Fear was never a good advisor and even less so when it is unjustified. The new coronavirus, SARS-CoV-2, which causes the disease known as COVID-19, has been spread very quickly around the world and in Europe there is a fairly large outbreak in Italy. Health professionals repeat over and over again that there is no reason for social alarm. And the statement that the new coronavirus is no more worrisome than the flu virus.
Javier Arranz, spokesman for the Group of Infectious Diseases of the Spanish Society of Family and Community Medicine (Semfyc), considers it very likely that the number of cases will increase significantly in Spain, so it will be necessary to "modify health interventions to adapt them to the changes that occur", as has been done since the beginning of the epidemic in China at the end of 2019. “The measures that are adopted cannot be the same if there are 10 cases than if there are 100”, he emphasizes.
For Pablo Barrero, associate physician of the Infectious and Tropical Diseases section of the Hospital La Paz-Carlos III, Madrid, and professor at the Master of Bioethics from UNIR, the most important thing at this time is that the population "do not be alarmed or saturate the sanitary services if you don't have any symptoms ”. Especially, at a time when the flu it is still in full season.
The situation of the epidemic on the morning of Tuesday, February 25, is as follows:
- More of 80,000 affected by COVID-19 in 37 countries.
- More of 2,700 deaths, the vast majority of them in China.
- More than 280 cases and 7 deaths in Italy.
- 4 confirmed cases in Spain and several under study.
Certainties and uncertainties
There are many aspects of the new coronavirus that are still unknown, but that does not mean that control has been lost. Arranz comments that “the number of cases is decreasing in China, where also suspected cases decrease and hospital discharges increase"In the opinion of the family doctor, this means that, probably" the transmission curve of the virus is decreasing in the main focus.
However, relevant outbreaks are occurring in other places at the same time, such as South Korea and Italy. In Japan it is foreseeable that the number of cases will increase after the end of the quarantine and the disembarkation of passengers from a cruise ship in which more than 600 cases and 3 deaths have been registered.
The expert points out that outbreaks like the one in Italy "create a lot of alarm because they affect a considerable number of people”. In this sense, it recognizes that they could constitute "an indication that we are approaching a pandemic, in which a sustained transmission is already taking place in all countries."
The truth is that it is not known when the epidemic will end. If SARS-CoV-2 had a seasonal character like that of influenza, it could disappear with the rise in temperatures in spring-summer. But it is something that is still unknown. In addition, there are other variables that can influence its continuity.
However, as Barrero points out, the cold "confers greater susceptibility to contracting all kinds of infections." With the arrival of summer, in addition to this vulnerability, the tendency to “overcrowding” in closed places typical of winter would decrease.
There are a few things about the virus that are beginning to become clear:
- In proportion to the large number of cases, the number of deaths is not excessively high. The overall mortality rate is around 2%. Deaths occur, in the vast majority of those affected, in people with previous serious pathologies. Hence, sometimes it cannot be determined whether an individual has died from or with coronavirus.
- He age factor it is quite confirmed. Mortality is around 15% in those over 80 years of age, reducing to less than 1% in those under 50. In childhood it drops even more. "In children under 9 there is not a single death by communicated coronavirus ”, says Barrero.
- More than 80% of cases are mild. "These data come from a study with more than 70,000 cases," emphasizes Arranz. "The severity is even a little less than the flu."
- The virus it is transmitted very easily and it will affect a large number of people because, unlike what happens with the influenza virus, as it is a new virus, there are neither defenses for having passed the disease or, of course, the vaccine.
The family doctor believes that the situation can be seen from two points of view: the individual and the global. The first is the most reassuring for healthy people: "If I catch the virus, I will be able to get ahead without problem because I do not suffer from any disease." The global perspective is the one that forces the health authorities to adopt containment measures because an epidemic that affects a significant part of the population means that a significant number of people will need specific attention due to their situation of greater vulnerability, many workers go to be unsubscribed, meetings and events will be canceled ...
Masks and other protective measures
The masks are out of stock in Spanish pharmacies, despite the fact that Arranz and the rest of the health professionals insist that “do not use them"Because" the physical barriers do not seem to protect much. " Masks should be reserved for those places where many cases of the disease have been detected in a confined space.
The World Health Organization (WHO) recommends that healthy people wear a mask only if they care for or are relatives of a person with COVID-19 or with a well-founded suspicion of having the infection.
Barrero comments that it would be advisable to establish the sanitary custom, already established in Asian countries, that those people with respiratory symptoms wear a mask when they are going to be in contact with other people (in the subway, in the cinema, etc.).
In addition, in case of suspicion of flu or other respiratory infections, including the new coronavirus, it is recommended avoid contact with the most susceptible people: the elderly and the chronically ill.
In any case, frequent hand washing is the main protection measure, as well as trying to keep a distance from other people and avoid touching things with your hands in places that may have been exposed to the virus.
Regarding the travel to other countries, Arranz appeals to common sense. “If I had planned a trip to Italy, I would not cancel it. If I had to go to Lombardy, I would go with all the necessary precautions; if I had a meeting, I would try to postpone it or hold it by videoconference ”.
The panic virus and misinformation
The lack of information and misinformation give wings to fear in general and, in this specific case, to the coronavirus. But there is something else. Many people continue to feel fear, or even panic, after receiving clear and rigorous information; For example, issued by the Ministry of Health or the World Health Organization (WHO) Why?
José Ramón Ubieto, professor of Psychology Studies at the Open University of Catalonia (UOC), explains that fear “is a very old phenomenon. Every time there is an epidemic or a terrorist attack, fear arises and the novelty compared to other moments is the viralization through social networks "
The increase in mobility, that is, what is known as globalization, and the type of discourses that are used to relate the epidemics do not help to calm the population. In this situation, there are those who “can shake fear for your own benefit; to close borders with commercial interests or to stop immigration, or to criminalize a group by blaming it for terrorism or an epidemic ”.
The cancellation of the Mobile congress in Barcelona, at a time when no outbreak like the one in Italy had yet been registered in Europe, revealed the current rise of two phenomena. On the one hand, the increasing judicialization of life, so that, according to the psychologist, "any situation can end up being susceptible to legal action, leading to a defensive reaction." On the other hand, companies move driven by the “fear of damage to the corporate image”.
Technology adds “a new element: disinformation.” Ubieto states that a study carried out in 2018 on the objectivity of the information broadcast through social networks revealed that “40% were false”. And a more recent investigation showed that "more than 13,000 posts about coronavirus on social media were false."
Finally, to complete the breeding ground that fosters fear, the credibility of leaders, especially politicians, is not at its best. For this reason, many times more credit is given to an anonymous WhatsApp message than to a statement from the health authorities.
By María Sánchez-Monge