China has responded promptly, but its efforts may have come a bit too late

In November 2002, a cluster of abnormal fevers in Guangdong province in China went unreported for a few weeks. By the time the cause of the outbreak, dubbed SARS, or Severe Acute Respiratory Syndrome, was finally established as a coronavirus by the Chinese authorities, it was already February 2003. The World Health Organization, which was in the dark about the cause of the outbreak, could only notify it in April 2003. By that time, the virus had already spread worldwide. Eventually, 8,445 cases were detected and over 790 deaths were reported. Trade and tourism were disrupted. The World Bank estimated more than $38 billion in damages because of this outbreak.

History has repeated itself. An outbreak of a new coronavirus (different from SARS), starting from Wuhan in Hubei province in the last few weeks, has caused widespread panic, disrupting travel, leading to travel advisories, and affecting stock markets. Compared to the situation with SARS, the response of the Chinese government has been robust. Anticipating both global concern and the risk of local transmission, the Chinese have effectively placed the populations of 11 large cities, including Wuhan, under quarantine. Taken together, the quarantine of 56 million people represents the largest such effort in recorded history. The case fatality rate, or the proportion of cases that result in deaths, is under 4%. Compare that to close to 10% in the case of SARS, or 40% for Ebola.

However, these efforts may have come too late. The virus has been detected relatively early, but it is still too late. Public health officials are justifiably concerned and are watching the situation closely.

Just like with SARS, it is possible that the Wuhan coronavirus could disappear quietly. More likely, it will establish itself as an endemic disease, causing periodic disease, with the need for a new treatment protocol and possibly a vaccine. A third scenario could emerge, wherein the disease acquires mutations that causes it to become more virulent and cause more fatalities than it does now.

China’s National Health Commission has reported that the patients who died of the Wuhan coronavirus also exhibited other symptoms such as breathing difficulty, chest tightness and coughing. Worryingly, many of those who died did not have fever. This means that airport screenings, which are not helpful in the best of situations, are completely useless. It also means that patients who are infected may not report to medical providers in time, thereby increasing the likelihood of a bad outcome. If this virus can be transmitted without causing fever, it’s easier for the infection to travel globally because it can stay under the radar for a while.

From an economic standpoint, the SARS outbreak caused huge damage simply because of the uncertainty created by the refusal of the Chinese government to share any information. This time it is different. The Chinese have been forthcoming with timely information, have responded promptly and have enabled the world to respond. Uncertainty creates business disruptions and the situation could have been worse.

However, there is much to do to prepare for these outbreaks. More prompt reporting of fevers could help. In India, a technology using HealthCube, a point-of-care diagnostic platform, uses advanced sensors and wide deployment to report abnormal clusters of adverse health events. Digital health is good for patients and when used responsibly it is a boon for population health. Digital systems can tell us how long it takes to get from one place to another based on population information, but is not yet geared to provide early warning on outbreaks. This is both an opportunity and a challenge for India.

Ramanan Laxminarayan is director and senior fellow at the Center for Disease Dynamics, Economics and Policy, in Washington DC .