Thread by @DrLeeJones

Having researched pandemic disease and its governance for my book with @ShaharHameiri, I'm usually v sceptical of hysteria around pandemic disease. Here's a thread on the Chinese #CoronaVirusOutbreak. 1/18
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Pandemic viruses often originate in animals. They are dangerous to us when they become "zoonotic" - they mutate to cross the species barrier between animals and humans. Scientists think #CoronaVirus may originate in snakes/ bats. Others came from bats, civets, chickens, etc. 2/18

Real danger is when a virus mutates further to enable human-to-human transmission. Then it can spread way beyond people in close contact with infected animals. This happened with SARS in 2003 and MERS in early 2010s, but not with other viruses like bird flu and swine flu. 3/18

That kept human casualties v low. E.g. in 2004 it was feared that H5N1 bird flu could have killed 350m worldwide. Ultimately it only infected 861, killing 455, because it never made the leap to human-to-human transmission. 4/18

Danger is therefore a function of a virus's transmissability and its mortality rate. H5N1 bird flu had a very high mortality rate (53%), hence the fears of massive deaths; but ultimately it did not become tramissable between humans and so could be contained. 5/18

What of #CoronaVirus 2019-nCoV? The World Health Organisation now suggests that it does spread through human-to-human contact, estimating each infected person infects another 1.4-2.5 people - lower than for SARS. So transmissability is quite high. 6/18

Chinese media suggest 299,600 people left Wuhan on 22 Jan alone, before yesterday's "lock down". So, #CoronaVirus 2019-nCOV may already have spread across the whole of China. Since the incubation period is 5 days, we can't know yet. 7/18

#CoronaVirus 2019-nCoV has already spread overseas, to the US, Thailand, South Korea and Japan. But so far there are only 19 overseas cases, and the WHO hasn't (yet) declared an international public health emergency. 8/18
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Currently #CoronaVirus 2019-nCoV also has *relatively* low mortality. Chinese officials now claim 830 people infected, 26 killed i.e. 3% mortality rate, mostly among young/old/ppl with underlying health problems. That rate could rise (yesterday it was 2.3%). 9/18

For comparison, the mortality rate of the seasonal influenza virus is estimated at 0.59% (again with most deaths among older people). So, currently 2019-nCoV is ~6 times more deadly than seasonal flu. Bad, but not apocalyptic. who.int/csr/don/archiv… 10/18

Viruses also tend to become less fatal over time. A virus that kills everyone it infects soon dies out itself; evolutionary pressure selects for less-fatal strains. 11/18

So, at the moment, it seems #CoronaVirus 2019-nCoV is not going to kill vast numbers people across the world. 12/18

But that's assuming Chinese official data is accurate. That's quite a big "if". A lot of Chinese data is crap - politically massaged to cover backsides. There are already rumours that 2019-nCoV broke out in Sept but was covered up until Dec when the WHO got wind of it. 13/18

That said, China has become far more open and cooperative around pandemic disease since 2003, when it covered up SARS for months. China has redefined security to include such non-traditional threats and greatly increased international cooperation. 14/18

E.g. Yunnan and Guangxi health officials are now part of the Mekong Basin Disease Surveillance Network which networks public health agencies, shares intel, and has multi-country teams respond to cross-border disease outbreaks. mbdsnet.org 15/18

So, China - a supposedly "Westphalian" state jealous of its sovereignty - is increasingly participating in non-traditional, border-spanning security governance networks whose emergence @ShaharHameiri and I traced in Governing Borderless Threats. 16/
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Chinese Communist Party elites also know that their domestic legitimacy will suffer badly if they don't respond effectively. Previous health scandals have been v damaging. They're likely to resort to extreme measures - possibly seriously infringing human rights. 17/

Overall: for now, no need to panic; but individuals & foreign govts should take sensible precautions to contain the virus. Current international screening that only targets flights from Wuhan seem inadequate to me and should probably extend to the whole of China. 18/18