Today, Explained - Coronavirus, 365 days later

Episode Date: January 26, 2021

One year after our first episode on the novel coronavirus, Vox’s Julia Belluz explains what we got right, what we got wrong, and what comes next. Transcript at vox.com/todayexplained. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Get groceries delivered across the GTA from Real Canadian Superstore with PC Express. Shop online for super prices and super savings. Try it today and get up to $75 in PC Optimum Points. Visit superstore.ca to get started. 2020, 2020, 2020. Julia Balouz, you report on health at Vox. And just about one year ago, I believe the 23rd of January 2020, we had you on the show and called the episode coronavirus. There was a new virus and we spoke to you about it for the very first time.

Can you believe it's only been 12 months, Balooz? Oh my God, the longest 12 months of all of our lives. Truly, truly. And I was thinking, you know, since it's been a very long year, maybe it'd be a good time to take a stroll down pandemic lane with you and talk about how we did a year ago. Maybe what we've learned since, what we got wrong. Are you game? I'm game. Let's take a virtual stroll and it won't require masks. It's true. At the time, January 2020, this virus, it was scary, but it also felt very far away.

So let's listen to a bit of what it sounded like in January of 2020. How many people has it killed so far? As of this morning, there are more than 600 cases and 17 people have died. And how should we think about those numbers? How deadly is a virus if for every 600 infected, 17 die? So it's way too early to figure out the case fatality, which is the number of deaths a virus causes among the number of people affected. Because it's possible that there are thousands more people with this virus who don't have symptoms,

who've never gone to the doctor, and therefore they're not counted as cases. So right now we have this 600 as the denominator, but it's likely to change drastically in the coming days. Now, over a year later, over 2 million people have died, and over 400,000 of those deaths came from the United States. Did you have any idea back then, in January, that it would look like this? No way, I did not.

And I think the funny part is, like, I wrote multiple pieces about how we were overdue for the next pandemic. I even published a story after Trump came into power about why he was sort of setting up the U.S. to botch a pandemic response. But I think at every turn over the last year, we underestimated the coronavirus, and obviously that was true even then. And let's talk about what the initial response to this was in China, which is what we were talking about back in January of last year.

What seemed like, you know, drastic, shocking measures the Chinese government had taken in Wuhan. Let's play some of that. This morning, the Chinese city of Wuhan on lockdown. Flights cancelled, trains halted. It's not just travel in and out of the city that's affected. It's everything within Wuhan as well. Wuhan is in virtual lockdown. You're not allowed to enter any public space without a mask. The city of 11 million people at the epicenter of a viral outbreak. So that's more people than live in New York City, for example, or an entire country like Greece.

They just shut down travel within the city and travel out of the city. Wow. And by this evening in China, they'd extended the travel restrictions to two other cities just east of Wuhan. Huanggang and Ezhou, with a combined population of 8.5 million, are 70 kilometers away from Wuhan, where 11 million residents have been told to stay put. So the response is escalating really fast as well, and part of that is driven by the fact that China is now undergoing

the biggest annual human migration for Chinese New Year on Saturday. This crackdown might also suggest that they know more than they're telling us, that maybe the virus is even more transmissible than it seems right now. Maybe it's in more places than we know. Maybe there are more cases. But the public health people I talked to said that quarantining a city of 11 million and imposing trade restrictions on being very effective in their shutdowns and from preventing this virus from spreading. What did you think at the time about those restrictions, Beluz? Just that it was absolutely, yeah, unprecedented, shocking. And everyone I spoke to said this was totally unique to China and that it would never fly in a Western democracy like countries in Europe or in the US. There was also expert guidance saying like, don't shut your countries down,

don't close your borders. We had never seen this like total restriction on movement that not only happened in China, but then happened in vast succession in countries around the world. And yeah, so it's wholly unprecedented. We still don't know what the impact is. There are still debates on the legality of these types of restrictions. But I think we probably should have imagined these scenarios, even if they seem totally unfathomable at the time. One thing that sticks out to me hearing that was hearing that, you know, China is on the verge of its biggest annual migration for the Chinese New Year. And, you know, it wasn't until we were hearing more about the cruise ships and

international travelers who were coming into contact with people in China that it really set in that this thing is spreading and we are not prepared for it. But really, it should have been obvious there, right, with the Chinese New Year, that of course, this is going to start spreading out of control. I think like, yeah, when we saw China shut down like that, that probably should have been a signal to the world that obviously, they wouldn't do that if they didn't perceive this was a major threat. But at the same time, we did have this precedent of previous viruses that ravaged China and that didn't have as much of an impact in other countries. And one was the first coronavirus that went pandemic, SARS-1, in 2002-2004.

So it took off in China. Actually, it also took off a little bit in Canada, but it didn't have this effect, obviously, that we're seeing with the current pandemic. And we also learned that this new coronavirus is quite different from the first SARS. With the first SARS, people were contagious after they were quite symptomatic. And with this one, we know that you're at peak contagion when you just start to experience symptoms if you experience them at all. Again, yeah, we underestimated just how much of a perfect pandemic virus this was. Let's talk about when we started to realize that this was something that was going to spread and that it was indeed spreading. We talked about the cruise ships at length on our show, the Diamond Princess and the Westerdam, one docked in Japan, the other in Cambodia. This was a few weeks after our initial coronavirus with you that we talked about the cruise ships.

Let's hear some of that. Up until this point in the outbreak, a lot of the effort has been on containing the virus, stopping it from spreading on the cruise ships, quarantining people, keeping them from disembarking in other countries and spreading the virus there. And now with what happened on the Westerdam and this American already testing positive, it feels like we're at a turning point. With every passing day, we've been seeing more and more people test positive for the virus outside of China. So the vast majority of the cases are still in China, but there's this mounting toll in

countries around the world. China has reported 70,635 cases of COVID-19 to WHO, including 1,772 deaths. Outside China, WHO has received reports of 694 cases from 25 countries and three deaths. And now with all these passengers just being let off these ships to travel back around the world, potentially carrying the virus with them, we're likely to see that toll outside of China mount even further. It's this highly contagious respiratory virus, and it seems like it's doing a very good job of spreading among people.

And we might be at a point where containing it is impossible. That was February 18th, 2020. I remember speaking to you from underneath a blanket in California where I was on a work trip. And I remember you saying that and thinking, okay, so this is just going to spread all around the country. I didn't realize a month later I'd be living in lockdown with the rest of the country, but it was the moment where I kind of realized this is maybe going to change the world. Was that where your head was at too? Yeah, I thought that the cruise ship seemed like this natural experiment where you could see just how contagious the virus was. But like at that point,

we still didn't have a clear answer on the severity of the virus. So what was definitely knocking around in my head was the swine flu pandemic, for example, of 2009, where it spread really quickly around the world. There were these concerns about its deadliness. The media definitely stroked fear and panic. Schools closed, flights were canceled. And then it turned out that it wasn't very deadly. And that caused this sort of mistrust in media and in politicians about hyping this threat and unnecessarily scaring people. And I think at that time we taped the episode, I was still hearing from some of the world's best infectious disease experts, like

even our very own Dr. Fauci, that this virus could be controlled and that maybe it would just burn itself out or it wouldn't be that big of a threat. Just a week later, we spoke to you again in an episode titled Pandemic? And this was when the virus was really starting to spread around the world. And I think I asked you how scared I should be. How scared should we be, Blues? Honestly, what scares me most right now is people's reaction to the virus

and the fear and xenophobia and lockdowns and damage to the economy that this might cause than the virus itself. Even as this spreads around the world, there's still a good chance it'll look more and more like the H1N1 swine flu pandemic, which was actually less deadly than seasonal flu and less and less like SARS. Were we wrong about that one, Balooz?

Yes, I think I was wrong. I thought at the time that travel restrictions would do more harm than good. What we saw in previous outbreaks was that travel restrictions really punished countries. They stopped the flow of people and goods into countries where help was needed, like we saw in the West Africa Ebola outbreak in 2014-16, for example. But now what we've seen is some of the biggest coronavirus success stories in the world, New Zealand, Australia, Vietnam, they've actually had some of the strictest travel restrictions. So the thinking here has definitely changed and evolved, but yeah, we were wrong. And that's just one of, I think, many failures. One is this failure to understand exponential growth. It's so contagious that even if all these cases that we were talking about that had popped up outside of China didn't look like very big outbreaks, they soon would be

because of how exponential growth works. And then also there was this failure to actually gauge the situation because when a virus is that contagious and it can spread that broadly, you don't even need that many severe cases to overwhelm a health system. So even if it kills less than 1% of the people who get it, it's going to spread so far. You can very quickly end up in a disaster like the kinds we've seen unfolding across the U.S. and in many other countries. And then I think there was arrogance, like this failure to learn from other countries. So I kept hearing, you know, the CDC in the U.S., we basically wrote the playbook for how to respond to epidemics. And maybe this virus is out of control in Iran, and maybe it's out of control in China, and then maybe it's out of control in China and then maybe it's out of control in Italy. But it won't be the same in the U.S.

And obviously that wasn't true. And actually one of the things the pandemic revealed was like, you know, some of the lower resource countries have done much, much better than high income countries like the U.S. because of public health and political decision-making. The one last thing I will say, another failure, the positivity bias. So kind of hoping that the best case scenario will play out rather than the worst case. And I think I was guilty of that. I know when we were talking, I was like very heavily pregnant. And yeah, about to give birth to my first child, and I was definitely hoping that I wouldn't be giving birth to him in this deadly pandemic,

and that that wouldn't be the world he was entering. And I think a lot of people had this type of thinking, like hoping for the best and not the worst. So Support for Today Explained comes from Aura. Thank you. unlimited photos and videos directly from your phone to the frame. When you give an AuraFrame as a gift, you can personalize it, you can preload it with a thoughtful message, maybe your favorite photos. Our colleague Andrew tried an AuraFrame for himself. So setup was super simple. In my case, we were celebrating my grandmother's birthday and she's very fortunate. She's got 10 grandkids and so we wanted to surprise her with the AuraFrame. And because she's a little bit older, it was just easier for us to source all the images together and have them uploaded to the frame itself. And because we're all connected over text message, it was just so easy to send a link to everybody.

You can save on the perfect gift by visiting AuraFrames.com to get $35 off Aura's best-selling Carvermat frames with promo code EXPLAINED at checkout. That's A-U-R-A-Frames.com promo code EXPLAINED. This deal is exclusive to listeners and available just in time for the holidays.

Terms and conditions do apply. BetMGM, authorized gaming partner of the NBA, has your back all season long. From tip-off to the final buzzer, you're always taken care of with a sportsbook born in Vegas. That's a feeling you can only get with BetMGM. And no matter your team, your favorite player, or your style, there's something every NBA fan will love about BetMGM. Download the app today and discover why BetMGM is your basketball home for the season.

Raise your game to the next level this year with BetMGM, a sportsbook worth a slam dunk, an authorized gaming partner of the NBA. BetMGM.com for terms and conditions. Must be 19 years of age or older to wager. Ontario only. Please play responsibly. If you have any questions or concerns about your gambling or someone close to you, Must be 19 years of age or older to wager. Ontario only. Please play responsibly.

If you have any questions or concerns about your gambling or someone close to you, please contact Connex Ontario at 1-866-531-2600 to speak to an advisor free of charge. BetMGM operates pursuant to an operating agreement with iGaming Ontario. Today, today it's playing. Okay, Blue, so we look back on the first few months of our coverage. And while we didn't get a ton of stuff wrong, per se, it's clear like so much of the rest of the world, we were potentially underestimating the severity of this virus. So I was hoping we could look ahead and provide people with an update on what the next few months and maybe even year of this pandemic might look like and try and get it right. Let's be as sobering and realistic as possible. We have vaccines now. How is it going? So the vaccine rollout around the world

is happening incredibly slowly. The race to vaccinate hits a major setback. Promised doses not delivered. Demand is far greater than the current supply. At least a dozen states are now reporting vaccine supply shortages. At Dodger Stadium, wait times for scheduled vaccines are reaching five hours. And California health officials are saying the state may not vaccinate all of its high-risk, high-priority seniors over 65 until June.

I think, yeah, we can imagine in the year ahead that there are at least two scenarios that could play out. So one is countries do speed up the distribution process. I feel confident that by summer we're going to be well on our way to heading toward herd immunity. People start to get vaccinated in really high numbers, and between them and the people who already have some immunity from prior infections, we slow the spread of the virus.

We also get into the warmer months in the northern hemisphere, and people start to go outside, and that also helps. So by maybe next autumn, winter, we're in much better shape. Scenario two is we don't get our act together with the vaccine rollout. Distribution continues to be painfully slow and that high-income countries continue to hoard the vaccine and delay access for the rest of the world. Wealthy countries with just 14% of the world's population

have bought more than half of the doses of leading vaccines. And then at the same time, the virus is constantly evolving and we already have this evidence that there are mutations that might be really good at escaping vaccine protections. One researcher in South Africa tells CBS News the strain is almost like a new pandemic and may require recalibrating the vaccines, much like is done with the annual flu shots. In that scenario, even toward the end of this year, things aren't looking great, and we're sort of in a similar place that we are right now.

I mean, everyone wants to get back to normal, but really what we're talking about when we talk about normal is getting to a place where we have herd immunity. And we had Dr. Fauci on late last year, and he said he expects herd immunity to be something like 75, 85 percent of the population getting the vaccine. Is that still the prevailing knowledge on herd immunity? I think Dr. Fauci's actually been increasing his estimates for herd immunity. And I think the most recent thing he's been saying is that it's something like 80% plus of Americans need to be vaccinated and others have estimated even higher numbers. But I think, yeah, we should probably be hopeful. The basic point is that the vaccines are definitely going to help eventually, but it might not be this on-off switch. There'll probably be

this period where we see a lot of people vaccinated in the U.S. and we can start to ease some of the measures but not fully lift our foot off the pedal. But we still have a long way to go. It's something like 6% of the U.S. population now that's had a vaccine. And let's talk about these new variants of the disease. I mean, do we know how the vaccine holds up against mutations? Scientists around the world are racing to figure this out right now. And what we know so far is mostly based on essentially studies in test tubes where they take blood samples from people who had a prior infection and then they challenge it with the new variant and then they see how whether the antibodies from that prior infection how they respond to the new variant

the studies on the variant that was discovered in the UK are suggesting that one's not a big concern for like challenging these antibodies that we might have. But the South Africa variant is emerging as a big concern. We need to know what this means for people who have been vaccinated and that we don't know yet. But yeah, the virologists I talked to in South Africa who are studying this are really concerned. How easy will it be to adapt the vaccine to the mutations? The two vaccines that are on the market are mRNA vaccines, and the companies behind those say that their technology is actually really well positioned

to adapt the vaccines to new variants. That's good news. That is really good news. I think that the concerning part, though, is that you just don't want to be in this catch-up position. Okay, so let's just say that the vaccine does hold up against most of these mutations. We get a lot better at vaccinations across the globe, not just in rich countries, but in poor ones, and that the rich countries start doing a much better job of vaccinations than they have been thus far. That means, though, eventually, we get to start easing up, right? Be it later this year, be it early next year, sometime.

I think that's right, yeah. Tell me this isn't forever, Balooz. This isn't forever. Tell me this isn't forever. This is going to end, and we just need to hang in there for a little bit longer. And maybe it's not going to end as soon as we would have hoped, but it's going to end. Thank you. You know, the positive thing we should say is like there's a new administration that for the first time has a national COVID strategy.

People are taking this seriously. They're not denying that there's a real threat out there. And so hopefully we're going to start seeing the fruits of that soon as well. What do you think we'll be talking about a year from now when we have you on to talk about what we got right and wrong in this episode? That's a hard one, but I think maybe we'll be wrong about the threat the mutations pose to the vaccines. Maybe it'll turn out that they're not as great a threat. Yeah, maybe the virus will continue to evolve in ways we can't even imagine. We'll probably learn a lot more

about how it affects our bodies and our health. But one maybe hopeful place to end is that we know what to do now to fight this virus. And we now have an administration in place that isn't denying the threat it poses or the science of COVID-19. We've seen other places where when leaders act decisively, when they have a plan in place and they execute it, they can successfully contain the virus. We saw that in New Zealand, in Vietnam, in other countries around the world and maybe we'll have that in the U.S. too,

and we'll be in a much better place than we can imagine a year from now. Thank you.