COVID-19: Are We Overreacting?

by Raywat Deonandan, PhD
Epidemiologist & Associate Professor
University of Ottawa
(I add my credentials to these COVID-19 blog posts in case they get shared. I want readers to know that my opinion is supposedly an educated and informed one)

This country and several others are pretty much in lock down. The borders might get sealed any day now. Jobs are being lost at breakneck speeds and entire industries might be collapsing.  The economic and psychological impacts of the response to the COVID-19 pandemic will likely be felt for months if not years.

Is this all an overreaction? In short: no, it is not.

That doesn’t mean that we are in the midst of a medieval plague or something out of a Stephen King novel. It simply means that this extreme administrative response to a disease that has a relatively low mortality rate is the appropriate thing to do in order to prevent the more dire economic, societal, and indeed physiological disruptions that almost certainly would otherwise occur.

Some news agencies, like Fox News in the USA are underplaying the seriousness of the situation.  Many assume the disease will “burn itself out” come the summer months. But other coronaviruses, like MERS, thrived in the heat of the desert. So we could be looking at still dealing with this well into the year. (I actually don’t think so, but it’s possible.) There are even some claiming that this pandemic reaction is a political ploy by the U.S. Democratic Party to undermine the Presidency of Donald Trump.

An article shared by a friend asked the question: how bad is COVID-19 compared to what? it made the argument that the disease’s (comparatively) meager global death toll of about 5000 (as of today) and 125 000 cases pale in comparison to, say, the more than a million traffic deaths that occur every year on this planet.

It’s a seductive argument, and I myself have made a similar one in the past. In the early days of this outbreak, when it was still isolated in one or two countries, I urged North Americans to focus on crossing the street vigilantly and on wearing their seat belts, and not to focus too much on a distant infectious threat. I still feel that it was the right message at the time.

But we are in a new time.

Remember back when under 3000 deaths stopped the world on September 11, 2001?  Flights were grounded, communities were in lock down, NATO was mobilized, economies shuddered and shuttered, and war was launched. The world lost its mind…. over 3000 deaths. That happened because those 3000 deaths represented a threat or a sentinel event that suggested that something worse was coming down the pipeline.

The traffic death two blocks over does not imply that you are in dire risk of a traffic death yourself. The cardiac arrest experienced by the gentleman across the street does not imply that you will have one, too, though statistically people with similar lifestyles tend to live near to one another.

In fact, the big ticket mortality events that get inappropriately compared to epidemics all share two very important characteristics: (1) they are not infectious; and (2) there are multiple things you can do to protect yourself from them with a very high likelihood of success.

In a pandemic scenario, on the other hand, we are always a few bad choices away from an untenable explosion of cases. And there is only one thing you can do to protect yourself: avoid contact with potential carriers.

That is why this international sequestration is not an overreaction. In Canada right now there are just over 200 cases of COVID-19 and a single death (as of today). That’s really not a lot for a base population of almost 37 million people. But the potential for that number to be very much higher is real. We can and must prevent that from happening. But right now, everything is very much in control and there is no reason to panic.

The panic is almost tangible, of course. At the request of a student, I penned a call for calm that has since been read several thousand times. I was a bit shocked at its need, but clearly we have underestimated the population’s thirst for balanced perspective on this matter.

I will recapitulate my note’s message here: This is not the Apocalypse. This is not the Bubonic Plague. This isn’t even the Spanish Flu. But some people are at great risk from it, making it very possible that our health care system will be cast into chaos. Our goal is not necessarily to stop the disease (though that would be nice), but rather to slow it down long enough for our health care system to do its job.

And that’s what this “overreaction” is all about.