Just in the last few days, as the World Health Organization declared a Global Health Emergency and a similar Public Health Emergency declaration was made in the U.S., there has been growing evidence of possible person to person transmission of the Wuhan coronavirus, and it is increasingly likely that people can be contagious even before the appearance of symptoms.
So, it should come as no surprise that public concerns about this new public health threat are also on the rise. Still, many questions remain unanswered and unanswerable at the moment.
It is equally unsurprising that messages from government agencies and even independent experts are inconsistent and subject to change, sometimes daily. After all, the very nature of a dangerous novel viral outbreak is that it is, by definition, new and inherently unpredictable.
Uncertainty about a lethal new virus almost always creates public anxiety. We want answers, even when conclusive information is not yet available. This is a problem not just for the public, but a concern for the financial markets and a challenge for journalists trying to make sense of a rapidly evolving crisis.
Calls coming to me about the Wuhan coronavirus outbreak have picked up this week. Not just from reporters, but friends, relatives, and neighbors. The questions are of the same genre. How dangerous is this new virus? Am I at risk? Is our government doing enough?
These are certainly valid concerns. And false reassurance is ill-advised. President Donald Trump, in an interview a week ago, said: “We have it totally under control. It’s one person coming in from China. We have it under control. It’s going to be just fine.”
But of course, we didn’t have it “totally under control.” The president’s attempt to reassure people was premature and felt shallow and uninformed.
In contrast, here’s what Alex Azar, Secretary of the U.S. Department of Health and Hunan Services, had to say: “This is potentially a very serious public health threat, but at this time Americans should not worry about their safety,” This is the appropriate response. The government is on it, even though, at the moment, we don’t know where this is all headed.
Is it possible that the new coronavirus will create a significant global pandemic, like the H1N1 pandemic of 2009, that sickened an estimated 61 million and killed over 12,000? It’s not impossible, but also not very likely.
The Centers for Disease Control and Prevention (CDC) in what they call a crisis, and Emergency Risk Communications guidelines stress that messaging during any crisis should be accurate, credible, empathetic, promote action, and show respect. And I think it would be fair to add — and to the extent possible — reassure.
Still, it’s a fine line to walk. Understating the threat will feel disingenuous and condescending; overstatement creates panic and often overreaction from the government. Case in point: In 2014, while Ebola was a raging outbreak in West Africa that killed more than 11,000 people, only 11 Ebola patients were identified in the U.S., two of whom died. But nearly $1.5 billion was appropriated to create early identification protocols and treatment centers in the U.S. alone.
So, how much should we worry about the new coronavirus? How likely is it that any one of us will get infected by the Wuhan virus? And what are the chances that this particular outbreak will spin out of control across the globe?
It’s easy to say that we should keep everything in perspective, but that’s a tough challenge in these early days of a legitimate, emerging bio-crisis. But consider this: so far, most people who are infected by the 2019-nCoV (as the virus is formally dubbed) will have only mild or moderate upper respiratory-like illness. And in terms of current data, about 2 percent will have severe disease and not survive. In contrast, SARS, another coronavirus that appeared in 2003, killed nearly 10 percent of those who became infected.
Bill Gates warned that “We can’t predict when, but given the continual emergence of new pathogens, the increasing risk of a bioterror attack, and the ever-increasing connectedness of our world, there is a significant probability that a large and lethal modern-day pandemic will occur in our lifetime.”
That may be true, but there is every reason to believe that international collaboration, more sophisticated means of prevention and surveillance, and new, highly effective pharmaceuticals will change that grim outlook. In the meantime, we need to depend on leaders to keep us informed with honest, credible updates as this crisis unfolds.
Yes, there is uncertainty, and the headlines are dramatic. But right now, the chances of any of us or anyone we know ever getting a severe, potentially lethal form of the Wuhan virus is negligible.
Irwin Redlener, M.D., is a professor of Health Policy and Management at Columbia University’s Mailman School of Public Health. He is also director of the National Center for Disaster Preparedness at Columbia’s Earth Institute. You can follow him on Twitter: @IrwinRedlenerMD.