Commentary / Coronavirus

Managing Fear – in an Age of Coronavirus

coronavirusCoronavirus is an infectious health condition that requires a rethink of daily routines. As the CDC has suggested, the bell curve of infections will flatten in proportion to society’s priority on minimizing social contact, staying home when sick or exposed, elevating hygiene, and practicing social distancing. A flatter infection curve allows the healthcare system to treat those infected rather than getting overwhelmed. Here is the unstated fact – fear must be managed.

Humans are conditioned, if not genetically inclined, to respond to fear. Survival requires attention to risks. The trick, of course, is striking a balance between risk and reward, fear and forging ahead. The coronavirus scare is reintroducing us to balance. Here are useful hints.

First, uncertainty creates anxiety. Anxiety produces distraction, paralysis, and overreaction. If the data needed for balancing is unclear, we imagine the worst. We drift into “what ifs …” Step one is avoiding that irrational “what if” trap.

On coronavirus, data is shifting – but fluctuates within a margin. Truth is comforting. We know the virus is not deadly, except in rare cases.
We know few Americans have it. We know transmission is preventable, with precautions. We know, in the worst case, contracting the virus typically produces a period of temporary discomfort.

The numbers are comforting. Here are a few. As of this writing, in a US population of 327 million, 4,226 persons have tested positive for the virus, most after traveling or meeting someone who did. We know that group is quarantined. Among highly vulnerable – 75 have died in two months.

Put differently, one in 124,429 Americans people have contracted the virus, and they are sequestered. One in 6,540,000 have died. Of those who contracted and died, most were vulnerable to death from other sources; this was simply the nearest cause.

Putting numbers in perspective, an American’s current chances of dying from coronavirus are lower than expiring from heart disease or cancer (one in seven), car accident (one in 114), falling (one in 127), drowning (one in 1,118), or being hit by lightning (one in 161,856). Current numbers suggest a low probability of contraction and low mortality for those who contract.

None of this means Americans should ignore common sense. Just because you can run in front of a train and avoid getting hit, does not mean you should start running in front of trains. Good hygiene improves the chances of not getting sick. At the same time, anxiety leading to preoccupation, distraction, or panic is not justified, period.

Contrary to Peggy Noonan’s conclusory, fear-fanning column in the Wall Street Journal last week, “don’t panic” is sound, grounded advice – coupled with exercising common sense. The notion that we should bow and curtsey to those who predicted Americans would get sick, and now listen to them predict Armageddon is nonsense. We can be wise, as a society, without panic.

Second, fear leads to forgetting important things. Among important things worth remembering are these. Viruses more often die than persist, especially in warm weather. This virus will end. As one expert noted, “viruses cannot tolerate high heat and humidity, preferring cool and dry conditions …” This virus will taper.

Even if a strain becomes “seasonal” or “endemic,” the world does not end. We already have four coronaviruses that regularly recur, say experts. Two produce the common cold; all four are manageable. They are coronaviruses OC43 and 229E, discovered in the 1960s, and HKU1 and NL63, discovered in the 2000s. If this one becomes endemic, we have five. That does not wildly change public risk or health policy.

By way of validation, a medical expert at St. Jude Children’s Hospital observed: “For the most part [the four known coronaviruses] cause common-cold-type symptoms,” and “maybe that is the most likely end scenario if this thing becomes entrenched.” The odds are even that it dies or becomes seasonal. Either way, risk is modest, effects minimal, and virus mild.

A Columbia University medical expert noted: “I can imagine a scenario where this [novel coronavirus] becomes a fifth endemic human coronavirus,” adding “we don’t pay much attention to them because they’re so mundane” – by comparison to the flu.

So, what is all the panic? In part, swift transmission through global economic dependence on China and international travel stirred public panic. In part, uncertainty about mortality rates – which we now know may be overstated – contributed.

In part, the absence of test kits and private lab analysis fed uncertainty since people want to know – even with long odds – if they are infected.

Likewise, not having an off-the-shelf inoculation reinforced fear. These problems are being addressed and hardly justify panic. Market incentives are amplified by government money.

What other factors should reduce fear? If data continues to fluctuate, people of goodwill are finally cooperating. That is true in the public and private sectors, and our population at large.

The President and Congress are coordinating the national response, even as they swap barbs. The initial supplemental was $8.3 billion, followed by a sensible “national emergency” plan. Local, State, and Federal leaders are communicating with each other and with the public.

Person-to-person, public awareness is leading to common cause and a resurgence in hand-cleaning, basic hygiene, and details taken for granted during non-crisis times. All of that is good.

Fear is useful at times. It can motivate positive behavior, which ripples across society, producing positive outcomes. It can also become a source of anxiety, producing senseless distraction, paralysis, and overreaction. The key is staying informed and balancing.

A story helps make the point. At the height of World War II’s Battle of Britain – a crisis that killed tens of thousands – Winston Churchill slept well. The notion that he could compartmentalize his fears, literally dismissing statistically unwarranted ones, was a mystery.

The media finally inquired of his wife, Clementine, how the Prime Minister managed this. How did he keep his mind off falling bombs, when others got distracted, paralyzed, and overreacted?

Beyond knowing available facts, keeping perspective, taking precautions and being Churchill, she reported: “He just says, ‘bother the world,’ turns out the light, and goes to sleep.” We cannot all be of such faith, but we can keep our perspective – as Churchill managed to do in a bigger crisis. Just do what you can, take a breath, say “bother the world,” and turn off the light. It worked then and will now. Fear is a thing to be managed – not feared.

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