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Pandemic World

Introduction

It seems like an age since of all of this began. Pandemic – that word that carried such urgency, never really registered in our collective consciousness. When major outbreaks of diseases were discussed before 2020, they were often in the realms of fiction such as the film Contagion, the video game Pandemic or novels like Stephen King’s The Stand. Where they actually occurred, the spread was usually contained to the developing world, where poor sanitary conditions and unhygienic practices helped facilitate the spread of new and existing viruses.

I knew of the famous pandemics of the past, chiefly the 1918 “Spanish Flu” but these were in the era before modern medicine. The only outbreaks of disease that occurred during my childhood were able to be swiftly controlled. I was 10 when SARS broke out, and nearing the end of high school when the 2009 H1N1 (Swine Flu) outbreak occurred. Only one person briefly wore a mask at our school, and was the subject of snide remarks during the lunch break.

While HIV/AIDS was still causing thousands of deaths and untold heartache worldwide, the suffering was largely isolated to the developing world. The AIDS crisis in the 80s had, with treatment, reached a manageable level in most of the developed world in the 90s. All of these earlier crises seemed distant and foreign. We became complacent and thought that with our sanitation and advanced healthcare systems. we were free of such terrors. Even though we heard the warnings from scientists surface periodically in the media, it didn’t register that it would actually happen within our lifetimes.

Yet here we are in the midst of the worst global pandemic in over a century. Coronavirus Disease 2019 (COVID-19) has spread across the world at a lightning fast rate. The developed world has not been spared, as in Milan and New York City during the first wave of the outbreak, we saw advanced healthcare systems completely overrun. No matter how skilled the doctors, the sheer volume of infected cases can bring a hospital to breaking point. Few Western countries were equipped with sufficient resources such as PPE and ventilators to deal with a massive amount of critical cases.

 

Social Distancing in Sydney, Australia 27/03/2020
Social Distancing in Sydney, Australia 27/03/2020

Many new phrases have been added to our vocabulary in the past year: Social Distancing, Contact Tracing,  PPE, Panic Buying, Flattening The Curve etc. As we’ve adjusted our language, so too have we adjusted our behaviour: keeping 2 metres apart from others when out and about, video calling our families instead of visiting them, wearing face masks and washing our hands with religious fervour.

As the disease spread throughout the world, it became clear that countries which took a proactive rather than a reactive approach, were those best prepared. The East Asian and South East Asian countries which had faced previous disease outbreaks such as Vietnam and Taiwan proved largely to be the best prepared. Those that remained in denial until cases spiked, most noticeably the United States, left themselves to be overwhelmed.

However the world has grown tired of the disease, and even countries which took the disease seriously are suffering from serious waves. India most noticeably instituted heavy restrictions in March, but since loosening these in June the cases have been surging. It is now on course to overtake The United States as the most heavily infected country on earth. Likewise as Europe eased restrictions and opened up a “travel corridor” to allow for pent-up tourists to take their summer holidays, the virus spread between previously impassable borders.

Many COVID-19 success stories turned out to be premature. Early success stories such as Australia, Singapore, and the Czech Republic had their numbers rise again. No country could remain locked down forever, and it has been clear that only a scant minority such as New Zealand, Taiwan and Vietnam, have been able to truly control the disease.

Play Equipment fenced off at my local park - Christchurch, New Zealand
Play Equipment fenced off at my local park in April 2020 – Christchurch, New Zealand

As the severity of the disease became clear in the early months of the year, world leaders took the unprecedented step of locking down their countries. Billions of people around the world went into lockdowns to avoid a total collapse of their healthcare systems.  Looking back on New Zealand’s lockdown it was a strange time. New Zealand went into a “Level 4” total lockdown on 25th March – one of the strictest in the world. Everything bar hospitals, supermarkets and a narrow list of “essential services” were closed, with the police on the ground to deter any potential rule-breakers. I remained working from home, but with a noticeable decrease in workload. For many workers who couldn’t, they enjoyed a holiday paid by the tax-payer.  A national wage-subsidy scheme had the government pay the wages of millions for several weeks.

For the first time in nearly a century, cars outnumbered people on the road. On my handful of trips outside for essential services, I confess that I found myself missing the traffic. One morning I heard a plane descend and it was a welcome sound. Normally, it’s just a minor annoyance, but I found myself rushing to look at the window to see the great flying machine of ages past. It was like we were living in a pre-aviation age, or perhaps more accurately a post-aviation one. All the planes were grounded. All of the trains were stuck. We were living with the pause button on humanity.

I began writing this post in the midst of New Zealand’s lockdown in April. At that time, the total infected worldwide was nearing two million. At present, the total of confirmed cases (i.e. those with positive test results) stands at over thirty eight million. Due to a combination of a lack of testing, fudging of the figures, and outstripped resources, the true number is likely to be far higher – The World Health Organization has estimated 800 million people may have contracted COVID-19.

Looking at cases on Microsoft’s COVID-19 tracker below, it seems like the whole earth has succumbed to a horrible sickness, with red blotches all over its surface.

Cases of COVID-19 as at 12/04/2020
Cases of COVID-19 as at 12/04/2020

 

Cases of COVID-19 as at 18/04/2020
Cases of COVID-19 as at 18/04/2020

 

Cases
Cases as at 14/06/2020

 

COVID 19 18th October 2020
Cases as at 18/10/2020

The exponential spread of this disease is a sickness emboldened by time. We passed the grim milestone of over a million recorded deaths with little fanfare at the end of September. It was no cause for celebration, but perhaps the reason why this milestone went so unnoticed is that it the figure is certain to increase. Confirmed deaths, as with confirmed cases, are likely to be much higher. While developed healthcare systems generally had more accurate figures, many have died without even being diagnosed. How can we possibly remember a million lost, so many of which could have been avoided? Humanity was never meant to be able to imagine such suffering. Every death leaves behind widows, children and other loved ones as the other victims of the disease.

As “second waves” and “third waves” of the disease continue to spread, and restrictions remain in place,  I thought I would take a moment to reflect on the dominant news story of 2020. I had originally intended a much more ambitious post on COVID-19, but the full story cannot yet be told. The disease will continue to impact our lives in the coming years, but as “second waves” and “third waves” of the disease continue to spread, I hope this serves as a refresher of what has occurred, and a reminder than this is not over yet.

Part One – Origin & Spread of The Virus

November 2019

The Huanan Seafood Market in Wuhan was like many other thousands of Wet Markets throughout China. Across over a thousand different stalls, shoppers could purchase a huge assortment of seafood, meat and produce.  The Chinese predilection towards fresh ingredients is well known (after all, what other cuisine features live fish tanks in its restaurants?)  At the Huanan Seafood Market, the seafood was either still alive or sold within a few hours of it being caught.

Wet Markets derive their name from the water needed to keep the stock fresh. Water is sprayed on the fruit and vegetables and sloshed over the meat and seafood regularly while the stall is open. In the narrow confines between the stalls, the water spills out onto the paths, and creates a humid environment.  Picture a farmers market, but a much less sanitary one, and you’ll begin to get the idea of Wet Markets. Wet Markets are common throughout all developing nations in Asia. ““In a country like India or Indonesia, between 25 and 40 million people rely on wet markets and informal food vendors for their livelihoods.”

It should be emphasized that Wet Markets are not necessarily wild animal markets, but the lack of regulation and poorer infrastructure housing them, has meant conditions are often unsanitary. The Huanan Seafood market was distinguished from other wet markets of China, by selling an assortment of less savoury items. Live animals were kept and slaughtered on site. As reported by the Times of Israel, “A price list issued by one merchant at the sprawling emporium, which circulated on China’s internet in January, contained a smorgasbord of exotic wildlife including civets, rats, snakes, giant salamanders and even live wolf pups. “

A price list at one stall at the Huanan Seafood Market pictured below featured the following items for sale:

  • Live Sika Deer 梅花鹿 6000元
  • Live ostrich 活鸵鸟 4000元
  • Live peacock 活孔雀 500元
  • Live #civet cat 活果子狸 130元
  • Crocodile tongue 鳄鱼舌 45元/1斤
  • Camel meat 骆驼肉 25元/1斤
  • Bull testicles 牛蛋 12元/1斤
A price list for a stall at the Huanan Seafood Market (Sourced from Douban)
A price list for a stall at the Huanan Seafood Market (Sourced from Douban)
Animal Carcases sold at Huanan Seafood Market (Source: Douban)
Animal Carcases sold at Huanan Seafood Market (Source: Douban)

 

Footage of the Huanan Seafood Market before its closure.

Many of these wild animals weren’t sold for consuming their meat, but rather their medicinal properties to treat a variety of ailments in Traditional Chinese Medicine. Even if a novel Coronavirus hadn’t originated at the Huanan Seafood Market, it’s clear that the unsanitary and cramped conditions, likely could have caused all manner of other diseases.

Who was Patient Zero?

“Finding the index case, or “patient zero,” for an infectious disease that’s just emerged can take months or years, if the person can even be found at all.”

The first confirmed case of COVID-19 is still uncertain. Finding “Patient Zero” remains challenging for any disease, especially one as contagious as COVID-19. Given the secrecy that the Chinese Government has instituted in trying to control the narrative of the disease, it is unlikely we will ever know.

All that we know is that some time in November 2019, the first human contracted case of SARSCoV2 emerged in Hubei, China. It was most likely connected to the Huanan Seafood Market. The South China Morning Post reports the following in relation to the origin of the outbreak:

According to the government data seen by the Post, a 55 year-old from Hubei province could have been the first person to have contracted Covid-19 on November 17.

From that date onwards, one to five new cases were reported each day. By December 15, the total number of infections stood at 27 – the first double-digit daily rise was reported on December 17 – and by December 20, the total number of confirmed cases had reached 60.”

On December 27, Zhang Jixian, a doctor from Hubei Provincial Hospital of Integrated Chinese and Western Medicine, told China’s health authorities that the disease was caused by a new coronavirus. By that date, more than 180 people had been infected, though doctors might not have been aware of all of them at the time. By the final day of 2019, the number of confirmed cases had risen to 266, On the first day of 2020 it stood at 381.Coronavirus: China’s first confirmed Covid-19 case traced back to November 17

Hold on. What’s the difference between COVID-19, Coronavirus and SARSCoV2?

Before continuing, I thought I should make a note on terminology since these terms certainly confused me. Essentially, the virus is the cause, the disease is the effect. The WHO explains:

“Viruses, and the diseases they cause, often have different names.  For example, HIV is the virus that causes AIDS.  People often know the name of a disease, but not the name of the virus that causes it.” – WHO 

In short, SARS-COV-2 is a type of Coronavirus responsible for the spread of the COVID-19 disease. Since cause and effect are invariably linked, they’re often used interchangeably.

Transmission of COVID-19

While the original cases are believed to be connected to the Huanan Seafood Market, it is still not clear as to what was the vector or intermediary host animal that caused the transmission of the virus from animal to human, or if indeed there was one. Several reports have postulated that it could be a Pangolin. The Pangolin is the most trafficked wild animal on earth, but ” It’s not yet clear whether any pangolins (or bats, for that matter) were sold at the Huanan market.” 

Another candidate is the civet, a nocturnal cat-like mammal which was believed to be the intermediary for the SARS outbreak in 2003. Interestingly, Civets are used in the production of which is created by the Civet defecating coffee beans to create one of the most expensive coffees in the world. I kid you not.

What is almost certain however, is regardless of whether there was an intermediary animal required for zoonotic (animal to human) transmission of the virus, SARS-CoV-2 first originated in bats.

Caged Pangolins at a Wild Animal Market in Yangon, Myanmar Source: https://www.flickr.com/photos/38518750@N00/4572625188
Caged Pangolins at a Wild Animal Market in Yangon, Myanmar
Source: Flickr

A scientific study undertaken in China between 2012-2015 – “Extensive diversity of coronaviruses in bats from China” examined samples of 1067 bats from throughout five different bat caves throughout Guizhou, Henan and Zhejiang provinces. In total, the 1067 bats were grouped into 21 different species, with only the Least Horsehoe Bat (Rhinolophus pusillus) found across all regions studied. The results of the study found that 6.84% of all bats studied (73/1067) carried at least one variety of Coronavirus.

Locations where Bat Samples were obtained - Extensive diversity of coronaviruses in bats from China
Locations where Bat Samples were obtained – Extensive diversity of coronaviruses in bats from China

The study also notes that bats are believed to be the origin of previous Coronavirus outbreaks, including SARS and MERS.

“Due to the close relationship between CoVs in bats and those causing human infections, it is believed that bats are the original source of human CoVs including SARS-CoV and MERS-CoV”

Interestingly, one study found that the Ebola Outbreak in 2013 was also likely connected to bats.

Lab Conspiracy Theory

While the overwhelming evidence points towards SARS-Cov-2 emerging in bats, a conspiracy theory emerged early on in the pandemic accusing China of deliberately created in a laboratory.  Given the lack of transparency provided by China over the origins of COVID-19, and the rapid spread of fake news on social media, it’s unsurprising that this has surfaced.  The Washington Times (the newspaper owned by Korea’s Moonie cult) suggested this theory in a story they published on January 26th 2020. An Editors note now reads that there is no evidence for the theory,  but not until months after they ran the story.

Although they denounced it, the Washington Times repeated the claim in a subsequent article on April 8th 2020.  USA Today further fact checked the claim and found there was no credibility to the theory.

In a Study Published in the medical journal Nature Medicine entitled The Proximal Origin of SARS-CoV-2, the authors deem it “improbable” that SARS-Cov-2 originated in a lab:

It is improbable that SARS-CoV-2 emerged through laboratory manipulation of a related SARS-CoV-like coronavirus. As noted above, the RBD of SARS-CoV-2 is optimized for binding to human ACE2 with an efficient solution different from those previously predicted7,11. Furthermore, if genetic manipulation had been performed, one of the several reverse-genetic systems available for betacoronaviruses would probably have been used19.

However, the genetic data irrefutably show that SARS-CoV-2 is not derived from any previously used virus backbone20. Instead, we propose two scenarios that can plausibly explain the origin of SARS-CoV-2: (i) natural selection in an animal host before zoonotic transfer; and (ii) natural selection in humans following zoonotic transfer. We also discuss whether selection during passage could have given rise to SARS-CoV-2. – Andersen, K.G., Rambaut, A., Lipkin, W.I. et al. The proximal origin of SARS-CoV-2. Nat Med 26, 450–452 (2020).

While it isn’t surprising that these theories have circulated, it’s disappointing that even high profile figures have cited them. To have the U.S. Secretary of State proposing a conspiracy theory in the midst of a global pandemic is just frankly embarrassing. Not to speak of the assorted other conspiracy theories that have emerged – 5G towers being vandalized in the UK  based on another fringe conspiracy theory with zero validity.

Surely the most obvious flaw in the COVID-19 lab theory is basic common sense.  If the Chinese Government were intent on developing a biological weapon which had escaped from a lab, then surely the fatality rate of the disease would be deadlier than it is. A biological weapon would be designed to kill, and COVID-19 kills a much smaller proportion of those than it infects. That’s not to diminish the seriousness of the disease, but there is no denying it could be worse.

Understanding the Disease

According to University of Oxford research published on the ‘Our World in Data’ website, in cases across four countries surveyed in February and March, the Case Fatality Rate for the bulk of age groups was below 1%.

Covid Case Fatality Rate by Age Group
Covid Case Fatality Rate by Age Group

Compare these rates to the 1918 Spanish Flu by contrast:

An estimated one third of the world’s population (or ≈500 million persons) were infected and had clinically apparent illnesses (1,2) during the 1918–1919 influenza pandemic. The disease was exceptionally severe. Case-fatality rates were >2.5%, compared to <0.1% in other influenza pandemics (3,4). Total deaths were estimated at ≈50 million (57) and were arguably as high as 100 million (7).” – 1918 Influenza, The Mother of All Pandemics

Indeed, it’s important to keep some historical perspective of how deadly previous pandemics were. The 6th century Plague of Justinian for example, is estimated to have killed 30-50 million people, roughly half the ancient world’s population at the time. COVID-19 would need to reach 3.5 billion casualties to be comparably devastating, The below infographic gives some quite chilling numbers:

The Deadliest Pandemics in History - Credit https://ceufast.com/blog/the-deadliest-pandemics-in-history
The Deadliest Pandemics in History ( Credit https://ceufast.com/)

As time has passed, we have begun to understand more about the disease. We know now COVID-19 is a respiratory disease largely transmitted by airborne droplets. We know it is much deadlier for the elderly and those with existing health conditions, but so much was unknown at the beginning of the outbreak. We know that face masks are an effective preventive measure, but confusion as to their effectiveness led to debate over their use at the beginning of the outbreak

The United States’ CDC lists the following as common symptoms of COVID-19

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhoea

Symptoms may appear 2-14 days after exposure to the virus, and can range from mild, to severe, to none at all. Asymptomatic spreaders are estimated to be as high as 20% of all cases.

What is concerning is that many who go through the course of infection still see lingering side effects months later. What has been of great concern to those researching the virus is what has been termed “Long COVID” where previously healthy people have been left with long lasting lung damage, fatigue and a permanent loss of smell and taste. This is a serious disease.

Comparison to Past Outbreaks 

As the Pandemic only began this year, there hasn’t been the time to study the long term effects of the disease. However, one study undertaken in a Shanghai hospital between January 20th – February 6th looked at the progression of COVID-19 in patients over several weeks. The sample size of the study was 249 patients with a median age of 51. It made some interesting comparisons between COVID-19 and past outbreaks.

As the disease progressed into week 2, symptoms began to relieve in most of the patients. 10 days after onset of symptoms, half of the patients were estimated to restore normal body temperature. The duration of fever was comparable to that in patients with SARS (11.4 days), but longer than those with MERS (8 days [range, 0–54 days]) and other coronavirus diseases.18, 19, 20 However, different from SARS, whose patients frequently had recurrence of fever in week 2, most of the patients with COVID-19 had normal temperature thereafter. – Clinical progression of patients with COVID-19 in Shanghai, China

While the 1918 “Spanish Flu” has been a common point of reference with the current pandemic, the most relevant comparison to be made with COVID-19 are other Coronaviruses.

SARS-CoV-2 is the seventh coronavirus known to infect humans; SARS-CoV, MERS-CoV and SARS-CoV-2 can cause severe disease, whereas HKU1, NL63, OC43 and 229E are associated with mild symptoms – Andersen, K.G., Rambaut, A., Lipkin, W.I. et al. The proximal origin of SARS-CoV-2. Nat Med 26, 450–452 (2020).

SARS-CoV, or just “SARS”, was another respiratory disease that originated in China in 2002, and was also initially covered up by the Chinese Communist Party. However, SARS could more effectively be controlled than COVID-19 as the virus could only be transmitted after symptoms including fever became present. COVID-19 is unique in that there’s a delay before symptoms present, and there’s asymptomatic spread. If it wasn’t for these unique features, then it would have been much easier to contain.

What many forget, was that there was no vaccine for SARS. Over time,the disease was no longer transmitted between humans and it burnt out. Somewhat unnervingly, there has never been a vaccine created for a human Coronavirus, however there was one created for Bovilis Coronavirus, a disease that affects livestock. This time however, the stakes cannot be higher. Numerous trials of vaccines are already underway. The Oxford/Astrazeneca vaccine has become a leading candidate, but time will only tell which vaccine is successful – and to what degree of protection from the virus it affords.

Part Two – The Disease Becomes a Pandemic

As China welcomed in 2020 with fireworks and large crowds in Beijing, the Chinese Government knew they had a problem. Strange cases of a pneumonia like disease were being reported in Wuhan and party officials in the Zhongnanhai were becoming concerned. The numbers were growing rapidly. Still, the Chinese Public and the global community were yet to be informed.

 

On 30th December 2019,  an Ophthalmologist working at Wuhan Central Hospital named Li Wenliang, had warned of seven cases of a SARS like virus he had seen at the hospital he worked at a medical chatgroup on Wechat. As all communications were monitored, he was forced to report to the Public Security Bureau and was told to sign a letter stating he had made false comments. He was one of eight other people the police said were”spreading rumours” about a virus. Even after this experience, Dr Li continued to speak out on the Chinese platform Weibo of the dangers of the virus.

One of the reasons why the denial was heightened under Xi Jinping’s leadership, is that the rival factions and any dissenting voices within the Chinese Communist Party were purged since Xi came to power in 2012. Towing the party line and saving face was paramount.

Dr Li was not the only whistleblower, but he remains the most prominent due to his tragic end. On 10th January he started developing symptoms and died less than a month later.

The Chinese Academic Xu Zhangrun published a brilliant critique of Xi Jinping in his essay “Viral Alarm: When Fury Overcomes Fear” An excerpt follows below, but I would recommend anyone read the full essay:

The cause of all of this lies, ultimately, with The Axle [that is, Xi Jinping] and the cabal that surrounds him. It began with the imposition of stern bans on the reporting of accurate information about the virus, which served to embolden deception at every level of government, although it only struck its true stride when bureaucrats throughout the system consciously shrugged off responsibility for the unfolding crisis while continuing to seek the approbation of their superiors. They stood by blithely as the crucial window of opportunity that was available to deal with the outbreak snapped shut in their faces.

Ours is a system in which The Ultimate Arbiter [定於一尊, an imperial-era term used by state media to describe Xi Jinping] monopolizes all effective power. This led to what I would call “organizational discombobulation” that, in turn, has served to enable a dangerous “systemic impotence” at every level. Thereby, a political culture has been nurtured that, in terms of the actual public good, is ethically bankrupt, for it is one that strains to vouchsafe its privatized Party-state, or what they call their “Mountains and Rivers,” while abandoning the people over which it holds sway to suffer the vicissitudes of a cruel fate. It is a system that turns every natural disaster into an even greater man-made catastrophe. The coronavirus epidemic has revealed the rotten core of Chinese governance; the fragile and vacuous heart of the jittering edifice of the state has thereby been shown up as never before. – ‘Viral Alarm: When Fury Overcomes Fear” – Xu Zhangrun. Published 02/02/2020

By Dr Li’s death in early February, the course of the disease had changed. No longer able to stop the disease, the Chinese Government had finally kicked into crisis mode.

Wuhan Locked Down (23/01/2020)

Life had continued as normal in Wuhan for most of January, despite rising numbers of pneumonia like infections. China’s 9th most populous city was looking forward to the holidays. On 18th January a Lunar New Year Banquet took place in Wuhan, where over 40,000 families gathered together.

On 21st January 2020, Chinese State Media made its first reference to Coronavirus. An excerpt from the state media mouthpiece follows below:

President Xi Jinping urged resolute efforts on Monday to contain the spread of pneumonia cases caused by a new strain of coronavirus as cases of the contagion rose to 224, all but six of them confirmed, as of 8 pm on Monday.- “All-out efforts ordered to curb spread of virus, China Daily, 21/01/2020

On 23rd January 2020, with less than a day’s warning, the city of 11 million was put into lockdown. Train services and flights were suspended. Road closures were set up to contain the city. Wuhan became the world’s first example of a large scale urban lockdown, although few countries looking on knew they would be soon emulating it. Much of the rest of surrounding Hubei province was subject to further restrictions – five further cities were locked down shortly after Wuhan.

Locking down one of China’s biggest cities was an unprecedented move, however I believe it wouldn’t have taken place until much later, had it not been for a crucial factor. Chunyun, or Spring Festival (Chinese New Year) Travel Season, is the largest migration of people on the planet – larger even than the hajj pilgrimage to Mecca.

Chinese New Year took place on January 25th 2020, and while migration had already begun a week ago, the mad travel rush was still continuing. The CCP couldn’t allow any more numbers travelling from Wuhan. Wuhan residents were cut off from celebrating with their distant relatives in China’s biggest celebration. Imagine a Christmas lockdown in the western world, and you begin to realize what an awful time it was for Wuhanese.

The extent of Wuhan’s lockdown is visible in the below historical flight data from FlightTracker. On 23rd January, arriving and departing flights all began to be cancelled.

Historical_(WUH)_Wuhan_Tianhe_International_Airport_Arrivals_-_2020-07-29_21.34.29

 

24th Jan Arrivals 2

23rd Jan Departures 1

23rd Jan MIDDAY CANCELLED DEPARTURES

 

23rd Jan Cancelled Departures foeefk

 

Restrictions started to become more widespread across the rest of China. It was to be a very subdued Year of the Rat, as the major fireworks displays and celebrations for Chinese New Year were soon cancelled throughout the country.

Vehicles checked in Xi’an, China – 30/01/2020

The Chinese New Year Holiday was extended and in the majority of Chinese Provinces, businesses were told not to re-open until 10th February. 

With millions of Chinese away from home and restrictions placed on transport, it soon transpired that workers wouldn’t be going back anytime soon. For much of February, the world’s factory was closed.

WENZHOU, China: The Xuda Shoes Company is usually bustling at this time of year, with workers having long returned from a Lunar New Year holiday in their hometowns to kick-start production of tens of thousands of shoes daily.

But China’s coronavirus epidemic has changed all that.

Only about one-third of the roughly 1,000-strong workforce at Xuda’s factory in the eastern export hub of Wenzhou are around, the rest blocked by virus-induced travel disruptions and safety measures. – Bangkok Post 01/03/2020

Each province in China soon instituted separate lockdown measures by the end of January. While most were not as serious as Wuhan’s, they were still heavily restrictive. Schools and workplaces were closed, and most of the world’s most populous country were stuck inside.

By that point [27 days into Chengdu’s lockdown], the country was deep into the most ambitious quarantine in history, with at least seven hundred and sixty million people confined largely to their homes. The legal groundwork had been established on January 20th, when the National Health Commission designated the highest level of treatment and control to fight the new coronavirus, which eventually became known as covid-19. After that, provinces and municipalities issued their own regulations, and the Chengdu government passed its first measures on January 24th. They were tightened seven days later, when it became clear that the epidemic had reached a point of crisis – The New Yorker, Life on Lockdown in China

The unprecedented lockdowns of Wuhan and other cities in China signaled to the world that the virus was more serious than China was acknowledging. The virus had become a crisis in China by late January, but only a select few countries were really taking notice at this stage.

 

13/01/2020 – First Case Detected Outside China

On 13th January 2020, the first case of COVID-19 was identified outside of China, from a passenger travelling from Wuhan to Bangkok, Thailand.

“The person was a traveller from Wuhan, China, and was identified by Thai officials on January 8 during a temperature check at Bangkok airport, and he was hospitalised that day.

From that day onwards the contagion began its spread across the world:

16th January 2020 – First confirmed case in Japan

20th January 2020 – First confirmed case in South Korea

21st January 2020 – First confirmed case in The United States

21st January 2020 – First confirmed case in Taiwan

24th January 2020 – First Confirmed Case in France

25th January 2020 – First confirmed case in Australia

30th January 2020 – First confirmed case in India

31st January 2020 – First confirmed case in the UK

31st January 2020 – First confirmed case in Russia

14th February 2020 – First Case in Egypt (and Africa’s first case of COVID-19)

19th February 2020 – First confirmed case in Iran

26th February 2020  – First confirmed case in Brazil

28th February 2020 – First confirmed case in New Zealand

There were some interesting insights that could be drawn from these index cases. The majority of the cases in January were unsurprisingly linked to China. As further global hot spots of infection had emerged in February, the later index cases discovered in Brazil and New Zealand were traced to Italy and Iran respectively. It’s worth noting that the virus emerged earlier in travel hot spots. Global cities such as New York, London and Tokyo would find their international reputation put them at a disadvantage.

It’s also worth noting that these were only the first confirmed cases that each government announced.  It is likely that in many countries, earlier cases went undetected. A study in Italy found genetic traces of SarsCOV2 in sewage water from 18th December 2019. As time passed, medical records from the months before of Pneumonia and other symptoms which matched COVID-19 were being re-examined. In France, a patient admitted to hospital on 27th December 2019 was later confirmed to have had COVID-19. In many countries, testing was only widely begun in February or even March.

The World Takes Notice – Travel Bans, Lockdowns & Quarantines

As the disease began to spread, unprecedented measures began to be announced.

On 31st January 2020, the United States banned flights and travel links from China to the United States for all non-residentsNinety six countries would follow in suspending flights from China or introducing travel restrictions in in the following days.

As cases rose exponentially over the next few months, unprecedented travel restrictions were put in place. For the first time since World War Two, many countries closed their borders to all but non-residents returning home. On 12th March, the United States extended its travel ban to restrict entry from most of Europe. On 17th March, the European Union suspended non-essential travel from outside the Schengen (Free movement) area. This was initially for a period of 30 days, but was ultimately extended until 30th June. From June onwards, the EU created the ‘ Recommendation on the gradual lifting of the temporary restrictions on non-essential travel into the EU’  which exempted various countries such as Thailand, South Korea, Australia and New Zealand from requiring to undergo quarantine.A “Traffic Light” system was also created for Inter-EU travel to determine the level of risk of each country, with red being the highest and green being the lowest.

As of writing, over 50 countries still have a global travel ban to all non-residents or those without special exemptions including: Argentina, Canada, India, Vietnam, The Philippines, and New Zealand. Much of the rest of the world still has heavy restrictions in place, including mandatory COVID-19 testing or entry, or entry only limited to citizens from “safe”  countries with a low number of cases.

The below infographic shows the progression in cases at the end of the first three months of the year. Note the huge spike in cases from late February to the end of March in the Western World.

 

January CasesFebruary Cases

 

A Timeline of The Coronavirus Outbreak (Source: Devex.com)
A Timeline of The Coronavirus Outbreak (Source: Devex.com)

 

February was a wasted month. Cases continued to rise in much of the world, but restrictions weren’t instituted. Had action been taken in February, the need to lockdown could have potentially been avoided. With a proactive response – large scale testing, enforced social distancing and mask wearing as was seen in East Asian countries, it would have been possible for life over the following months to be much more “normal”. However, I wonder whether many of the population would comply with heavy restrictions at the time. It seemed like it was only in March when cases spiked rapidly, that the crisis became undeniable. Looking back, it’s evident that much of the world missed a crucial window of opportunity to contain the virus.

In March, much of the world went into hibernation. Copying China’s playbook, countries around the world emulated Wuhan’s original lockdown. Citizens were urged to stay at home, although the severity of lockdown measures varied in each country.

On 11th March 2020 the World Health Organization officially declared COVID-19 a pandemic.

 

Part Three – Contrasting Responses to Battling a Pandemic

Early Success Stories

South Korea would emerge as one of the major success stories during COVID-19. While it was one of the first countries in the world to report cases outside of China on 20th January, South Korea was well prepared to handle an outbreak.

Today, south Korea’s COVID-19 response strategy sits atop three pillars: fast and free testing, expansive tracing technology, and mandatory isolation of the most severe cases. Each pillar was shaped by the epidemics that preceded the 2019 novel coronavirus. – What’s Behind South Korea’s COVID-19 exceptionalism, The Atlantic

In 2015 after the MERS outbreak, South Korea overhauled their approach to responding to pandemics. When COVID-19 arrived, the South Korean government were ready to test as many of their population as was required. In March, testing rates was approaching 20,000 per day, some of the highest per capita testing in the world.  South Korea’s contact tracing system was world class, and in a country with one of the world’s highest per capita rates of smartphone use, most Koreans were alerted whenever they were near someone posing a risk of COVID-19

 Masks were encouraged to be used from early on, and it didn’t take a mandate to get the majority on board.

According to a recent article, 63.2% of Koreans reported wearing a face mask when they are outside [3]. In another international survey, the reported rate of wearing face masks among Koreans was even higher (94%); this was the highest rate among 28 countries – Face masks and containment of COVID-19: experience from South Korea

What was remarkable about South Korea’s organized response, was they were able to avoid a nationwide lockdown. Shops, retailers and businesses remained open, however higher risk locations including schools, universities and gyms were closed.

Despite further outbreaks linked to a nightclub  and a church, south Korea was able to flatten the curve again.

"What mask do you prefer?" - Public Health poster at Seoul City Hall
“What mask do you prefer?” – Public Health poster at Seoul City Hall

Taiwan has handled COVID-19 perhaps better than any other country. Its proximity to China, heavily urbanized population of 23 million and early arrival of the virus put it at a high risk. Due to its unique political status under the “One China” Policy, it was also outside of international bodies like the WHO and diplomatic channels.

In December 2019, when China remained silent on the virus, Taiwanese travellers to Wuhan were reporting of a strange pneumonia outbreak. Alarm bells rung in Taipei and flights from Wuhan to Taipei were screened from 31st December 2020. Once Taiwan recorded its first COVID-19 case, air travel would be further restricted. On 26th January 2020 air travel was suspended to China. On 19th March all foreign nationals were banned from entering Taiwan. Taiwanese returning from abroad were required to undergo a two week quarantine.

Since the 2003 SARS outbreak, Taiwan had a plan and structure in place for battling a pandemic, and on 20th January 2020 it was activated. The Central Epidemic Command Center was the emergency task force set up to coordinate the government response to the virus. The measures the task force put in place were largely the same as would be adopted by other countries – testing, contact tracing, masks and public hygiene. The difference was, these measures were clearly communicated to the public and were in force from late January.

“There was easy access to almost free and rapid testing centers,” said Han Jin, founder of a start-up in Taiwan called LucidPix. “At every building, including restaurants, gyms and offices, they check your temperature — and you cannot enter without face masks.”

There’s also enforcement for those who don’t follow the rules. There are huge fines if people are caught not wearing masks in designated areas, such as the subway, and for breaking quarantine.

Social pressure also plays a part. Jin said that it’s become part of the culture in Taiwan to name and shame those who are not wearing masks in the subway or are breaking quarantine early. Those who do so might see their face pop up on a social media app. – How Taiwan beat the Coronavirus, CNBC

Under wartime like measures, factories in Taiwan ramped up domestic production of masks, producing 13 million a day. Alcohol distilleries were reappropriated to build hand sanitiser. With a surge of clear patriotism, the Taiwanese got on board and did their country proud.

The proactive response from Taiwan meant that like Korea, the country able to avoid a lockdown in March. Even despite the lack of diplomatic recognition, Taiwan has not foregone gestures of goodwill.In April, Taiwan announced it would donate 10 million masks to Europe, The United States and its allies.

Taiwan’s success has also dealt a blow to Beijing’s propaganda. It deals a blow to the myth that only authoritarian might can tackle the virus. Liberal democracies including Taiwan and South Korea, have successfully responded without forfeiting the rights of the citizens they represent.

Under Tsai Ing-wen, Taiwan has become the bane of Beijing’s current propaganda campaign. The island outperformed China in dealing with the coronavirus without resorting to the strict measures touted by Beijing. Taiwan has had less than 380 confirmed cases and five deaths as of Wednesday — a remarkable feat considering Taiwan’s proximity to mainland China. – Taiwan’s Success Is the Bane of Beijing’s Global Coronavirus Propaganda, The Diplomat

 

The Grand Hotel in Taipei illuminated to show zero new case in Taiwan - May 2020
The Grand Hotel in Taipei illuminated to show zero new case in Taiwan – May 2020

New Zealand – my own dear Pacific homeland, has been one of the most touted success stories during the pandemic. Unlike many of the premature COVID success stories in the west, we haven’t seen the emergence of a major second wave. Aside from one regional outbreak in Auckland in August, which saw a return to restrictions for several weeks, we have lived for months without any community spread of COVID-19. All newly reported cases have been detected in the managed isolation facilities.

Since 20th March the borders have been closed for all but New Zealand residents, or individuals with special exemptions. All returnees have to undergo a two week quarantine in hotels converted into managed isolation facilities, and have a negative Covid test result before they are allowed into the community.

New Zealand does have some natural advantages going for it that helped in fighting a pandemic – namely a comparatively small population of five million and the nation being a relatively distant group of islands from the rest of the developed world, but in 2020 New Zealand was not the kind of untouched civilization that many international commentators seemed to think it was. The country has five international airports and had over 3.8 million annual passenger arrivals at the end of 2019. 86.7 % of the New Zealand population lives in an urban area- a higher rate than many countries including the United States. With a modern trade emphasis on the Asia Pacific region and a high number of immigrant arrivals from Asia, we had strong links to China and other COVID hotspots.

Yet somehow, we managed to avoid the fate that befell the rest of the English speaking World. How did we do it?

The key to New Zealand’s success was the severity of our lockdown. The move to a “Level 4” lockdown on 25th March lasted just over a month, and was a near total shutdown of the country, with only essential services were allowed to operate. While some other countries, notably The UK and Australia, had a looser definition of what “Essential Services” were and allowed more workplaces to remain open,  in New Zealand Level 4 restrictions were largely confined to Supermarkets, convenience stores, food suppliers, and those in the healthcare and energy sectors.

New Zealand's 4 level alert system for COVID-19.
New Zealand’s 4 level alert system for COVID-19.

The virus had minimal opportunity to spread with everyone stuck at home. Restrictions were eased in phases. Firstly from Level 4 down to Level 3, which remained heavily restricted but allowed offices and fast food retailers to open, provided there was no direct contact with the public. Secondly, down down to level 2 with social distancing and masks encouraged. Finally on 8th June, the country moved to level 1. Aside from encouraging contact tracing and social distancing, life returned to normal. Concerts, sports matches, weddings and the other large social gatherings before the pandemic resumed. Only the border restrictions remained.

In hindsight the lockdown now seemed inevitable. With a growing spread of the virus worldwide, New Zealand followed much of the rest of the world in locking down in March, but at the time I was surprised by the announcement, and the extreme measures the government was going to in order to contain the virus.The country was only given only 48 hours notice to shut down. While this was better than in India, where only four hours notice was given before the country shut down, it didn’t give a lot of time for business to prepare. People who were mid-moving houses or out of town had to rush back home, otherwise they would be stuck when the lockdown began.

The list of essential services at level 4 also seemed quite unjust, giving a monopoly to the supermarkets, when butchers, greengrocers and other food businesses weren’t able to operate. There was a lot of confusion when the announcement was made of the move to a total lockdown as to what was defined as an “essential service.” This led to a hilarious slapdown of The Warehouse (think New Zealand’s Walmart) announcing they were open for business, until (to paraphrase) the government advised “No, you’re actually not” and prevented them from opening.

The severity of the lockdown was likely motivated with how poorly prepared we were had things gone south. New Zealand’s healthcare system was prepared for an outbreak of a major respiratory illness. In March, there were only about 200 ICU beds available for the entire country.  New Zealand was fortunate to have its first confirmed arrive on 28th February, over a month later than Australia and much later than other major countries. At the beginning of New Zealand’s lockdown, the reproduction value (or R_{0}) used to measure how fast the virus was spreading was lower than in many other countries before their lockdowns began.

Before New Zealand went in lockdown, for instance, researchers estimated the R0 value was 1.8 – and had been quashed to just 0.35 as a result of it, leading to its effective elimination in the country. – ‘Coronavirus COVID 19: How fast could virus spread if Unleashed’  New Zealand Herald 18/06/2020

What also made the lockdown so highly successful in New Zealand was the transparency that came from the government, and the trust the public placed in the government’s response. The number of new cases and COVID-19 updates were broadcast in daily press briefings. New Zealand’s Director General of Health, Dr Ashley Bloomfield, became something of a celebrity during the crisis with his clear and calm messaging to the public at these briefings.Unlike in the UK, any politician who flouted the rules, notably our health minister ended up losing their jobs. There were no exemptions.

New Zealand also avoided the kind of back and forth restrictions that have been so damaging to overseas economies. The public believed that the lockdown would pay dividends if they committed to it, and had faith in the government to get it right. It’s fortunate that the government has been able to eliminate community spread of the disease, because New Zealanders have not been stellar when it comes to having to change our behaviour. The COVID-19 contact tracing app has been underutilized and even at the height of the pandemic, mask usage wasn’t widespread. Countries which have been hit worse by the disease have been taking social distancing and other preventative measures more carefully. The mentality in much of New Zealand, is – we beat the virus, now life can go back to normal.

Prime Minister Jacinda Ardern and Director General of Health Ashley Bloomfield speaking at a press conference in August
Prime Minister Jacinda Ardern and Director General of Health Ashley Bloomfield speaking at a press conference in August

After the easing of restrictions, the border closure remains Zealand’s greatest defence against the virus. There has been considerable pressure from the private sector and special interest groups to lobby the government to loosen border control restrictions. Even before a vaccine is distributed, there is a likelihood of a “travel bubble” opening with Australia, which after an outbreak in the state of Victoria, has now largely got the virus under control. Other pacific nations such as The Cook Islands, Samoa and Fiji – all nations largely dependant on tourism, have been hoping for a resumption of travel.

While New Zealand was not quite as successful as Taiwan, South Korea and Vietnam in being able to avoid a lockdown, it remains the most successful western country in its response to COVID-19.

 

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Scenes from New Zealand’s National Lockdown across Christchurch, Wellington & Auckland- 25th March – 27th April 2020

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Differing Responses to battling a Pandemic

While Taiwan, South Korea, and New Zealand have by no means been the only successful countries in their handling ofCOVID-19, the list of successful countries remains much slimmer than the unsuccessful.

Italy was one of the earliest countries to record a case of SARS-COV-2 and was hit particularly hard. Northern Italy’s fashion brands had strong trade ties to China, having outsourced much of their clothing manufacturing and when the first cases of the virus arrived from China, Milan had direct flights to Wuhan.

The Mayor of Milan spent the cities’ budget on an advertising campaign entitled Milano Non Si Ferma (Milan Doesn’t Stop.) This was posted to his Facebook page on 27th February 2020.

Only tragically and predictably, Milano si ferma’d. The Mayor of Milan was one of many politicians who remained in denial at the beginning of the the crisis.This wasn’t terrorism or a natural disaster, where stoicism was effective. The virus was indifferent as to what you thought of it, and many of those who ignored it would pay the ultimate price.

With an ageing population, the virus wreaked havoc  across the country. The below video from March shows the sheer numbers of daily obituaries recorded in a newspaper in the city of Bergamo.

Italy became the first country outside of China to institute lockdown measures on a regional basis. Parts of Veneto and Lombardy provinces were locked down on 21st February 2020. By 9th March, the entire country was locked down, and travel between Italian provinces and other European countries would remain in place until 3rd June.

Differing Responses – Lockdowns & Restrictions Across the World

Much of the rest of Europe followed in Italy’s footsteps. In March, lockdowns and travel bans were instituted across the continent, to various degrees of severity. Spain, France & The UK all saw particularly bad outbreaks of COVID-19 in their first waves.

In The United Kingdom Prime Minister Boris Johnson notably tested positive for COVID-19 the first major world leader to do so. Boris Johnson’s government instituted a nationwide lockdown on 23rd March. and while millions of Britons were told to stay at home, exemptions were wider than in another countries. The British Government’s guidance was for the public to work from home unless they were unable to.

Unsurprisingly there are quite a large number of jobs that cannot be done at home that qualified under these exemptions. Factory workers, tradespeople, nannies and a substantial list of others were able to continue working unabated by the lockdown. Brits could continue having unknown builders come in to their homes to work on their kitchen remodels or conservatories, provided they weren’t showing COVID-19 symptoms.

Public transport was still operating during the lockdown.To dissuade London’s essential workers from working as legally required, Transport For London cut the tube services by up to 40%. As  public transport demand increased as restrictions were eased, it led to completely unforeseen scenario of packed trains on the London Underground, filled to the brim with commuters spreading the disease at rush hour.

Oxford Street belongs to the Pigeons - London during Lockdown
Oxford Street belongs to the Pigeons – London during Lockdown

The public’s trust in the lockdown was also lost due to alleged government hypocrisy over an incident involving Dominic Cummings, a senior policy advisor to Boris Johnson. During the lockdown while exhibiting Covid symptoms, he drove his family to their home at Barnard Castle in Durham, to have a more enjoyable lockdown. While staying in Durham, he would also pick up his son from the hospital while exhibiting Covid symptoms. When the scandal surfaced in the media, Dominic Cummings refused to apologize and the PM also stood by his advisor.

The “Barnard Castle” incident was one of many scandals in the UK during its Covid crisis. The NHS has allegedly struggled with shortages of protective equipment, and the government’s decision to outsource the contact tracing system to the private sector via contracts worth billions of pounds, has proven dysfunctional.

How Effective Were the lockdowns?

It’s interesting looking back at the unprecedented lockdowns and border closures instituted to see how effective they were. Clearly the UK’s had its flaws, but how much did they flatten the curve?

The Lockdowns were not designed to eliminate COVID-19, although in select countries like New Zealand, that did end up becoming achievable. The main purpose was to avoid the healthcare system being pushed to breaking point, as could be seen in Milan and New York. Nearly half the world’s population was in lockdown in early April.  The difference in some countries approaches to their lockdowns would become quite puzzling. South Africa left people with fewer escapes at home as the country banned the sale of cigarettes and alcohol during lockdown. Violent crime did drop 29% during the period, but it’s uncertain as to whether this should be attributed to prohibition, or the potential victims being stuck at home.

Lockdowns were all pursued as a last resort. The economic cost of shutting down a country was monumental but when the whole world was entering a recession, no nation’s economy would emerge unaffected, lockdown or otherwise.

Two countries which took wildly different approaches to lockdowns were Sweden and Argentina. While much of Europe was closed in March, Sweden took a laissez-faire approach. While restrictions were instituted, there was not much of a “lockdown” per se. Large gatherings were banned and inter-regional travel was restricted, but workplaces remained open. The public was encouraged to practice social distancing and good hygiene, but was not forced indoors.

The country was trying to pursue “herd immunity.” The British Government had toyed with this idea too, but considered the potential loss of lives too great and abandoned it. Sweden however, refused to change its response and largely stayed the course.

Did avoiding a lockdown work? Sweden was able to avoid its healthcare system being overwhelmed, but it had to double its ICU capacity within a month. Sweden’s deaths per capita were also much higher than its neighbours. Cases have also been rising as Sweden battles the second wave of the disease.

In the population as a whole, the impact of Sweden’s approach is unmistakable. More than 94,000 people have so far been diagnosed with COVID-19, and at least 5895 have died. The country has seen roughly 590 deaths per million—on par with 591 per million in the United States and 600 in Italy, but many times the 50 per million in Norway, 108 in Denmark, and 113 in Germany. – ‘Critics of Sweden’s lax pandemic policies face severe backlash’, Sciencemag.org

Clearly the laissez faire response had more of negative impact on the healthcare system in Sweden than its other Nordic neighbours. However, despite the lack of a lockdown, Sweden was not overwhelmed by cases. Perhaps the Government simply thought the trade off was worth it.

One of the main reasons Sweden pursued its approach was the same reason why so many countries were reluctant to enact a lockdown – the economic cost. However, their reasoning was flawed. No economy could remain isolated from the effects of a global pandemic.

Argentina by contrast enacted one of the longest and most extreme lockdowns in the world. Unlike its neighbour Brazil and Latin America’s other powerhouse Mexico, the Argentine government took decisive action. On 19th March a nationwide lockdown was announced to be in place until the end of the month.The lockdown was subsequently extended until the of April, then May, then June…..

In Buenos Aires, home of the harshest lockdown restrictions, residents were stuck at home for over five months. The city has been a state of lockdown since March.

Argentina’s first positive COVID-19 test was registered in Buenos Aires on March 3. The infected individual was a man returning from Milan, Italy. Four days later, Argentina’s Ministry of Health confirmed the country’s first coronavirus death — which was also the first in South America.

Just over two weeks later, on March 20, a national lockdown went into effect. That was the last time — 160 days ago — residents in the metropolitan Buenos Aires area, the country’s coronavirus epicenter, were allowed to leave their homes for any other reason than to buy groceries or medicine. Now, many frustrated Argentines are asking: “What is worse, the illness or the cure?” – ‘Coronavirus: Argentina’s never ending quarantine’, Deutsche Welle, 27/08/2020

However, lockdown restrictions varied elsewhere in the country. On 8th May, the Argentinian Government announced they were easing COVID-19 restrictions outside of Buenos Aires, as cases remained low in the other provinces. While Buenos Aires endured the most inhibiting restrictions, the virus spread elsewhere around the country. Today, the virus is spreading rapidly in provincial Argentina.

Since the start of August, Argentina’s rate of confirmed COVID-19 cases to daily tests has been between 40-50% – the highest in the world. Nearly half of those being tested are returning positive test results.

Buenos Aires under Quarantine, March 2020
Buenos Aires under Quarantine, March 2020

Popularity in President Fernandez soared at the beginning, but as the lockdowns extended his popularity has plummeted. Even before the Covid crisis struck, Argentina was in a state of economic crisis, with the country owing foreign debts to the tune of $66 billion. The cost of six months worth of lockdowns will significantly add to Argentina’s economic miseries.

While lives were undoubtably saved by Argentina’s lockdown, the question remains –  at what cost? Argentina is just one further example of a country seeing cases spike once restrictions have eased – India is another notable example. Much of the world is now experiencing second and third “post lockdown waves.” As lockdowns have now returned in nations like France and England, many locals will be wondering whether the restrictions were even worth it.

Argentina’s recent surge in cases also underscores how lockdowns are not the only measure required for battling COVID-19. The lacklustre testing and contact tracing has contributed to undoing its early success.

Lockdowns did have a measurable impact in containing COVID-19. The below infographic details the reduction in daily COVID-19 cases after restrictions (most notably national lockdowns) were imposed.

Impact of Controls
Covid 19 coronavirus: The new data that shows how NZ got it right, New Zealand Herald

However a country can’t remain perpetually locked down. Humans are social creatures and the impact on mental health and families can drive people to a breaking point.

In addition to the social cost of lockdowns, there is the sheer economic cost to factor in. In New Zealand, millions were eligible for a wage subsidy scheme, with the government paying employees wages. This luxury was not afforded to most of the world. In countries where people live day to day on a subsistence living, staying at home was an impossibility.

Across Latin America and the Caribbean – where an estimated 113 million people live in low-income barrios, favelas or villas – families are struggling to adapt to coronavirus lockdowns or social isolation orders because of more immediate financial imperatives.

“People are more worried about being able to feed their families than they are about the coronavirus,” said Pérez, one of more than three million people who live in Argentina’s densely populated villas. – Lockdowns leave poor Latin Americans with impossible choice: stay home or feed families, The Guardian.

 

The unprecedented global lockdowns will be evaluated for years to come, but could they have been avoided, as Taiwan and Korea were able to do?

Some commentators have pointed at the high levels of social cohesion and trust in the government for these Asian success stories. Others have emphasized the cultural differences as to why these countries in particular avoided a lockdown i.e. collectivism vs individualism, and an established culture of mask wearing. The “Panic Buying” which saw supermarket shelves stripped bare – perhaps one of the most insidious examples of individualism, did not occur in East Asian societies.

However one of the most important factors to their success, as it always is in life, is experience. Asia had battled pandemics in recent history, the west had not. We were more resistant to changes in behaviour, whereas there was less resistance to something like mask wearing, when these measures had been instituted before. Senegal and many other African nations, well experienced with infectious diseases, have also quietly seen significant success in their approaches to the pandemic.

While 2020’s lockdowns will be analysed for years to come, the question remains as to whether the experience has taught us for the next pandemic.

 

Part Four- America’s Failed Crisis

Perhaps the most disappointing episode of this entire Pandemic has been the United States. The country which was ranked the “best prepared for handling a pandemic” became the world leader for all the wrong reasons. The reports that emerged from America such as this this account of healthcare workers in New York during the height of the pandemic, make for grim reading. The death toll stands at over 200,000 – one fifth of the global total. How is it possible?

America, as we have examined, has been far from the only country to fail its response to Covid-19, but it is the scale of its failure that has proven so monumental. There were many factors which had made handling a pandemic in a country the size of The United States a challenge: The federal system left the responsibility handling each state’s response to 50 different governors across the country, the dysfunctional healthcare system meant many Americans were reluctant to set foot in a hospital, and many swathes of conservative America were marked by a distrust of government

However, the primary cause of America’s failure in the crisis has been an absence of leadership that lies with one man alone.

A Golfer in Chief

When I wrote about Donald Trump four years ago, I predicted that he would be like many other populist candidates who ended up making promises they could not deliver. He had campaigned on an “America First” platform to bring the return of manufacturing to the United States. He was going to reduce immigration and built a wall across the U.S Mexico border. Donald Trump claimed he was going to do many things in his term, but no one administration could rollback decades worth of trends.

On Election Night 2016, as we all know, the polls were wildly wrong. While Hillary Clinton had won more than two million votes more than Donald Trump, the quirks of the electoral college had handed the most important political role in the world to a man with no experience in politics.

As the election results came in, I sat fully entertained watching the news coverage. I felt a sense of schadenfreude as left wing America’s nightmare had come to pass. The hysterical social media posts. The horrified reactions of the TV hosts. The empty threats to move to Canada. A great night of “owning the libs.” However the entertainment value was short lived. America’s next president would be in the White House in a few months, and the work would have to begin at getting him prepared. America had elected an idiot, but surely he’d manage once he became acquainted with the bureaucracy.  After all, didn’t they say the same things about George W Bush?

In the early months of his presidency, I thought a lot of the criticism of Donald Trump was childish. The stupid nicknames, the baby balloon – all a coping method by left wing America that a reality TV host was their President. The Democrats like apparent sore losers, were claiming that Russia interfered in the election. America’s left pinned their hopes of Trump’s removal from office on the underwhelming “Mueller Report” which emerged three years later.

Yet as the months went by, it became clear to even Republicans that there was an absence of leadership in the White House. The United States had an accomplished golfer (albeit one who cheats at the sport) but a poor leader. Since inauguration, Donald Trump has played Golf on the taxpayers dime at least 283 times in office – that’s an average of about 1.4 times a week.

The list of gaffes and abhorrent behaviour that have made Donald Trump’s presidency are well documented. The obscene, nasty diatribes that have been tweeted from the oval office would make even Richard Nixon blush. Whether rolling back environmental regulations and consumer protections to benefit his donors, attacking journalists in the vein of an authoritarian Caudillo, or attempting to bribe the Ukrainian president in a quid pro quo deal the very day after he was narrowly exonerated in Robert Mueller’s testimony, Donald Trump has proven himself incapable of exhibiting the leadership or political talent required for the presidency.

That’s not to say that he has achieved nothing of note during his tenure. The Trump administration played a major role in several arab states including the UAE establishing diplomatic ties with Israel. There were also the groundbreaking if controversial summits with North Korea, the tax cuts which played well into his conservative donors, the likely appointment of three Supreme Court Justices, and credit where credit is due, avoiding another senseless war in the Middle East ( even despite hiring America’s warmonger in chief John Bolton as national security advisor.)

Perhaps most notably, his administration marked a turning point in US China Relations, although due to the aggressive foreign-policy of Xi Jinping, it’s arguable that relations would have soured under any sitting president. It’s telling that one of the few pieces of bipartisan legislation in United States passed during the Trump Administration was The Hong Kong Human Rights and Democracy Act. 

But these achievements pale in comparison to the severity of the greatest public health crisis in generations. Donald Trump was simply not equipped to lead the United States, and it is his failure of leadership that has directly contributed to the the United States’ failure in this pandemic.

The image Donald Trump marketed of himself was that of a skilful negotiator and businessman, but this has mostly been without substance. His inability to negotiate in late 2018 led to the longest U.S government shutdown in history that saw hundreds and thousands of federal employees unpaid, all over a childish stand off over his border wall. A democratic institution cannot run like a business. The President is not a Chief Executive Officer, but a Commander in Chief. Leading not demanding is the order of priority.

The Trump administration has exhibited the kind of cronyism and nepotism seen in banana republics and dictatorships. Who would have thought the unqualified daughter and son-in-law of a president would be appointed to hold political office in The United States of America?  At least seven high profile campaign or administration figures including Steve Bannon, Michael Cohen, & Michael Flynn have been convicted of various crimes during his term, including fraud and lying to the FBI.

Criticism of Donald Trump isn’t a matter of partisan politics, it’s a natural reaction to the obscene behaviour that has emanated from someone who was supposed to be a leader. Like George III or Caligula, Donald Trump has inherited a great power and has abdicated his responsibilities in favour of personal pleasure. I don’t dislike Donald Trump for being a conservative. He isn’t a conservative. His ideology is “Donald Trump,”

If America were ruled by a sane republican like Mitt Romney or John Kasich, those that were able to acknowledge the severity of the crisis, America would not have sunk to the depths it remains in.

I was wrong about Donald Trump. Rather than merely wasting four years, he has actively crippled America’s international standings and its domestic response. The damage done under the Trump presidency will take years to repair, as will the divisions he has exacerbated.

Crippling America’s Response

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Yet for all that was objectionable about Donald Trump, it has been his handling of the Covid crisis that will mark the legacy of his presidency. Before it all began there were worrying signs.

No other President in living memory has been so deliberate in undoing the legacy of his predecessor. Barack Obama was by no means a perfect president, but even with ideological differences over “Obamacare” and social policies, most Republicans recognized he instituted some decent policy during his tenure.

One of the most significant pieces of legislation to be abandoned by the Trump Administration was “The Joint Comprehensive Plan of Action” (JCPOA) aka The Iran Deal. This was the culmination of years of negotiations by the major powers including The US, China, Russia, France & The UK to hold Iran to account and prevent it enriching uranium to levels required to develop a nuclear weapon.  Iran was abiding by the terms of the deal and The International Atomic Energy Agency was regularly inspecting to ensure its compliance. While it wasn’t a perfect deal, it marked the most important piece of international legislation Iran had ever been involved in since the overthrow of the Shah. The sanctions that had made the lives of ordinary Iranians unbearable would be lifted, and with the threat of an Iranian nuclear arsenal off the table, the deal helped to strengthen the fragile peace in the region. The US under the Trump administration was seemingly on a collision course against the world.

Domestically however, the cuts and policy changes would be unprecedented. Anything tainted as being “Obama Era” has been gutted, including much of the state department. The idea that civil servant appointees can be apolitical hasn’t seemed to register with him. Perhaps it is why the Trump Administration has potentially more unfilled positions than any other U.S administration in history. When these positions were filled, the incumbents often didn’t last long enough to make a noticeable difference. Donald Trump has seen record numbers of resignations during his term in office.

As of Monday, the White House had yet to put forward the names of candidates for 204 of the 665 key positions that require Senate confirmation, according to the Partnership for Public Service, a nonpartisan group that advises incoming administrations.

The longest list of empty desks waiting to be filled is at the State Department, where more than 40 top jobs are vacant. Dozens of ambassadors appointed by the Obama administration were fired by Trump on Inauguration Day and have yet to be replaced. – After 500 days dozens of white house jobs remain unfilled, CNBC

Below are extracts from an NPR radio segment in April, which details how the U.S Government staffing shortages contributed to the crisis.

At this moment, there is an acting director of the Office of Management and Budget, an acting homeland security secretary and an acting director of national intelligence, who also happens to be the U.S. ambassador to Germany. Acting officials, numerous vacancies throughout the executive branch – these have been hallmarks of the Trump presidency….

GRAFF: It is unprecedented in modern times, the depth and breadth of these acting appointments and vacancies across the U.S. government. At DHS, just one-third – 35% to be exact – of the top roles are actually filled with permanent officials.

KELLY: And I will note, the length of some of these vacancies, too – you mentioned homeland security, the Department of Homeland Security today marks one year exactly, if I’m not mistaken, that the top job there has gone unfilled. The deputy secretary job is also vacant and on and on.

GRAFF: Yeah. And both the deputy director and the director of national intelligence are both acting officials. And remember – these jobs, the director of national intelligence and the secretary of homeland security, were literally the jobs created after 9/11 to prevent the next 9/11. These were jobs created by the 9/11 Commission’s report. And as we find ourselves, as the U.S. surgeon general has said, in our own 9/11 moment this week with the COVID-19 crisis, it’s worth noting – and, I think, not unrelated – that those jobs have been vacant for as long as they have been.

KELLY: Well, why do you say it’s unrelated? I mean, why is this a problem when it comes to this specific coronavirus crisis?

GRAFF: Well, so one thing is – you know, the Department of Homeland Security is the agency that is supposed to be protecting the homeland and responding to disasters. This is the agency – the department that oversees FEMA, which is the lead government agency dealing with the COVID response.

Unfilled Or ‘Acting’ Positions In Federal Agencies Delay U.S. Response To Epidemic – NPR, April 10th 2020.

Trump entered the White House promising to “Drain the Swamp” and while there is plenty of necessary fat to be trimmed from a bureaucracy as large as the US government, Donald Trump would make some disastrous budget cuts that would come to haunt him during the pandemic.

One particular agency which saw its funding slashed during was the Centers for Disease Control and Prevention (CDC), the nation’s leading public health institute.

Due to a lack of funds, the CDC had to cut its epidemic prevention programs back by 80% in 2018, terminating its activities in 39 out of 49 countries. The programs were made possible by a one-time emergency package of $600 million from Congress in 2014 to respond to the Ebola epidemic. The Trump administration proposed moving $59 million from other global health programs at the agency instead of replenishing the account. A full replenishment would have required $120 million annually, without reducing the global health budget in other areas.

Accordingly, the CDC chose to focus on only ten countries, cutting epidemic prevention in 39 countries including China, the source of COVID-19, and the Democratic Republic of Congo, the center of the most recent Ebola outbreak. – Forensic News ‘Trump’s botched coronavirus response has been 3 years in the making’, Forensic News, 1oth March 2020

In addition to having to downsize its operations in China and elsewhere, the CDC also struggled with similar unfilled positions and staffing shortages that would be a hallmark of the Trump administration.

Another U.S Government agency affected by funding cuts was the National Institute of Allergy and Infectious Diseases (NAID), famously headed by Dr Anthony Fauci. NAID was one of 27 different centers that fell under the umbrella of the National Institute of Health (NIH)  The 2018 United States Federal budget saw an 18% drop in funding to the National Institute of Health, with $838 million in funding cut to the National Institute of Allergy and Infectious diseases.

Interestingly only three agencies actually received additional funding  in the same budget – The Department of Defense, Department of Homeland Security & The Department of Veterans Affairs. The rest, including agencies handling transportation, healthcare, and education all saw budget cuts.

One of the most contentious claims has been that Donald Trump Fired The Pandemic Response Team. Officially known as The Global Health Security and Biodefense unit, it was a special unit that resided within The National Security Council. It was established during the Obama administration in 2015, to prepare the country for a future pandemic. When the head Timothy Zeiner  left the team in 2018, it was effectively disbanded.

John Bolton, the head National Security Advisor claimed that the effective disbanding of the team was part of “streamlining” the NSC, although it’s not clear exactly how closing the unit made the NSC better prepared for handling a pandemic. The whole episode reminds me of the joke about the lady calling to cancel her insurance policy claiming it was a waste of money as she hadn’t used it yet.

Laurie Garrett, an author who has written extensively about outbreaks of diseases, has written how the Trump Administration intentionally rendered The United States less prepared by its budget and administrative cuts.

In May 2018, Trump ordered the NSC’s entire global health security unit shut down, calling for reassignment of Rear Adm. Timothy Ziemer and dissolution of his team inside the agency. The month before, then-White House National Security Advisor John Bolton pressured Ziemer’s DHS counterpart, Tom Bossert, to resign along with his team. Neither the NSC nor DHS epidemic teams have been replaced. The global health section of the CDC was so drastically cut in 2018 that much of its staff was laid off and the number of countries it was working in was reduced from 49 to merely 10. Meanwhile, throughout 2018, the U.S. Agency for International Development and its director, Mark Green, came repeatedly under fire from both the White House and Secretary of State Mike Pompeo. And though Congress has so far managed to block Trump administration plans to cut the U.S. Public Health Service Commissioned Corps by 40 percent, the disease-fighting cadres have steadily eroded as retiring officers go unreplaced.

Public health advocates have been ringing alarm bells to no avail. Klain has been warning for two years that the United States was in grave danger should a pandemic emerge. In 2017 and 2018, the philanthropist billionaire Bill Gates met repeatedly with Bolton and his predecessor, H.R. McMaster, warning that ongoing cuts to the global health disease infrastructure would render the United States vulnerable to, as he put it, the “significant probability of a large and lethal modern-day pandemic occurring in our lifetimes.” And an independent, bipartisan panel formed by the Center for Strategic and International Studies concluded that lack of preparedness was so acute in the Trump administration that the “United States must either pay now and gain protection and security or wait for the next epidemic and pay a much greater price in human and economic costs.” – Trump Has Sabotaged America’s Coronavirus Response, Laurie Garrett, Foreign Policy

 

America’s Intentional Failure

If America’s botched response had been sheer incompetence, I might feel some pity for the U.S President.  After all, a global pandemic is not the only task Donald Trump has been ill prepared for. But as the months have passed, it appears that the failure was deliberate.

COVID-19 arrived in the United States on the 21st January, the same day it arrived in Taiwan. In January before the outbreak spread across the country, Donald Trump was full of praise towards China’s handling of COVID-19.

Meanwhile, the outlook within the White House was not so rosy. At the end of January, Trump’s economic advisor Peter Navarrro was warning him of the potential loss of hundreds and thousands of lives unless action was taken.

On February 7 – Trump interviewed veteran journalist Bob Woodward. In a series of taped recordings, the president didn’t mince his words about the severity of the virus: “This is deadly stuff,” “You just breathe the air and that’s how it’s passed,” “And so that’s a very tricky one. That’s a very delicate one. It’s also more deadly than even your strenuous flus.”

He would later reveal the reason he wasn’t honest to the public about the greatest public health crisis in decades was that he didn’t want to “create panic”.

One early measure that was taken that did have a measurable impact in reducing the spread, was instituting flight restrictions from China. The U.S also declared a Public Health Emergency at the end of January, which quarantined any travellers returning from Wuhan. While these steps were beneficial, the “China Travel Ban” did not stop the import of the virus. In February, Italy and other European states were already scoring some of the highest new cases in the world, and flights continued from these Covid hot spots. It was not until March 11th that a travel ban was extended to much of Europe.

Domestically, the availability of testing was limited across the entire country in February, and would continue to be a major problem as the outbreak worsened. By the end of February, The United States was seeing multiple COVID-19 cases with no history of overseas travel, and no close contact with an infected person. These “cases of unknown origin” marked the first cases the U.S had identified instances of community transmission of the virus. Due to the lack of testing, it was likely occurring much earlier.

Until March, the United States still made the mistake of seeing COVID-19 as primarily a foreign disease. By the time that the threat was taken seriously on the ground, cases were already out of control.

Worsening of The Pandemic & Establishment of Task Force

From March 16th to April 24th the White House Task Force ran its daily televised address to the American Public. Established on January 29th, the task force’s daily briefings became a symbol of the Trump administration’s handling of the pandemic. The task force was headed by Mike Pence, but the star of the show was undoubtedly Donald Trump.

Commentators likened the White House Task Force briefings to a circus show. The briefings became a kind of replacement for the campaign rallies that Trump normally held. Without his scheduled campaign rallies to stroke his ego, (which had begun practically as soon as he had been elected) these White House Task Force Briefings became another platform for the president to launch diatribes against his opponents and at least give the appearance that the commander in chief was taking action. The task force briefings also offered a rare opportunity for the press to engage the U.S President.

While brilliant minds such as Deborah Birx, Anthony Fauci and Francis Collins also fronted the cameras, each would share the briefing with Donald Trump’s own ramblings. Perhaps the most memorable example of his ignorance was suggesting to a senior member of his task force that injecting disinfectant into the body might help combat the virus.  This was followed by particularly unconvincing bout of damage control the following day, in which the remarks were deemed “sarcastic”. Sarcastic or not, major manufacturers of disinfectant had to issue statements warning of the danger of human consumption of their cleaning products. It was not long after “Disinfectant-gate” that the limelight proved too much for the U.S President. The Task Force briefings would no longer be televised, and once the briefings were taken off the air, Trump reportedly failed to bother showing up to them.

On 26th March, the United States overtook Italy to count the most Coronavirus cases of any country in the world. As of writing, it still retains this dubious honour. New York City was hit particularly badly. As the United States’ biggest transit hub and a densely urbanized metropolis, the virus spread around all five Burroughs. Hart Island was New York’s burial site for those without living relatives or those who couldn’t afford a conventional funeral. The island’s interments increased from 24 bodies a week, to 25 a day during the pandemic leading to headlines about “Mass Graves” in New York.

On 27th March United States passed a record $2.2 trillion stimulus bill to deal with the crisis, informally known as the CARES act. The wide-ranging bill, the largest in U.S history included: $300 billion worth of one-time cash payments to individual Americans (normally $1,200 USD per person), $260 billion in unemployment benefits, $500 billion aid for large companies, $669 billion in loans to small businesses and $339 billion in funding to local governments.

Unsurprisingly such a large cash grab has led to allegations of misappropriation of funds. In West Virginia, $50 million in CARES act funds was spent on road repairs, leading one senator to remark “I’ve yet to meet a pothole that has the coronavirus.”

The Act also allocated more in corporate aid assistance than it did to individuals. BBC News surveyed Americans on what their $1,200 stimulus cheque was being spent on. Interviewees had quite wide-ranging answers, from the expected food, rent and medicine to bidets and gun A one-time payment for a year-long crisis is not enough.

Denial & Scapegoating

Throughout the whole crisis, Donald Trump has only had one consistent position on COVID-19 –  Hoping that the disease goes away:

  • February 7 – <10 cases: “He (Xi) will be successful, especially as the weather starts to warm & the virus hopefully becomes weaker, and then gone.”
  • February 10 – <10 cases: “a lot of people think that goes away in April with the heat — as the heat comes in. Typically, that will go away in April.”
  • February 25 – 15 cases: “So I think that’s a problem that’s going to go away.”
  • February 26 – 15 cases: “You have 15 people, and the 15 within a couple of days is going to be down to close to zero.” “It’s a little like the regular flu that we have flu shots for,”
  • February 27 – 60 cases: “It’s going to disappear…One day — it’s like a miracle — it will disappear.”
  • February 28 – 63 cases: “The coronavirus, this is their new hoax.”
  • March 6 – 319 cases, 15 deaths: “Be calm. It will go away.”
  • March 10 – 994 cases, 30 deaths: “We’re prepared, and we’re doing a great job with it. And it will go away. Just stay calm. It will go away,”
  • March 12 – 1,631 cases, 41 deaths: “It’s going away. We want it to go away with very, very few deaths.”
  • March 19, (Bob Woodward tapes) 14,896 cases, 240 deaths: – “I wanted to always play it down. I still like playing it down”
  • March 30 – 168,680 cases, 4,105 deaths: “It will go away. You know it — you know it is going away, and it will go away.”
  • March 31 – 193,954 cases, 5,206 deaths: “It’s going to go away, hopefully at the end of the month. And, if not, hopefully it will be soon after that.”
  • April 3 – 284,504 cases, 8,960 deaths: “It is going to go away. It is going away.…I said it’s going away, and it is going away.”
  • April 7 – 410,788 cases, 15,755 deaths: “It will go away” “the cases really didn’t build up for a while.” “I think what happens is it’s going to go away. This is going to go away”.
  • April 29 – 1,068,111 cases, 62,852 deaths: “It’s gonna go. It’s gonna leave. It’s gonna be gone. It’s going to be eradicated and – uh – it might take longer. It might be in smaller sections. It won’t be what we had”
  • May 8 – 1,326,579 cases, 80,202 deaths: “It’s going to go away. And we’re not going to see it again, hopefully, after a period of time.”
  • May 15 – 1,517,723 cases, 91,154 deaths: “It’ll go away at some point, It’ll go away. It may flare up and it may not flare up.”
  • June 16 – 2,211,406 cases, 121,807 deaths: “I always say, even without it [a vaccine], it goes away.”
  • June 17 – 2,237,660 cases, 122,632 deaths: Coronavirus would “fade away”.
  • June 23 – 2,246,338 cases, 126,326: “We did so well before the plague and we’re doing so well after the plague. It’s going away.”
  • July 1 – 2,778,452 cases, 130,985 deaths: “We’re headed back in a very strong fashion. … And I think we’re going to be very good with the coronavirus. I think that at some point that’s going to sort of just disappear. I hope.”
  • July 19 – 3,836,674 cases, 143,788 deaths: “I will be right eventually. You know, I said, ‘It’s going to disappear.’ I’ll say it again. … It’s going to disappear, and I’ll be right,”
  • August 5 – 4,978,414 cases, 162,019 deaths: “This thing’s going away. It will go away like things go away,”
  • September 16 – 6,828,301 cases, 201,351 deaths: “It’s going to be, it’s going to be herd-developed, and that’s going to happen. That will all happen. But with a vaccine, I think it will go away very quickly.”
  • October 1 – 7,505,449 cases, 212,661 deaths: Trump and Melania announce they test positive for coronavirus. “We will begin quarantine immediately.”
  • October 5 – 7,683,501 cases, 215,043 deaths: “Don’t be afraid of Covid. Don’t let it dominate your life.”
  • October 12 – 8,037,789 cases, 220,011 deaths: “It will run its course. Vaccines and cures are coming fast!”
  • October 198,414,388 cases, 224,987 deaths: “People are tired of Covid,” “People are tired of hearing Fauci and these idiots, all these idiots who got it wrong.”
  • October 228,665,743 cases, 228,381 deaths: “We’re rounding the corner. It’s going away.”

As cases passed into the triple digits in March, Trump began looking for a scapegoat for his administration’s failures.  And so After initially praising Chairman Xi Jinping’s response to the virus, he decided to double down.China was the scapegoat. The virus was “The Wuhan Flu” and no failure was his. If wishing the disease away didn’t work, blaming it away was the next best thing.

It is hard to believe that even Donald Trump would have taken the Chinese Government at face value in those early months.  A state with such censorship and millions employed in propaganda was never going to be honest of a crisis that would cause them to lose face in the international community.As the Bob Woodward tapes have shown, the Trump administration knew of the severity of the disease. The “China Blame” was just an attempt at deflection.

Final Evaluation

The United States was always going to have a major challenge during a pandemic.  In late March, the strictness of the lockdowns varied across the country- several states including Iowa, North Dakota and Nebraska never even issued a stay-at-home order. Some states which did lockdown, such as Georgia, pressed ahead with re-opening ahead of schedule against the advice of public health officials.However it was the absence of leadership and dysfunctional policy from the White House that made America’s failure so fatally bad.

Today, it still holds the dubious honour of the world’s highest number of COVID-19 cases and deaths. Over 200,000 Americans have died – a fifth of the entire global total. While every major nation has had its citizens die, no nation has failed its response as monumentally as America.

For the last eight decades since World War Two, America has been envied, loathed and awed by nations across the globe, but seldom ever pitied. The world has looked on at the greatest superpower in history with sadness and bemusement, watching the world’s wealthiest nation reduced to its knees. The United States was the biggest contributer to the World Health Organization, and during H1N1 and other pandemics, the US was always there to direct the response. In a time of  global crisis, American’s allies wanted to believe in American exceptionalism. How utterly the myth has been destroyed will shape our relations in the years to come.

Had the Trump administration followed the guidelines of the CDC and the pandemic playbook, America would have contained the disease months ago. Donald Trump could have continued bragging about the “Rockstar economy” he inherited from the previous President and would likely have secured four more years in the White House.

Crises can be opportunities for world leaders – George W Bush, Margaret Thatcher and certainly New Zealand’s own Jacinda Ardern are well aware of the positive PR that comes with managing a crisis. Donald Trump could have used America’s resources to make the country the envy of the world in its handling of the crisis. But instead of leadership there was just denial, and farcical statements such as “”If we stop testing right now, we’d have very few cases, if any,” 

One of the greatest U.S Presidents, Harry S Truman who oversaw the country in its post-war years from 1946-1953 famously kept a sign at the oval office stating “The Buck Stops Here”. It was a reminder that responsibility ultimately resided with the President. The successes and failures. The highs and the lows. From crisis to celebration – all reflected the leadership of the country.

“I don’t take responsibility”   are the words of Donald Trump, when asked whether he feels responsible for the  most serious crisis facing his country. Instead of taking his duty to the country seriously, he has continued to scapegoat anyone but himself. Rather than uniting the country, he tried to turn a public health crisis into a partisan issue. Withholding funding for blue states and opposing the use of masks to make them became a symbol, rather than a safety feature. It is hard to imagine how anyone else could have done a worse job.

During early discussions in replacing The Affordable Care Act, one quote from Trump was particularly telling. While Donald Trump claimed “Nobody knew health care could be so complicated.” ( it should be noted that “Nobody” and “Everybody” is almost always Donald Trump referring to himself in the third person) he followed his remarks by addressing healthcare CEO’s and claiming “If things don’t work out I’m blaming you anyway,”

Has that not been the administrations defining response during the crisis? . If things don’t work out, I’ll blame China, or Obama, or the Democrats. The endless scapegoating is Donald Trump’s modus operandi. It’s true that China misled the world about the severity of the disease, but China has not been responsible for America’s failure. The Trump Administration is responsible for America’s failure.

The legacy of the US President will now forever be the man who bungled the pandemic. This is the legacy of a failure of a president and a failure of an empathetic human being. A sad, corrupt man who never deserved the trust of his voters.

As America heads to its election, Trump continues to campaign on a strategy of anything but COVID-19. He hopes his supporters will forget that their health is at risk coming to his rallies, and that the disease will simply go away. However the odds are not good for the incumbent – his approval numbers are sinking and his campaign has blown through millions of dollars. In the words of Republican Stratgist Mike Murphy, “You could literally have 10 monkeys with flamethrowers go after the money, and they wouldn’t have burned through it as stupidly.”

In spite of what he is campaigning on, his legacy will be inextricably linked to this virus. For a man so concerned with how the public perceives him, I’m sure he will have great regrets

Part Five – China’s Response & The World Health Organization

This time you’ve gone too far.

This time you’ve gone too far.

I told you, I told you, I told you. I told you.

 – Peter Gabriel, Digging in the Dirt

Ten months since China began reporting of an unknown strain of Pneumonia in Wuhan, there has been renewed criticism of China’s handling of the origin of the pandemic. Conservative commentators have accursed China of a cover-up of the outbreak of the pandemic.  Additionally criticism has been levelled at the World Health Organization of being unduly influenced by China.

There has been scepticism of the relatively low case numbers in China. It seemed difficult to fathom that the most populous nation in the world remained relatively unscathed, when the other most populous nations behind it, namely India, Indonesia, and the United States are all struggling to contain the spread of the disease.

So did China cover-up COVID-19, or did they simply handle it well? Perhaps the answer is a little bit of both.

How China defeated the Virus

The perks of an authoritarian government are the total control it exerts over its populace. These prove to be beneficial in a crisis, but are the source of fear and paranoia in most other areas of day to day life. While some believe that China’s role as the world’s factory forfeited its classification as a communist government, they are only willingly deceiving themselves. It’s a communist nation open to trade, but the internal mechanisms that drives the world’s factory, are still overseen entirely by the state. The China isn’t communist line was trotted out by western business leaders to delude themselves that they weren’t dealing with an authoritarian regime which could reappropriate their factories and steal their IP at a moments notice.

In China, the state does not even give the pretence of answering to its own citizens. The military and all civil branches report directly to the Chinese Communist Party and the largest companies within China are still state owned. These include China State Construction Engineering – the world’s largest construction company by revenue, and State Grid Corporation of China – the largest electrical company.  In fact the largest private companies – Huawei and Alibaba, are all subject to the whims of the state, and have sizeable military contracts. Hypothetically had the Soviet economy not met an abrupt end in 1991, and manufacturing continued to liberalize with the reforms introduced through petestroika, I do wonder if the same claimants would label the Soviet Union of the 21st century as no longer being communist.

China’s enormous level of state control was one of the reasons why they were able to weather the 2008 financial crisis relatively unscathed – the state owned enterprises ramped up construction projects on a huge scale to boost the nation’s GDP.  In the same way that China was able to leverage its enormous state apparatus to weather the 2008 crisis, once it took 2020’s crisis seriously, it was able to mobilize resources on a massive scale.

The answer as to how China defeated COVID-19 was at the very thing China excels at – depriving its citizens of their rights and freedoms. The authoritarian power used all its tools in the state’s apparatus to enforce strict nation-wide lockdowns.

Hubei province recorded 80% of China’s COVID-19 infections in the early months of the pandemic, and while the disease spread to other provinces, it couldn’t spread widely in the community once the country went into lockdown.

“Real Chinese infection numbers were significantly higher than officially reported, but not recorded because almost the entire population was forced into strict lockdowns from late January through mid-February. “Every province in China got infected within a month [of the Wuhan outbreak] and [their official case counts] generally settled into triple figures because their lockdowns were harsh,” said Dr Fisher. “Diagnoses weren’t made because everyone was staying at home. People with mild cases probably spread it to a couple of people in their family who also had mild cases and the virus just burnt itself out . . . Within three to four weeks they were able to unlock things.”– China and Covid-19: what went wrong in Wuhan?’, ~ Dr Dale Fisher, Financial Times.

Wuhan and Hubei province remained totally locked off for longer than the rest of China – only in April did the province open up.

DUBIOUS DATA

While it’s clear that China lied about the numbers that died in Wuhan and Hubei, there is no doubt that the disease has been successfully controlled.

Despite the initial outbreak, China has been quite successful in its handling the disease. You can read multiple accounts of expats experiences during China’s lockdown. China is not the Soviet Union. There is no Jade Curtain, and thousands of westerners live there. If there was an elaborate cover up of a widespread outbreak of COVID 19, then it would have leaked its way into the world’s media.

However the number of recorded cases within China have been so laughably skewed that it’s difficult to make any sense of how many cases actually occurred. As of writing, the world’s most populous nation and origin of the outbreak recorded fewer than 5000 deaths from the disease.

Chinese data on COVID-19 was so unbelievable that The British Government stopped using Chinese figures in its press briefings. Numbers were seemingly revised on the fly in April, and very little could be ascertained as to the true scale of the figures. The US president’s observation that “If we stop testing right now, we’d have very few cases, if any,”  proved to be the reality in China, as China chose not to record asymptomatic cases in its official figures, even when the patients had tested positive.

Such cases, where patients test positive but show no clinical symptoms such as a cough or fever, are excluded from China’s tally of confirmed cases. – Reuters, April 19th 2020. 

Wuhan and Hubei province recorded the majority of China’s COVID-19 cases, and there was extra sensitivity in numbers at ground zero of Sars COV2. The Lockdown in Wuhan lasted an extraordinary 76 days – longer than most other lockdowns throughout the world, but local residents were skeptical of the government’s figures.

There are many people we have spoken to, even doctors in Wuhan, who don’t trust the numbers given by the Government. For reasons of scepticism on behalf of the public.

But from medics, it’s mostly due to the fact that in the chaos that engulfed the city in the early weeks of the outbreak many, potentially thousands, of deaths and cases went undiagnosed and therefore unreported. – Debi Edward, ITV News, 07/04/2020

Much of China’s propaganda relating to COVID-19 was centred on the authoritarian state’s efficiency. Who could forget the headlines “China Builds a hospital in 10 days”. A remarkable achievement certainly, but one not without issues. Video footage showed the hospital badly leaking from the ceiling. When the existing hospitals of Wuhan were completely filled, most COVID-19 patients were treated at 16 makeshift hospitals, which were set up at locations such as the Wuchang Honshan sports stadium. Open tents in a sport stadium don’t quite make for the same headlines.

PERSONAL RESTRICTIONS

The vast majority of personal movement within China now requires signing in with a QR Code and getting the “Green Light” on the Alipay app. This extends not only to entering shops and offices, but taking public transport and even leaving an apartment complex. Alipay and WeChat are the two universally used apps within China – the majority of Chinese citizens were already using these for day-to-day mobile payments and communications, so tying in the COVID tracing was a smart move. No surprise though, since like every other digital service it’s subject to the oversight of the Chinese Government.

China is not taking measures lightly on controlling the outbreak. Although Wuhan has been opened up, it is very difficult for visitors to leave. After the city opened up, the government instituted a lottery system, with only select applicants able to travel out of the city. Wuhan’s residents were then be quarantined for 14 days, regardless of a negative test result.

Truthfully, we have no idea the true number that died or were infected in China, however had draconian measures not been taken, it’s likely cases would be similar to what India is currently experiencing.

The World Health Organization & Traditional Chinese Medicine

From 16th-24th February, the World Health Organization led a joint mission to China to report on the origin of COVID-19. Their report can be read here.

In short, the missions findings were full of praise towards China’s handling of the outbreak. The WHO’s response has been so flattering to China, that criticism has been levelled of a pro-china bias within the organization. Perhaps the most prominent sycophant within the organization has been Dr Bruce Aylward, the Assistant Director General who led the joint mission to china.

In a viral interview with with the Hong Kong current affairs program ‘The Pulse’, Dr Aylward  was asked about Taiwan’s handling of COVID-19. He firstly pretended not to hear the question, and then when the interviewer refused to move on, he abruptly ended it.

Taiwan’s exclusion from The WHO is a legacy of the political stalemate known as the “One China Policy”.  Much like Kosovo is unlikely to get a seat at the table any time soon, a country with limited democratic recognition cannot belong to a UN body. The “One China Policy” and the lasting legacy of the Chinese Civil War are a topic for another post, but a cursory read through the Wikipedia Page of Foreign Relations of Taiwan shows a meagre total of 14 countries plus The Vatican provide it with diplomatic recognition. Numerous other international bodies also exclude Taiwan. Perhaps this whole crisis will lead the world to reconsider that a proud, independent nation of ethnic Chinese people with, strong institutions and democratic values, should be recognized on the world stage.

Of course China is not the only country the WHO complimented. It also praised South Korea’s response as well, but the China bias has been a difficult accusation for the organization to disregard.

An investigation by the Associated Press uncovered that one of the reasons for the WHO’s early praise towards China, was in an an attempt to get further information from them.

WHO officials were lauding China in public because they wanted to coax more information out of the government, the recordings obtained by the AP suggest. Privately, they complained in meetings the week of Jan. 6 that China was not sharing enough data to assess how effectively the virus spread between people or what risk it posed to the rest of the world, costing valuable time.

“We’re going on very minimal information,” said American epidemiologist Maria Van Kerkhove, now WHO’s technical lead for COVID-19, in one internal meeting. “It’s clearly not enough for you to do proper planning.” – China Delayed Releasing Coronavirus Info, The Associated Press

Other criticisms levelled at the WHO were in relation to reversing its advice on Travel Bans & Mask Usage. Due to concerns that face masks would be unavailable for healthcare workers who needed them, the WHO recommended against general public wearing them. It would later issue advice in June for government’s to recommend their citizens wear face masks.  It has been clear that there has been muddling responses from the WHO throughout the pandemic, but it must be remembered that there was a great deal of uncertainty regarding COVID-19 in the early stages of the outbreak.  While the WHO revised its response, criticism seems to have been levelled that they should never have changed their minds. This is entirely against the principle of the scientific method – If the evidence is in favour of revising your theory, then you revise it.

The WHO has been one of several scapegoats for the US president’s botched response and one of several international organizations he has threatened to defund. “The United States owed $381 million to the regular budget [of the UN] as of Jan. 1 and some $776 million to the peacekeeping budget, U.N. officials said, figures the U.S. mission to the U.N. confirmed.” Another is USAID, the US government agency in charge of  humanitarian and international development missions, which the Trump Administration is seeking to freeze their funds.  USAID not only helps cement U.S soft power in the developing world, but has played an important role in preventing outbreaks of diseases such as Ebola.

What Donald Trump cannot comprehend, is that all of these projects pay dividends in soft power, which the United States has been rapidly losing to China. Freezing funding does not mean that the issues will go away. A defunded UN and defunded governments in the developing world will simply look elsewhere to pay their debts – chiefly to China.

As the government of Xi Jinping seeks a more assertive role for China on the world stage, it is fortuitously timed with a U.S administration handing them influence on a silver platter. The world is entering into a multipolar world, once again, and the power vacuum is being filled by China.

The WHO may be bloated like every UN bureaucracy, but it’s a necessary diplomatic tool. While China may be influential, if influence is chiefly procured by financial means, then it is not China that is most influential at the WHO but Bill Gates. The Bill & Melinda Gates Foundation is the second largest donor to the World Health Organization after the United States. Unsurprisingly, Bill Gates is more than displeased at the United States’ defunding of the organization. Regardless of its issues, leaving the WHO would be a mistake at the time of a major international health crisis.

On Traditional Chinese Medicine

One issue that needs to be evaluated in relation to the outbreak of COVID-19 is the use of Traditional Chinese Medicine.Again it is worth emphasising – the reason so many animals were at the Huanan Market where SARS-COV-2 broke out, was for use in Traditional Chinese Medicine.

One of the main reasons these potentially deadly animals are kept at Wet Markets, is for their use as ingredients in various TCM concoctions. Traditional Chinese Medicine has thousands of years of history in China. It is the accumulation of folk knowledge, as well as spiritual practice.

I do not want to be insensitive of an issue I know is important for many Chinese people. There can be great wisdom in following tradition. One case in point is The Chinese preference for hot water. Over the centuries, rural Chinese villages began to notice that when they consumed hot water, they would not get the same sicknesses water-borne sickness such as Cholera that would break out in neighbouring villages. Over time, even while germ theory and waterborne diseases was not properly understood by the Chinese, the tradition stuck and to this day Chinese people prefer drinking hot water.  Drinking hot water was also endorsed by the Chinese Communist Party in a 1952 public health campaign after the end of the Chinese Civil War.

The herbal remedies used in TCM have on rare occasions been validated by science. “One notable product that has emerged from TCM is artemisinin. First isolated by Youyou Tu at the China Academy of Traditional Chinese Medicine in Beijing, the molecule is now a powerful treatment for malaria and won Tu the Nobel Prize in Physiology or Medicine in 2015.”

Unfortunately in the majority of cases, TCM contains more than just popular folk wisdom, and does not complement actual medicine, but overrules it. While certain herbal remedies contain beneficial properties, the majority of Traditional Chinese Medicine has no scientific basis. It is folk knowledge, tradition and superstition, with any effects likely just a placebo.

No other country has been pressing the WHO for inclusion of TCM other than China. In 2019, The World Health Organization legitimized Traditional Chinese Medicine by including it in a significant WHO Publication.

These mixed signals are now worryingly mirrored by the World Health Organization (WHO), which last week approved a new version of its International Classification of Diseases, a highly influential document that categorizes and assigns codes to medical conditions, and is used internationally to decide how doctors diagnose conditions and whether insurance companies will pay to treat them. The latest version, ICD-11, is the first to include a chapter on TCM — part of a warming to the practice under former director-general Margaret Chan, who led the WHO from 2006 to 2017.- The World Health Organization’s decision about traditional Chinese medicine could backfire – Source: Nature.com

The oldest known document for Chinese Traditional Medicine is the Recipes for 52 ailments which was found in a Han Dynasty Tomb dating back to 168 BC. When evaluating the actual herbs listed in the great ancient tome of TCM, the findings weren’t positive –  “In modern study, some of these herbs have been shown to have certain medicinal benefits (such as boneset’s anti-inflammatory properties), though the majority of them have been proven ineffective against their listed ailments and even harmful in many cases”

Much of Traditional Chinese Medicine originated from  spiritual and religious practice. Qi – the lifeforce, is inextricable from TCM.

One might question why Traditional Chinese Medicine has been promoted. In an excellent article in Slate Magazine in 2013, Alan Levinovitz summarized how Traditional Chinese Medicine was repurposed by the Chinese Communist Party as a potential propaganda weapon.

The reason so many people take Chinese medicine seriously, at least in part, is that it was reinvented by one of the most powerful propaganda machines of all time and then consciously marketed to a West disillusioned by its own spiritual traditions. – ‘Chairman Mao Invented Traditional Chinese Medicine’, Slate Magazine

In addition to contributing to the poaching of endangered animals such as the pangolin, certain ingredients in TCM can necessitate animal cruelty. Bear bile is touted as a “cure all” ingredient. While bile used to be extracted from bears which were killed, live extraction has occurred for decades. These bears live a miserable existence within tiny cages. A catheter tube is shoved into their gall bladder to extract the bile. The catheter can remain  permanently installed depending upon the method of extraction, as bears frequently die during the process.

However, TCM is still largely unproven and remains pseudoscientifc. The words of comedian Tim Minchin sum it up quite nicely You know what they call alternative medicine that’s been proved to work? – Medicine.”

These practices can only be stopped if the Chinese Government makes a significant attempt to stamp the practice out. The CCP clearly is able to change attitudes in China. As an authoritarian state, they have the power to exert influence over every facet of society, and yet TCM seems to have been one of the few areas of Chinese culture that has remained unmodernised.

As long as the government remains in denial, there is nothing stopping another outbreak of a Zoonotic disease originating in China. The Daily Mail has reported that even after the outbreak, the Southern City of Dongguan had Traditional Chinese Medicine stalls at the local market advertising bats, lizards and scorpions for sale.

A Traditional Chinese Medicine Stall in Dongguan advertising bats, spiders and other unsafe wildlife
A Traditional Chinese Medicine Stall in Dongguan advertising bats, spiders and other unsafe wildlife

What is shocking is that after Wuhan emerged from lockdown, it has been reported that the wet markets are now operating once more. Not the Huanan Market, but other similar markets.

However the CCP appears to see Traditional Chinese Medicine as an important cultural weapon. Rather than urging caution, they have been aggressively promoting it.

Traditional Chinese Medicine is only one form of many different pseudoscience’s worldwide (Wikipedia’s list of pseudoscience topics makes for extensive reading) and it should be clear that China is not the only country with these practices. In Korea, Traditional Korean Medicine (TKM) is similar to its Chinese counterpart. Japan is home to Shiatsu and Reiki. The West is the home of the Anti-Vax movement. Yet, perhaps it is because China is so influential and aggressively promotes TCM, that the potential for another pandemic could once again break out in the future in another Chinese Wet Market.

Rewriting the Narrative

It’s clear that COVID-19’s origins in Wuhan are an embarrassment to Beijing, and throughout the course of the pandemic it has been attempting to rewrite the narrative as to the origin and spread of the disease.

Domestically, it has taken to its usual heavy handed censorship  –censoring discussion of Li Wenliang and anything deemed critical of the Chinese Communist Party’s response on WeChat.

Beijing is naturally sensitive about its early handling of what has gone on to become a global catastrophe. At home its censorship is so overwhelming that it can control the timeline and edit the facts to suit its narrative. Since January, censors have assiduously deleted documentary evidence and added events and comments retrospectively to suggest leadership engagement. Seven months on, the silencing of doctors and scientists continues, while some Chinese citizens who have tried to preserve inconvenient facts or present a different version of the narrative have disappeared. – China is rewriting the facts about Covid-19 to suit its own narrative, The Guardian

However, it has also tried to spread its insidious propaganda overseas. In April, Chinese diplomats encouraged German officials to speak positively of China’s handling of the pandemic. Around the same time, officials at the Chinese Consulate in Chicago targeted a U.S senator in Wisconson with a similar request.

While these attempts may have failed, officials in Italy, Serbia, Poland & Mexico all reportedly offered praise to China in return for medical supplies. Meanwhile, vassal states like Pakistan, whose credit lines had soured elsewhere, were practically falling over themselves to praise China.

But, far from learning from past mistakes, China’s leaders are trying to cover them up. As virtually the entire global economy effectively shuts down to contain the China-born virus, the Communist Party of China has shifted its propaganda machine into high gear. Its goal: change the narrative of the Covid-19 crisis.

At home, this has meant touting the CPC’s leadership in mobilising the country to “win the war” against the virus. It has also meant encouraging the spread on Chinese social media of exaggerated or outright false stories about Western democracies’ “inept” responses to the outbreak. – China’s misplaced pandemic propaganda

The extent of China’s propaganda has been wide-ranging. Chinese state media ludicrously implied that COVID-19 may have originated in Italy. Although under this theory they don’t deny it was first detected in China, they dispute that it was the first case. Another fringe theory pushed by a Chinese foreign ministry spokesman, speculates the U.S military may have brought the virus to Wuhan during a sports competition. Fake social media accounts have also been used by the Chinese Government to push a pro-China narrative online.

In the early months of the pandemic, China affiliated organizations such as the POLY group led to Chinese abroad sending 2.02 billion surgical masks desperately needed by locals back to China all the while underplaying the severity of the disease.

China’s actions throughout the pandemic, particularly its early cover-up, have revealed just how dangerous it would be as a globally dominant superpower.  COVID-19 could have broken out in another nation with unsanitary markets and we would be faced with a similar crisis. Diseases replicate themselves without a great deal of human involvement. Few people resented the African Republic of Guinea for the EBOLA outbreak in 2013, for example, no it is China’s denial at the origins of COVID-19 and the the scale of its spread that has so  angered the world.

Yet what has been disappointing is throughout the entire crisis, is due to the United States absence from global leadership under the Trump administration, there has not been the co-ordinated response required to hold them to account. We likely will never know the true story of how COVID-19 appeared, but the West missed a crucial opportunity here. In failing to control the disease, it lost the initiative on COVID-19. If the country in which the disease originated was able to control it, why couldn’t we?

 

Part Six – Where to From Here? 

Photographer: Laurel Chor/Getty Images
A British Airways flight from Milan to London on 05/03/2020 Photographer: Laurel Chor/Getty Images

COVID-19 was not the only news story of 2020, even though it may have seemed like it. Armenia and Azerbeijan found themselves at war, China fiurther eroded Hong Kong’s freedoms, Beirut had its waterfront shattered by a huge explosion and  The ‘Black Lives Matter’ movement saw the pent up frustration of lockdowns finding an outlet in the George Floyd protests, in which people took to the streets again in defiance of restrictions. While the fight against police brutality and racial injustice was admirable, it was unfortunate timing for worldwide mass protests.

Yet all the other stories and events faded into the background against the overwhelming dominance of the pandemic. This has been the great De-Globalizer. Borders Shut, Travel postponed, trade Disrupted, Churches & Schools Closed. The things once thought unthinkable in the modern era have come to pass.

It’s interesting looking back at the ill conceived statements of many politicians and officials from early in the year.  On 26th February, Ireland’s Health Minister ruled out COVID-19 screening at airports and flight restrictions, claiming “We can’t ban Travel”.  The EU of course would do just that weeks later. The Olympics were still scheduled for July 2020 and officials claimed they were still going ahead back in March until delaying them until 2021. Concerts, sports matches, weddings, film launches – every major event seems to have been postponed.

As the disease has dominated this 21st century Annus horribilis we ask ourselves – when are we coming out of it?

Waiting for a Vaccine

Since the beginning of the outbreak, medical researchers around the globe have been working on developing a vaccine for SARS-COV-2. 59 vaccines are currently in clinical research. Three in particular, produced by Moderna, Oxford/Astrazenaca & Pfizer/BioNTech have been the most promising candidates.

The race to make the first  widespread vaccine for COVID-19 has made drug companies salivate at the trillions of dollars in potential profits. Yet the huge demand has some fearing they’ve cut corners. There has never been a sucessful vaccine developed for a human Coronavirus,and the process of developing a vaccine normally takes years. Despite the rapid speed at which they’re developed, the process for approval by government health agencies remains the same as for other vaccines in use. Personally, I’m confident that all candidates that make it to production in the west will be suitable due to the rigorous trials each have had over months.

There is understandable hesitation about Chinese vaccines, however. China has had previous medical scandals with defective rabies vaccines in the past. However the country is likely aware that a COVID-19 vaccine would be a huge boost to its prestige, and two vaccines from Sinovac and Sinopham are undergoing successful trials. China’s vaccine candidates are likely to be more widely used in the developing world, as unlike the western candidates don’t need to be stored at sub-zero temperatures in cold-storage

“Vaccine Diplomacy” has already emerged and the competition between the available vaccines next year will be an interesting story to follow.

What still remains unknown however, is the frequency to which a COVID-19 vaccine is required, which will largely depend on the nature of the disease. Humanity has only ever completely eliminated a single disease in our 200,000 odd years on our planet – Smallpox. We came very close with Polio, and hopefully one day this too will be eliminated, but COVID-19 is unlikely to be eliminated. Like Influenza, it may become another seasonal disease, in which case it’s likely an annual COVID jab will be required. Outbreaks will be isolated and contained, and with the immunological protection of a vaccine defending against the disease’s worst effects, we will learn to live with the virus.

The idea that COVID-19 will be eliminated seems unlikely. However the pandemic will end and the world will move on, as we always do…..as we already seemingly are.

On China Relationship

Geopolitically, COVID-19 seems to mark a turning point with our relationship with China.  In an article by Richard Haass in Foreign Affairs titled “The Pandemic Will Accelerate History Rather than Reshape It.”  He concludes that rather than marking a radical change in relations, the western world will continue its existing trend of de-coupling from China.

The impetus to decouple will grow as a result of the pandemic, and only in part because of concerns about China. There will be renewed focus on the potential for interruption of supply chains along with a desire to stimulate domestic manufacturing. Global trade will partly recover, but more of it will be managed by governments rather than markets. – Richard Haass, Foreign Affairs

The “De-Coupling” from China had already begun before this crisis. Prior to COVID-19, the Trump Administration was already upending trade conventions with his “Trade War”. American, European and Japanese companies began looking at making the move out of China, or at least further diversifying their supply chains. Apple began iPhone production in India,  but many manufacturers have chosen South East Asian economies.

The move away from “The World’s Factory” is partially due to souring political relations, and partially sensiible business acumen. A matter of avoiding putting all your eggs in one basket. Vietnam was one of the main beneficiaries of the U.S China Trade War. More and more Multinational companies began setting up manufacturing base. Vietnam is advantageous due to its geography, business friendly climate and lower salaries relative to China.

China had been attempting to get around these moves, with an illicit process known as “Transhipment.” The concept is quite simple – to avoid restrictive tarrifs, Chinese companies would continue manufacturing in China and falsify the origin of the goods, by using Vietnam as a entrepot.  Vietnamese customs had reported in June 2019 that they were cracking down on China falsifying the manufacturing origin of products, and stamping a “Made in Vietnam” label on them. After all, it’s bad business for them.

Likewise, the reliance on China for masks and protective equipment was a lesson to government’s to boost domestic production.

Politically, there is goodwill throughout the west for holding China to account. However, it has to be done in a constructive and strategic way. Calling COVID-19 “The China Virus”, while perhaps technically correct, achieves nothing. A future US administration will need to work collectively with allies if it is to maintain its dominance in the Asia Pacific.

Travel

Won’t somebody think of the travel bloggers!

With Borders remaining shut around the world, few people will be travelling anytime soon. Many international borders will remain closed until the end of the year. Fare increases, route changes and pre-flight health checks are some of the measures predicted to be introduced when international travel resumes. Once vaccines are widely available, a carte jaune may be required for travellers as evidence of vaccination. This is not unprecedented – several African countries already require travellers to be immunised against yellow fever before entering, but will certainly be an additional hurdle.

Global Airline seat capacity in the first week of April 2020 is operating at 23% of its capacity in April 2019, falling from 44.2 million seats to 10 million. 

The decline of business travel in the age of ‘Zoom’ and ‘Microsoft Teams’ will come as an unwelcome development to airlines. First Class and Business Class helped subsisde the cost of economy flights on the major carriers. Governments are already being forced to bail out their national carriers, and several major airlines including WOW Air, Flybe and Air Italy have gone under. It seems likely that many budget airlines will go under before widespread international travel resumes.

“I love it when we’re cruising together”

The Cruise industry has been badly battered by the pandemic. The majority of these multi million dollar floating resorts will be sitting unused for the forseeable future. It will be difficult for them to shake off the news footage of hundreds of sick passengers stuck aboard the Diamond Princess off the coast of Japan.

An Australian based ship –  ‘The Ruby Princess’, had a large outbreak on board in early March. Passengers were allowed to disembark in Sydney despite showing symptoms, and 900 later tested positive. Even before COVID-19, outbreaks of Norovirus made for grim headlines, although the frequency was relatively rare.

The Diamond Princess cruise ship- the source of COVID-19's earliest major outbreaks
The Diamond Princess cruise ship- the source of COVID-19’s earliest major outbreaks

The cruise industry had been under fire for its wastefulness and environmental harm, and often tax avoidance by flying flags of convenience, so there were few tears shed at their financial woes. Cruising was always a purely recreational form of travel, and so the calls by executives to bail out the industry have largely fallen on deaf ears, as both the public and politicians are unsympathetic to a wasteful industry. While it’s hard to see cruising disappearing completely, most operators have delayed their international voyages until well into 2021.

Has the world really changed?

In March it seemed as if for a brief few weeks, life was different. During New Zealand’s national lockdown, there were op-eds about how “the world has changed”. Certainly with most of the world stuck at home, our carbon footprint was lower. I really wanted to believe that this Pandemic might be a kind of diluvial blank state for society. All of the old problems would be replaced by the collective challenge we faced. It was easy to be sucked into the media hype of monumental societal shift. Of course they were saying that – it was clickbait.

As restrictions eased we largely went back to the same old behaviours. The human capacity for boredom exceeds our capacity for fear, and many became incensed at being told what to do. The “Anti-Mask” movement has been an embarassing indictment on our species’ collective intelligence. The equivalent of wearing a facial seatbelt was too much for some, particularly in the United States, as numerous viral videos have shown.

Even in New Zealand we have seen numerous examples of rank selfishness and entitlement. All that returning citizens had to endure was two weeks in hotel quarantine, but that was too much for some champagne sipping freedom fighters. Within a single week we had four escapees from isolation hotels. Rules for thee but not for me.

We have all grown tired of this disease that has dominated the year. COVID-19 has defined 2020, but the economic effects will continue throughout the decade. Businesses all over the world have been forced to adapt or face closure. By most forecasts the economic damage be worse on our economies than the 2008 Global Financial Crisis. According to the IMF, we are heading for the worst recession since the Great Depression.

Certain trends will continue to grow after the pandemic. The decline of the shopping mall has continued in the United States as Jeff Bezos moves ever closer towards being a trillionaire. Consumers became wary of crowded locations, and especially during lockdown there was a huge growth in e-commerce.

The traditional office has also certainly seen a shakeup during this pandemic. Perhaps the bigest trend of 2020 has been the rise of remote working. Silicon Valley companies are now looking at potentially moving their workforce into permanent remote work setups.

But these are all superficial changes.

Imagine if we could get rid of all the troubling aspects of “going back to normal”. The wealth gap, the culture wars, the divisions, the lack of communities. We haven’t critically looked at building a better society out of all of this.

So, perhaps I am a little jaded, but beyond the political fallout, economic hit and de-détente with China, I truly hoped we would re-evaluate what matters. COVID-19 hasn’t really changed the world for good, it’s just made us a bit more anti-social.

 Lessons Learned

In a review of the book “SARS how a global epidemic was stopped”, some extracts of lessons from the outbreak of the SARS outbreak published in 2006, the reviewer Auok Kai Chew notes:

First: “transparency is the best policy”. Although nothing was known about the SARS coronavirus at the time when the disease first struck, we soon realized that, as Doberstyn points out, “some of the affected countries did not acknowledge openly and squarely the presence of SARS, downplayed its extent, and attempted to prove that it was something else.” Perhaps, if there had been prompt and accurate reporting of the full facts so that others could have been forewarned and taken preventive measures, history may have taken a different course. Infectious diseases such as SARS do not respect international borders. In one of the chapters in part II of the book, Mangai Balasegaram & Alan Schnur caution that “one nation’s weak response could endanger the world’s public health security.” – SARS: how a global epidemic was stopped

Transparency was not given at the beginning of this outbreak, however given China’s previous track record that could be expected. What has been most disappointing was the weak response of certain countries.

So much was unknown about the disease in the early months of the year. Many of the early cases were misdiagnosed as it was still unclear what the symptoms of the disease were. America’s first death from COVID-19 on February 6th, was believed to be a heart attack. It is only as the disease became much more widespread that the symptoms became more easily disagnosable.

Of course, the initial coverup did not help matters. Had COVID-19 not broken out in as secretive state as China, then perhaps we would have had a better initial understanding of the disease. However, South Korea, Taiwan and other countries all demonstrated that it is still possible to successfully deal with a pandemic through decisive leadership and effective public health measures.

We have been living isolated from wars and disease in the developed world for so many decades, we forget they are a daily reality in other corners of the world. There are many disease outbreaks that simply go under-reported. Looking at the WHO’s data from 2019, there were numerous naturally occurring outbreaks of other diseases – even Coronaviruses likes MERSCoV .  Few people took notice of these outbreaks last year. In another timeline, COVID-19 might have merely been another virus on that list.

The British Health Secretary,Matt Hancock, described COVID-19 as a “Once in a Century” event. Of course, it isn’t necessarily. His phrasing was chosen to reflect the gravity of the situation, but there’s certainly no factual basis for it.

It’s a depressing thought after a very long year, but it’s true. COVID-19 in all likelihood will not be the only global outbreak of disease in our lifetimes. Lets hope we can learn our lessons from this pandemic so in the event of a COVID 43 or another similarly morbid future disease emerging, we will all be better prepared to fight the challenge together.

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