AFD Blog Tuesday, December 31, 2019
#17,202
We are literally only hours away from the third anniversary of our first indication of a serious outbreak in Wuhan, China of what would eventually become known as COVID-19 (aka SARS-CoV-2).
While it would take several days for mainstream media to take notice - within 48 hours I'd written 6 blogs on the topic - and the newshounds on FluTrackers had amassed scores of reports.
But despite our early concerns, none of us could have predicted how dramatically the world was about to change, or that we'd still dealing with it 3 years later.
COVID has rewritten the textbooks on what a pandemic could be (in this case, a coronavirus), how long it could last (> 3 years), and the lengths countries would go (lockdowns) to prevent transmission.
Early assurances that the virus was `mild', that asymptomatic transmission or airborne spread were not factors, and that the virus was `remarkably stable' and `unlikely' to mutate substantially all proved overly optimistic.
Equally bad advice was proffered on `face masks' being useless (see below), and that `herd immunity' would end the outbreak quickly (see GAO: A Herd Immunity For COVID-19 Primer).
On the positive side, we saw a number of (initially) highly effective vaccines developed in record time, and emergency vaccine production far exceeded anything that had been done before. New treatments (some of which are no longer effective) were developed, including monoclonal antibodies and antivirals.
Despite all of this, billions of people have likely been infected (many more than once), and an unknown number of people have died (estimates range from 7 to > 20 million). In truth, we'll never really know its full impact.
While initial expectations (based largely on the 1918 pandemic) were that this pandemic could last up to 18 months, we find ourselves about to enter our 36th month and - after six months of increasingly relaxed restrictions - the recent explosion of cases in China has many countries reimposing COVID tests before entry.
Yesterday the United States Department of State issued a travel advisory for all arrivals from China, reinstating the requirement for a negative COVID test within 2 days of departure, joining a growing number of other countries including Spain, Italy, Japan, and India.
These measures are being implemented not due to something we know, but due to what we don't know. As discussed ad nauseam in this blog, China has a long history of holding back `bad' or `unflattering' news from its people, and the world.
Now, with numerous anecdotal reports coming out of China of increased deaths, swamped hospitals, and `new' symptoms (all unverified) - and China's NHC shutting down official reporting - the rest of the world is left wondering whether that a new, potentially worse, variant has emerged in China.
Even the Secretary-General of the World Health Organization has expressed concerns about this lack of openness.
I would stress that we have no information that a new variant has emerged, and no way to know the likelihood of that happening. But the absence of reliable data from China is forcing many countries to take expensive, and sometimes divisive, steps to protect their people.
As a result we only rarely, and often belatedly, hear about human infections with novel viruses (e.g. MERS-CoV, H5N6, H5N1, H3N8, etc.), and large epidemics can rage under an `information blackout'.
In the summer of 2021, in PNAS Research: Intensity and Frequency of Extreme Novel Epidemics, researchers suggested that the probability of novel disease outbreaks will likely grow three-fold in the next few decades.
A short list of recently emerging zoonotic threats can be viewed in NEJM: A Novel Henipavirus With Human Spillover In China).
Whether COVID is about to enter a new, more dangerous phase - or China's epidemic is COVID's last hurrah - the world will almost certainly be faced with many new emerging disease threats in the years ahead.
We either figure out how to effectively and consistently share disease and outbreak information, or we are going to find ourselves going from one public health crisis to the next, with little time to relax in between.
