How serious is the coronavirus?

logo March 14th, 2020

How serious is the coronavirus?

coronavirus masks

Take precautions, keep calm, and carry on REUTERS

Most cases will be mild, but the elderly may need special care

The coronavirus (Covid-19) has struck, starting in China and spreading rapidly around the world. This is the latest in a series of coronaviruses that have emerged in the past 50 years.

Early in the 20th century, another virus, popularly called the Spanish flu, swept the Earth killing 50-100 million persons in the course of two years.

The explosive impact of this virus arose from the fact that the world was at war; in 1918 the war was ending with massive movements of people soldiers and refugees around Europe. Four empires had collapsed: The German, the Ottoman, the Austro-Hungarian, and the Russian. Governance in Eastern Europe and the Middle East had collapsed. Soldiers were gathered together in large numbers in close proximity to each other.

Desperate refugees banded together to seek food and shelter. In 1918, the Earth’s population was about 1.8 billion. Perhaps half of this population caught the Spanish flu. The implied death rate is about 5%. That is, if you got the Spanish flu you had a 5% chance of dying. In modern times, this is the worst infectious disease to hit humanity.

Death rates depend on medical facilities and the age distribution. Old people are much more likely to die than young.

Now there are 7.8 billion people on Earth. The population has increased more than four times since 1918. We have improved our knowledge of viral diseases manifold. But there is no medicine to treat the flu or related viruses.

The vaccines used for the flu are based on the last flu virus that circulated in the West. But the viruses mutate and next year’s virus may be different so the vaccine may be less effective.

We have never been successful in developing a vaccine for HIV/AIDS. There is no medical method for preventing contagion if there is no vaccine; and with unstable viruses, the vaccine that is developed may not be effective in the future.

The simple way to think about infectious diseases is to focus on two numbers: First, the number of people that an infectious person will infect over some period of time. The second is how many infected people die.

If there is no effort to break the transmission, I assess the available estimates are of the order that one person infects two persons over a 14 day period; these estimates imply that about 700 million people, or about 9% of the Earth’s population, will be infected over a year. The best available data on mortality seems to come from South Korea and it implies that about 0.6%, or about 4.2 million, of infected people will die.

There are many other higher estimates. The difficulty is that in the absence of widespread testing, one does not know of many infected people who are not particularly sick. This is much less than the mortality rate of the Spanish flu. There are other much higher estimates of death rates, but I believe the Koreans have the more extensive testing program compared to China.

If these numbers are applied to the US, there would be 28 million infected people and 170,000 deaths. This is small compared to the Spanish flu. In 1918, the US population was 103 million, and 600,000 people died from the Spanish flu. The death rate was about 1.2%. We summarize death rates: Spanish flu in US 1.2%, Spanish flu worldwide 5%, coronavirus (Covid-19) 0.6%; ordinary flu 0.1%.

The purpose of quarantines and reduction of public gatherings is to reduce the number of people that an infected person will give the virus to. Washing your hands is supposed to have the same impact in reducing the chance that you receive the virus if it is in your vicinity.

One must be cautious in assessing the seriousness of the pandemic that has hit humanity. In the case of the Spanish flu, there were three waves. The first, relatively mild. The second, horrific and resulted in most of the deaths. The third was less lethal.

Viruses mutate readily, and climatic effects are difficult to work out. This current pandemic is very dangerous and obviously must be taken very seriously.

The rapid spread is a consequence of the increasing interconnection of our world. The economic impacts are enhanced due to the tremendous increase in the interactions of different countries in the supply chains.

Globalization has increased the economic welfare of almost everyone. The price we pay for this improved welfare is the increased danger of a breakdown in this interconnectedness. Our world is more and more vulnerable to the network effects.

Consider the impact of mobile telephones on Bangladesh. This utility has literally changed everyone’s lives. Imagine doing without your phone for just one day. The more complex the system, the greater the chance of a system breakdown.

The breakdown may come from our inability to realize the complexity of the networks we build or it may come from an attack on our systems. Humanity in 2020 really cannot live without electricity, international airline connections, telephone service, internet access, and the giant databases that support our societies.

The medical problems associated with the virus are probably exaggerated. Most cases will be mild and have little impact on the patient. Estimates of the number of cases in different countries are not based on biological testing of the population. Artificial Intelligence methods are of limited validity as there is not enough accurate data to train the AI program.

We see the people that get really sick, but we do not see those who have very mild cases. Vulnerable populations are the old and persons with impaired health conditions. The public health message should be that almost everyone is going to be all right, but special care is really only needed for the old and persons who are otherwise sick.

The conclusion is that this virus is very serious but not a real disaster. The message is to stay calm and go about your life. If you are old, stay inside and avoid public gatherings.

We should fear a mutation into a virus that kills a higher proportion of its victims, but that is out of our hands. Bangladesh should have plans for managing pandemics.

Public health authorities should prepare such plans, determine the money that is needed and how it will be raised; there should be regular training of doctors (we are talking about 3-4 hours a year).

We are a long way from being able to carry out the systematic testing of biological conditions, but AI programs can be improved. Implementation is a problem. The only organization with the resources and discipline to do an adequate job is the military. If the political authority determines to turn over implementation of the plan to the military, then the military should train to do this assignment.

Unless there is a mutation into something more dangerous we can give thanks that it is not worse. There is really no need for the hysterical reactions that are taking place around the world.

Forrest Cookson is an American economist.