On the menu today: Remember a few weeks ago, when all kinds of media sources offered you ominous reports about a surge of patients with respiratory illnesses, particularly children, crowding into Chinese hospitals? And then after a couple of days, coverage of that portentous topic just seemed to disappear? Fear not. We have more data and information now, and doctors and health experts — from China to Taiwan to the World Health Organization to the U.S. CDC — are all seeing the same thing and offering the same assessment: This is what happens when the usual bouillabaisse of cold, flu, and other familiar viruses hit a population that spent much of the past three years in lockdowns. We in North America are probably going to have a typically frustrating winter of sniffles and coughs, but there’s little reason to think that the return of lockdowns is just around the corner. And finally, I take the histrionics of my critics seriously.
Back on the Virus Beat
Sometimes a new virus in China is the next great global pandemic. And sometimes, it’s just another virus.
I can’t begrudge anyone for hearing news about hospitals filling up in China last month and thinking, “Oh no, here we go again.” Back in late November, news organizations reported that hospitals in Beijing and northern China were “grappling with a surge of children with respiratory illnesses” and that “wait times to see doctors stretch for hours, with hundreds of patients queuing at some children’s hospitals in major cities across northern China.”
On December 1, Senator Marco Rubio of Florida, along with four other Republican senators, wrote to President Biden, declaring, “In light of an unknown respiratory illness spreading throughout the People’s Republic of China, we call on you to immediately restrict travel between the United States and the PRC. As you know, the Chinese Communist Party has a long history of lying about public health crises.”
That all sounds ominous and familiar to those of us who can remember back to early 2020. Readers and colleagues asked me* if this was Covid, the sequel. I held off on writing about this, wanting to know more, and knowing that time would give a clearer sense of what was spreading around those ill residents of northern China.
So far, this does not look like Covid, the sequel.
For starters, these illnesses appear to be caused by known viruses and bugs, not something new or unfamiliar to medical personnel. Back on November 22, the World Health Organization made an “official request to China for detailed information on an increase in respiratory illnesses and reported clusters of pneumonia in children.” A day later, the WHO concluded:
In the current outbreak of respiratory illness, the reported symptoms are common to several respiratory diseases and, as of now, at the present time, Chinese surveillance and hospital systems report that the clinical manifestations are caused by known pathogens in circulation. Mycoplasma pneumoniae is a common respiratory pathogen and a common cause of pediatric pneumonia and is readily treated with antibiotics. [Emphasis added.]
Mycoplasma pneumoniae is nothing new here in the U.S.; roughly 2 million people get it each year; “However, many infections are not diagnosed, so the actual number is likely higher.”
Now, I know you might have memories of the WHO saying, back on February 24, 2020, that it was “too early” to declare Covid-19 a global pandemic and then declaring it a pandemic on March 11. You may also remember the reports that the WHO simply went along with the erroneous, happy-talk assessments of Chinese authorities. So I understand if you don’t want to take the WHO’s assessment as the final word on the subject.
The good news is Taiwan’s Centers for Disease Control is carefully watching the reports and travelers from China, looking for any sign of a new virus or reason for concern — and it is safe to say the Taiwanese CDC is not inclined to trust the word of Chinese health authorities, or give them the benefit of the doubt. So far, Taiwanese officials are seeing the same things the WHO did — familiar pathogens, no reason for panic:
Public health officials have resumed the scouring of Chinese social media, medical and press reports and testing passengers at Taiwan’s four main airports for any anomalies, Lo Yi-chun, the deputy head of Taiwan’s CDC, told the Telegraph in an interview.
However, this time the data was “more reassuring” that the flu-like outbreak making headlines in China was not due to “unknown or unusual pathogens,” said Dr Lo, an epidemiologist.
“We look at social media posts and we don’t see alarming reports from healthcare providers this time, compared with December 2019,” he said.
“We also don’t see reports about hospital outbreaks among healthcare workers compared to last time. Those two usually indicate two alarming signals that can be related to unusual or unknown pathogens.”
Voluntary testing of inbound passengers from China, Hong Kong and Macau to airports in the main cities of Taipei, Kaohsiung and Tainan have also put minds at ease for now, he said.
And I know there’s a chunk of Americans out there who don’t hold the Centers for Disease Control and Prevention in such high esteem anymore, but the U.S. CDC is seeing the same things as well:
“What we know as of right now, today, what’s happening in China, they are having an increase in some of their respiratory illness they’re seeing in the northern part of their country, they’re seeing an uptick in their pediatric population,” CDC Director Mandy Cohen told a House subcommittee. “What we do know as of, again, as of today, is we do not believe this is a new or novel pathogen. We believe this is all existing – meaning COVID, flu, RSV, mycoplasma. But they are seeing an upsurgence.”
What we are seeing in Beijing and northern China is probably a consequence of the Chinese government keeping its citizens in lockdowns for long stretches of the past three years — the ridiculously strict “zero Covid” policies that kept some cities locked down for more than 100 days.
People’s immune systems haven’t encountered as many viruses and bacteria as they normally would have, and their immune systems are “out of practice” in fighting them off, resulting in more severe and longer illnesses. And that’s particularly true for children’s immune systems, as their young bodies have even less “practice” fighting off pathogens than adults. Keep kids indoors and away from their peers for a couple of winters, and the next cold and flu season is going to hit them like a wrecking ball.
Also note that the assessment is that these Chinese communities are encountering several known pathogens simultaneously as winter begins — “COVID, flu, RSV, mycoplasma,” in the CDC director’s testimony.
Covid, influenza, and RSV (respiratory syncytial virus) are viruses, while mycoplasma is bacteria.
Let’s pause for a clear definition of some terms. Most lung infections result in pneumonia, which is an inflammation of the lungs’ air sacs (alveoli). The air sacs may fill up with fluid or pus, causing symptoms such as a cough, fever, chills, and trouble breathing. It can be fairly mild — you may have heard the term “walking pneumonia” — or it can be serious enough to kill you if you’re old enough or have other health complications.
The short version of the differences between bacteria and viruses is that “bacteria are free-living cells that can live inside or outside a body, while viruses are a non-living collection of molecules that need a host to survive.” Pneumonia can be caused by viruses, bacteria, or fungi. (Insert The Last of Us jokes here.)
You can find frightening-sounding headlines about the outbreak in China like, “Doctors in meltdown as mystery China virus’ stops responding’ to all antibiotics.”
There is an argument that what Chinese doctors are seeing in these cases is a consequence of excessive use of antibiotics in the past; as Bloomberg News reported, “Several experts blame overuse in mild infections for the high level of resistance. In many cases, the drugs remain easy to get, with doctors prescribing them upon request or in anticipation of illness.”
Also, keep in mind that antibiotics are effective against bacterial infections, not viruses. Viruses do not respond to antibiotics; if they did, we could have just given antibiotics to those who caught Covid-19. Some of the Chinese patients who are being treated with antibiotics and not seeing any improvement probably have viral infections, not bacterial infections.
By the way, the fact that China’s crowded hospitals are not the result of a new pathogen doesn’t mean that everybody is out of the woods. Old, familiar pathogens can still give you a really bad case of pneumonia!
We’re now roughly a month into this outbreak, and there have been plenty of flights from China to other countries during that span. We’ve seen some increases in respiratory ailments here and there — 15 states and New York City — but there’s no clear tie to travelers from China. One of the problems with trying to figure out what’s causing a rise in cases in early winter is that this is cold and flu season — this is when cases go up for normal, seasonal reasons. We have the same colds, flu, Covid-19, and RSV going around as the rest of the world. The CDC is tracking a new variant of Covid, JN1, that is “either more transmissible or better at evading our immune systems. At this time, there is no evidence that JN.1 presents an increased risk to public health relative to other currently circulating variants.”
We can get through this winter with the usual common sense: Stay home if you’re sick, wash your hands, and drink plenty of fluids. If you think your child may have pneumonia, take your child to the doctor. If you think you may have pneumonia, go see a doctor.
*I am not a doctor, nor do I play one on TV. According to Taiwan’s Mainland Affairs Council deputy minister Jyh-horng Jan, my reporting on the lab-leak theory and Covid “made me an enemy” to the Chinese government, so I’ve got that going for me.
ADDENDUM: Friday’s Jolt, asserting that the U.S. military would not assist a second-term President Trump in canceling elections and staying in power for the rest of his life, generated the expected reaction. And by that I mean the Trump critics insist that I am a MAGA-hat-wearing Trump apologist, and Trump fans are denouncing me for my “visceral Trump Hatred Disorder.”
Tom Nichols recognized that I’m not a Trump guy — that means nothing to his followers — but contended that I fail to see that any Republican return to the White House would have dire consequences for democracy.
People whose worldview and identity are built around the belief that we are on the doorstep of a second Civil War really hate being told that we are not on the doorstep of a second Civil War. People whose worldview and identity are built around the belief that their neighbors who vote differently are plotting to kill them really hate being told that their neighbors are not plotting to kill them.
But let’s take these folks at their word. Let’s accept, for the sake of argument, that if Donald Trump wins the 2024 election, that will be the last free and fair election in U.S. history, and that if Trump wins, America as we know it is gone forever. A second-term Trump will create a right-wing cult-of-personality dictatorship that barrels through all the checks and balances in the U.S. Constitution.
From such a perspective, the stakes seem as high as possible: If Biden or some other Democrat wins, America is preserved. If Trump wins, the country is destroyed.
I guess you could call this upcoming presidential election . . . a Flight 93 election?
And if you really believe that the election of Trump means the end of American democracy and the rule of law and inevitably leads to a descent into authoritarian fascism . . . doesn’t that justify stopping him by any means necessary?