Focus Live: Only patient hospitalised with coronavirus ready to be discharged
The world's geopolitical order will be unrecognisable once Covid-19 has done its worst. Long-standing regimes will be badly compromised. Political systems that have never fully recovered from the Lehman crisis will suffer a second body blow.
Those Western democratic governments that have been most complacent or incompetent will be torn to shreds by unforgiving electorates. Social media will see to that.
Covid-19 is turning into a strategic contest between the social control model of China's Communist Party and the unruly pluralism of the West. How that plays out will shape the global order in the 21st Century.
In Britain, Brexit scarcely matters right now. Decimal points of GDP are irrelevant. Boris Johnson will be judged on whether or not his administration allows tens of thousands of avoidable deaths of the elderly and the not so elderly, and whether the NHS buckles in catastrophic failure.
Germany has four times as many intensive care (ICU) beds per capita. What we know so far from Lombardy is that 13 per cent of those infected require ICU treatment, on average for two to three weeks. The outbreak is already overwhelming the best-equipped region in Italy. The country's anaesthesia and critical care doctors say it may be necessary to reserve "scarce resources" for patients with a "higher chance of survival and more years of life to come". The unthinkable is happening.
"Italy should be a warning to everybody, everywhere," says Professor Massimo Galli, the head of infectious diseases at Milan's Luigi Sacco hospital.
Britain's Prime Minister Boris Johnson speaks during a press conference at Downing Street on the government's coronavirus action plan. Photo / AP
If Britain can buy vital weeks to "flatten the peak" and stretch the epidemic into the summer, when hopefully less contagious, it might just prevent a national disgrace, beginning with a shortage of respirators - one variable explaining why reported mortality rates are 5.8 per cent in Wuhan, and 1 per cent in Shanghai, but rising as slow deaths come in.
Should the British Prime Minister succeed in limiting ratios to, or close to, best-in-the-class levels among democracies, he has some chance of political survival. The crucial choices will be made this week in Cobra sessions. My advice is to opt for drastic contagion barriers, biting the bullet on economic trauma. The Government cannot dodge this trade-off, but can use all its powers to cushion the blow for business.
Data from China suggests a death rate of 15 per cent for infected patients over the age of 80. It is 8 per cent for those in their 70s and 3.6 per cent for those in their 60s (5.4 per cent for men). No government in any western democracy will survive if it lets such carnage unfold.
Early figures from Italy are tracking the epidemiology of China's Hubei province with a horrible consistency. The death rate for all ages is 4.25 per cent. While there may be many undetected infections distorting ratios, the country has tested widely, much more so than Germany or France.
As I write, 197 have died in Italy. The average age is 81, three quarters men. For whatever reason the Italian system seems unable to save them. The death rate is six times that reported in South Korea, even adjusting for demographics. Is it because the Italian strain has mutated into a more lethal form (we don't have sequence data yet), or because Europeans are genetically more vulnerable?
Is it because Italy's decade of austerity has been harsher than anything George Osborne ever imposed? Are we seeing the delayed kick from cut after cut to the servizio nazionale sanitario, its budget pared to 6.6 per cent of GDP? If you think Britain's NHS has been starved of funds, spare a thought for Italy, Portugal and Greece.
Giuseppe Conte, the Italian premier, is riding a wave of national unity but his drastic decision to lock down Milan, Venice and much of Italy's industrial core will - while necessary - have violent recessionary consequences that Italy cannot counter. It lacks the sovereign instruments to do so.
As this becomes clear, Covid-19 will chip away at the ruling coalition and play into the hands of Matteo Salvini, the League strongman waiting in the wings. The spectacle of Rome pleading with Brussels for licence to defend its society in an emergency is his perfect foil. "Paying to belong to a union that sticks two fingers in our eyes is no longer sustainable," he said. Europeanism is a fair-weather attitude. In death people are national.
Traders work on the floor of the New York Stock Exchange, with concerns growing about how the coronavirus might affect the economy. Photo / AP
Germany is just days behind on a similar contagion trajectory, like most of Europe, and it too has been caught off guard. No doubt German efficiency and good kit will prevent the worst, but citizens have a surprise coming.
Hotlines are just as jammed as in Britain. Testing bureaucracy has been Kafkaesque. Berlin seems to be tilting towards economic business as usual, rather than contagion control. It will regret that choice.
My conjecture is that Covid-19 will trip up Angela Merkel's grand coalition, with the hard-Left (Linke), and the hard-Right (AfD) tearing into the flesh of a decaying political centre. Medical failings will unfold in tandem with a slump across the eurozone, which has failed to take advantage of the Draghi reprieve to rebuild monetary union on viable foundations.
The European Central Bank is exhausted. Interest rates are minus 0.5 per cent. The ECB can compress corporate debt yields further, or offer free loans to banks, but this is damage control.
Only fiscal stimulus on the scale of the New Deal can pull the eurozone out of a deflationary slide. Such a move collides head on with the EU's machinery of spending restraint. Token flexibility on deficit targets is not going to move the economic needle. It is too soon to tell whether Covid-19 is China's "Chernobyl moment" or to the advantage of the Communist Party. Xi Jinping has seized on the epidemic to tighten surveillance and build his personality cult.
He has launched a media blitz declaring a heroic victory, with martyrs entering the pantheon like heroes of the Long March. Party officials are putting it about that the coronavirus came from the US. It is a propaganda war.
We cannot judge claims that the epidemic is contained given the police state methods deployed to suppress any verification. There are rumours the virus is spreading fast in Beijing itself.
The Politburo's frantic efforts to revive economic output cuts against disease control. This relaxation in containment is akin to "suppressing a forest fire, but not putting it out," says Professor Mike Osterholm, author of Deadliest Enemy: Our War Against Killer Germs. What we have seen in China may be the "herald wave" before the virus returns, as it did with such ferocity in wave two of the 1918 Spanish Flu.
Tourists wearing protective masks walk past the Louvre Museum as the museum was closed for a staff meeting about the coronavirus outbreak. Photo / AP
The jury is also out on the US. It has allowed a surveillance failure. The fight is being led by a man who persisted in calling it a "hoax" after it was already endemic. That infamous mantra will ring down through the ages as his defining epithet.
Barely in office, Donald Trump slashed the global epidemic funds of the Centres for Disease Control by 80 per cent. His first reflex when cases escalated was to spin the message. All must be well so long as Wall Street is rising. The markets were wrong. On matters of science, it is better to heed scientists. The US tested almost nobody until early March. By then it was too late.
America is about to face a grim reckoning. The US has the best healthcare in the rich world, and the worst. Pandemics exploit the worst.
Trump can still avert disaster if he invokes executive powers to extend testing and care to the uninsured, and if he switches to lockdowns and wartime policies. But that is not happening. So the crowded rallies go on and the contagion will go exponential. I fear that the coming news cycle will be gold dust for Chinese propagandists.
As for this wet little island, we have weaknesses but also strengths. Listening to the candid reassuring tones of Professor Chris Whitty and Sir Patrick Vallance, I feel at least that we are not being spun. The decisions taken will be judicious. It is the old British style. We may just muddle through with our national model intact, if we are lucky.
