You and I may get coronavirus - and live with it: here's how to prepare for a pandemic
You and I may get coronavirus - and live with it: here's how to prepare for a pandemic
By Ian Mackay
February 27, 2020 — 12.00am
It’s impossible to avoid news about the impact of the clumsily named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
The illness it causes, coronavirus disease 2019 (COVID-19), is on every news and social media platform in a hyperlinked world. In China, the spread of SARS-CoV-2 from each infected person to about three new people launched an epidemic across a nation of modern megacities.
[IMG alt="Tourists wearing face masks at the Trevi Fountain in Rome this week amid the spread of the virus in Italy.
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Tourists wearing face masks at the Trevi Fountain in Rome this week amid the spread of the virus in Italy. Credit:Bloomberg
From there it hitched a ride in infected travellers to more than 30 other regions. It's spreading quickly because no one has any immunity to this new and distinct virus.
Some nations, such as Singapore, have valiantly limited the spread while others, such as Korea, Italy and Japan, have seen rapidly rising COVID-19 cases.
Of concern to the Middle East was the unseen spread in Iran, first identified through deaths. Because death lags illness onset by weeks and represents only a small portion of all SARS-CoV-2 infections, there are likely many cases already there.
The virus is so globally widespread that it’s unlikely we’ll ever see it eradicated. The SARS virus in 2002-04 was different; it spread and shed differently and so good public health measures contained it. But SARS-CoV-2 may be with us for good – a new addition to the rogue's gallery of four human coronaviruses we live with all the time. At some point you and I will likely be infected by SARS-CoV-2. But the important point is that we can
live with it.
Australia has done well. Since February, 15 expertly managed COVID-19 cases and 30,000 self-isolated people have resulted in no outbreaks or spread, and no deaths.
However, we’re suffering a daily economic impact on our tourism, education and export sectors and this may not be sustainable for much longer. At some point, travel will resume, and we should expect new COVID-19 cases. This is inevitable.
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The discussion should turn to the use of a perfectly normal English-language word: pandemic. That needs to be done with care, subtlety and extra words. But the word
pandemic doesn’t change anything about the virus already with us. Its nature, spread, genetic sequence and its human impact remain unchanged by saying it is about to cause a pandemic. But because of the way the word has been previously used, or rather not used, it is held in fearful regard.
Whether we call what likely will come next an “epidemic in many countries”, a “multi-country outbreak” or a pandemic doesn’t change what it will be. So instead of holding certain terms in reserve, let's define and use them early on.
For now, the world is still in containment mode, but many countries are deep in preparations for when the virus breaks containment and spreads widely. Slowing the spread so far has been mostly because of China’s extreme and large-scale quarantine. It limited movement of well, but possibly exposed, people. It isolated ill people from the well. And it imposed social-distancing measures, closing mass transit, keeping people home, delaying the return to work after the Lunar New Year break. That has bought us the time to prepare.
However, right now, it's spreading quickly because no one has any immunity to this new and distinct virus. That will change once more people are infected or, in the future, vaccinated. Immunity will protect us from future severe disease.
We have seen that severe disease and death do occur, but we also know little about the extent of mild and moderate COVID-19 illness – the kind that don’t put us in hospital. Cases outside China have a pattern that suggests a milder spectrum of outcomes and a lower proportion of death. If we imagine a submerged iceberg represents all the COVID-19 cases, the bit we see most of – the severe disease above the waterline – is only a fraction of the outcomes. It’s the size of what lies beneath that we’re still unsure of. Because China focused intently on pneumonia, what we’ve seen thus far may overstate the severity of COVID-19.
In Australia, it's time for individuals to plan before we have more cases arrive. While not guaranteed, it's likely. Think more hand-washing and less face-touching. Discuss working from home. Stay clear of obviously sick people. All good advice during flu season, too.
Talk to doctors about extra prescriptions if needed. Get a box, label it “pandemic stuff” and each grocery shop for the next few weeks, buy an extra couple of things such as toilet paper, cleaning and feminine hygiene products, pet food, dried foods and cans that will last but still get eaten if this is all a flash in the pan. This is just in case of interruptions to supply. Truck drivers and their families get sick, too.
But do not panic-buy. And do not panic otherwise. Prepare, but do not panic. It’s OK to feel anxious, but don’t act without thinking.
Be a calm voice for others. Listen to the public health authorities. They will hopefully better communicate specifics about what we are likely to face and more that we can do, as individuals.
A pandemic is coming, but we managed the swine flu pandemic in 2009. We got through it as a community relying on science, knowledge and communication, and we can do that again. Words convey knowledge and knowledge is both powerful and comforting. Let’s not get caught by surprise. Let's keep talking about this, working together and supporting each other to be as ready as we can possibly be.
Ian Mackay is a virologist and associate professor at the University of Queensland.
. Anyone who can keep up with this thread has no life, and I say that as a person who has no life.
