Manchuria 1910-1911: North-East China’s End of Empire Frontier Plague

International Relations, Medical history, Political geography, Public health,, Regional History

In 1910 the 265 year-old Qing Dynasty in China was fasting approaching its denouement. The following year it would be deposed and replaced with a republic. Over the years leading up to this point, Imperial China had been in long drawn-out decline, suffering a series of reversals – a disastrous defeat in the (1st) Sino-Japanese War (1894-95) and ensuing loss of territorial sovereignty in Manchuria; the crushing of the Peking Boxer Rebellion in 1900. In 1907 China had been beset by the latest (and one of the worst) of a series of famines (“Third Plague Pandemic”), losing an estimated 25 million of it’s population. And in late 1910, Manchuria in the midst of a tense political situation—China having to share the region with competing Russian and Japanese aspirations—a plague broke out.

FDA0880F-AA83-4106-9454-5939A414DD1AThe plague was first noticed in the Inner Mongolian town of Manzhouli on the Chinese-Russian border, where Russian doctors began treating patients with fever and haemoptysis symptoms. Thus began the Great Manchurian Plague which eventually took up to 60,000 lives in less than six months – with a mortality rate very close to 100 per cent [William C Summers, The Great Manchurian Plague: The Geopolitics of an Epidemic Disease, (2012)].

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Vector from the rodent family
Because of a past pattern of bubonic plague in China, rats and fleas were initially suspected to be the source of human infection.  50,000 rats were examined but the results proved negative [CHERNIN, ELI. “Richard Pearson Strong and the Manchurian Epidemic of Pneumonic Plague, 1910–1911.” Journal of the History of Medicine and Allied Sciences, vol. 44, no. 3, 1989, pp. 296–319. JSTOR, www.jstor.org/stable/24633015. Accessed 5 May 2020]. The disease was eventually traced to the Siberian marmot (Marmota sibirica) or tarbagan, found in Inner Mongolia, eastern Siberia and Heilongjiang. Later research by Dr Wu (see below) and others established that the plague, like the present coronavirus, was pneumonic, transmitted animal to human by respiratory droplets, and not bubonic.

A roaring trade in fake mink
The European fashion for mink and ermine furs can be ‘fingered’ for being at the bottom of the preconditions leading to the 1910 plague. Mink’s popularity as one of the most prized materials for clothing accessories made it’s cost prohibitive to all but the richest Europeans. Things changed when it was discovered that the fur of the marmot when dyed passed very convincingly for mink fur. After the pelt price for marmot fur soared from 12 cents to 72 cents a hide, hordes of Chinese hunters from the central provinces swarmed into the region to join the lucrative hunt for the now in-demand creature. Mongol and Buryat hunters, long experienced in marmot-hunting knew how to select only tarbagan marmots which were not diseased for culling. The inexperienced Chinese trappers however didn’t practice safe hunting methods, failing to discern the difference, they hunted marmots indiscriminately. Thus, the infection was passed on to humans from the pelts of the disease-ridden rodents (Chernin; ‘Manchurian Plague 1910-11’, (Summers; Iain Meiklejohn), Disasterhistory.org, (April 2020), www.disasterhistory.org].

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Spreading the plague by rail
Manchuria at the time was equipped with an extensive network of railroads, thanks to the vested interests of the Russians and the Japanese which the Qing Dynasty had, reluctantly, conceded. Russia controlled the Trans-Siberian Railway (TSR) and the China Eastern Railway (CER), Japan controlled the Southern Manchurian Railway (SMR). The time of the year was an important factor. From November/December, as the weather turned arctic-like, the Chinese hunters and agricultural migrant workers started to return to their home regions. The foremost consideration was to get back before the Chinese New Year. The hunters and the labourers, huddled together infecting each other  in the bitter cold of the train carriages, carried the plague along the railway lines. In a short time the plague travelled from its origin point to large cities on the Dongbei line, Harbin, including the central district of Fuchiatien (Fujiandian), Changchun and Mukden (today Shenyang). Compare this to what happened with the coronavirus outbreak which spread from Wuhan to other Chinese cities by airplane.

5EC44B3F-9EA7-477C-8AE9-C2BFEEE17955In the disease’s wake mortality proceeded at an alarming rate, Harbin in the far north was the initial epicentre. In November 5,272 died in the city. It then spread along the tracks to cities further south, Mukden recorded a death toll of 2,571 by January 1911, and Changchun was losing over 200 a day to the plague (Meiklejohn). The plague was sustained and promoted by the prevailing conditions it encountered – dense population, high human mobility and poor hygiene environments (Cornelia Knab, cited in Meiklejohn). Eventually the plague reached Peking and as far as central China.

Enter Dr Wu
The authorities, in desperation, turned to a migrant, Penang-born doctor working at the time in Tianjin, Wu Lien-Teh. Cambridge-educated Wu took immediate charge of the medical emergency in Harbin. Enforcing a strict quarantine in the city, Wu put in place a series of comprehensive measures to contain the disease, including:

● converting railway freight cars to makeshift quarantine centres and turning a bathing establishment into a plague hospital

● establishing “sanitary zones” in the city

● closing down the railways in Manchuria, impose blockades, border controls and so stop infected people from travelling (Wu needed to secure the co-operation of the Russian and Japanese rail companies to achieve this)

● burning the lodgings of those infected

● monitoring the population by checking households for new cases

● advocating the wearing of face masks (Wu had more effective masks with extra gauze padding made)

● carrying out mass cremations of the infected dead (considered a sacrilege in Chinese society, Wu had to petition the emperor for permission)

● undertaking post-mortem examinations of the victims (again, a Chinese taboo that Wu had to overcome objections to)✲

Temperature check, Fuchiatien 
(www.Flickr.com)

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With no vaccine for pneumatic plague available, Wu’s quarantine measures involved isolating people for a five to ten day period, if no symptoms present, they are released with a wire band attached to their wrist signifying they have been cleared of the disease [‘In 1911, another epidemic swept through China. That time, the world came together’, (Paul French), CNN, 19-Apr-2020, www.cnn.com; ‘The Chinese Doctor Who Beat the Plague’, (Jeremiah Jenne), China Channel, 20-Dec-2018, www.chinachannel.org].

 

 Old plague hospital, Harbin. When the epidemic was suppressed, the hospital was burnt down to eliminate any residual risk of contamination  

 

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(Photowww.avezink.livejournal.com)

Keeping the ports plague-free
The concerted efforts of Japanese, Russian and Chinese managed to prevent the epidemic from reaching the eastern seaboard. Several towns close to the major port city Dalian reported cases, but Dalian itself (by this time under Japanese control, known as Dairen), initially undertook mass inspections of train and ship passengers, before closing the South Manchurian line altogether. With such strictures in place Dalian was wholly spared from the plague (French).  The Russians were able to similarly stem the outbreak’s movement along the CER rail line and stop it from reaching Russia’s vital Pacific port, Vladivostok.

Racing against catastrophe
What added even more pressure to Wu’s task in trying to control the plague was that he was working against a tight deadline. The plague needed to be contained before 30th January which was Chinese New Year’s Eve. Thousands of migrant workers would be returning home to their families for this most important annual celebrations in China via the Manchurian railway network, which Wu knew would make it almost impossible to rein in the outbreak. The conscientious and thorough measures implemented in northern China made it possible for Wu to be able to declare the epidemic virtually suppressed by the end of January. Decisive action in N.E. China also prevented the plague from spreading to near-by (Outer) Mongolia and Russian Siberia. By March all the region’s shops, factories and schools were reopened and the only lingering infection was confined within the specially established plague hospitals (Meiklejohn).

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Endnote: Dr Wu 
Many Chinese medical personnel including epidemiologists and other physicians contributed to preventing the plague spreading throughout China, and to suppressing it all together within a short period. But if anyone should be called a hero of the Great Manchurian Plague of 1910-11, certainly that mantle should land on Dr Wu Lien-Teh, whose decisive leadership, organisation and enterprise saved China’s North-East provinces from a much higher casualty toll and from the regional plague developing into a nationwide epidemic.

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 China for it’s part controlled the Imperial Railways of North China, which linked Peking with Mukden
 one case was recorded in Shanghai, 2,000 miles away
 thousands of bodies were still above ground in coffins because the relatives were waiting for the spring thaw to bury the dead…ideal incubators for the plague bacillus to magnify the contamination [‘Dr Wu Lien-Teh, plague fighter and father of the Chinese public health system’, (Zhongliang Ma & Yanli Li), www.ncbi.nim.nih.gov; Jenne)
✲ Wu performed the first autopsy in Harbin, identifying the disease as the bacterium Yersinia pestis of the pneumonic variant [‘Wu Lieh-Teh: Malaysia’s little-known plague virus fighter’, Star Online, 11-Feb-2020, www.msn.com]

Not Missing the Human Touch: Robots Stepping Up in the Time of COVID-19

Medical history, Public health,, Science and society

 

Intelligent design, AI, artificial humanoids, bionic life, androids, cyborgs, have all moved outside of the cloistered environment of the lab and the science fiction genre and are all embracing the day-to-day functions of human existence. Well, perhaps not all of these products of imagination and creativity – but with the restrictions placed on human communication in the all–enveloping cloud of the coronavirus crisis, automatons are the new “white knights” coming to the rescue (or relief) of humans.

The sudden emergence of the pandemic has propelled Medtech companies into the war on COVID-19. Drones as well as robots are being enlisted in the fight, taking the load off medical professionals and health care systems. Delivery robots are used as a way of circumventing the danger of human-to-human contagion. UVD robots are employed to kill viruses and bacteria in rooms to avoid the need for human involvement [‘Robots And Drones Are Now Used To Fight COVID-19’, (Bernard Marr), Forbes, 18-Mar-2020, www.forbes.com].

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‘Xenex’ Germ-zapping robots (CBS News)

As healthcare experts and governments search for the optimum strategy to contain and suppress the coronavirus outbreak, other intelligent humans are finding new applications and roles for intelligent non-humans in the health emergency crisis. It starts, appropriately enough for a public health disaster, at the medical coal face, in the ICU wards where doctors and nurses have been overwhelmed, physically and emotionally, with the skyrocketing workload of coronavirus-affected patients. In Lombardy in northern Italy, one of the first hotspots of the pandemic outside of China, six robot nurses have been fast-tracked into hospital service in Varese where they help lighten the human nurses’ face-to-face load and reduce their risk of personal infection. The robots man the wards, monitor the medical equipment and communicate remotely with doctors. Similarly in India, at a hospital in Chennai, ‘Zafi’ the robot does the rounds, transporting food and medicine to virus patients to lessen the risk to hospital medical staff [‘Tommy the robot nurse helps keep Italian doctors safe from coronavirus’, (Flavio LoScalzo), Reuters, 02-Apr-2020, www.reuters.com].

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Pepper the robot  (Photo: Reuters)

Japan is using humanoid robots as reception staff at hotels to greet patients with mild coronavirus symptoms. Robots like ‘Pepper’ at Kyogoku in Tokyo greet arriving patients and instruct them how to check-in while reassuring them with warm and positive messages [‘Pepper the robot set to greet COVID-19 patients checking in Tokyo hotels’, Hindustan Times, 01-May-2020, www.hidustantimes.com].

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With the need for pristine clean surfaces in public spaces to prevent the spread of the virus outbreak, a number of countries now employ robots as cleaners. At Hong Kong International Airport autonomous cleaning robots known as “Intelligent Sterilisation Robots” use UV light and air sterilisers to routinely clean and disinfect key operational areas of the airport [‘Clean me up, Scotty: Hong Kong airport debuts cleaning robots, disinfection booth in fight against COVID-19’, Coconuts, 30-Apr-2020, www.msn.com].

Such medical uses of robots have been replicated across a range of countries hit by the pandemic. With people confined to their homes under quarantine orders and required to maintain a distance of at least 150 cm from other humans, robots on wheels are being increasingly used to deliver products to them, or to deliver food to overworked NHS workers (Britain).

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(Photo: www.uk.news.yahoo.com)

Singapore has brought into service a robot with the decidedly unsexy name of “O-R3”, whose job it is to patrol the city’s parks and monitor the behaviour of joggers. This ever vigilant robot spots transgressors and warns them about the need to practice social distancing in public [‘Robot in Singapore tells joggers to stay home’, SBS, 28-Apr-2020, www.sbs.com.au]. Joggers and walkers in Singapore need to ultra-alert around the parks as the city has a second social distancing-monitor robot, Boston-built Spot the robotic dog (Robocop?)…if O-R3 doesn’t nap the violators, Spot (below) might.

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(Photo: CNA)

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Tunisia’s ‘Robocop’ looks more like a military style armoured vehicle  
(Photo: AFP)

Tunisian authorities have had a similar idea to curtail the incidence of virus infection in the capital Tunis. The police have been using a robot (a ‘Robocop’) who ‘walks’ the city beats, stopping and questioning people who it suspects should not be on the streets during lockdown. The Robocop asks people to produce their IDs which can be scanned by the robot’s in-built computer [‘Coronavirus: Tunisia deploys police robot on lockdown patrol’, (Rana Jawad), BBC News, (03-Apr-2020), www.bbcnews.com].

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Robot Cop (Source: The Hindu)

Chennai Police (southern India) are on the same wavelength as Tunis’, deploying it’s new “Robot Cop LD v5.0” equipped with a two-way intercom to surveil citizens in coronavirus hotspots in the city during containment. The Robot Cop is un-humanoid in appearance and has been described as “an oversized box on wheels” [‘Chennai Police Deploys “Robot Cop” in COVID-19 Hotspot’, (Kishalaya Kundu), Beebom, 01-May-2020, www.beebom.com].

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(Photo: BBT University)

Robotic engineers in Japan have produced avatar robots who can stand in for university graduands in virtual graduation ceremonies. BBT University in Tokyo uses ‘newme’ robots dressed in black graduation gowns and caps with mobile screens showing the student’s face attached to a motherboard. The robot proxies line up to be officially presented with a testamur by the university president while the actual graduate watches via Zoom from a safe distance at home [‘BBT University in Japan has graduates attend ceremonies via robots in light of Covid-19’, (Guan Zhen Tan), Mothership, 02-Apr-2020, www.mothership.sg].

The National Health Emergency ‘Tyranny’: The Lockdown Through Libertarian Eyes

Medical history, National politics, Politics, Society & Culture

The majority of countries where coronavirus infection rates have experienced an upward curve have resorted to locking down the community to varying degrees. In the USA, more than elsewhere, this has tested the faith of those of a libertarian disposition. In recent weeks we have seen the mega-massive jolt to the economy and enforced closures of businesses resulting in millions of workers finding themselves in the dole queues. Many libertarians, albeit with reluctance, accept the inevitability of the present state intervention as the only means available of providing the fiscal stimulus to keep people and businesses afloat.

8B2670AB-5F2C-43D3-A075-CE2FDBE664E5Its when it comes to the matter of mandatory quarantine as a counter-virus measure, that the issue becomes more thorny for libertarians. The classic libertarian position would see voluntary self-isolation as the ideal solution in an ideal (ie, libertarian) world… compulsory quarantine is the last resort to them. Some of a libertarian mind would reject it outright – on ideological grounds, while also claiming it to be an ineffective measure as a social curative. Others accept it as a legitimate move given the uniqueness of the Covid-19 crisis situation, but with a very clear rider that the measures taken need to be temporary only. As shown below, this aspect of  libertarianism is a “hot-button” issue currently for many in the US with skin in the game [‘What libertarians would do in response to coronavirus’, (Bonnie Kristian), The Week, 13-Mar-2020, www.theweek.com]. 

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Gadsden flag: associated with libertarianism & the American Tea Party

Social distancing as an imposed, mandated practice during the pandemic, fails the libertarian test. The pure libertarian much prefers to see voluntary compliance by the individual, in the expectation (or hope) that most people will ultimately do the right thing [‘Libertarianism and the Coronavirus Pandemic’, (Andy Craig), Cato Institute, 25-Mar-2020, www.cato.com]. Accordingly, a small minority of  US states (five?) have not enforced the distancing and stay-at-home edicts, their leaders pledging to hold fast to the “sacred liberties” of their citizenries. But most everywhere else the pandemic has hit, certainly in urban areas, the civil authorities have gone for some form of lockdown.

Escape from Lockdown 13
For the average “Joe and Joanna Citizen” in Main Street, Anywheresville, being locked down inside four walls indefinitely is one of the hardest things to cop. For most people “cabin fever” will inevitably set in…confined at home, unable to congregate and socialise in cafes, eateries and bars with friends and colleagues or do road trips. In First World societies such as the US, Western Europe or the Commonwealth of Nations, freedom of movement is such an inherently natural expectation, once deprived, resistance to these rigid controls can reach a tipping point which easily spills over into increasingly bold attempts to subvert or defy the government’s edicts. Recently we have witnessed this perhaps at its apogee in the Midwest and Southern states of the US. Protest groups, the new scofflaws of Trumpian America, have mushroomed in particular in “rust-belt” states such as Michigan, Ohio, Indiana, Pennsylvania and West Virginia.

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(Photo: AP Photo/Paul Sancya)

As the lockdowns extend from weeks into months bunches of pro-Republican conservatives have more and more blatantly violated the stay-at-home orders of mostly Democratic governors (in contrast serving GOP governors like South Dakota’s Kristi Noem, continue to play the libertarian card, steadfastly refusing to implement a stay-at-home order regardless of virus outbreaks within the state). For the protesters, egged on by the schizophrenic tweets of President Trump, a call to “Liberate Michigan” (Virginia, etc) and amplified by the Fox press, one prime target of their vitriol has been Michigan governor Gretchen Whitmer who has mandated a strict ”stay home, stay safe” executive order to counteract the virus. This month organised gatherings of protesters have assembled outside the Capitol building and the governor’s home, flaunting the restrictions and demonstrating their displeasure at Whitmer’s policies. Some of the dissenters have been armed with AR-15s and AK-47s, very few wearing face masks but brandishing Confederate and Gadsden flags and even Nazi emblems (loosely equating the state “governor/tyrant” with Nazis). Some protesters have held up signs such as “The cure is worse than the virus” (which, if you have watched the president’s coronavirus press briefings ‘sideshow’, has a faintly familiar ring to it).

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(Photo: REUTERS/Alyson McClaran)

This orchestrated “Operation Gridlock”, in Michigan and elsewhere, is organised by a conservative patriot/militia group with connexions to Trump’s education secretary, Betsy DeVos. One of its objectives (successful) was to grind city centre traffic down to a standstill, including the blocking of ambulances conveying patients. Protesters in various states have also tried to intimidate health workers engaged in the frontline of the fight against the pandemic. So far Whitmer has remained resolute in maintaining  a strict state lockdown, pointing to the gravity of the state’s health predicament (Michigan has had 37,778 confirmed cases and 3,315 deaths due to coronavirus, as at 27-April-2020) [‘Conservative group linked to DeVos family organises protest of coronavirus restrictions in Michigan’, (Igor Derbyshire), Salon, 16-Apr-2020, www.salon.com; ‘Trump Supporters Are Staging Armed Protests to Stick it to Coronavirus’, (Caleb Ecarma), Vanity Fair, 16-Apr-2020, www.vanityfair.com].

🔻 Gov. Whitmer (Photo: U.S. News & World)

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What’s motivating the scofflaw behaviour?
Researchers at the University of Maryland have concluded that “quarantine fatigue” has set in. Increasing numbers of fed-up or plain bored Americans are venturing outside of “the box” in defiance of state stay-at-home orders. Many of these are exercising, or as the weather gets warmer, going to the beach (most of the escapees are doing these things without bothering to practice safe distancing) [‘Quarantine fatigue is setting in: Smartphone data shows thousands are fed up after weeks under lockdown’, (Ralph R Ortega), Daily Mail, 27-Apr-2020, www.dailymail.com].

The inalienable right to be ‘selective’ 
The gatherings of those discontented with the status quo in America have exercised their right to protest against their state’s political leaders. Interestingly, their decision to protest on this occasion, as has been noted, does not signify their endorsement of the right to protest per se – a perfectly admirable and consistent libertarian trait. Previously when sectors of the Left in America took to protesting issues such as climate change and police brutality, these Right-wing elements were vigorously supporting the conservative politicians’ endeavours to bring in legislation to outlaw protests [’The hypocrisy of the anti-lockdown protests’, (Anthony L Fisher), Business Insider Australia, 22-Apr-2020, www.businessinsider.com.au]. 

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🔺The ‘tyranny’ avengers
(Photo: Nikolaus Kama/AFP via Getty Images)

These insurrectionists and those who facilitate and encourage them, argue that they are motivated, nay compelled, by the (temporary) loss of their basic liberties… evoking the First Amendment and the Founding Fathers, they portray Whitmer and other governors as tyrants, preventing their right to come and go as they wish, to work and leisure untrammelled. Thus, it comes back to that same nub at the core of libertarian values, the right to do as one pleases — (with the rider)…so long as it doesn’t harm anyone else. This added qualifier is fundamental to the credo of libertarian theory.

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“Inviolable freedom”…so long as it doesn’t harm harm anyone else
The casualty toll of the Covid-19 health crisis in the US—the worse in the world by far—is rapidly overtaking that of the total of American lives lost in the ten-years of the Vietnam War. Disproportionally, the pandemic everywhere is killing the older and the most vulnerable, people with co-morbidities. Coronavirus, the epidemiologists have shown us, is transmitted from a human host to a human recipient, the more people interacting with each other, the more likelihood of transmission, the greater the incidence of morbidity and mortality from the virus, simple as that!

An unavoidable trade-off
The temporary suspension of liberties is the price to pay to preserve lives. Yes, the measures are inconveniences and hardships on individuals, but they’ve been imposed on the population for a health safety reason – the greater good of the community and the health of all. Yes, the libertarians have some grounds to quibble, a few of the measures taken have been over-the-top and seem disproportionate. Even Gov. Whitmer, a rising Democrat star on the national political scene, has at times pulled the wrong rein (eg, barring people from purchasing garden equipment and baby restrainers for cars seems to be over-zealous)  [‘Quarantine Protesters Are No Heroes of Civil Disobedience’, (Jonah Goldberg), National Review, 22-Apr-2020, www.nationalreview.com].

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🔺 Colorado protesters visualising a totalitarian pivot by their governor?
(Photo: AP)

FN: Heat in the kitchen
Democrat governors in “swing states” like Gov. Whitmer—caught in a pincer of intimidatory Scofflaw defiance, demands from business to re-open and constant sniping from a divisive chief executive at 1600 Pennsylvania Ave—are not the only ones feeling the mounting pressure of the moment. Florida’s GOP governor, Ron DeSantis, has copped plenty of flak himself. He was very late in issuing stay-at-home orders, having rejected calls to close Florida’s crowded beaches, citing the libertarian manta of free choice. When the lockdown finally came, church services got a “go free” card from the restrictions. Consequently, the state’s coronavirus ‘scorecard’ is now 32,138 confirmed cases and 1,088 deaths (27-April-2020). The current virus “hot spots” in Florida don’t augur well for a lifting of it’s restrictions any time soon. On top of this gloomy prognosis, Florida, being a ‘bellwether’ state, Trump will be expecting DeSantis to deliver it to the Republicans in the November elections [‘Anti-quarantine protests, Trump pressure on governors on political tightrope over coronavirus’, (Deidre Shesgreen & Maureen Groppe), USA Today, 23-Apr-2020, www.amp.usatoday.com].

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the protests have by no means been confined to these states – such happenings have been increasingly the done thing from Pennsylvania to Nebraska to California. Nor have lockdown protests been confined to America, ‘Berlin police anti-lockdown protestors accusing Angela Merkel of “banning life”’, SBS News, 25-Apr-2020, www.sbsnews.com.au
the same kind of pro-Trump people that Hillary Clinton (unwisely) labelled a “basket of deplorables” in the 2016 presidential campaign
”schizophrenic” because at the same time the president at his daily podium is officially asking Americans to adhere to the prescribed Covid-19 safety measures
there’s obviously other underlying factors in the tendency towards civil disobedience in Midwestern states and perhaps more so in the South – greater religiosity (and associated with that) scepticism towards scientific evidence and government experts, and even the “Siamese twins” attachment of many Americans to car culture (especially in suburbia and rural regions), ‘The American South has resisted social distancing measures — and we’re all going to pay the price’, Raw Story, 03-Apr-2020, www.rawstory.com

Behind the Coronavirus Counts, How well do the Numbers Stack up?

International Relations, Media & Communications, Medical history, Natural Environment, Politics, Public health,

Every day we are reminded of the global reach of the novel coronavirus crisis. We know it’s a pandemic because WHO and other health agencies publish data showing that 211 countries and territories have been affected by the disease. The international media coverage tends to focus largely on the unenviable “big five” chart-toppers who have been most affected – the US, Italy, Spain, France and the UK. A number of sites publish constantly updated lists of the growing toll of Covid-19 casualties, a sort of sombre “score card” listing all the countries who have recorded instances of the disease.

Confirmed Coronavirus Cases: Globally tracked, country-by-country – as @ 23-Apr-2020

Country Total casesTotal deaths Region
USA850,00047,700Americas
Italy 188,00025,500Western Europe
Spain 208,50021,750Western Europe
France 160,00021,500Western Europe
UK134,00018,300Western Europe
Sources: WHO http://covid19.who.int/;
http://worldometers.info/

When we scroll through the world tables of where the pandemic has landed, it’s instructive to look at the comparative totals by continent – Europe has a bit over 1.28 million confirmed cases recorded, and the Americas, 995,510 (predominantly from the US), compare these to South-East Asia, a bit more than 38,572 and Africa, a mere 18,234 cases✺✺.

(Source: www.vietnamcredit.com.vn)

From a statistical standpoint we might wonder if the published data gives a true impression of the extent of of the pandemic? It needs to be kept in mind that the numbers we have are those that have been reported to the World Health Organisation. Population differences aside, it is clear that the low numbers in South-East Asia and Africa (examples: Cambodia 122 cases, zero fatalities✺✺, Myanmar 139 cases, five fatalities✺✺, Ghana 1,279 cases, 10 fatalities✺✺, Ethiopia 117 cases, three fatalities✺✺) mask the full impact of the catastrophe. They are a product of limited testing by countries in these regions … widespread poverty, surplus populations, lack of resources and infrastructure mitigate against the capacity to take corrective, safety monitoring measures.

(Photo: www.theborneopost.com)

Limited testing capacity and weak surveillance
The small numbers of recorded cases and handful of reported deaths in Africa and S.E. Asia (the Caribbean is another such case in point) can engender a false security and justify a lack of action by such already economically and health-challenged countries, thus the risk of infections spreading is magnified. In the early phases of the outbreak some S.E. Asian states were slow to acknowledge the risks…even as late as mid-March, Myanmar’s government was still attributing it’s low number of cases to the superior “lifestyle and diet” of the locals. The fight against Covid-19 by Third World countries is further retarded by a failure to test widely and in the numbers necessitated by the crisis. It shouldn’t be overlooked that some of these countries have quite repressive regimes that don’t rank the goal of a universal healthcare system as their highest priority [‘Experts Doubt Low Coronavirus Counts of Some Southeast Asian Countries’, (Zsombor Peter), VOA, 29-Mar-2020, www.voanews.com].

(Photo: www.upnews.info.com)

For the bulk of African countries the story is similar. A by-product of their lack of development is that their health systems are fragile before the onset of coronavirus hits them. Awareness of the inability to cope with a full-blown health crisis, had led some leaders to advocate so-called “miracle cures” for the virus (eg, Madagascar’s president’s championing of untested traditional plant remedies). Nigeria (Africa’s largest nation by population)  shows only 981 confirmed cases and 31 deaths✺✺ to date but is looking as vulnerable as anyone in Africa. Oil exports are the hub of Nigeria’s economy and the fall of the world’s crude oil price to a record low will hamstrung the country’s efforts to contain any future eruptions of the disease [‘Coronavirus: How drop in oil price affects Nigeria’s economy’, (Michael Eboh), Vanguard, 17-Mar-2020, www.vanguardngr.com]. The outbreak of pandemic hotspots in Nigeria could be devastating, especially in the north, given the country’s population of nearly 200 million people and it’s inadequate healthcare capacity.

(Photo: www.newswirenow.com)

Too good to be …
Some countries have reported being lightly or relatively lightly touched by the onslaught of the coronavirus, these results have surprised outside observers. One such country that raises eyebrows in this respect is Russia. The republic has 146 million people and shares long borders with China, yet it fesses up to having had only 68,622 cases✺✺ (well under half of that of the UK) and suffered only a comparatively low 615 deaths✺✺ from the epidemic (most of those since the start of April). If you cast aside the anomalies, on paper it’s an excellent result! But whether Soviet or post-Soviet, there’s always an air of suspicious doubt about Russian information. The Russian Bear has had form in the past with cover-ups…a prime example—the Soviet Union throwing a tarpaulin over the Chernobyl nuclear disaster in the 1980s —indicative of a less than honest response to major disasters [‘The Very Low Number of Russia’s Reported COVID-19 Cases Raises Questions of a Cover-Up’, (Rick Moran), PJ Media, 22-Mar-2020, www.pjmedia.com].

Image: www.asianews.it

Russia, if it so erred, is not “Robinson Crusoe” in deliberately underreporting the pandemic’s effect. China for nearly three months from the initial outbreak didn’t include asymptomatic patients in the official stats, and only rectified this oversight on April Fools Day [‘China acknowledges underreporting coronavirus cases in official count’, (Mark Moore), New York Post, 01-Apr-2001, www.nypost.com]. For six weeks after WHO declared a global health emergency Indonesia did not report a single Covid-19 case (unlike most of it’s S.E. Asian neighbours). Considering the republic’s population size (more than 270 million) and it’s close links with China, this aroused widespread suspicion of underreporting and criticism in a Harvard University study which seemed to belatedly jolt Indonesia into disclosure. The first notification by Djakarta of coronavirus cases occurred on 2nd March, and from then on Indonesia’s curve has been on an upward trajectory – currently 8,211 cases, 689 deaths✺✺ [‘Why are there no reported cases of coronavirus in Indonesia?’, (Randy Mulyanto & Febriana Firdaus), Aljazeera, 18-Feb-2020, www.aljazeera.com].


Doubting a hermetically-sealed “Hermit Kingdom”
North-East Asia’s renegade, secretive state, North Korea, can be added to the list of countries purporting to be Covid-19–free. Pyongyang‘s official line has been met with disbelief from several external sources such as South Korea and Radio Free Europe which asserts that disclosures from within North Korean military circles confirm the occurrence of coronavirus cases in the border areas [‘What Is the Coronavirus Doing to North Korea’, (Nicholas Eberstadt), New York Times, 22-Apr-2020, www.nytimes.com]

Addendum: (Coronavirus as at 0130 hrs EAT time, 25-April-2020)
USA 890,200 cases | 50,403 deaths
Italy 189,973 cases | 25,549 deaths
Spain 219,764 cases  | 22,524 deaths
France 158,183 cases | 21,856 deaths
UK 143,464 cases | 19,506 deaths

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✺✺ figures as at 0130 hrs EAT time, 25-Apr-2020
just over the last week the African continent experienced a sudden surge in infections, ‘Africa’s 43% jump in virus cases in 1 week worries experts’, (Gerard Zim Rae), ABC News, 23-Apr-2020, www.abcnews.go.com
although Russia did close its eastern border with China after the virus breakout