Meanwhile, on the other side of the Earth, there have been more than 75,000 cases of coronavirus and more than 2,000 deaths. This leaves U.S. health experts hoping that the number of infections has been dramatically underreported.
That is not a typo. If the current numbers are close to accurate, it indicates a coronavirus mortality rate upward of 2 percent. The mortality rate for the seasonal flu is generally 0.1 percent. The mortality rate for pandemic flu is 0.3 to 0.5 percent. The particularly deadly flu pandemic of 1918 — which took the lives of 50 million people around the world — had a mortality rate of about 2 percent.
So, if 2,000 deaths is the numerator, scientists hope that the denominator is actually much larger. And that is probable, given the likelihood that there are many more people who have the infection but don’t know it, or are not showing symptoms.
The good news? The outbreak started in a single location and seems largely contained there. There have been more than 1,000 cases in more than 25 countries outside of China. But the overwhelming majority have been travel-related. The containment measures of South Korea, Singapore, Hong Kong and Japan — which have the most cases — seem to have been successful. Of the 15 U.S. cases (before the evacuation of American passengers from a stricken Japanese cruise ship), 13 are travel-related. The two others are spouses of people in that group. We still have not seen widespread, sustained transmission from person to person outside of China.
The Chinese reaction to the virus has shown the weaknesses and advantages of authoritarianism. The immediate response of a system built on fear to a problem like this one is denial and deception. No one wants to carry bad news. The incentives are all against initiative. So local Chinese officials spent the first weeks of the outbreak — as the disease was spreading under the radar — insisting that the transmission of the virus was all animal-to-human.
But authoritarian states are good at things that require mass regimentation without public input. Only in a society like China could you have the effective lockdown of 50 million people, including the entire city of Wuhan, to slow the spread of the disease. Public-health officials in most places — who are required to balance health needs with civil liberties — would never consider such a measure. Yet it appears to be working.
The danger? “All that is needed is for a few countries in the developing world that can’t contain the coronavirus,” Anthony S. Fauci, the head of the National Institute of Allergy and Infectious Diseases, told me. “This could be the second wave of the outbreak that could then progress to a true pandemic.”
Pandemic infections tend to attack the weakest links — the most vulnerable health systems — in the global chain. If there is sustained transmission in those places, says Fauci, “even countries with best practices will suffer.” Countries in Africa are particularly vulnerable. There are more than 1 million Chinese people in Africa, and many Africans study in China. Countries such as Ethiopia, Senegal and South Africa are capable of adequately testing random samples for coronavirus in key cities. But Liberia? Guinea? Sierra Leone?
Seldom has there been a stronger argument for U.S. global engagement to strengthen African health systems, which constitute part of our own line of defense against pandemics. Seldom has there been a better argument to abandon “America First” posturing and to recognize that our own fate is closely tied to the health and hopes of other nations.
Much about the future course of the disease depends on the answer to a scientific question: Is someone who has coronavirus but lacks symptoms — or has symptoms so mild that he or she hardly notices — capable of transmitting the virus to others? “It looks like the answer is yes,” says Fauci. Which would make the virus far harder to control.
“We may find that the virus is highly transmissible but less lethal than we thought in the beginning,” Fauci told me. In this case, the danger would be similar to a particularly bad influenza. And the outbreaks, as with the flu, could be seasonal. Fauci says he “would not be surprised if that happened.”
I imagine that most Americans would be surprised and dismayed if that happened. But there is also hurried, promising work being done on a coronavirus vaccine. And so the endless race continues between human ingenuity and the pathogens that regularly emerge to threaten us.
Michael Gerson is a nationally syndicated columnist who appears twice weekly in The Post.