Is it Going to Become a Pandemic?
Our estimates of RR0 are broadly consistent with early estimates from other groups: 2.0–3.3 (Majumder and Mandl, 2020); 2.6 (uncertainty range 1.5-3.5)(Imai et al., 2020b); 2.92 (95% CI 2.28, 3.67)(Liu et al., 2020); 2.2 (90% interval: 1.4-3.8) (Riou and Althaus, 2020).
It looks like Corona is becoming a full-fledged pandemic in geographic terms, with multiple cases of human to human transmission confirmed in Germany yesterday. This has also been observed in Japan and Taiwan.
If that happened there, then surely it must have happened in other countries with close contacts to China, such as Thailand (they may not have been picked up there due to weaker epidemiological resources).
Which Countries Are Best Prepared for a Pandemic?
Historically, it seems like simple wealth, and the advantages it brings – larger state capacity (e.g. to effect quarantines), more physically robust constitutions, greater physical space (e.g. private cars, detached houses), etc. – have played a critical role. For instance, mortality during the Spanish Flu was at just 0.5% in the US and 0.5%-1.0% in the combatant states of Western Europe, but rose to 1.5% in Italy and the Balkans, and 5% in India and Indonesia.
Overall, we might expect to see a similar distribution, although weighted downwards to account for its lower mortality rates (currently ~1%, vs. 10% for the Spanish Flu).
Consequently, I expect suburbia-centered Anglo countries to do best in a global pandemic. Though the physical infrastructure might be depressive, one thing it’s good at is minimizing human contact.
Most of Western Europe might do slightly worse because of its older populations, greater reliance on public transport, and greater share of the population living in apartments.
One “perfect” solution is to just avoid contact altogether, like American Samoa managed to do during the Spanish Flu. But the only polity capable and willing to do nationwide sakoku today is Best Korea.
Maximizing the number of hospital beds per capita is usually a misallocation of resources. It was mostly done in the commie bloc because it was an easy to quantify target, but it wasn’t matched by quality training or funding for modern equipment, so real health outcomes increasingly lagged the West as the Cold War wore on.
But the one situation in which too many hospital beds would come in handy is in a large epidemic.
As one can see, Russia and many East European countries – and the Germanies – have three times the hospital beds per capita as many countries in Western Europe, where this indicator has been “rationalized” for a longer time period.
So for once there’s a Soviet legacy that’s actually good for a change.
In terms of wealth and healthcare resources, China would be broadly in this category.
India and the Third World in general seems screwed – not just because of that, but because both state capacity and competence are much lower than in the Global North. E.g., an observer from Nepal:
lol, that sounds bad but you are correct mate, i am in Nepal and we have confirmed here and he was released back into Kathmandu before the results were back from HongKong (no lab here for this test) Now they are trying to trace him and his family but no addresses here so he is fred from this part of town etc…. Shockingly inept of them to allow him to leave but still, yeah India and Nepal have open border with tens of thousands crossing openly daily, gonna be testing when it starts to spread cos the lack of hygiene and numbers of people crammed into anywhere is the perfect breeding ground.
With this going down in Nepal, it’s surely on a matter of time before it spreads to India. Now that will be a true nightmare, as it’s got almost ten times fewer hospital beds than China (and yet Wuhan’s are strained enough as it is), and people are much less robust (e.g. child malnutrition in India comparable to S.S. Africa).
If this does go global, I expect India to eventually accrue many more deaths per capita than China – which will in turn have many more deaths than the West. Eastern Europe, including Russia, would be somewhere in between China and the Western countries.
When can we expect Corona to start getting noticed abroad?
(if control measures don’t work and it retains its contagiousness).
It took about 1.5 months for the epidemic in Wuhan to flare up to the point at which the authorities decided to quarantine it. On the one hand, authorities everywhere are now aware of Corona, and preparing countermeasures. On the other hand, the Wuhan crisis began with one Patient Zero, whereas cities elsewhere may get multiple infected visitors from China. So perhaps allow 2 months for major cities with links to China to get to that state, i.e. from around mid-March to early April.
Isn’t it just like the flu?
Many people have this weird propensity to either dismiss this as a complete nothingburger, often based on a lack of understanding of exponential growth (e.g. it’s only
20 50 100 deaths so far, you do know China has a billion people lol), while others spin up equally ridiculous apocalyptic vistas comparing it to the Black Death.
So here are some comparative statistics based on the flu, something we’re all familiar with:
- Mortality from ordinary flu is 0.01% (1/10,000), heavily loaded towards older people.
- Mortality from Corona is ~1%, i.e. take the one concrete number we have (mortality = 15% for the first 41 confirmed cases), and adjust downwards by the number of unregistered cases (90%+). That said, we don’t really know, and this could be off the mark by up to an order of magnitude either way. Like flu, heavily loaded towards the elderly.
So ordinary flu and Corona are not comparable in scale. It is very understandable to want to avoid experiencing the risk equivalent of ~100 flus, regardless of age.
For comparison, if you spend your entire life (24/7, 365 days a year) flying on modern commercial airliners, you will have just a 0.1% chance of dying in a crash. It would also quicker and less painful.
Ultimately, the Chinese authorities are not particularly sentimental, and would not have quarantined the population of Spain and slowed their GDP growth over a nothingburger.