1.1.1 The Covid-19 Epidemic: A Basic Chronology
It appears that the virus responsible for “Covid-19”, short for “coronavirus disease 2019”, namely “SARS-CoV-2”, short for “severe acute respiratory syndrome coronavirus 2”, began infecting people for the first time in December 2019 in Wuhan, a city of about 11 million people located in Hubei province, China.Footnote 1
The emergence of SARS-CoV-2 was first observed when cases of unexplained pneumonia were reported in Wuhan. Within the first few weeks of the outbreak in Wuhan, an association was noted between these first cases of Covid-19 and the Wuhan Huanan Seafood Wholesale Market (also known as the “Huanan Market”). Authorities therefore decided to close the market on 1 January 2020 in order to clean up and disinfect the environment. The market, which sold aquatic and seafood products, as well as farmed wild animal products, was soon suspected to be the epicentre of the outbreak, which also suggested a human-animal interface event. However, retrospective investigations later identified additional cases with onset of illness as early as December 2019, but not all of these early cases were associated with the Huanan market.Footnote 2
On 9 January 2020, the World Health Organization (WHO) was still in doubt about the roots of what would become the Covid-19 pandemic. Yet the WHO noted from the outset that the wave of pneumonia cases in Wuhan could have been caused by an unknown coronavirus. There were, at that time, fifty-nine known cases of Covid-19, and travel precautions were already at the forefront of experts’ minds.Footnote 3
The Chinese government and the WHO initially downplayed growing concerns that the disease could be easily transmitted between humans. At a press conference in Geneva that took place on 14 January 2020, Maria Van Kerkhove, acting head of the WHO’s emerging diseases unit, was quoted by Reuters as saying that there had been “limited human-to-human transmission” in Wuhan.Footnote 4 Another 6 days passed before Zhong Nanshan, a Chinese epidemiologist and government adviser, finally confirmed in an interview with state media on 20 January 2020 that the virus could indeed be transmitted between people.Footnote 5
As the Covid-19 outbreak coincided with the approach of the Lunar New Year, it is suspected that travel between Chinese cities prior to the start of the festival facilitated the transmission of the virus within China. In this way, Covid-19 quickly spread to other cities in Hubei province and then to other parts of China as well. Within a month, the virus that caused Covid-19 had spread to all 34 provinces in China.Footnote 6
On 20 January 2020, three new cases of Covid-19 were reported in Thailand and Japan, prompting the US Centers for Disease Control and Prevention (CDC) to start screening for the virus at JFK, San Francisco and Los Angeles International airports. These airports were chosen because most passengers flying from Wuhan to the United States make use of these airports.Footnote 7 By the next day, Covid-19 had killed four people and infected more than 200 in China, before Dr. Zhong Nanshan finally confirmed that the disease could be transmitted from human to human. However, the WHO was still not convinced of the necessity to declare a public health emergency.Footnote 8
After weeks of surveillance, on 23 January 2020—when the first cases of Covid-19 were reported in the United States (cf. Sect. 2.5.1) and Europe (cf. Sects. 2.3 and 2.4)—Wuhan was quarantined; the city was locked down to contain any further contagion, with curfews and extremely restricting movement for a period that would last another 11 weeks.Footnote 9 By this time, another 13 people had died and 300 were ill. China took the unprecedented step of not only closing Wuhan and its population of 11 million, but also placing a restricted access protocol on Huanggang, 30 miles to the east, where residents could no longer leave without special permission. This meant that up to 18 million people were placed under strict control.Footnote 10
The Covid-19 epidemic in China is said to have reached its epidemic peak in February 2020. According to the National Health Commission of China, the total number of cases continued to rise sharply in early February 2020, at an average rate of over 3000 new confirmed cases per day. To control Covid-19, China resorted to unprecedentedly stringent public health measures. As a result of these measures, the daily number of new cases in China would soon begin to decline steadily.Footnote 11
In February 2020, a joint WHO-China mission on Covid-19 was convened to discuss planning in China and internationally on the next steps in response to the Covid-19 epidemic:Footnote 12
The official death rate in Wuhan was 1147 per 100,000 over the period 1 January to 31 March 2020. Outside Wuhan, the death rate was 675 per 100,000, lower than the expected rate of 715, after lockdowns reduced deaths from other causes, such as ordinary pneumonia or road accidents. Further research suggested that there were around 6000 additional deaths in Wuhan over the period January–March 2020 (compared to the same period in 2019), of which 4573 were caused by pneumonia, most of them related to Covid-19.Footnote 13
In the Western world, events in China could be followed through broadcasts and publications on the news and social media; however, at that time, the West did not take the threat posed by Covid-19 all too seriously. Given the severe containment measures that China used, one should have known better.
With a global death toll of more than 200 and an exponential jump to more than 9800 cases, on 31 January 2020, the WHO finally declared a “public health emergency”, for only the sixth time in its history.Footnote 14 On the same day, Joseph Wu—together with his colleagues Kathy and Gabriel Leung—published in “The Lancet” the results of a study he had been conducting since the outbreak of Covid-19 in Wuhan, in which he warned that countries should already start preparing for a possible pandemic:Footnote 15
Given that 2019-nCoV is no longer contained within Wuhan, other major Chinese cities are probably sustaining localized outbreaks. Large cities overseas with close transport links to China could also become outbreak epicenters, unless substantial public health interventions at both the population and personal levels are implemented immediately. Independent self-sustaining outbreaks in major cities globally could become inevitable because of substantial exportation of presymptomatic cases and in the absence of large-scale public health interventions. Preparedness plans and mitigation interventions should be readied for quick deployment globally.
From February 2020 on, the highly transmissible Covid-19 virus gradually spread to various other countries, including many European countries and the United States, as well as Asian countries such as Japan, Vietnam and Taiwan.Footnote 16 The Covid-19 virus rapidly surpassed SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) in terms of the number of people infected and the spatial extent of epidemic areas, posing an extraordinary threat to global public health.Footnote 17 Indeed, already by 10 February 2020, the number of deaths caused by Covid-19 in China had surpassed that of the SARS epidemic 17 years earlier, with 908 deaths reported in China in the previous month, compared to (“only”) 774 deaths during the SARS crisis.Footnote 18
On 25 February 2020, Nancy Messonnier, MD, director of the CDC’s National Centre for Immunization and Respiratory Diseases, explained that the Covid-19 outbreak already met two of the three conditions required for qualifying it as a pandemic: (1) a disease-causing death, and (2) sustained person-to-person spread. (3) Global spread was the third criterion, but it was not yet met at the time.Footnote 19
On 11 March 2020, the WHO declared Covid-19 a “pandemic”.Footnote 20 In making this declaration, Tedros Adhanom Ghebreyesus, WHO Director-General, told at a briefing in Geneva that the agency was deeply concerned about the alarming levels of “spread and severity” of the Covid-19 epidemic. Mr. Ghebreyesus also expressed his huge concern about the alarming levels of inaction.Footnote 21
In the words of the WHO Director General:Footnote 22
We have therefore made the assessment that COVID-19 can be characterized as a pandemic.
Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.
Describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this virus. It does not change what WHO is doing, and it does not change what countries should do.
We have never before seen a pandemic sparked by a coronavirus. This is the first pandemic caused by a coronavirus.
And we have never before seen a pandemic that can be controlled, at the same time.
WHO has been in full response mode since we were notified of the first cases.
And we have called every day for countries to take urgent and aggressive action.
We have rung the alarm bell loud and clear.
Since then, both the horror of Covid-19 and the arsenal of measures to contain it have rapidly increased and have even been overtaken by a variety of complex socio-economic and cultural implications, soon triggering a capitalist crisis that was still ongoing at the time of finishing this book.Footnote 23
Already at the beginning of March 2020, the number of Covid-19-related deaths in Europe exceeded those in Asia. From mid-April 2020 onwards, the focus of the pandemic shifted to the United States where, due to the Trump administration’s lack of adequate response to the Covid-19 crisis (cf. Sect. 2.5), the number of deaths would since then remain consistently high until 2021—when the US vaccination-campaign started gradually protecting the American people from the Covid-19 virus—although the epidemic shifted from the North East to other parts of the country.Footnote 24
In May 2020, the 73rd World Health Assembly adopted Resolution WHA73.1 dealing with the response to Covid-19. In this resolution, WHO Member States requested the Director-General:Footnote 25
to continue work closely with the World Organization for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO) and countries, as part of the One-Health Approach to identify the zoonotic source of the virus and the route of introduction to the human population, including the possible role of intermediate hosts, including through efforts such as scientific and collaborative field missions, which will enable targeted interventions and a research agenda to reduce the risk of similar events occurring, as well as to provide guidance on how to prevent infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in animals and humans and prevent the establishment of new zoonotic reservoirs, as well as to reduce further risks of emergence and transmission of zoonotic diseases.
As of 3 June 2020, Covid-19 had already claimed some 380,000 human lives and had infected approximately 6.4 million people in more than 185 countries worldwide.Footnote 26
Remarkably, it was only by 6 July 2020 that a group consisting of hundreds of scientists from various countries began to ask the WHO “to revise the recommendations on Covid-19 to better reflect its potential for airborne transmission”. Previously, WHO itself had kept on stating that “Covid-19 is spread mainly by small droplets from the nose or mouth emitted when an infected person coughs, sneezes or talks”.Footnote 27 Finally, on 9 July 2020, the WHO announced that Covid-19 could be transmitted by air, in response to the letter of the aforementioned group of scientists asking the agency to revise its previous recommendations. In an updated scientific note, the WHO acknowledged that Covid-19 could persist in the air of crowded indoor spaces and pointed out that the virus could also be transmitted by asymptomatic people.Footnote 28 This view was subsequently confirmed by a study (based on an analysis of mobile phone mobility data in major cities) published in the journal “Nature” on 11 November 2020, which showed that most new Covid-19 cases came from indoor gatherings in places such as bars, restaurants, gyms and grocery shops.Footnote 29
In July 2020, based on the recommendations of the 73rd World Health Assembly, the WHO sent an advance team to China to agree on a way forward to better understand the origins of the Covid-19 virus.Footnote 30
On 28 September 2020, according to the New York Times, the number of Covid-19-related deaths worldwide passed the one million mark, “surpassing deaths from HIV, dysentery, malaria, influenza, cholera and measles combined in 2020”.Footnote 31
Less than a month later, on 19 October 2020, Data from Johns Hopkins University indicated that Covid-19 cases had surpassed the number of 40 million on a global scale. Indeed, in the aftermath of the 2020 summer season, the United States and various European countries then even experienced their highest rate of new cases in months, a situation soon to be known as the “second wave” of the Covid-19 pandemic. By then, more than 1.1 million people had been killed by the Covid-19 virus worldwide, including nearly 220,000 in the United States, the hardest-hit country at the time.Footnote 32
As of 3 March 2021, Covid-19 had infected more than 115,773,776 people, with 2,571,296 deaths reported. North and South America were the most affected regions in terms of cases and deaths, but Asia was not far behind, mainly due to outbreaks in India. Meanwhile, according to National Geographic, the global economy had collapsed, while containment and mitigation efforts continued to disrupt all sectors of economic life, such as manufacturing, education, the financial sector, and numerous other sectors (Table 1.1).Footnote 33
On 12 April 2021, the WHO reported that the global Covid-19 pandemic continued to grow exponentially, with reports of 4.4 million new cases in the preceding week, the seventh consecutive week of rising numbers, indicating what was being referred to as the “third wave” of the Covid-19 pandemic.Footnote 34 Covid-19 had by then killed at least 2,937,355 people since its outbreak in China in December 2019. At least 135,952,650 cases of infection had been recorded on a global scale. In its announcement of 12 April 2021, the WHO said its latest global figures represented a 9% increase in infections over the previous week and a 5% increase in deaths. WHO Director-General Tedros Adhanom Ghebreyesus also said that “confusion, complacency and inconsistency in public health measures” were prolonging the Covid-19 pandemic, and that it would take still months before the situation was brought under control, and only through concerted action.Footnote 35
According to The Guardian, on 17 April 2021, a dark milestone was reached in the Covid-19 tragedy when it was revealed that the number of deaths from the disease worldwide had exceeded three million.Footnote 36 The news was announced by the Welcome Trust’s director, Jeremy Farrar, who also warned that the actual number of Covid-19 deaths was likely much higher. More worryingly, the Covid-19 pandemic was reported to continue to grow at an alarming rate, with hundreds of thousands of people still dying every month.Footnote 37 As of the same date, according to the Covid-19 dashboard managed by Johns Hopkins University, there had already been more than 140 million cases of the disease since the Covid-19 pandemic began in 2020, with the official death toll reaching 3,001,068. The most affected country in absolute numbers was the United States, with more than 31 million cases and over 560,000 deaths.Footnote 38 India and Brazil had also been badly hit, with the former recording over 14 million cases and 175,000 deaths, while the latter had just under 14 million cases and almost 370,000 deaths. Britain, which was also heavily affected by the disease, recorded more than four million cases and a death toll that at the time stood at more than 127,000.Footnote 39
In the week leading up to 27 April 2021, there were more than 5.8 million new cases of Covid-19 worldwide, the highest number ever. By the same date, more than three million people had died from Covid-19, with the WHO reporting that infections and hospitalizations among people aged 25–59 were increasing at an alarming rate. According to WHO Director-General Tedros Adhanom Ghebreyesus, it took “nine months to reach 1 million deaths, four months to reach 2 million and three months to reach 3 million”.Footnote 40
In April 2021, the biggest increases of the Covid-19 outbreak were seen in South-East Asia, largely in India, and in the Eastern Mediterranean and Western Pacific regions, but the situation was also very bad in Latin America, where it was reported that people who had migrated to Brazil in search for work were fleeing the humanitarian disaster there.Footnote 41 Infection rates also remained high in many rich countries, including the United States and large parts of Europe, but in these rich countries the mood was more optimistic: as Covid-19 vaccines were distributed at an increasing extent, many people felt that the worst was behind them.Footnote 42
However, the Covid-19 endemic in countries such as India and Brazil began to shape the subsequent evolution of the Covid-19 virus, and there was a growing concern that it could lead to the emergence of even more dangerous variants of the Covid-19 virus, which neither borders nor vaccines could guarantee to prevent.Footnote 43
On Saturday 24 April 2021, at least 1,002,938,540 doses of a Covid-19 vaccine were reported to have been administered in 207 countries and territories all over the world. Nevertheless, the global number of new infections in a single day still reached a record high of 893,000 on 23 April 2021, with India accounting for more than a third of these new infections.Footnote 44 On the same date, Saturday 24 April 2021, Brazil had its deadliest month on account of the Covid-19 virus, with nearly 68,000 deaths reported in April 2021 so far (with still 1 week left in the month).Footnote 45
In April and May 2021, a second horrific wave of Covid-19 hit India, home to nearly one-fifth of the world’s population. This second wave was reported to plunge the country into “death, despair and desolation”. Scenes of suffering were shown, of people dying for lack of oxygen and medical care, both hardly available while the country was in general enduring shortages of medicines and other commodities, as well as mass cremations and burials, grieving survivors of diseased, overwhelmed health workers and “sheer human helplessness”. On 8 May 2021, India recorded about 400,000 reported cases per day (although the actual number may have been eight to ten times higher). Some models even predicted that by mid to late May 2021, the actual numbers could be between 800,000 and 1 million cases per day, and 5–10,000 deaths per day.Footnote 46
On 12 May 2021, India accounted for one-third of the world’s reported Covid-19 deaths. Hospital and medical staff, as well as morgues and crematoria were completely overwhelmed, and medication and medical oxygen were in short supply.Footnote 47 Two days earlier, dozens of bodies—some media reports put the number of corpses as high as 100—all believed to be Covid-19 victims, were reported to have washed up on the banks of the sacred Ganges River in northern India, as the Covid-19 pandemic spread through the country’s vast rural hinterland, also there overwhelming local health facilities, crematoria and cemeteries alike.Footnote 48
1.1.2 Nature of Covid-19
According to Morens et al., until the outbreak of the Covid-10 epidemic, relatively little had been known about coronaviruses. Moreover, research interest in these “cold viruses” was said to be minimal.Footnote 49 Also according to Morens et al., the viral agent of Covid-19, “SARS-CoV-2”, was named after the genetically related “SARS-CoV” (more recently distinguished, by some, as “SARS-CoV-1”) which had already been reported to have caused a deadly near-pandemic in 2002–2003. However, until 2019, neither SARS-CoV-2 nor its genetic sequences themselves had ever been identified in human or animal viruses.Footnote 50
Morens et al., have defined coronaviruses as RNA viruses that are distributed worldwide in a large but unknown number of animal species.Footnote 51
According to these same authors,Footnote 52 18 years before the Covid-19 epidemic, a previously unknown β-coronavirus, “SARS-CoV” (also known as “SARS-CoV-1”), had suddenly appeared. After its initial appearance in China, SARS-CoV-1 had spread to twenty-nine other countries, causing a near-pandemic while killing 813 of the 8809 people who contracted the infection, before finally being controlled by aggressive public health measures. This “SARS-CoV”-virus has reportedly not been seen since.Footnote 53
Still according to Morens et al., in 2021, another previously unknown β-coronavirus, called “Middle East respiratory syndrome coronavirus” (“MERS-CoV”), emerged to cause highly lethal human infections. However, this virus, which is closely related to “SARS-CoV”, does not transmit efficiently between humans. Cases have, therefore, remained largely limited to the Middle East because its intermediate host, the dromedary camel, is said to be present there in relatively high numbers.Footnote 54
Morens et al., furthermore, made the observation that in 2016, another new coronavirus originating from bats, this time an α-coronavirus, emerged in China to cause a new epizootic in pigs, namely the “porcine acute diarrhoea syndrome coronavirus” (“SADS-CoV”).Footnote 55 Finally, at least as of late November 2019, “SARS-CoV-2”, commonly referred to as (the) “Covid-19” (virus), was recognised as the third fatal emergence of human disease associated with a bat virus and the fourth mammalian emergence associated with a bat virus in 18 years.Footnote 56
Unlike its predecessors, the Covid-19 virus quickly became a phenomenal success and even managed to cause the worst pandemic in over a century.
In addition, the Covid-19 virus would soon begin to mutate,Footnote 57 raising concerns about: (1) a higher degree of contagiousness; (2) the fact that a new variant could be more deadly, or lead to more severe disease, and (3) a greater resistance of the virus to vaccines.
The Sars-CoV-2 virus has mutated from the start. On average, a single Sars-CoV-2 virus accumulates two single-letter mutations per month.Footnote 58 In comparison, the flu virus mutates at about twice that rate. Many of the mutations that occurred early on helped the Sars-CoV-2 virus adapt to humans.Footnote 59 For example, the variant of the virus that was first detected in Wuhan, China, was not the same as the one that reached most parts of the world, the D614G mutation that appeared in Europe in February 2020, to then become the dominant form of the virus worldwide. Another variant, called A222V, spread to Europe and was linked to people’s summer holidays in Spain.Footnote 60
On 23 September 2020, a study at Houston Methodist Hospital described a new, more contagious strain of Covid-19 in a large proportion of samples from—at the time—“recent” patients. Investigators reportedly analysed samples from the earliest phase of the Covid-19 pandemic and from a more recent wave of infection, concluding that almost all strains from the most recent phase of the Covid-19 disease had a mutation that allowed the virus to bind and infect more human cells.Footnote 61
New mutations in the virus have kept appearing since then, with scientists starting to focus on those that were likely to make Sars-CoV-2 more problematic. One of the most common mutations has been “N501Y”, also known as “Nelly” to geneticists who track new variants. This mutation affects the 501st amino acid of the virus, swapping asparagine for another amino acid called tyrosine. This changes the shape of the spike protein in a way that allows the virus to bind more tightly to human cells. A likely consequence of these characteristics is that less virus is needed to cause an infection, so that the disease spreads more effectively.Footnote 62
The Nelly mutation was reported to occur in at least three variants that have begun to cause concern worldwide: (1) the rapidly spreading B117 or 501YV1 variant, first spotted in Kent; (2) the B1351 or 501YV2 variant, first discovered in South Africa; and (3) the P1 or 501YV3 variant, first observed in Brazil.Footnote 63
On 21 December 2020, the United Kingdom announced that a new strain of the Covid-19 virus, B.1.1.7, was spreading in the country. This new strain was first detected in September 2020. By November 2020, around a quarter of new Covid-19 cases in London were reported to be caused by this new variant. This figure rose to almost two-thirds of cases by mid-December 2020. The new variant, soon known as the UK or Kent variant, was reported to be more contagious but did not appear to be more deadly or cause more severe disease.Footnote 64 This variant was reported in the United States in late December 2020.Footnote 65
The South African variant, named B1351 or 501YV2, was first identified in Nelson Mandela Bay, South Africa, in samples from early October 2020. Since then, other cases were detected outside South Africa, including in the United States. The variant was also found in Zambia in late December 2020, by which time it appeared to have become the predominant variant in the latter country.Footnote 66 The South African variant (as this variant was soon called) carries a mutation, called “N501Y”, which appears to make it more contagious or easier to spread. Another mutation, called E484K, is thought to help the virus bypass a person’s immune system and to affect the effectiveness of Covid-19 vaccines (which was one of the main reasons why South Africa would soon after stop using the Oxford/AstraZeneca vaccine, a fact which we shall readdress in Chap. 9).Footnote 67 Cases attributed to this variant have since been detected in several other countries outside South Africa. The variant was detected in the United States in late January 2021.Footnote 68
In Japan, still another variant of SARS-CoV-2 (known as “P.1”) was first identified in January 2021 in four travellers from Brazil who had been tested during routine screening at Haneda airport near Tokyo, Japan. This variant has no less than seventeen unique mutations, including three in the receptor-binding domain of the spike protein. The P.1 variant is a branch of the B.1.1.28 lineage. This variant, which was quickly dubbed the Brazilian variant (because it has been first detected in travellers from Brazil), was discovered in the United States in late January 2021.Footnote 69
But some of these “variants of concern” also were reported to share other mutations. Both the B1351 and P1 variants carry another leading mutation, K417N, whose impact is not yet clear. One of the most worrying mutations found on the date of finishing this book was “E484K”, or “Eeek”. This mutation was reported to alter the spike protein, making it more difficult for some antibodies formed by vaccination or previous infection to latch onto the Sars-CoV-2 virus. Scientists were particularly concerned that variants carrying the E484K mutation could still spread in populations that had already been hard hit by the Covid-19 virus or had already been substantially vaccinated, hence the fear that the South African variant could reverse the vaccination programme in the United Kingdom. According to Sample, the number of variants that have started to carry the mutation indicates that it is beneficial to the virus. According to this same author, geneticists have identified the E484K mutation in the South African and Brazilian variants and in other variants found in the United Kingdom, New York, Nigeria and, more recently, Angola. In the United Kingdom, samples of the Kent variant that was widespread in the south-west of the country also evolved into the E484K mutation, as had another variant circulating in Merseyside. Still according to Sample, the same mutations can appear by chance. But when variants around the world are stimulated after acquiring several corresponding mutations (D614G, N501Y and E484K were all found in variants from Kent, South Africa and Brazil), it may mean that “convergent evolution” is at work. This occurs when a virus present in different parts of the world finds the same way to adapt to evolutionary pressure.Footnote 70
Again according to Sample, between December 2020 and March 2021, a new variant of the Covid-19 virus gained ground in the western state of Maharashtra, India. On 24 March 2021, the Indian Ministry of Health reported that 15–20% of the Covid-19 virus sequenced in the region—it concerned one of the first outbreaks of the second wave in the country—carried two unusual mutations: “E484Q” and “L425R”. This figure rose to over 60% in the region by mid-April 2021. The variant has been named “B.1.617”.Footnote 71 According to Sample, genomic surveillance in the United Kingdom found the Indian variant in samples dating back to February 2021. In mid-April 2021, Public Health England (PHE) said it was aware of 73 cases in England and four in Scotland, but on 19 April 2021, UK Health Secretary Matt Hancock revised this figure upwards to 103. Most of the UK cases were linked to travel from India, but some cases were due to transmission of the virus in people’s homes.Footnote 72 Scientists also began to research whether the variant is/was more dangerous than others in circulation, for example by spreading more quickly, causing more severe disease or evading immunity acquired through previous infection or vaccination. They found that of the two main mutations in the Indian variant, L452R may help the virus evade some vaccine-derived antibodies, while E484Q has similarities to the E484K mutation that helps make the South African variant at least partially resistant to vaccines. However, it was not expected that the mutations in the Indian variant would render the vaccines completely ineffective, as injections were said to induce broad immune defences. Nor was it known whether the new variant was the cause of the upsurge in cases in India. Genomic sequencing in the United Kingdom showed that the Indian variant increased from 0.2% to 1% of cases over a 2-week period after 20 March 2021, but the majority of these cases were thought to be imports. The concern has been reinforced by Health Canada data, which showed that Covid-19 infected passengers were found on all 27 flights arriving in Canada from Delhi between 4 April 2012 and 14 April 2021.Footnote 73
On 10 Monday 2021, the WHO (as quoted by Nebehay and Farge) declared that the Covid-19 variant first identified in India in December 2020, was classified as a “variant of global concern”, as some preliminary studies had shown that it spread more easily.Footnote 74
On 12 May 2021, Farrer reported that the WHO had announced that the Indian Covid-19 variant had already been found in dozens of countries around the world. The UN health agency added that the Covid-19 variant B.1.617, first discovered in India in October 2020, had since been detected in more than 4500 samples uploaded to an open-access database “from 44 countries in the six WHO regions, with additional reports of detections in five additional countries”. Apart from India, Britain was said to have reported the highest number of cases of Covid-19 caused by the variant.Footnote 75 (Cf. Sect. 126.96.36.199.5.3) As of 14 May 2021, outside of India, the United Kingdom had recorded the highest number of cases of the Indian variant, at 1587 cases. The United States (with 486 cases detected), Singapore (with 156 cases detected) and Germany (with 103 cases detected) were the only other countries to have sequenced more than 100 cases of the B.1.617+ variant. Australia had detected 85 cases of the Indian variant, and Denmark 39.Footnote 76
1.1.3 Plausible Causes of the Covid-19 Outbreak
Especially since the outbreak of the Covid-19 pandemic, it has become public knowledge that bats of a wide variety of genera and species spread around the world are known to be the main reservoir of coronaviruses. According to Morens et al., it has even been revealed that bats are responsible for more than 98% of coronavirus detections.Footnote 77
According to these same authors, investigators have since recent been able to map global hotspots for the potential emergence of infections. These hotspots include southern/southwestern China and neighbouring regions and countries. Still according to these same authors, investigators also identified numerous human-animal interactions that may be risk factors for emergence of viral infections, such as bat tourism, wet markets, wildlife supply chains for human consumption, capitalistic land (and agriculture) management practices and environmental disturbances.Footnote 78 We shall come back to this in Sect. 2.2.2 hereafter. Not surprisingly, both SARS-CoV and SARS-CoV-2 have emerged in China, home to bats of more than 100 species, many of which carry α- and/or β-coronavirus.Footnote 79 According to further research cited by Morens et al., more than 780 partial genetic sequences of coronaviruses have been identified from bats of 41 species infected with α- and 31 species infected with β-coronaviruses. According to the same research, nature is clearly “a cauldron for intense and dangerous coronavirus evolution”.Footnote 80
Since then, an even clearer and more disturbing picture of the coronavirus ecosystem has emerged.Footnote 81
From this research:Footnote 82
it appears that a contiguous area encompassing parts of south/southwest China, Laos, Myanmar, and Vietnam constitutes a bat coronavirus “hotspot,” featuring intense interspecies viral transmission. In such hotspots, a rich diversity of SARS-like viruses is to be found, not only in rhinophid bats, but also in bats of other genera and species to which these viruses have host-switched. The same rhinophid bats are also implicated in the emergence of ‘SADS-CoV’ in southern China. Many of these SARS-like viruses bind to human angiotensin-converting enzyme-2 (ACE2) receptors and infect human respiratory epithelial cells in vitro, suggesting their pandemic potential.
As phrased by Morens et al., SARS-CoV-2 arose, in essence, as predicted by this research, as a result of a natural event associated with either direct transmission of a coronavirus from bats to humans or indirect transmission to humans via an intermediate host, such as a “Malaysian pangolin” or other mammal.Footnote 83 As with the coronaviruses that caused SARS and MERS, human-to-human transmission of SARS-CoV-2 was also quickly established, although the latter virus showed much greater infectivity than these other two coronaviruses.Footnote 84 It was according to Morens et al., also quickly established that those infected with SARS-CoV-2 appeared to be most infectious at the time of symptom onset, but were also infectious in the days before symptom onset. It was also shown that infections could be asymptomatic, cause mild illness or result in severe illness and death.Footnote 85
The emergence of this “bat-to-human coronavirus or indirect transmission”, although a natural phenomenon, obviously caused by a virus, was however at the same time facilitated by the characteristics of globalised capitalism which helped to provide the societal factors that made this transmission, and especially the Covid-19 pandemic itself, possible.
This will be discussed briefly in the next Sects. 1.2 and 1.3 and then, in more depth, throughout the rest of this book.