The world is starting to panic over the 2019 coronavirus outbreak. Are we over-reacting?
Here are 3 reasons why we should panic, followed by 4 reasons why we shouldn't.
- The virus, 2019-nCoV, is completely new to humans, and we don't know exactly how bad it will get. As of 29 February, it has already killed nearly 3,000 people, over 2,700 of them in China.
- It appears to be very infectious. Cases are now appearing in people who didn't travel to China, and who didn't have any contact with known cases. Coronavirus illness (newl named COVID-19) has now been reported in over 60 countries, on every continent except Antarctica. No matter where you are, it is probably coming your way.
- The mortality rate has been reported to be as high as 2%. The Johns Hopkins University tracking site makes it appear even higher, with 2,933 deaths out of 85,688 cases, which is over 3%. By comparison, the 1918 Influenza pandemic had a mortality rate of around 2-3%, and in that epidemic, the worst in modern history, 30–50 million people died, which was 1.7% of the world's population at the time. Extrapolating to today's population of 7.7 billion people, a virus that deadly would kill 130 million people.
This seems really bad. So perhaps we are not overreacting.
On the other hand, there are several very good reasons why we should stay calm.
- The mortality rate is probably much, much less than 2%. The rapid spread of COVID-19 suggests that many more people are infected than those who have confirmed cases. The number of people who have no symptoms or very mild symptoms is likely to be ten times as high as the number of reported cases. (This is only a guess.) That would mean the mortality rate might be only 0.2%, or even lower. We still don't know. (The cruise ship that was quarantined in the Japan had just over 700 cases, and 6 people have died, suggesting a mortality rate of 1%.)
- The reported mortality rate is dramatically lower in young people. If you are under 30, you can probably relax a bit. However, if you are over 70, the mortality rate is frighteningly high, 8-15%.
- 2,933 deaths is a tragedy, but it's a tiny number compared to the annual deaths from the influenza virus, which we have learned to live with. In the U.S. alone, the CDC estimates that 12,000–61,000 people die each year from the flu (the number varies a lot because the virus itself changes from year to year), and 9-45 million people get sick. The worldwide totals are far higher. So in terms of numbers, the world is definitely over-reacting to the new coronavirus.
- Infectious viruses tended to become milder over time. At least 4 other coronaviruses already circulate among humans, causing little more than mild cold symptoms. It is quite possible that the virus causing COVID-19, nCoV-19, may mutate to become a milder disease as well. RNA viruses mutate extremely rapidly, and from an evolutionary perspective, viruses adapt to their hosts by becoming milder. (My perspective is based in part on my past research on the influenza virus.) From the virus's point of view, it can't spread itself around if the host is too sick.
What can we do? A few things:
- Panic isn't helpful. Don't panic.
- In the short term, the best response will be to develop a vaccine. (Dr. Peter Hotez and colleagues at Baylor College of Medicine are already working on one.) We need to dramatically increase government investment in vaccine development. It seems that the U.S. is doing that, although not quickly enough.
- If you feel sick, stay home.
- It's probably best to avoid travel to a location where COVID-19 is known to be circulating widely. Right now this list includes China and Iran, but it could grow in the coming weeks.
- In the longer term, we need to increase rather than cut biomedical research funding. Even if we get a vaccine, we still need actual treatments, not only for COVID-19 but for other viruses. (Most viruses are incurable with current technology.) The recent proposal out of the White House aims to cut NIH funding by 7% and CDC funding by 16%. As anyone following the coronavirus news now realizes, the CDC is responsible for tracking the virus in the U.S. and for coordinating our public health measures to respond to the outbreak.
Finally, I should add a note of caution about the bogus treatments already being hawked by peddlers of pseudoscience. There are multiple websites and Facebook pages, including some anti-vaccine sites, already claiming they know how to treat coronavirus illness. (I won't link to any of them, as I don't want to give them the traffic.) These are complete scams. No one has any treatment that will prevent or cure COVID-19, but if we make the investment, we'll get a treatment one day.
(Note: the WHO has renamed the virus SARS-CoV-2, but The Lancet article that first described its genome calls it nCoV-19.)
