Virus death rate summons a huge, historic alarm
COVID-19 ‘knows no borders’: Officials anticipate outbreak in Canadian community
Amid reports of the novel coronavirus’s devastating effects on global health and welfare, the worst news this week seemed to be a simple little number. The death rate for known cases of the Wuhan virus, or COVID-19, is now measured at 3.4%, higher than earlier estimates, and several times higher than seasonal influenza.
More than 3,000 people have died out of more than 90,000 cases, and although the outbreak is largely confined to a few countries — China, Iran, Italy, South Korea — the nascent outbreak is becoming “increasingly complex,” said Tedros Adhanom Ghebreyesus, director-general of the World Health Organization.
He meant that the initial focus on cases and clusters has now shifted to the third “C" in the WHO’S advice to national governments: community transmission.
Community transmission hasn’t happened in Canada yet but a new government emergency committee expects that to change.
“We can anticipate that there will be an outbreak in one of our Canadian communities. This is a virus that knows no borders and that is growing,” said Health Minister Patty Hajdu at a news conference on Wednesday afternoon.
What once seemed to be a series of disease clusters that could be isolated and contained — as on that ill-fated cruise ship in Japan, whose Canadian passengers are set to be freed from quarantine in Cornwall, Ont., on Friday — now seems likely to become a pandemic that can only be managed as it follows its own course throughout the world.
This realization has kicked off a panic and heralded a new normal among the worried public.
Handwashing has become a novel virtue. Sneezing is newly anti-social behaviour. People who touch their face might just as well lick a doorknob. Masks are as common as scarves and about as effective for the general public, who tend to misuse them.
After weeks of skepticism and sanguine reminders that this is just another cold virus, an urgency has set in.
This is curious, as the WHO’S declaration of a global health emergency in January passed without causing similar upset, in part because the designation was then a borderline judgment call, first rejected then accepted within the same week.
That has all changed.
In what was widely described as hitting the proverbial panic button, the U.S. Federal Reserve cut interest rates by a half percentage point, but that was not enough to prevent a massive slump in stocks.
Canada followed suit on Wednesday. Finance Minister Bill Morneau warned that businesses were likely to suffer interruptions to supply, and demand from customers unable to shop under quarantine or depressed economic activity.
Italy closed all schools and universities for two weeks until March 15. Los Angeles declared an emergency of community transmission. New York City registered its first few cases, including one of unknown origin. In Britain, public health authorities were considering telling people to stop shaking hands.
The virus is out and about, and causing trouble, for companies as much as people. Lufthansa grounded 150 planes because of its effects on their business. The producers of the new James Bond movie delayed its spring release to the fall. Shopify cancelled a conference in Toronto in May. Australia was struck by a supermarket run on toilet paper by people anticipating quarantine or shortages.
All this has prompted concerns that the panic volume is a few levels too high for the actual crisis.
“As Canadians, if we can maintain our sang-froid, we should be fine,” said Heather Macdougall, a medical historian at the University of Waterloo, and an expert in the history of pandemics including the Spanish Flu pandemic of 1918 and Toronto’s SARS outbreak in 2003.
“The unknown is so much more frightening than the known,” she said. The trick is that the unknown is not necessarily more dangerous.
For one thing, the interest rate cuts are less expressions of panic over the virus than reflections of changes to global manufacturing patterns, Macdougall said. If Chinese manufacturing slows down, everything slows down, and the business world is at risk.
“It’s fascinating to think that a disease could cause this challenge to an economic system that is so heavily interconnected,” she said.
After SARS, the Bank of Canada estimated the outbreak cut gross domestic product by 0.1%, a loss that was soon recovered. On Wednesday, similarly, markets rallied strongly, in part because of the rate cut.
For another thing, COVID-19 is a pretty mild illness most of the time, not much more than a cold for healthy people. And the true number of cases is certainly under-reported, so the true overall death rate is lower than the current measure.
More countries do not have cases (119) than do (75), according to the WHO. Of the countries that do have cases, more than half have fewer than 10.
SARS had a much higher death rate, but was less easily spread, so with fewer cases to deal with, containment made for a better strategy and in time it was snuffed out without spreading much beyond Toronto.
Macdougall described SARS as a study in a health system being overwhelmed, with no answers to the central questions until the whole thing was over. With the novel coronavirus, however, the key questions were being asked and answered from the beginning, informed by previous experiences with SARS and the more recent Middle East Respiratory Syndrome.
In SARS, it was not until quite late in the outbreak that the virus was even identified, compared to this time, when the Chinese had identified it within a few days, and shared that information.
“Big difference if you know what you’re looking for,” Macdougall said.
So the future of COVID-19 is likely to look something like past pandemics, which is to say it will peak, then pass.
She noted that stories of price-gouging on hand-sanitizer and face masks recall stories in the Spanish Flu outbreak about profiteering and hoarding of garlic and camphor, which were thought to be preventatives.
“Human nature is what pretty much stays the same,” Macdougall said.