Ending the Complacency: Why Covid-19 in Europe and Covid-19 in China are two very different beasts

Have a Lemsip Willya; it's only a cold

I just finished watching the Irish national news in which another “expert” mouthpiece reassured us all that Covid-19 is no worse than a common cold. Bit of a pause….for 80% of the population. Bad news for 20% of us but all good for the rest - it’s grand anyway sure..... gran had a good life. For the lucky 80, grab some lemsip, take a two-week sickie, binge watch Netflix, maybe even have a few bottles of corona for irony’s sake. Shame then, the advice and information on the risks associated with coronavirus being disseminated by our government, health care services, and media dangerously downplays the threat facing Ireland and the rest of Europe. So why have I come to this conclusion?

The China Advantage

Ireland (and the rest of Europe) is drastically different from China in many vital areas. Our cities are not planned the same. Our urban environment is not the same. Our healthcare system is not the same. Our technical capacities in key areas are not the same, and most importantly, our government’s ability to rapidly mobilize a vast military-industrial complex and gargantuan tech sector is not the same. Anyone that has spent any significant amount of time in China would understand that Ireland is in no position to mount the same robust national immune response to this viral outbreak. Another major flaw in our current assessment of the risks of coronavirus is that most of our assumptions and understanding is based on how the virus has spread in China. Monumental mistake….

War Games

Chinese cities are a fascinating place. I remember my first stint in China in 2009. One of the things that struck me first was the ubiquity of police and army. They were everywhere. At the front of my apartment complex, at the doors of hotels, at the doors of shops and supermarkets, at the swimming pool, in the hospitals. Well, at least that's what my uninitiated eyes assumed until I found out that in China security guards, sometimes cleaning staff, and all manner of worker with nothing to do with the armed services or police force wear tactical gear and military fatigues. They get up in the morning and do drills in formations with an uncanny similarity to the boot camp situation you might expect military or police recruits to engage in. They are ready to step in when the excrement hits the fans, and the contribution of these workers and the infrastructure supporting them in China’s battle with coronavirus cannot be underestimated. This is by design.

The Infrastructure

My apartment complex in China was a fully gated community, with about 30 high rise apartment blocks of about 22 stories each. The facility was fully enclosed by a tall metal fence with razor wire discreetly embedded on the tops of the walls and security cameras at regular intervals all along the perimeter. I know my description sounds Orwellian, but actually, the complex was beautiful with stunningly landscaped gardens, large ponds, playgrounds and a host of amenities including a local shop, vegetable and fruit market, restaurants and very convenient electronic lockers for delivery of packages, letters, and even fresh food.

 I would estimate this complex was home to thousands of people and hundreds of families. The ways in and out of the complex are under 24-hour security watch comprised of the religiously consistent presence of 2 to 3 guards. One guard standing duty in front of the gate, and one or two more in a fixed concrete building with large glass walls and a wall of TV screens transmitting the images from the numerous CCTV cameras scattered throughout the facility. On the wall next to TVs, a rack of riot gear. Truncheons, helmets, PVC shields, and something with a long handle and U bend that looks like something you would use to catch a stray dog..or stray human. Entrance to the complex is permitted only to residents with cards. If you don’t have an entrance card, you need to wait at the gate while security checks with a resident to make sure you are expected. After this, you need to present your national ID.

Scalable compartmentalization and layers of redundancy

On the basement level of all buildings in my apartment complex is a large interconnected series of car parks. At a set point under each of the buildings is a large shelter with impressively heavy steel doors almost a foot thick surrounded by steel-reinforced concrete of a similar thickness. Bomb shelters? I never actually confirmed this was the function, but they weren’t built for playing table tennis.

This is China. 1.4 billion people. Living in this kind of complexes and gated communities. These lads are not messing about. China was born ready for COVID-19 and is a country defined by scalable compartmentalization and layers of redundancy built upon layers of redundancy. China can put a province on lockdown, it can put all the cities in that province on lockdown, and within those cities, it can put all the individual apartment complexes on lockdown.

Does this sound like Ireland? Sound like Europe? 

The Flu Fallacy and an R0 Value Based on an Incomplete Data Set

I genuinely get upset by the lack of critical thinking that goes into comparing Covid 19 with seasonal influenza or worse still… the common cold. Beyond symptomatology, the comparison is dangerous. Non- experts making this comparison are just cabbages. Still, I'll give experts the benefit of the doubt that they are trying to provide some context for the public to help them get to grips with the infectivity and virulence of the virus. One of the key reasons the COVID-19 infection has been downgraded from zombie apocalypse to pesky man-flu is the calculation of its R0 value. R0 is a measure used in epidemiology to assess how contagious an infection is, or more specifically, how many people a person with the virus will infect. At present, we are looking at an R0 value of about 2, reassuringly close to the seasonal flu, which has an average value of 1.2. It’s important to remember that the R0 is not an intrinsic property of a virus in the same ways as the virus capsule, surface receptors or virus genome is. Instead, it is an assigned number we give a virus based on calculations that are affected by numerous variables. One of the most important variables. The response of the country to the virus. So China’s R-value may not be Ireland’s R-value.

Respect the tech

The major problem with the current consensus on R0 is that it has largely been retrospectively calculated based on data derived from China. A country with all the attributes I've mentioned above. A country that can leverage its state-run telecommunications companies and national identity database to track and communicate with all people that had potential contact with the virus epicenter. A country that can retrofit the software of its vast network of CCTV cameras with face recognition and heat-sensing capabilities to conduct real-time body temperature scans on its population. A country that can build a thousand-bed hospital in just several days. A country with the most digitalized supply chain in the world, the most advanced cashless payment systems in the world, the most advanced e-commerce infrastructure in the world, massive mobile penetration, a monstrous fleet of light urban logistics that can be mobilized to make contactless deliveries of foods, medicines and medical supplies, protective clothing and masks and everything in between. Does this sound like Ireland? Sound like Europe?

A more robust model

 Let’s get real…We are still in unknown territory with Covid-19. Let’s stop the daft attempts at providing context and remove the preconceptions that will hinder a reliable analysis of the situation so that we can properly consider the risks and make appropriate plans. Let's understand that our current model needs to need to be robust enough to encompass new data that could see the R0 value revised upwards. We are seeing worrying signs out of Iran of a much higher case fatality rate of almost 20%, drastically higher than the currently accepted 2.2%. Sure this could be an outlier attributable to a low n value. It could mean that the virus has picked up a mutation, which has made it entirely more virulent. Or it could even mean that the healthcare system of a country that thinks quarantine and lockdowns don't work …to put it mildly.. sucks.