Is the world fortunate that the coronavirus hit China first?

Is the world fortunate that the coronavirus hit China first? China’s government has totalitarian impulses but that–for the most part– is working to its favor in combating the virus. What other country in the world could quarantine a city of 11 million people on the basis of (at the time) 17 reported deaths?

CNN: Across China, 15 cities with a combined population of over 57 million people — more than the entire population of South Korea — have been placed under full or partial lockdown.

Wuhan itself has been effectively quarantined, with all routes in and out of the city closed or highly regulated. The government announced it is sending an additional 1,200 health workers — along with 135 People’s Liberation Army medical personnel — to help the city’s stretched hospital staff.

China’s response to the virus has been unprecedented and one cannot help but be a little bit impressed.

I was in India recently and if the coronavirus hits India it could spread very rapidly and millions could die not just in India but around the world. India does not have a strong public health system (it has invested instead in sickness treatment, another example of premature imitation), it also has plenty of other opportunistic diseases and bacteria which would magnify viral sickness and overwhelm the public health system, and India does not have a state strong enough to effectively lock down cities. India’s only big advantage versus China is that it’s relatively free press and communication system could make an outbreak more quickly spotted. China, in contrast, tried to hide the initial outbreak. This does, however, cut both ways. India’s 1994 outbreak of the plague quickly became news, which led to official action, but hundreds of thousands of people quickly left the epicenter in Surat–smart action at the time but deadly if those fleeing are infectious.

We need a Manhattan Project to research, develop and produce new vaccines at a faster pace; the US is best placed to be the world leader in this regard. On other actions, the United States stands somewhere in between China and India. US quarantine action would certainly be slower than in China but it could happen, probably through the military, as we are seeing now.

The US approach of slow but eventually decisive action is probably best but how slow is too slow? Right now most people assume that the coronavirus is a blow to China but if does create a serious pandemic then China may be the first to recover and stabilize.

Hat tip: Lunch discussions with Robin, John and Ajay.

Comments

Good point.

But no mention of patents :( According the stylized history of penicillin, a life saving antibiotic, after Fleming's discovery of the drug in 1928 as a byproduct of a common mold, it was not commercialized because it was not patented. (see Wikipedia below*). Only when the UK/US government got involved, i.e. read 'state sponsored research, aka PATENT (owned by the public but still a patent)' did penicillin get commercialized. Where are our society's patent champions now?

Bonus trivia: if you have a dog and it gets infected, don't take it to the vet, but save money and just treat it yourself, based on its weight, with a cheap antibiotic like amoxicilin ("Amoxicillin is a penicillin antibiotic that fights bacteria. Amoxicillin is used to treat many different types of infection"). It's what I do, and I'm in the 1% (we have so many dogs I can't take the time to take them to the vet for every minor problem; I got 12 puppies right now for example).

*Wikipedia on penicillin: "Fleming published his discovery in 1929, in the British Journal of Experimental Pathology,[17] but little attention was paid to his article. Fleming continued his investigations, but found that cultivating Penicillium was quite difficult, and that after having grown the mould, it was even more difficult to isolate the antibiotic agent. Fleming's impression was that because of the problem of producing it in quantity, and because its action appeared to be rather slow, penicillin would not be important in treating infection. Fleming also became convinced that penicillin would not last long enough in the human body (in vivo) to kill bacteria effectively. Many clinical tests were inconclusive, probably because it had been used as a surface antiseptic. In the 1930s, Fleming's trials occasionally showed more promise,[18] but Fleming largely abandoned penicillin work, leaving Howard Florey and Ernst Boris Chain at the Radcliffe Infirmary in Oxford to take up research to mass-produce it, with funds from the U.S. and British governments.[19] They started mass production after the bombing of Pearl Harbor. By D-Day in 1944, enough penicillin had been produced to treat all the wounded in the Allied forces."

Intellectual property: the last bastion of those afraid they might never have another good idea.

It's too soon to know. The virus has only been known for 70 days and for 50 of them it was only in China. Wait until the virus has gone to every country and infected 100's of millions of people THEN it will be time to evaluate it.

@taylor No taylor, the ones I see and have do not look like that. They are very tiny, oval shaped, white or other colours. They resemble a tightly wound ball of yarn but very tiny. They seem to wrap themselves in a cocoon of threads or hair and if you soak them in vinegar a small black/white dot will come out as the cocoon dissolves. Sometimes, especially around the computer moniter I see them fly straight up from the surface. I can’t catch one. I have one of those lighters for bbq’s and I try to burn them as they fly or spray them with hairspray. ( I don’t combine the lighter and hairspray though…but if this continues much longer I may:-)

China's totalitarian impulse to control information has hindered its response to the outbreak more than its police state has enhanced that response.

Early warnings, when the disease might have been contained in a single city, were ignored or suppressed in an attempt to conceal bad news. And however impressive and chilling the scale of the quarantines is, they occurred after 5 million people had fled Wuhan. Too late, too rigid, too focused on appearances.

I'm inclined to agree with Heedless here.

Have equivalent diseases been found in modern Europe or modern North America in recent years? Maybe they've arisen and then been supressed before they became a global disaster?

The first thing that came to mind is the Sin Nombre virus outbreak in 1993: https://en.wikipedia.org/wiki/1993_Four_Corners_hantavirus_outbreak

(Admittedly, despite the far cooler name of Sin Nombre, it did run into the same naming resistance as this outbreak.)

Agree with Heedless. This is the enlightened despot fallacy again (AKA Thomas Friedman's disease).

Even libertarian economists have a totalitarian impulse.

The US and Europe don't have the same wet-market culture.

I see you also listen to PRI

agree with heedless, see https://www.nytimes.com/2020/01/25/world/asia/coronavirus-crisis-china-response.html for a more balanced view.

Translated from German: Prof. Didier Sornette about our society and Coronavirus:

„ No. But the subject does worry people. And rightly so.

We must put it into perspective. About 10 million people die every year in China, about 150,000 of them from a normal flu. In the United States, 30 000 people die of influenza every year, and between 600 000 and 1 million worldwide. But journalists like you reinforce their importance; they are part of the problem.“

Dr. Sornette is French so translating from French to German to English risks something lost in translation. Since information is power, journalists have the power to inform us, so reporting on COVID-2019 is not a crime, but if done responsibly is a public good.

2019-nCoV can survive more than a week outside the body (keep that in mind when you handle a "Made In China" good), is very hard to diagnose properly (one woman had four false negatives until the virus was found), has a history of relapsing, has a 4% or higher death rate --combat deaths in major WWII battles were 10%, the 1918 Spanish flu had a 2% death rate--kills disproportionately people over 65 years old --non-Boomers rejoice--has a R0 = 4.0, which means it spreads like wildfire, much much faster than the common cold, one super-spreader infected 60 people in a hospital, who were all taking precautions, and is projected to not only reach 50k new cases a day in about a month--yes, you read that right--but eventually, some say, infect 75% of the people in China and in time the entire world.
Yes, I'm yelling "FIRE!" in a crowded theatre, for good reason. Stock markets still up however, as of this moment...that too will change, since the DJ-30 should drop 30% (down 10k points) if history is any guide (avg drawdown during bear markets is about that, sometimes even greater; I'd not be surprised if DJ-30 goes to even year 1999 levels if the pandemic causes panic).

Bonus trivia: Didier Sornette started as a physicist and has patented--no kidding, you can Google Patent search it--a formulae that is based on a log-normal earthquake prediction formula that predicts, based on various economic data fed into it, that the world will suffer an anomaly around the year 2050, about the time populations peak in the world. May we live to see such interesting times!

I also have a bunch of predictions for 2050 and will let you kill me if I get any of them wrong.

In response to various government targets of zero carbon emissions on the same timeframe, I have also committed to consuming zero calories before they reach zero emissions.

I mostly agree with what you are saying but Spanish flu mortality rate was 10-20%, 2-3% of the world population died that is where the commonly cited 2% figure comes from.

"but Spanish flu mortality rate was 10-20%, "

I later waves of Spanish flu had a high mortality, the first wave was closer to the flu.

"The first wave of influenza was comparatively mild. "

https://www.britannica.com/event/influenza-pandemic-of-1918-1919

Hello Ray, thanks for mentionning Sornette.

1) "Dr. Sornette is French so translating from French to German to English risks something lost in translation."
Sornette is Prof. at the ETH Zurich. He gives interviews directly in German too.

2) [2019 n-Cov] is very hard to diagnose properly (one woman had four false negatives until the virus was found)"
It doesn't logically follow from this example (anecdote?) that the virus is difficult to diagnose. All tests have some false negatives. You need to have some idea about the rate of false negatives to make such an inferance. Do you have some precise sources for this information?
Plus, in my humble opinion, the potential lack of a sufficient number of test-kits is a bigger problem.
3) "[The virus] has a history of relapsing." Again, what's the rate? Sources?
4) Where did you hear about this "4.0" basic reproductive number? Current estimates place it somewhere between 2.1 and 3.1. And it's only one parameter among others. The spread rate could well be either better or worse thant this sole number suggests.
5) "[The virus] has a 4% or higher death rate." Seriously? Where did you hear about that? If one simply divide the number of deaths by the number of detected cases for one day, the rate has been stable between 2.0 and 2.4 for more than 10 days. If you take into consideration the fact the virus takes some time to kill is host, and divide the number of deaths by the number of cases from 6 days earlier, you obtain something around 2.7-2.9, not 4.0. At least for the last few days (8-11 February), because it was higher before, and has been constantly descreasing. Add to this the fact that they can be 4-fold to 10-fold more cases than dectected, it drops even more to a low 0.3 (that is the higher estimate of undetected cases) and a high 0.7 (lower...) Which is still a lot more than the <0.01 of the common flu, or the 0.03-0.3 of the swine flu.
Please note that my estimates stop when the counting method change on 12th of February. You now need to wait a little bit for the Chineses to make some order in their counting. It will be reliable again after a few days.
Important : the fatality rate is way smaller outside mainland China, at least for now (and a few hudred cases). What worries me whay more is the rate of 'severe' forms of the disease. About 15%... at least. If the spread is important, this is the crucial factor that can make a health system kind of collapse, and create a higher death rate (not only for people infected with 2019 n-Cov).
6) The vast majority of infections kill disproportionately people over 65 years old. Non-boomers will get old in their own time. And projections forecast more epidemies in decades to come. Not so lucky "non-boomers"...
7) "Stock markets still up however... that too will change, since the DJ-30 should drop 30% [... ]" My bet is that markets will start worrying when Tokyo will consider canceling the Olympics. Not yet.

Trivia : Did you know that 'SornetteS' means 'bullshit' in French?

How long between when a product leaves China until it's brought home by someone in the US? A week sounds awfully fast for that, unless we're talking airmailed material.

Are you by any chance a bot? A rapidly spreading new virus with a long incubation period is not a concern because it (in it's brief existence and limited spread) has killed less than the flu? If it's not a concern why quarantine a city? Why say to burn bodies?

I see a lot of posts like yours that are usually on the top of articles and twitter responses. It makes me think you are a bot, but why would china put so much effort into bots for his virus? Is it man-made?

This disease would have probably spread slower in the US because of our lower population density and the fact that most people here can afford private cars so they don’t spend much time on public transit. In addition, a higher proportion of jobs in the US could be done from home, making it less economically imperative to go back to work. If an outbreak like this happened in a typical US city, it would be easier for everyone to just stay at home for two weeks and it would be over.

Ultimately, it is more about income level than state capacity. It’s fortunate that this virus hit China first instead of India or an impoverished African country with no public health resources. But it’s unfortunate that the virus hit China first instead of a fully developed one where people would have had more resources to segregate themselves and bear the economic costs.

And China’s response while it may be effective certainly violated human rights far more than a response in a fully developed country would have. The closest parallel is the police state in Xinjiang; sure it appears to be effective at stopping terrorism but its costs clearly outweigh the benefits.

Don’t forget fewer people per household and single family housing.

"...single family housing ..."

And yet so many economists and econobloggers want us to build more high density housing. Pack 'em in and stack 'em up they say! Then there are always those pesky unintended consequences.

Like.......

..........slums

Everyone staying home? Not going to happen. Many jobs can't be done from home, and many jobs don't come with sick or vacation time and low income people can't afford to stay home.

+1. Strange reasoning. The US probably relies more on connectivity of people and a lack of interruptions of flow for a much more complex internal goods and services market.

(I don't really know where it would be "best" for such a virus to emerge. I suspect there's not really a "best" place. That said, you could argue it's better for coronavirus to hit China (and be contained there) in the sense that person lost - incapacitated or to mortality - to economic efficiency to coronavirus probably has less hit on the world economy, as China less interlinked, and productivity is lower.)

There are lessons for the US in this crisis, but one lesson is most certainly not that CCP moved quickly on containment. More than a month was lost before Chinese people were told of the virus. Can an authoritarian government move quickly if it wishes? Of course. So can the US military, or any authoritarian organization.

http://chinareflections.com/index.php/104-comments-on-the-news/439-for-leaders-information-does-not-want-to-be-free

For leaders, information does not want to be free

The covid 19 crisis has lessons for Americans. Isolation – not of the sick, but leaders – and ignorance are no way to govern – in China or the US. Our own recent political processes have nascent signs of copying CCP.

Lessons will not be learned by leaders in China, where the lessons are mostly anathema to CCP. But the crucial lessons are there for us, too - about openness to experienced advice and telling the truth.

The lessons are about
- meritocracy in government and in leadership;
- hierarchical management;
- political priorities and
- information management and closing access to alternative voices

On meritocracy in government

Government officials in China can be smart, committed, and generous people. They can rightfully claim an elite status based on merit. I taught scores of them – vice mayors, organization department leaders, political liaisons, policemen urban planners and judges in Chicago, over a span of seven years. Many are long term friends. But they are caught in a system that does not value telling the truth until the leader announces it.

Officials in federal agencies are highly educated and well-trained. But we have a political system in the US now that devalues experience and expertise in favor of fleeting ideas tweeted by the leader. Federal agencies in the US are now politicized to a far greater extent than ever before. The lead prosecutors have resigned from the Roger Stone case after Trump, through Barr, intervened in the sentencing . The Trump intervention in military courts martial cases in another example of destroying honored practice in favor of short term cheap grandstanding. Experienced staff at EPA, State, and other agencies are fleeing from the politics.

It is easy to trash government response to a crisis. Crises are by definition long tailed events. Crises are made worse when the political side of government holds itself out as the only purveyor of information, the only purveyor of truth or experience. It needs the local knowledge, local voices, local actors from within government and from outside. The coronavirus teaches us that. Chinese people were telling us that, wechat post by wechat post, until they were deleted. In America, we must learn it, for, as the Washington Post tells us, democracy dies in darkness.

On meritocracy in leadership

That system of smart committed people in government in China is frustrated by political correctness in leadership at every level. There is no truth, there is no openness until the senior leader announces it. For effective response in crisis, openness must permeate the government and the society, so that no one need fear retribution for speaking the truth. We see how speaking the truth is valued by Trump in his firings of those testifying in the Congressional hearings. We see how lack of openness failed the people in China, as it failed the people in New Orleans at Katrina or the people of Puerto Rico at Hurricane Maria. You remember “heckuva job, Brownie.”

CCP does continuous training for leaders, both technical and political. This is a bit of a deficiency in American government leadership. But the training in China cannot obviate differences in provincial education quality and local political priorities. At least some of the difficulties in Hubei and Wuhan could be attributed to lesser quality of both leaders and officials, compared with those in more sophisticated places like Zhejiang, Jiangsu, or Shanghai. But certainly all of them have a career in politics.

By comparison, only a third of the Trump cabinet and high official appointees have had public sector experience. Most seem chosen for their conservative political views and their obvious wealth. Or think of the US Senate – almost no one on the GOP side dare counter the leader. When faced with evidence, or faced with truth, the system can’t help but close in around leaders. No different than CCP.

Why do we think that going to school (China) or simply running a business or being a lawyer (US) qualifies one to govern? Those who have promoted CCP as a model of political meritocracy should be chastened. The US could stand a little more meritocracy in its leadership, but Isaiah Berlin was right in his essay On Political Judgment. Good political judgment is a skill - it is practical wisdom. Vetting is important, prior experience is important, but good judgment comes from exercising it, not suppressing it. Vetting in an authoritarian system prepares one only for authoritarian values. On the home front, real estate is an authoritarian model business. The developer is far more powerful than the buyers or renters, and meritocracy never enters the picture. Legal training alone does teach governance. Lawyers tend to look for solutions that may be efficient in time or money, but not wise or stable for the people.

On strict hierarchical management in a modern world

CCP is an authoritarian model – the leader has all the answers and the power. No one wants to report bad information up the chain of command, and strict censorship limits alternative voices. It is in no particular leader’s interest to act until their own leader has acted, and that trail goes from a district health official all the way to Beijing. At the same time, no one with authority wants to take responsibility. In Wuhan, in Beijing, doctors and nurses and researchers are willing to be responsible, but they have no authority. And no one can speak out of turn, for fear of real punishment.

But a crisis and crisis planning demand good local information. Without crisis planning, we get the result in Hubei, modeling the old adage – authority without responsibility is tyranny; responsibility without authority is chaos. There is disaster planning in China; there is extensive training for officials at all levels. But the learning is blocked by the necessities of hierarchy and power maintenance. A political response is considered far more important than effective disaster response.  Within organizations, within departments, effort is then put into not learning: preventing learning or suppressing it.

Trump has power, but not responsibility, and he has removed career officials who dare to demonstrate responsible actions. Think of our former ambassador to Ukraine, Marie Yovanovitch. She wrote “We must not allow the United States to become a country where standing up to our government is a dangerous act.”

How better to destroy a management system? Trump recently defunded the Global Health Security program, which provided funding to some of the world’s poorest countries to assist in health crisis research and planning. Heckuva job, Donnie.

Alexis de Tocqueville, Frederick Hayek and James Scott told us about the importance of local knowledge and local information and warned about the dangers inherent in high management attempting to implement grand plans. In a strict hierarchy, top leaders in China are truly masked from exposure to information. Fear of the leader in the US accomplishes the same task.

On political priorities

Part of the delay in reporting to the public was the desire to not interfere with Spring Festival and the provincial People’s Congress meeting and the planned two meetings in Beijing in March. Now, the ham-handed approach to late remedial action – closing all movement in and out, banning private vehicles on the streets, restricting household movements to one a day – means that now people are running out of food, out of medicines for all illnesses, out of emotional reserves. I have friends who are frightened, depressed, and feel there is nowhere to turn. It is the realization of Camus’ The Plague. But ask Americans in Puerto Rico if they feel supported by the US government. Remember the $300 million electrical restoration contract that went to a company with two employees, but a strong relationship to the federal Secretary of the Interior?

On information management

You know that the Wuhan doctor who tried to warn his wechat group of the new virus was punished, and later died. Many other doctors have been silenced, along with citizens reporting on sicknesses, deaths, lack of response from government, and lies. When there is no supply of information, demand will create fear and stories and hoarding. But free information is considered life threatening, not to Chinese people but to CCP.

In Hubei, no one knows how many people are only a little bit sick, and are sent home or never got to the hospital. No one knows how many of those a “little bit sick” will develop the virus, or whether they just have a cold. No one knows whether sequestering those who are a “little bit sick” in large exhibition halls, several hundred to a room, will make some sicker or not. No one knows how many deaths are not recorded. There is no such data, and no system in place to collect it. But a recent phone conversation with a crematory director in Wuhan provided one datum – about 35% of their cremations come from hospitals right now. About 65% are coming directly from residential compounds. No one knows how many of those from residences are virus related. But in normal times, one would expect very few deaths at home. That belies the government reports of cases and deaths. No one can trust data coming from the government. Chinese know it. In our times, some Americans are still learning it.

Lessons from the China model

The international brand of China and CCP is certainly damaged in this crisis. Warren Buffet reminded us that it is only when the tide goes out that we see who is swimming naked. Chinese political governance is showing itself every bit as incompetent as the American political response to Hurricane Maria or gun violence or health or education failure, where America has been swimming naked for years. Americans have no reason to gloat over the China response to crisis. The American international brand has been effectively damaged for a generation with its policies, foreign and domestic.

Chinese students are taught from early on that positive attitude is the way to end all written schoolwork – something on the order of, “if we all work hard, tomorrow will be better.” It is a trite formulaic ending to school papers. What is not valued in working hard is learning to tell the truth. Such training is unnecessary, since government will always have the truth when it is needed.

There are two lessons for Americans to heed. First is that government contains experienced, thoughtful, smart people who are committed to doing good. To ignore them, to sideline them, to ignore their truth, is to put us all on Plato’s ship of fools.

Second, government always needs a counterbalancing voice, whether the Church or real political opposition or civil society or free journalism or social media or experienced and wise people in government agencies. That alternative voice is the voice of experience and history, and is usually the voice of truth. Otherwise, we are all at greater risk of the unforeseen virus. Remember the last sentence of Camus’ The Plague – paraphrasing – “the plague bacillus never dies out completely … even in happy times, it waits beneath our notice, until it decides to rouse its rats again and send them forth to die in a happy city.”

Viruses thrive when there is only one voice of authority that sees self-preservation as more important than serving the people. That is the lesson for America from the coronavirus.

Nothin' like a dread disease to bring an appreciation of the deep state and career civil servants.

Nothing new under the sun when it comes to right wing patronage and deconsuction from inside: Heckofajob Brownie.

This was quite the screed towards, "business as usual," isn't one of the largest issues the US faces the actual USG?

One of the worst things about Trump is he carried on with some of the same folks that were Obama-era appointees. Hard to root out corruption, when the corrupt are the ones investigating.

There is a need to draw a distinction between civil servants, in the US or in China, who are generally smart, well educated, loyal, and trying to do a good job, and their political masters, who may ignore science, warnings from doctors, and experience and history in handling of any public issue. Heckuva job, Brownie is not so different from Heckuva job, Mr. Xi.

Here in Seattle our civil service is filled with Highly Experienced Urban Planners. No doubt they are promoted by merit.

Yet we have a massive homelessness crisis. "Merit" means different things to different people. It could mean "adherence to dogma" just as much as it could mean "achieving desirable results for society".

So: the claim that the civil service (or any other institution, "science" included) will shower us with benefits if it's left to operate on its own definition of merit is stupid and ignorant and has been proven wrong time and again throughout history.

Furthermore it's in direct opposition to the concept of democracy, in which leadership is elected by the people to run the government as the leadership sees fit, and the people have the right to oust the leadership if they disagree.

I make no claim that any civil service organization should run anything on its own. But politics plays a role, as it should, in China as well as in the US. In both countries, leaders respond to priorities other than those promoted by the professionals. In China, officials respond to their leaders, all the way up to Xi. In the US, elected officials respond to some combination of business interests and a segment of voters. In both systems, we too often end up on Plato's ship of fools. Homelessness is not a professional civil servant problem. It is a political problem.

William D. Markle:

You claim that the civil service should just be left to run itself is patently stupid.

I commented response to "wild woman" but my comment was intended as a response to you.

Left to it's own devices on an unlimited budget almost any institution no matter how intelligent and well meaning its personnel would devolve into progressively larger organization that does progressively less as it grows.

Corporations are forever cutting middle management because middle management is forever making worthless jobs for itself. Even companies like Microsoft, burdened with more cash that most countries, frequently pair the excesses of middle management.

Thanks for an intelligent and thoughtful comment. One of the best on MR and deserves a considered reflection.

The U.S. was best placed. These days, the manufacturing facilities tend not to be in the U.S.

Not vaccines, but illustrative regarding another low profit area that American pharma companies tend to ignore - "Last month, the U.S.-China Economic and Security Review Commission held a hearing on the United States’ growing reliance on China's pharmaceutical products. The topic reminded me of a spirited discussion described in Bob Woodward’s book, Fear: Trump in the White House. In the discussion, Gary Cohn, then chief economic advisor to President Trump, argued against a trade war with China by invoking a Department of Commerce study that found that 97 percent of all antibiotics in the United States came from China. “If you’re the Chinese and you want to really just destroy us, just stop sending us antibiotics,” he said." https://www.cfr.org/blog/us-dependence-pharmaceutical-products-china

they occur in china because the country is poorer and has lower public health than we do. They also have greater population density. Most of these diseases migrate from animals to humans. That mechanism would be relatively weak in the US as not many people interact with wildlife in the US and when they do they are in low population density areas.

Its nearly impossible for something like this to develop in the US and if it did it would likely die out due to lower population density in those areas.

Invalid article.
The best way to fight diseases is not stopping them from spreading but to prevent them in the first place.
Why both Sras and Coronavirus originated in China ?
Why democracies haven't had to fight such viruses in the past ?
Those are the right question to ask.

These are indeed the correct questions. China lacks even the most basic agricultural safeguards and the state keeps its people poor(er) so they work much more closely in much less safe conditions with poultry than American farmers.

Then we get to Wuhan. Sure the Chinese might be able to quarantine the place faster, but in the US, Wuhan would simply not exist. When you look at American cities on inland riversides, there are none the size of Wuhan, but more importantly none begin to approach the density of Wuhan.

Contact rate scales with population density (up until it saturates), this is one of the major drivers for turning isolated infections into epidemics. Not surprisingly, an autocratic China elected not to care about this in their Rise of Central China Plan. For all the gnashing of teeth about Americans liking the burbs and resisting the urbanification of the burbs, they are less deadly than the endless high rises China put up in Wuhan.

Likewise, official Chinese policy has been to move population from low productivity region into high productivity ones. They have instituted the largest mass migration in human history to affect this. Shockingly, this resulted in atomized populations and disruptions of social care networks.

This is terrible in disease outbreaks. If the patient gets sick you might, might be able to get collateral from one family member as to who they saw recently and might have infected. Likewise, when somebody does see someone who is sick, they are vastly less likely to know who they are or what becomes of them. Shockingly have a traditional social network where you know the people around you is extremely valuable during disease outbreaks.

China's responsiveness after the fact appears to have been utter garbage (losing the most precious days of response to utter denial), but part of the reason we see these outbreaks in China is because they have been autocratically implementing a lot of GDP growing economic policy without considering knock on effects.

But that's okay. It is not like our economics professionals would never argue to overturn democratic processes in order to enact development policies that would contribute to the rise of epidemics. Right ...

Your comments are always good, but this one actually moved my opinion on urbanization. Thanks.

I thought that was the weakest aspect really. Do we expect anything like coronavirus to ever radiate from Seoul or Tokyo?

Depends on what you mean by "like coronavirus". If you just mean an official epidemic, Seoul had one that (barely) met criteria in 2016 for cholera.

Last year Tokyo was an epicenter for small epidemic of some influenza subtype.

Per the official working definitions a "propagated outbreak" is when you have significant rise above baseline with some degree of sustained transmission. Tokyo is the single most likely area to cross this threshold in Japan. It remains, consistently, among the most likely regions to do so even when weighted by population (other places become more likely due to the fact the are many more smaller areas in the running; they rarely return to the list twice. Shockingly, Seoul is the single most likely place in the Republic of Korea to have an epidemic.

Pathogens spread much more efficiently in high density areas than in low ones. In general, in any country the place most likely to be the epicenter of an epidemic is going to be the densest, most populous city in the place.

Now if you mean a place more likely to witness a zoonotic jump and spark a global pandemic? Sure, Seoul and Tokyo are unlikely. But the rest of South Korea and Japan are also unlikely. Sparking that sort of bad outcome requires two bad things: high contact with infected zoonotic sources and population density sufficient to sustain the infection rate.

And this is where I fault the Rise of Central China Plan. In the main, most cities do not juxtapose huge dense populations with poor quality farms and animal markets. Wuhan does not have a lot of buffer space between the two ingredients needed for this sort of disease spread. Likewise, the rapid build out and densification of Guangzhou joined agricultural sources of zoonosis quite closely to a large, high contact supply of humans. This is the most common recipe for dangerous pandemics since forever.

Over a century ago, we had similar types of disease outbreaks in the US. Back of the Yards was not a healthy place back then and sparked a good share of epidemics. Likewise, old Chinatown in SanFrancisco was the epidecenter of a lot of US outbreaks.

If we look in the middle - not a source of novel infectious agents but things that kill lots of people - the megalopoli are the most likely places to be the spread points for pandemics. And they are more likely to be such even after correcting for population and their status as entry points.

This is one of the major reasons why cities tended not to last as major population centers for cities. Routinely, some infection would get access to enough people to have sustained propagation, and, at best, the population of the city would be decimated by disease. At worst the city would depopulate and spread the disease to the surrounding countryside in a non-organic manner and worsen the death toll. Cities really only began long term growth in the 19th century when modern sanitation dropped the numbers to stop the places from being overrun by plague (or whatever) every couple of centuries. But sanitation is just a linear reduction in risk. And it works everywhere.

Cities have been, and will continue to be, the riskiest places due to the inherent laws of infection spread.

Cities like Wuhan, built when central planners decided to stuff huge numbers of people into areas with little buffer between them and the agricultural risks, are the worst. Central planners opted to undertake a course of development that was engineered to get more people to move into high productivity areas and to build out high density in the old buffer areas. This was neither sufficient nor necessary to produce Covid 19, but it certainly increased the odds for it.

It does not seem from the reporting that China's response is considered good.

The early cover-up was probably much more of a negative than the later quarantine and decisive action was a positive. Early action might have better contained the virus before a high infection rate took hold in a large population, resulting in 1100 deaths so far.

Plus there is China's refusal to share the virus with top researchers around the world for political reasons, as well as their failure to report all the information they have about the virus's epidemiology. This is causing harm and delays in the response.

China's response is probably better than India's hypothetical response, but "better than India" in the public health space is a very low bar (as you note). This doesn't seem like a great example of totalitarians doing better.

Why did China cover-up the outbreak? Doing so allowed 5 million people in Wuhan to evacuate before the quarantine. Would millions leave NYC in the event of an outbreak? Would the U.S. quarantine NYC? Perhaps all those people in Wuhan who evacuated did so because China is totalitarian.

I have tried to make sense of this and failed, sorry.

" China’s government has totalitarian impulses " AT

... so lucky that Mao and his sucessors never acted upon those stray 'impulses'

-20 million Cultural Reactionaries

Not sure what media Alex is consuming to get this impression. It seems that the politically driven urge to cover up the outbreak early on allowed it to get much worse than it otherwise would have been. The lack of open media and civil society also hampered the flows of information which would have allowed people to know accurately whats happenning and start taking informed measures early. The reported number of case jumped by 15,000 today alone. But nobody trusts the numbers anyway because of the history of distorted statistics, and again the lack of open information flows.

"The reported number of case jumped by 15,000 today alone. "

Alex's timing with this post is epically poor.

Why was it fortunate anyway? Epidemies is the way the Earth is defending itself against the overpopulation of certain species.

I don't know how bad the virus is, or if the response by the Chinese government has been appropriate, or what the actual political fall-out will be for Xi Jinping. What I am certain of is that the Communist Party of China just LOVE this sort of thing. Declaring an emergency! Shutting down a whole city! Commandeering cars, equipment, and supplies! Ordering people about! Meting out harsh punishments arbitrarily! They love it. It is catnip to them.

We should keep this in mind before jumping to the conclusion that the Chinese response has been optimal and, gee, how can we implement such a policy ourselves? Especially on a blog by 2 people who claim to be Libertarians. If anyone should be skeptical it should be Tyler and Alex.

Grrr.

+1 CCP eats this up

All true about CCP, but I'm still waiting to hear how a strictly libertarian government can do anything but watch an epidemic unfold.

Depends on your flavor of libertarian.

Anarchists can't do anything, but they are weird and not very numerous.

Minarchists recognize a legitimate role for the state in managing outbreaks, so a night watchman state could impose quarantines and isolate the infected just the same as any constitutional republic.

I think the jury is still out on whether or not the central government's policies were better at the start than would have been the case in less centralized political settings.

At this point there are a lot of questions about good data even being available yet.

The Chinese are clearly lying. Today they released an update to their numbers that is far out of line with anything to date.

IE they bumped the numbers of infected up from 33K to 48K in a single day. More than likely they have been drastically under reporting the numbers. There have been numerous reports of this happening, but I was on the fence until this.

"What other country in the world could quarantine a city of 11 million people on the basis of (at the time) 17 deaths?"

No one, and I suspect it's because the Chinese leadership was lying about the 17 deaths. They were reporting a lot of coronavirus deaths as pneumonia, which to be fair is what they do with the flu every year.

To be fair here, the Chinese didn't exactly report 15K new cases, they just recategorized a lot of "suspected" cases into the "confirmed" column. So this isn't a jump in actual cases but instead jump in officially "confirmed" cases.

So my comment about "The Chinese are clearly lying ... their numbers that is far out of line with anything to date." was hyperbolic. It's clear that they have been downplaying the numbers but it's impossible to prove their intent.

They sacked the leadership in one province. Not a sign they are being effective.

Alex, you're asking the wrong question.

The question should be "given India's poor public health system, low state capacity and endemic disease problems why aren't mega epidemics happening ALL THE TIME?"

Now that’s a good question.

+1, that's an excellent question

Vegetarianism.

Not sarcastic.

Yup... they don't live with live animals like the Chinese do

Just cows. WaPo - In India, more than 5.2 million stray cows roam sidewalks in major cities, block traffic in small villages and destroy fields.

What’s the viral load of bats compared to cows?

What's the prion load of bats compared to cows?

If they’re not eating the cows....

It has been a funny four years.

I'm pretty sure that in 2016 you would not have had libertarians praising totalitarianism as a state capacity.

Or maybe it just took you 4 years to figure out there are no libertarians on this blog.

For once, you've made a good comment. Let me expound on that in my own idiosyncratic way.

If the world is "fortunate" that a disease epidemic hit a people with a tyrannical government first, then how much more "fortunate" would we be if coronavirus had first appeared in a nazi concentration camp, where it could have not only been quarantined, but incinerated?

Isn't that an ugly thought? Tyranny is not something that makes any of us "fortunate." Coronavirus doesn't change that, at least not in my opinion.

My comments are actually self-consistent.

Oligarchy is bad.

"My comments are actually self-consistent."

+1 Yes, you consistently insert TDS comments into threads that have nothing to do with American politics.

This thread is about state capacity and authoritarianism. In the last 48 hours the President United States has suggested that a number of people should be punished for telling the truth. For committing no known crimes.

If you, and this blog, deny that connection, what does it actually say about the state capacity you desire?

The thread is about the Corona virus.

Which will be gone by spring anyways. At least according to two leading public health experts.

President Donald Trump on Monday issued an optimistic prediction about the novel coronavirus outbreak. „A lot of people think that goes away in April, with the heat that comes in,“ he said.

Speaking with US governors at the White House about the coronavirus, the president added: „I had a long talk with President Xi – for the people in this room – two nights ago, and he feels very confident. He feels that, again as I mentioned, by April or during the month of April, the heat, generally speaking, kills this kind of virus.“

This is not just a one off.

Trump’s comments on Monday echo a tweet the president posted Friday after talking to Xi.

„He feels they are doing very well, even building hospitals in a matter of only days,“ Trump tweeted. „Nothing is easy, but … he will be successful, especially as the weather starts to warm & the virus hopefully becomes weaker, and then gone.“

Hi prior. Use your handle.

Weirdly enough NPR had an expert on who said the same thing, less idiotically.

I’m not qualified to judge it on the merits, but the epidemiologist guest said the contraction rate is seasonal and weather dependent.

Sure can weigh in as our resident doc?

Aerosol transmission works best in dry, cold air. The average distance a particle travels increases under such conditions. This increase transmissibility (R0).

As the air warms it typically gets more humid and aerosol droplets travel shorter distances. Humidity, until it reaches near the levels found in the respiratory tree (humans humidify all the air they breath, hence why beardsicles form when you breath repeatedly in cold enough weather) tends to denature viral particles and lower their transmissibility.

And of course there are other seasonal effects: people tend to travel and gather for holidays (e.g. Christmas, Chinese New Year, Epiphany), our mucous membranes change in cold weather, and we spend more time inside for example.

Covid 19 may well die out in the spring. Viral outbreaks that are sustained have an R0 above 1. Influenza A tends to have an R0 around 1.3 for instance. Covid 19 initially had an R0 around 2.2, but the will almost certainly drop with better numbers (counting more cases and not just the worst ones) and with better weather. If it drops soon enough, then the virus will burn out before the weather changes back. and bumps R0 above 1.0.

This is why it is dangerous to have large, dense settings of people near likely outbreak points. Large populations provide time to build a huge infection source. Density allows them to achieve high R0s. With enough sources, infections can survive for a while even with R0 < 1.0. And the difference between something staying an epidemic versus becoming endemic is can the outbreak outlast the less infectious weather.

'.... For committing no known crimes.....' You just described the whole impeachment.

I don't want to prolong this, but that is incorrect.

-1 to both of you

Unless you have a comment about the Corona virus, keep it to yourself

I trust that everyone else has read the first two sentences of this piece.

-100

This is a post about the Corona virus and the outbreak in China. Some of us have family there; this is a real thing that matters you pompous politically extremist partisan jackass. There are millions of Americans like me who have family in that area of China. I’m buying facemasks and sanitizer to ship there right now.

Unsurprisingly you instead go on political rants about political bullshit drama that doesn’t affect anyone and you use the opportunity to leverage your 10th grade education to make nonsensical smears about the 5% of Americans who are libertarian.

Dude, you’re a Boomer. Learn to adult. Step number one, pandemics matter more than your Reeeeeeee!

I actually see just one rant, with cursing, on this page.

My apologies for contributing to this. You are correct it was off topic on a post about a very serious matter.

He's got you there TMC. The Trump administration broke the law in the same manner the previous 4 administrations have.

Thats not totalitarism: its state capacity, pure and simple. Its consistent with libertarianism since it is about protecting people from the negative externality of infections diseases.

Ladies and gentlemen, I will leave you to consider that.

What exactly are the values of libertarianism, or this new state capacity thing, if they need a powerful command and control government waiting in the wings to do "what is needed."

Don't forget to consider in such a scenario who decides what is needed.

Interesting. So state capacity libertarians should then support the central government banning alcohol, right?

Because, less we forget, the US has around 40,000 births annually with Fetal Alcohol Effects. Of those about 8,000 will have full Fetal Alcohol Syndrome - which means an average lifespan of 25 years.

In terms of raw lives, alcohol consumption blows Covid 19 out of the water every single year solely when looking at the "externality" dead newborns. Then of course there is the drunk driving deaths where we lose around 10,000 people per annum, depending on how you define the "innocent" you get around 2-3,000 innocent deaths every year when a drunk driver kills them.

Should we continue on to look at the number of murderers who were ethanol positive in blood when killing? Or perhaps we might look at the suicides and count those as externalities. Or maybe we should look at the fun morass of liver and kidney transplants where alcohol induced disease helps create a donor organ shortage and deprives non-drinkers of transplants ...

If "libertarians" are fine with placing one of the largest cities in the world under house arrest to protect the innocent from a death they did not cause, how exactly can they argue that the state shouldn't restrict alcohol?

I mean sure you could argue that banning alcohol would be hard. It might require deployment of military assets and incarcerating huge swathes of society ... but that is exactly what is happening in Wuhan to protect fewer lives (so far). And lest we get too sidetracked, should technology advance to make prohibition viable (e.g. dosing the water supply with an ethanol contingent release formulation of naltrexone) and cost effective, then the state capacity libertarians should all jump on board.

If "state capacity" is just about "saving lives" then we really will need to be looking at bring back prohibition, banning marijuana, and all the rest. Most likely Covid 19 is not going to kill as many innocent people as any of the highly popular recreational drugs. If we believe the state should have and use the capacity to curtail civil rights for things that kill a few thousands of innocents, we are either are going to see some odd policies from libertarians ... or we will find that this is much more a smokescreen of the wealthy doing what they want while the poor suffer what they must.

>one cannot help but be a little bit impressed.

Yeah, you and Tom Friedman. Statists gotta State.

" Is the world fortunate that the coronavirus hit China first? "
Hard to think of any other country where viruses could transfer from wild animals to humans so easily.

The Chinese response has been a disaster. I don't know what the professor is smoking.

Its all sound and fury. Closing cities. Building "hospitals" in 10 days. Spraying god knows what by trucks.

We have no solid evidence that anything they have done has been effective.

It has been effective at scaring the people, at looking busy, and at drawing envious glances from wanna be authoritarian in the US.

Are there other metrics that matter?

First, this assumes the official count of 17 deaths is honest.
Second, the Chinese government had extra motivation this time because its response to SARS greatly undermined the public’s confidence.

The whole premise is bizarre. Was the Corona virus aimed at Earth from space, that it had to touch land here, there or somewhere? It "came to China" because the disgusting environmental and sanitary conditions there are the womb that birthed it. And you want us to discuss how good or bad for the spawn's prospects that same womb is. Bizarre.

At this point, it might be more of an “oops” than a “hit.”

China is not the only place where viruses cross from animals to humans.

This reminder brought to you by team ebola/HIV.

That can happen anywhere humans live close to animals. Hantavirus originated in the US Southwest.

Nothing like a taste of dread disease to bring the authoritarians out of the closet.

Say what you want about Adolph Hitler, he made the trains run on time...

Live food sales seem to have been the cause. I suggest we American quit eating puppies from the dog pound.

I think this post is true given that there was a crisis.

But China should've learned its lesson after SARS: this is the second potential pandemic caused by their wildlife markets within 20 years. The Chinese government has no problem being authoritarian in any aspect of life... except wildlife markets, apparently (they did shut them down temporarily after SARS, but evidently that didn't stick... even currently, the ban on wildlife markets is only "temporary").

They want to be seen as an advanced, modern economy, but they allow these cesspools of disease to continue and threaten lives worldwide as a result. Time to end this backwards relic of their third world roots. I pretty much never favor trade wars, but I think it would be worth it for the US to legislate an contingent ban of trade with China for a decade if they're caught having even just one more wildlife market. Their government evidently needs to have an economic threat to do the right thing.

A couple hundred Canadians were extracted from Wuhan and placed in a two-week quarantine. That has elicited condemnations of civil liberties violations.

Last week, federal and provincial health officials began asking anyone coming to Canada from the Hubei province of China, the epicentre of the coronavirus outbreak, to “self-isolate" for two weeks to reduce the risk of spreading the virus.

Alex has a few things off here. China's response has been to deny reality. At first, they insisted there was no outbreak. Then they released absurdly low numbers. Does anyone really think the Chinese government has quarantined 57M people because of a few hundred deaths? Clearly there are much bigger numbers here, as many citizen journalists in China are now reporting.
China's response to the outside world has been obfuscation and denial. China's response to their own people has been callous and authoritarian. There is nothing here to praise.

Another thing about autoritarian regimes - they tend to engender conspiracy theorizing. I wouldn't be shocked if this turned out to be some sort of Chinese bioweapon that got accidentally released.

Chinese ambassador to the United States Cui Tiankai has criticized Cotton's suggestion, including in an interview Sunday with CBS News.

"It's very harmful, it's very dangerous to stir up suspicion, rumors and spread them among the people. For one thing, this will create panic. Tom Cotton suggested as much, and the following ensued:

Another thing, that it will fan up racial discrimination, xenophobia, all these things, that will really harm our joint efforts to combat the virus," the ambassador said.

We’ve scrambled the sentences - figure it out and win a prize!

Do read the whole thing.

Personally I don't think that is what happened. I'm merely illustrating the point that authoritarian governments tend to engage in a lot of secrecy and lying, and all the secrecy and lying makes people wonder what else they might be lying about.

Seems like the US has about as much conspiracy theorising tbh, and this lack of trust is not helped by "Libertarians" who claim that certain factual things should not be permitted to be discussed in private society, defend "cancelling" etc.

You noticed that ..

I love how "libertarians" principles' are easily tossed overboard for the problems they consider to be serious, but when others want to do so for health care, poverty, or gun violence, they abhor even minor steps as inevitably leading to serfdom.

Time for a review: https://en.wikipedia.org/wiki/Negative_and_positive_rights

So is not being killed by a drunk driver a negative right? Should we ban, or at least heavily restrict, alcohol consumption because it directly leads to more innocent dead than Covid 19?

Just asking for a coherent explanation as to why authoritarianism is good for preventing one set of deaths, but bad for the other.

"We need a Manhattan Project ...": it's best not to write when you are tired, Mr Tabarrock.

"India does not have a strong public health system": I wonder how many countries do. In the UK people who claim to work on public health actually seem to work on widespread individual health problems. That is not at all the same thing.

Yea, at best. In several major US cities the public health folks seem too busy worrying about the ill effects of proper pronoun usage to keep the crap and used syringes off the sidewalks. The reports of diseases “not seen in a generation” seem to be increasing.

> China’s government has totalitarian impulses but that–for the most part– is working to its favor in combating the virus. What other country in the world could quarantine a city of 11 million people on the basis of (at the time) 17 reported deaths?

Given that the Chinese government is the organization who reported those deaths, and is also the organization that decided and implemented the quarantine around the city, I find it unlikely that "they're so totalitarian that they'd do this" is the correct explanation. "They have private information suggesting the problem is much worse, worse enough to merit a quarantine" seems more plausible

The Occam explanation suggests that after an initial local “suppress information and hope the problem goes away “, someone very senior became aware. The extreme and very, very expensive response suggests they were and are afraid of a major disaster, not a slightly worse than usual flu experience.

I expect that information now is being censored and fabricated to, in their view, minimize political and economic damage. I wouldn’t trust anything coming from the Chinese government regarding origin, extent, or severity without validation by an independent non-Chinese authority.

"We need a Manhattan Project"

If I had a dollar for every time in my life I've read something saying that we need another Manhattan Project, I'd probably have close to $20.

Just for giggles, do a Bing search for "need a Manhattan Project".

Is a quarantine a quarantine when international flights continued as normal for 2 more weeks?

What other country in the world could quarantine a city of 11 million people on the basis of (at the time) 17 reported deaths?

Funny, I was taking that as evidence that the official numbers vastly understated the problem.

Regardless, could we wait to throw bouquets until the growth rate departs from an exponential? A semilog plot of cases or deaths vs time looks disturbingly close to a straight line right now.

Here's a plot of cases vs time, compared to Swine Flu and SARS. It has an option to use a log plot.

Total number of cases and total number of deaths track eerily close to one another. Growth rates are quite a bit higher than for either of the comps. The only departure from an exponential is in the early day jitter, and a recent change in how cases are reported.

Serious question -- are the quarantines doing any good at all?

"Regardless, could we wait to throw bouquets until the growth rate departs from an exponential? A semilog plot of cases or deaths vs time looks disturbingly close to a straight line right now."

That's an exaggeration. Here's the link to what I assume is the graph you were referring to. The Log graph is not a straight line. It's not good, but it's not that bad.

https://ncov.r6.no/

Are you kidding? The section from Day 16 (2400 cases) to Day 33 (40000 cases) is nearly a straight line on that plot.

There's some curvature in the early days, probably due to small number statistics and idiosyncracies in data gathering. But you would not get a bad match to that curve simply drawing a straight line from Day 33 to Day 1.

+1, I must admit if you look at the Day 16+ data, it is a pretty straight plot line. And with a steeper slope than either SARs or the SwineFlu.

Imagine the good fortune if the virus started in North Korea.

https://www.dailystar.co.uk/news/latest-news/breaking-north-korea-executes-coronavirus-21488604

If this disease hit another country, one advantage would be China could still produce the medical equipment needed to deal with it.

Its interesting that SARS and COVID came from China...whereas SE Asia has few such diseases?

Maybe you need that cold weather period?

Speculative:

Perhaps the cold weather drives the healthy people inside with the sick person and enhances the infection rate. Whereas, in warmer weather people tend to not be inside around a sick person.

This might also indicate that the US would be more resistant to such a disease, because we have much larger housing and it is much easier to quarantine a sick person in a house to their own bedroom and bathroom and thus everyone else in the dwelling is less likely to get the disease.

"What other country in the world could quarantine a city of 11 million people on the basis of (at the time) 17 reported deaths?"

Great idea, trust communist reports. Like all those evil generals who Stalin saved Russia from, by torturing confessions from them.

Yep, our great and fearless leader saved us, by anticipating that millions would die, all because of 17 deaths!!! How wise he is!!!

I used to worry the CCP would eclipse the US thanks to it stacking its government with economists, and getting more sensible decisions and clear thinking. Thanks for calming my worries.

Is 1200 health workers anywhere near the efficient quantity? How can anyone possibly know? Could be an order of magnitude larger or smaller than required, if it is a number chosen for publicity.

Premature imitation (of an ideal at least) applies to the US too, especially and increasingly in the recent times, though to a far less extent than to India.

"India does not have a state strong enough to effectively lock down cities."
The Kashmiris might have a different opinion.

I think the west learned from SARS, and is prepared for Corona. I feel there are many competent people in the US government who prepare for this type of situation.

In 1981 American author (of thrillers) Dean Koontz wrote 'The Eyes of Darkness’ about a Chinese military lab in Wuhan creating a viral bio weapon called Wuhan-400.

Did Dean Koontz work for the CCP (sarc)?

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