PANDEMIC MONITOR: 20 February 2020
The aggregate number of new confirmed infections per day globally has decreased since a spike on 13 February, when there were over 5,000 new cases globally, and 441 outside of China. However, since then the daily rate of new confirmed infections worldwide has stabilised and gone below the 2,000 mark for the first time since 31 January. Nevertheless, the number of new infections recorded daily outside China has been more mixed, with 157 and 111 new cases on 16 and 17 February, respectively, but barely reaching 10 infections on 18 February. Singapore is one of the countries with the highest number of cases outside of China, and will be a key location to watch in the coming week or two.
Despite the slowing contagion, the World Health Organization (WHO) continues to assess the risk of further spread of the disease as VERY HIGH in China, while the risk of further propagation is deemed HIGH both on the regional and global levels. According to the WHO’s situation report on 17 February, just over half of the confirmed infections outside China have been asymptomatic, which suggests the virus is very likely to continue to spread and will require longer-term monitoring. About 80 per cent of those infected only develop mild symptoms, while fatalities account for around 2 per cent of cases. Conversely, those most at risk of dying are the elderly or people with pre-existing health conditions. According to a study by China Centers for Disease Control, released on 17 February, individuals aged over 80 years of age faced the highest morbidity rate, at 14.8 per cent of cases. The first fatality in France, which was confirmed on 14 February was a Chinese octogenarian who had travelled to Paris from Hubei province, also followed this pattern.
In addition to the first fatality recorded in Europe, Africa has also recorded its first infection this week in Egypt. The Middle East has also experienced its first fatalities. Two elderly people died in the city of Qom in Iran on 19 February after contracting the virus. Following this, Iran confirmed three more cases of COVID-19, including two in Qom and one in Araq on 20 February. As a precautionary measure, authorities have now temporarily closed down schools in the city of Qom. The Iranian health ministry has advised people to limit their movements around Qom, located 140km south of the capital, Tehran.
However, no cases have yet been reported in the rest of Sub-Saharan Africa, although some authorities, particularly those in Madagascar, have toughened and prolonged restrictive measures imposed since the beginning of the year on travel for individuals who have travelled from China over the past 14 days to one month.
Tougher conditions have also been imposed at ports across Sub-Saharan Africa, including in Cameron, Côte d'Ivoire, Kenya, and South Africa. The port of Douala in Cameroon on 13 February announced vessels had to anchor for at least 14 days before being allowed to moor at the port, while port operators at Durban – the largest port in Sub-Saharan Africa – have reported mandatory quarantines for crew manifesting symptoms of COVID-19 while authorities have imposed tougher health controls.
What is coronavirus?
Coronavirus is a pathogen that causes respiratory illness. The virus was first detected in the Chinese city of Wuhan, Hubei province, in December 2019. The vast majority of cases have been reported in China, notably in Hubei province, although the virus has also been detected in more than 20 other countries, and this number is likely to increase in the coming week. Physical severity can range from mild illness to pneumonia, and around one in five cases are thought to be severe. The mortality rate for coronavirus to date is recorded at around 2 per cent.
The most common symptoms of COVID-19 are fever, cough, sore throat, fatigue and shortness of breath. Epidemiologists note that human-to-human transmission generally occurs between people in close proximity (less than 2m), and is believed to spread primarily via respiratory droplets dispersed through coughing or sneezing. The incubation period – the time between exposure to the virus and the onset of symptoms – is thought to be between two and 14 days. Others estimate a median period of three days, with the period ranging between zero and 24 days. There is no specific antiviral treatment available for coronavirus. People with the virus receive supportive care to relieve symptoms, while treatment for severe cases includes care to support vital organ functions.
While a vaccine is unlikely to be developed within the next 6-12 months, Chinese health officials have started using convalescent plasma from patients who have recovered from COVID-19 to treat newly infected patients. The method, which has been trialled on a few patients in Hubei province, has generated positive initial results, and it has also been welcomed by the WHO as a treatment method. It was against this backdrop that Chinese authorities on 17 February called on patients who have recovered from the virus to donate blood so that plasma can be extracted to treat new infected patients.
Meanwhile, scientists continue to trace the outbreak’s origins. Two Chinese scientists have claimed that one of two major animal-testing laboratories in Wuhan could be the source of the outbreak. Other researchers from South China Agricultural University in Guangzhou claim they have identified a coronavirus strain in pangolins that matches that of the COVID-19 to 99 per cent.
There is a growing number of indications this unprecedented attempt to manage a health emergency through extremely high levels of population control, through mass quarantines and travel restrictions, may be succeeding in slowing the spread of the virus, at least within China.
However, the lack of empirically significant, and reliable, data means that uncertainty about the threat of the outbreak and how to treat it will remain elevated for the foreseeable future. And many Sino-critics believe the lack of reliable data is in part due to under-reporting by Chinese authorities, perhaps in an attempt to reduce fears of the virus’ rapid spreadability.
For instance, a team of researchers from Umeå University in Sweden conducted a review of scientific, and determined that the reproduction number (R0) – the average number of new infections that a contaminated individual can spread in a previously unexposed population – of COVID-19 is far higher than current estimates. The estimates had a median of 2.79, an average of 3.28, and a range of 1.4 to 6.49, compared to the WHO’s figure of 1.4-2.5. Based on the review, the researchers assessed that COVID-19 is ‘at least as transmissible as the SARS virus.’ However, the researchers noted that current estimates could be biased due to insufficient data and expect future estimates to range from 2 to 3, roughly aligning with those of the WHO.
The coronavirus outbreak continues to severely hamper economic activity and damaging outlooks in a growing number of sectors. While the implications of travel restrictions and intensified health checks continue to be largely the same for commercial aviation and shipping, other sectors are now also beginning to suffer knock-on effects from the outbreak.
Major car manufacturers in China, including General Motors, Fiat Chrysler, and Toyota Motor Corporation, have resumed, or indicated they would restart, operations at their car assembly plants across the country. But Europe-based companies remain concerned about supply shortages, and have either started scaling down operations, or warned about doing so. What is clear is that the declining economic activity will impact quarterly earnings.
Fiat Chrysler on 14 February, announced it was suspending production at its plant in the Serbian city of Kragujevac, due to shortages of parts, while Jaguar Land Rover warned it could run out of parts within two weeks. Swedish car maker Volvo Cars on 19 February made similar warnings about its plant in Torslanda, while some of its Sweden-based suppliers are also running low on supply, due to fewer imports arriving from China.
By the same token, UK-based excavator manufacturer JCB has started scaling down production and weekly hours that its roughly 4,000 staff are generally required to work.
Since 18 February, there are also growing concerns about supply-chain disruption for electronic consumer goods, particularly of Apple’s iPhone, which is assembled by its contract provider, Foxconn, based in Zhengzhou. The supply-chain issues there are primarily related to workers’ impeded access because of mass quarantines. In line with our warning on 13 February, this could now threaten the launch of new iPhone models in March and September, or at the very least the company’s earnings expectations for the next two quarters if the outbreak is not contained.
In addition, recruitment firms providing short-term labour and support to major car manufacturers and other industries are also likely to face declining revenue in the one to two-month outlook, and there is a growing risk that local markets will experience increased consolidation over the coming year.