Scientific models show a reasonably high probability that the Wuhan coronavirus will accelerate in its spread outside of China. That’s concerning, to say the least. But even as the news gets darker, the tone of news coverage is swinging the wrong way, offering too much false reassurance.
It’s extremely unlikely to turn into a nightmare scenario ripped from movies like Contagion. It isn’t an immediate threat to most people’s lives. But if it spreads widely as some credible estimates predict, the disease could still easily disrupt business and everyday life for millions of people.
Given all the other threats in the world — earthquakes, nuclear weapons, global warming, the flu — it was unrealistic to expect people to prepare for a new viral outbreak before the threat was imminent. Now it’s crazy that people aren’t doing more.
What does preparation entail? Nothing drastic — mostly advance planning, says Peter Sandman, an independent consultant on risk communication. People can plan what they will do if they get sick, or their child’s school is closed. Businesses can plan for absenteeism, and can think about which employees are essential and who will fill in for them if they get too sick — or too scared — to come to work.
There is a reason that so many scientists have dropped what they’re doing to study this particular virus. Viruses that have recently jumped to the human population from other animals — such as bats — do warrant immediate concern.
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As Purdue University virologist David Sanders explains, we are without immunity to such viruses, and they are not well adapted to us. The viruses that cause, say, seasonal flu have had time to evolve so that they usually avoid killing their human host. That’s how they become successful viruses — they give themselves time to spread. However, when a new virus first makes the leap to humans, “there’s a mismatch between the immune system and the incoming virus.”
That’s one reason the 1918 flu was so deadly. That strain of the flu had just picked up new genetic material from a bird flu, and it tended to trigger an extreme immune reaction called a cytokine storm, which damaged the lungs. Most of the deaths were from secondary infections that took hold in flu patients’ severely damaged lung tissue. After the pandemic was over, the same virus evolved and circulated for decades as a less deadly seasonal flu. (Something that’s worth remembering when you read a headline declaring the flu to be the “real danger” this winter.)
The big unknown now is how easily the new coronavirus can spread and how many invisible cases are out there. This kind of outbreak is like a pyramid, with the dead and very sick at the top, and a much wider base of people who are not very sick, or not sick at all, but capable of carrying or spreading the disease. There’s no sense yet of the disease incubation time, which CDC estimates could be anywhere from 2 to 14 days.
One of the reasons SARS didn’t become the global catastrophe some feared is that virus was less contagious before severe symptoms set in. Once people felt symptomatic, they tended to stay home or go to the hospital — hence many transmissions either happened in hospitals or through people who had been sick but started to feel better.
Doctors and public health officials are still arguing about whether this new coronavirus is being spread by asymptomatic people. According to this update in Science, the modelers say this is the critical unknown.
Risk communication expert Sandman emphasizes that timing matters in this situation. Whether 100,000 people or a million get this disease, the situation will be much worse if they get infected over the course of a month than if they get infected over the course of a year. If it happens faster, there could be drug shortages, hospital overcrowding and economic fallout from a loss of business continuity.
Experts so far have tended to speak in dichotomies — either the disease will be controlled or it will not. Something in the middle is still very much a possibility. As I wrote in a previous column, many experts say that travel bans and extreme quarantines won’t keep the disease under control — it’s already spread too far. But such measures may be slowing the spread of the disease. Even if the delay is minimal, as some experts estimate, we should still be using that time to prepare.
The WHO and CDC have been giving out plentiful information, but haven’t been emphasizing that preparation is justified. The WHO has a motto of “Facts not Fear”, but these are not mutually exclusive, Sandman says. “Sometimes the facts are fearful.”-Bloomberg
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