Looking back at 2020

When my Jan 26, 2020 blog started with “The biggest news in the young 2020” being COVID-19, even that turns out to be the Understatement of the Year.  Over the next 11 months new findings and developments emerge fast and furious, old ideas dispelled, new consensus forms, old and new predictions get thrown out, verified, or refined.  There are still plenty of unknowns, but the year 2020 has given people plenty to think about, and to reflect on one’s knowledge base and belief.

My earliest blogs got a few things wrong, all in the direction of underestimating COVID-19 (dissected in the Mar 15, 2020 blog) and predicting the West could get it under control easily or the US deaths wouldn’t go beyond 100K (May 23, 2020 blog).  All residual optimism evaporated by June, when it became crystal clear that the US couldn’t suppress it in the summer.  I bet in the beginning most people were in the same league of not seeing the COVID-19 as badly as it has become.  This is likely because of the SARS experience, analyzed in the July 20, 2020 blog.  Humans probably got a bit lucky with SARS, but our luck ran out for COVID-19, which is inherently harder to tackle than SARS.  There are quite a few success stories against COVID-19, so COVID-19 wasn’t always destined to be the most intense pandemic for the last 100 years, in Jan 2020.  COVID-19 doesn’t cause the damages by itself; the human factor has at least as much say as the virus, because many peoples and countries haven’t done the necessary, hard work (July 18, 2020 blog).

My blogs, even early on, also got many things right.  The Jan 26, 2020 blog said the real mortality rate is below 1% (the consensus now is around 0.3%), and that COVID-19 will stay with humans, unlike SARS.  My Mar 15, 2020 blog wrote that the “moral combat” by the US against China prevented the West from better preparation for the pandemic, which might lead to another 1929.  Now the whole world has witnessed the damages.  My Aug 11, 2020 blog predicted we will have vaccines, which will all work similarly, despite all the West’s “concerns” about the Russian and Chinese vaccines.  Since Nov 2020 we have had good data for vaccines from Pfizer, Moderna, Russia, Oxford, and China, and expect to see more, which will bear out this prediction more and more.  Then, I also said the Trump voter fraud case was crap (Nov 28, 2020).  Now the SC had shut it down.

There remain a few things unsettled, some because it is still too early, some because it is not purely scientific in nature, and some because there are no parallel universes we can see.

One of them is: what is the best way to handle COVID-19, with a feature question being: could the Wuhan lockdown have been handled better or differently (May 2, 2020 blog)?  The short answer is of course, but the real question is: how?  The frenzies and chaos in Wuhan have been well reported by the Chinese media since Jan, and even an official documentary shows many hard data and evidence (Sept 7, 2020 blog).  But nobody is perfect, and judgments can’t form in a vacuum.  There are comparisons: how well have other countries performed?  There are precedents: what did people do in similar situations in history?  Lastly, being the first to learn and do everything new is much more difficult than being the 2^nd, 3^rd, etc, one month or two later.  Everybody can talk a good Monday morning QB, but someone needs to throw the ball on Sunday night.

Another is of significant scientific interest, the origin of COVID-19 (July 7, Nov 7, 2020, and others blogs).  We might not get the answer for a long time, if ever, and that is before politicization making it even harder.  With science and historical precedents as the guide, no body or country has been blamed for any pandemic.  Humans have had hundreds of pandemics, and AIDS has killed 40 million people since 1980.  The closest and most consequential parallel was the European settlers bringing smallpox and other diseases to the Americas, annihilating the native populations.  Only the native Americans had paid a price.

With the political blame game out of the way, what have we learned or improved on since Jan?  A lot, actually.  The Huanan Market in Wuhan, the focal point in the early days, was a superspreading site, but almost certainly not the origin.  By waste water, Ab, and limited RNA testing (https://wwwnc.cdc.gov/eid/article/27/2/20-4632_article), COVID-19 could have been global by late 2019.  Definitely not to shame Wuhan, Italy, Spain, or any other places, with science always having to cast a wide net.  Bats exist everywhere and harbor many viruses, some bats fly over 1000 km, so if there is a bat mixing and “relay”, theoretically, no place a virus can’t go around the world.  Moreover, if the COVID-19 virus is “guilty”, its predecessors are “guilty” as well.  Following this line of logic, there is zero validity blaming anybody for starting COVID-19, a natural occurrence.

If COVID-19 had existed widely in 2019, why didn’t the pandemic start until 2020?  Consensus now is that superspreading events drive the pandemic, as 80% of the total cases are transmitted by 10-20% patients.  Yet superspreading events are relatively rare, and never assume an infection will automatically lead to another, because most of the time it does not.  So a low grade transmission can be easily missed when nobody heard about it.  Maybe a superspreading event at Wuhan, a large city with strong medical infrastructure, coupled with SARS alertness, led to its COVID-19 discovery (July 20, and Sept 10, 2020 blogs).  Absent one of those priming factors, the virus could have flied under the radar longer.

A new finding has multiple implications (Oct 17, 2020 blog).  One is how COVID-19 can transmit over a long distance, e.g., by air or across oceans, through objects, the other is how to reduce transmission further, e.g., after vaccines.  Scientists around the world have shown that the virus or at least RNA can persist on cold surfaces for days to weeks.  China has done the most testing on actual goods and linked cold food packaging or product handling to human infections.  While more studies are needed, it has become unavoidable to conclude that many if not most recent domestic infections in China were sourced to contaminated imported materials.  The Western media want their readers to think here is another Chinese ruse to demonstrate foreign origin of COVID-19, even citing some scientists or WHO that surface transmission is rare, but the West may be traveling down the same, dangerous path of ignoring findings from China, just like how they ignored the data from China and Wuhan lockdown in Jan, but blamed Chinese coverup nonetheless. 

Nobody says surface transmission is common: when you have 20K or 200K daily new cases, surface contamination is the last thing you need to worry about (Oct 17, 2020).  But China has been in a different situation since late March, as even a single spark is big news.  Once you eliminate the usual suspects, you go down the list to find the unusual causes.  In addition, China has been doing city-wide mass testing since May (August 6, 2020 blog).  While failing the cost-benefit analysis, it nevertheless constitutes an expensive experiment best for sourcing and tracing.  So far China has found ~ 100 positives from imported sources, suggested few than 10 COVID-19 clusters as a result, and ~ 5 with strong evidence or links.  Again, China was able to do this or find the evidence only because Chinese domestic transmission has been essentially zero for months. 

The usefulness of this will be apparent once vaccination reduces cases dramatically, as in 2021 more countries will be like China right now.  In fact, cold food packaging and transport is not limited to international trade at all.  In the spring many meat processing plants in the US had had major outbreaks, with hundreds of infections per site.  One has to wonder that how they contaminated the meat packaging, and how it led to infections during transport and at Kroger, etc.  No one has looked at this in the US or elsewhere but China, a glaring omission!   

Studying object-to-human transmission gives us a new angle to look at how COVID-19 spreads, domestically and internationally.  Generally speaking, there should be significant infections occurring at the source of the goods, a condition well satisfied currently.  But how about in the early days, e.g., before humans even knew about COVID-19, when the infections were likely minimal?  In other words, is it possible that somebody who was infected handled cold food (packaging), which led to infections in a different country?  But then why didn’t he infect others around him, triggering an alarm locally instead, since humans are much better virus carriers than goods?  Ultimately, we need to realize that while pandemics are common, any particular infectious disease is rare, for COVID-19 being what it is invariably involves a lot of (bad) luck.  That is, a lot of statistically rare things must happen before COVID-19 turned up.  In this regard, object-to-human transmission is not as far-fetched as it sounds.  Just have to treat this as a scientific exercise instead of a political football. 

Still hard work ahead, but tired and exhausted, few people will feel bad leaving behind 2020, whatever 2021 will bring.