Hyperbole, overreaction, and panicking in the Wuhan virus scare of 2020

The biggest news in the young 2020 is undoubtedly the Wuhan coV, which started in late Dec, 2019, according to hospital records and local media reports at the time.  Within 2-3 weeks (early 2020), the new coV virus had been isolated and sequenced, allowing definitive identification of patients and a better understanding of the extent of infection.  Since mid-late January 2020, drastic measures have been imposed on the Wuhan city, then most of the Hubei province.  Commonly referring to “lockdown” in the media, these measures include suspension of public transportation within the cities, and no train and flight services into and out of the cities, although trains passing by may still be running, and private cars can still more or less move.  Most other places in China have later enacted traveling or visiting restrictions of their own.  

All these are serious overreactions, based on what we know about the disease and other diseases.

First, what we know.  As of Jan 27, there are approximately 2900 confirmed cases, 5800 suspected cases, over 60000 quarantined, and 81 deaths.  Infections and deaths will increase further, but infections are much easier to underestimate, so the mortality rate will likely drop to or below 1% when the dust settles.  Most deaths are the elderly with additional health conditions, with children less likely to be infected, and young adults typically having few or only mild symptoms.  Much has been said about how easily the new coV spreads, but this is hard to assess for two reasons, not mutually exclusive.  One is that, based on current quarantine-release data and media reports, family members much more often not are not sickened by a patient.  The other is how to define a transmission.  If you get the virus into your lung/system, but you have no symptoms, does it count as an infection, a successful infection, or anything?  Are you able to pass the virus to others?   PCR detects coV, but it doesn’t tell you physiology.  As for many viruses, like Zika, most infected individuals have no symptoms and don’t even know they are infected.  There are obviously unanswered questions here, but the overall picture is emerging: the coV is not that THAT transmissible and not THAT dangerous.

Next, what those drastic measures like lockdown do to the pubic health system in Wuhan, in Hubei, and in the rest of China.  The most obvious and natural reaction is panicking.  Many people are rushing out of Wuhan, and residents elsewhere are looking at people from Wuhan and Hubei suspiciously, even though at least 99% of them are absolutely not infected.  Then in Wuhan, hospitals are flooded with people with a tiny bit of fever or coughing, instantly overwhelming the healthcare system.  If you didn’t have the coV before, you are now much more likely to get it from the hospitals.  Because of so many “patients” jamming the hospitals, the real coV patients will actually receive less attention, maybe partly explaining the recent spikes in coV deaths.  If you have other health problems, like heart attack, cancer, GI issues, etc, since the public transport is down, taxis are fewer (drivers are afraid too), most ambulances are for coV now, your local hospitals have been converted for coV treatment, leading to a longer trip, you will have less care and will be adversely affected.  In other words, these drastic measures, while will probably reduce coV infections and deaths, will likely increase deaths due to other causes, including depression.  And I have yet to count the major disruption in economic and social activities, which have their own vast monetary and life values.

Then why did the governments instigate such restrictions?  The officials may truly believe they are doing the right thing, but the most underlying reason is panicking, and facing immerse pressure from the internet and social media in China.  It is better to do something big, so that nobody can fault me for not taking coV seriously.  Whether it will work, or whether it will do more harm than good, nobody in the social media understands.  Scientists may analyze the data months later and find it unhelpful, but everybody else will forget about it by then.  

During the winter season, most people will have common cold and flu, from viruses (including other, “old” coVs), have a fever and cough, and recover in a few days.  Old people are also the most susceptible.  Even if you are not infected, if you hear so much about coV, you may feel sick as well.  When you get sick, the best treatment is to rest in a quiet environment, and relax.  But if it is noisy outside, because of all the commotion from the new coV, and with the mental pressure from the non-stopping internet and TV coverage of the epidemic, your recovery will be hampered.  The death rate from common cold and flu may be a bit lower than the new coV, but tens of thousands of people die from them in China every year.  For the new coV, while hard to count an infection at the moment (see above), it seems implausible to be more deadly than SARS (800 deaths) in 2003.  

In fact, most measures adopted in China right now are to identify individuals with a fever, especially from the Hubei province, and quarantine them and those people in contact with them.  But since most people, Hebei or not, definitively don’t have coV, and many people, Hebei or not, have common cold or flu, vast energy, resource, and mentality is being wasted, which inevitably reduces attention to other, real problems.  I can even imagine a scenario that someone has both coV and common cold infections.  PCR identifies coV, but his symptoms actually arise from the common cold (because coV is not intrinsically THAT dangerous, see above).  We will give him a separate room in a hospital for 3 weeks, many tests, expensive machines and drugs, and keep his 20 family and friends in a “hotel” for 15 days.  All is to just make us feel good and safe.  The best outcome is he recovers, but the likely outcome is he and family and friends will get unnecessarily anxious and depressed, and the worst outcome is somebody else who really needs better care does not.  The current situation in China is that the Chinese officials seem unknowingly trying to fight a war against the common cold and flu, not just coV.  This is a fool’s errand.  This is beyond current human knowledge and ability.  It will fail.  

But what really should be done?  Well, first lift the lockdown, and tell the public be careful, but not fearful.  Allow public transportation: you will see fewer passengers, and chance of getting infected is very low.  Allow one-time masks to be freely distributed at public transport stations.  Advertising to turn on the heat indoor.  Most Chinese in the south don’t like heating in the winter at home because they prefer to have outside air and to save money, but this tradition and notion must change: it is cheaper to spend on your electricity at home than getting sick, and there are other ways to circulate air.  I have no problem with quarantine and treatment measures, except not to cast a too wider net than necessary.  Regardless, eventually the Chinese governments will have to loosen the criteria to lift the lockdown and declare the end of Wuhan coV saga.   

Lastly, hyperbole happened everywhere, not just in China.  A glaring example is https://republicanfreedom.com/2020/01/26/thermonuclear-pandemic-level-bad-harvard-epidemiologist-warns-viral-outbreak-might-get-a-lot-worse/.  It is so silly that it hurts your eyes to read.  It even quoted some experts, but there are scientists who don’t think HIV causes AIDS, so what does it mean?   Following this line of thought, it is curious that expert who have spoken so far publicly are mostly medical doctors and PhD scientists analyzing the coV, and their comments are narrowly focused.  Few “prominent” biologists have said anything, especially about the drastic measures in China.  China’s Rao Yi, who has been outspoken on many topics, only said, before the widespread lockdown, that it is a new virus, so everything is possible.  Words that are true, but also useless.  I am venturing to say that most basic biological scientists share my concerns but are not talking because they don’t want to seem aloof in face of a new public health crisis and criticize the draconian measures, which have good intentions and satisfy popular instincts but will ultimately fail the cost vs benefit test.

Regarding the new coV, my hunch is that it will stay with humans for a while as an annoyance, just like other coVs that cause the common cold, especially if it is found to be as infectious.  But unlike the flu, coVs are likely better targets for antiviral drugs and vaccines, so the threat will be better contained later, definitely not the thermonuclear level.