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Rodney Richie: Don’t be quick to blame Chinese for obscuring viral contagion

Rodney Richie: Don’t be quick to blame Chinese for obscuring viral contagion

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The president of the United States, Donald J. Trump, and others in the conservative media are repeatedly casting blame on China’s “hiding this infection” from the West till it became uncontrollable, and that if the West (i.e., the United States) had just had more warning, we would have been more prepared for what exploded into a pandemic. Here are the straight-up facts, based on a study by Dr. Tomas Paeyo as reported in the Journal of the American Medical Association drawing on raw case data from the Chinese Center for Disease Control and Prevention.

Four unusual cases of pneumonia — three in the same family — were noted by Jixian Zhang, MD, in HICWM Hospital on Dec. 26, 2019. Dr. Zhang reported these pneumonia cases to the local CDC on Dec. 27. Three more cases of pneumonia were found in HICWM Hospital (for a total of seven) on Dec. 28 and Dec. 29. The now famous Chinese ophthalmologist Dr. Li Wenliang began warning colleagues about these unusual pneumonia cases about this same time.

The local Chinese CDC began active case-finding the following day, on Dec. 30. The Wuhan Health Commission on Dec. 31 alerted the National Health Commission and China CDC and WHO (World Health Organization). The Huanan Seafood Market was closed New Year’s Day 2020. The 2019-nCoV virus was identified in a Chinese laboratory on Jan. 7, was sequenced on Jan. 12, and the first 2019-nCoV test kits became available Jan. 13. As medical professionals and local governmental leaders know all too well, such a rapid response to this infection has not been seen in the United States, despite rhetoric to the contrary.

12-day lag

With use of the viral testing kits, official diagnoses of cases were not made till Jan. 18, when there were already more than 1,500 clinical cases in Chinese hospitals. This raises another point of misunderstanding by the general public: The number of confirmed cases of COVID-19 lags behind actual infected numbers by up to 12 days. So the cases we know about today don’t take into account the known cases that simply have not been diagnosed. This misunderstanding is compounded by our continuing lack of testing in the United States — with only those with travel or contact history, symptoms and persistence being tested.

Yet another misunderstanding persists, gaining traction through politicians and the political pundits serving them: the claim that COVID-19 is just “a little worse than the common flu, and certainly not worth crashing our economy over.” The facts are these: COVID-19 is at least twice as infective (in terms of number of persons being infected by an initial infected person) as influenza. COVID-19 causes anywhere from 5 times to 20 times the requirement of hospitalization in comparison with influenza.

386 vs. 99,000

This higher rate of infectivity and higher rate of hospitalization conspire to wreak havoc. A single person with the flu can result in the infection of 386 other people over two months, with only a handful of these persons requiring hospitalization. But in that same period one COVID-19 person could lead to the infection of 99,000 people, of whom nearly 20,000 might need to be hospitalized. And then there’s the lethality of COVID-19. Influenza kills at most 0.1% of those infected; with COVID-19 the kill rate is 10-20 times higher.

Past civilizations decimated or hobbled by epidemic calamities are afterward judged by history on the ignorance of those civilizations’ leadership, their medical communities and societies in understanding how to deal with spreading contagions. In the United States, we will have no such excuse — and blaming the Chinese in digressive tirades sure won’t save more lives in America or help equip our hospitals and medical facilities as the number of infections rise across our nation.

Rodney C. Richie, MD, FACP, FCCP, is medical director of Palliative Care Service, Ascension Providence.

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