Mass hysteria is making coronavirus worse than it is

So far it would seem that when COVID-19 finds its way into a care facility for the sick and/or elderly, it incubates for a few days and then starts killing people left and right. And some of the best hospitals in America (e.g., Evergreen and Harborview) can't save them.

We've seen what does and doesn't work in places like Japan, Korea, and Italy. Meanwhile most of the schools around here are still open and the workers transferring suspected COVID-19 patients to ambulances are using only loose-fitting face masks as PPE.

I feel like we're collectively failing an open-book test right now.

> In all likelihood, however, given the one-off infections that are being detected in disparate locations, thousands if not millions have already had mild or asymptomatic SARS-CoV2.

An assistance director general and epidemiologist for the WHO, Bruce Aylward, makes the opposite argument in a recent Vox interview (https://www.vox.com/2020/3/2/21161067/coronavirus-covid19-ch...):

> Bruce Aylward: ... More of a surprise, and this is something we still don’t understand, is how little virus there was in the much broader community. Everywhere we went, we tried to find and understand how many tests had been done, how many people were tested, and who were they.

> In Guangdong province, for example, there were 320,000 tests done in people coming to fever clinics, outpatient clinics. And at the peak of the outbreak, 0.47 percent of those tests were positive. People keep saying [the cases are the] tip of the iceberg. But we couldn’t find that. We found there’s a lot of people who are cases, a lot of close contacts — but not a lot of asymptomatic circulation of this virus in the bigger population. And that’s different from flu. In flu, you’ll find this virus right through the child population, right through blood samples of 20 to 40 percent of the population.

> Julia Belluz: If you didn’t find the “iceberg” of mild cases in China, what does it say about how deadly the virus is — the case fatality rate?

> Bruce Aylward: It says you’re probably not way off. The average case fatality rate is 3.8 percent in China, but a lot of that is driven by the early epidemic in Wuhan where numbers were higher. ... This suggests the Chinese are really good at keeping people alive with this disease, and just because it’s 1 percent in the general population outside of Wuhan doesn’t mean it [will be the same in other countries].

I find Aylward's arguments cogent and backed with evidence from the ground. I also don't see "mass hysteria." The evidence points to COVID-19 being more severe than the seasonal flu, we have an opportunity to contain it, and we're trying to do so. Canceling large events and unnecessary travel seems reasonable.

consider that the preliminary WHO incident report regarding the chinese response to the outbreak in wuhan essentially said that the radical and severe measures taken by the chinese government were the only thing which allowed for some semblance of control over the course of weeks. if we assume that the chinese are not fabricating their numbers, it's not much of a relief for us because they still had thousands of deaths despite their colossal efforts. if we assume that the chinese have been faking their numbers, the picture is much more grim.

a lot of the hysteria in the US is stemming from the fact that the CDC is asleep at the wheel as a result of political pressure or potentially severe incompetence. after seeing how seriously the chinese took the outbreak and how badly iran is getting hit by it right now, it is extremely disconcerting to see our own government doing absolutely nothing as cases continue to mount.

we're barely even testing people. daily life is continuing as normal when perhaps it shouldn't be.

i know that this isn't the end of the world, but i'm starting to expect that this epidemic might make life a bit less comfortable for a while.

if the US gets hit very hard and some of the preventable/fixable weaknesses in american society end up being exposed and exacerbated by the epidemic, i think we'll be in a severe crisis.

1) Washing hands often, significantly reduces chances of getting infected (because virus has a fat membrane that breaks when in contact with soap)

2) If you are under 60 yrs old, covid-19 infection becoming fatal is extremely low, which in turn means, keep older population away from anyone carrying this virus, hence self-quarantine around elders is extremely important.

3) Wear mask only if infected.

4) The virus doesn't last long on dry surfaces, hot weather (bumped up the heat in house by a few degrees, yet comfortable enough).

5) I try to eat cooked foods (no salads, no cold foods). This should further reduce the chances of getting infected

6) Follow less frequent yet more reliable sources of news (this is the hardest to achieve for most people).

(correct me if I'm wrong, or add more to it if needed)

Buying stuff you don't normally use can also be sensible. Consider putting together an earthquake kit in California. Unfortunately, having a pandemic kit ready isn't something most people do, but maybe it should be?

There probably are some kinds of preparation that are sensible and others that aren't, and we should try to figure out the difference.

I'm also wondering if there might be an untapped market to help people be prepared without keeping a lot of inventory themselves? Usually there is advance notice for a pandemic so you just want some assurance that someone can ship you something when it's time. This would avoid shortages by making it profitable to keep inventory.

Like the Y2K bug, focusing a large amount of society's resources on the problem is the only think that may prevent it from becoming catastrophic.

I also don't see much hysteria - some real concern, starting to slowly take action, a long-overdue stock market correction that's already moderating, but not hysteria.

Moreover, this author seems to have little knowledge of the dynamics of exponential growth. They also miss the fact that the USA has essentially zero testing capability, restrict the tests to absurdly tight criteria (returned from a known hotspot, or contact w/+tested person), so new cases are now popping up across the nation.

Mostly there is completely insufficient data, especially in the USA, where the administration has gutted the science-based agencies including the CDC, is trying to protect the stock market for it's re-election before protecting the people, and so is basically flying the in the fog saying "it's fine, we don't see any mountains".

Sitting the the same dataless fog and saying "it's fine we don't see any mountains either" is not helpful.

To paraphrase: "We don't want to take aggressive action until we're certain that it is actually bad.".

In many situations, that is a fine approach, but when the adversary scales exponentially, it is a dangerous road to travel.

I don't see mass hysteria, but I do see growing concern.

The last several decades of child-rearing in the US have been marked by an increased focus upon stress rduction, conflict mitigation, and obstacle-clearing for the purposes of opening up a larger swath of opportunities for our children in their futures.

Especially among the upper and middle-classes, I believe that this has resulted in a larger portion of the population lacking the fundamental coping mechanisms to respond rationally and proportionally to perceived threats.

Combined with a lack of actual experience dealing with pandemics in our cultural memory, lower social capital in our immediate communities preventing stronger bonds of mutual reassurance/support, and our ability to communicate our concerns with a broad likeminded audience over the internet, and I don't wonder that an unreasonably high number of young individuals panicking over the COVID outbreak.

I don't know that this is the case in Europe, as it is outside my direct experience. But Europeans seem to have a greater sense of institutional trust than we do here stateside.

We seem to be in a constant state of cultural hyperventilation right now. Of all the wolves we've worried about wandering the earth, COVID's the one that's actually coming for us, irrespective of ethnicity, gender, or creed, and it's also the one we lack the tools to effectively combat at scale.

Even though the article raises a number of reasons why the outbreak may not be as bad as we fear, if someone's truly concerned that they're in danger of passing from it, reach out to them and ask how you can help.

Especially among the lower-classes, self-quarantine isn't a realistic option, and constructing a network of mutual support for the event that it does become as bad as our most panicked commentators say it might be is a good way to keep everyone's emotional and physical struggles down while we weather the storm, if and when it comes.

Then you have excellent leadership in Iran which knowingly hides their coronavirus situation and thus have exported the virus to poor and incapable places like Afghanistan, Pakistan, Iraq?

Heck, compared to Iran, even Pakistan is being much more stringent and transparent.

( Belgium)

What I’ve observed from friends and news out of Seattle is general caution and a measured public response, which if successful can dramatically slow the rate of transmission.

For public institutions responsible for health, you would never say that things aren't that bad. There is nothing to gain here. If it isn't too bad, you would have been too careful, no big deal. If you are downplaying the issue, you can get in a lot of trouble because you are suddenly responsible for every single person who died from this if the outbreak is worse than previously assumed.

Of course there are some other options like hiding the outbreak completely. Those fail as the information cannot be contained anymore.

Cases have declined in China only because of the extreme measures they undertook to stop it. (In other words, "hysteria.")

You can't write off the Diamond Princess as "well the people on it were old, so their mortality doesn't count." It's the one natural experiment where we do have good, hard numbers. In terms of access to treatment, they're the optimal scenario, and so it's likely that the mortality rate will be around 1% for older people with access to treatment. This is far higher than the flu and a disaster in itself.

But what makes this a mega-disaster is what happens when the medical system is overloaded. That's when you get the scary 2%+ overall mortality. And we are getting closer and closer to the point of no return where community transmission swamps all medical facilities. It is what happened in Wuhan, and it can happen in Western countries.

Beyond that, the author piles on as many optimistic assumptions as possible: every death is accurately counted! Millions of people are asymptomatically infected! The USA will be as effective as Singapore in responding! Cases are peaking and will start to decline! I'd usually refrain from calling something like that idiotic, but since he's more than happy to lodge insults like hysterical and witch hunt, yes, he's saying idiotic things.

The thing is, by approaching the issue with seriousness and diligence, it's possible to avoid that death spiral! China did in all of its other provinces. And, in a better and more applicable way, Singapore has responded with effectiveness and humanity.

But it seems like the main opinions among the ruling class in the US range from "it's just the flu" to "it's a hoax!"

Here in Switzerland, I see practically no change apart from few people on streets wearing masks (by few I mean like 2 today, for the first time since months). No panic shopping, our company is not going crazy just doing what seems adequate (extra hand disinfection available, there was a question of checking if remote works OK if needed). Shops have +-same amount of people, nobody binge shopping, all is available (apart from useless face masks in pharmacies, of course). Bear in mind that in my town we have at least 5 cases, could be more (not following this closely, what would be the point apart from getting into negative mental spiral).

Same look in France just across the border - big shopping centres seems exactly same as before. Went last weekend to Grenoble and ended up shopping at Carrefour there - again, business as usual. Nobody checking anything at EU borders, in nor out.

Back home in Eastern europe, some folks are going a bit mental and things for sure look a bit differently there.

I resumed my efforts in mid February after learning that the CDC had rejected WHO test kits, then had produced defective test kits, which, coupled with unreasonably strict test criteria, caused virtually no surveillance in the US to be done. It did not inspire confidence that mass gatherings continued to be held, and were even encouraged (e.g., San Francisco's Mayor's issuance of a statement encouraging RSA conference attendance, or the recent Bernie Sanders rally in San Jose).

Note that the failure of the US to adequately surveil, moreover its failure to respond quickly to that failure, mirrors what transpired in Wuhan. In the case of Wuhan, the national state only became aware of the problem when the local medical system was overwhelmed, and the epidemic had gone, ahem, viral.

Given the similarity between the surveillance gap in China and the US, and the failure to respond to that gap in the US, I thought prudent to continue to prepare.

I might, though, have a different perspective due to the fact that my father was head of serology and virology labs with reporting, diagnostic, and research responsibilities for animal diseases for a US state. Or, maybe a little knowledge is a dangerous thing, I don’t know. But I can, thus, recommend journalistic potboilers such as “Rats, Lice, and Men” and “Plagues and Peoples”. More seriously, David Quammen, given the background he gained in evolutionary biology from writing “Song of the Dodo”, in “Spillover” gives what’s probably the best elucidation of zoonotic pathogens.

Previous zoonotic pathogenic outbreaks have killed more than probably all wars combined. Disruption of habitat by human colonization and climate change have intersected with mass jet travel to increase the likelihood that pathogens will make it from animal reservoirs to our species.

Shouldn’t we opt for action assuming the worst even though we may deem it an overreaction in the future? Then if it is bad we’ll have done what we could.

Genomic analysis suggests that the virus has been spreading undetected in the community since January 15th https://bedford.io/blog/ncov-cryptic-transmission/ This is from a virologist at Fred Hutch Cancer Institute who is part of a viral epidemiology study. If the virus doubles every 6 or 7 days as estimated, then... well, you're all good with your powers of 2, there are likely hundreds of cases already.

Every day there are new announcements of deaths from this disease just miles away, of new people showing symptoms, of people whose "flu" has been diagnosed after the fact as coronavirus. In a dense urban center like this with people crowded together on streets, in buses, in workplaces, I am working under the assumption that it is already in my neighborhood. I don't think that's unreasonable. The pharmacies in the area have been filling people's prescriptions for three months' worth without any prompting. They are planning for a long slog in which they want to keep people AWAY from the pharmacy as much as possible. The county has purchased a hotel to repurpose as a quarantine center, and is prepping portable isolation units. We've seen what a lackadaisical response brought Wuhan---it is not "hysteria" to work to avoid that same fate.

For the rest of the nation, I think it's eminently sensible to get a supply of nonperishible food, of prescriptions, of some fever reducer, etc. to last two weeks to a month. Get in the habit of washing your hands regularly, thoroughly according to CDC recommendations. Get in the habit of NOT TOUCHING YOUR FACE (it's very hard!) and all the usual stuff but actually applied. Be mindful of who in your family and community might be vulnerable, have respiratory conditions, be elderly, be in treatment for cancer, have an impaired immune system, etc., and make plans for how to protect them in the event of an outbreak in your community.

Those decrying "mass hysteria" do have a point---prudence can become paranoia, preparation can become panic. But mostly I think people should be encouraged rather than discouraged to prepare, because this will very likely be in your area soon.

Tweets of mass-disruption have done more than any WMD.