Coronavirus is a deadly wake-up call, writes historian DOMINIC SANDBROOK

One day, long after the worst of the coronavirus pandemic is behind us, historians may see the last few days as the moment when the world tumbled into the abyss.

On Thursday, the head of the World Health Organisation declared that mankind stood at a ‘decisive point’.

The world faced ‘a crisis, an epidemic that is coming,’ agreed France’s President Emmanuel Macron. ‘We know that we’re only at the beginning.’

He was right. Only a few hours after those words flashed around the world, stock markets began to crumble.

We pride ourselves on our supremacy over the natural world and our mastery of science. But as the last week has shown, our modernity has made us weaker than ever, writes Dominic Sandbrook (pictured are women wearing face masks in Milan)

By the end of play on Thursday, Wall Street’s Dow Jones index had suffered its greatest losses in history. 

And when Asian and European markets opened yesterday morning, share prices immediately began to plunge. Not since the financial crisis of 2008 has the outlook been bleaker.

But this, I fear, is in a different league altogether. As President Macron said, we are only at the beginning. And when you read about contingency plans for mass burials here in Britain — or about a potential nationwide death toll of at least 400,000 — it is hard not to feel a chill of foreboding.

Perhaps you think that sounds alarmist. If so, listen to the Chief Medical Officer, Professor Chris Whitty.

The coronavirus, he told health experts two days ago, now poses a major ‘problem for society’. Britain could face serious disruption ‘for quite a long period’. And to defeat it, we may have to pay a heavy ‘social cost’. His words came just hours before the first British coronavirus death was announced yesterday.

When I heard Professor Whitty’s words, my mind went back 36 years. I was nine years old, and I had just caught a glimpse of my parents’ copy of the new Radio Times. The cover showed a man in a tattered traffic warden uniform, his face half-masked by a bandage. He was carrying what looked like a submachine gun.

By the end of play on Thursday, Wall Street’s Dow Jones index had suffered its greatest losses in history (pictured traders at the opening bell on Friday)

By the end of play on Thursday, Wall Street’s Dow Jones index had suffered its greatest losses in history (pictured traders at the opening bell on Friday)

The image haunted me for days. Only later did I discover it was promoting the terrifying BBC drama series Threads, which depicted life in Britain during and after a nuclear war.

I have often thought of Threads since the coronavirus epidemic started. Of course the disease is not remotely comparable to the shock of a nuclear apocalypse, not least since the mortality rate appears to be relatively low.

Even so, how many people can honestly say that, in the dead of night, they have never stared up into the darkness, worrying about the future?

All too often, cocooned in the complacency of daily life, we forget that we are only a step or two from disaster.

A war, a nuclear accident, a natural catastrophe or, yes, a killer virus, and everything could change in an instant.

Indeed, the words with which Threads opens are even more telling now than they were back in 1984, when we lived in the shadow of nuclear Armageddon.

‘In an urban society,’ says a narrator, ‘everything connects. Each person’s needs are fed by the skills of many others. Our lives are woven together in a fabric. But the connections that make society strong also make it vulnerable.’

More than three decades on, those words have a chillingly prophetic ring.

Every day has brought a chilling new development, with more than 84,000 people infected across the planet by last night. It feels like the stuff of some terrifying apocalyptic blockbuster (professionals are seen disinfecting a subway station in South Korea)

Every day has brought a chilling new development, with more than 84,000 people infected across the planet by last night. It feels like the stuff of some terrifying apocalyptic blockbuster (professionals are seen disinfecting a subway station in South Korea)

Free trade, cheaper flights, globalisation and digital technology have brought us closer together than ever.

We live in an age of unparalleled sophistication, freedom and comfort. We pride ourselves on our supremacy over the natural world and our mastery of science.

But as the last week has shown, our very modernity has made us weaker than ever.

Only a few weeks after the first cases were reported in the Chinese city of Wuhan, the coronavirus has become a genuinely global scourge. Every day has brought a chilling new development, with more than 84,000 people infected across the planet by last night.

One moment you are reading about towns shut down in Northern Italy, or foreign pilgrims being turned away from Saudi Arabia.

The next, you hear that a primary school in Buxton has closed its doors, and that the Cabinet Office has contacted local authorities about ‘Excess Death Contingency Planning’, including possible sites for mass burials.

It feels like the stuff of some terrifying apocalyptic blockbuster. Yet in some corners of the world, such stories are nothing new.

A woman wearing a face mask on a bus in London, where the UK's 20th case is being treated

A woman wearing a face mask on a bus in London, where the UK’s 20th case is being treated

The UK's 20th coronavirus patient has been confirmed, marking the first case to have caught the infection on British soil. He came from Surrey

The UK’s 20th coronavirus patient has been confirmed, marking the first case to have caught the infection on British soil 

The Sars (Severe Acute Respiratory Syndrome) virus outbreak killed 774 people in China in 2002 and 2003.

Mers (Middle East Respiratory Syndrome) killed 525 people between 2012 and 2015, most of them in Saudi Arabia.

And Ebola killed more than 11,000 people in West Africa between 2013 and 2016.

It was easy for us to ignore these stories. After all, they seemed so far away, so remote from our everyday lives. Yet as anyone familiar with history will know, our sense of security was always an illusion.

You can easily tell the story of the past two thousand years, not as a saga of kings and battles, but as a succession of devastating pandemics.

By far the most infamous is the Black Death. Just like the coronavirus, it spread along global trade routes, the contagion seeping unstoppably across the map.

The coronavirus outbreak has devastated markets around the world with London, Frankfurt, Tokyo and Hong Kong all hit hard overnight on Thursday and on Friday morning

The coronavirus outbreak has devastated markets around the world with London, Frankfurt, Tokyo and Hong Kong all hit hard overnight on Thursday and on Friday morning

Health personnel check the temperatures of a guest leaving the H10 Costa Adeje Palace hotel in La Caleta, Tenerife today. British guests at the hotel were still in lockdown as of Friday

Health personnel check the temperatures of a guest leaving the H10 Costa Adeje Palace hotel in La Caleta, Tenerife today. British guests at the hotel were still in lockdown as of Friday

Although historians still argue about the details, it probably reached our shores in June 1348, when a merchant ship docked in Melcombe Regis, Dorset. Among its crew were a group of Gascon sailors who had fallen ill and had to be carried ashore.

On inspection, their bodies were found to be covered with black blotches, boils and ulcers under the arms and in the groin.

Within a few days the Gascons were dead. They had only just been buried when other sailors began to cough up blood.

And when they began dying, too, Melcombe folk began to worry. But it was too late. On Midsummer Eve, the first Melcombe patients died. The Black Death had claimed its first English victims. Even now, centuries later, it is a genuinely terrifying story. Like the coronavirus, the plague almost certainly originated in the world’s most populous country, China, and travelled across the world’s trading networks into Europe.

There was no cure. In Italy, recorded the poet Boccaccio, people ‘dropped dead in the open streets, both by day and by night’. As the graveyards filled up, the survivors dug deep trenches, in which corpses were piled ‘tier upon tier like ships’ cargo’. Today, when the Black Death has become the stuff of textbooks and exam papers, we have lost sight of what this actually meant.

SCHOOLS IN THE UK COULD BE CLOSED FOR TWO MONTHS TO CONTAIN THE KILLER CORONAVIRUS 

Emergency plans are being drawn up by health officials to contain the coronavirus, which could see schools closed for at least two months.

England’s chief medical officer Professor Chris Whitty revealed an unprecedented ban on large public gatherings could be required to fight a global pandemic.

The most extreme measure could be to mirror the decision to shut Japan’s entire school system, which will close from Monday for a month until April. 

A shutdown would see millions of parents, including key workers such as surgeons, nurses and paramedics, forced to stay at home to care for their children.

Professor Whitty admitted it is ‘just a matter of time’ until coronavirus spreads more widely and quicker through the UK.

The fightback could include ‘reducing mass gatherings and school closures’, with Premier League matches either under threat or played behind closed doors.

The London Marathon and the Grand National in April could also be at risk because of the large number of spectators.

And this summer’s Euro 2020 tournament, which is being played in cities across the continent including London, Glasgow and Rome is under review.

Theatre performances, gigs and music festivals such as Glastonbury could also be banned or pared back if the UK fails to get a grip on the crisis. 

In Europe as a whole, about a third of the population died. In London, roughly every second person died. In places such as Italy and the south of France, the death rate may have been as high as 80 per cent.

It is tempting, of course, to dismiss this as the kind of thing that happened during the dim and distant Middle Ages.

But we are deluding ourselves if we think modern medicine is an inviolable safeguard against the ravages of nature.

Modern medicine, after all, did nothing to protect our more recent forebears from the horrors of the ‘Spanish flu’ after World War I. (Incidentally, historians now think it began in Kansas, but because some of the first reports came from Spain, the Hispanic label has stuck.)

Again, the figures defy imagination. One in three people worldwide was infected, and the death toll came to somewhere between 50 million and 100 million, more than both world wars combined.

On current figures, the coronavirus is nowhere near as lethal — as long as it does not mutate, that is. Experts believe the mortality rate is between one and two per cent, although the WHO cautions that it is not known yet.

Even so, its repercussions could well be devastating, not merely for affected families, but for our economy, our politics and our entire way of life.

Just consider, for example, the economic impact so far, only a few weeks into what may prove a very long and deadly crisis.

Stock markets have just had their worst week for more than a decade. Oil prices have plunged by more than 10 per cent.

The epidemic in Lombardy seems almost certain to tip Italy’s economy into recession. Above all, China’s growth seems likely to fall by as much as half this year.

According to some experts, this would make life impossible for some of its major banks, which have taken on massive debts in the last few years. Even apparently trivial details tell the story. Coca-Cola has warned that stocks of Diet Coke may run dry, because the virus has disrupted supplies of its raw sweeteners.

And as the Mail reported, not only are dentists running out of surgical masks, but there is a shortage of wedding dresses in the UK and clothes manufacturers are running short of zips, which are largely produced in China.

Some of these may seem like little things. But little things add up; and in any case, some consequences may not be so little.

Even sober economists are now talking of a shock greater than the financial crisis of 2008. That could well send the entire world economy into recession, with unfathomable political repercussions.

The last downturn, after all, gave us austerity, Brexit and Donald Trump.

Throw millions of deaths into the mix — as well as massive social dislocation and authoritarian restrictions — and the consequences could be toxic indeed.

Contrary to what is often thought, pandemics do not bring people together. Human nature being as it is, people tend to lash out. They look for somebody to blame, from the political elite to vulnerable minorities.

People are seen leaving the Costa Adeje Palace hotel in La Caleta in Tenerife on Friday

People are seen leaving the Costa Adeje Palace hotel in La Caleta in Tenerife on Friday

During the Black Death, for example, there was a marked spike in attacks on beggars, pilgrims and gypsies.

Jews, in particular, were suspected of causing the plague by poisoning wells — precisely the kind of vicious conspiracy theory that you can imagine spreading on Twitter and Facebook today. From Toulon and Barcelona to Basel and Cologne, Jewish families were attacked and murdered.

In Strasbourg, some 2,000 Jews were burned alive in one of medieval Europe’s first major pogroms.

In England, meanwhile, the social and economic instability caused by the Black Death provoked the Peasants’ Revolt of 1381, in which Wat Tyler led a mob into London, smashing, looting and burning. Although it was eventually put down, the death toll stretched into the thousands.

Even the flu epidemic of 1918 to 1920 had colossal social consequences. It undoubtedly contributed to the widespread paranoia and instability that followed World War I, shattering faith in the established order and pushing people towards the rival extremes of communism and fascism.

Grim stuff, then. So are there lessons we can learn?

One obvious point is that — while we are rightly urged not to panic — downplaying or censoring the truth is generally a very bad idea.

The first stages of the Spanish flu coincided with the final months of World War I, so newspapers and governments deliberately played it down.

As a result, thousands, perhaps even millions of people, probably died unnecessarily.

There is surely a moral there for secretive, authoritarian societies such as China and Iran. By and large, though, the striking thing is how few lessons we can learn — a depressing thought in itself.

Does quarantine work, for example? Not necessarily. During the flu pandemic, Australia, which had strict quarantine regulations, suffered more losses, proportionally, than New Zealand, which did not.

The truth is that although we can take every possible precaution, viruses will always be with us. Falling ill is part of being human.

Sometimes the obvious lessons are wrong. During the 1918 to 1920 pandemic, New York’s health commissioner refused to close the schools, arguing that children would be easier to monitor and treat if they went to school.

People thought he was mad, but he was right. In New York, there were fewer cases of flu among children, proportionately, than in any other major city.

All this, I know, hardly makes for cheerful weekend reading. So it is worth repeating that, so far, the coronavirus seems to be less deadly than the Spanish flu, and certainly much less deadly than the aptly-named Black Death.

Perhaps, then, the worst will not happen, and society will escape largely unscathed.

Even so, the coronavirus could hardly be a more frightening warning. All too often, we boast that we have conquered disease, extended our lifespan, overcome our limitations and transformed our planet.

But in our hubris, we often forget that to be human is to be weak. We have not mastered nature; we survive only because nature allows us to.

And the more sophisticated our society becomes, the more we weave our webs of connections, the more we depend on machines and computers, the more vulnerable we become.

All it takes is one infinitesimal virus to tug on a thread, and the whole tapestry could unravel in an instant.

WHAT DO WE KNOW ABOUT THE DEADLY CORONAVIRUS IN CHINA?

Someone who is infected with the coronavirus can spread it with just a simple cough or a sneeze, scientists say.

Nearly 3,000 people with the virus are now confirmed to have died and more than 83,000 have been infected. Here’s what we know so far:

What is the coronavirus? 

A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body’s normal functions. Coronaviruses are named after the Latin word ‘corona’, which means crown, because they are encased by a spiked shell which resembles a royal crown.

The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.

Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a ‘sister’ of the SARS illness which hit China in 2002, so has been named after it.

The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019.

Dr Helena Maier, from the Pirbright Institute, said: ‘Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals. 

‘Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses). 

‘Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.’ 

The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.

By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.

The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000.

Just a week after that, there had been more than 800 confirmed cases and those same scientists estimated that some 4,000 – possibly 9,700 – were infected in Wuhan alone. By that point, 26 people had died. 

By January 27, more than 2,800 people were confirmed to have been infected, 81 had died, and estimates of the total number of cases ranged from 100,000 to 350,000 in Wuhan alone.

By January 29, the number of deaths had risen to 132 and cases were in excess of 6,000.  

By February 5, there were more than 24,000 cases and 492 deaths.

By February 11, this had risen to more than 43,000 cases and 1,000 deaths. 

A change in the way cases are confirmed on February 13 – doctors decided to start using lung scans as a formal diagnosis, as well as laboratory tests – caused a spike in the number of cases, to more than 60,000 and to 1,369 deaths.

By February 25, around 80,000 people had been infected and some 2,700 had died. February 25 was the first day in the outbreak when fewer cases were diagnosed within China than in the rest of the world. 

Where does the virus come from?

According to scientists, the virus almost certainly came from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.

The first cases of COVID-19 came from people visiting or working in a live animal market in Wuhan, which has since been closed down for investigation.

Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat. 

A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent identical to a coronavirus they found in bats.

However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.

Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: ‘The discovery definitely places the origin of nCoV in bats in China.

‘We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.’  

So far the fatalities are quite low. Why are health experts so worried about it? 

Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.

It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans’ lungs. It is less deadly than SARS, however, which killed around one in 10 people, compared to approximately one in 50 for COVID-19.

Another reason for concern is that nobody has any immunity to the virus because they’ve never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.

Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: ‘Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.

‘Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we’re talking about a virus where we don’t understand fully the severity spectrum but it’s possible the case fatality rate could be as high as two per cent.’

If the death rate is truly two per cent, that means two out of every 100 patients who get it will die. 

‘My feeling is it’s lower,’ Dr Horby added. ‘We’re probably missing this iceberg of milder cases. But that’s the current circumstance we’re in.

‘Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.’

How does the virus spread?

The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.

It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky. 

Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person.

There is now evidence that it can spread third hand – to someone from a person who caught it from another person.

What does the virus do to you? What are the symptoms?

Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.

If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients will recover from these without any issues, and many will need no medical help at all.

In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.

Figures are showing that young children do not seem to be particularly badly affected by the virus, which they say is peculiar considering their susceptibility to flu, but it is not clear why. 

What have genetic tests revealed about the virus? 

Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world. 

This allows others to study them, develop tests and potentially look into treating the illness they cause.   

Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.

However, the director-general of China’s Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.

This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.   

More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.

How dangerous is the virus?  

The virus has a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.

Experts have been conflicted since the beginning of the outbreak about whether the true number of people who are infected is significantly higher than the official numbers of recorded cases. Some people are expected to have such mild symptoms that they never even realise they are ill unless they’re tested, so only the more serious cases get discovered, making the death toll seem higher than it really is.

However, an investigation into government surveillance in China said it had found no reason to believe this was true.

Dr Bruce Aylward, a World Health Organization official who went on a mission to China, said there was no evidence that figures were only showing the tip of the iceberg, and said recording appeared to be accurate, Stat News reported.

Can the virus be cured? 

The COVID-19 virus cannot be cured and it is proving difficult to contain.

Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.

No vaccine exists for the coronavirus yet and it’s not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.

The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.

Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.

People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.

And airports around the world are putting in place screening measures such as having doctors on-site, taking people’s temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).

However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.

Is this outbreak an epidemic or a pandemic?   

The outbreak is an epidemic, which is when a disease takes hold of one community such as a country or region. 

Although it has spread to dozens of countries, the outbreak is not yet classed as a pandemic, which is defined by the World Health Organization as the ‘worldwide spread of a new disease’.

The head of WHO’s global infectious hazard preparedness, Dr Sylvie Briand, said: ‘Currently we are not in a pandemic. We are at the phase where it is an epidemic with multiple foci, and we try to extinguish the transmission in each of these foci,’ the Guardian reported.

She said that most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.

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