Sanjiva Wijesinha -writer and physician

Short stories, Travel and Health Information

COVID – The View From the East

Having lived and worked as a surgeon in Hong Kong for many years, I still have friends and colleagues there with whom I keep in regular contact – and I make it a point to follow events there with great interest.

So I am publishing on my web-page today this article written by one of my good friends, a retired surgeon now living in Hong Kong – which provides a different perspective to that which the mainstream Western media feeds the Anglophone world.

Here is his article:

Although long retired from medical practice, I still retain an interest in things medical – so a disease like COVID-19 has naturally piqued my curiosity .

COVID-19 is meaner than SARS and MERS combined – and I want to know ‘Why’?.

With much time on my hands I’ve so far watched over 40 documentaries on the topic of COVID 19 – the most recent being the BBC’s latest biased documentary. Having seen Panorama China’s Coronavirus Cover-up‘ in July last year I cannot help thinking that the West (in particular the United States) and China should end the blame game over the pandemic, collaborate to conquer it, and lay the groundwork for more effectively handling future outbreaks.

Based on what we now know about COVID-19’s early and asymptomatic transmission and many countries’ ineffective responses, it is clear that greater transparency in the first weeks of becoming aware of this new and deadly virus cannot be blamed for the wildfire-like spread of this virus.

Let me go through the known the timeline of events. More details may be found in the FRONTLINE article A Timeline of China’s Response in the First Days of Covid-19′.

DECEMBER 1, 2019 A man in his seventies fell ill and was LATER admitted to a hospital in Chinese Wuhan city.

MID-DECEMBER, 2019 People began turning up at hospitals in Wuhan with strange white spots on their lung scans .  Many cases were traced back to Huanan Seafood Market .

DECEMBER 24, 2019 A sample was taken from a hospital patient’s lungs and sent to Vision Medicals , a private company , which within 48 hours produced a PARTIAL genetic sequence of the virus.

DECEMBER 26, 2019 That sequence was strikingly similar to the virus that caused SARS –so the lab went on to inform the Wuhan Central Hospital doctors and the city’s Centre for  Disease Control.

DECEMBER 30, 2019 Hospitals in Wuhan started seeing dozens of patients with severe pneumonia  so more samples were sent to other labs. One such lab told Wuhan Central Hospital , mistakenly , that the infecting organism was SARS itself .

JANUARY 3, 2020 The World Health Organisation (WHO) was informed by the Chinese government of approximately 44 cases of “viral pneumonia” of unknown cause .

JANUARY 5, 2020 The laboratory run by Professor Zhang Yongzhen obtained a full genetic sequence confirming the virus’s similarity to SARS – and hence inferred that this virus was likely to be capable of human-to-human transmission .  Zhang was eager to release the sequence but could not do so without authorization from China’s National Health Commission .

JANUARY 6, 2020 New York Times reporter Sui-Lee Wee wrote an article headlined “China Grapples With Mystery Pneumonia-Like Illness”.

JANUARY 8, 2020 A 61-year-old woman travelled to Thailand from Wuhan . Temperature checking at the airport indicated she had fever.  Since she had no contact with Huanan Seafood Market — the “official” source of the virus — Rome Buathong of  Thailand’s Ministry Of Public Health commented “That is really the critical information for us, that spread of this virus may be GENERALIZED in Wuhan” .

JANUARY 9-10, 2020  A health care worker from Wuhan Central Hospital told FRONTLINEaround this time  “The hospital respiratory department became full.. I realized that this thing had become big and was out of control . Then we started to panic.

JANUARY 11, 2020 China’s Centre for Disease Control and Prevention and National Health Commission shared the genetic sequencing with WHO and other parties.

JANUARY 13, 2020 German scientists published a toolkit so other countries could test for cases.      Thailand reported the first confirmed case outside China — the 61-year-old woman — to WHO .

JANUARY 23, 2020 The Chinese government placed Wuhan under lockdown .

In session one of the 2021 edition of the BBC’s current affairs documentary ‘This World’, about 2 minutes into the documentary Prof. Lawrence Gostin is heard saying “It’s always going to be very difficult to control this virus from day one but that’s the shot we had and we lost it” . This “nip the crisis in the bud” idea is mentioned several times – implying that those who first noticed the bud should take sole blame for not nipping it before it spread and bloomed devastatingly across the world.

To nip a crisis in its bud, as a concept , is certainly a good idea. However, this particular pandemic is not one where the concept of nipping a bud before it blooms can be applied – because nobody knew that this was a dangerous bud when it first appeared!

To be realistic, for the world to have been FULLY protected the only plausible action for China to have taken would have been a TOTAL BAN on all outbound traffic WELL BEFORE the 23 January Wuhan lockdown i.e. stop all international outbound flights , close all sea ports and seal all borders . Nothing less drastic would have worked.I n all fairness, one could not ask ANY country to take such drastic action while a possible crisis is merely in the making , when that country did not even know that there was there was a new and dangerous bud “starting to begin to commence to bloom”!.

Based on the timeline above, the EARLIEST POSSIBLE TIME for this total ban to be executed would have been 6th January – the day after the virus was fully identified . With no definite evidence, no drastic action could be taken.

This is why talking about December 26th – when all that was known was that a new type of pneumonia attributable to a short virus segment strikingly similar to SARS identified by a single laboratory but with full identification not yet confirmed – is not realistic.

Even if the total bans mentioned above had been implemented on 6th January would the outcome have been different?

Sadly no , for there would have been more than enough virus-bearing travellers having left Wuhan/China before the ban to spread the infection to wherever they went. The genie was already out of the bottle!

Greater initial transparency from China would not necessarily have prevented the worldwide spread of the disease. With relatively few confirmed patients in the first weeks and not yet understanding that up to 80% of COVID-19 cases are asymptomatic, pre-symptomatic, or have only mild non-specific symptoms, China was not in a position to tell the rest of the world that this was a deadly and highly contagious virus. 

Clearly , in order for the pandemic to be curbed unilateral action from China would have been meaningless . Most countries , if not all would have had to instantaneously procure test kits , exhaustively track down all travellers returning from China between November 2019 and January 2020 together with all of their local contacts so that each can be tested then isolated/quarantined . The same would have had to be done (except local contact tracing) for subsequent inbound travellers as well.

Was the rest of the world at that instant capable of pulling off this near impossible mission? Test kits would have needed to be designed , tested for efficacy, manufactured, distributed  – and a protocol of who to test would have had to be drawn up.  All these take time – and Time is what the world did not then have .

The means of identification was indeed available as early as  13 January but not the ability for mass application.

Air/Sea terminal and land border screening by body temperature measurement is a net with big holes (since for obvious reasons you cannot test every traveller – and we now know that many of those infected have normal temperatures either because they are at the mild end of the spectrum OR because they are at an early phase of the disease OR have just popped a paracetamol tablet shortly before being subject to a temperature check!). For every one identified there would have  been many who slipped through .

“No crisis on hand so no drastic action is taken” holds true for all governments . A case in point is quarantine blunder made by the American Center for Disease Control as told in CBS’ The Story of the COVID Flight from Hell’.

For further information about how other coutries acted during the innitial phases of the COVID pandemic, the following documentaries are recommended:

Four Corners : Pandemic hosted by Sam Nicholls . (Australia)

 Channel Four News ‘Coronavirus : Are We Doing Enough ?’ (UK)

 BBC Panorama ‘Coronavirus : The Week That Changed Britain . (UK)

This talk of bud-nipping makes a daunting task look easy and can fool the lay public . When one hears the often trumpeted observation ‘China ought to have contained the spread much earlier, the complementary and co-operative part the rest of the world should have done to make this endeavour a successful one is hardly ever mentioned . Is this investigative or manipulative reporting? 

If one follows this simple model, consider this: On a certain day , let’s say there are 100 infected cases in a community and only 10 are seriously ill . If one considers the most favourable scenario here, let us say that all 10 come to the same hospital 1 day later and the head of the Centre for Disease Control happens to be there too . Within 24 hours i.e. D-Day+2 , let us assume the head of the CDC comes to the conclusion that a novel virus is involved and starts laboratory testing right away. 48 hours later the virus is identified and fully sequenced and he immediately announces a total travel ban on D-day+4 .

Assuming that just ONE infected person can transmit the disease to 1 other per day say for just 5 days , the 10 index cases would have infected 10 others prior to hospitalization on D-Day, and 40 more while in hospital . All the while the non-hospitalized 90 D-Day cases have not been idle and have contributed 450 new cases in five days . Total number of infected cases = 50+450!.

Adding to the spread, there would be secondary cases catching the infection from these 50+450 and tertiary cases catching from the secondary cases?

And who infected these initial 100 on D-Day in the first place, and what about the chain each one of these has perpetuated ? To put it even more simply, no large enough case load in a community mean that no alarm is raised, there is no detection and no action . By the time enough suspicion is raised it is always too late for a disease like COVID-19 , just ten hospitalised cases would mean thousands already infected within the community . Any number of these could have left before lockdown for very legitimate reasons.

This why the choice between 6 January and 26 December, so much trumpeted by the western media, is immaterial .

The window of opportunity for curbing COVID-19 in Wuhan is therefore more imaginary than real. Peddling the “Why couldn’t they not nip it in the bud?” is a convenient stick with which to beat the East – as folk like Donald Trump and his minions like Mike Pompeo have been doing, whipping one of their favourite whipping boys to divert attention from their own less than perfect reponses!

Elite virologists tell us that this novel coronavirus happens to possess all the right attributes for creating a perfect storm — the pathogen is airborne , the disease highly transmissible but not very deadly , early symptoms are indistinguishable from the common cold, infectious viral particles are shed at an early phase of disease rather than late, and (as was clearly explained in the 2020 Netflix Original Documentary Coronavirus, Explained: This Pandemic) those affected can have minimal or no symptoms yet remain infectious.

This is also why SARS then MERS lasted only months – these viral strains simply did not have what it took to blossom into a full pandemic .

It is true that the government of China did a sloppy job at the initial phase of the outbreak – but can the current pandemic be blamed solely on China’s initial below par performance?

The answer has to be a definite ” NO ” .

One comment on “COVID – The View From the East

  1. Edward Jones
    February 11, 2021

    The argument presented is straight forward. ‘Nip the bud’ is theoretically possible,in an ideal world,if
    a.China issues a TOTAL BAN on all outbound traffic early enough.
    b.Rest of the world implements COMPLEMENTARY measures the same day or next.

    So what’s with the Real World ?
    a1.No country is altruistic enough to attempt this mission suicidal(using the author’s slang),thus China eventually locked down only Wuhan.
    a2.There probably is a “window of opportunity” but it is so narrow that it can be “more imaginary than real”(as demonstrated by the author’s crude yet sensible model.)
    b1.However confused,misinformed,the rest of the world might previously have been, there is no excuse for not attempting mission near-impossible after January 23,2021.
    The alarm bell was crystal clear and all needed information was at hand:
    -SARS-like virus fully identified(Jan.5)
    -viral genetic sequence shared(Jan.11)
    -first confirmed case outside China(Jan.13)
    -human-to-human transmission acknowledged by Dr. Zhong Namshan onTV(Jan.20)
    [an event reported in “54 Days” but not included in the timeline]
    -Wuhan lockdown(Jan.23)
    Still,the rest of the world remained in business-as-usual mode and one saw no measure or half measures being adopted.
    b2.The means for Mass-testing can only come much later,screening is “a net with big holes”,and this is perhaps the single valid defense for an inability to accomplish “mission near-impossible”.All else are excuses.

    The inescapable conclusion:Whatever The PRC Government could/should have done or not done,infected cases going into other countries was unavoidable(though actual number of such cases may vary).Since the rest of the world was ill-prepared,voila,a perfect storm.

    As for my view : a1-True,
    a2-True until proved otherwise by mathematical models or computer
    simulation analysis.
    b1-True,
    b2-True.
    How can I not be convinced?!
    Consider posting my summary and comment.

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This entry was posted on February 8, 2021 by in covid, Health Matters, Opinion and tagged , , .
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