The first wave and beyond: China and the USA

For every jurisdiction, the first encounter with the COVID-19 virus has been a challenge of how to respond to a pandemic. It was China’s turn first. All things considered, I assume that in most places where there has been a first wave, it will have ended after the 26th week of the pandemic. (There are countries where a first wave has not occurred or has been strongly stretched, but after half a year of news about the pandemic as a global phenomenon, I no longer expect an operational first-wave effect.) For China and for the US I give the data, beginning with the first 27 weeks of the pandemic, thereafter with its remainder.

The first wave and beyond: in China

It is becoming increasingly clear that the COVID-19 virus has surfaced somewhere in China, perhaps as early as November 2019, and that it has not been immediately recognized as the danger it has since proven to be.

Communicability during incubation period

For those trying to imagine how the Netherlands (or the US) might have responded to a first, isolated case of an unusually serious manifestation of a possibly new form of pneumonia, emerging somewhere in a rural area of the country, possibly under the cover of being infectious during its incubation period and of widely diverging symptomatic manifestations, the Chinese course of events as currently known need not be understood as having been so earth-shattering as it has become in popular mainstream Western discourse. A month after the unnoticed emergence, a first super-spreader event took place at a fresh market (in Wuhan) that would leave experts and authorities in uncertainty for a few days about what was going on and what to do next. It is certain that mistakes have been made. But that was in or before December 2019. The WHO was informed on the 29th of that month.

The first victim in the US (who had been visiting Wuhan) died on February 6 and was only identified as having been a COVID-19 victim on April 24. On February 29, the first American COVID-19 victim was recognized as such.

The first wave looked like this in China:

Fig. 1 The first wave in China (WHO data)

Judging by the numbers, that wave started around January 10, 2020 and was finished (all across China) by April 27 (when a correction to the earlier numbers had been processed). The wave took an estimated 15 weeks or three and a half months. Local lock-downs first took effect on January 23 in Wuhan (and were lifted there on April 8); sixteen emergency hospitals were built in Wuhan from February 8 onward, they were removed again from March 10 onward (see theWikipedia quote below). Social life and the economy in China are now back on track, albeit more cautiously in terms of social distancing and such than before.

For me, as an EU Westerner, China’s way of controlling the pandemic is remarkable for many reasons. I take the facts from Wikipedia, consulted on March 29, 2021.

In Wuhan, at the onset of the COVID-19 pandemic in January 2020, general medical institutions and the newly expanded pneumonia specialist hospital were overwhelmed by the sudden surge in hospital bed demands by suspected COVID-19 cases.[5] Many patients with existing conditions were also turned away, leading to deaths which were otherwise preventable.[6][7] Authorities were criticized by experts and citizens alike.[6] Meanwhile, the large number of low-severity cases — almost all are individuals with suspected or mild symptoms — still needed at least a fortnight of isolation (due to the incubation period of SARS-CoV-2).

Officials decided against home isolation for mild to moderate cases, as home isolation is not always properly complied with and it was difficult to organize medical care and monitoring for those in isolation. Furthermore, home isolation could be psychologically taxing on the patients as the patients know that they are putting their family members at risk of infection.[8] On the other hand, in-hospital isolation will hold up medical resources and increase the risk of nosocomial exposure. Under such circumstances, the principle of centralized low-level care management of non-critical patients was adopted. The Government of the People’s Republic of China established 16 fangcang hospitals in Wuhan, providing a total of more than 20,000 beds.[9][10][11]

As of March 10, 2020, all patients admitted to the square cabin hospital of Wuhan Wushan Hongshan Stadium were discharged. Thus, all 16 fangcang hospitals in Wuhan completed their missions and their cabins were shut down.[12]

Chinese Responses to COVID-19

It amounted to decisive action by the central and also the regional administrative authorities. But that action seems to have been influenced by public opinion in a very different way than in the West, which appears in China to have led to central provisions being made for the isolation (quarantine of at least 2 weeks) of persons with mild symptoms. With this, China got and keeps the virus under control.

Fig. 2 Covid in China, after the first wave

The image in Fig 2 shows a different scale than that in Fig. 1. Using the same scale in fig. 2 would make it look like the second half of Fig. 1. With the details I can show that there are numbers of deaths per day, but that they do not exceed 3 per day anywhere, and that the numbers of new infections per day do not exceed 220 anywhere.

The first wave and beyond in the US

In the EU, the UK and the US, a Chinese approach (as summarized in the Wikipedia quote above) has not been followed. In fact, the Chinese approach would without exception violate constitutionally guaranteed human rights in those countries. Here I show the first wave and its sequel in the US:

Fig. 3 US: the first “wave”

In the US, the first wave begins when more than 4,500 deaths have been reported in China alone and when the pandemic has spread all over the world, and also when the emergency hospitals in Wuhan are being closed down again and dismantled. There are big differences between the curves in the US and those in China. In China the highest number of deaths per day in the first wave is about 150, in the US it is about 3000. In China the highest number of infections per day in the first wave is about 5,000, in the US it is about 28,000. What seems most distinctive is that the first wave in the US is not a wave at all, it never goes down to a level that makes the new number of infections manageable. If I let the end of the first wave in the US coincide with the moment when the daily numbers of infections start to rise again, that number is around 22000. Those are not numbers in which other means than lock-downs (individual quarantines, contact research) will be effective. And in that first period, no effective vaccines are available yet. The measures being taken in the US are in the hands of the states and coordinated under the authority of a president who publicly denies the severity of the pandemic. If these measures are toned down in June 2020, the first wave comes to an end. Then, the US will have 26 times the number of COVID deaths in China, while China holds 4.5 times its population.

Fig.4 US: after the first “wave”

In fig. 4 I give a picture of what came after the first wave in the US. Here too, the scale has been adjusted (from 1/11 to 1/75 times the numbers of infections per day) based on the need to be able to show what is going on between maximums and minimums. The number of new infections per day (with a few exceptions around September 10) nowhere falls below 37,000. The daily number of deaths nowhere falls below 600 (July 12) and seems to stabilize today (March 28) at around 1000. At the end of the curves, which initially showed spectacular decreases from January 15, 2021 (the infections) and February 18, 2021 (the deaths), there seems to be a trend towards stabilization at around 1000 deaths and 60,000 infections per day.

The first vaccine became available at the end of December 2020. It is not entirely clear whether the stagnation in infections and deaths are the result of a shortage of vaccines, a shortage of those who want to be vaccinated, or a mutation in the virus. It may be a combination of those and other factors.

The first wave and beyond: China v. The US?

For those who, like me, are 76 years old and have never been outside ‘the west’ (apart from a week in St Petersburg in 1996), the spectacle of a region rushing towards its own ruin (if this rush would concern a single region only) is in many ways intriguing. Also because it feels like being right in the middle of it.