A Sickening Need for Trustworthy Reporting

We've written at length about the longstanding tendency of American media to lean left and bemoaned the now well-known fact that they're totally in the tank for woke liberals.  As poll after poll has shown, nobody trusts the media anymore, and rightly so.

Yet, all the quotes from our Founders extolling the existential virtues of a free press, so beloved of huffily bloviating "journalists," are not actually fake news.  They were real then, and they're true today.  A free and honest press is, indeed, something that any free nation really ought to have.

In fact, we are living in a time right now where it would be extraordinarily helpful to have trustworthy media.  As of February 1, 2019, The Guardian reported 12,000 confirmed cases worldwide of the coronavirus that's been capturing the world's fevered imagination, and that 213 Chinese have died.  Both numbers are presumably growing grow by the hour: the Wall Street Journal reported on January 31 that there had been more than 200 fatalities and that the number of cases was approaching 10,000.

The rapid spread of this new plague from Wuhan, China to the rest of the world provides a vivid illustration of the wisdom of our Founders, when Thomas Jefferson said such things as "The only security of all is in a free press" - and also, "The press is impotent when it abandons itself to falsehood."

Let's Look at the Record

There are two important numbers about any disease: morbidity, the rate of disease in a population; and mortality, a measure of the number of deaths in a given population.

The difference between these two numbers is the difference between a pandemic, bad luck, and an annoyance.  The common cold has a high morbidity in New England in that a major fraction of the population gets a cold at one point or another during the winter, but nobody panics because nobody dies - the mortality is close to zero.  In contrast, tetanus has a high mortality and kills almost everyone who gets it, but the morbidity is low, as it is quite rare.

The WSJ tries to put the coronavirus in perspective by discussing what's happening in our American flu season, which thus far has been without the new virus:

The Centers for Disease Control and Prevention estimates that, so far this winter, at least 140,000 in the U.S. have been hospitalized with seasonal influenza, with at least 8,200 fatalities. And this has been a fairly mild flu season.  [emphasis added]

The US Census Bureau estimates the US population at 329.45 million as of August, 2019.  The morbidity of our seasonal influenza is 0.04% - only .04% of our population has suffered flu this year.  The mortality is 0.002%, which represents a minute risk to any individual who doesn't engage in high-risk behavior such as nursing flu patients.

The percentage of people who get a disease who die from it is also interesting.  In our case, 5.8% of the people who are known to have had the flu died from it.  That's somewhat nervous-making, but compared to the 70% of patients who died in the recent Ebola epidemic it's no big deal.

Note that the CDC report used weasel words "at least."  This makes sense - people who get a mild case of any flu are wise not to go anywhere near a hospital where the finest germs in town hang out.  We have no idea how many Americans got the flu without telling anybody in officialdom, and presumably next to none of them ended up dying from it.

Death counts are probably more accurate, but the CDC could easily have missed deaths of old people in nursing homes who were already ailing when flu pushed them over the edge.  Many of our friends got the flu; none went to a hospital where the CDC could count them, so the percentage of flu patients who die is really a lot lower than 5.8%.  To that point, the South China Morning Post published a comparison table showing that our 2019-2020 flu infected 13 million and killed 10,000 for a fatality rate of 0.07%.  They're guessing that only 1% of the people who got the flu went to a hospital.

Their table showed 17,387 coronavirus cases with 362 deaths for a fatality rate of 2.1%.  That's a tiny sample compared to our 13 million flu cases, and the number will get more precise over time.  Their table also shows 10% fatalites for the Sars virus of a few years ago, which would put Sars at 5 times worse than the new virus if the current numbers turn out to be accurate.  In case you've forgotten, the world didn't end from Sars.

To Panic or Not to Panic?

Compare the Guardian's figure of 12,000 infected and 200 dead as the coronavirus spreads in China.  The population of China was estimated at 1.386 billion in 2017, call it 1.4 to simplify the math.  That would make morbidity .0008% because 12,000 is such a small fraction of the population.  There's no point in calculating the mortality because 200 is such a tiny fraction of 1.4 billion.

If we look at death rates, 200 dying out of 10,000 is 2%.  This agrees with the SCMP estimate of 2.1% which is 1/3 the percentage of hospitalized patients killed by our flu.  On that scale, coronavirus isn't worth thinking about.

But are these numbers correct?  First, our seasonal flu is spread the length and breadth of our land by our custom of sending college kids home for both Thanksgiving and Christmas in airplanes whose air circulation systems couldn't spread airborne diseases between passengers any more contagiously if they had been designed specifically for that purpose.  That means it's already been pretty much everywhere it's going to get - unlike a new disease from the other side of the world.

Secondly, we're far enough past our Christmas break to have had many cycles of infection and re-infection.  The CDC's number is based on enough flu exposure to be meaningful.  Coronavirus was recognized officially just over a month ago, so there hasn't been enough time for the statistics to settle down.

To Freak or Not To Freak?

Should we panic about the corona virus?  The Sun reports that panicked Chinese are throwing pets out of skyscrapers because of rumors that dogs and cats can spread the virus, and quotes Chinese sources to the effect that the authorities are cremating victims in secret to keep the official body count down.  The South China Morning Post tells us that Hong Kong hospital workers have threatened to close the hospitals unless the border between Hong Kong and the mainland is sealed.  That's right, they too want to Build a Wall!

Members of the Hospital Authority Employees Alliance, a newly formed group that emerged from the anti-government protest movement, voted 3,123-10 on Saturday to take industrial action in phases over five days.

Why are they freaking out when the "official" mortality figures are so low?  Put simply, they have good reasons not to believe what they're being told.

For two weeks, from January 5 to 16, the city [Wuhan] reported virtually no new cases, while hundreds of officials gathered in Wuhan, the provincial capital, for Hubei's two biggest political meetings of the year. It was only after a medical team dispatched by the National Health Commission went to investigate on January 19 that the severity of the situation became public. ...

Thousands of people flooded Wuhan's hospitals, which pleaded for donations of masks, disinfectant and medical supplies as overworked doctors and nurses grappled with the crowds. ...

Wuhan's mayor, Zhou Xianwang, defended his actions in an unusually tough interview with state broadcaster CCTV on Monday, offering to step down over his decision to close the city - not because of any delays in reporting the epidemic. He said the city government was slow to disclose information about the virus due to national regulations.

"As a local government official, I could disclose information only after being authorized," Zhou said. "A lot of people didn't understand this."  [emphasis added]

Hong Kong residents aren't controlled nearly as tightly as mainlanders and have been publishing their own estimates.

As many as 75,815 people in Wuhan may have been infected with the new coronavirus, according to a study by University of Hong Kong scientists.

Their research, published in The Lancet on Saturday, is based on the assumption that each infected person could have passed the virus on to 2.68 others. The estimated total was as of Tuesday, it said.

This brings up R0, pronounced R-naught, the number of persons whom one sick person will infect.  It's a vital number for estimating how widely and how fast any disease will spread, particularly if the disease has a long incubation period during which someone can infect others without showing any symptoms.  For comparison, R0 for measles, for which we have a great deal more data, is between 12 and 18.

The common cold, which is caused by a rhinovirus, has an R0 of about 6, but that's an average.  Actual results in any group are affected by environmental conditions such as crowding, use of mass transit, weather, previous exposure to similar viruses, and many other factors.  Hong Kong medical people know that they live in one of the most overcrowded places on earth.  Whatever R0 might be in Wuhan, it will almost certainly be higher if the virus gets loose in Hong Kong.

Although the virus has been detected in all of mainland China's 31 provinces, municipalities, and autonomous regions, the disease hasn't had nearly as much time to spread as our seasonal flu.  Given the lack of data, R0 and incubation period estimates could be off in either direction.

Estimation is made more difficult because we don't really know all the ways the virus spreads.  People wear masks because we think the virus multiplies in the lungs and spreads through sneezing or coughing.  It's also being said that it's mostly spread by hands, so masks wouldn't do much good.

Livemint, an Indian newspaper, reports that the virus has been detected in the feces of the first American patient.  This suggests that the virus multiplies in the digestive system as well as in the lungs.  The Chinese haven't said anything about patients having diarrhea which would suggest a digestive infection path, but their medical people are so overwhelmed that they could easily have overlooked digestive issues.  If it spreads by touching contaminated surfaces, hand washing would be more effective than wearing masks, or both might be needed.  Who knows?  We can't all wear bunny suits all day.

Chinese Know They're Being Lied To

When the citizens of Wuhan demanded that their mayor resign for lying about the virus, his defense was that he couldn't tell the truth without permission from On High.  In this one case, we have every reason to believe that he was telling the truth, and his listening constituents had even more reason to believe him - his replacement, if any, would be under the same restrictions if he wished to keep his job and his head.

The fact is, nobody we can talk to - not the ordinary voter, not the mayor, not anybody outside the country, and probably not many people outside the very highest ranks of the Chinese Communist Party - knows the spin the Chinese government wants to put on whatever facts they may have.  Only afterwords can the truth be derived, and sometimes not even then.

To be fair, it's extremely hard to predict what a new virus will do, particularly in the early stages.  The WSJ reminds us of the 1976 swine flu fiasco where the government urged millions to be vaccinated:

Inaction is the bane of all politicians, but a wait-and-see approach is often the most prudent medical course to take. Sure enough, when three elderly people died after receiving flu vaccinations at one clinic, the backlash was so severe that Walter Cronkite tried to reassure the public about vaccinations on his evening news show. In the end, not one person died from swine flu, but thousands claimed ill effects from the vaccine, a number of judgments were won in lawsuits against the government and the director of the Centers for Disease Control (as it was then called) was forced to resign.

Shortly after the NIH declared that a nurse named Nina Pham who contracted Ebola from a patient in Dallas had been rendered free from the virus and "poses no public health threat," it was found that the Ebola virus can persist in the testes and in the eyeball for years after a person is "cured."  It's difficult to detect the virus when it lodges in the eyeball unless the victim starts to go blind, to say the least, and inspecting the insides of testes whose owners want to use them again is even less convenient.

To Jab or Not To Jab?

As we learned in 1976, anti-vaxers have a germ of a point.  Are some people harmed by vaccination?  Of course.  This is an indisputable truth, and when anti-vaxers put forward horror stories of awful and needless deaths, they aren't making them up - they are very much real.

What makes them wrong on the whole, however, is the fact that the percentage of people harmed by a vaccine is usually far smaller than the percentage of people who, unvaccinated, would die from the disease the vaccine fights.  The problem is that, even though fewer people die in a vaccinated world than an unvaccinated one, it's different individual people.

When Dr. Salk's polio vaccine was first being tested, some parents pulled strings to get their kids into the program - including those of your humble correspondent, thus possibly allowing you to be reading this article today - even though they knew that the vaccine could cause children to get polio who might not have gotten it without being vaccinated.  Being well educated as well as well-connected, they knew enough about probability to know that an unvaccinated child's chances of getting polio were far greater than a vaccinated child.  Their acquaintance with polio was vivid enough for them to opt for the lesser probability of calamity.

If your child is killed or harmed by a vaccine though - and yes, this does truly happen, even today - do you care that the odds were only 1 in a million?  Of course not, and people who do not understand relative probabilities kick up a fuss.

Medical uncertainties make vaccination fraught, particularly when news media have lost so much trust.  Walter Cronkite was considered to be highly trustworthy in his day.  His assurance about overall vaccination safety had an effect, but there's no news source with comparable stature anywhere in the world today.

Other Voices

The initial Wuhan cover-up unraveled spectacularly, leaving the Chinese public having no faith whatsoever in official pronouncements about the disease.  Rumors about hasty cremations suggest that the death toll is higher than officially admitted, and a shortage of labs which can test for the virus suggests that there are more cases than currently known.

The LA Times doesn't think we should keep people from traveling to and from China:

But what the WHO is cheering [stopping travel] is both ineffective and dangerous. The virus has already spread. Barricading Wuhan, a city larger than New York City, is very unlikely to prevent further spread of the virus. Current efforts by other nations to ban travel to and from China or to shutdown trade routes - which the WHO advises against - will likely take a large global economic toll but also will not contain the virus.

The Times forgets that when you're in a hole, the first step is to stop digging.  Of course the virus will spread further in America than it has, particularly if the time during which people can infect others without having symptoms is longer than we think - "Typhoid Mary" spread typhoid fever for years despite having no visible symptoms.  But as of right now, airlines and airport passport checkers know who recently arrived from Wuhan or anywhere in China, and we can track them all if we have to.

These viruses change rapidly, though - that's why we have brand-new flu strains every year.  People can have "flu" more than once if there are multiple strains floating around.  The best place for the virus to mutate is in crowded Wuhan.  The virus may not mutate to a stronger strain, but if it does, the last thing we want is for the upgraded version to get here.

Not only that, R0 is an average.  Some diseases have "super-spreaders" who are far more infectious than average.  There's already a hint of a super-spreader, in that 14 Wuhan hospital workers became ill from one patient.

Not all diseases get super-spreaders like Typhoid Mary, but the more people have the virus, the more likely that a super-spreader will emerge.  Most of the cases are in China, so that's the most likely source of super-spreading, so it's just common sense to try to keep any of them from personally spreading their way here.

Forbes made essentially the same point as the Times, and we disagree with them on the same grounds.

The New York Post published "Why Americans don't need to panic over the coronavirus," the most balanced article we've seen.

"Do not let fear or panic decide your actions," a Centers for Disease Control official urged Friday. Those are words of wisdom Americans would do well to remember now that Health and Human Services Secretary Alex Azar has declared coronavirus a public health emergency in the United States.

The CDC issued its first quarantine order in 50 years, ordering all passengers returning to the country on an evacuation flight from Wuhan, China, to stay put for 14 days. Then Azar announced all Americans returning from Hubei province will be subject to quarantine.  [emphasis added] ...

Most important, Americans have reason to trust officials like Azar when he says, "The risk to the American public remains low at this time, and we are working to keep this risk low."

That action makes total sense.  Mr. Obama was lucky that Ebola didn't spread further in America when he didn't block travel.  Ebola seems to spread by touch.  The coronavirus may or may not spread that way, but we know it spreads in the air which makes it more contageous than Ebola, particularly in airplanes.  We favor the travel ban, given what we think we know so far.

We Aren't Alone

We aren't the only ones who value credibility in helping people make sensible decisions.  We don't usually agree with conclusions published in Foreign Affairs, but we've found them to be pretty reliable on basic facts.  In this case, they're spot on:

Public trust is essential to controlling an epidemic, for a simple reason: trust will determine whether the public listens to what authorities advise, such as suspending social gatherings, getting diagnosed quickly, seeking care at certain locations, and agreeing to be isolated while contagious. To such ends, confidence in government action and advice will be crucial.  [emphasis added]

Boy, are they right!  Not only must governments be honest, their commands must make sense.

Several of the SCMP articles cited above tell us that Chinese authorities plan to forcibly convey people who might have the virus to isolation areas instead of quarantining them in place.  Knowing that a cough could be ordinary flu, will sick people be eager to go to isolation areas where they will come into contact with people who do have it?  Or will they hide?  On a positive note, no big shot will want to harvest an organ from a coronavirus patient even after they're supposedly cured.

Known Lies

Lest we think our media are more honest than Chinese media, remember how our MSM treated Mr. Bush's response to Hurricane Katrina which flooded New Orleans:

... the federal disaster response to Katrina was amazing. Huge numbers of personnel and vast quantities of supplies poured into the stricken area in an incredibly short time. The incompetence came from - shocker - the Democrat leadership locally, but the media hung it around George W. Bush's gentlemanly neck. And because he was too gentlemanly to cry "Bull Schiff!," most everyone thinks what was a logistical miracle was a clusterfark.

The media is aching, yearning, begging for the chance to do the same thing to [Mr.] Trump.

Enough Americans have lost confidence that government officials or our media will tell them the truth that they're as inclined to panic as Hong Kong medical personnel are.

And really, that's the only choice on offer.  If we had trustworthy information, we could sensibly gage what the appropriate response might be: check people for fevers who're getting off flights from there?  Quarantine them a week or two?  Or three?  Build a wall and stop anyone trying to cross, as is reportedly occurring in some neighborhoods around Wuhan?

Six months from now, those paranoid citizens will either look like antisocial loons... or they may be the only ones left alive.  Who knows?  We can't, and they can't, because they don't trust what they're being told.

So the only real alternatives are to keep on living life as normal, or to take the most extreme measures as the only sensible precaution possible.  In effect, everybody has just one tool, the panic button, and one choice - press it, or not.  Given the little we know now, we agree with the Post which said:

We're pretty confident that the American public is good with this overreaction - even though there really is no reason to panic. You're far more likely to die from the regular flu - which has already claimed 10,000 lives in the United States this season.

Better information allows for a more finely-graded response.  But the Chinese know that they haven't got any worthwhile information - and, really, we don't either.

It would be really helpful if we had media and officials we could trust.  Pity we don't!