Niall Ferguson is the Milbank Family senior fellow at the Hoover Institution, Stanford
When I was 11 years old, I was scarred for life by the BBC. It was 1975 and the TV show was called Survivors.
The title sequence began with a masked Chinese scientist dropping a glass flask. It smashes. We then see him boarding a plane to Moscow, where he starts to feel unwell. Suddenly, an arm falls lifeless across the screen. We see passport stamps for Berlin, Singapore, New York, and finally London. And then a ghastly red stain spreads across the screen.
The genius of the series was that it was set in middle-class England, however, that England was spiralling back to the 14th century; for the Chinese scientist’s flask contained a bacterium even more deadly than Yersinia pestis, which is now generally recognized to have caused the Black Death.
The Black Death – mainly bubonic plague but also the even more lethal pneumonic variant – killed between 75 million and 200 million people as it spread eastwards across Eurasia in the 1340s. The disease was transmitted by flea bites; the fleas travelled by rodent. Up to 60 per cent of the population of Europe perished. Survivors imagined an even worse plague – originating, like the Black Death, in China.
I have long believed that, even with all the subsequent advances of medicine, we are far more vulnerable to a similar pandemic than to, say, climate change. So you won’t be surprised to hear that I have been tracking obsessively the progress of the Wuhan coronavirus, ever since the Chinese authorities belatedly admitted that it can be passed from human to human.
I have seen a few rash commentators playing down the danger. But it is much too early to conclude, with Marc Siegel in the Los Angeles Times, that the coronavirus “does not currently pose a threat [outside China] and may well never do so.”
We don’t know enough yet to say how bad this will be. Among the things we don’t know for sure are the virus’s reproduction number (R0) – the number of infections produced by each host – and its mortality rate, or the number of deaths per 100 cases. Early estimates by the World Health Organization suggest an R0 of between 1.4 and 2.5 – lower than the measles (12-18), but higher than SARS (0.5). According to Johns Hopkins University, by Saturday there were 12,024 confirmed cases and 259 deaths, for a mortality rate of 2.2 per cent. But these numbers are likely to be underestimates.
The volume of air travel in China has ballooned since SARS. China’s 100 busiest airports last year handled 1.2 billion passengers, up from 170 million back then. Wuhan’s Tianhe airport was almost as busy last year as Hong Kong’s was in 2002. Disastrously, this outbreak came not long before the Lunar New Year holiday – the peak travel season – and the regional and/or national authorities were slow to acknowledge how contagious the virus was.
At the time of writing, a total of 164 cases have been confirmed in 26 countries other than China, including seven in the United States, four in Canada and two in the U.K.n other words, we are now dealing with an epidemic in the world’s most populous country, which has a significant chance of becoming a global pandemic.
But how big a chance? How big a pandemic? And how lethal? The bad news, as Joseph Norman, Yaneer Bar-Yam and Nassim Nicholas Taleb argue in a new paper for the New England Complex Systems Institute, is that the answers lie in the realm of “asymmetric uncertainty” because pandemics have so-called “fat-tailed” (as opposed to normal or “bell-curve”) distributions, especially with global connectivity at an all-time high.
Researchers define the severity of pandemics using “standardized mortality units” (SMUs), where one SMU equals a mortality rate of 0.01 per cent or 770,000 deaths worldwide. A “moderate” global pandemic is defined as causing less than 10 SMU; a “severe” pandemic is above 10 SMU. Yet the average excess mortality of a moderate pandemic is 2.5 SMU, compared with 58 SMU for a severe pandemic. In other words, the mortality rate in a severe pandemic would be about 20 times larger, for a death toll of 44.7 million.
Thanks to the BBC, I have been paranoid about pandemics for more than 40 years. Nevertheless, the challenge is still to resist that strange fatalism that leads most of us not to cancel our travel plans and not to wear uncomfortable masks, even when a dangerous virus is spreading exponentially. Time to watch Survivors again. At home.