Stirrings of a Pandemic



Millions of people have received the Covid-19 vaccine made by Pfizer and Moderna and with hundreds of millions more are slated for distribution later in the year. With more vials of the vaccines being made available worldwide, gone are the bitterness that made China a pariah around the world. Thanks to American President Donald Trump for his efforts to put the blame on China as an early campaign strategy only to abandon it when it failed to gain traction among the majority of the U.S. electorate.


The focus he devoted to blaming China for the coronavirus made more Americans harbor a negative view of the communist country. The extra attention showered on China, however, backfired as Trump’s incompetence in handling the pandemic came to light. The ever rising Covid-19 morbidity and mortality in the United States became the bigger issue that sealed Trump’s fate. China’s economy has recovered much better than the rest of the world. The U.S. is struggling mightily trying to contain the virus and resuscitating the economy.


Amidst the ebbing anger, it is worth revisiting the stirrings of a pandemic. Wuhan, China was indisputably the epicenter of what has become a severe and still lingering pandemic. The genesis of the outbreak became fodder for conspiracy theorists alleging a Chinese conspiracy to cover up a manmade virus gone astray, the Wuhan virus. Despite scientific evidence to the contrary, the Russian onslaught in an effort to help reelect Trump by purveying fake news successfully fanned anti-Chinese sentiments that lingered for months.


Clearly, the outbreak started with bats sold at a nearby wet market as the source. As in previous pandemics, containment of an initial outbreak is hard to do given so many factors. One, the virus strain is not readily identified and understood as to its virulence until it has already left the containment area.  Add to that, a government’s futile effort to contain the information longer than what is acceptable. Two, global travel is hard to stop given the different modes of travel (air, sea, rail), porousness and geographical closeness of borders.


It might surprise readers to know that the current Covid-19 pandemic really mirrors the Spanish Influenza pandemic of 1918-1919 in many ways. Although the flu strain is called the “Spanish Influenza,” its origin is not from Spain. The name was adopted because of Spain’s “neutral” country designation. Historical studies, however, point to an influenza outbreak that was initially thought to be “bubonic-type” in Northwest China in November 1917. Note that the 2020 Wuhan outbreak began in November 2019 but was not identified until January 2020.


Anyway, a flu outbreak was initially reported among soldiers in the trenches in the United Kingdom (UK) and France in January-February 1918 during World War I. By March 1918, returning Americans soldiers who fought in Europe brought the virus home to a military camp in Kansas. By then, the pandemic mortality was already high in other countries with probably over 20 million just in India alone.


It turned out, the influenza outbreak in Northwest China that quickly spread to Europe was traced to tens of thousands Chinese laborers shipped to Canada for later transport to UK’s and France’s Chinese labor camps. They were transported in sealed railcars to Halifax to avoid scrutiny from angry Canadians who despised the Chinese laborers.  


Many of these laborers were medically quarantined while in Europe. They were in war trenches doing hard labor along with British, French, and American soldiers who were doing the fighting. Their symbiotic existence at the war zone played a significant role in the spread of the mutated virus.


In comparison, the Covid-19’s rapid spread to Asia (including China itself), Europe, Africa and the Americas was traceable to an outbound travel surge from Wuhan before travel restrictions (December-February) were implemented. January is a major holiday period in China, and the 40-day period around Lunar New Year marks the largest annual human movement in the world, with major travel flows out of large cities. The purpose of this holiday travel is often to visit family members or to visit the world as a tourist.  


In the United States alone, at least 430,000 people have arrived in the U. S. port of entries on direct flights from China, including nearly 40,000 in the two months after President Trump imposed restrictions on such travel. The bulk of the passengers (mixed nationalities) who flew directly from Wuhan arrived in January, at airports in Los Angeles, San Francisco, New York, Chicago, Seattle, Newark and Detroit. These cities absorbed the brunt of the initial wave.


The morbidity and mortality of the Spanish Flu in China in 1918 were mild (0.11%, 87,000 cases). Outside China, the mortality of influenza was very high (99.99%, 82 million plus). Within only three months from September to November 1918, the influenza pandemic swept over Norway, Sweden, Canada, Spain, the UK, France, Germany, Senegal, Tanzania, Algeria, Zimbabwe, South Africa, India and Indonesia, and the Philippines. It killed over 50 million worldwide.


If this sounds familiar that is because the initial outbreak (or first wave) in Wuhan killed a small number compared to other countries. China’s total share is 0.01% (96,000 cases) with the world sharing the bulk of 10 million cases. China’s very small mortality rate gave rise to suspicion that China was playing fast and loose with its numbers, or that it has deployed a bioweapon perfected from its biological laboratory.


The symptoms reported during the 1918 and 2020 pandemics were typical influenza type: fever, headache, back pain, leg pain, vomiting, fatigue, pneumonia and bronchitis. The virulence followed a similar pattern as well with the first wave being mild, followed by a higher second wave, and a much higher third wave. The escalating number of deaths are attributed to mutating (variant) strains and people’s high travel movements and risky behaviors particularly during major holidays.


These comparisons point to the fact that while pandemics will occur, when and where are always unknown until it is too late to prevent a global spread. Some previous pandemics were contained much earlier because of worldwide cooperation; this time was different as many countries including the United States turned inwards. China’s low morbidity and mortality rates follows a similar approach that the Chinese employs – that of quickly instituting draconian measures. Quick response by western democracies are often hobbled by politics thus their poor health and economic outcomes.


China does better in responding to severe outbreaks other than their draconian measures because their citizens arguably are more responsive to government’s public health measures because failure has severe consequences. Pandemics are not new to China. China has been the source of various deadly pandemics involving various types from bubonic (rats), SARS (civet cats), smallpox (rodent), and now Covid-19 (bats).


China’s heightened knowledge of pandemics from previous occurrences in the country (and captive citizenry) makes it a leader in pandemic response and treatment of the diseases. Instead of vilifying them, the global community can benefit from China’s knowledge by working with them instead of against.