Friends in masks have been showing up on Facebook these couple of days. Yes, it’s the Wuhan virus and so far the Hubei city of 11 million is the only Chinese city that has been locked down. Apparently, it’s a case of closing the stable door after the horse has bolted. The worst blunder from the Wuhan authorities was probably announcing the lockdown of the city some 8 hours before it was to be implemented, causing a massive exodus of Wuhan residents in the wee hours of the morning on 23/01/20. Check out the following video. You can ignore his call to end CCP rule towards the end of the video if you’re not interested in politics.

Meanwhile, our very own MOH sent me an “situation update” via SMS along with a embarrassing dead link. This should not and ought not happen but it did happen, so we’re very sorry that it happened (but it’s not our fault?) I guess it doesn’t matter. There are numerous sources of timely updates out there. A subsequent link I got from TCM Board worked.

Meanwhile, from the Daily Mail 25/01/20:

Leading US health experts predicted a coronavirus could kill tens of millions of people in a chilling warning three months before the deadly outbreak in China.

Scientists at the prestigious Johns Hopkins Center for Health Security modeled a hypothetical pandemic on a computer as part of research last October.

The simulation predicted 65million people from every corner of the world would be wiped out in just 18 months.  

So far the highly contagious disease currently ravaging China has killed 26 people and infected more than 900 – but experts predict the true number to be thousands.

Coronaviruses are infections of the respiratory tract that can lead to illnesses like pneumonia or the common cold.

One was also responsible for the outbreak of severe acute respiratory syndrome (SARS) in China, which affected 8,000 people and killed 774 in the early 2000s.  

Dr Toner’s computer simulation suggested that after six months, nearly every country in the world would have cases of coronavirus. 

A virus similar to SARS, responsible for the mysterious outbreak of pneumonia in China

Within 18 months, 65million people could die. The outbreak in Wuhan isn’t considered a pandemic, but the virus has been reported in 10 different nations.

The US, Thailand, Japan, South Korea, Taiwan, Vietnam, Singapore, Hong Kong, Macau and Nepal have all confirmed cases.  

Dr Toner’s simulation imagined a fictional virus called CAPS – a pandemic that originated in Brazil’s pig farms in the hypothetical scenario.

The virus in Toner’s simulation would be resistant to any modern vaccine. It would be deadlier than SARS, but about as easy to catch as the flu.

His computer modelled outbreak started small, with farmers coming down with fevers or pneumonia-like symptoms. You can read the rest of the article here.

We’ve been told not to panic, but if Dr Toner’s computer-generated model pans out, then the situation is decidedly grave. Panic is of course useless, but how concerned should we be? I’ll be going to China (Nanning, Guangxi) on a business trip at the end of February. How worried am I? On a scale of 1 to 10, maybe 6-7. There are folks out there who say that we should put matters in “perspective”.

Mr Michael Fumento, the American author who wrote the now infamous (thankfully out of print) book The Myth of Heterosexual AIDS (in which he claimed that the only heterosexual people at risk of AIDS are Black women who have sex regularly with drug addicts) wrote a piece in which he seriously downplayed the virulence and potential damage that the Wuhan virus could cause.

In an article published in the New York Post (please note that the New York Post is a tabloid that has nothing to do with the more reputable New York Times), Fumento urged us not to buy into the media hype over the new China virus.

Fumento wrote in the New York Post:

The media are correct in saying the closest comparison here is SARS. It also was first reported in China and was what’s called a coronavirus. But while they want you to remember SARS as akin to the Black Death with cries of “Bring out your dead!,” fact is, there was a grand total of only 8,098 cases, of whom 774 died. Then the disease simply disappeared. More than 7,000 of those cases and about 650 of the deaths occurred just in mainland China and Hong Kong. The United States had just 75 cases and zero deaths.

By contrast, the CDC estimates about 80,000 Americans died of flu two seasons ago.

To be fair to Fumento, the virus may not be as deadly as it is feared and I agree that the seriousness of this crisis could have been exaggerated by experts like Dr Toner. However, complacency has no place in a situation like this. True, evolution selects strains that are less deadly to the host, but while evolution is not random, mutations are. The fact that the virus has evolved to spread from human to human has been a move in the “wrong” direction.

Next, are Fumento’s comparisons of the Wuhan virus with SARS and influenza fair? Consider the late Dr Alexandre Chao who was only 37 when he contracted SARS and died. Had Dr Chao not survived at least a couple of bouts of influenza throughout his 37-year lifespan? Of course he must have. Most young and healthy individuals are only given 2 days’ MC (grossly inadequate, but nobody cares) for flu. With SARS, they could end up in ICU. If SARS killed someone like Dr Chao, then it must be something quite different from influenza – something that we should all be very concerned about and make sure that it does not spread like flu.

Mr Fumento might also want to know that on 25/01/20, a doctor at a hospital in China’s Hubei province, the centre of the coronavirus outbreak, has died from the virus. Liang Wudong, a doctor at Hubei Xinhua Hospital who had been at the front line of the coronavirus outbreak in Wuhan city, died from the virus aged 62. Do any doctors die while treating influenza patients?

The fact that influenza appears to kill so many is because nobody bothers to contain it and the vast majority of otherwise healthy people who are infected recover after two weeks. Only the medically compromised succumb to it. In contrast, desperate attempts have been made to contain SARS. Victims were all ill enough to mandate hospitalisation and robust management of their condition. What if we had treated SARS in the same way that we had treated influenza? For sure, the death toll would not have been just 774.

For the sake of argument, what might have happened if no attempts were made to contain SARS back in 2003? In 1918, the Spanish Flu killed 100 million people or 3-5% of the human population back then. It’s called the Spanish Flu because Spain seemed to have the largest number of cases. It has been found that that’s because Spain was the only country that did not cover up or under-report the numbers. Make no mistake, this was no ordinary flu virus. The deadly thing about this virus is that it could trigger a cytokine storm (overproduction of immune cells and inflammatory factors) which ravages the stronger immune system of young adults. Apparently, that’s how SARS killed so many otherwise healthy adults.

The fatality rate for the Wuhan virus, based on available data, is only about 2%, but 20% of the those infected require ventilation. Without timely and adequate treatment, it will certainly not be a 2% fatality rate. Without robust management and containment, the final death toll could be closer to that of the Spanish Flu – 50 million.

The medical community is not stupid, paranoid or buying into media hype. They know the common flu has killed more people this season. But this is something far more sinister. If SARS had not been dealt with aggressively, the death toll would greatly exceeded that of the common flu in any season, any year.

It’s extremely irresponsible for the ignorant denialists to make light of the situation and point at the “insignificant” death toll without recognising the herculean effort of medical staff all over the world.

If the Wuhan virus were really as “harmless” as folks like Mr Fumento would like to believe, then we shouldn’t be too worried about letting it run its course without taking any action to contain it. But if it turns out to be another version of SARS or the Spanish Flu in terms of virulence, then we’re in for a catastrophe. I can assure him that the vast majority of planet earth’s population is not prepared to take the risk. This is what our local academics and intellectuals said.

And this is what a true authority on epidemiology said.

Without analysing his claims, it’s easy to find Mr Fumento’s perspective sexy. Not surprisingly, even some of our university professors (thankfully not medical) agree with him. Let’s hope this sort of complacency isn’t too contagious. The image below is sure to provoke some thoughts, but the I blog about socio-political issues in another blog.

Dental Phobia by Chan Joon Yee