Multiple Perspectives on China's Battle with Coronavirus: Dispelling Myths and Clarifying the Situation

The medical perspective -

One of the more bizarre things we have seen during the nCOV epidemic is a deluge of misinformation. For me, one of the more annoyingly pervasive themes still being propagated through media is the utility of a comparison of nCOV with the seasonal flu. Sure I get the human need to contextualize something new relative to something familiar and the need to quantify risk BUT... these comparisons can also be counterproductive and do little to promote understanding of an emerging infection in which the learning curve (and unfortunately some other curves) are very steep. The only sensible comparison to make is between nCOV and the other major zoonotic coronaviruses SARS and MERS.

So to offer people some clarity lets look at the best available scientific and medical studies on nCOV to date, particularly the two studies linked below, the first published in JAMA and the other from the Lancet.

• Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China
• Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

What do these studies tell us? Some medical facts

• The median age of those that develop pneumonia is 56 years. 54.3% were men.
• About 17% of people that develop nCOV pneumonia go on to develop serious complications. These complications include acute respiratory distress, heart arrhythmias, acute cardiac injury, and acute renal injury. Of this 17%, there is only about a 4% case fatality rate.
• The case-fatality rate in the wider population is currently 2.2%.
• For those that develop serious complications the median time from the development of first symptoms to clinical impairment of lung function (evidenced by shortness of breath) was 5 days. The median time to hospitalization was 7 days and the median time to development of acute respiratory distress was 8 days
• The major risk factor appears to be smoking and increased blood pressure which might explain the virus's predilection for males. The blood pressure risk might be explained by the upregulation of angiotensin ( part of the RAAS feedback mechanism involved in blood pressure homeostasis) which the viruses use to bind. (just a quick thought I had so don't hold me to it) . This might also explain why ACE inhibitors were described as having some efficacy in treating SARS and might also work for nCOV. Both SARS and nCOV use the ANG2 receptor to bind.
• As expected other major comorbidities worsen clinical outcomes including COPD, diabetes, cardiovascular disease, etc.
• Clinical presentations include fever (98.6%), fatigue (69.6%), dry cough (59.4%), muscle pain (34.8%), shortness of breath (31.2%), diarrhea and nausea prior to the onset of fever (10.1%)
• The virus has about 96.2% homology with an existing bat coronavirus.
• The infection started with a single transmission event from an intermediary animal to humans.
• nCOV has 79.5% sequence homology with SARS.
• nCOV has lower virulence than SARs (e.g a lower case fatality rate) but higher infectivity (e.g a higher R0 value)
• The best current data puts the R0 value at 2.2

The impact on China's economy - Some general observations

As expected the virus has caused considerable disruption to China's economy with the impact being felt at all links in the supply and value chains. Multiple high population density urban hubs are currently on lockdown. Major restrictions on movement and transportation are being imposed. The impact of the virus is manifesting in both supply and demand-side pressures.

The central government has extended the temporary restrictions on employees returning to work which is significantly impacting the production capacities of key sectors. As raw materials and stock are used up and supply becomes scarcer we can expect an increase in prices across numerous key sectors.

In an effort to combat the virus Chinese policymakers have introduced several emergency interim measures to expedite the entry of much needed medical supplies and disinfectants including developing a green channel for disinfectant products that offer temporary exemptions from regulatory compliance obligations to international stakeholders. Other exemptions for medical devices (includes masks, medical protective clothing etc.) have also been extended to international stakeholders.

As expected bricks and mortar businesses are suffering the most, while online enterprises are better equipped to buffer the impact of the epidemic with some sectors over-performing during the epidemic.

For further reading check out the following articles on Chemlinked:

• Coronavirus Epidemic Significantly Impacting Dairy Supply Chain
• Coronavirus Outbreak Fueling Sales of Health Foods
• The Economic Impact of Coronavirus in China: Food Supply Chain Focus
• Expedited Market Entry for Imported Disinfectants: China's Emergency Response Green Channel