Don’t Scold People for Worrying About the Coronavirus

Don’t scold people for worrying about the coronavirus
A commercial street in Beijing is nearly empty amid coronavirus fears on February 5, 2020. Kevin Frayer/Getty Images

Yes, we shouldn’t panic — but let’s not dismiss people’s worries so easily. There’s still much we don’t know about the virus.

In the last week or so, new cases of the 2019-nCoV coronavirus have soared to 24,500 infected and 494 people dead. Cases outside China have proliferated.

So have news articles scolding us for worrying about it.

“Don’t worry about the coronavirus. Worry about the flu,” BuzzFeed argued. The flu “poses the bigger and more pressing peril,” the Washington Post said. “Why should we be afraid of something that has not killed people here in this country?” an epidemiologist argued in the LA TimesOther outlets have agreed. An ex-White House health adviser has told Americans to “stop panicking and being hysterical.”

On one level, this impulse is understandable. Panic isn’t good, and we’re apt to act more sensibly with a clear head.

But something about the insistence that we not freak out has also rubbed me the wrong way. Some of thesereassurances come off astoo dismissive and not very fair to their audience. Yes, it’s true that other things kill more people than this coronavirus has so far. But part of the reason for that is that it’s a major public health emergency that’s being tackled like one. A great deal of effort and plenty of resources have gone into the effort to contain it.

The Wuhan coronavirus is very unlikely to kill you personally. It might not kill many people at all. Butit’sunhelpful to scold people for worrying about something that public health experts are actually pretty worried about, too.

“‘No reason for alarm’ is bad science as well as bad risk communication,” risk communications expert Peter Sandman wrote last week. “Telling people not to worry about an emerging infectious disease because it isn’t a significant risk here and now is foolish. We want people to worry about measles when there’s very little measles around, so they will take the precaution of vaccinating their children before it’s imminently necessary. We want people to worry about retirement when they’re years away from retiring, so they will start saving now.”

New infectious diseases are scary, and any one might well be catastrophic if it’s highly lethal and spreads quickly. The way we avoid catastrophe is by reacting strongly to every new emergent human-transmissible disease that we don’t know much about, and throwing tons of resources at containment, vaccine development, treatments, and research. Worry about pandemic diseases isn’t misplaced. The reality is that pandemic diseases are potentially very scary, and that on the whole the world is underprepared, not overprepared.

The backlash against coronavirus panic, explained

The situation with the coronavirus is rapidly changing, but here’s what we know: More than 24,000 people, mostly in China,have been infected. The World Health Organization has declared the outbreak a global public health emergency, and many of China’s neighbors have sealed their borders, while the US has banned travel from foreign nationals who’ve recently been in China. The disease is not yet a “pandemic” — that would require outbreaks in multiple regions of the globe — and only11 people in the US have been confirmed to have the disease.

The people warning Americans not to panic makesome good points — and to be fair, articles making the case against panicking are much more nuanced than their simplistic headlines. The core of their case is this: The virus isn’t that dangerous to us, panic about it is causing avoidable social problems, and we should all calm down.

With so few cases and no deaths in the US, it’s admittedly absurd for Americans to be paranoid when they hear someone cough nearby.

And such paranoia isn’t just unnecessary; it’s also causing problems. Shops have put up signs banning people coming from China, and people of East Asian descent who have never been to China have faced hostility. Anti-Asian racism has targeted innocent people eating Asian food on social media. Damaging lies have spread about Asian businesses (no, you can’t get the coronavirus from Chinese food). Obviously, there should be extensive efforts to tamp down on virus panic when it takes the form of vicious racism.

The anti-hysteria push also comes in the face of rampant misinformation.Misinformation has spread rapidly on the internet, partially as a result of a panicked and uninformed public that wants to read about the virus and is looking for someone to blame. One paper wrongly claimed that telltale signs in the genome of 2019-nCoV proved it had been engineered from HIV; biologists quickly refuted this, pointing out that the supposed similarities are present in lots of viruses, but the false claim had already gained widespread attention.

Similarly, there’sa conspiracy theory circulating that the virus escaped from a Wuhan research lab. (Not true.)And there’sa different conspiracy theory that it was engineered by Bill Gates (who funds a research group that has done pandemic-control exercises about a hypothetical deadly coronavirus). (Also not true.)Internet trolls have spread falseclaims that drinking bleach protects against coronavirus. (Please don’t do this.)

In light of all that, it’s no wonder that so many people want to tell the public not to panic. Certainly, public health communications should target misinformation, unjustified paranoia, and other negative effects of coronavirus fear. We should make sure public health communications don’t fan the flames of racism and that recommendations to policymakers balance disease control and other considerations.

We still don’t know how bad the coronavirus will be

But the pushback against panic in some cases has taken on a tone of certainty that’s not quite earned. And there’s reason to think that telling people not to worry too much in the face of a public health emergency may end up being premature.

The coronavirus killed fewer people than the flu did in January. But it might kill more in February — and unlike the flu, its scope and effects are poorly understood and hard to guess at. The Chinese National Health Commission reports 24,324 cases, including 3,887 new ones today. There are some indications that these numbers understate the situation, as overwhelmed hospitals in Wuhan only have the resources to test the most severe cases. As of Tuesday,171,329 people are under medical observation because they’ve had close contact with a confirmed case.

It is unclear whether China will be able to get the outbreak under control or whether it will cause a series of epidemics throughout the country. It’s also unclear whether other countries — especially those with weak health systems — will be able to quickly identify any cases in their country and avoid Wuhan-scale outbreaks.


How the new coronavirus outbreak gets better — or much worse

The point is, it’s simply too soon to assert we’ll do well on both those fronts — and if we fail, then the coronavirus death toll could well climb up into the tens of thousands. It also remains to be seen if vaccines or effective antiviral treatments will be developed. That’s just far too much uncertainty to assure people that they have nothing to worry about. And misleadingly assuring people that there’s nothing to worry about can end updoing harm.

“Instead of deriding people’s fears about the Wuhan coronavirus,” Sandman, the communications expert, writes, “I would advise officials and reporters to focus more on the high likelihood that things will get worse and the not-so-small possibility that they will get much worse.”

That’s a less reassuring message, but it more accurately represents the current situation.

A lot of the demands not to worry are weirdly ahistorical

Another oddity about assurances we shouldn’t panic is that they often rest on taking the disease numbers from China at face value.Currently, China’s numbers show that the virus is still spreading, but not quite as rapidly as initially feared, and with an approximately 2 percent fatality rate.

But there are certainly reasons to doubt those numbers. Many of them arenot China’s fault, like an overwhelmed health system that can’t test every case.

But China’s actions certainly give us cause to be skeptical. First, they seem to have shared misleading information at the onsetof the pandemic, including implying that most cases were tied to a Wuhan seafood market even when they already knew of cases that were not.

Second, in the early stages of the outbreak, people were arrested for speaking out about it, and even now censors are deleting articles arguing that the true figures are underreported.

Third, the last time this happened — the 2003 SARS outbreak — Chinese official numbers were consistently misleading, as the state worked to understate the disease and got in the way of international efforts to accurately report on it. It doesn’t make sense to have absolute confidence thatwe have the whole story now, and people who are suspicious of official numbers aren’t being senselessly paranoid.

In particular, a lot of the greatest public anger and demands for action are from Hong Kong, where medical workers have gone on strike to demand closed borders with China and where a man died of the coronavirus on Tuesday — only the second victim to die outside mainland China. Residents of Hong Kong have good reason to doubt official numbers and resent official policy that they perceive as putting them at risk. China has been imprisoning, teargassing, and killing peaceful Hong Kong protestors for the last year. Of course people in Hong Kong won’t sit quietly and trust in officials who have repeatedly demonstrated they don’t value their lives.

It’s true that if China’s numbers are right, then the outbreak doesn’t look too terrifying yet — but demanding everyone trust thisregime is bizarre, and it’s a particularly cruel demand when directed at the victims of that regime. And if numbers out of China are systematically misleading, we could still have a lot of problems ahead.

The Wuhan coronavirus likely won’t be a nightmare pandemic, but that scenario is still in play

The general public may have just gotten worried about the possibility of a deadly flu in the last few weeks, but public health experts have actually been worried about it for a long time. As former Ebola response official Ron Klain wrote for Vox in 2018, a pandemic “poses the greatest risk of a massive casualty event in the United States.”

And, Klain argued, “we need to take the risk seriously. A catastrophic pandemic is not merely the stuff of dystopian fiction. It is very much a real danger, as real today as it was 100 years ago.”

The Wuhan coronavirus almost certainly will not be a nightmare pandemic with 50 million deaths worldwide, like the 1918 influenza was. Its current lethality of 2 percent is likely an overestimate, and it’s certainly much less deadly than the emergent viruses it has been much compared to, SARS and MERS. But that was not at all obvious when China first announced that an unknown influenza was killing people. Given that, a strong response and a dash of paranoia were actually pretty justified.

Health experts suspect that a deadly influenza that sweeps across the globe is a very real possibility. Such a virus will probably look like the novel coronavirus at first — and we won’t know the magnitude of the threat until lots of people have put lots of effort into containment. Initially treating 2019-nCoV as though it had the potential to be the next 1918 influenza was, from a public health perspective, absolutely the correct call.

In fact, there’s a decent argument that we needed to do more, and that the main takeaway from the fight against the coronavirus is that next time a dangerous disease emerges, we should mount an even stronger international reaction.

“We don’t have the capability to detect, isolate, and ultimately stop a fast-spreading pandemic influenza, like the 1918 flu that killed at least 50 million people, from spreading,” Beth Cameron, who was the senior director for global health security and biodefense on the White House National Security Council under Obama, told my colleague Dylan last week. “This is yet another wake-up call for the world that we’re not where we need to be.”

In other words, maybe we should actually be more paranoid. The coronavirus appears not to be deadly enough to kill tens of millions of people, as was initially feared, but this is more or less a matter of luck. The virus could easily have been deadlier, and the world would currently be in the grip of a horrifying mass casualty event.

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