The Black Death. Smallpox. Spanish Flu. By now we have all read how these pandemics ravaged humanity, leading to death tolls in the tens of millions. We have also seen how they raved the human body in gruesome, graphic ways. The bubonic plague caused black pustulent swellings that give the disease its nickname. Smallpox deforms the body with thousands of blisters. The Spanish Flu had many symptoms, some of which included uncontrollable nose bleeds and cyanosis, a darkening of the skin into a blue-black hue due to lack of oxygen. In many cases it was so swift that people feeling fine in the morning were gone by the end of the day, often simply dropping dead. More recently we have seen the scourge of Ebola, a hemorrhagic fever, that not only has death rates of 80% among its most lethal strains but also kill you in a horrifying manner, effectively liquefying your insides and bleeding them out from every orifice.
Compared to that, the novel coronavirus known as SARS-CoV-2 (or specifically, the disease that it causes which is Covid-19) that is currently affecting the planet is remarkably unremarkable in terms of its lethality and gruesomeness. Death rates have been widely quoted as being around 3%, give or take depending on a country’s demographics as well as general levels of health and preparedness, but they are far lower when all of the untested, asymptomatic cases are considered. Certainly worse than “just the flu” but considerably lower than some of its corona-cousins like SARS (1-in-3 dead) and MERS (2-in-3 dead), the latter being by far the most deadly of the bunch and up there in lethality with most hemorrhagic fevers. And although the clinical description of what Covid-19 does to so many parts of the body is nightmarish, it is all mercifully hidden under the skin. A Hollywood summer blockbuster disease this is not.
Which leads me to believe that although Covid-19 may not be an apocalyptic “perfect killer” disease, it is quite possibly the most perfect destroyer of a modern globalized economy. In fact, if one had to design a disease to bring global capitalism to its knees, it would probably be this.
The silent spreader
With an estimated R0 of 2-2.5, that is, an infected person is likely to infect 2-2.5 other people, SARS-CoV-2 is dangerously contagious as far as non-airborne diseases (like measles) go. Although there are no shortage of alarmist reports on how the virus can live for days on certain surfaces, the main risk of transmission is interpersonal. This is mostly because of its lengthy incubation period (up to 14 days) combined with the fact that many (most) people will get infected by the virus but never develop the disease. But in both of these cases, infected people will be able to spread it. In contrast, asymptomatic cases of SARS and MERS have been extremely rare and the incubation period of most flu strains is just a few days. As far as its capability for silent spreading, SARS-CoV-2 is an almost perfect pathogen, with just the right combination of long incubation periods and capability for asymptomatic infection that other diseases lack.
From an economics perspective, the consequence of this kind of silent spread is that localized lockdowns are woefully ineffective. By the time you have just a few cases, the virus is already spreading like wildfire within a community as we have seen in so many cases where just a week delay in locking down caused astronomic surges in cases and deaths later on. This is why the only countries which have successfully avoided large numbers of deaths are those that either began lockdowns at the very instance (New Zealand) or which have undertaken mass testing and contact tracing (South Korea, Germany, Iceland, plus a small number of others), ensuring that single cases can be effectively isolated.
The problem of course, both strategies involve costs that most countries have been unwilling to undertake. In the first case, because early lockdowns have been seen as “overreactions” and widely opposed by businesses. For example, the objection by Confindustria, an Italian industrial lobby group, to lockdowns is now widely seen as having been one of the reasons why my northern Italian cities like Bergamo waited too long, with disastrous results. In the second case, because not every government has felt that the expense of contact tracing is worth it, even though billions if not trillions are later spent on the economic costs of the inevitable lockdowns once cases surge. The short-termist mentality of so many governments (particularly those with right-wing leaders) has been the perfect breeding ground for this virus which seems designed to make them pay dearly for these kind of mistakes. A good example is Boris Johnson’s Britain, which despite having the tremendous luck in seeing its outbreak later than the rest of Europe is now in line to have its highest number of deaths.
In terms of lethality, the novel coronavirus is very much a Goldilocks type: lethal enough to swamp a healthcare system, not lethal enough to scare the living daylights out of everyone. The sight of Florida beaches swamped with spring breakers, or Britons packing pubs on the last night they were open would have not happened if this virus had the lethality of SARS or MERS or if it could be dismissed as harmless from such high levels of asymptomatic infection, particularly among the young. American right-wing protesters demanding the economy be reopened would not be out of the streets either. Because of its low lethality and its lack of visually gruesome symptoms, the virus is perfectly designed to dupe the millions of willingly misinformed idiots of the internet age, people who are more likely to get their information from memes, blogs, and other fake news outlets. The fact that people can still claim that the coronavirus is a “hoax” is testament to just how detached it is from our visual and physical experience, except in the case of those who have experienced it firsthand.
The low lethality also makes governments doubt whether strict measures like lockdowns are necessary at first. Make no mistake, if this virus had a demonstrable 1-in-3 mortality rate along with its existing R0 of 2-2.5, most countries would have locked down once the very first case in their territory appeared, or even beforehand. A disease like that would not just be a global public health crisis but a near-extinction level event; but ironically, one which would have had a higher probability of being stopped early on because governments would have taken it seriously from the start. Instead we waited too long, the dithering and hesitation piling up until it became too late. The result will certainly not be the killer disease we all feared (barring some highly unlikely mutation to a more lethal form), but one which will result in one of the most economically costly disasters in human history, comparable only to a world war or global depression.
Another element that exacerbates the virus’ cost is that it is also extremely expensive to treat. For critically ill patients, equipment like mechanical ventilators and dialysis machines are needed to give them any hope of survival (even then it’s about 50-50) and patients usually end up two weeks or more hooked up to these devices. Even an Ebola patient requires less complicated machinery for an infinitely deadlier disease. If disease progression was quicker, there would also be a quicker turnaround in patients recovering or dying and new patients coming in, but it’s not hard to see how even the best staffed and well-equipped hospital will quickly get swamped with hospital stays averaging 3-4 weeks for critically ill patients. An average large urban hospital has no more than 30 ICU beds which means that just five additional patients a day requiring ICU will fill capacity in less than a week. In a tragic case of the sunk cost fallacy, the less governments are willing to accept losses, the more they mount.
The perfect economic wrecking ball
As you can see, the novel coronavirus may not be the perfect killer. But it is frightening in the way it is so perfectly fine tuned to cause economic chaos. For those thinking that such fine tuning implies human design, I’m afraid to disappoint your biowarfare conspirational tendencies: it is virtually impossible that anyone could have seen the way the pandemic played out and thus fine tune it so well. Nevertheless it is a perfect disease for our age. A disease meant to take advantage of globalized movement, capitalist short-termism, and plutocratic resistance to lockdowns. Had it been more deadly or less likely to transmit asymptomatically, we wouldn’t have hesitated. Had it been more gruesome, we would have been frightened into action.
Make no mistake. We will beat it. The death count will probably not run into the tens of millions. No large healthcare system has collapsed nor will collapse and the disease is mercifully sparing most of the poorest countries on earth (most likely because there is less travel to them). But the economic consequences may well leave the West with another lost decade of progress and prosperity, and will leave capitalism with yet another blight on its already sordid record. We are therefore left to wonder what kind of world we want, knowing that a return to normal won’t be enough.