African-Americans are being hit harder by Covid-19 than others in the USA.
In Chicago, African-Americans are half the Covid-19 cases and more than 70% of deaths, yet only 30% of the city.
In Milwaukee, they are 81% of Covid-19 cases and 26% of the population. In Louisiana, 70% of deaths and 33% of the population.
Almost always in epidemics, the worst-off suffer worse. They are likely to be in poorer health already; to live in more crowded housing; to have to continue to work in sometimes crowded workplaces, rather than working from home or taking time off.
In Britain, home care workers - usually un-unionised and with almost no workplace organisation - are still out and about with no PPE (Personal Protective Equipment).
We campaign for equal rights for all to PPE, for closing down inessential workplaces in the shutdown, and for rent cancellations, fallback pay, etc. for all, so no-one is under economic pressure to behave unsafely.
In the Spanish Flu pandemic, the Chinese in San Francisco seemed on paper to get off lightly. Almost certainly they got little medical help and their flu deaths were not counted as such.
Something like that is happening on a global scale today. On the official figures, Covid-19 deaths in Ecuador are running at about 10% of long-term average deaths per day. In Britain now, around 50%.
But journalists report desperate households in Guayaquil, Ecuador’s biggest city, dumping corpses in the street because they can get no help. No-one counts accurately.
The statistics of this epidemic are difficult to pin down even with good and well-resourced effort.
On 6 April scientists in the Netherlands concluded that the country will need two years of gradually-eased lockdown to tame the virus (see here). On 24 March scientists at Stanford University in the USA modelled different lockdown and easing schedules: all of them project some on-off lockdown well into 2021 (see here).
But we don’t know some of the basic numbers here.
What proportion of Covid-19 cases have gone uncounted with no or tiny symptoms? Estimates range from 5% to 80% (see here). We don’t know how many uncounted infections have happened with symptoms which might be Covid-19 or might be another virus (see here).
What is R0, the number of people a sufferer will infect in a population where no-one has immunity? The study by British scientist Neil Ferguson which pushed the British government into lockdown measures by predicting high deaths cited best estimates between 2.2 and 2.6 (see here). Now a study from the US Center for Disease Control estimates 5.7 (they’re fairly sure it’s between 3.8 and 8.9): see here.
With R0=2.2, 54% of the population will eventually get the virus, unless a vaccine comes; with R0=5.7, 82%. (So far, counted Covid-19 cases number just over 0.1% of the UK population).
The purpose of the lockdowns is to push down R0, delay the spread, and help the hospitals cope. But full lockdowns cannot continue forever, and (except in a small country which can police its borders rigidly) they can’t wipe out the virus. Without a vaccine, they will be followed by a bigger R0 and some new spread of the virus.
We’re fairly sure that Covid-19 is spread via person-to-person contact, by droplets carrying the virus. Some say that most of the spread has come from household contact and gatherings where people kissed, hugged, held hands, etc. A recent Chinese study reckons the risk from casual contact, on public transport for example, is only 1% of that from household contact: see here. But we don’t know. We don’t know how your outcome if infected depends on the “viral load”, the quantity of the virus you first receive.
We want more testing. But Germany, with the highest testing rate of all the big countries, has done only 1.5 tests per 100 population. And we are not sure how accurate the tests are: see here.
None of this tells us to despair. A vaccine may be developed. A treatment may be developed. The virus may mutate benignly. We may find social-distancing policies more sustainable long-term than full lockdown which can reduce R0 a lot. The higher estimates of uncounted cases and the lower ones of initial R0 may prove right. The current easings of lockdowns by China, Austria, Denmark, and Norway may go well.
But five conclusions follow.
We’re in for a long haul.
We are ignorant. We should insist on open scientific debate and scrutiny, and warn against quack “instant” answers. More information from more testing will help.
Vaccine research is vital. That the Wellcome Trust has to appeal to donors for $8 billion to fund that research is a scandal.
Pharmaceuticals and other industries should be requisitioned and put under public control and workers’ scrutiny to get the best mobilisation both for basic health supplies (like PPE) and for future vaccines or treatments.
Whatever the medical parameters turn out to be, a fight for social equality will reduce the extra blow against the worst-off.