by Bruce Dunlavy
(An index to my other posts is available from the pull-down menus at the top of this page, and my blog home page and index of other posts may be found here.)
[Update 4/5/2020: Five weeks after I published this post, things are looking different, and it appears I may have underestimated the potential severity of the COVID-19 outbreak. It looks likely that the death toll will be much greater than I predicted, and the collateral damage is colossal. But I never promised that my posts are The Truth. They are only reflective of where I am in my knowledge. Quandoque bonus dormitat Homerus.]
In a previous post, I opined on the topic of risk assessment and how it can be corrupted by poor communication. The issue is a salient feature of the current near-panic about novel coronavirus, a/k/a COVID-19.
The recent discovery and spread of this virus is the cause of – among other things – quarantines, travel restrictions, recalls of American students studying in Europe, a dramatic fall in the U. S. stock market, and a huge shortage of medical face masks. The dangerous-deadly-killer coronavirus might strike down nearly all of us, and mass death is looming.
Or so it would seem from what we are being told. A recent headline told us so. Above Tim O’Donnell’s story in The Week, it says this: “Harvard scientist predicts coronavirus will infect up to 70 percent of humanity.”
Yikes, people! What? Only 30 percent of humanity might escape this menace? Maybe only 30 percent will survive it? What are we going to do?
Hopefully, we are going to calm down. This sort of thing comes around every few years. It’s like an urban legend with some factual basis, one that comes and then goes and then comes again after the passage of a sufficient amount of time for people to forget.
I’m old enough to remember the Swine Flu panic of 1976. Fort Dix, a military base in New Jersey, experienced a small outbreak of a variety of H1N1-type influenza. Thirteen people were hospitalized, and one died. This was not the first time there had been an outbreak of Swine Flu, as it is a common disease of pigs all over the world. Occasionally, some variety of it jumps the swine-human barrier and starts infecting people.
The reaction to the Fort Dix outbreak was not just disproportionate, it was massively so. President Gerald Ford, concerned about his prospects for re-election, did not want to be seen as the guy who sat on his hands while Swine Flu devastated the nation. Thus he instituted a huge vaccination plan which ultimately was administered to about a quarter of all Americans.
The vaccination program was a botched job from the beginning. It was pushed onto the public by scaring them into compliance, and it administration of the vaccine began long before there was a significant likelihood of widespread infections. By the time it was over, several cases of Guillaun-Barré Syndrome – which can cause serious physical problems which are sometimes long-lasting and occasionally fatal – had been attributed to the Swine Flu vaccine. Meanwhile, the total number of deaths from the disease remained at one.
The bungled response had deep effects. It made Ford look bad and contributed to his re-election failure. Some people who were vaccinated had immediate ill effects, some other ill effects were wrongly attributed to the vaccine at the time, and some people apparently suffered ill effects decades later. It may be that memories of the Swine Flu fiasco helped establish and sustain the “anti-vaxx” movement that threatens American public health today.
Image credit: robertscottbell.com
Now – about this coronavirus. There are a few things to be established before beginning any analysis. First, “coronavirus” is not some new and unique affliction. This coronavirus is one of many that fall under that name. Coronaviruses were first identified over 50 years ago. In addition, a coronavirus is not necessarily a danger to humans, nor is it normally a deadly infection. You can read about the five kinds of coronaviruses that can infect humans, and the mild upper-respiratory symptoms they usually cause in this 2019 release by the Centers for Disease Control.
So coronavirus might or might not be the worldwide pandemic that has caused the response highlighted above. But what about that Harvard doctor who said 70 percent of us were going to get sick?
What he actually said (if you read the article, you’ll see it) was that perhaps 40 percent, and as many as 70 percent, of people may be exposed to the virus and would test positive for it. He also pointed out that a lot of them won’t know it, because they won’t have any symptoms. This particular coronavirus is not unusually severe or deadly, and only a small portion of people will become seriously ill. While it is comparatively deadly as flu-like illnesses go, the death rate is nevertheless not in Ebola territory. It is probably less than two percent. In the USA, more people are killed annually by the flu than are likely to be killed by this coronavirus outbreak. Yet most people don’t get a flu vaccination.
What befell the doctor was that the news media got hold of his report. In the world of mass news coverage, that which sounds the scariest attracts the most attention and therefore the most readers, viewers, and advertising dollars. This has caused those who report on issues affecting public health to be inclined to seek out worst-case scenarios and tell a story that emphasizes them.
When I worked in environmental regulation, for the last half of my career I managed a unit that responded to hazardous materials spills, Superfund sites, and other such potential disasters. I quickly learned not to follow the line of questioning that reporters pursue, because they are looking for a big story on a big threat.
The process works like this – a baseline is established for what might happen, and then the range of possibilities is examined to find the most terrifying ones:
What are the chances that a spill of methyl-ethyl-oh-my-god could reach a stream?
And how does the stream empty into a bigger stream, and that one into a river?
How many people get their public drinking water from that river?
Is this chemical dangerous?
Could someone die?
The answers are most often going to be something like “not likely,” “yes,” “somewhere between 3,000 and 50,000,” “in large doses it’s possible,” and “almost certainly no one, though nothing in science is absolute,” but the evening news will lead with, “As many as 50,000 people could die from the effects of a chemical spill.”
The lure of as-many-as/as-much-as is irresistible to some newswriters, and it affects small-town newspapers, big-city television stations, and national news outlets across all platforms. Which teaser will grab your attention: “Small risk of danger to a few people” or “As many as half a million people could be endangered”? The same information could be used to generate either one.
Thus we cannot say much with certainty, although it definitely will be wise to err on the side of caution with this virus. Even if only ten percent of Americans become infected and the two percent mortality rate proves accurate, there would be at least 650,000 deaths. That’s about the same as the number of annual deaths from America’s leading killer, heart disease.
As usual, the antidote to this kind of misprision is being informed by reputable sources, reliably reported. Step one is to calm down. Step two is to find out what underlies the story. Step three is to (and I know this is difficult) trust the people who have more knowledge than you do. Chances are they will not promise that they are certain, because uncertainty is a hallmark of real science. The pseudo-scientists, scaremongers, and conspiracy theorists are the ones who are most likely to promise certainty in an uncertain environment. And the more certain they are, the more likely they are not to know what they’re talking about.
The government – at the Federal, State, and local level – must be able to speak with one voice, giving the public honest, science-based information delivered by honest science, medicine, and public health experts. No lying, no spinning, no faking. Sound, well-founded information, including the admission that nothing can be guaranteed and that all estimates are just that – estimates – will be the basis for a sensible response from the American people.