The Worst-Cast Scenario for Coronavirus Is Likely

I haven't been posting much about the coronavirus outbreak, although I have been following the news closely. Here's an article that expresses my opinion fairly closely. Jonathan Quick is the former chair of the Global Health Council. In this interview from The Guardian, he expresses the opinion that the worst-case scenario for the coronavirus is likely. I think he's right.

The Covid-19 epidemic looks like it’s edging towards becoming a pandemic – that is, as the WHO defines it, “the worldwide spread of a new disease” – but the WHO hasn’t declared a pandemic yet. What are the best-case and worst-case scenarios?

The best case is that the Chinese conflagration is brought under control, the smaller “flames” we’ve seen flare up in other countries are extinguished, there’s little or no spread to new countries or continents, and the epidemic dies out. The worst case is that the outbreak goes global and the disease eventually becomes endemic, meaning it circulates permanently in the human population. 

Your feeling as to which is more likely, as of today, 27 February?

The worst-case scenario is looking increasingly likely. We’ve now seen cases on six continents, apparently “silent” – that is, at least partly asymptomatic – chains of human-to-human transmission both inside and outside China, with additional countries reporting cases within the last week – bringing the total to 47 – and new, accelerating outbreaks in Iran, Italy and South Korea. If it becomes a pandemic, the questions are, how bad will it get and how long will it last? The case fatality rate – the proportion of cases that are fatal – has been just over 2%, much less than it was for Sars, but 20 times that of seasonal flu. There are still many unknowns – we may have underestimated the period during which a person is contagious, for instance, and the variety of ways in which the virus spreads.

If you want more backing for being pessimistic, read this article (also from the Guardian) about how the horrible, predatory health system in the United States is likely to make the outbreak worse. 

This system is exactly why a 2018 West Health Institute/NORC at the University of Chicago national poll found that 44% of Americans declined to see a doctor due to cost, and why nearly a third of Americans polled said they didn’t get their prescriptions filled due to the high cost of their medicine. This is the same system that killed 38-year-old Texas public school teacher Heather Holland, who couldn’t afford the $116 co-pay for her flu medication and later died from flu complications. It’s the same system that Guardian contributor Luke O’Neil refers to as “Go viral or die trying”, in which Americans who can’t afford life-saving healthcare procedures are forced to become their own advocate and PR agency by launching a viral GoFundMe campaign to ask strangers on the internet to save their lives.

When you multiply my situation by 27.5 million, you end up with a country full of people who won’t see a doctor unless they’re extremely sick. And when you combine a for-profit healthcare system – in which only those wealthy enough to get care actually receive it – with a global pandemic, the only outcome will be unmitigated disaster. This could be somewhat remedied if the US had a single-payer, universal healthcare system, like every other industrialized nation. And as a team of Yale epidemiologists discovered in a study recently published in the Lancet, a single-payer healthcare system in the US could simultaneously save 68,000 lives and $450bn in taxpayer dollars each year.

After you've digested that, read this. "HHS Chief Azar Refuses to Vow Coronavirus Vaccine Will Be Affordable for All, Not Just the Rich." And weep for what our world has become.