The 2020 Novel Coronavirus Outbreak
Fear plays a vital role in epidemic response.
Widespread fear in the public compels authorities to act with urgency and increases the chances of collective survival.
Some people can’t estimate epidemic severity
If you want to know the severity of an outbreak, you should be careful not to naively look at the final figures of past outbreaks. These final figures are influenced by a variety of factors:
- Virus transmissibility (important)
- Virus lethality (important)
- Containment effectiveness (misleading)
- Healthcare quality and access (misleading)
It is important to account for the effect of human intervention when considering severity. Otherwise, a highly lethal and contagious virus, which is brilliantly contained at an early stage, would appear not severe at all.
Some people say: No need to fear — past epidemic severity has been overestimated by the irrational public.
A Feb 19 Bloomberg opinion piece, titled “The Economic Hit From Coronavirus Is All in Your Mind” argues that “psychology can be more powerful than facts when it comes to the impact of an epidemic.”
The article states:
“At the height of the 2003 outbreak, 23% of respondents to a public-opinion survey in Hong Kong thought they were either very likely or somewhat likely to be infected. The number of cases wound up at 1,755, according to the World Health Organization, which would have been roughly 0.026% of the population.”
“In Taipei, 74% rated the likelihood of death following contraction of SARS at four or five on a five-point scale compared with an actual mortality rate of 11%.”
and based on this example, concludes:
“Individuals, under prevailing circumstances of poor information and stress, can arrive at biased subjective assessments concerning the risk of disease contraction.”
So in summary, people overestimated the severity of SARS. The author knows this (only in hindsight, by the way) because it turned out to infect and kill less people than was generally predicted.
But he forgets that excessive fear would have spurred human intervention in the outbreak allowing the virus to be contained quickly and effectively. And the Asian Development Bank study cited in that article states:
“…it would seem obvious that the mass tendency for social aversion that arose in the peak of the SARS epidemic had a significant role in its containment.”
People should shut off their natural impulse to be afraid, and yet… it played a role in containing the outbreak and thus reducing the final case and death count. Maybe fear is the precise reason why he gets to tell people, in hindsight, that fear was unnecessary.
“…leaders need to think carefully about how to minimize our natural impulse to be afraid.”
Dangerous words.
Even Epidemiologists Try To Create Overestimates
The purpose of predicting the severity of an outbreak isn’t to be correct. It is to decide what sort of actions are needed to reduce death and increase the chance of survival.
In the midst of an epidemic, researchers gain information about disease transmission and lethality. By using this information, epidemiologists can generate projections to understand the worst-case scenarios of virus outbreaks without human intervention. They can then use this to recommend containment measures. This is good enough for increasing the chances of collective survival.
What epidemiologists have predicted for COVID-19 — far more infections than reported.
The Purpose of Fear
Ordinary people think like epidemiologists
The fear instinct is like the epidemiologist’s projection of an epidemic. It may not always be “accurate”, but this distorted perception of reality tricks people into trying to take actions which increase the probability of survival.
Some, but not all actions increase the probability of survival
There are effective and ineffective ways of containing an outbreak. We can agree that uncoordinated local action will not always help to solve a disease outbreak. And of course, we should not have outright disinformation (not the same as speculation) which masquerades as certain truth.
A common problem during epidemics is panic buying. It is easy to criticise people buying seemingly excessive amounts of items in the supermarket, but imagine directing that critcism to the people in Wuhan who are confined to their homes amidst the lockdown. It makes perfect sense for people to guarantee access to resources while they still can. We have to solve the problem with better planning — building up community inventories in anticipation of a larger outbreak and finding a way to distribute supplies during the quarantine. (Eg. Use AI/technology to deliver food to people’s doorsteps while they quarantine themselves inside their homes. Maybe too futuristic for now, but we have to think about it for later.)
Despite how they seem, epidemics are somewhat predictable when thoroughly researched by epidemiologists. We can responsibly implement appropriate measures.
The authorities might hesitate and downplay the outbreak
Authorities will not automatically act with vigilance — this was proven in the COVID-19 outbreak.
How many times were people told:
- No evidence of human-to-human transmission.
- No evidence of asymptomatic transmission.
- No evidence of local transmission.
- The outbreak is easily containable.
And now that these have been proven wrong, how many people are now suffering the consequences?
(Update: Feb 26) Should we believe that the authorities have everything under control?
“To limit the impact on growth, then, leaders need to think carefully about how to minimize our natural impulse to be afraid.”
Pushing for action
Fear and public pressure plays a big role in the political process. Politicians have to deal with competing interests, and there are interests which try to compete with the health of the public. We need public health at the top of the political agenda. The world is heavily interconnected, and only coordination at the highest levels will be able to allocate the necessary resources to the right places. But with blind trust and no fear, we cannot guarantee that this will be the case.
If we want to solve this crisis, we need to harness fear to pressure the system into action.
