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Covid-19: Hysteria or Common Sense?

So, yes: some of us are wondering how much of the squealing and the yelling about the coronavirus is justified and how much of it is clickbait. Okay…I shifted into science writer/tech editor mode and took a look around. Here’s what I found out:

As far as we can tell to date, Covid-19 has a death rate of about 3.4%, although among the elderly that figure jumps to 15%.

Let us compare these figures with the mortality rates of a few other famous dread diseases.

Swine flu: .5%
H1N1: .01% – .08% (one strain of swine flu is a sub-type of H1N1 influenza, but since 2017 the dominant subtype is H3N2)
Spanish flu (responsible for the 1918 pandemic): 10%
SARS (also caused by a coronavirus) 9.3%
Ebola: 58.5%
MERS: 9.4%

Several of these ailments are spread most commonly by contact with certain animals, such as pigs or camels. At least one, Spanish flu, is thought to be extinct. What seems to make Covid-19 so terrifying is that it spreads much the same way the common cold or seasonal influenza spreads: by direct contact between humans or by contact with surfaces recently contaminated with fluids from people who already are sickened by the disease. And of course: it’s new. We don’t know exactly what it can or will do, so of course we’re scared. We do know those who have an underlying illness are most vulnerable. And, for reference: 60% of adult Americans host at least one underlying health condition, according to Tom Frieden, former director of the U.S. Centers for Disease Control and Prevention.

Now that we have the mildly alarming facts — Covid-19 is more deadly than swine flu, one helluva lot less deadly than the Spanish flu, and one whole helluva lot less deadly than a horror like Ebola, but the older you are the more at risk you are — let’s take a look at what some experts have to say.

STAT, a science magazine that focuses on life sciences, convened a panel of Harvard scientists to address the question of just how worried we should be, and about what, specifically. Although we know there are similarly dangerous or worse diseases out there, most of them haven’t affected Western countries, with the exception of Spanish flu, which struck over a century ago. As epidemiologist Michal Mina observes, the present issue is that “We have an entirely susceptible population. The potential for this to burn through a population very quickly is very high without extraordinary measures.”

The experts are alarmed because this virus has some odd characteristics not seen before in similar flu-like ailments: younger people are mildly affected, but the disease’s severity grows with increasing age of the victim. The older you are, the sicker you are likely to get. The death rate among the elderly is apparently around 15%.

By way of background: in China, 78% of cases occurred among people aged 30 to 60; 2.3% of these patients died. However, among patients 80 or older, the death rate leapt to 14.3%. This is thought to be a function of  the strength and health of one’s respiratory system and the presence of other conditions.

For other age brackets, the death rates were 1.4% among people in their 50’s; .4% for those in their 40s; and .2% among ages 1-30.

Among patients who were hospitalized, about half developed acute respiratory distress syndrome (ARDS). Half of these people died (note that this implies about a quarter of people who land in the hospital with this disease die of it). ARDS fills up the lungs’ air sacs with fluid, restricting the intake of oxygen. Patients who developed ARDS had an average age of 61. Those who did not develop it had an average age of 49. Fifty percent of ARDS patients died, as compared with 9% who did not get ARDS.

You understand: 9% is almost 10 in 100. That is…well, alarming.

“We’re in the response phase, Juliette Kayyem told STAT. “Our measure of success is not containment anymore. Our measure of success now is, will fewer people die or get severely sick because of our efforts?” Kayyem is the faculty chair of the Harvard Kennedy School of Government’s homeland security program and a former homeland security official at the state and federal levels.

Dr. Mina added, “Part of the problem is the fragmented state of US healthcare system. . . . “[T]he way we have privatized everything about it for the most part, is going to seriously impact our ability,” he said,“[W]e have no ability to create out of the blue new hospital beds. We can’t even test appropriately.”

Helen Branswell, STAT’s infectious diseases and public health reporter, observed, “I’m really concerned about people living in long-term care facilities. If this virus gets into long-term care facilities [as it has in the Seattle area], it will be really bad. I’m worried about people who stay in homeless shelters. I’m worried about people who work in retail. I’m worried about people who don’t have the money to stockpile food because they don’t have extra money. I’m worried about the fact that there isn’t much social cohesion right now. People seem to be really angry at each other a lot and this is a time when we’re really going to need to help each other.”

So yes: when all Hell is about to break loose (at least, so it appears), it’s easy to get worried.

So what can we as individuals do to protect ourselves from this ailment, and what can we do as a people to try to contain its spread?

  • Number 1, first and foremost: WASH YOUR HANDS! And keep washing them. Get some hand wipes containing alcohol or, if those are not available, sanitizing countertop wipes such as the ones marketed by Lysol. Carry these in your car.
  • Whenever you go into a store where you’ll be pushing a cart, rub down the handle with one or two of these sanitary wipes.
  • As soon as you get back in the car, wipe your hands, your car keys, and your car’s steering wheel with an antiseptic wipe. If you have kids or other passengers with you, pass the wipes and be sure everyone wipes their hands thoroughly.
  • When you get home or to the office, wash your hands promptly and thoroughly with soap and water. Take your time. You should scrub actively for at least 20 or 30 seconds.
  • Stay out of crowded places. This includes restaurants, crowded stores, stadiums, rallies, and any other venue that draws large numbers of people together in close proximity. Try to allow at least three feet and if at all possible about six feet between you and the folks around you.
  • Avoid travel on public transit and airplanes if at all possible.
  • Stifle your sneezes and coughs in a jacket, handkerchief, or Kleenex.
  • Wash your clothes after each wearing.
  • Wash all fresh produce thoroughly, in detergent water (rinse well, of course).
  • Eat healthy meals, stay hydrated, and try to get enough sleep to avoid becoming run-down.

One thing you don’t have to bother with is wearing a face mask. These do nothing to prevent exposure to the virus.

Indeed, we are seeing a lot of hysteria out there. We’re also seeing some valid concern. The best way to deal with it? Common sense.

5 thoughts on “Covid-19: Hysteria or Common Sense?”

  1. When discussing covid-19 in comparison to other epidemics/pandemics many immediately jump to comparing mortality rates, but that is a nearly useless comparison when assessing the general risk of a population. The mortality rate tells us, of those who contract the given illness, how many will die, but it says nothing of how many will contract it. Plain ol’ influenza (seasonal flu) has a mortality rate around 0.1% but yet is responsible for an estimated 61,000 deaths in the US alone during the 2017-18 season because nearly 45mm people contract it. Ebola (per your figures) has a mortality rate of nearly 60%. In the 2015 epidemic in Africa in excess of 11,000 people died, out of nearly 30,000 who contracted it. But yet in the US we are not that concerned about ebola, even with its high mortality rate, because relatively few people contract it. In the US, approximately 10% of the population will contract influenza in a given season. In the 1918 pandemic around 33% of the population contracted the flu. Covid-19 is too new to know how widespread infections will be. I have seen estimates from epidemiologists as high as 40-70% of the population. If those estimates end up being accurate and the mortality rate holds, we are looking at a very significant event. By extrapolation the death toll in the US would be between 4.5 – 8mm deaths. By comparison, about 2.8mm people die in an average year in the US. Given the significant unknowns about the virus I think there is reason to be cautious/concerned.

  2. Yes, these are excellent points: complicated, IMHO, by the strange age-related variation in response to the infection, and of course as you note by the fact that the virus’s emergence is too new to estimate accurately the extent of its likely spread.

    It’s unclear to me that the frenzy we’re seeing is a useful response, in terms of public education or of control of the virus’s spread. Is clearing all the toilet paper off retail shelves useful? Hm.

    There’s also the question of the potential seasonality of this virus. Some speculate that like influenza, it will recede when summer temperatures and longer sunlight hours heat and irradiate the environment. IMHO that remains to be seen.

    The 1918 influenza epidemic — Spanish flu — was near-catastrophic for reasons having to do with its contagiousness and the apparent lack of immune response among large populations. We didn’t have antibiotics with which to treat follow-on bacterial infections, and we had large numbers of men still in military service, living in the close quarters of barracks and tents. What kills Covid-19 patients appears to be ARDS; we don’t seem to have a very effective treatment for that, either. So…there are some alarming similarities.

    As for ebola, personally I question whether it’s in the same category as a flu-like infection; its relevance seems to be rooted in its propensity for contagion rather than in its characteristics as a disease, once it has infected a human.

    Many — possibly most — Covid-19 deaths in the US would occur among the elderly. While this would not be a good thing, because most of the aged population has been superannuated out of productive jobs, the result could be less catastrophic than a uniformly effective infection of all strata and ages in a society. That is, let us say we have 5 million deaths caused by this disease. If 3 to 4 million (3/5 to 4/5) of them take out people 60 and older, in pragmatic terms one could argue that is less bad than if 1 million people from infancy to adolescence died, another 3 million from around 12 or 14 to around 55 or 60 died, and the remaining 1 million fatalities took those 60 and older. In the latter event, 4/5 of fatalities would comprise producing members of the society and young people who soon would become productive members.

    Agreed that caution and concern are appropriate responses. But it’s unclear to me that outright panic fits into the category of appropriate response.

    • A good amount of the panic we are seeing is useless. This notion of clearing out the toilet paper aisle is useless panic brought about by social media claims of it being manufactured in China. A simple look at a toilet paper package would show that a good portion of what is sold in the US is manufactured in the US. Buying all the bottled water? I have yet to see anything that indicates this impacts the water systems. It would also help if there was leadership in the federal government that could be trusted to provide sound guidance to the nation rather than fan the flames of conspiracy theories and hysteria.

      I do think there is some useful preparation that we should all be taking. None of us knows if at some point we may be exposed and have to quarantine. I would make sure I have enough food on hand (and any other necessary supplies) to last my household through that quarantine period. My household purchased additional meat to freeze, frozen vegetables, dried beans/lentils, oats, etc. They’re all products that we will eventually eat whether or not we have to quarantine so they’re not wasted food but will also allow us to continue eating nutritionally sound meals if we’re stuck in the house. I have also stocked up on the dog’s food/medication. It’s not unlike preparing for winter in the north or hurricane season along the coasts. For those in higher risk groups, I would be trying to make larger purchases so as to minimize the number of potential exposure events by frequent trips to the store.

      If people want to be concerned about Chinese manufacturing, I have concerns about the availability of medical equipment in the event this does get very bad. So much of our medical equipment is essentially specialized computers. Much of the world’s supply of computer chips is manufactured in China. It takes billions of dollars and years to setup a computer chip manufacturing line so they cannot quickly or easily be moved. Many manufacturers also operate on some variation of just in time manufacturing to minimize the cost of parts inventory. So how much inventory do they have on hand?

      • Around here, it doesn’t appear that the stores are taking the TP off the shelves…paranoid shoppers are stacking the stuff into their shopping carts. You would have been amazed (possibly entertained) by the scene in Costco. I’d gone in for a routine shop, and a new lifetime-supply of TP was on the shopping list. When I got to that aisle, I found a feeding frenzy going on. By the time I reached the shipping pallets where CC stacks the stuff, there were three (count ’em: 3) packages left.

        Bottled water??? I’ve never been able to see the logic to buying bottled water, when you’re paying the city or your water company to deliver treated water to your faucet. If you’re REALLY that scared, you can’t…you know…boil a pot of it???? Or is that beyond the comprehension of the average American?

        As for stocking up, because of my noxious habit of shopping for one at Costco, at any given time I have three to six months’ worth of supplies, so it’s hard to get very exercised here. Normal people should, however, do as you suggest: freeze enough extra meat (beef, lamb, pork, chicken) to last a few weeks, put in enough dog food while you’re at it, and stock in some frozen veggies and fruits, cereals, rice, and beans.

        Agreed: our two bigger problems at this point are infrastructure and our wretched political scene.

  3. Thanks for the info, it’s very useful. I work in a restaurant, so can’t avoid the public, but so far, so good. I don’t think we have many cases here and Arkansas doesn’t have an international airport, so that helps.

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