Covid-19 is not the flu. It’s worse.
It’s deadlier, more contagious, and more likely to severely disrupt our health care system.
In early March, President Donald Trump tweeted a statistic he said we
all should “think about.”
It was a comparison of the flu to the current coronavirus pandemic.
The flu kills tens of thousands of people a year, he reminded us. At
the time, only under a dozen or so people in the US had died of
Covid-19, the disease caused by the novel coronavirus. The tweet read
a lot like much of the rhetoric coming out of the White House, which,
for weeks now, has been trying to downplay the severity of the
situation.
A lot of people besides Trump have been comparing the coronavirus to
flu. And it’s a question friends and family members who want to
know how worried they should be keep asking me: Isn’t this like the
flu?
Put
simply, while the exact
death rate is
not yet clear, this disease kills a larger proportion of people than
the flu (and it’s particularly
lethal for people older than 80).
It
also has a higher potential to overwhelm
our health care system and
hurt people with other illnesses.
At
present, there is also no vaccine
to combat it,
nor any approved therapeutics to slow the course of its toll on the
human body. (Doctors can treat cytokine
storm syndrome,
an immune response that may in some cases be dealing the fatal blow
to those dying of Covid-19.)
Sober-minded
epidemiologists say,
without exaggeration, that 20 to 60 percent of the world’s adult
population could end up catching this
virus.
Biologically,
it behaves differently than the flu, although some symptoms are
similar. It takes around five days for Covid-19 infection to
develop symptoms (the
most common are fever and a cough). For the flu, it’s two days.
That potentially gives people more time to spread the illness
asymptomatically before they know they are sick.
Around the country, health care providers are worried about their
facilities being overrun with an influx of patients, and having to
ration lifesaving medical supplies.
“We’re
already overwhelmed here, in terms of patients coming in the middle
of a terrible influenza season,” says Barbara North, the medical
director of a small, rural clinic in Northern California. If the
pandemic hits her community, her clinic is the only provider for
miles. She fears they’d be overrun. “We are struggling to
establish the isolation and infection precautions needed at the
clinic.”
Three
months ago, this virus was not known to science. No human immune
system had seen it before January, so no unexposed human has any
natural immunity to it. That means it’s more contagious than the
flu — about
twice as contagious,
perhaps more; the numbers are still being worked out.
This is bad. It’s bad enough to roil our stock markets, put people
out of work, potentially cause a recession, and infect millions, if
not billions, of people around the world. It could also kill
millions, both here and abroad.
It’s possible that Covid-19 will become endemic — meaning it will
be a disease that regularly attacks humans and will not go away until
there’s a treatment or a vaccine.
Yes, flu variants kill tens of thousands a year in the US. But
imagine if there was another kind of flu, “except potentially with
a higher case fatality rate,” Angela Rasmussen, a Columbia
University virologist, told me recently. “Which is definitely a
problem because the seasonal flu kills 30,000 to 60,000 Americans
every year. And even if it’s the same case fatality rate of
seasonal flu, that still presents a substantial public health
burden.”
If
that spooks you, now is the time to take a deep breath, and know that
there are many things you can do to prepare (read
more about them here).
We can still avoid the worst-case scenario.
It’s okay to feel fearful of Covid-19. It’s just human.
Flu
is a regular occurrence, and its toll is something that we’ve grown
numb to. Psychology teaches
us a depressing lesson here:
As we think about larger and larger numbers of people, our empathy
and our ability to care and take action decreases. It’s
called psychic
numbing —
and studies show our willingness to take action to protect others
even decreases when the number of victims increases from one, to two.
By mentioning the flu numbers, Trump is hoping to get people thinking
of big numbers, and induce numbing. He might want us to think: Tens
of thousands of people die of the flu, this new disease isn’t a big
deal.
Paul Slovic, one of the lead psychologists who has studied psychic
numbing, says he doesn’t expect Americans to grow numb to this
growing crisis. It hits on a lot of the psychological buttons that
tell us to be fearful.
Slovic does call comparisons to the flu “misleading.” But he
doesn’t think people are going to fall for it.
“People
are not numb with regard to this new virus,” Slovic writes in an
email. “This virus hits all the risk perception ‘hot buttons’
... It is new, unfamiliar, and hard to control through individual or
societal action. There is no vaccine and it spreads invisibly, adding
to the difficulty of controlling it. It can be fatal and widespread
(hence pandemic). All of these qualities ramp up the dread feelings
that we have long known to be the major drivers of risk perception.”
It’s okay to be a bit scared in times like these. It’s natural,
and extremely human. I can even understand why many people might be
asking the flu comparison question themselves, in an attempt to maybe
numb themselves to the stark reality we’re facing. (Trump, and
other leaders, should know better, and not give people seeking
psychological relief an easy out.)
But we can’t be numb. We can channel fear into useful tasks. The
bigger concern is that people won’t act in the way they really need
to. During a flu season, schools aren’t typically shut down; people
don’t stop going to the movies. To fight Covid-19 requires a much
larger disruption in our lives.
For
what it’s worth, in his Oval Office address on
March 11, Trump did outline the danger of the situation and gave
basic, decent, public health advice. But it might not make up for the
months of him trying to downplay the outbreak.
If you see people make the flu comparison, don’t be fooled into
thinking that Covid-19 is an equivalent. It doesn’t look as bad as
the flu in terms of raw numbers. But the top minds modeling this
outbreak fear that will change. And, again, we really need to act
differently than normal to prevent contagion and deaths.




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