Coronavirus response hampered by obfuscation and uncertainty
5 Feb 2020|

The outbreak of a new coronavirus, dubbed 2019-nCoV, has shown that we haven’t learned enough from the 2003 SARS epidemic. China continues to struggle with transparency, and, in the absence of data, the international community is implementing a variety of inconsistent policies. Put simply, we can’t be sure whether China is using a sledgehammer to crack a nut, or whether this new coronavirus presents a serious international threat.

The latest official figures from China show almost 500 people have died, almost 25,000 have been infected and more than 900 have recovered. Thousands more are suspected of infection, and the death count for mainland China has now exceeded the toll from SARS. Once it accepted the threat that 2019-nCoV might pose, China marshalled incredible resources at impressive speed and scale—isolating cities, and building a field hospital in less than two weeks.

Cases of 2019-nCoV have been reported in Australia, Asia, Europe and North America—a total of about 150 in two dozen countries. Most are imported—travellers who were infected in China—but Japan, Germany and Taiwan have reported cases of domestic person-to-person transmission. More such cases are inevitable, and deaths will follow.

There are many known unknowns, and not yet enough useful indicators, to properly judge how dangerous this virus is. For example, beyond the elderly and those with pre-existing medical conditions, how many are getting infected and dying? A useful measure of the severity of the virus might be statistics of medical personnel and first responders who have fallen ill and died.

China has been more forthcoming with information on this outbreak than it was with SARS, but the same system that can quarantine millions is still beset with poor information-sharing, systematic cover-ups, and an initial denial about the seriousness of the virus among local officials. As Minxin Pei notes, ‘The survival of the one-party state depends on secrecy, media suppression and constraints on civil liberties.’

A lack of transparency and an information vacuum encourage irrational behaviour. There have been reports of panic-buying of protective masks, rumours of used masks being repacked and resold, fears that carriers could transmit the virus when asymptomatic, and questions about whether one can catch 2019-nCoV from mail packages (for the record, highly unlikely). Fringe conspiracy theorists (and Russian trolls) are pushing a theory that this was a manufactured bioweapon.

The same opacity and oversensitivity from China also undermine the international political response to the virus. In principle, infection control can’t be a bad thing and should be driven by data and risk management. But international responses to 2019-nCoV are inconsistent, ranging from the extremes of ‘nothing to see here’ to a health equivalent of a worst-case ‘one percent doctrine’. Flights have been banned—not just from the Chinese mainland but, in some cases, from Hong Kong and even Taiwan. Quarantine policies have been announced and then revised.

China has railed against many of these responses, pushing allies to take minimal precautions while threatening others with claims for compensation in the wake of travel bans. The World Health Organization was slow to call this a public health emergency of international concern, almost certainly for fear of angering Beijing.

Future epidemics and pandemics are inevitable, and the safer movement and potential quarantine of people in such circumstances needs to be considered beyond a two-week stay on Christmas Island. Airports may need to incorporate designs that allow for much more effective monitoring of passengers than the temporary temperature scans set up during an outbreak. Immigration systems may need to cope with large quarantine groups—for example, to enable the movement of students, athletes, convention delegates or tourists. Ultimately, an improved ability to detect and isolate sick travellers has benefits beyond a coronavirus, to diseases like measles, which are unfortunately increasingly common.

Politically, China and the international community need to work together more openly and transparently to best manage and contain this outbreak. Practically, blanket bans on flights and the movement of people are crudely effective, but they come with political and economic costs. Whether this virus is a serious threat or not, the current posturing and blunt policy responses show we have a long way to go.