The Wuhan Coronavirus - will it be a new Spanish Flu?

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During December, 2019, in Wuhan, a large city in Central China, someone was infected with a virus that they probably contracted from a wild animal. The most likely location of this wild animal was the South China Seafood Wholesale Market in the city. This is not a surprise, as most infectious diseases that harm humans originate in wild animals, where they can circulate without killing their host. For example, the bubonic plague still circulates in wild animals in North America, which is why there are isolated incidents of a person in the United States and Canada dying from the disease after coming into contact with a sick, wild animal. This same contact between a person and an infected wild animal seems to have happened in Wuhan. This BBC article states that researchers think that the virus is closely related to a disease found in horseshoe bats. Unfortunately, Chinese wet markets, where large amounts of raw meat are sold, are allegedly notoriously for a lack of hygiene, and so it is easy for a virus to come from the wild animal and then circulate in the market, in spilled blood, pieces of meat etc, until it finds its way into a human.

The Chinese government seems to be making every effort to deal with the outbreak but some observers are concerned that it may be making the same mistakes that were made with the SARS epidemic of 2003. This video makes some pertinent comments about the differences between the official line and what's happening on the ground.



The abilities of the common cold

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In some ways, it isn't important where the Wuhan virus came from; what is important is how the virus operates. Our general media has already explained that the virus is a novel coronavirus, which is one form of the common cold. This might make it sound relatively harmless but that is deceptive. The common cold, which also includes rhinoviruses, the most likely version that someone will contract, is an extremely resilient and successful disease. It continues to infect large numbers of people worldwide and has never been eradicated. Our modern, sophisticated health service with all its technology has never been able to produce a cold vaccine. This is because a rhinovirus has the ability to mutate into many different forms. It can change its structure, particularly its surface proteins and when it does that, any vaccine made for that version will no longer work. According to this very useful Guardian article, there are around 200 possible different mutations of the common cold. A person would need to gain immunity to every single strain to become entirely immune to catching a cold. Some people, particularly the elderly, might actually reach this stage but they would have had to suffer 200 colds to get there.

The Wuhan virus may be in the same family as a common cold virus but it doesn't mean it's less dangerous. Instead, being a coronavirus may just mean that it's extremely good at spreading itself and mutating. What's worse, as soon as the virus mutates, just as with the common cold, it will be able to infect the same people again that suffered from its earlier form. Someone could get the Wuhan virus, suffer the infection, survive, but then get a new, mutated version of the Wuhan virus. Their immune system would not be any better than it was before at dealing with this new infection. What's worse, the person could still be weak and impaired from the first infection, making the second bout of the disease, for them, potentially even more dangerous.

Reproductive rate

The Wuhan virus has already shown elements of what it can do. For starters, it is very good at spreading itself. In this Guardian newspaper article, it states:

"Prof Neil Ferguson, a public health expert at Imperial College, said his “best guess” was that there were 100,000 affected by the virus even though there are only 2,000 confirmed cases so far, mostly in the city of Wuhan in China where the virus first appeared."

Later on in the same article, Prof Ferguson adds:

"Ferguson, whose team have been modelling the disease for the World Health Organization, said they estimated the virus had a reproductive rate of 2.5-3, meaning that each person infected would potentially transmit it to up to three others."

A reproductive rate of 2.5 to 3 may not sound like a lot, but it is, in fact, a very high number. It effectively means that the disease will spread rapidly. Disease which are contagious, in other words diseases that spread through physical contact, generally have a lower reproductive rate. The SARS virus (severe acute respiratory syndrome), which spread through China and Hong Kong in 2003, had a reproductive rate of around 1 to 1.5, according to this scientific paper. SARS' spread, based on this number, could have been said to be 'steadily contagious'. A reproductive rate of 2.5 to 3, by comparison, is more like 'wildly contagious'. We can see the effects of this high reproduction rate of the Wuhan virus already, in the following two BBC diagrams from these articles.

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That is the change measured over only two days. As Professor Ferguson stated, the true number of infections is likely to be far higher than the official value. This would occur because of several factors. Firstly, the Wuhan virus seems to have an incubation period of up to fourteen days. In other words, someone can be infected with the virus and show no symptoms, such as high temperature or cough, for two weeks. What's worse, they seem to be infectious during this period. The second reason that the true number of infected people is likely to be much higher is because many people who have the disease and show symptoms may not bother to go the hospital because they know it has already been overwhelmed with existing cases. The sufferers may instead elect to stay at home and see out the disease with help from their partners and/or family.

The global threat

The Wuhan coronavirus epidemic is unlikely to be confined to China. This is because of several reasons. Firstly, the disease spreads very rapidly, with its reproductive rate of 2.5-3. Secondly, it has a relatively long, infectious incubation period. This means that people can travel elsewhere, and abroad, without showing any physical symptoms. They will appear entirely normal as they go through airport health-security checks. Thirdly, the efforts of governments around the world to monitor travellers is currently patchy at best. To quote from the earlier Guardian article:

"Prof Martin Dove, a British academic, said no one from the UK government had tried to contact him regarding the coronavirus outbreak despite recently returning home from working in Wuhan."

In other words, not only has a potential carrier of the disease appeared in Britain, that person hasn't even been phoned by the British government, never mind visited and checked!

If we examine the disease's rapid spread, and the likelihood that it has an up-to-two-week incubation period, then it is only a matter of time before its spreads outside China, and this is very much more likely because of one modern trend; cheap air-flights. Cheap air travel is a relatively new phenomenon on our planet. It has only been available in large parts of our world for around a generation but it is a massive new factor in the global spread of a disease. Up until now, we have all been saved from the potentially disastrous combination of a fast, global movement of people and a highly infectious, dangerous disease. This has only ever been a temporary delay. It has always been a case of not if cheap flights spread a global pandemic, but when.

The global spread of the Wuhan virus creates two serious, further problems. Firstly, the disease infects more people, which is bad enough by itself. Secondly, the chances of the Wuhan virus mutating into a more virulent form goes up. We can calculate the likelihood of a worse mutation as simply the amount of the virus present, multiplied by the variety of its hosts, multiplied by the time it is active. If the Wuhan virus spreads globally, it is therefore clear that the likelihood that a worse mutation will appear skyrockets.

The Wuhan virus is therefore, potentially, a huge global threat. In its current form, it causes a dry cough, a high temperature and shortness of breath. This is why it is being compared to Severe Acute Respirators Syndrome. Young people and old people are particularly susceptible to it, especially anyone whose immune system or respiration is already impaired. This is bad but it could get worse because the virus, being similar to the common cold coronavirus, is likely to mutate. Common colds mutate into relatively benign forms but the Wuhan virus could mutate into something more life-threatening. Knowing all this, it's worth comparing the Wuhan virus to probably the most important recent global epidemic, the Spanish Flu.

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Policemen wearing masks provided by the American Red Cross in Seattle, 1918 (courtesy of Wikipedia)

The Spanish Flu

This Wikipedia page explains the Spanish Flu epidemic. It was named this way because reports from neutral Spain about the epidemic were not censored by its government, making it appear to originate there. It's therefore an unfair name but, nevertheless, this is how many people identify it. This pandemic began at the end of the First World War and ravaged large parts of the world for around two years. Just like the Wuhan virus, as far as we can tell, it was a virus that affected the respiratory system and was able to spread rapidly from person to person. Its spread was hastened by poor hygiene and the sad fact that many people being malnourished by the Great War, but the disease also spread because of large-scale troop movements. Here is a useful and informative video on the pandemic:



According to this scientific article, the Spanish Flu's reproductive rate was 1.8, roughly two-thirds as reproductive that of the latest Wuhan virus estimate. The deaths from the Spanish Flu in Britain, over time, are shown in the following graph:

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The graph shows that a virus epidemic can be dangerously deceptive. Just as everyone starts to believe that the problem is over, a new strain appears and spreads even worse havoc on the population. In the end, the Spanish flu killed between 50 and 100 million people worldwide, approximately 3% to 5% of the global population.

Will the Wuhan virus be a new Spanish Flu?

At the moment, the Wuhan virus doesn't seem to be as dangerous as the second wave of the Spanish Flu, but coronaviruses are highly mutable (they mutate easily). The Wuhan virus could, therefore, over time, turn into a more lethal form. This could then produce mortality figures that are similar to the graph above. It's very difficult to know what numbers would appear on the vertical axis of a Wuhan virus mortality graph but the signs aren't good. This Guardian article states:

"Yi Guan, a senior Hong Kong-based virologist who helped identify the cause of the Sars virus, said he was much more worried about this disease, and feared the window for controlling its spread might already have closed. "I’ve never felt scared. This time I’m scared,” Yi, who heads the University of Hong Kong State's key laboratory of emerging infectious diseases, told China’s influential Caixin magazine."

The title of this article may seem alarmist but the science already gathered about the Wuhan virus, I think, begs such a question. The Wuhan virus is not an influenza strain but that does not lessen its dangers. It behaves much like an influenza virus, it seems to be as infectious and it seems to be spreading faster than a flu. The mortality rate of the Wuhan virus is currently unknown but even it if is a lower rate than the Spanish Flu, in that disease's worst phase, there is no reason to believe that the Wuhan virus will not get mutate into a more lethal form as it spreads. I would say that everyone on Earth should prepare for the strong possibility that we are going to get, effectively, another Spanish Flu. It may not happen to that level of severity but we should plan for it, regardless.

We can summarise the key factors, when comparing the Wuhan virus to the Spanish Flu, as follows:

Incubation infection period: AS SERIOUS
Rate of infection: MORE SERIOUS
Mortality rate: CURRENTLY LESS SERIOUS
Mutation potential: MORE SERIOUS
Infectability: AS SERIOUS
Movement of people involved: MORE SERIOUS

The above list shows that the Wuhan virus could be nothing like as damaging as the Spanish flu but at the same time, it could potentially be even worse.

What can we do?

Our options in the face of a viral pneumonia epidemic are limited, to say the least. There has been talk of vaccine development for the Wuhan virus but the spokesperson concerned was talking of the first tests being performed in three months time (April 2020). This would mean that a vaccine wouldn't appear at anyone's local hospital until at least six months after that, even if one was successfully developed. What's more, as already mentioned, it is notoriously difficult to make a vaccine for a coronavirus, due to their high mutability. To quote from the earlier Guardian article on rhinoviruses (the common cold):

"Today, “winter remedy” sales in the UK reach £300m each year, though most over-the-counter products have not actually been proven to work. Some contain paracetamol, an effective analgesic, but the dosage is often sub-optimal. Taking vitamin C in regular doses does little to ward off disease. Hot toddies, medicated tissues and immune system “boosts” of echinacea or ginger are ineffective. Antibiotics do nothing for colds. The only failsafe means of avoiding a cold is to live in complete isolation from the rest of humanity."

The same article then describes attempts by researchers to create a vaccine for another type of common cold, respiratory syncytial virus (RSV):

"Successes have been rare, and there have been spectacular flops. Last year, shares in US firm Novavax fell by 83% after its vaccine for RSV, one of the virus families responsible for colds, failed in a late-stage clinical trial. While it is less common than rhinovirus, RSV can cause great harm and even death in those with weakened immunity, including infants and the elderly. An effective vaccine presented an estimated $1bn opportunity for Novavax in the US alone. Before the results came through, chief executive Stanley Erck said it could be “the largest-selling vaccine in the history of vaccines”. But in the phase III trial of elderly patients, it did little to protect against infection. In the hours after the news broke, Novavax share prices fell from $8.34 to $1.40."

It seems that the only practical steps we can take to lessen the damage to us of a global Wuhan virus epidemic is to focus on supplies and habits. I have talked before on this website of the benefits of small-scale prepping so that we can handle future disasters. I think we face many dangers in the next thirty years, due to multiple factors such as climate change, the likelihood of climate-change induced natural disasters, the worsening nuclear situation, and others. This concern is held by others. The Doomsday Clock was recently set to 100 seconds to midnight. The Wuhan virus is another of these dangers and it makes sense to prepare (or prep) for it too. A few weeks supply of food, kept in the house, will help if the epidemic spreads to your country and you decide to minimise your contact with others for a while. A sensible supply of face-masks, first aid equipment, painkillers and related medical products will help, especially as these supplies would soon run out if an epidemic hit your area.

It would also be a good idea to get into good hygiene habits, so that these become automatic. Washing your hands after you return from the town centre is a good idea. Another good habit is not touching your face with your hands, while out and about. These habits may seem minor but they work very well in preventing anyone contracting a cold or flu infection.

Summary

In conclusion, the Wuhan virus will never be exactly like the Spanish Flu but it is alarming, nevertheless. The rational way, I think, for all of us to deal with it is to prepare for it n a practical way; to have supplies, to get into good habits and then to see what happens.