The Technium

Virus Scenarios

[Written 28/02/2020. Updated 05/03/2020. Updated 15/05/2020.]

My guess is that we’ll be wrong about our assumptions and first impressions about the Covid-19 virus. I just don’t know how we’ll be wrong. In an attempt to not be wrong myself, I am trying to open myself it unexpected scenarios, since whatever does eventually happen will probably be unexpected.

There are a lot of expected scenarios for the virus. One expected scenario that it will be a massive truly global pandemic that kills hundreds of thousands, if not millions, of people. It started in China, then hops around the world, constantly escaping the noose of containment, until every country is eventually affected. That scenario is entirely possible; no one would be surprised if it happened, including me. After all, the flu virus kills hundreds of thousands of people even year, so this virus needs to be “only” as mortal as flu.

Another expected scenario is that this is a deadly disease that needs drastic efforts like massive quarantines, and that through great effort like these measures, the disease is stamped out early without huge loses. And with enough global cooperation, Covid-19 could be eradicated like SARS was. Also possible.

Another scenario being articulated in recent days is that this coronovirus will sort of be controlled in the coming months, that it may diminish as summer comes, but not be eradicated, and will show up next winter as fierce or even fiercer. It might even become like flu, a perennial plague. Very possible.

But I don’t think these are unexpected enough. So I am working on more unusual ones. One unlikely but possible scenario is that this “novel” virus is not really novel. Because its symptoms are generally mild and very similar to other symptoms from flu and other viruses, it may have been circulating around the globe for a while, without a name. It can be transmitted by people who have no symptoms at the time or even while they have the virus. If the majority of people infected don’t ever get sick, but easily pass it on, then it can spread widely unseen. Evidence for this is new virus DNA sequencing which suggests the first cases of Covid-19 in Washington state may have been there 6 weeks earlier, but was completely undetected. So for six weeks the virus is spreading with little damage. But once people begin to look, and devise a test, the next person to get sick is tested, and it seems as if the virus just appeared, when it has been there a while.

But a few are susceptible to it and die. Because the symptoms are not unique to it,  this illness is assumed to be flu or something else. Then something happened in China to produce notice — maybe someone created a test for it — and then as people died, the new test found many people positive. So the test was spread around and with that we suddenly find many positive results. Then when a few people later get sick in distant countries like Iran, the test shows positive results because the virus was already there, maybe even years earlier.

In this scenario, cases will start to pile up very quickly, not because the virus is spreading, but because testing is spreading.  One way to check the real rate of infection is to begin to test random asymptomatic people to see what percent are infected. It could very well be at least 2% of the random population right now.

If this scenario is true then at some point in the future there’ll be evidence found for the virus in samples way before the “first” known case in Wuhan in fall of 2019. Perhaps the virus underwent a mutation in Wuhan, a mutation that current tests don’t distinguish from earlier forms.

Yet another alternative scenario: Perhaps today there are already more than one variant of Covid-19, and these mutations are not equally detected by current tests. A recent study says there may be two variants with different levels of potency, which could explain why some clusters are more deadly than others. There could be multiple variants in the wild with different rates of contagion. It’s possible the current test may be unreliable in detecting all the variants, either way, over-reporting and under-reporting different strands.

Another scenario is that there is more than one variant of the virus and each of these variants have different lethality and infection rates. So the virus that is raging through Italy and causing a lot of damage may not be the same virus that is creeping through the US. There is some suggestions that the virus in the US is related to the one from Wuhan, but the actual details of difference may matter greatly. As far as I can tell the tests the US is using to identify the virus is not the same test that is being used in Italy or Iran. So it is possible that different tests are masking the different viruses, which may be creating different symptoms.  An extension of this same scenario is that there may be more than two variants of the disease with different behaviors circulating in the same population, and that the current tests are not detecting this difference.

In the same vein, another scenario is that the virus is being over-reported because it is being over-diagnosed. Perhaps the tests that are being used in places like Iran, Italy or Korea are not all testing the same thing. How did all these stations get the same test so fast? How was Korea able to test 10,000 people per day, as they claim. What exactly are they testing. Who made these tests? What equipment are they using? Because I was curious I found two firms making Covid-19 test kits. PrimerDesign is UK-based and claims to be shipping kits to the US. No price is given on their website. The other is Chinese firm Sansure, which seems to have a device or system, rather than a kit. There seems to be a suggestion that either/both of these are selling their systems to public health departments round the world and this is what is being used to test for the virus, but it is not clear to me they are. If not them, what is the test they are using in the hundreds to test for this virus?

From recent New York Times news reports from Italy (Feb 28, 2020) it seems that if you use one kind of test and test people who have no symptoms, many will test positive for Covid-19. What’s odd is that the positive tested have no contact with anyone with symptoms either. Likewise, as reported, in Germany, officials spent great effort to determine the chain of infection for a German man who tested positive for Covid-19 but were unable to link him to anyone infected. The virus might be especially transmittable with zero symptoms, or the tests are inaccurate.

It’s possible this virus will join the flu virus as a perennial plague, one that we never get rid of, that continues to mutate and returns every year. It could be another flu that we try to deal with vaccines but will still prey on the old and infirmed.  It might be that there will not be some moment, so week when the epidemic is declared over. Instead, there’s just a background level of outbreaks as it migrates around the world.

Some conspiracists offer the scenario that the virus is man-made and escaped from China’s first level 4 biohazard research lab which was built recently in Wuhan. A deliberate release of a pathogen seems very unlikely given how much it hurt China. It is possible some research experiment could have escaped but since the Level 4 facility is designed against this, I’d call this unlikely, but possible.

Another radical scenario that is also in the conspiratorial camp is that there have been massive numbers of cases and deaths in China, maybe hundreds of times more than they are reporting, which suggests that the virus is extremely potent and contagious, far more than current data suggests. The top-level secrecy and censoring in China make this scenario believable but it’s also unlikely given the virus’s behavior in other countries outside of China. And the scale of the cover-up needed seems very unlikely given my own experience in China: they would be the first to report it to each other.

If my scenario about Covid-19 being older and already global, here are some predictions that would be testable: 1) We would find retro samples of symptom-free blood more than a year old will test positive. 2) Consensus that in 2019 and in early 2020 multiple mutants and variants of Covid-19 were on the loose. 3) Because of its asymptomatic transmission it will still be found in the wild a year from now.

There are probably more scenarios that I have not considered, but should. Please leave a comment if you have one.