I have been interested in “risk” for my research on
pesticides, and as part of my work on magic and the supernatural. I therefore
look at the world response to the new coronavirus that emerged in Wuhan with a
slightly different perspective. While I understand the fear of a novel illness
(having lived through SARS in Hong Kong), I also see that a lot of the fear is
unnecessary and irrational, if understandable.
Every year, influenza kills thousands of people in the US
and around the world, and people accept that as somehow normal. Pneumonia is
the 2nd leading cause of death in HK (8032 people in 2017, causing 17.5% of
deaths). And the death-rate from pneumonia shoots up for people over 74. In the US,
55,672 people died of influenza and pneumonia in 2017. The press regularly mentions large numbers of infected and dead (14,300 and
305 as I write) which seem like large numbers, but in comparison to the overall
population of China is small. For the US, the NY Times reports:
For perspective: The flu kills roughly 35,000 Americans every year. This season, it has already sickened an estimated 15 million Americans and killed 8,200, according to C.D.C. estimates.
- Influenza kills more Americans every year than any other virus, Dr. Peter Hotez, a professor at Baylor College of Medicine, told Liz Sabo at Kaiser Health News. But the flu is rarely paid such attention, and fewer than half of adults get a vaccine.
- “When we think about the relative danger of this new coronavirus and influenza, there’s just no comparison,” Dr. William Schaffner, a professor at Vanderbilt University Medical Center, told Ms. Sabo. “Coronavirus will be a blip on the horizon in comparison.”
As Elizabeth Rosenthal (a physician and NY Times journalistwho lived in Beijing through SARS) says, “Remember, by all indications SARS,
which killed about 10 percent of those infected, was a deadlier virus than the
new coronavirus circulating now. So keep things in perspective.” As you can see
from the table below, influenza regularly kills between 0.2 and 0.4% of patients
who see a doctor for the flu, and 7-13% of those who are hospitalized for the
flu. It is estimated that 10% of those affected by the Spanish flu of 1918
died. The main reason for the fear today is that the coronavirus is new, so we
don’t know everything about it. But much about it is already quite clear: the
mortality rate appears to be at most 2-4%, and it spreads through heavy water
droplets (i.e. sneezing and direct contact). This is not Ebola.
The media tend to emphasize the risk because fear attracts
viewers. Readers are much more likely to forward and make viral an article that
warns about the virus and emphasizes the danger. The NY Times had a photo essayentitled “China’s Battle with a Deadly Corona Virus” and “The Test a Deadly Coronavirus Outbreak Poses to China’s Leadership” but it was already clear on Jan. 21 that this virus is not as deadly as SARS or
Ebola. And though we don’t know some things about the new coronavirus, we do
know a lot, and it is misleading to call it “mysterious” (as Fox News did here).
Lest I be considered distant and unaffected by the virus,
let me add that my wife has a colleague in China whose father-in-law is among
the dead, so I fully understand how serious and tragic influenza can be. But we
need to take reasonable precautions and not panic. Often, panic causes more
problems than the problem that sparked the fear. The point is, as Ian Johnsonputs it, “This outbreak is serious but not catastrophic.” (His essay on the government's Aksionismus or "actionism" is excellent, like most of his writing.)
There has been a run on masks, but as Rosenthal notes, masks
are not that effective. They help in crowded places, but they have to be
replaced frequently, because if they work and get viruses on them, they are contaminated. It is basic
hygiene, like washing your hands frequently, and staying home if sick, that
helps prevent the spread of viruses. There are many draconian measures
undertaken in China that are pointless (like shutting gates to apartment complexes at night). Lest Americans think they are more “rational,” I hasten to
point out that our local drug stores have sold out of masks. We tried to buy
some for a friend who wanted to send them to Hong Kong, but even in St Louis,
there has already been a run on masks!
Many of the bans being put in place are informed as much by
xenophobia as by public health concerns. Particularly worrying are bans on all
Chinese (like in Singapore), as if being Chinese was a marker of likely being ill. Stories that focus on
Chinese eating wild animals have gone viral (pun unintended) but have nothing
to do with the cause or spread of the disease (see the weird case of “bat soup”here). Jason Oliver Chang, Associate Professor of History and
Asian American Studies at the University of Connecticut, has created a Googledoc
with resources to teach about “Yellow Peril” to try to counteract these racist
and xenophobic narratives that unfortunately fit into Trumpian anti-foreign
sentiments.
It is natural to be cautious and afraid. I remember from the
SARS outbreak in Hong Kong, and Emily Feng of NPR in Beijing said the same thing last week, you
can know the chance of getting sick is small and not worry about yourself, but
you worry more about transmitting it to others. You think, “What if I’m the
person that spreads the disease to my workplace?”
Those of us who lived through SARS in Asia changed our
habits, as Rosenthal notes. In addition to washing our hands more often, we
push elevator buttons with our knuckles and not our fingertip, and we stay home
if we are sick. I’m struck that many people with a cold or flu symptoms in the
US do not quarantine themselves, but continue going to work and social events. And
how many people who are worried about the coronavirus did not get their flu
vaccine this year?
It is not that we don’t have to be vigilant. In fact, Laurie
Garrett (Pulitzer-prize winning author of books on epidemics and public health)
notes that the US is totally unprepared for an epidemic because: “In 2018, the Trump administration fired the government’s entire pandemic
response chain of command, including the White House management infrastructure.
In numerous phone calls and emails with key agencies across the U.S.
government, the only consistent response I encountered was distressed
confusion.” Not that is alarming.
Another thing is also clear: governments are under
tremendous pressure to "do something" even if it is not necessary; no
one wants to be blamed for not doing enough. And the weird thing is, if public
health efforts succeed and there is no pandemic, or the virus burns out
naturally before becoming a pandemic, both health and political officials will be accused of
overreacting! It is not easy to make the calls right now. But we individually
can at least avoid panicking.
PS: Here is a good NPR Morning Edition story from Monday Feb. 3rd that argues there is no need to panic.
PS: Here is a good NPR Morning Edition story from Monday Feb. 3rd that argues there is no need to panic.
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See also
Coronavirus ‘Hits All the Hot Buttons’ for How We Misjudge Risk
Psychologists say that differing responses to coronavirus and the flu illustrate our shortcomings when it comes to evaluating danger.
https://www.nytimes.com/2020/02/13/world/asia/coronavirus-risk-interpreter.html
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