Concerning the Recent 2019-Novel Coronavirus Outbreak

Up­date: Most in­for­ma­tion pre­sented here is out of date. See the 80,000 hours page for more up-to-date in­for­ma­tion.

I have been re­search­ing the Wuhan Coron­avirus for sev­eral hours to­day, and I have come to the ten­ta­tive con­clu­sion that the situ­a­tion is worse than I ini­tially thought.

Given my cur­rent un­der­stand­ing, it now seems rea­son­able to as­sign a non-neg­ligible prob­a­bil­ity (>2%) to the propo­si­tion that the cur­rent out­break will re­sult in a global dis­aster (>50 mil­lion deaths re­sult­ing from the pathogen within 1 year). I un­der­stand this pre­dic­tion will sound alarmist, but in this post I will out­line some of the rea­sons why I have come to this con­clu­sion.

I now be­lieve that it is war­ranted for effec­tive al­tru­ists to take par­tic­u­lar ac­tions to pre­pare for a re­sult­ing pan­demic. The most effec­tive ac­tion is likely to re­search prepa­ra­tion in or­der to limit ex­po­sure to sources of the virus. Send­ing out ev­i­dence-based warn­ing sig­nals to at-risk com­mu­ni­ties may also be effec­tive at limit­ing the spread of the pathogen.

Sum­mary of my rea­sons for be­liev­ing that this out­break could re­sult in a global disaster

  • The cur­rent out­break matches the crite­ria that sci­en­tists have iden­ti­fied as be­ing par­tic­u­larly likely char­ac­ter­is­tics of a pan­demic-in­duced global dis­aster. That is, it’s a dis­ease that’s con­ta­gious dur­ing a long in­cu­ba­tion pe­riod, has a high in­fec­tion rate, has no known treat­ment, few peo­ple are im­mune, and it has a low but sig­nifi­cant mor­tal­ity rate. See this ar­ti­cle for a sum­mary of likely char­ac­ter­is­tics of a pan­demic-in­duced global dis­aster.

    • Based on my re­search, I wasn’t able to iden­tify any his­tor­i­cally re­cent pathogen with these char­ac­ter­is­tics, giv­ing me rea­son to be­lieve that us­ing an out­side view to ar­gue against alarmism may not be war­ranted. For refer­ence, the 2003 SARS out­break, the 2009 Swine Flu, and the sev­eral Ebola out­breaks do not match the pro­files of a global dis­aster as com­pletely as the cur­rent out­break.

    • Es­ti­mates of the mor­tal­ity rate vary, but one me­dia source says, “While the sin­gle figures of deaths in early Jan­uary seemed re­as­sur­ing, the death toll has now climbed to above 3 per­cent.” This would put itroughly on par with the mor­tal­ity rate of the 1918 flu pan­demic, and over 10 times more deadly than a nor­mal sea­sonal flu. It’s worth not­ing, how­ever, that the 1918 flu pan­demic kil­led mostly young adults, whereas the pat­tern for this pathogen ap­pears to be the op­po­site (which is nor­mal for pathogens).

    • The in­cu­ba­tion pe­riod (the pe­riod dur­ing which symp­toms are not pre­sent but those in­fected can still in­fect oth­ers) could be as long as 14 days, ac­cord­ing to many sources.

  • An Im­pe­rial Col­lege Lon­don re­port stated, “Self-sus­tain­ing hu­man-to-hu­man trans­mis­sion of the novel coro­n­avirus (2019-nCov) is the only plau­si­ble ex­pla­na­tion of the scale of the out­break in Wuhan. We es­ti­mate that, on av­er­age, each case in­fected 2.6 (un­cer­tainty range: 1.5-3.5) other peo­ple up to 18th Jan­uary 2020, based on an anal­y­sis com­bin­ing our past es­ti­mates of the size of the out­break in Wuhan with com­pu­ta­tional mod­el­ling of po­ten­tial epi­demic tra­jec­to­ries. This im­plies that con­trol mea­sures need to block well over 60% of trans­mis­sion to be effec­tive in con­trol­ling the out­break.”

    • Com­pare the above in­fec­tion rate to the H1N1 virus, which some es­ti­mate to have in­fected 10-20% of the world pop­u­la­tion in 2009. The World Health Or­ga­ni­za­tion has said, “The pan­demic (H1N1) 2009 in­fluenza virus has a R0 of 1.2 to 1.6 (Fraser, 2009) which makes con­trol­ling its spread eas­ier than viruses with higher trans­mis­si­bil­ity.”

  • A sim­ple re­gres­sion model in­di­cates that the growth rate of the pathogen is pre­dictable and ex­tremely rapid.

    • The num­ber of cases as re­ported by the Na­tional Health Com­mis­sion of China forms the ba­sis of my re­gres­sion model (you can cur­rently find the num­ber of cases re­ported in graph­i­cal for­mat on the Wikipe­dia page here). An ex­po­nen­tial re­gres­sion model fit to the data re­veals that the equa­tion 38.7 * e^(0.389 * (t+11)) strongly retro­d­icts the num­ber of cases (where t is the num­ber of days since Jan­uary 26th). In this model, the growth is very high.

    • [Up­date: Growth for Jan­uary 27th re­mained roughly in line with the pre­dicted growth from the ex­po­nen­tial re­gres­sion model. The new equa­tion is 35.5*exp(0.401*t) where t is the num­ber of days since Jan­uary 15th]

  • A top ex­pert has es­ti­mated that ap­prox­i­mately 100,000 peo­ple have already been in­fected, which is much more than the con­firmed num­ber of 2808 (as of Jan­uary 26th). If the num­ber were this high, then the pathogen has likely already crossed the quaran­tine. The in­fec­tion has also spread to 12 other coun­tries be­sides China, sup­port­ing this point.

  • The Me­tac­u­lus com­mu­nity’s es­ti­mate for the num­ber of to­tal cases in 2020 is much higher than it was just two or three days ago. Com­pare this older ques­tion here, ver­sus this new ques­tion (when it opens).

  • While sev­eral or­ga­ni­za­tions are de­vel­op­ing a vac­cine, Wikipe­dia seems to in­di­cate that it will take months be­fore vac­cines even en­ter tri­als, and we should ex­pect that it will take about a year be­fore a vac­cine comes out.

Sum­mary of my recommendations

I think it’s un­likely that EAs are in any spe­cial po­si­tion to help stop the pan­demic. How­ever, we can guard our­selves against the pan­demic by heed­ing early warn­ings, re­search ways to limit our ex­po­sure to the virus, and use our plat­forms to warn those at-risk.

The CDC has a page for prepar­ing for dis­aster.

Cur­rently, the pathogen ap­pears to have a sig­nifi­cant mor­tal­ity rate, but kills mainly older peo­ple. There­fore, old peo­ple are most at-risk of dy­ing.

Even if you con­tract the dis­ease and don’t die, the symp­toms are likely to be se­vere. One source says,

ARDS (acute res­pi­ra­tory dis­tress syn­drome) is a com­mon com­pli­ca­tion. Between 25 and 32 per­cent of cases are ad­mit­ted to the in­ten­sive care unit (ICU) for me­chan­i­cal ven­tila­tion and some­times ECMO (pump­ing blood through an ar­tifi­cial lung for oxy­gena­tion).
Other com­pli­ca­tions in­clude sep­tic shock, acute kid­ney in­jury, and virus-in­duced car­diac in­jury. The ex­ten­sive lung dam­age also sets the lung up for sec­ondary bac­te­rial pneu­mo­nia, which oc­curs in 10 per­cent of ICU ad­mis­sions.

Ac­knowl­edge­ments: Dony Christie and Louis Franc­ini helped gather sources and write this post.