(Bloomberg Opinion) -- For a time, it looked like our defenses might hold.
The extraordinary lockdown of China’s Hubei province over the past month had at times appeared to be halting the spread of the Covid-19 coronavirus. For much of that period, new cases outside China were running at just a dozen or so a day, most of them with clear connections back to the epicenter in the city of Wuhan.
Perhaps this latest infection could follow the path of severe acute respiratory syndrome? The SARS strain of coronavirus vanished within months of its emergence in 2003 thanks to stringent quarantine measures, and has since hardly ever been seen outside of laboratories.
That prospect is looking increasingly remote now. For most of the past month, just a percentage point of so of new daily infections have occurred outside China. Since Thursday, that proportion has risen to a fifth. Nearly half of cases so far found outside of China have been reported in the past four days.
Fresh outbreaks in Italy and Iran, and a galloping rate of new infections in South Korea and Japan, suggest that Covid-19 is skipping past our quarantine cordons quite as easily as it jumps the body’s defenses.
“Those countries are canaries in the coalmine that the virus is quite active — a sign that containment is reaching the end of its applicability,” said Ian Mackay, an associate professor of virology at the University of Queensland. “There could be these sorts of spot fires burning everywhere with us not knowing.”
These outbreaks may still be just the tip of the iceberg. About two-thirds of coronavirus cases exported from China haven’t been detected yet, according to a study last week by Imperial College London.
In a separate study by doctors in Henan province to the north of Hubei, a woman from Wuhan was found to have incubated coronavirus for 19 days and infected five family members while frequently showing no symptoms herself, even under repeated medical testing. China’s official case tallies often seem hard to reconcile, and may be under-counted.
That presents an alarming prospect. If similar outbreaks continue to emerge elsewhere in the world, it looks like Covid-19 will no longer remain a localized epidemic in Hubei province. Instead, it’s turning into a global infection — a pandemic — and will eventually become an endemic disease prevalent throughout the human population.
Some chance remains that this outcome could be prevented, but the odds are narrowing. “It’s too early to call it, but it’s on a knife’s edge,” Professor Raina MacIntyre, head of the Biosecurity Research Program at the University of New South Wales, said by e-mail.
It’s hard to know how to respond to this. The good news is that if Covid-19 becomes globally endemic, it’s likely that human immunity will improve significantly. That should push the fatality rate down from current levels of between 1% and 3% of cases to those more comparable with measles, which kills in about 0.1% of cases outside of the poorest countries, or even seasonal influenza, which is closer to 0.005%. The trouble is, no one knows how many people will die on the way to establishing that immunity. The figure could easily run into the millions — even the seasonal flu kills between 290,000 and 650,000 people each year.
Measures being taken already may at least slow the progress of any further outbreaks. Venice, the city that invented quarantine in the face of medieval epidemics, has shut down its historic annual carnival to limit infection. Schools and sporting events have been closed too and 10 towns have been locked down in a manner similar to what we’ve seen in China.
This is unlikely to be enough. If Covid-19 can really be carried undetected for as long as the Henan study suggests, there’s no reasonable way we can lock down the human population sufficiently to stop its worldwide spread. The better course of action may be to accept that it may come to our neighborhoods sooner or later, and redouble efforts to build resilience and resistance.
That means following some of the basic practices suggested by risk communications specialists Jody Lanard and Peter Sandman: Regular hand-washing; avoiding putting our hands to our faces; limiting contact with regularly touched surfaces like lift buttons; and ensuring we have sufficient basic supplies and essential medications to see us through any period when health clinics become crowded with infected people and panic-buying clears out grocery shelves.
If that sounds worrying, it’s because pandemics are. Mercifully, they are also relatively rare. As with previous outbreaks, humanity will survive this infection, come to see it as normal, and even forget how it felt when it first struck fear into us. If Covid-19 really has gone global, though, the next few months are likely to test all of us in much the same way that the population of China has been tested so far. We shouldn’t be overly alarmed — but we should certainly be alert.
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David Fickling is a Bloomberg Opinion columnist covering commodities, as well as industrial and consumer companies. He has been a reporter for Bloomberg News, Dow Jones, the Wall Street Journal, the Financial Times and the Guardian.
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