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

  • 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.

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

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.

Interview: Neil Ferguson explains what an epidemiologist’s estimate is useful for — preparation for the worst-case, not for accurate prediction.

What epidemiologists have predicted for COVID-19 — far more infections than reported.

The Purpose of Fear

Ordinary people think like epidemiologists

Some, but not all actions increase the probability of survival

Empty supermarket shelf in Milan. Stockpiling/panic buying causes supply shortages, but is perfectly rational.

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

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.”

Estimated number of COVID-19 cases in Iran: 18,300 (95% confidence interval: 3770 to 53,470 by Feb 19–23

Pushing for action

If we want to solve this crisis, we need to harness fear to pressure the system into action.

Math, stats, data. Influenced by the complex systems perspective. I prefer to take the critical view.

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store