Not The Bubonic Plague

Well despite the fact that its not the bubonic plague (which oddly after exposure also has flu-like symptoms) .... YET ....

The Black Death - A Real Pandemic That
Brought The World To An End ......Almost.

... it might as well be, as we have decided to lock the world down, because of what is still just an aggressive flu like variant.

To be honest, and I know its not a popular view, especially with people under 40 who seem to be really spooked, but I think the panicked political responses over this coronavirus has been partly driven by the media, both news and social forms. But I am also aware that I am in a minority who are prepared to say so .... at least publicly (privately a lot of people have told me they think its madness ... in fact virtually everyone I have talked to is totally bemused by the panic and extreme response).

All the older people I spoke to in the pub about the corona virus last Sunday, just thought we should tough it out and not lock people in their homes for months (obviously with a few extra precautions for those with other health issues), but such is the power of the media, Twitter and Facebook with politicians, that this older view hasn't prevailed.

We apparently prefer to create a worldwide recession, and mass unemployment instead, while also trashing a large number of western companies. Meanwhile the Chinese subsidise theirs, and clean up in western markets after the mess they created by their unhygienic food markets .... and not for the first time, remember the severe acute respiratory syndrome (SARS) outbreak in 2008?

Coronavirus Figures March 16 2020 - Some Nations
 Are Likely To Be Under Reporting Cases And Deaths .....

I can't help noting that when thousands die each year worldwide of Seasonal Flu, we pay little or no attention, because its largely old people with a perceived little economic significance, but that with this non seasonal flu variant, that has a somewhat higher mortality rate .... its a different response, because crucially, it can also sometimes kill younger victims (although so can seasonal flu), and so the result is the world wide panic. It would be instructive to have the daily, weekly, and monthly mortality figures for Seasonal flu for comparison ... but they are hard to find for some reason.

Lets be honest, 25-30 years ago we would have been told to go to bed with a hot drink, take lots of fluids and stay isolated for 3 or 4 days (even now if you get the dry cough and fever, 37.8c or above, then the advice is stay home for 7 days with paracetamol etc). The world wouldn't have stopped, and there would have been no recession or mass unemployment. The generation that went through the second world war would be shaking their heads in astonishment at the sheer fear that both the news and social media have generated ..... we would have surrendered to Hitler if our press had taken the same line in 1940.

I am not suggesting it's not a serious illness, far from it, it is, but for 90 - 95 per cent of those under 50 who get it, it's just a mild, or slightly nastier version of a flu like illness ... but for those over 50 its more dangerous, and between 10 - 25 per cent will need hospital treatment (depending on age group and health e.g smokers) and sadly (usually older patients with existing health issues, but not always) some will die, however at what rate seems to depend on the healthcare available in each country (contrast Italy and Norway).

But should we use the figures for policy as provided by the Imperial College London, that has models that suggest that in the UK (based on Italy's very high death rates, partly driven by its unusually high *older population demographics), there would be 260,000 deaths in the UK if we let the virus spread unsuppressed? Should we be basing our health policy planning on modelling taken against the aberrant Italian (and Spanish) figures, or on how we see seasonal flu pan out every year in the UK?

*18 percent of Europe's population are over age 65, but Italy has the second-oldest population on earth, with 23 percent of the population over the age of 65 (compared to the US, for example, where that population is 16 percent, and the UK where its 18% of the total UK population). It also has a stronger family tradition (as do Spain) than many northern countries, where its younger population tend to mingle more often with the elderly, and their grandparents thus leading to higher transmission rates to the elderly. These two differences are partly driving the higher Italian death rates.

The three public health policy options in a pandemic are always the same:

• Suppression - break the chains of transmission, and effectively try to stop the epidemic in its tracks, and thus bring cases down as low as possible - the China approach.
• Mitigation - Accept you cannot completely stop the virus, so slow its spread e.g Flu Jabs for seasonal flu in the elderly, and prevent a massive peak in cases, that would otherwise overwhelm the health services, while building up natural immunity in the general population and trying to protect those most at risk of severe disease by isolation - the UK approach, until now.
• Do Nothing  - and let the virus run its course through the population as a whole as we do with Seasonal Flu aka the medieval approach (although noticeably the wealthy often hid themselves well away from plague outbreaks).

The strategy we are all now adopting globally, of moving to attempting suppressing of the transmission of the virus via lock-down, also has the flaw in that it allows us all no end game or exit strategy. Without a large number of people catching it, and then recovering (aka the mitigation policy), with the herd immunity that it affords the population, then cases of transmission in the UK and elsewhere, could simply rebound again as soon as these extraordinary measures are lifted.

As for waiting on a vaccine, well even with the rushed trials in the US and elsewhere, it could be 18 months before one is available (the Russians suggest they may have something in June ... hmm) .... can we self isolate the Western world for 18 months, while China for example is already taking some tentative steps to return to normality after just 4 months?

Hospitalisation And Fatality Rates Coronavirus

So maybe (very probably if we don't get a vaccine), I'll get it, and just possibly I'll be very unlucky and develop the pneumonia stage, and then be extremely unlucky and go on and die. But frankly, the odds are actually fairly good that I will survive unless very unlucky. I don't smoke, I have no chronic conditions, and I am nearly 3 years post chemotherapy (my immune system no longer compromised) ... so fairly good odds, I hope 👍

But whatever the outcome, I still wouldn't change my thoughts on the poor role that the media have held in starting this panic (the Dutch and its media have taken a different, and possibly more adult approach to the pandemic) .... I guess I just come from a different, more stoic generation, to those from the Millennials and Generation X.

If you want to track the coronavirus position worldwide, this is a dashboard that combines all the various health organisations reports daily. All figures quoted in this post were correct as of 18/03 but the dashboard is updated daily.

For Context: 

• The news headlines say that the global coronavirus death toll has passed 10,000, with confirmed cases near 250,000, and more than 80,000 have now fully recovered. 

• The Centres for Disease Control and Prevention (CDC) in the USA estimates that seasonal influenza has resulted in between 9 million – 45 million illnesses, between 140,000 – 810,000 hospitalizations, and between 12,000 – 61,000 deaths annually in the USA since 2010. If you add in the figures from other countries in the world, this will far exceed any current figures for this coronavirus, and we don't destroy the world trying to stop this annual population cull. Of course when this is all over it may prove far more deadly but it may be a while before we know that.