Tuesday 3 March 2020

Covid-19 - Putting facts before apathy & hyperbole


The information ecosystem around Covid-19 (aka Coronavirus) is dense and riddled with both apathy and hyperbole, and attempts by civic authorities to cut through the social media noise and achieve that delicate balance which encourages alertness and preparation without inciting panic have been, at best, only partially successful.  Supermarket shelves are being rapidly emptied by folks preparing their bunker for a 6 month apocalypse (please don’t).  On the flipside, I hear so many people dismissing worries over the virus as a media beatup, it’s “the same as a cold”, or “driven by anti-Asian racism”.

All of this is so very frustrating, and I appreciate it’s hard to know what to believe with all of this flying around, so without telling anyone how worried or not worried they ought to be, I thought it might be helpful to share some of the basic facts as they stand.

There are several key metrics experts use to determine the risk profile of an epidemic. One is its reproduction number – its “R0” value – an estimate of, on average, how many other people will be infected by one carrier of the disease. Measles, for example, has an R0 of between 12 and 18, which is very high. The various forms of Influenza, on the other hand, have an average R0 of between 2 and 3.

There are a number of difficulties involved in reliably determining the R0 of Covid-19 at this point. Firstly, for most infected, the earliest symptoms won’t differ significantly from those associated with a common cold or flu, and some will recover without intervention before it gets any worse than that. Secondly, it’s possible that those without symptoms (yet) can carry the virus and pass it onto others. We can only estimate the R0 based on number of diagnoses, which is unreliable, and only made more difficult by the differences between health systems and reporting practices across different countries. 

Most models place the R0 of Covid-19 at somewhere between 1.4 and 3.8, and it seems to be settling, for now, at around 2.2, similar to flu. This could still change significantly, but there’s good reason to think it’s probably about right – namely, that sequencing of the virus has shown that it’s fairly closely related to the virus which caused the 2002-2003 SARS outbreak, which also has an R0 in that range.
Another key metric is the case mortality rate  – what percentage of people infected with the virus are killed by it. Again, hard to know for sure for the same reasons it’s hard to know the R0. So far though, the best guess is that around 2% of diagnosed cases have resulted in death. That might sound low, but it’s twenty times higher than influenza’s mortality rate of 0.1% – which kills somewhere between about 300,000 and 650,000 people per year, at a similar estimated R0.

If, in the worst case scenario, Covid-19 becomes established globally as a regular seasonal infection.. well, you do the math. Yeah, it ain’t good. While there are at least 20 vaccines in development internationally, this could take months, and the further the virus spreads the more mutations we will see which a single vaccine may not be able to deal with.

Panicking, however, is not going to help. We know that communities that beat pandemics are ones that pull together, share resources and cooperate. When people freak out, spread misinformation, or stampede to stockpile for the apocalypse, they only increase risks for themselves and others. Remember that the vast majority of people, especially healthy adults, who get Covid-19 and seek medical attention early will be absolutely fine. Every one of us can play a role in reducing risk. Practice good hygiene, wash your hands properly and regularly, use sanitiser if you have it, disinfect surfaces like keyboards/mice or food preparation areas regularly, ensure (where possible) that you’re set up to work from home if it becomes necessary or otherwise have a plan if you can’t work for a while (good employers will generally offer paid discretionary leave in such circumstances but if you’re a contractor or casual this can be trickier), minimise use of public transport, avoid densely-crowded spaces and events if you can, make sure you have a week or so’s worth of surplus supplies but DO NOT PANIC BUY (society is not going to come to a standstill and hoarding bunker-loads of stuff is only going to deprive others), and – as should be really freaking obvious – IF YOU ARE SICK, STAY HOME, keep your damn germs to yourself and contact your doctor as soon as possible.

Symptom-wise, Covid-19 will generally give you a gnarly fever and mess with your lungs – causing cough, shortness of breath and/or sore throat. If you have those particular symptoms, it is probably wise to call in advance rather than just showing up to your GPs office. That goes a hundredfold if you’ve been travelling recently (or been in close contact with someone who has).

Keep in mind that as of 3rd March, there has only been one confirmed case in Aotearoa. While the official Ministry of Health advice still ranks the risk of a widespread outbreak as low-moderate, evidence and the experience of other countries suggests that it is likely we’ll see community transmission at some point over the coming days or weeks.

Here's a really good piece from Dr Siouxsie Wiles on how to prepare your household:

You can also check the WHO website for updates and guidance on how to keep yourself and others safe as poss:

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