The first identified case of 2019 novel coronavirus was identified and reported to the World Health Organization at the end of December. That person was likely infected around the beginning of the month, and their first symptoms appeared on December 8. From that single instance, the number of confirmed infections of 2019-nCoV, or Wuhan coronavirus, has increased to more than 12,000, spread across more than a dozen countries. Those known to have died from the disease stand at 259, and rising. The number of identified cases has already raced past the totals from the 2003 emergence of SARS.
It’s exactly that kind of explosive growth — from a single case to over 12,000 in one month — that makes novel, emerging diseases so dangerous. And in the case of the Wuhan coronavirus, this growth has come in spite of a rapid, effective response by the China government that has drawn praise from officials at WHO.
It’s understandable that the Wuhan coronavirus is generating fear. But there’s a genuine risk that the fear may do more damage than the disease.
The worst thing that any epidemiologist or health organization can possibly do is under react. In most situations, the person who is saying “don’t panic” is regarded as reasonable … but there are times for panic. And there are times when health officials need to raise ever red flag, sound every alarm, and call for drastic actions.
But there are also costs for overreacting. Those costs aren’t just measured in economic damage, or esoteric items like delayed holidays and missing shipments. They’re measured in the credibility of the health organizations themselves. Every time either national or international health officials raise concerns about an emerging disease, or the ever cycling danger of flu, they risk decreasing their ability to generate a response to the next threat.
No one wants to lead the WHO that cried pandemic, when there was no pandemic at the door. But failing to shout those warnings when pandemic is even possible is much worse. So, not surprisingly, the WHO couches its announcements in terms that are meant to generate attention. They want to create actions that have proven to be effective, but not raise alarms that turn concern about emerging diseases into a background noise that is too easily ignored.
Which is why the U.S. action, taken this week, to prevent non-citizens who have visited China in the last 30 days from entering the country, is a concern. Like the Russian action to close their border with China, this action was not recommended by WHO. Neither of these decisions has been, so far, strongly disruptive to world trade or had a strong impact on international travel. The concern is that these aren’t decisions being made on the best available scientific information and using the experience of international experts.
They’re early signs of decisions being made out of fear. Decisions that could easily be stoked by politics, prejudice, and a cascade of panic.
To see that, it’s not necessary to look any further back than 2016, when Donald Trump was one of the loudest voices raised in an attempt to generate panic about an Ebola outbreak in Guinea, Liberia, and Sierra Leone. That outbreak—which ultimately generated over 28,000 confirmed cases and 11,000 deaths—was frightening because Ebola is an infectious disease with a very high mortality rate and astoundingly dire effects.
But transmission and treatment of Ebola is also understood. What was mainly needed during the outbreak of 2014 to 2016 was the ability to bring in medical resources to help in isolating and treating infected persons, so that the outbreak could be brought under control and the greatest number of those infected could be saved. The biggest threat to many of those lies was not the disease itself, but overreaction leading to the kind of isolating tactics suggested by Trump and others.
The kind of “stop all fights!” panic that Trump was fanning in 2016, wasn’t appropriate then, it’s not appropriate now. That kind of panic absolutely made things worse during the SARS outbreak, and a whole series of mistakes related to fear about the disease contributed to greater numbers of death in areas where spread did occur outside of China, such as in Toronto.
In recent years, right-wing media has fueled the idea that “terrorists” crossing the border are a source of Ebola, plague, and other diseases. It will be exceptionally easy for Trump to expand his bigotry-fueled travel bans and anti-immigrant policies by rolling into them a fear of 2019-nCoV.
This is a serious outbreak, marked by rapid expansion, a very high rate of transmission, and concerning mortality figures. But the WHO has made it clear that the threat of this infection reaching the United States in any great numbers remains “low.”
The biggest concern is that those who have control of U.S. policies will use those policies not to prevent disease, but to increase panic. Because if there’s another thing Trump would like to add to his faux resume going into the 2020 election, it’s how he “saved America” from Democrats who wanted to “let in foreign diseases.”
Fighting on the side of reason in this case is going to be difficult. It’s also going to be necessary. Because reason saves lives.
