Coronavirus is a Big Deal

Isaac Stoner
4 min readJan 31, 2020

2020–01–31

This is not the end of the world

The new 2019-nCoV virus, which was first reported in China at the end of 2019, will not wipe out humanity. This coronavirus, one of many, first appeared in Wuhan at the beginning of December. A few weeks of delays by city-level Chinese bureaucrats enabled it to spread undetected; by the time it was formally reported, it had likely already infected hundreds of patients who were not yet symptomatic.

The delay in reporting this outbreak would seem suspicious. But in China, where control of information is paramount, it’s hardly surprising. The common narrative, that this virus jumped to humans through an illegal wildlife market, is believable. However, other theories point to the BSL-4 virology research center in the heart of Wuhan. If 2019-nCoV originated there, it’s unlikely anyone wants to bring attention to this fact. The harsh Chinese judicial system discourages individuals from taking responsibility for unfortunate accidents.

Early signs suggest that this virus kills the very old, very young, and those with pre-existing pulmonary or cardiovascular issues. The mortality rate looks to be in line with seasonal influenza. This is unlikely to be an outbreak like the 1918 Spanish Flu outbreak, which killed between 3 and 5 percent of the global population, or Ebola with a 50% mortality rate. Coincidentally, Spanish Influenza may have also started in a wildlife market in China.

It will kill millions anyway.

Pundits point to 2019-nCoV as being “no more dangerous than the flu” in order to downplay the risk of a pandemic. But the emergence of a novel virus on-par with influenza is a really big deal. Seasonal influenza kills around 500,000 people globally each year, even with a partially effective vaccine available. If 2019-nCoV escapes the unprecedented quarantine efforts in China and beyond, we will not get rid of it anytime soon. Due to asymptomatic transmission and a lengthy incubation period, this is likely to be a virus that stays with us for decades or centuries, slowly mutating around each new vaccine attempt and spitting off new more virulent strains. If this is the case, it will claim millions of lives in coming years.

There is no effective vaccine for coronavirus. In fact, modern medicine has a pretty pathetic arsenal of antivirals in general! Current clinical trials are focused on using existing vaccines or antiviral medicines to treat 2019-nCoV; drug and vaccine development just takes too damn long to impact the spread of this thing.

Also, developing vaccines for pandemics tends to be bad business. By the time a novel medicine is ready for human testing (12–18 months at minimum), this outbreak will have burned itself down to a controllable level. The only company to develop a (likely effective) vaccine for the last Ebola virus outbreak is no longer in business. There are a lot of parallels to developing antibiotics for resistant superbugs; it’s hard to make money from a product you hope to never use.

Worst case scenario

In the worst case, 2019-nCoV will get out of China and spread broadly around the globe. If the infectiousness, R0, is sufficiently high, the virus will sicken hundreds of millions, maybe billions. With appropriate palliative care and monitoring, the mortality rate for 2019-nCoV is low. If our already-overburdened healthcare systems are overwhelmed, the death toll will spike. In the developing world, this virus could be a massacre. Those who get sick early, while hospitals still have capacity and medical personnel are still showing up to work, will be better off.

The political correctness and lack of resolve from the WHO, who dithered and delayed for weeks, has made this worst case scenario far more likely.

This is the worst case scenario model…and the current trajectory for 2019-nCoV. We could see 1 million deaths by the end of February.

Nationalism and Global GDP

We are living in strange times. The UK just Brexit-ed the European Union, with a strong protectionist movement outvoting a young educated minority. Across the pond, Trump is making nationalism great again, and we have been embroiled in lengthy trade and cultural wars with China, Mexico, and others. Slogans that encourage us to close borders and keep “Britain British” or “America American” are promoting a special brand of dog-whistle racism. Ironically, these disturbing nationalist and anti-immigrant trends may be helping to contain 2019-nCoV. One of Trump’s flunkies just went on the record about how 2019-nCoV will be good for American competitiveness and repatriating American jobs, never mind the many many Chinese people who will die.

No, sir, it will not.

We live in a complex global marketplace in which many interconnected supply chains begin or end in China. China’s economy will take a major hit due to the outbreak. Quarantines, shuttered businesses, travel bans…it will take many months to return to business as usual and will set their economy back years. On top of the loss of life, 2019-nCoV will send a ripple effect through the global economy. My own company, here in the Boston-area, has already been negatively impacted.

Pay attention, question everything, make a plan

Even without Ebola-level mortality rates, this is scary. Follow the progression in your home country. Don’t believe what your government tells you, nor the numbers coming from the media (Chinese or otherwise). Stock food and water and be prepared to take care of yourself for a little while if this gets out of hand. Pray for China, and pray that China is able to contain the virus. A “new flu” is no small thing.

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Isaac Stoner

Dreamer, thinker, loudmouth. Founder, Octagon Therapeutics, adventurer.