No, I am not saying we anyone should be calling Sars-Cov2 the US virus. What I am saying, is that there is a real risk unless there is some caution, some people could start pointing the finger at the US, for new outbreaks of Covid-19 as time progresses. Consider, the US is currently the largest source the virus worldwide, and there are now outbreaks outside the US that arise due to arrivals from the US. Could blaming the pandemic on mismanagement backfire?
- Is it fair to call it the China Virus?
- Testing: Does it matter?
- Who could call it the ‘America Virus’?
- Enemies, not Allies
Is it fair to call it the China Virus?
Where did it start?
Neither the Wuhan wet market, nor even necessarily anywhere in Wuhan is certain to be the original source of the virus, but there is little doubt the virus first person known to be infected was someone in China. Further, regardless of origin of the first infected person, the first outbreak of size was definitely in China.
A problem with assigning blame to the country with the first known cases arises when considering the Spanish Flu of 1918. No, it did not start in Spain, and while again there is no proof of actual origin, working on the basis of the first known infection this time points to Haskell County, Kansas. It would not be pleasant to assign blame for an outbreak that infected around 1/3 of the worlds population, and resulted in the deaths of around 3% of all people in the world. Looking back, no one was at fault because by random chance the first case happened in that location when it could just as well happened anywhere else. Blame should be about actions that made things worse, and I have not seen any country accused of actions that spread the 1918 flu.
China: Deserving of blame?
In the early stages of the outbreak, there was mismanagement by China. However, evidence suggests the outbreak had already spread to France, Italy and Spain prior to the first identified cases in China, and perhaps even already spread to the USA. That doesn’t mean mismanagement by China didn’t make the outbreak worse, but it does mean there would still have been an outbreak, as there was spread even before any ‘questionable’ management of the outbreak by Chinese authorities.
More worryingly, the accusation is not innocent mistakes by China, the accusation is that China put government image above concerns over national and eventually global health outcomes.
Testing: Does it matter?
What is the new issue with testing in the US?
The CDC has just announced a new, widely condemned, policy on testing. Condemnation relates to the policy having an appearance of risking additional infections, in order to appease political pressure to reduce reporting of the actual number of infections.
The accusation is that change of policy will result in people with a significant chance of having been infected, being advised to not bother being tested.
Why Bother With Testing Anyway?
There are three main reasons for testing:
- testing allows early detection of potential illness allowing best practice in managing infections
- testing can identify asymptomatic people who should isolate in order to protect against the spread of infection
- testing provides authorities with data on the degree of spread, enabling informed policy decisions
The new US policy fails on all three counts.
Firstly, not testing people identified as exposed to the virus until symptomatic may result in some who do later develop symptoms receiving delayed medical care, requiring getting tested and waiting for results while already unwell.
Secondly, and this is the main point, asymptomatic people will continue the spread. If the new policy required all exposed people to quarantine, making testing not unnecessary to prevent asymptomatic spread, then it would be fine. However there is no self isolation recommendation.
Thirdly, data on the outbreak will be masked, and there is even the appearance that this is deliberate.
When Italy had low testing rates, no one complained!
At the peak of the outbreak in northern Italy, testing was almost non-existent. In practice few, apart from those requiring admission to hospital, were tested. While at least the new US policy suggests those with symptoms be tested even when they do not require hospitalisation. However, there were some special circumstances that reduced the value of testing:
- detecting infection was only useful for those requiring emergency hospital treatment, as medical resources were so overwhelmed that care could not even be given to all who would die otherwise
- everyone was already in quarantine, meaning asymptomatic cases were already isolated and thus there was already protection from further infections
- policy was already at the highest alert level, with data already indicating every possible preventative measure was required
In Italy at that Are things in the US really comparable to Italy at that time?
In the State of Victoria, Australia, testing rates are falling too!
Australia has been doing relative well in dealing with Covid-19 (approx. 20 deaths per million vs of 500 deaths per million in the US), and even in Melbourne, Australia, they seem unconcerned about falling testing rates. Firstly, note that testing rates in Australia are higher than in the US. Secondly, while there may be some degree of screw-up, there is no policy to hide data behind any drop in testing in Melbourne. Thirdly, and perhaps most significantly, even though cases are still lower than almost anywhere in the US, Melbourne is lockdown to further reduce cases, which means everyone is already in isolation, so the need to identify asymptomatic people is reduced.
Testing: The US as an opaque regime.
The main difference between any other problem with testing in a western democracy, is the guideline to reduce testing in the US has the appearance as being driven by a desire to become less transparent. The appearance is that of a nation hiding the levels of infection from both the outside world and the nation itself. If there is fault with China and Covid-19, it is that in the early stages of the pandemic China took steps to hide what was happening, and as a result put more lives at risk. We still do not trust data coming out of China, but the US is a risk of moving into that exact same pattern.
Testing certainly does matter in terms of transparency on the state of the outbreak.
Who could call it the ‘USA Virus’?
Enemies, not Allies.
The obvious answer is the enemies of the USA. Fortunately, some of the countries experiencing a link between Covid-19 and the US at this time are strong US allies. The concern, is that if such experiences themselves continue, then enemies of the US which governments looks for reasons to criticise the US may be provided with ammunition.
Australia: The US vs China as a source of Covid-19.
Australia had an initial wave, generally assumed to be mostly as a result of spread from the outbreak of Covid-19 China. From the graph show here, it can be seen deaths plateaued during April, and did not increase significantly until the end of June. The initial outbreak had been contained, and second climb in the number of death came as a result infection from an international arrival getting through quarantine and into the wider community. What is not discussed is where did the virus arrive from this second time? Logically, the first phase of the outbreak would have originated in China. It takes at least a month following the virus arriving to have an outbreak, and people arriving infected with the virus in early March would most likely have come from China as that is where the cases were.
The second phase, resulting in the most deaths in Australia, most likely originated in the USA. In late June or Early July, by far the country with the most infected people was the USA, and there we far more arrivals to Australia from the USA than from other countries with high case numbers.
Australia is one of the strongest allies of the USA, following the US into every conflict since the second world war, and with a very pro-USA government, and there is also the suggestion that cases should never have escaped quarantine in Australia. There will be no ‘finger pointing’ but the direct origin of the virus resulting in most deaths in Australia in most certainly the USA, not China. If China had managed the initial outbreak better, there may have been no pandemic. If the US had managed the outbreak in the US better, most Australians how have died from the virus may still be alive.
The second spike in New Zealand looks insignificant on the graph, but it was only reduced to that level through an immediate lockdown. It was still sufficiently significant that Trump declared things in New Zealand as ‘terrible’, and something the US must avoid. It is true that this new outbreak reached as many as 14 infections per day, and the US would not want that! (Although day there were 14 infections detected, only 10 of those infections happened in New Zealand). It is now clear that some, if not all, of the virus that entered New Zealand this time to cause that ‘terrible’ situation, came from the US.
For a country that had previously been able to allow crowds at sporting matches, and very much had allowed pre-covid19 behaviour to return, going back into lockdown did come at a cost. New Zealand is another country where a second wave of the virus entered the country at a time when cases in China were almost non-existent, and cases in the US were at their peak. It has been revealed that genomic testing shows some new infections arrived from the US. Did all of the new virus arrive from the US? That was not released. It is not that the US should rightfully be blamed, but Trump criticising the terrible number Covid-19 cases, when so many cases detected in New Zealand are detected as carrying the virus on arrival from the US, it not helpful. If this type of event takes place in country hostile to the US, it would provide the ammunition for trying to incite anti-US sentiment.
No one is now calling Covid-19 the ‘US virus’. Most likely the pandemic will end without that happening. Even though US citizens may be banned from travelling to many countries, those same countries still have their own citizens and other still arriving from the US. Every time someone from the US brings the virus with them, it highlights how the US has performed at less than ‘world leading’ levels in controlling the pandemic.
In many ways, the handling of the pandemic continues to lower the world standing of the US.