in Wuhan or the whole China during Jan and Feb.  A more limited quarantine effort, but coupled with testing to the point of excess.  In May Wuhan tested 10 million people, an expensive exercise with a dubious cost-benefit relationship (5/12/2020 blog).  Then in Beijing in June, another 10 million were tested.  In Dalian and Xinjiang, some people were tested 3 times or more, amounting to ~ 5 million total tests each.  Perhaps by testing the same people over and over, Dalian and Xinjiang were able to find infections more thoroughly than prior outbreaks.  

China announced that by the end of July it has the capacity of testing 4.84 million people per day.  Even if it is 5-in-1 pool test, it is still almost 1 million.  It is highly questionable whether the recent testing from Wuhan to Dalian is not an overkill.  Granted, perhaps most were pool-tested, but still, it uses up a lot of work, manpower, time, money, and reagents.  Testing also uses toxic chemicals and produces toxic waste.  From the Jan 23 lockdown to saturated testing now, the Chinese responses have been on the excessive side, compared to the rest of the world.  It is better to save the efforts and materials for the fall and winter, when COVID-19 may come back harder.  

Still, hearing Trump boasting daily the US did the most tests is funny (7/18/2020 blog).  In so many ways.  Conducting the most tests confers no gold medal.  Much prefer fewer tests because of few infections.