Wednesday, February 05, 2020

Blessed isolation, part 1

We pulled our luggage from the car and decided who would take what up to the apartment. She brought up the groceries first and then I followed a moment later wheeling the large suitcases. To greet us were our downstairs neighbours on the balcony of their place, father and son. They're familiar in the neighbourly way. The father and I know each other to the point of names and his son always says hi to us, usually while playing frontyard cricket with the lawn at the front of the complex.
"Been travelling?" the father asks.
"Yes," I say but drawing a metre further past him.
"Where to?" he asks, which I can't help but wince in response to.
"China," I say. 
He smiles without any recoil: "So you'll be having a 14 day holiday then." I nod and he says: "If there's anything you need help with, let me know." It was nice to know that the first real "stranger" experience to this recent China traveller wasn't of shrieking dread, but actual friendly support. I thanked him and headed up to what will be our almost 24/7 bunker for the next 14 days.

Shrieking dread though is something the media likes. My Australian friend, who after quite the ordeal is boarding a plane today to leave Guangdong, struggled to get access to the Australian newspapers and I let him know about the New Zealand Herald, which isn't blocked in China. 
"It's such a breath of fresh air," he said. "None of the sensationalism that the Aussie papers have." I'm not sure if the Australian dailies are ridiculous or he just read the NZ Herald on a good day, but the coverage has been shrieking and inflammatory in the Herald. And boy does it serve its purpose. 
Step 1: Report the issue with not-so-subtle editorialising, which will certainly inflame and hypersensitise, perhaps by emphasising the extreme. 
Step 2: Wait for the statistically likely response of the ill-informed who read the previous reporting to do something ridiculous to further report on. 
Such is the case with coronavirus, which even in our liberal populace triggered racists responses. 

Is coronavirus something to fear? China's reported numbers are hard to be certain of but they were shamed by SARS outbreak where they clearly weren't open and honest, and praised for their reaction to avian flu a few years back. and I still believe the numbers to an extent are accurate. The picture on the left is one I saw circulating on WeChat after the international community suddenly started shutting off borders to Chinese travellers. It's not accurate - H1N1 did not have a 17.4% fatality rate. (They've mixed a hypothetical death count with the actual reported number of cases. That puts it on par with the Spanish Flu. It's more likely to be 3-4%) It's hard to fact-check in China but excluding the nationalist chip on the shoulder, it has to be said no modern effort to control an outbreak matches this. 

The media in China is controlled so you will never have news that panics unless you the government wants you to panic. The best way to know is by reading the response, and also knowing that even the aspiring omniscient, omnipotent state does not know everything and cannot do everything. 
Fact: Wuhan and several other cities are still "sealed". Something that is a massive undertaking.
Fact: The country's holidays have been extended by weeks damaging production and consumption. Fact: The whole tourism industry was shut down during its most lucrative time. 
I'd conclude that all of these self-damaging decisions were made by the Chinese authorities with the best understanding of the outbreak, whether it is the same as what they're projecting to the public. They put a huge resource into halting the cultural imperatives to gather during Chinese New Year and sent crucial staff and teams from all over China into Hubei province, gambling it wouldn't break out there. The kind of actions they have taken imply it is pretty bad. These are actions that panic, too. I surmise they're doing things openly because they want the populace to take it seriously.

But even trusting the figures for all provinces and foreign countries, except for Hubei province, shows that it isn't necessarily much worse than a seasonal flu - many provinces have had large numbers who have recovered, most provinces are yet to have a fatality. The picture on the left shows the province names, the confirmed cases, the recovered cases and the fatalities in the 10 most affected provinces. (Hubei at the top, then Zhejiang, followed by Guangdong, Henan and Hunan.)

I do have a hypothesis that rationalises both the extreme actions taken to contain it with the low fatalities as of now in other provinces against the large number in Hubei. I would guess that this virus does transmit easily and causes death, not from its extreme symptoms per se, but from the lack of medical care and sustaining medical supplies, as well as the inevitable deaths of weak and vulnerable. I would guess that this wasn't well contained early and that caused a huge wave of infected people. A large proportion required hospitalisation and almost all would survive with adequate supplies and professionals. China is a massive country with an organised health system but there is a point where medical resources cannot match the spike of cases this particular virus caused. I saw pictures of queues and crowds outside hospitals in Wuhan, sent via social media, but never seen in the mainstream media. Anecdotally people were queuing for the test and then were waiting for the confirmation of coronavirus before isolating and treating just so they could make sure that they were treating the right people. But with a lack of testing equipment during a down time in production and also a lengthening turn around time for results, most people in Wuhan who get the virus cannot get care. If the number above is accurate over 13,000 people in Hubei province should be in a quarantined room with special supplies. 

But there is a huge and fast moving social media environment. Pictures always get out. I would presume the videos of body bags and stories of people dropping dead in Hubei are real. I would say that the number there is underreported just because confirming is a process that requires the person to be there to be tested. 
Initially all the cases in other provinces was among the five million people who left Wuhan before the city was sealed who went to all cities and countries some carrying the virus. Its now 14 days since Wuhan went into quarantine, which means of those five million, those who caught it must have all been symptomatic and have hopefully got the care they need in the less burdened hospitals outside of Hubei. Therefore, tomorrow's number of new cases for provinces outside of Hubei will almost all be those infected outside of Hubei itself despite the shutting down of the country. In a way, the numbers tomorrow are the most interesting of all. If the majority of the cases are nipped in the bud, while there are adequate hospital quarantined beds, there is a good chance this is the end of the outbreak. If the number keeps rising especially in certain cities, there could be further sealed cities.

So is coronavirus to be feared? If it there weren't the huge efforts being undertaken, I would guess that it would cause a similar systems failure in other cities and provinces. If I were apocalyptic, either Guangzhou, Wenzhou or Shenzhen could be overcome if there gets to a point. It's only during my peaceful contemplation from my place in the protection of my own home that I now think it's more dangerous than I thought it was while in China. 

New Zealand's response at the border (as reported: https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12305734) was my experience of it too. I was underwhelmed and I'm not sure if it's putting to much trust in human trust and diligence, as New Zealand systems often do. China's ports are fitted out for pandemics. The airports have better temperature measurement technology than hospitals (when we went to the doctor in our last trip, we still needed to do the "thermometer-under-the-armpit for 10 minutes" trick). I have no idea what the outlay is for Auckland Airport to do that but I would say that a country should have something similar and have the resources to staff it. We live in a country where people generally do the right thing without direction and generally follow the advice (except for the idiots who go to the beach to check for tsunamis). 

After a restless day of travel and jet lag, my cold has been reactivated. My temperature taken: 36.2 degrees. I hope with a bit more rest I can actually feel like I'm not sick during this quarantine. My company has allowed me to work from home, which means I won't have trouble getting through the period but I've given myself sick leave to get to next week. This post is called part 1. There might not be a part 2. I'm kind of hoping that there isn't.

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