Before we start taking drastic measures in response to the #coronavirus, let us ask ourselves: Can we believe the #COVID-19 statistics being reported out of China? 1/53
The People’s Republic of China is pushing the narrative that it has been uniquely successful in combating the #coronavirus. It acted early, and took draconian steps that successfully suppressed (contained) the virus, 2/53 tinyurl.com/rfj5khn
This bought valuable time for other countries to deal effectively with the crisis too (which China notes, they have not done). For this, China and its highly authoritarian government and its supreme leader Xi Jinping, deserve our thanks and admiration. 3/53
Color me skeptical about this Chinese narrative, and allow me to present another narrative. (We will find out soon enough whether this narrative or the one being pushed by the Chinese government is the true one.) 4/53
I begin by noting that there is a puzzling and growing disparity between the experience of other countries and the data and profile of the virus that we have gotten from China (as well as the WHO report on China). For details, see my Medium article 5/53
These disparities suggest that we need to question the reporting about COVID-19 coming out of China, and the claim that the extreme measures taken by the Chinese government, especially in Wuhan, did succeed in containing the epidemic there. 6/53
Beginning about a month ago, China began reporting that the number of new cases had begun to decline (meaning a reproduction rate R0 < 1), and it is now reporting new case numbers on the order of two to three dozen per day. 7/53
A striking fact about these statistics is this: While China is reporting some new cases, it is also claiming that these new cases have entered the country from abroad. 8/53
In other words, it isn’t China’s fault that it is continuing to have to deal with the problem. The only problem for the Chinese government now is how to deal with a pandemic that has emerged due to the failures of *other* countries. 9/53
This narrative is highly suspect because of the authoritarian nature of the Chinese Communist Party (CCP) and its government. (They are one and the same, of course.) 10/53
Everything we know about such governments tells us that they will lie if they have a strong motivation to do so and if they can. And the problem with China is that it can. 11/53
All of the medical officials in the country, even at the regional and local level, are CCP members. This means that the party (which is actually the government) has total control over all the parameters involved in the country’s medical and health sector reporting, 12/53
including how many clinical tests are conducted and what numbers to report about them.
And of course, there is no free (non-governmentally controlled) press in China. 13/53
China, unlike other countries, seems to be reporting hospital cases and discharges almost exclusively, meaning that it is (at best) only reporting laboratory-identified hospital cases, 14/53
putting the Chinese government in a position where it can (for a time, anyway) suppress, manage, or otherwise manipulate its case reporting numbers. 15/53
An interesting case to consider is the large spike in reported cases from China on Feb 12, when under pressure from medical personnel in Wuhan, 16/53 tinyurl.com/rfj5khn
the central government included clinical diagnoses (involving X-rays, for example) for the case number count for Hubei province — though not for the rest of the country, which continued to count only laboratory confirmed (i.e., COVID-tested) cases. 17/53
The laboratory confirmed case numbers are what WHO requires for its reporting and it is the criterion used by Worldometers and other sites for its case counts. 18/53
This makes it *highly* significant that, according to the Worldometers site, *we have virtually no statistics, official or otherwise, about COVID-19 testing in China*.
This alone makes China’s reported case numbers highly suspect. 19/53 tinyurl.com/tftkaep
Since it is likely that China’s lab tests are conducted in hospitals, and that the hospitals are controlled, both in their operations and their reporting by the CCP, and that we do not even know how many lab tests China has conducted, 20/53
we have every reason to question the numbers that the National Health Commission of the Republic of China is reporting in its Daily Briefings. 21/53 tinyurl.com/sva54e2
(Note that these briefings do not give the number of tests the country has conducted.) 22/53
It would be easy for the PRC to hide the true COVID-19 numbers from its own citizens and the rest of the world. One likely method would involve lying, but another would be even easier, and wouldn’t even require that. 23/53
As to the first, the government could hide the true COVID numbers by classifying COVID cases and deaths as influenza cases and deaths. This could easily be done because the common flu strikes China every year, just as it does in other countries. 24/53
The presenting symptoms of both illnesses are very similar, and the cause of death in both is also very similar: secondary, usually bacterial, infections like pneumonia. So this would be an easy place for the PRC to hide the true number of its covid cases. 25/53
(I have been unable to find influenza statistics on China’s National Health Commission website to see if there has been a spike in reported flu cases there.) 26/53
The other way would be even simpler and even less risky: severely restricting COVID-19 testing. This is what Trump was hoping would happen here in the early days, when he hoped to keep the numbers low because of concern about the economic impact of the virus. 27/53
It is also what experts told Business Insider in its article on Feb 19 China must have been doing in Feb, when it first began reporting a decline in case numbers (R0 < 1) and deaths. 28/53
While China could manage or manipulate these numbers for a while, it clearly could not significantly underreport covid cases indefinitely, given how lethal the coronavirus is. 29/53
But to serve its own political purposes (and even survival), the Xi Jinping regime might not have to underreport the numbers indefinitely, because now it is in a position to blame the rest of the world, not itself, for any “resurgence” of the disease within its own borders. 30/53
If all the medical experts are right, it is inevitable that China will start reporting such a “resurgence”, sooner or later, given what we know now about SARS-Cov-2. 31/53
What I am suggesting is that when these higher numbers start getting reported, we cannot assume that they are entirely (or even mostly) due to new cases “imported from overseas” (to use China’s language), 32/53
rather than the types of cases which China should have been reporting all along. 33/53
Note also that if this is what China has been planning to do, it would not take long for its numbers to start looking a lot like those in other countries like the U.S. and those in Western Europe. 34/53
On March 19, China reported 34 new cases, allegedly all “imported from overseas.”
Here is a graph of the exponential growth of cases in the U.S. The U.S. reached 34 officially reported cases on Mar 4. The current total is about 4,530 cases. 35/53 tinyurl.com/sachnme
The thing to watch now is the number of new cases reported by China, and the percentage of these that are reported to have been “imported from overseas,” particularly if these “new” numbers start escalating exponentially. 36/53
Significantly, in the last couple of days, all of the new cases reported by China have been these alleged “imported from overseas” cases: 34 on March 19 and 39 on March 20. 37/53
What is suspect isn’t these numbers themselves. What *is* highly suspect is that there are no new *indigenous* numbers being reported, and that the numbers (34 or 39 new cases in total) are so low. 38/53
My alternative narrative might prove to be wrong, but I think I can safely say this much: the numbers being reported by China cry out for confirmation. 39/53
Compare China’s numbers today with what medical experts are saying about the virus: that it will inevitably infect 50–80% of the global population and become endemic almost everywhere, leading to perhaps 50–100 million deaths worldwide. 40/53
One would naturally expect all of this to be reflected in the numbers from China, given that the virus originated there, and that an estimated 5 million Chinese fled to over a 100 other cities in China before the lockdown in Wuhan and Hubei province. 41/53
Inevitably, large numbers of Chinese have been infected. Indeed, the Daily Briefing for March 20 tells us: “So far, 684,331 people have been identified as having had close contact with infected patients. 8,989 are now under medical observation.” 42/53
It is very, very hard to see how this very large number of case contact numbers — and the true numbers for close contacts, identified or unidentified, in China are likely to be much larger — 43/53
together with the extremely low rates of new cases and death can be reconciled with everything we know about the virulence of this disease: its pathology, lethality, and rate of transmission. 44/53
So we cannot take the numbers we are getting from China at face value, especially because Xi’s regime has a strong motivation to suppress high numbers, at least for a while, in order to stave off political instability and protect China’s international standing. 45/53
I raise these matters not because I want to promote paranoia about China or engage in China bashing. It is just that it is extraordinarily important to be able to believe and properly evaluate the reporting out of China. 46/53
China is the country that has dealt with the virus the longest, and it has taken the most extreme measures of any country to date to defeat it, so we need to know for sure how successful those measures have been. 47/53
There is every reason to doubt that China has succeeded in beating the virus, but if it has, great.
If it hasn’t, then we need to know, not just that it will fail (a resurgence is coming), but whether it has *already* failed. 48/53
We need to know that so that we (along with other countries) can do our own planning, because there are significant pros and cons to all the ways we might respond ourselves. 49/53
Inevitably, questions are going to be raised about the tradeoffs and the wisdom of applying extreme measures to deal with COVID-19 the way China did. Indeed, those questions are already being raised. Here’s an example today from the Twitter feed of Mad Money’s @jimcramer: 50/53
The picture of the virus that we’re getting from the virologists, epidemiologists, and medical experts is that it will probably run its course globally anyway. The most we can do is flatten some of the peaks and reduce peak loads on the health care system. 51/53
If so, then applying extreme measures like the ones China used may be the worst option, resulting in the same overall number of illnesses and deaths (though these would be spread out over a longer time period) while also devastating the economy. 52/53
That, I am suggesting, might be the worst case scenario that Xi Jinping is in right now in China. 53/53
