The news that an unknown virus which caused breathing and respiratory problems was spreading rapidly in Wuhan at the end of last year caused little alarm at first, and people could be forgiven for paying it no attention. The other news stories of January and February 2020 included the assassination of one of Iran’s leading generals by the US and the horrific Australian bush fires. In the UK, Labour had suffered its worst election defeat since 1935, and now the country would for good or bad ‘get Brexit done’. Despite the mounting alarm in China as hospitals struggled to contain the situation in Wuhan, as people, especially the elderly, began to die and get extremely ill in large numbers, most people in Europe paid little attention. The Chinese government was anxious to reassure the world everything was fine. It was facing mounting but ultimately ineffectual criticism of its treatment of Uighur Muslims and other religious minorities, and its treatment of protesters in Hong Kong. When the lockdown of Wuhan first occurred it was against this backdrop of technologically enabled repression. Par for the course for China, and nothing to do with the rest of the world.
Except, of course, this coronavirus, SARS-Cov2, causes the disease now known as COVID-19. As of the time of writing the virus has caused at least 1200 deaths in the UK, and over 10000 deaths in Italy. It is overwhelming already strained health systems across the world. Rather than Wuhan being an anomaly from an authoritarian state like China, it turned out to simply be a preview as governments desperately tried to contain the outbreak. Despite the British government’s initial panicked claims of reassurance that the population would be able to achieve ‘herd immunity’ and all that was needed was ‘taking it on the chin’ and washing your hands, reality has asserted itself as the hospital beds rapidly become overwhelmed. The COVID-19 pandemic has been compared to a ‘tsunami’ and ‘a plane crash every two days’ for the countries worse affected by the disease.
SARS-Cov2 is related to several viruses which cause colds, as well as serious illnesses such as SARS and MERS. It is thought to be twice as contagious as influenza, and people unlucky enough to contract it may be asymptomatic for 14 days before showing signs of infection. The WHO has estimated its death rate to be about 3.4%, although this varies widely between countries. And even in non-fatal cases you may have to spend days or weeks in hospital if you catch it, needing resources the health services don’t have. Tragically, many infections are treatable in hospital, but life threatening if you stay at home. There is evidence that many people with no or mild symptoms have reduced lung capacity, kidney problems and other issues following their recovery. Intensive care patients in the UK have just over a 50% survival rate.
We’ve all heard that the COVID-19 pandemic is simply a ‘panic over nothing like bird flu and SARS’ while hospitals rapidly run out of beds, masks and equipment and bodies begin piling up. People are still saying it. The presenter of the TV show Embarrassing Bodies claimed the Italian lockdown was ‘an excuse to be lazy and have a siesta’. ‘Well, actually, the mortality rate is 0’ has become a meme at this point, even while, for example, the number of people known to be killed by COVID-19 in America, almost certainly an underestimation, looks set to overtake the number of monthly deaths on the roads in that country. The influx of patients carrying a highly infectious disease, with many doctors and nurses becoming sick and dying through prolonged exposure, means heart attack victims, cancer patients and even people with broken legs are now in serious trouble. This is especially true if you are unlucky enough to have many of the so called ‘underlying conditions’ which put you at greater risk of a serious illness such as diabetes, heart disease and respiratory problems. The social effects are catastrophic with entire industries collapsing and millions uncertain if they will keep their jobs, in a world where even without this plague people struggle to put food on the table.
The British response to this crisis seems to be neither ‘taking the right measures at the right time’ (an utterly vapid slogan to rival ‘strong and stable’, an example of history repeating first as farce then as tragedy) or a ‘conspiracy to cull the elderly’ as some more breathless critics of the government have transitioned towards, after weeks claiming the virus was a ‘boomer plague’ which was going to wipe out the stock market, causing rich people in their 60s to lose money but no problem for anyone else. Rather it was a panic response made worse by chaos at the top and a total lack of consensus on what to do at senior levels of the state, as demonstrated by constant U-turns, denials, confirmations which turned into denials which turned into confirmations again, and constant leakage by ‘senior government sources’. The UK government has failed to communicate any kind of consistent healthcare message or advice. This is compounded by a long-term funding and resources crisis in the NHS and social care. The NHS regularly goes through the ‘winter flu crisis’, the ‘waiting list crisis’ and the ‘hospital bed crisis’, the shortages and long waiting lists leaving the NHS struggling at the best of times. This is hardly unique in Europe, and the initial UK response did not differ significantly to that of other European governments, with a few more tone-deaf gaffes thrown in.
You could write a book about the failings of the British state in response to COVID-19. It would be a mistake to label any other country’s response to this outbreak as ‘successful’, although it is worth noting that Taiwan had 238 cases and only 2 deaths, and Hong Kong had 641 confirmed cases and 4 deaths. However shortages of protective equipment for medical staff, delivery drivers and shop workers, and commuters forced to use rammed trains have arisen in multiple countries such as Italy, Spain, the USA and Russia as well as the UK, with the tragic result that these workers are at heightened risk of death from the sheer amount of exposure they have to suffer. Poorer countries with collapsing, outdated medical infrastructure, widespread food insecurity and no ability to introduce social distancing measures are facing catastrophe. Even in China, cases of COVID-19 are still being found, mostly from overseas travel, and there are reports that cases in Wuhan arising from asymptomatic carriers may have been hidden in the desperation to return to ‘business as usual’. The Chinese state’s desperate attempt to cover up the outbreak, the same error it made during SARS in 2003 when it attempted to cover up the number of infections, meant the virus may have been circulating in the Wuhan area undetected since November.
The idea that this coronavirus is ‘just like SARS or bird flu’ and therefore nothing to worry about, has bred complacency and had deadly consequences. Far from being a panic over nothing, in 2003, SARS had an even higher mortality rate than COVID-19, and infected around 8200 people worldwide after it had spread from China. The outbreak was contained through rigorous testing, quarantine and targeted but brief lockdowns and halts to travel, and everyone who had contracted it was rapidly traced. However, it claimed the lives of 10% of people who caught it, around 775 people, including doctors treating patients with the condition. Many former SARS patients still have lung complications and other medical issues resulting from the disease, as well as suffering PTSD from their experiences. SARS was only stopped from becoming a pandemic with swift action to trace those infected and treat them. While in many cases COVID-19 will be a mild illness like a cold, it is related to SARS (the original virus is known as SARS-Cov1) and in too many people produces similar symptoms.
H5N1 bird flu was similarly no laughing matter. H5N1 is related to the strain of influenza which caused the notorious Spanish flu of 1918, which killed over 100 million people. There are two reasons why bird flu never became a pandemic like COVID-19, and they are nothing to do with the fact it was ‘no big deal’ or ‘a fuss about nothing’. Firstly, it never achieved widespread human-to-human transmission in the way COVID-19 has done and is rarely able to be passed any other way than contact with an infected animal. Secondly, H5N1 is so deadly it kills over 50% of people who catch it, within a very rapid space of time, so the epidemic was self-limiting and burned itself out quickly. If it had become a pandemic, the consequences could have been far more catastrophic than this one.
H5N1 was still killing people up to 2014, with the last case being someone who felt sick on an international flight and died a few days later. In one case it wiped out 7 out of 8 members of an Indonesian family. Slaughterhouse workers in poor, unsanitary conditions, and people who lived in close proximity to poultry, were particularly at risk. Indonesia had 168 cases and 84% of those who contracted bird flu died. In some countries, such as Laos, everyone who caught the disease died, with many victims being children under five. For example, a three year old girl in Vietnam who lived near an illegal slaughterhouse was taken to hospital and died a week later. Mass slaughter of poultry in affected countries helped to prevent future infections, at a huge cost to farmers’ livelihoods. Bird flu and SARS were hardly a panic over nothing to the people whose lives were devastated by these diseases, and it is difficult to escape the conclusion that they were only viewed as such because they didn’t affect Europe and North America. And the complacency of the ‘developed world’, thinking pandemics were a thing of the past and the risks of an outbreak exaggerated or ridiculed, while health infrastructure was steadily run into the ground, helped create the conditions for SARS-Cov2 to ravage its way across the world.
The catalogue of failures on COVID-19 include Trump’s decision to fire the team in charge of the US’s pandemic response to save money, and the decision to shelve a potential vaccine for SARS because of difficulty in finding funding. However, as early as 2015, Chinese scientists reported that viruses similar to SARS were found in bats and could infect human tissues. The UK government initially justified its notorious ‘herd immunity’ position with a ten-year old plan based on flu, rather than a coronavirus, before announcing the ‘science had changed’ after modelling from Imperial College, justifying measures which escalated from ‘wash your hands and sing happy birthday’ to ‘You must only go for one walk a day’ in under two weeks. Even if COVID-19 had been no more than a form of flu, the NHS was warning of shortages in personal protective equipment for treating patients in a potential flu outbreak as early as 2017. It’s not just the UK. Bolsonaro has claimed lockdowns are not necessary as Brazilians are immune to everything. Putin has said COVID-19 in Russia is ‘under control’ even as Moscow has gone into lockdown.
Although Wuhan’s lockdown was seen as a weird curiosity from an increasingly authoritarian Chinese state, it certainly isn’t now. The Chinese state was unable to contain the outbreak within the city, a major manufacturing hub, and prevent it spreading. Whistleblowers who tried to raise the alarm about the ‘pneumonia of unknown cause’ spreading throughout the city were arrested, with one of the most prominent doctors later dying of the disease. This all raises the question of why the authoritarian, corrupt Chinese state should have been the only thing standing between the world and a deadly pandemic. Why did country after country assume pandemics were a thing of the past and not a serious threat, and when a contagious, deadly disease emerged, took the attitude of ‘the Chinese will deal with it and we don’t have to worry’, until the last minute, when ‘the science changed’ and the only option to stop the coronavirus was a Wuhan-style lockdown, which is already causing unimaginable social and economic consequences around the world. But why should the people of Wuhan have to ‘deal with it’ to keep underprepared and grossly unequal societies safe while their governments rapidly stopped trying to monitor and track the disease and carried on as ‘normal’?
And as for the old joke ‘we can put a man on the moon but can’t find a cure for the common cold’? Well, maybe we should have tried to cure the common cold? The same people screeching ‘actually more people die from the flu’ are often the same people who think it is some way desirable to turn up to work with a temperature to ‘battle through it’ after spending the weekend hacking up into snotty tissues. This runs the risk of secondary bacterial infections and, of course, spreading it to someone unable to ‘battle through it’ without a stay in the ICU. Huge numbers of people do not get sick pay, and the loss of income caused by this crisis, despite the well-publicized measures announced by the government could push millions into destitution. After COVID-19, workers and the self employed must have adequate protection if they are sick or lose income because of illness. There is no excuse for not providing adequate sick pay and assuming flu and other illnesses are an excuse to laze around in bed, while accepting the slow decline of the healthcare system so healthcare workers have to share masks or improvise with bin bags.
Most of us will probably survive COVID-19. But some things cannot ‘go back to normal’ afterwards and nor should they, or the next pandemic really will make this one look like a bad cold.