A matter of Performance

Sometimes, in December 2019, the virus CoV-SARS-2 erupted in China. Although, at the very end of the year,  the WHO (World Health Organisation) Chinese office became aware of a previously unknown virus behind a number of pneumonia cases in Wuhan, the first official report from its central office based in Geneva was  published  on January 21^st. At this point of time they reported a total of confirmed cases of 282, of which 278 in China, 2 in Thailand and 1 each in Japan and Korea.

On 23 January 2020, as the epidemy was mushrooming and risked spreading in the rest of the country, the Central Chinese government responded to the initial outbreak by placing Wuhan and nearby cities under a de-facto quarantine encompassing roughly 50 million people in Hubei province. As there were already 20 cases outside Hubei a strict test, track, isolate, and cure system was established in the rest of the country. The latest figures available are reproduced below and it can be seen that the bulk of cases and death was in the Hubei provinces. (note that the WHO detailed figures by provinces were available only until the 15^th of March and therefore extrapolations have been made).

The epidemy spread first to the Eastern region of Asia and was, as amply reported by the international press, very efficiently contained by South Korea, Singapore, and Japan. We reproduce below the overall statistics for the Asian Eastern region.

and then eventually to Europe and the US. We reproduce below the current figures for Europe (including Russia) and those of the US. It is interesting to note that even if we compare the infection and death rates per 1 Million population, the figures for the Province of Hubei alone are markedly lower than those of Europe and United States.

Whereas the epidemic in China is more or less eliminated it is still in action in both Europe and the US albeit at a lower rate than at its peak. However, in the US reopening has happened at a much earlier stage than in Europe and it is expected that it will take some time before the epidemic is extinguished and the final statistics are available for comparison.

In Europe Greece was one of the outstanding performers with very low number of cases and death because progressive measures had been implemented very early according to a well prepared plan that was elegantly managed by Professor Tsiodras without any interference from political figures. Somebody emitted a theory that there may have been a contributory factor in the Greek population. The hypothesis is that, as a result of the compulsory BCG vaccine in Greece, the innate immune system of the population was stronger. As the BCG vaccine was also compulsory in all the former soviet bloc countries and of course in Russia, it was thought interesting to verify this theory and see if indeed one could detect a similar pattern in those countries.    

What is striking when comparing the two regions, is the staggering difference between number of fatalities, a ratio of 13 to 1 in absolute numbers and a ratio of 11 to 1 in the rate per million inhabitants.  Even the number of cases in western Europe is 70% greater than that of Eastern region including Greece. We are reproducing below the statistics of that region.

Greece is third in terms of detected cases per million population narrowly defeated by Slovakia and Georgia and fourth in terms of fatalities per million. May be these figures are not yet frozen as the epidemic in Russia is still in progress even if slowing down and the number of deaths was 83 reported in Russia are questioned by the international press. Even if the death rate is 83 per million as in Moldova, the total death number would be less than 20,000, a fraction of the total of Western Europe.

 If Russia that delayed its lockdown measures is excluded from the group, the numbers are even more astounding. The death numbers for about half the total population is 6645 compared to 161,993 in Western Europe something to comfort the regional politicians.

However, the absolute winner is not in Europe but in Asia, and it is rarely mentioned in the press despite its stellar performance: it is Vietnam, not a single death, 329 cases, only 1 critical case at this time. This was due to very stringent measures of detection and isolation implemented early. The testing ratio to detected cases was 836 versus 10.5 times in the US.  Also, very interestingly, Vietnam has a compulsory vaccination program of not only BCG but an array of diseases. This combination may have contributed to reinforce the innate immunity of the population. We shall revisit this interesting hypothesis in another article.

Yet, Vietnam was hit early in the epidemic. On the 24th of January, WHO in its situation report mentioned that Vietnam had two cases within a family originating from the father who had a travel history to Wuhan. Not withstanding the US allegations of China’s non transparency, this was the first human transmission publicly recorded outside China and it had been made available worldwide by WHO, an institution so decried by our Dr Strangelove. However, his unforgivable negligent spurn for this disease and his prevarication in taking any measures would be the model for other incompetent decisions in Latin America particularly in Brazil and Mexico whose figures are presented below.

Also, in the table above the other Latin American countries are represented as a group. As the epidemic is in full swing there, it is too early to make any valid assessment of its severity.

Elsewhere the epidemic is still circulating in the Indian subcontinent (India, Pakistan. Bangladesh and Sri Lanka) and the near East which involves Iran, Turkey, Nepal, Afghanistan and all the other “-stans”.  The Arab countries which together have a population equal to that of the US are also experiencing a severe attack especially in Qatar and Saudi Arabia.

The one continent that appears to have been spared is Africa. This ay be due to less international and interregional travel current in ore developed country. We have calculated the figures for that growing continent where the population even not counting the Arab countries counts now more than a million soles.

It is too early to launch oneself in long pronunciamentos as the are likely to be proven wrong. What seems clear is that the Asian Countries near China reacted methodically and promptly. Even without the coercive power of the Chinese authorities, they managed to instill discipline and acceptations of electronic controls that may not been acceptable in Western democracies. The other unknown is whether the immune systems of the Asiatic people are better equipped to fight these kinds of viruses than the Westerners.

Lastly the interesting observation when breaking down the world population is the shift in demographics towards Asia and even Africa. The population of the Indian subcontinent was just under 400 million people at the time of Independence from Britain. Whereas China was hovering above the half billion mark at the time.