The novel coronavirus’ unexpected and massive spread across the world has shaken the West to its core, prompting many to ask the question: why this disease? Why not Ebola, or SARS, or any of the other strains of the flu that come about every season? What is it different about the coronavirus, and our clearly inferior response, that has the world reeling?
You can blame politics; you can blame China; you can blame Trump. In America, you can blame the outdated and obviously lethargic Center for Disease Control for ineffectively mobilizing to defeat the virus as soon as it arrived on Western shores. All should share in some blame.
But the truth is, the novel coronavirus itself, and the factors surrounding its origin, contain some unprecedented characteristics that made the disease difficult to predict and stop from the very beginning. And, the signs that we did get were based in faulty statistics that drastically underestimated the disease’s capabilities to wreak havoc on the global ecosystem.
The R0 Factor
The R0 Factor signifies the average number of people that a person with the coronavirus will pass it to. Initial estimates by the World Health Organization pegged the R0 factor between 1.4 and 2.5 (meaning that an infected person will spread to between 1.4-2.5 other people). However, followup research in January by a team of researchers led by Swedish health professor Joacim Rocklov revised that range upwards to between 1.4 and 6.9 people. The initial underestimation of COVID-19’s contagiability led to a false sense of security by world leaders and possibly contributed to its more relaxed approach to the virus.
This range is far more concerning due to the now-prevailing consensus that COVID-19 spreads faster than the notoriously fast-spreading SARS disease (which is in the same family as COVID-19) during its Chinese outbreak in 2003-2004. With SARS claiming 8,000 infected and COVID-19 claiming over 200,000 now, that increased R0 factor has been proven correct in real life. The original SARS outbreak had an R0 of 4.
The other recent disease of note that was eventually contained, the 2014 Ebola outbreak, only had an R0 of 2. The coronavirus is well on its way to getting a much higher contagiousness label.
The Potential Asymptomatic Carrier Function
What makes this disease even more dangerous than its previous recent counterparts, however, is the discovery of its contagiousness through asymptomatic carriers as young as pre-teens. “Asymptomatic and mildly symptomatic transmission are a major factor in transmission for COVID-19,” says Vanderbilt professor of medicine Dr. William Schaffner.
Asymptomatic carrier transmission is truly unprecedented in the history of recent disease, to the point where Health and Human Services Secretary Alex Azar denied such a capability as late as March 1st. An outbreak in Massachusetts was initially started by an asymptomatic carrier, the state Department of Health asserts.
Neither SARS nor Ebola were contagious before symptoms, and Ebola couldn’t be transferred except through bodily fluid direct contact – meaning it couldn’t be contagious through the air or through coughing or sneezing. This enabled governments to quickly get a hold of Ebola cases and quickly quash its spread. In contrast, COVID-19 can pass to others through any of the above means – making it much harder to isolate and control.
Even more damning is COVID-19’s long incubation period over 2 to 14 days with an average estimate of 5.1 days – during which time it is still contagious. Compare this number with the incubation period for the common flu, which is 2 days. This extended lease on asymptomatic contagiousness makes COVID-19 even harder to track and contain than other diseases of its time.
The Origin and Spread
The geography of COVID-19’s initial spread and its timing of arrival also played a huge factor in making it a truly crippling disease to the entire world. Although you likely had not heard of Wuhan, China before the outbreak of this disease, the reality is that the city of 11 million people, called “The Chicago of China” by international observers, is one of China’s biggest railroad and transportation hubs. It is quite unfortunate that the deadly coronavirus decided to make Wuhan its epicenter, because the city is quite literally the Gateway across all of China and the rest of the world. As Chinese authorities suppressed information of the disease in its early stages, the coronavirus was allowed to make its way across multitudinous railways, waterways, and roads and infect thousands.
This is simply an unlucky event. The Ebola virus began in the much more socially and geopolitically isolated West African region, which impacted poorer regions of the world but also limited its spread. The SARS virus first impacted Southern China in 2003, but at a time and place where China was less socially and infrastructurally developed than it is today. We live in the most globalized and interconnected time in human history. The confluence of the time and place of origin compounded the virus’ spread.
And of course, the coronavirus is a deadlier strain of virus than others like it. The common flu has a death rate of 0.1 percent, while the coronavirus’ death rate appears to be larger – at least 10 people per thousand infected (1 percent).
Part of this reason is because the COVID-19 virus has mutated in a number of innovative ways to penetrate more deeply in the human body than other diseases. The deadliest innovation is a protein found in a virus that latches onto a human enzyme called furin – which is found all over the human body. This allows the virus to penetrate both the upper respiratory and the lower respiratory systems, which is rare for a disease of its kind. Upper respiratory diseases tend to spread more quickly but have milder symptoms, but lower respiratory diseases tend to be less contagious but inflict greater damage to the body. COVID-19 is unique in that it afflicts both systems.
Now we live in a new era, one of social distancing and the closure of businesses across America. Some Americans question the supposedly “extreme” approach that our government is taking to prevent the spread of this highly pathogenic and damaging virus. Yet, our approach is sound and right. Any less cautionary approach would be gambling thousands of lives for the sake of a few weeks of comfort.
Nassim Nicholas Taleb, mathematician and venerable risk analyst, first noted back in January 26th, long before the coronavirus “officially” hit Western shores, that the virus has a potential for a multiplicative effect with few ways to stop the disease if it really got going, advocating for a “precautionary principle” that cut off access to the disease before it could multiply as it did in Wuhan. Then, on February 2nd, the Trump Administration instituted a travel ban with China, which likely mitigated the initial onflow of cases to the United States. However, even that travel ban was not enough as by then the virus had spread undetected into the U.S. and Europe.
It was impossible to truly know how deadly this virus could be. But what this virus showed the world is that unknowns with even low probabilities of severe impact need to be treated and mitigated based on its potential future risk, before waiting for empirical data to confirm or deny our hypotheses. We need to be wiser, and be more cognisant of extreme possibilities, and quicker to react in protective ways than we currently are. We cannot assume that historical distributions can always predict the future, because there’s so little we know about the future. Whenever possible, overcorrecting is likely the better option than allowing for the potentiality of the future to play itself out. Because when it does, the consequences can be more severe than we could ever think.