The coronavirus epidemic has become a dominant issue for much of the world’s population, and is having a major impact on the economy, daily life and personal security. It has already paralyzed entire countries and is on the way to affect more countries where cases have recently been diagnosed, as concern about the virus and the protective measures being taken keep increasing.
Just as importantly, the anxiety level over the epidemic and worries about the future have been steadily rising around the world. The main cause of all these developments is the currently accepted public health policy in most developed countries, led by the main health authorities, which in turn are guided by the World Health Organization. The policy calls for a minimum two-week quarantine for anyone suspected of being infected with the virus, and a halt to all public activity that could contribute to the spread of the virus.
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Is this policy justified, and what is behind it? It’s not hard to understand the profound concern felt by the health authorities about the discovery of the virus and its classification as an epidemic-level infectious disease. Everyone who works in the fields of infectious diseases and public health is worried, with some justification, about the possible appearance of a new virulent and dangerous infectious agent that will rapidly spread around the world.
The Spanish Flu that appeared after World War I spread worldwide and killed millions of people is one concrete example of such a possibility. Therefore, with the outbreak of the current epidemic, there was certainly justification for taking drastic measures, as long as its nature, causes and manifestations remained unknown.
In addition, there was concern about the credibility of the information being provided by the Chinese authorities. What has happened since then? With the rise in the number of people infected and who have fallen ill, and the spread of the virus to more countries, and with the intensification of research into the disease and the isolation of its viral factor, a clearer picture of its nature and behavior, and especially of its virulence, has emerged.
Although the information gathered so far is limited and certainly meager in comparison to the knowledge that has been amassed regarding “regular” flu epidemics, several clear observations that characterize important components of the current disease have already been made. Firstly, the cause of the illness that has been discerned belongs to the corona family, familiar to us from the two SARS epidemics of 2002 and 2012 that were caused by other viruses from this family.
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What these viruses have in common is that they hone in on lung tissue, hence the main manifestation of the illness in the respiratory system and its airborne transmission. Also, according to a recent edition of the New England Journal of Medicine, the mortality rate from the current disease ranges from 0.5 to 2 percent, and is significantly lower than the mortality rate from the 2002 SARS outbreak (9.5 percent) and much lower than the 2012 SARS outbreak (34.4 percent). It may even be close to the mortality rate from an ordinary flu outbreak in the United States.
What are the immediate conclusions to be drawn from these observations? There are no longer grounds to fear a virulent epidemic that threatens the whole world and will cause widespread illness and death. It is quite likely that the current epidemic will behave like a flu epidemic with which we’re familiar and will run its course within a few months, even though the infection rate may remain high since the current virus is highly contagious.
These conclusions have clear implications for current policy. Since no significant danger is anticipated, there is no longer any justification for the very extreme and difficult health policy that is vastly different than the policy applied in the event of a “regular” flu epidemic.
Moreover, the ease of transmission of the virus, due to its particular characteristics, means the drastic measures presently being taken to quarantine patients and cancel public activities have little chance of success, though such steps are causing enormous economic damage, spreading anxiety and seriously harming the public welfare.
Amending health policy is never easy and inevitably runs into opposition. Isn’t it possible that quarantining patients and closing public places will prevent a wider outbreak? And who can promise that the virus won’t become more virulent? Of course there can be no unequivocal response to all these questions, but in the overall calculation, on the basis of the data we now possess, and certainly in terms of a cost-benefit risk analysis, it is vital that the current policy be changed, and the sooner the better.
The health authorities ought to reassess the current policy and focus their efforts on increased use of the standard preventive measures – hand-washing, wearing masks and encouraging people who are ill to stay home. At the same time, we should welcome publication of further explanatory information, one important aim of this being to reduce the level of fear of the disease.
While it is too soon to sum up the story of the new coronavirus, this outbreak will surely be studied in the future as an example of the extensive implementation of a drastic world health policy. In my estimation, the main lesson that will be drawn from this episode is that drastic measures should be employed in a much more cautious and measured manner, and only after evidence has accumulated of significant danger on a greater scale. Until then, the standard measures for preventing the spread of infectious diseases should be used. Just as important is the message that people should no longer fear the coronavirus.
Prof. Bentwich is the director of Ben-Gurion University’s Center for Emerging Diseases, Tropical Diseases and AIDS.