“My daughter is supposed to go to Singapore for work next week,” a friend said to me in late January. “I told her she shouldn’t go. Right?”
The odds were that her daughter would be fine, but a very small risk of infection existed. Singapore, with a population of almost six million people, had less than 20 cases of coronavirus, almost all of which were acquired in China. Fewer than one in around 100,000 people in Singapore had gotten infected there.
In comparison, every year in the U.S., influenza sickens up to 45 million people—about one in seven—and kills up to about 61,000, or about one in 10,000 people.
As of today, throughout the world, coronavirus has killed around 2,700 people, and the vast majority of patients appear to recover on their own. We don’t yet know the full extent of the new virus’s spread, but based on the data so far and estimated projections, my friend’s daughter would undoubtedly be about 10,000 times more likely to get the flu in the U.S. than coronavirus in Singapore.
We are, however, now confronting an epidemic of fear. Initially, people tend to respond to new epidemics with denial, minimizing the risks. If no one we personally know has gotten the disease, we easily feel immune.
But as the disease spreads, anxieties surge and commonly take over, and can lead to over-reaction. New virus outbreaks thus pose dual challenges of how to avoid both over- or underreaction.
Unfortunately, in past epidemics, including HIV, SARS, and Ebola, the pendulum has swung too quickly from one extreme to the other, from under- to over-reaction, it now could potentially to do so again. We need to respond rationally, in evidence-based ways, and not panic.
The new coronavirus is generating mass confusion among the stock markets, travelers, and others, including my friend and her daughter, but importantly, it should also serve as a teaching point—a reminder to all of us and our political leaders.
To be sure, we should all protect ourselves, but should be careful, as individuals and a society, not to over-react. We need to act as logically as we can.
The epidemic should incentivize us all to follow everyday measures to prevent any respiratory virus—from the common cold to the flu to this new bug. Our mothers told us to follow these easy preventive steps, but many of us don’t—washing our hands often with soap and water for at least 20 seconds, especially after going to the bathroom, before meals, and after blowing our noses, coughing or sneezing, avoiding being in close contact with people who are sick, and staying home when we are sick—better safe than sorry. If we all took these measures, we would all be much healthier.
Most Americans still also fail to get a flu shot every year. Anti-vaxxers vehemently fight this proven preventive measure. Countless Americans eschew vaccines against mumps, measles, and rubella, too.
This new epidemic should also motivate us to learn from our past mistakes and to avoid under-reactions. Unfortunately, the Chinese government hid and delayed reporting cases of SARS, facilitating the disease spread. But the government did the same with coronavirus, even reprimanding physicians who reported the outbreak. The world lost valuable time.
Alas, in response to such underreactions, overreactions typically then occur. In 2014, the WHO waited months before declaring the world’s largest Ebola outbreak an emergency of international concern.
Subsequently, several U.S. political leaders overreacted. When Kaci Hickox, a nurse who had heroically treated Ebola patients while working for Doctors Without Borders, returned to Newark Airport, she tested negative for the virus and had no symptoms. Public health experts thus said she should be allowed to return home to Maine to monitor herself for any future symptoms. Unfortunately, then-Governor Christie, facing re-election the following month, detained her against her will for three days.
Similarly, when Dr. Craig Spencer returned to New York from treating Ebola patients for Doctors Without Borders, he appropriately monitored himself—as recommended by public health experts. Immediately on developing a fever, he reported to the hospital. But Governor Cuomo, also facing reelection, publicly criticized him as having been careless. As Spencer later argued, “politicians, caught up in the election season, took advantage of the panic to try to appear presidential instead of supporting a sound, science-based public health response”
In one respect, these Chinese and American leaders’ responses differ: while China under-reacted, these governors over-reacted to the disease. But they exemplify the same problem: political, rather than public health priorities guiding governmental responses.
Thirty-five cases of coronavirus have emerged in the US as of today, and more will surely surface. Luckily, thus far, none have died. Yet we will soon face challenges as citizens and a country. At least some political leaders and candidates will surely use these to help advance their own agenda. With Ebola, Trump harshly criticized President Obama for permitting Americans who had worked with patients in Africa to return to the U.S. Yet, such reentries proved completely safe. In our already-fraught election year, we must work to avoid both under- and over-responses. While the State Department has already sought to ban all travel to and from all of China, the CDC more prudently recommends that Americans avoid all non-essential travel, since travel bans can backfire, unnecessarily increasing fear and stigma that could lead people to lie about travel or potential exposures, and prompt countries to hide cases, for fear of being blockaded. Xenophobia could ensue.
We should also learn from past mistakes by better preparing for future epidemics, developing vaccines. After the 2003 SARS epidemic, for instance, scientists found that bats harbored the virus along with other SARS-like coronaviruses that had also developed abilities to enter humans. Yet, nothing was done about these other viruses. No vaccines were sought or developed against them. It was only a matter of time before such other coronaviruses attacked humans.
This new epidemic raises understandable fears, but should also inspire us to learn—to use this new outbreak as a teaching opportunity, leading us to take precautions against other, far more common viruses, and prepare, better than we have in the past, for future epidemics. We need to ready ourselves with not only face masks but scientific facts.
Sometimes our mothers had good advice.