Commentary: CoVid-19: Fear vs Reality

By Tia Will

In 2014 – 2016 there was an outbreak of Ebola in Africa. It was devastating due to the local conditions on the ground. By 3/16, the WHO had documented a total of 14,124 cases, including 3,955 deaths, in Sierra Leone alone. In the United States, there were a total of 11 cases reported, 4 in individuals believed to have acquired the virus in the US, the others repatriated for care. I wrote about it at the time and a lively discussion ensued.

Although there were not any cases of Ebola reported in California, and there were only 2 deaths from Ebola in those who had acquired it outside the US, there was a great outcry for the government to “do something”. For comparison, during the 2015-2016 reporting period, the CDC registered 85 pediatric deaths due to the flu. Adult deaths are not reportable but one can reasonably assume there were more than the number of pediatric deaths and yet there was no comparable public outcry.

Worse than no public demand for enhanced flu surveillance and corresponding public health response was the call for more resources to fight Ebola. Here in the Sacramento area including Yolo County, this was the cost. At Kaiser alone, where I was employed at the time, each department and/or facility had to designate both an adult and a pediatric “czar” to be trained in screening, testing and monitoring of suspected Ebola carriers. This included the designation of special screening rooms, complete personal protection gear for every entry into the designated area, and designation of surrogates to track patients & contacts and relay results. These were resources diverted from the usual winter care of primary care patients in a late, & fortunately moderate flu season. I do not know how many lives may have been lost, or how much money was spent on a nonexistent emergency in the US, but I believe those numbers to be more than zero. Far, far more in the case of
dollars spent.

Now, 5 years later, we are facing another global epidemic (25 countries have reported confirmed cases). CoVid-19 first reported in early January in a Wuhan, a single city in an inland province of China has affected approximately 15,000 people in Hubei province, including 1,700 health care workers, and approximately 1,400 deaths all but a handful in Hubei, the source of origin. We have as of 2/14, a reported total of 15 cases in the US. We are also in the US in a serious flu season. So what is our actual risk ? The answer is “we don’t know”. But we do know some tendencies in risk assessment that can lead to serious errors in judgment.

https://www.nytimes.com/2020/02/13/world/asia/coronavirus-risk-interpreter.html

From information provided with regard to Yolo County from the County Health Council yesterday:

-There are zero cases of Corona virus confirmed in Yolo County

-There are currently eight known cases of CoVid-19 in California and 15 total in the US

However, as we did in the case of Ebola, Yolo County is investing a vast amount of time and energy, not in the flu which has already been the cause of 2 deaths in the county, but in identifying, testing and tracking those who have displayed symptoms of CoVid-19 and their contacts. I am not expert in allocation of resources. I have no idea at this time whether this is an appropriate allocation or not. However, having spent a large part of my career considering preventive health measures, I would recommend the following:

  • Do pay attention to symptoms, especially fever, cough & difficulty breathing.
  • Do stay home if you are feeling ill
  • Call your physicians line for advice. Do not present to the office with these symptoms without calling first as there may be special protocols in place.
  • Do not get your news about CoVid-19 from social media.
  • Do not get your medical advice from online purveyors of “cures”.
  • Do not get health tips from social media
  • Do not hoard masks which are badly needed by health care personnel.

 


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25 comments

  1. Thanks Tia. Ignorance and fear are deadly than most viral outbreaks. Airlines are terrible about allowing sick people, especially kids to infect the rest of the passengers. Employers are also remiss when they urge employees to come to work with the flu. In my union shop civil service job I can’t count how many times a boss threatened me with discipline up to termination for using my sick leave for the flu. BTW last week at an imaging lab in Roseville, the staff gave masks to everyone in the waiting room. Maybe they knew something we didn’t or maybe they were erring on the side of caution.

    1. John,

      Thanks for sharing your experience. In flu season, I see it as an entirely reasonable option to provide masks for waiting patients. It is also a good idea to have hand disinfectant available for people to use as they enter and exit, since many infectious agents are passed from the rapid transition from person to person via door knobs and hand, rests before the organism has died.

       

    2. Yes, the “panic”/social media ‘epidemic’ is huge… in Davis, seeing Asian UCD students wearing masks…

      No deaths in the US… miniscule diagnoses… this is not ‘the Spanish Flu’ which actually had a higher death toll than all combat deaths in WWI… which was considered to be the ‘war to end all wars’ (yeah, right)… same time frame…

      Have an in-law who e-mailed an urgent warning to wear masks… not realizing that masks that prevent inhalation of wood chips/dust, pollens, are not particularly effective as to viruses… they can protect against aerosols.  Still…

      Tia pretty much has this nailed… as did FDR when he quipped, “We have nothing to fear, except fear itself…”

      The hand-washing/”purell” thing is simple, easy, inexpensive, cheap insurance, but not necessarybut a good idea (conservative)… as someone who has experienced “panic attacks”, the current situation should not cause that…  like Alfred E Newman, “Why worry?”  Or, paraphrase McFadden, “don’t worry, be happy, but be thinking”.

      Tia nailed it.

  2. Hi Tia. What are the prospects for a 74 year-old sedentary obese male who contracts covid 19?

    I hear his prospects are very good for at least another four healthy years.  It’s not like he has dementia.

    1. And I heard a medical professional note that the critical dates are five to ten days into diagnosis, that’s the point at which breathing and other developments can occur.

        1. I am hoping he makes a full recovery despite the fact that I believe he has acted completely irresponsibly personally and professionally in response to this.

      1. “Anyone else find it weird that it’s nearly 4 pm on the East Coast and no briefing, no press conference from the President or his doctors?”

        I knew there was something calmer about today, maybe you just put your finger on it.

        “My doctors say I’ve got the greatest, you know biggest viral load they’ve ever seen. Dr. Brix sent over a case of bleach and I’ve got plenty of chloroquine tablets.”

        1. “When Reagan was shot, he was in far worse condition and far closer to death than was ever communicated to the public at the time.”

          Yeah, I can’t imagine any sensible doctor putting him in the hospital out of an abundance of caution. Frankly, they do their best to keep you out of the hospital to limit their exposure. I suspect he’s got pretty severe symptoms.

          1. I think caution is a relative thing since the condition can change rapidly, from what we’ve seen. Witness Boris Johnson:

            U.K. Prime Minister Boris Johnson was the first, requiring intensive care treatment in April and leaving him out of action for a month.

            He later revealed doctors were at one point preparing to announce his death and thanked them for saving his life. Despite the later severity of his condition, Johnson reported having only “mild symptoms” when he tested positive and the government initially said his hospitalization was a “precautionary step.”

            https://www.marketwatch.com/story/what-happens-when-a-world-leader-tests-positive-for-covid-19-11601635408
            Mild symptoms, precautionary step, and he almost died.

      2. Anyone else find it weird that it’s nearly 4 pm on the East Coast and no briefing, no press conference from the President or his doctors?

        The man has COVID and you want a press conference from him?

        Trump’s doctor has already put out a statement saying Trump had mild symptoms and expected him to be fine in 7 to 10 days.

         

        1. I did say “or”

          There is something called Zoom where I cover most press conferences these days

          And a statement is not the same thing as a press conference where people can ask questions

          1. Now they have announced that he is headed to Walter Reed hospital. They are saying it’s out of an abundance of caution, but again, no press conference.

          1. When Reagan was shot, he was in far worse condition and far closer to death than was ever communicated to the public at the time.

    1. John,

      I just saw the question. I presume you are asking the odds of our being briefed on Trump’s true condition. I would say the odds are next to nothing for two reasons, one having nothing to do with Trump per se, the other having everything to do with Trump.

      First, we have a long history of not being made aware of our president’s true condition in the modern era. Roosevelt’s degree of debilitation was hidden, a fairly ineffective attempt was made to hide Reagan’s dementia, and as has been noted, we were likely not fully apprised of the nature of Reagan’s injury.

      In the case of Trump, we have much documentation of the falsification of facts regarding both his physical and mental health. His doctors have never been forthcoming with so much as his true height/weight ratio, so I anticipate other information may have been falsified as well, although of course, I do not know that. As for the MOCA, a screening test for mild cognitive deficits. This is not an intelligence test. One either has no evidence of deficit, or there is suspicion thereof warranting further testing. This is not a test one “aces”.

      Or in retrospect, maybe you were asking about Trump’s odds of a full recovery due to his age & physical condition. I can’t answer that either. While the majority of people who die or are permanently disabled are over 70, one cannot prognosticate for any given individual.

       

      1. Thanks, Tia. I see that they are giving him a  covid antibody c–ktail to reduce the virus levels. Do you know anything about how that might work? BTW, you’d better call them mixed drinks ’cause the Vanguard don’t allow no c–k.

      2. Tia:

        In the case of Trump, we have much documentation of the falsification of facts regarding both his physical and mental health.

        Please share the documentation of the falsification of facts regarding Trump’s mental health.

    1. It’s not that odd.  It’s not really what we cover.  I already did my article (Vallejo) when the news broke.  I did do a quick written on the newsletter, but we cover local and criminal justice reform.  Note that this was Tia’s article.

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