Which Cities are most likely for the Coronavirus to Spread?

Covid-19 does not respect artificial human boundaries like national borders.

While China has done a commendable job in slowing down the virus and containing it long enough for some countries to make decent preparations, I think most of the evidence points to outbreaks in large cities. Which cities are most likely to be impacted?

Beijing, China

Shanghai, China

Singapore

Hong Kong

Tokyo, Japan

Kuala Lumpur, Malaysia

New York, U.S.A

In a nutshell those cities with community spread and where community spread is most likely to occur. Outbreak at that speed occurs faster in densely populated urban areas.

Again China’s information isn’t correct as thousands of Chinese health-workers have been infected, not hundreds. Combed with deception by Huawei, there’s very historical reasons why the U.S. doesn’t trust China’s numbers regarding the outbreak. Neither of course does any rational person interested in the novel coronavirus outbreak.

When Beijing made self-quarantine mandatory for all returning citizens, it showed that the situation in major cities in China is likely worse than is being reported. What starts in Wuhan doesn’t stay in Wuhan, as community spread in Singapore, Japan, Hong Kong and now perhaps Malaysia is showing.

As the coronavirus is not really peaking, of course there will be major economic consequences. China is in a heap of trouble to maintain social order and its economic engines on.

The coronavirus that emerged from China’s Hubei province over a month ago and has spread to nearly thirty countries with even a case in Egypt, the first in Africa. Indonesia, India and many African countries are seen as nearly incapable of stopping or identifying the spread of the virus in a timely manner.

So why should we be worried about major urban centers?

The Geneva-based WHO have done a decent job corroborating China’s story on the virus, but that will soon become impossible if community transmission occurs in more major cities in the world. Many virologists and analysts expect this to occur.

Covid-19 is challenging because transmission could be higher than the upper range of 2.5 noted by the WHO. Most cases will spread to a spouse, and some super-spreaders will spread the virus to 10 or more others. As it continues for several more weeks and likely many months, China will have difficult keeping its cyberspace free from protests.

Japan’s cases went from 41 to 59 in the last two days, and community transmission in hospital settings are very difficult to contain. As new clusters occur all over Japan, it becomes difficult for them to contain it. Countries who were slow to shut down travel from China are at higher risk. These include Japan and Hong Kong especially.

Singapore: 75 cases

Japan: 59 cases

Hong Kong: 57 cases

Japan recently overtook Hong Kong in the number of cases.

U.S. mistrust of China goes as far back as the 1950s, when national authorities set unrealistic production quotas that led local officials to inflate data. With Huawei denying its back-door capabilities, mistrust of Chinese numbers is widespread in the Western world.

Unfortunately for China's history of trustworthiness, mishaps with the 2003 outbreak of SARS, which sickened 8,098 people and killed about 800 over nine months, and discrepancies in reporting of economic data over the past two decades has only hardened the U.S. government’s belief that China cannot be trusted, experts say.

While China reports under 400 cases in both Shanghai and Beijing, the latest Canadian cases is from a woman from Shanghai. Not any travel to Hubei province. What does this likely indicate? China only let in the WHO team the weekend of February 15th, more than 6 weeks after the first cases emerged.

With even Facebook and Twitter pushing the WHO official numbers, we have to wonder at how to find objective figures as to what is going on, as the WHO data increasingly by academic experts, is seen as not syncing with what we know about how contagious this virus actually is.

The Lancet has some interesting coronavirus studies. Spread on the Princess Diamond cruiseship has been very fast, up to 355 cases as testing continues and evacuations are now occurring. Apparently being quarantined in your room doesn’t do a whole lot of good.

A lot of young people below 35 appear to have no or delayed symptoms even as they are carriers (the virus is contagious at the earliest symptom stage).

These symptoms are like a cold or flu and are thus difficult to test for or prevent. The virus can be lethal for people over 70 with pre-existing complications where their organs can become more vulnerable to its impact.

Beijing and Shanghai have under 1,000 reported cases and only four deaths, based on data compiled by Johns Hopkins University.

But these are just the official Chinese numbers given. We have to assume the busiest Chinese cities would have been the most vulnerable with the Wuhan escape of millions of citizens.

China has invested in aggressive quarantines, lock-downs, travel bans and technology but without much success in lowering the spread of the infection. At a certain point their system will be over-taxed by this “war-zone” approach to dealing with the virus.

At a certain point that approach breaks down because it’s no longer logical given the Wuhan migration of millions before the Wuhan lock-down occurred on January 23rd.

Officials finally began to seal the borders on Jan. 23. But it was too late. In this light, the quarantine approach made little sense and likely will have economic consequences and not just social stability decreases that dramatized the impact of the novel coronavirus. I believe it was the wrong approach, as do many virologists that see how it could backfire in the long-run.

Most virologists see Covid-19 becoming like H1N1, just another type of yearly flue that we’ll have to deal with. There doesn’t seem to be much way around that, but by being so aggressive against the virus, China elevated the Wuhan novel coronavirus into a celebrity virus.

China created a martyr in Dr. Li, got rid of citizen journalists and likely left Wuhan to fend for itself without adequate supplies, all forms of collective mismanagement. But that’s just the reality of a new virus, you cannot blame the country where it started — as it knows no boundaries like we do.

Where is Community Spread likely to Occur First?

Community spread is most definitely occurring in Beijing, Shanghai, Singapore, Hong Kong and perhaps Tokyo by mid February, 2020. Why would this not occur in other major global cities? From Singapore and Hong Kong it spreads to:

Tokyo, Japan

Kuala Lumpur, Malaysia

Jakarta, Indonesia

Bangkok, Thailand

Manilla, Philippines

Ho Chi Minh City, Vietnam

New Delhi, India

And so forth. The CDC very nearly expects community transmission to occur in the U.S. in the next few weeks.

Covid-19 is not a doomsday Pandemic, it’s not the big one we are due for. It’s more like a serious flu dangerous for the elderly with weakened immune systems and organs.

New York, Vancouver, Manchester, London, Toronto and Los Angeles all have significant East-Asian populations which could make outbreaks likely in those cities before others.

However up until today on February 16th, there’s been no evidence of community spread taking place in the U.S., with very limited clusters in Europe. However, it may be simply too early to say.

If the virologists are right and this becomes just another global virus, we won’t associate it with Wuhan or Chinese people in the long-run, it will just happen to be where the virus originated.

As a Chinese woman who wears a mask on the subway, I’m already getting some weird looks. But I’m more interested in the data and the speculation of where the virus could be headed next.

China’s critical initial failure to inform the public heightened anxieties, fear, and widespread speculation and its quarantine approach also raised the global alarm and fear. In early 2020, we’re just discovering the true economic impact of the virus as well as the dust settles.

Travel bans only make sense in slowing the virus, not stopping it. The WHO saying there’s a “window of opportunity” to stamp out the virus doesn’t make medical sense in any epidemiological context.

The “virus cruise” shows just how contagious the Covid-19 appears to be. If death occurs, it usually only occurs in the 9 to 15 day period. How many of those 355 cases may lose their lives?

There are only 68,500 official cases. Chinese are some of the most mobile global citizens, so now the WHO is saying that “China has bought the world time”. I’d suggest China has proven to be a panic button with their handling of this virus. It’s a media and information circus when censorship releases even more extreme content.

It’s possible to quarantine hundreds, but not thousands. Chinese style draconian lock-downs are not possible in most countries, nor desirable.

You have to treat the patient, not the problem. Because you cannot fight a virus. You can go to war with invisible monsters.

The idea that this is some foreign China problem is absurd, the world is by far too small a place for that to be true any more. With a media circus already, imagine if Covid-19 does spread to global cities with community transmission in the coming weeks? It will be a chaotic sight.

There’s some rumblings that Covid-19 could not just be droplet spread but airborne. Remember China denied that human to human transmission even was occurring for weeks at the beginning. But Chinese videos has shown the spraying of cities, neighborhoods and external areas which has led many to question the means of transmission.

If Covid-19 continues further outbreaks, central banks won’t be able to bail out the world indefinitely. A global recession could become more possible, with a stock market correction occurring potentially in March or April, 2020.

Wall Street has totally ignored Covid-19 for the most part, since it’s not an American problem, yet.

If the coronavirus spreads to Japan with a fresh outbreak, the chances of it spreading to major global cities rises. I believe in the 3rd and 4th weeks of February this is what we’ll witness. Early signs point to this looming outbreak event.

China’s official cases correlates simply with their testing capacity, nothing else. The coronavirus isn’t contained, the peak could be months away, not days.

What cities do you think could be most susceptible to Covid-19?