Allan Maynard, MSc. April 17, 2020
It is impossible to escape the daily barrage of news about the CoVid Pandemic unless we were to add an additional dimension to our isolation by turning off all screens and cancelling all publications. In following the news outlets we are seeing examples of informed, decisive leadership. We are also seeing examples of responses riddled with muddled misinformation and untruths. For certain, the muddled responses are providing us with the clearest examples of the dreaded “Ds”: DENIAL (the problem does not exist); DELAY (we don’t know for certain – let’s wait and see and not disturb the economy), DODGE or DEFLECT (the questions that then come) – all leading to DEADLY OUTCOMES. Clearly, the need for evidence-based decision-making is critical with this kind of crisis.
Risk Assessment – it would be expected that progressive governance involves sound policies around societal risk assessment. Broadly speaking, risk assessment is the combined effort of identifying and analyzing potential events that may negatively impact individuals, assets and/or the environment followed by making judgments on the tolerability of such risks. Another way of putting it – prepare for the worst while hoping for the best. It is frustrating indeed to consider how different things might look had these principals been rigorously applied. Of course hindsight is 20/20 and casting back can look like a blame game. However it is a necessary exercise to acknowledge the many failings that have exacerbated this mess. That is the only way to learn for future planning.
There has been extensive research around the world and particularly in China about zoonotic corona viruses – especially the role of bats as primary carriers. The CoVid 19 virus first emerged in the Chinese city of Wuhan in December, and is thought through most investigations (but not all) to have leapt to humans at a seafood and wild-animal market (Huanan Market), where many of the first people to become infected, worked. After the SARS outbreak in 2003, the Chinese government closed wet markets and banned the ‘farming’ of wildlife. But this ban was later reversed. This is a clear failing in terms of risk management. While it is not straightforward to close these markets, the Chinese government had over 17 years to work on solutions to this, but denial and complacency set in.
The first signs of danger associated with this new (novel) corona virus were probably detected in November or early December, 2019. The Chinese government first tried to keep it quiet (and contained?) and even silenced one of the early researchers that made the information public (a Dr. Li Wenliang who later died of the disease). The Chinese first notified the World Health Organization (WHO) on December 31, 2019. This should have been done sooner. Moreover they did not initially reveal that human-to-human transfer was occurring – likely because of lack of evidence of such.
By January 23rd, 2020 Wuhan was in full lock down and the virus had spread to other countries – mostly in Asia. Despite this WHO decided that it was ‘too early’ to declare a global health emergency. This was then declared a week later but without recommending trade and travel restrictions, claiming these would be an unnecessary disruption. As well, from December 31 to January 14th, WHO and China stated that there was no clear evidence of human-human transfer. By January 23rd however, this statement was updated with the warning of clear evidence of human-to-human infection.
By March 11, WHO declared the outbreak to be a Global Pandemic. By then the CoVid virus was found in almost all countries with infections rates often doubling every 2 to 4 days. At least by then, WHO had developed a fairly reliable test, which was rapidly put to use in many afflicted countries. Those (example South Korea and Taiwan) that did extensive testing, followed by quarantine and contact tracing – along with social distancing and lock downs, demonstrated an ability to start reducing infection rates. But many of the European countries were slow to accept the gravity of the CoVid virus and infection rates ramped up drastically and rapidly.
By some measures the responses from early January through February can seem acceptable but not through the lens of rigorous risk management. The most significant failings in retrospect were the warnings about human-to-human transfer. Because of the similarity of the CoVid 19 to SARs, it would have been prudent to assume human-to-human transfer right from the onset. The primary obstacle to taking more drastic action at some of the critical points seemed to be the fear of disrupting the economy. Initial denial and delay were evident from the onset. Of course – the delays made both the health crisis and the economy much worse.
In no country was the denial/delay/dodge strategy more glaring that the USA. That is because President Trump, from mid- January until around March 10th, verbalized the denial almost daily. Six to eight precious weeks were mostly squandered. This was made worse by the unfortunate roll out of a faulty test protocol. Now the USA has the most cases worldwide and one of the highest rates of infection. These failings cannot now be re-written.
Claims by Trump and his administration that they could not possibly have been ready for this pandemic and was then misinformed by WHO, are incorrect. Seven days before Donald Trump took office, his incoming team faced a sober briefing from the outgoing Obama administration about the possibility of a global pandemic and the need to be prepared. The Obama administration had learned from the H1N1 and Ebola outbreaks. As such, the Obama administration had created a pandemic preparedness team within the White House that was then ‘reorganized’ in 2018 with the loss of expertise. Moreover, the US embassy in China initially had a large team of health professionals which was then cut over 60% by the Trump administration thereby removing expertise that would have been ‘on the ground’ at the onset of the outbreak. Furthermore – in 2018/19 a pandemic simulation conducted by the Dept. Of Health and Human Services showed the nation was unprepared for a pandemic, according to a critical draft assessment. The exercise, code named “Crimson Contagion,” had eerie similarities to the current real-life coronavirus pandemic. As well, a program funded by USAID (named PREDICT) that was set up to investigate corona viruses in bats and pangolins, was cancelled in 2019.
The failings in response to this pandemic are wide spread and in many locations continuing. In most cases the failings have resulted in denial leading to delay. Delay is not an option in fighting a pandemic. It’s deadly. Time matters. Expertise matters. Evidence based decision-making matters. The countries that were much more successful in dealing with this crisis such as Germany, South Korea, Taiwan and others, prove this.
The corona virus pandemic has brought a definite urgency to the defining political question of our age: how to deal with risk on a global scale. For certain, this question also applies to climate change, which is an even greater crisis in the making. There can be no question about that. The CoVid pandemic is a crisis in fast-forward whereas climate change has been building over 50 years and counting. But the same principles of risk assessment and evidence-based decision-making, apply. Denial followed by delay of both crises is deadly.
Well done! I know I’m being optimistic but let’s hope some positive social and economic priorities are a result.
Thanx Allan, I can appreciate that one doesn’t want to get political or point fingers at who to blame. After the fact doesn’t change history but it does help to make future protocols and decisions. I look forward to reading more of your thoughts ………We are so glad to hear that Margrit is still fine …..Like you said care facilities seem to be the worst environment at the moment, We haven’t heard from Jacquie lately so assume all is ok with Jack and his care facility …….cheers
Thanks Allan for your thoughtful discourse. History will tell us which jurisdictions did the right thing in reacting to the pandemic, as I’m sure there will be reviews and studies for many years to come. The USA will probably garner the most analysis, particularly the reaction of the federal administration. And now, with Trump pushing his followers to civil disobedience we will have even more to consider.
Is a good report Allan.I agree so much with you! Keep up the good work at hand!
Glad that Margrit is doing well and that the care home she is in has not been touched with this pandemic.
Thank you Allan for sharing your blog when we met in science class a few months ago! Your articles are always instructive and clear. I look forward to the next one! I hope you and your family are keeping well.