Strategy ( not the Flu)

I’ve seen people compare the new coronavirus to influenza.  Some have said that we should worry more about the flu, since it kills every year (maybe 10,000 in the US last year). They are mistaken. The danger in this case is not entirely clear, but on the high end, we’re talking big trouble, way bigger than current influenza strains.

Current flu strains seem much less severe that this new coronavirus, much less likely to put you in intensive care or kill you. Fewer people are susceptible to the flu: we have a vaccine, and most people already have some degree of immunity from vaccination and past bouts with the flu.   We have somewhat useful antiviral drugs for the flu.

2019-nCoV: it’s new, nobody is immune. As yet we don’t know of antiviral drugs that are effective against it, although people are certainly trying out existing ones.  Perhaps we will get lucky. We will be working on a vaccine, and that is likely to succeed eventually, but  that takes time, on the order of a year or more.  Supportive care is helpful: ventilation and oxygen can give you time to beat the virus.

Even without a vaccine or useful drugs, you can foresee an end to it – say after most people have already had it. Fires need fuel.

It seems to spread fairly efficiently, comparable to influenza.  You have to think of two regimes of severity:  what happens when A. there is supportive care (hospitals, ventilators, oxygen) and B. when there is not. If it becomes common enough, regionally, you go from regime A to regime B (capacity for supportive care is limited) – and since it is new, since nobody is immune, that might happen.  Regime B looks not so good: in Wuhan, a few percent lethality, mainly among older men.

What’s the death rate in situation A? Hard to say.  For that matter, what’s the true number of people infected?  Also hard to say, but there is reason to think it’s lot higher than the official number, which ( I think)  is limited by the number of testing kits available. That may mean that the fraction of people infected that get terribly sick is lower than current reports suggest  – but since the majority of all cases must be very new, maybe they haven’t had time to get that sick yet. And then, we know that some people in Wuhan are dying without managing to get into a hospital – and without their deaths being counted.  But is this common enough to materially change the picture?

Even if the authorities in China are telling all they know, they themselves likely don’t  know enough. Might they be lying?  Sure. Lying about the 1918 flu epidemic was routine: that’s why it’s called the Spanish flu, since Spain was neutral and didn’t censor the newspapers.

The only thing you can be confident of is that the situation is no _better_ than the official line – the current story is against interest,  very bad for business.