The outbreak of the new coronavirus, now branded as Covid-19, a more impersonal and seemingly scientific term that hints at possible containment, has pushed the world into a panic. Hysteria is hard to take. I am much more sympathetic about the human race when I see war or a concrete disaster. I remember how shattered I was as I walked among the ruins of beautiful L’Aquila after an earthquake crushed its medieval walls, churches, and palaces on April 6, 2009. It was like walking through the graveyard of humanity’s illusion of eternity. The majestic work, an effort of many generations, collapsed in mere seconds as if it had been made of cardboard.
I also lose hope every time I encounter human stupidity and ignorance. To me, these are scarier than the coronavirus. And the chances of eradicating them are slim to none. The current coronavirus campaign is a good example of human irrationality. In my home, we talk a lot about the outbreak. I am lucky to be able to learn more about the coronavirus from Elisabeth Rosenthal, a trained doctor and former New York Times reporter who worked on the frontlines of the Aids and Sars outbreaks in China. This home-cooked Yonder is based on the dialogue between us.
I may become a victim of the coronavirus. As we prepare to go to Europe, my wife and I have realized that we may be forced into this corona campaign. Since erratic president Trump could easily ban travelers from infected countries from entering the U.S., we would be risking spending time in quarantine if we travel. While I do not care much about time lost if the story is good, Elisabeth has an important job related to healthcare and needs to be out on the battlefield at all times. Plus, I don’t trust the efficiency of an administration that defunded the CDC(Center for Disease Control) in a way that suggests the U.S. isn’t prepared for an epidemic of this kind. I think I might run pretty high chances of getting infected by the virus while healthy and have to spend two weeks in quarantine. And of course, all this is happening when flight tickets are as cheap as they were over 20 years ago!
Every viral outbreak arrives in silence. Never announced, never preceded by a declaration of war or an urgent meeting of the National Security Council. The new coronavirus has been around for only a couple of months and we are just getting to know it. Compared to Sars, Covid-19 is particularly silent, fast and subtle in its action. Sars, the super killer, was much more severe than most other coronaviruses–and certainly this one. This new one is an influenza-like illness that occasionally leads to progressively severe respiratory insufficiency.
Sars-Cov was first detected in the Guangdong province of China in November 2002 and subsequently spread to 30 countries. In this outbreak, 8,000 cases were reported worldwide, with 774 deaths (about a 10% case fatality rate). The immediate source was presumed to be civets, mongoose-like animals found throughout Africa and Asia, which had been infected through contact with bats before they were sold in live meat markets. Bats are frequent carrier hosts of coronaviruses while civets serve as the intermediate hosts, a platform from which the virus can be transferred to humans. From a delicacy on the table, civets became targets. They were promptly culled en mass and banned from many countries. Some civets are ground-dwelling and omnivorous, however, the Chinese species tied to the Sars virus, the masked palm civet, lives in trees and eats oranges, papayas, and mangos.
In Beijing, we learned about Sars three months after the outbreak. It was not long after the yearly session of the National People Congress in 2003, which I was covering for the last time. On the day I was boarding a plane to go home, the news came out. By the time I had landed in Rome, I was worried that Italian authorities would pull me off the plane and keep me in quarantine. Nothing like this happened. Italians, like the Chinese, were taking a long time to react.
Elisabeth reported on Sars from South China, the hotbed of the epidemic. So I have decided to ask her here what the differences are between the outbreaks of Sars and Corona.
E: You have to understand the origin of all outbreaks otherwise you have no chance to make sure that they will not happen in the future. The Sars outbreak started from live animals in the market in Canton and Southern China.
Was it a specific animal?
E: They did not know at that moment. You just have to follow the cluster of cases and in that case, it was the market of Guandong. Because, as you know, rich Chinese people enjoy eating wild animals, and they are sometimes legally, sometimes illegally, sold and slaughtered on the spot. That is a great way to spread viruses from animals to humans because when you slaughter an animal there is blood.
When did they actually figure out that the civet was the host of the virus?
E: I know they traced the virus back to the market and they knew that a similar virus existed in bats, but bats aren’t something that people eat. So there was a connector and they identified the connector. But it was later when they understood what the connection was. It was not that important what the connector was, but the fact that the virus was coming from these markets. With the Sars, these markets should have been closed down forever. It obviously did not happen and the fact that the new virus came out of a similar situation is the proof of this. Since these markets are the origin of epidemics, the only right thing to do is to close them down immediately. Then, to halt the spread, you very quickly identify the people who are sick, who have been to the markets, and see what happened to them. In the case of Wuhan that happened with much delay.
So how did they stop Sars in the end?
E: Well, Sars was a different virus than this one and it kind of burned itself out. It was not very transmissible as the one we are seeing now. In short, the Sars virus did not spread very well. But there were certain people who were superspreaders who could contaminate twice as many people as normal.
There was no vaccine that stopped Sars. As said before, virus outbreaks tend to burn themselves out as officials take measures to prevent person-to-person spread and the outbreak recedes. These are zoonotic viruses that exist best in nature. Ebola is similar, it kind of receded back to its natural host. Most of hese viruses are not very good at settling in humans. We do not know about the coronavirus yet. This one seems to be much better in spreading, it spreads faster than Sars.
Scientifically, the viruses that kill people quickly tend to not be very spreadable because if you are killed with something like ebola, you are not walking around for a long time with it and giving it to other people. The new coronavirus does not appear to be a big killer, but it spreads easily. Someone who has it does not feel that bad and can walk around, spreading it a lot more. However, even though it’s rapidly spreading, the Coronavirus does not seem to kill healthy people. The people who have died so far were older people or those who had other health conditions.
Elisabeth is a person rich in emotions. But when it comes to the facts, she takes no crap. I can imagine how she was while working in an emergency room for seven years. A real commanding officer, capable of reading the situation, a characteristic also owned by a good journalist. By the end of this January, when the Coronavirus started to show its claws, Elisabeth wrote a piece that acted as a manual on how to react when a new virus breaks out. Amidst the starting panic, she was a calm voice with the experience of having been in epidemic hotbeds, appealing to Americans to calm down and wash their hands. Just a few days ago, she wrote a second Corona piece, explaining why there are delays in research about the virus.
As the scientists focused on the palm civet, the intermediate host of the virus during the Sars outbreak, the pangolins are now under scrutiny in relation to the new coronavirus. The pangolin is an endangered, scaly, ant-eating mammal that is imported in huge numbers to Chinese markets for food and medicine. The demand for pangolins is so high that they are said to be the most trafficked mammals on the planet. Erica Goode, who visited the pangolins in Asia, wrote five years ago:
Pangolin meat is considered a delicacy in parts of China, where it is believed to nourish the kidneys. Pangolin scales, made of keratin, like human fingernails, are used in traditional medicine to treat skin diseases and other ailments. Trade in the animal has a long history: In 1820, King George III of England was presented with a suit of armor made from pangolin scales.
But the demand for pangolins — and with it the hunting of the animals — has grown sharply in recent decades. Poaching has increased not only in Southeast Asia but also in Africa, according to Traffic, an organization that monitors wildlife trade.
Five years ago, pangolins were just endangered animals, considered a delicacy served on special occasions and used in traditional medicine. The outbreak of the coronavirus made the situation for the pangolins even worse. They became the enemy of humans. Along with other wild animals at the Wuhan market, pangolins have been either killed, destroyed, or eaten. We do not know the specifics.
The New York Times reported:
The virus was found in people associated with the market, and in the market environment — on surfaces, for instance, or in cages. However, some of the early cases, including what might have been the first reported case, were in people who were not associated with the market. Jon Epstein, vice president for science and outreach at EcoHealth Alliance in New York, said this means the first jump from animals to humans may not have occurred in the marketplace. People may have contracted the disease from animals at another location or earlier, as yet unknown cases may have contracted the disease at the market and passed it on to other people.
In October of last year, Chinese scientists published research that was not related to the outbreak, but that did identify pangolins as hosts of the coronavirus. On February 7, Xinhua, the Chinese news agency, published another report, claiming that “the metagenome sequence of the novel coronavirus strain separated from pangolins was 99 percent identical to that from infected people, indicating pangolins may be an intermediate host of the virus, a study has found.”
The Chinese were admitting that the virus found in the pangolins matched the novel coronavirus that had by then sickened 40,000 people and killed more than 900. Three weeks later this number has more than doubled. There are now 90,000 people infected and 3,000 people dead.
As Elisabeth says, we don’t know much about the virus. We don’t know why some people get really sick while others get a little sick and some people don’t get sick at all. The exact locations of the breakout are not clear. We hear that almost all the cases are in Hubei province and in the city of Wuhan, but this is because the Chinese are only testing there. We need to understand if the 3000 who have now died are the tip of the iceberg or if it is something smaller as some scientists predict.
There are two obstacles that contribute to the unknown about the virus and help increase the panic. While the Chinese authorities have been cooperating better than they did during Sars, the countries outside China still don’t have access to complete data, as the information is still trickling out. To deal more efficiently with the epidemic, we need to get all available information out in the open.
So what are the people afraid of, why this panic? We in Washington have no reports of infected people, yet we do not know for sure. However, although there is no panic in the capital yet, the country and the media are all burning. The market is crashing.
Elisabeth: It’s bizarre. There are 64 contaminated people in the US but you go to the CVS (one of the big chains of pharmacies) and there are no hand sanitizers, while in the high season of the flu there would be dozens. On the other hand, headlines like “3000 people dead by a deadly virus,” have an effect. But I am asking, do we call the flu the deadly flu? No, we don’t and yet it kills more people. The flu has about one percent death rate, the sars was 10, the corona at the moment is 2.3 but the number of infected people that we know of is still limited. What if the number of people who are contaminated in Wuhan is around 2 million? If so, the percentage of death could be much lower. Many people say that a pandemic is around the corner, that it is now the question of when it will erupt. What does the when mean? It does not mean when people are going to die. It just means this virus is going to be around and that if I would say to you there will be another cold virus soon, you would not panic. But it is a new unknown, even if it’s not as strong as Sars. But people in the last few years got trained to think in terms of horrific ebola. When they hear about a new exotic disease, they remember the people in hazmat suits. There is this kind of dramatization because whenever people hear pandemic, it’s alarming. The pandemic of a not very bad virus is still a pandemic, but it’s not a deadly pandemic, right?
Now, the coronavirus is traveling to us, it’s coming here. It makes for a good story and it’s dramatic. There are a lot of Sci-fi novels written about pandemics. And again, we watched Sars, we watched Ebola. Our minds would rather put the coronavirus in that same category rather than go ok, it’s kind of like the flu.