The chart above shows cases (C), deaths (D) and recoveries (R) in the Chinese province of Henan, 22 January – 7 March 2020 (source John Hopkins).
As you can see, the number of cases rises rapidly until early February, then the rise slows, and from mid February tails off completely. With a delay of about two weeks the number of recoveries rises, then falls, following the same pattern. Thus there are now 1,272 diagnosed cases in Henan, with 1,243 recoveries, and only 7 unresolved cases, and 7 deaths.
With a population of 95m in Henan, that means that the fatality ratio of cases resolved is 1 in 58, but as a ratio of the general population it is only 1 in 4,333,000.
Does that mean there is no cause for worry?
Well not at all. The data shows overwhelmingly that the best chance of surviving coronavirus is not getting it.
Assuming the data is correct, the chart above is not showing us any medical property of the disease, but rather a human and political phenomenon. The shape of the curve reflects the authorities first picking up that something very serious could be happening, then reacting, first slowly then increasingly quickly, to limit the outbreak.
In an article here, Bruce Aylward of the WHO argues forcefully that we should learn from China’s efforts to respond to and limit the spread of the virus.
According to Aylward, the efforts mostly did not involve lockdowns.The key learning from China is speed — “the faster you can find the cases, isolate the cases, and track their close contacts, the more successful you’re going to be”. We should therefore be suspicious of the repeated argument that only ‘in a state like China’ can you impose such measures. We can do the same using the following three principles.
- The population has to know this disease, i.e. what are the two presenting signs (fever and dry cough).
- The authorities should rapidly assess whether or not they really have those symptoms, test those people, and, if necessary, isolate and trace their contacts
- Act. “In China, they have set up a giant network of fever hospitals. In some areas, a team can go to you and swab you and have an answer for you in four to seven hours. But you’ve got to be set up — speed is everything.”
… make sure your people know [about the virus]. Make sure you have mechanisms for working with them very quickly through your health system. Then enough public health infrastructure to investigate cases, identify the close contacts, and then make sure they remain under surveillance. That’s 90 percent of the Chinese response.
To the big question of whether the data is correct (see chart at top), Aylward thinks the Chinese are not hiding anything.
We looked at many different things to try to corroborate that cases are dropping. When I went to fever clinics and talked to people working there, they’d say, “We used to have a line out the door, and now we see a case once per hour.”