Overreaction or appropriate response to coronavirus?
Often I wonder if we – and the stock markets – are overreacting to the Coronavirus, COVID-19, epidemic (not declared as a pandemic).
Other infectious diseases like the flu and multidrug-resistant organisms are present in our schools, workplaces and hospitals as well as globally, and we seem to manage with our day to day lives. Should we be giving COVID-19 so much attention?
Majority of our response has to do with uncertainty.
COVID-19 is a novel virus on the global stage and it’s unpredictable how it may evolve. By contrast, the seasonal flu is a well-predicted menace in our lives and we have learned to adjust.
Another reason we are paying so much attention to COVID-19 is individual risk tolerance. My wife and I both have drastically different risk portfolios for our 401K savings account, although we are in a similar circumstance. Point being, rational humans react very differently even under the same circumstances.
Community outbreak over time by the numbers
If, given the present dynamics, the course of COVID-19 epidemic illness in a community may last for months. The rise in the number of cases will follow a bell-shaped curve with the first case being identified about a month after the index case is introduced in the community. Vigilance on part of our health systems and early rapid testing can achieve earlier detection.
Aggressive interventions, such as tele-schooling, tele-work, cancellations of large gatherings, as part of a social-distancing effort can temper the epidemic. What may be the new peak and duration of the local epidemic is still unclear.
Coronavirus in comparison to others
So how does COVID-19 epidemic compare with our experience with the seasonal flu of 2017-18 and the pandemic flu of 1917-18? In a given year nearly 45 million people, or 14% of the population, gets the flu.
Based on the numbers from Wuhan, China, we estimate only 1% of the population is infected with COVID19. If this number is applied to the US population that could mean about 3 million people in the USA.
Of this, an estimated 20% or 600,000 may be hospitalized, nearly doubling the hospitalization number due to the flu.
Since the mortality rate of COVID-19 is significantly higher than the flu, there may be as many more additional deaths due to COVID-19. However, with aggressive supportive care the mortality rate in the United States may be much lower than in other countries. All this is significant enough to stress our overburdened healthcare system and the vulnerable populations.
Exactly how deadly is Coronavirus?
The next question is how risk-averse should we be given the estimated number of illnesses from COVID-19. Let’s compare various conditions such as gun violence (34,000 deaths annually), breast cancer (43,000), motor vehicular accidents (37,000) or even the opioid epidemic (70,000) based on their death rate.
COVID-19 may have anywhere from 30,000 to 300,000 depending on our response, which is within range of the seasonal flu which has 60,000 deaths and lower than the 1918 Influenza pandemic which had 675,000 deaths.
Our reaction and response to each is quite different. This risk tolerance also changes with what we can do as individuals. Locking up guns, wearing seat belts, getting a mammogram, availing of addiction rehabilitation services, and influenza vaccines can all mitigate individual risks and we feel we are empowered in preventing a potential illness or death.
Often adding helplessness to uncertainty compounds the fear of COVID-19. In the present situation preparedness, not panic is the appropriate response. The Centers for Disease Control and Prevention has laid out a preparedness plan for communities, which is important for our decision-makers to read and follow.
Also, we must understand that each of us will react differently based on our risk tolerance to the present COVID-19 epidemic, as do my wife and I.
Manoj Jain, MD,MPH is an infectious disease physician and epidemiologist. He is a faculty member at Emory University’s Rollins School of Public Health. www.mjainmd.com