Viruses & imperialism

The coronavirus pandemic highlights many features of imperialism today. But people often misunderstand what is happening and can easily end up giving a reactionary response.⁽¹⁾ For example, if modern capitalist production methods, especially in agriculture with factory farming, are seen by some to have caused or at least exacerbated this pandemic, how is it that viral outbreaks most commonly start in less developed capitalist countries? Or if, as some ecologists suppose, the pandemic is a sign of ‘nature’ responding to human intrusion, what are we to think of programmes to eliminate mosquito-borne malaria? This article begins with relevant facts about viruses, and then looks at developments in China, the U.S. and the UK.

Appendices to the article discuss the ‘R’ reproduction number for a virus and the report on potential virus deaths that influenced UK government policy. Technical details and sources are given in footnotes.

Viruses

Contrasting with the global mayhem it has caused, a virus can be seen as just a submicroscopic infectious particle. It can replicate itself only within a host cell–of a plant, an animal or a human being, and it can sometimes transfer from one type of host to another. It may cause serious disease and death, or be relatively harmless. How problematic it might become depends upon the social and economic context.

Scientists estimate that about three-quarters of new human diseases originate from existing viruses in animals:

Animals that harbour and can transmit a particular virus but are generally unaffected by it are said to act as a natural reservoir for that virus. For example, the H1N1 virus that caused the 2009 flu pandemic⁽²⁾ … was likely passed to humans from pigs; for this reason, it was originally called ‘swine flu’.⁽³⁾

There are around 150 animal viruses that affect humans, and there are possibly half a million more that could potentially do so.

The virus causing COVID-19 disease is thought to have come from a bat, which then passed on the virus to another animal and then it was passed onto humans. Along the way, this virus, like others, can mutate as it gets reproduced in the host’s cells, which can make it more, or perhaps less lethal to humans. The first outbreak of the disease was in Wuhan, capital city of Hubei province in China, and the most widely suspected original location was a ‘wet market’ in Wuhan that was selling freshly killed animals for meat.

Despite conspiracy theories, there is no evidence whatsoever that the virus was manufactured in or escaped from a laboratory, in China or anywhere else. Such accusations ignore how easy viral transmission can be when other factors come into play.

What made the new virus, SARS-Cov-2,⁽⁴⁾ frightening was that it was roughly 10 times more deadly than the regular seasonal flu virus and that it could be transmitted more readily, since many who were infected and who could pass it on had no symptoms themselves. Even those who ended up having severe, life-threatening symptoms would usually only develop these after more than a week or so, giving the virus plenty of time to spread to family, friends and accidental contacts.

But the real issue for zoonotic viruses–the ones infecting humans that come from animals–is the animal-human connection.⁽⁵⁾ The cells in all animals, including humans, are more similar than one might think. While many animal viruses have not been known to infect humans, there are still plenty that might. If a virus particle exists in a cow, a pig, a chicken, a bat or wherever, then there is also a chance that it can attach itself to particular cells in the human body. The more that animals and humans interact, the greater the chance. Equally, some viruses infecting humans can be passed on to animals.

Nature & society

In economically developed countries, most animals are kept away from people–apart from household pets that have not been found to be a threat to health. The risks of infection in livestock farming, etc, are also generally known and are kept under control with hygiene measures and vaccinations, although there have still been outbreaks. Some people may not like the capitalistic, large-scale farming of animals, but in this respect they tend to work well.

The risks of zoonotic viral epidemics have been far greater in the poorer countries of Asia, Africa and Latin America. In these countries, markets are more common where live animals–not only ‘exotic’ animals, but also ducks and chickens–are slaughtered and sold for meat. These can raise the risk of human infection from viruses, including providing a forum for originating new viruses, especially if the trading is not strictly regulated and the markets are not kept sufficiently clean.

So, while the virus particles provide the potential for viral epidemics, that potential is only realised in particular social-economic contexts. An important context was brought out by a 2017 study of emerging infectious diseases globally. It argued that such diseases, and almost all recent pandemics ‘originate in animals, mostly wildlife, and their emergence often involves dynamic interactions among populations of wildlife, livestock & people within rapidly changing environments’.⁽⁶⁾ Among the factors involved were large land-use change programs such as logging and mining concessions, dam building, and road development.

The risk of new infectious diseases emerging is clearly a global problem. As the chart taken from the 2017 study brings out, the risk spans every continent, although to different degrees in each country.

Note that the projection used in the map diminishes the area of countries closer to the equator and increases that of regions nearer the poles.

Estimated risk of emerging infectious diseases by location

These development-driven environmental changes have been going on for centuries, also pre-dating modern capitalism. What makes them more problematic now is the greater integration of the world economy, with more opportunities for travel, the expansion of urban areas and the shift of populations from the countryside to towns, especially if some former peasants wish to continue their previous ways.

But this does not imply that economic development should stop, or that travel and global integration are bad things that should be reversed. We do not need to adopt The League of Gentlemen’s ‘local shops for local people’ approach. Development gives evident benefits for humanity, not just in economic terms, but also by improving social connections, knowledge of the world, science and health. To take just one example of public health achievements: average life expectancy was less than 50 years before 1900, even in the richer countries; today it is more than 60 years even in the poorest and up to 80 years in the richest. Unless you believe in an afterlife and would be pleased to meet your maker at the earliest opportunity, that has to be a good thing.

Humanity has made progress by understanding, modifying and channelling nature to meet human needs. One should not think that the reckless way capitalism treats the environment is something that is inherent in all possible forms of economic system. The latter view would call a halt to development, despite 10% of the world still being in extreme poverty, and it would support the reactionary idea that ‘nature’ is a barrier that should be left alone. Viruses and other diseases have been dealt with in the past, and can be dealt with again. But, as the following sections will show, imperialism today creates many barriers to achieving this.

Capitalism & disease inequality

Capitalism will not readily minimise the risk of diseases emerging, since it costs money to do so. But an epidemic is still bad for business, and might also affect the ruling groups. So governments in rich countries will usually impose some health measures, promote widespread vaccinations and find other ways to stop or limit the spread of disease. Such measures mean, for example, that smallpox, measles, polio, malaria and cholera have been almost eliminated.⁽⁷⁾ These things also apply to capitalist agriculture and animal farming, where big efforts are made to keep animals free from disease. If infected meat got into consumer products, food production companies would see their business collapse. Witness what happened to the demand for British beef after the outbreak of BSE, or ‘mad cow disease’, in the late 1980s!

By contrast, poorer countries have fewer sources of funds to deal with disease, and less scope for doing this when capitalist exploitation is less restricted. Dominated by the rich powers and their companies, they can do little to thwart the capitalist objective to screw out as much profit as possible. Poor countries are also more burdened with dangerous levels of pollution–often based on their dealings with the rich–and many of their population groups do not even have easy access to clean drinking water. The social and environmental changes brought about by the ruthless, capitalist one-sided development of poorer countries have destructive consequences, but that is an argument to stop this destruction, not to stop development itself.

China & the latest virus

Substantial evidence links the emergence of COVID-19 to a ‘wet market’ in Wuhan that sold fresh meat, fish and other perishable goods. Animals were also slaughtered for meat on customer demand. These types of market are common in many developing countries, particularly in Asia and Africa, but they are not unknown in richer countries, for example fish markets selling live fish, crabs, lobsters, etc. The earlier comments made about the possible transmission of disease clearly imply that such markets should at least be tightly regulated. But China’s authorities have been concerned that closing the markets would encourage these practices to continue outside of a formal market setting, which could make things worse.

In many respects, the problem comes down to consumers not being happy that the meat is fresh, unless they see the animal killed. That in turn reflects a worry both about the quality of shop-bought meat and a desire to do things the old, trusted way as in traditional livestock farming and in more rural communities. These traditional ways will not easily disappear until safer, new methods gain acceptance, but it is very likely that China’s government will take stronger measures against wet markets in future.

The Chinese authorities had been slow to act on the outbreak in late 2019, and censored the initial warnings from medical personnel. However, they then acted quickly and decisively, including locking down Wuhan and other cities in the Hubei region on 23 January, thus affecting over 50 million people (other regions came shortly after). Detailed information on the new virus was given to scientists internationally by early January 2020. An English language article was also published on 24 January in the prestigious medical journal, The Lancet, warning about the risk of human-human infection.

China’s state is authoritarian and can sometimes seem to act in a paranoid manner. However, this country has a history of being dominated by major powers in Europe, by Japan and also by the US. That history, added to the more recent hostility of the US, gives plenty of material to support such a political response: they really are out to get me! Note that the U.S. has military bases around China–including in South Korea and in Okinawa Island, Japan–and it is the major supplier of weapons to Taiwan, an island province that China rightfully claims.⁽⁸⁾ China has no military bases around the US.

One Flu Over the Cuckoo’s Nest

US President Trump has used the latest virus pandemic to increase hostility to China, attacking the World Health Organization for being too ‘China-centric’ and stepping up the pressure on U.S. allies to impose economic sanctions on the country’s major companies. This anti-China stance is a common theme in all U.S. political thinking, worried as it is about the rise of China as a rival power.

Trump blames China for ‘covering up’ the virus in its early stages, thus setting the stage for a pandemic. There may be some validity to that view, but even if so, there are no grounds on which to criticise China’s subsequent actions. The allegation of a cover up does not excuse the delayed reaction of the U.S. authorities when the virus was widely known about. It also has to answer reports on U.S. mainstream media that the U.S. intelligence agencies (the CIA) knew of a viral outbreak in China in November 2019. Of course, the CIA’s main concern was that it might affect U.S. forces in Asia!⁽⁹⁾

POTUS#45 has distinguished himself in this pandemic, easily exceeding any stupidity measure of which his critics might have thought him capable. From comparing the virus to a normal, regular flu epidemic, to promoting a drug, hydroxychloroquine, used for other conditions that was untested and possibly dangerous for COVID-19, to even suggesting that somehow injecting or ingesting household bleach might be a way of fending off the virus, his statements have stunned most observers, including the administration’s medical advisers.

Still, an egomaniac might easily become distracted by the fear that economic damage from the COVID-19 crisis, and now the protests against racist violence by the U.S. police, could undermine his hopes for re-election as president in November. Who could expect any coherent strategy for dealing with the virus?

I will not deal with those economic outcomes of collapsed output and employment, which are easily found in daily news reports. But it is worth noting that in recent years severe cutbacks in funding to federal and state agencies responsible for dealing with such crises will have hindered an effective anti-virus policy in the US. For example, in 2018 the Trump administration ‘streamlined’, as the euphemism goes, the Global Health Security and Biodefense team, and put it into a more general directorate combining arms control and non-proliferation, weapons of mass destruction, terrorism, and global health and biodefence. At the same time, maintenance contracts on stockpiled ventilators lapsed and there was an insufficient stockpile of medical equipment. All this added to the confusion caused by the president’s own absurd statements.

To crown all these achievements, on 29 May President Trump terminated the U.S. relationship with the World Health Organization, following up his previous decision to suspend U.S. funding for it. His rationale was the previously alleged Chinese culpability and, for good measure, adding to his anti-China policies, he has also announced that in future Hong Kong would no longer have special trade and investment relationships with the US.

The English Patient

The U.S. tops the world in the number of COVID-19 cases and in the number of fatalities from it, the latter passing the 100,000 mark just after U.S. Memorial Day. But at least the U.S. has a population of 328 million; the UK with its 67 million has no such size excuse for having the second highest number of virus deaths on the planet.

There are many parallels between the UK and the U.S. handling of the virus impact. For example: the lack of specialist medical and personal protective equipment that would, in former times, have been seen as a necessary stockpile for emergencies; a too long delayed, confused and halting ‘strategy’ by the government to deal with the crisis, and a political leadership that tried to bluff its way through a pandemic and push back any criticism with an escalating series of half-truths and outright lies. One could also cite the narcissism of both Trump and UK Prime Minister Johnson as the reason they always have something else on their minds than dealing with the pandemic.

Johnson claims to be following the recommendations of his scientific advisers. This gives him cover for any decision his government makes that goes wrong. More than that, the scientists concerned have basically colluded with the government. Here is the editor of The Lancet, Richard Horton, recently criticising the somewhat less than independent role of many UK scientists:

Every day a cast of experts–led by the chief scientific adviser, Sir Patrick Vallance, and the chief medical officer, Chris Whitty–lends credibility to this government by annealing their reputations with those of ministers.…

The failures within the scientific and medical establishment do not end with government experts. The UK is fortunate to have an array of scientific and medical institutions that promote and protect the quality of science and medicine in this country–royal colleges, the Academy of Medical Sciences and the Royal Society. Their presidents have been elected to defend and advance the reputation of medicine and medical science. And yet they have failed to criticise government policy. Why? Surely their silence amounts to complicity.

… When advisers are asked questions, they speak with one voice in support of government policy. They never deviate from the political scripts.⁽¹⁰⁾

In the UK, available resources for managing the pandemic were focused on the National Health Service, to the detriment of care homes. The sharply rising death toll in UK care homes was ignored for weeks until accumulating news media reports forced a modest change in government policy. It would clearly have been straying too far into the political arena for the main medical advisers to point out this problem in public.

Probably the most egregious policy error of the UK government was to have ignored for several weeks what was going on in Italy. That country’s health system was quickly in a state of collapse as infections and the death toll from COVID-19 soared. At least Italy had some excuse of being surprised at how quickly the virus could spread; the UK did not.

The first, outrageous policy response from the government was to go for ‘herd immunity’. The rationale was this: no vaccine was available for the new disease, it looked like the death rate among those infected was ‘only’ around 1%, so letting a large number of people get it and then recover would provide a buffer of immune people in the population–assuming, of course, that one could not get infected again later.

How disastrous this policy could turn out to be should have been obvious from the start. A rate of 1% for deaths might sound low, but not when the herd was judged to include 50-80% of the UK population! It would have implied anything from 300,000 to 550,000 deaths in total. Yet it took another two weeks or so for the implications to sink in. The bias of policy finally changed the week after a report from Imperial College, published on 16 March, spelled out to the government the potential scale of deaths under different scenarios, from no measures taken to a complete lockdown and suppression of the virus.⁽¹¹⁾

Government policies

Lockdown policies in many economies to contain the new virus led to a slump in economic activity, output, employment and incomes. To some extent, richer countries were able to offset the disaster caused for people’s livelihoods by offering subsidies for wages, increasing grants and cheap loans to companies and reducing the cost of borrowing. The scale of the extra spending and liabilities taken on has been truly colossal.⁽¹²⁾ Poorer countries were, as usual, in a much worse position, with their populations facing penury or facing risks of being infected with the virus if they continued working.

The global spread of the virus has nevertheless been very uneven. Some countries have so far been relatively lucky to escape from a big impact, whatever may have been the response of their governments. Others have had experience with previous epidemics and were well prepared to deal with this one. However, countries with right-wing populist leaders–notably the U.S., UK and Brazil –have tended to be much worse at implementing an effective anti-virus policy.

The advantages enjoyed by richer countries in their virus-crisis spending plans are brought out by the very low, even negative yields they pay on government debt issues. But it is naïve in the extreme to assume that such high borrowing will have no cost. Interest rate costs on the debt may be minimal, but the extra debt itself has to be paid back and will be an economic burden–via taxation or spending cuts–in future years. That debt is added to already high levels compared to GDP. Among other reports about this issue on this blog, see here.

Some debts owed by companies, eg short-term low interest loans, might be paid back fairly quickly if the collapse of business activity stops and is partially reversed in the next six months. Yet that still leaves them with a net loss of revenue and far worse prospects than they had assumed before the crisis. In the UK’s case, the Bank of England has forecast 2020 GDP at minus 14% in 2020. While it projected a hard-to-believe bounce back of 15% in 2021, even that would still leave 2021’s GDP lower than in 2019.⁽¹³⁾ Similar down/up hopes and guesses will apply to all countries in the rest of 2020 and in 2021. The Bank was also optimistic because private banks now have much better capital ratios than in 2007-08, so they are better able to bear losses from loans not repaid. But that is not saying much compared to that disastrous episode.

Viruses & Moribund Capitalism

From the point of view of ruling elites, viruses along with many other diseases are usually seen as being a little too indiscriminate. They can infect or kill anyone, rich or poor, so it makes sense to have public health systems in place to deal with them or to limit their damage, both to the national population and in economic terms. This particular virus has, however, been far more global, far more quickly and with a far greater impact than any other in recent memory.

The big, rich countries were well aware of the risk of pandemics, often had specialist teams of scientists to study and monitor them, and also supported international health institutions. This should make shocking the British and U.S. delays and incompetence in dealing with the latest virus. But it is not much of a surprise when you examine the political leaderships in each country. And if you ask how did such people ever get into positions of responsibility, that question is answered by the fact that very large numbers of people voted for them. It is not in the nature of these ugly beasts to be prepared for a public health crisis, especially when there are other political objectives in mind, whether that is a Brexit fantasy or re-election.

The imperial grinding machine: what goes in, what comes out

In previous articles I have covered many aspects of imperialism, looking at how the major countries have exploited the world and wreaked havoc. One image I have used is of the imperial grinding machine, where the resources of the world available to meet humanity’s needs end up in crises, poverty, racism, war and oppression. The latest virus episode throws a different light on these topics, one that shows how they are not even good at protecting the more vulnerable in their own populations. While the major powers can handle the economic costs, or postpone the economic impact, this contrasts with many other countries where local populations are faced with the choice of losing their livelihoods or risking death.

Health risks and viruses are clearly global issues, but these cannot be dealt with effectively in the imperialist world economy. Even the international bodies set up to manage health are poorly funded and cannot work well to contain disease. Trump cutting funds to the World Health Organization is bad enough, but there have also been moves from the U.S. to prevent future vaccines and medicines for COVID-19 from being ‘public goods’ available to all countries and not bound by patent rights. The UK also backs the U.S. approach.⁽¹⁴⁾ Both the U.S. and UK governments are providing huge sums to their own pharmaceutical companies, and want them to benefit from any vaccine or treatment breakthrough by the patent protection of such ‘intellectual property’. In March, Trump even attempted to get exclusive rights to a potential vaccine from a German pharmaceutical company!⁽¹⁵⁾

Every day the capitalist economy answers the question of what life is worth by asking back: how much can you pay? The world’s resources are monopolised by the major countries, but they still screw it up. Unable to run the economy without threats, violence and terror, we now see clearly that they cannot even save their own citizens’ lives.

Appendices:

a) Talking out of their Rs?

It is difficult to estimate how many people have been infected with a virus when there are few tests carried out, as is still the case in most countries. Full population tests may not be necessary for an accurate view of infections, since representative samples, as in opinion polls, might be sufficient. But with regular opinion polls, for voting preference, etc, there is usually already a good population-based estimate of voters, by age, gender, social circumstances, previous voting choice, likelihood to vote, and so on. This helps a pollster build a representative sample to reflect the population; the larger the sample, the more accurate it is. With this new virus, however, it is not possible to get many of the same kind of key, relevant data items, and without large scale testing, judgements on the course of the infection will be far less reliable than most opinion polls. In the absence of data, models for predicting the virus make many assumptions based on little evidence.

Early in the outbreak, recorded hospital deaths indicated that older people were more vulnerable to COVID-19, especially those who also had other diseases that led to difficulties breathing. It also seemed that younger people, especially children, were far more likely to develop only mild, or even no symptoms, even if they had been infected. But each of these assumptions is being at least partially revised as more evidence accumulates. One other unexplained feature of the virus is that the non-white section of the population seems to be more vulnerable to developing bad symptoms and dying. This seems to be the case even when factors such as socio-economic status and occupation are taken into account. All this makes estimates of the potential impact of the virus very uncertain.

Yet one virus parameter commonly promoted is its ‘basic reproduction rate’ R₀ (or R in the usual discourse, and in what follows). This parameter reflects the degree to which one infected person will infect someone else, and is critical for the future path of the virus in a population.⁽¹⁶⁾ If the R number is two and that person goes on to infect another two people, and they each do the same, and so on, then there is a doubling of the numbers in each round of infection, which may be every couple of days. This leads to an exponentially rising number of infections.⁽¹⁷⁾

An R number remaining less than 1.0 means the virus will diminish and eventually die out, the lower the number, the more quickly. A number that stays above 1.0 means that infections could grow until more or less everyone is impacted, and grow more quickly, the bigger the R. So, governments would like to promote any reports of R < 1.0 from scientists in order to get out of the lockdown that is damaging economies.

But the reports of various R numbers in the media, no matter which scientists they are from, need to be read with caution. To put this in a fuller perspective, it is worth reading a critical article on such calculations from the U.S. Centers for Disease Control and Prevention, published in January 2019. Its main point is that ‘many of the parameters included in the models used to estimate R are merely educated guesses; the true values are often unknown or difficult or impossible to measure directly’.⁽¹⁸⁾

Without mass testing, it will be difficult to get a good estimate of the virus reproduction rate, let alone the percentage of the population that has been infected. Of course, if the number of new cases diagnosed in tests trends lower, then one can argue that the R number has dropped, but all that is really being said is that the number of new cases is lower!

b) The Imperial College virus model

The media reports of Imperial’s projected UK deaths from the virus–from around 250,000 to 500,000–had the salutary effect of making the UK government wake up. Three months on, those numbers seem crazily pessimistic, even though the reality of around 50,000 at present is no cause for celebration and the impact of the virus is far from over. Yet the report made a very well argued case in favour of suppressing the virus, to prevent both an extremely high death toll and the collapse of the health system.⁽¹⁹⁾ A closer look at the report also qualifies the headline numbers.

One of Imperial’s scenarios did project 510,000 deaths, but that was if the R number for the virus were 2.4, and it was in ‘the (unlikely) absence of any control measures or spontaneous changes in individual behaviour’.⁽²⁰⁾ Mitigation, with some measures, was projected to result in 250,000 deaths, even assuming all patients could be treated in hospital (which was not very likely). So their recommendation was that much firmer measures would be needed to suppress the virus. In the most extreme range of measures they considered, schools and colleges being closed, social distancing, household quarantine and home isolation of cases, then, on various scenarios about the R value, total deaths from the virus could probably be reduced to less than 50,000. Interestingly, they did not consider any economic lockdown scenario in the 16 March report, but they noted that the effects on the economy would be profound.

I think the only criticism that can be made of the Imperial report–apart from my scepticism about being able to calculate R numbers with any precision–is that its extreme scenarios for deaths were pretty unlikely to come about. The ‘spontaneous changes’ in behaviour it noted were possible would have been inevitable if people began to see a high number of fatalities from the virus. Even with the low death toll in the UK in the early stages, people were ahead of the government in curbing their activity well before the government’s lockdown measures on 23 March. Some usually busy shopping streets, for example, were already becoming deserted by early March.

Notes:

1. Critics of capitalism can be reactionary too, as Marx and Engels explained in the Communist Manifesto, especially Part III. See here.
2. First recorded in Mexico and the US. Regarding the H1N1 virus name, the H and the N refer to two proteins on the surface of the virus particle, hemagglutinin and neuraminidase, which help the virus attach to a target cell. The numbers refer to the form of those particular proteins, so you can also get H5N1, H9N2, etc, for different viruses.
3. Campbell Biology, Pearson, 2018, p428.
4. This name when expanded means Severe Acute Respiratory Syndrome Coronavirus number 2, after the first viral outbreak of this type seen in 2002-04. That episode had a death rate of close to 10%, but less than 10,000 cases in total. The term ‘coronavirus’ describes the crown-like shape of the glycoprotein spike on the surface of this type of viral particle that enables it to attach to certain receptors in the host cell. COVID-19 means the Coronavirus disease of 2019, with the relevant symptoms, and the first cases have been traced back to November-December 2019.
5. Examples of other animal origin viruses of recent years that have been passed on, helped by the proximity of humans to the animals concerned, including eating them, are: Avian flu 1997-, 2007-, 2013- (chickens, ducks, geese), Nipah virus 1998- (bats, pigs), SARS 2002-04 (bats), Middle East Respiratory Syndrome 2012- (camels), Ebola 2013-20 (bats, monkeys), Zika 2007- (mosquitoes). Bats and poultry have been such a common channel for human viruses that it is surprising that horror films about zombies and devastating viruses fail to mention them. Note that viruses are far from being the only problem; bacterial infections can also be widespread and deadly.
6. See Allen et al, ‘Global hotspots and correlates of emerging zoonotic diseases’, Nature Communications, 24 October 2017, here.
7. Viruses cause smallpox, measles and polio, malaria is caused by a mosquito-borne parasite and cholera is caused by a bacterium, usually through poor sanitation. Smallpox, a dreadful disease with a 30% death rate, killed up to 300 million people in the 20th century, but has been eliminated worldwide since 1980 due to a global effort.
8. China’s Communist Party is not known for its openness to criticism, but its paranoia index will also have been dialled up by protests in Hong Kong. Joshua Wong, one of the leading activists, has had discussions with U.S. Senator Marco Rubio, known for his reactionary and interventionist policies; some have also called for U.S. economic sanctions to be imposed on Hong Kong – which Trump has now done – and carried U.S. flags on demonstrations.
9. ABC news report of 9 April 2020.
10. Richard Horton, ‘How can any scientists stand by this government now?’, The Guardian, 27 May 2020.
11. A very good report on the timeline of UK government measures and the rationale behind them, including the medical advice given, is The Guardian, ‘The inside story of the UK’s COVID-19 crisis’, 29 April 2020. The Imperial College report is reviewed in the Appendix.
12.  US federal government measures, including spending, grants and guarantees, amount to some $3 trillion, in addition to vast new loans and securities purchases from the Federal Reserve. The EU is also planning a €750bn fund, in addition to individual country measures. The UK government will likely borrow more than £300bn, with up to some £80bn going on various income subsidies. I will not detail all these spending plans, but those interested could consult the European think tank Bruegel’s report covering 10 EU countries plus the UK and U.S. here.
13. Note that starting from 100 for GDP, minus 14% gives 86. Adding 15% to that only gives 98.9, lower than at the start.
14. See the interesting report from Asia Times, ‘US declares a vaccine war on the world’, 28 May 2020.
15. An article on the attempted deal in March is here.
16. If the R value is high, it does not matter so much for public health if the spreading of the virus in a population gets stopped at an early stage by appropriate measures.
17. I will not deal with the mathematics here, but note that media reports usually only focus on the total of new infections, on the 5th round, for example, not the total of all infections, including past ones, that is much higher, of course. In the case of R = 2, new infections are 32 by the 5th round, but all infections by then amount to 63.
18. See Paul Delamater, ‘Complexity of the Basic Reproduction Number (R₀)’, EID Journal, January 2019, here.
19. Imperial College COVID-19 Response Team, Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand, 16 March 2020.
20. A similar projection for the U.S. had a total of 2.2 million deaths.