There are no masks, no obvious viruses and no storm clouds in sunny Miami Beach. From here, it is hard to believe that a new pandemic is coming and — and, in fact, it may or may not be. But the not-knowing worries us.
The director of the U.S. Centers for Disease Control and Prevention, Dr. Robert Redfield, has warned over the past few days that the new coronavirus that erupted in China (now officially known as COVID-19) may spread in the first several days without symptoms, that “this virus is probably with us beyond this season, beyond this year, and I think eventually the virus will find a foothold and we will get community-based transmission.”
These are measured words, and the word “eventually” is especially important, though it may be lost on many among a panicked public. Viruses are invisible, and not entirely predictable, which causes many of us to over-personalize the risks and jump to worst-case scenarios.
Viruses obey the laws of science, but our perception of viruses don’t. Despite my book, “False Alarm, the Truth About the Epidemic of Fear,” I am guilty of feeding the flames of public fear, too, when I use the alarming word “pandemic” without explaining that it means a sustained spread in several regions of the world but that it may never happen here.
With the total number of confirmed coronavirus cases passing 70,000 with 1,500 deaths — and the real numbers probably a lot more — many public health officials are quickly jumping to the assumption that there will be a sustained spread in communities here.
This assumption is based on the fact that COVID-19 appears more contagious than SARS, another coronavirus which jumped from China to Toronto and scared people around the globe when someone seemingly caught it by pushing an elevator button.
With COVID-19, there is a higher disease burden, which increases the chance that it will take root elsewhere. But good public health measures and a far more effective health care infrastructure than found in central China decreases that chance in the United States. Many people live farther apart here, and effective social distancing decreases the risk of spread. It is by no means a given that we are facing a worldwide pandemic here, though we are wise to prepare for one. We have been wrong many times before.
It is prudent that the CDC, working with state and local health departments, has been isolating cases and potential cases, tracing contacts, issuing strict travel advisories, and quarantining American travelers coming from Wuhan, China and vicinity, where the vast majority of cases have occurred.
This is part of the reason that we only have 15 cases of the coronavirus here in the U.S., at the time of this writing. It is a given that we will have more, but how many more, and how many deaths?
Seasonal changes, with warmer and more humid weather coming in late spring, make it more difficult for a respiratory virus to spread, and chances are that the outbreak may diminish or die out, at least until autumn, when it may recur.
By then, one of several promising vaccine candidates may emerge and be ready to be mass-produced. With SARS, clinical studies began with a vaccine but were halted when the outbreak smoldered and then stopped.
There is a much greater likelihood that a vaccine will be needed with COVID-19. Remdesivir is an anti-viral drug that shows activity against coronaviruses and was used effectively (after being approved for compassionate use) on the first U.S. case in Washington. It now is being studied and will be made ready for use in China, here in the U.S., and around the world.
Hospitals across the country are gearing up for a pandemic that may never occur. The protocols for preparation are prudent but the masks seen on many city streets are props of fear. Health and Human Services have instituted a policy of checking for coronavirus as part of the flu and respiratory virus surveillance for those with flu symptoms at public health clinics initially in five major cities (New York, Chicago, Los Angeles, San Francisco and Seattle), which is a wise precaution.
Good public health precautions, vaccines and effective treatments are all antidotes to our coronavirus fears.
Unfortunately, fear and worry don’t always bring out the best in us. I bought cupcakes at my favorite bakery last week and was disturbed to see only one cashier, an Asian American, wearing a loose-fitting mask — probably a collector of viruses more than an effective barrier. I asked her if she wore it because she was being targeted by insensitive customers, and she said yes, adding that she knew there was no coronavirus here.
Viruses do not pay attention to borders or politics or race. They are non-discriminatory. We need to be that way, too, in order to defeat them.
Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent. Follow him on Twitter: @drmarcsiegel.