History tells us that fear is always a key component of any novel virus which has the potential to become an epidemic or pandemic. How big is it going to be? How long to find a cure? Can we trust our health systems to manage the crisis? How safe is my family?
The US Centers for Disease Control says that much is still unknown about 2019-nCoV or Wuhan coronavirus. We don’t know exactly how it is transmitted and other variables; more data is needed before they can begin to predict just how dangerous it is.
What we think we know about it is largely based on what is known about similar coronaviruses, like influenza, Sars and Mers. It is unclear if a person can get 2019-nCoV by touching a surface or object that has the virus on it and then touching their own mouth, nose or eyes.
With most respiratory illnesses, people are thought to be most contagious when they are most symptomatic (the sickest). With 2019-nCoV, however, there have been reports of spread from an infected person with no symptoms to a close contact.
The Wuhan virus seems to spread quickly and easily, possibly because of the up to 14-day incubation period
While health authorities collect data on confirmed cases, public fear can be managed. We need to be reassured with clear, accurate information. Governments must show they are making sensible and timely provisions as well as giving advice on quarantine measures, how and when to access medical services, what home medicines and nursing skills we might deploy if hospitals are overwhelmed – as they are in Wuhan.
Simple measures like frequent handwashing after touching potentially infected surfaces (like shoes, shopping trolley handles, and money) will become very important, if the virus spreads here.
And that is a real possibility: it happened before, in the 1918-19 influenza pandemic – the Spanish flu – which was the biggest killing pandemic (coronavirus or otherwise) on record. That pandemic overwhelmed the Irish medical services, with an estimated 800,000 people taken ill and 23,000 dying in an 11-month period.
Community nursing and community kitchens delivering food to the ill saved many lives then in Ireland and elsewhere. More than 50 million of the world’s two billion population died, according to the World Health Organisation (WHO). Somewhere between one-fifth and half of the world’s population contracted the disease.
The 1918-19 pandemic is the marker against which public health authorities judge emerging serious disease threats like the Wuhan coronavirus. The 1918 flu has a couple of similar features – the usual case fatality rate for that pandemic is about 2.5 per cent, while some authorities have suggested the Wuhan coronavirus is killing about two per cent of those who catch it.
Incubation period
Like the 1918-19 virus, the Wuhan virus seems to spread quickly and easily, possibly because of the up to 14-day incubation period. This makes it difficult to identify those infected and limit their movements.
A big difference is that the 1918-19 pandemic seemed to target healthy adults in the 25-35 age group, whereas Wuhan coronavirus deaths have usually been over 40 with other health complications.
In the coming weeks and months, as the coronavirus story develops, we will see increasing management of public fear by the WHO and national health services around the world, in tandem with efforts to treat sufferers, contain its spread, and find a vaccine.
In June 1918, the Spanish flu pandemic began to take hold in Ireland . . . Major panic broke out, as people puzzled over the best options for their families
The process of quelling panic is already under way with the Chinese government inviting journalists to inspect the new 1,000-bed quarantine hospitals with isolation hatches to deliver food to patients, and sending 1,400 army medical staff to treat patients.
Stories from civilians, however, describe calling for ambulances and being told there are 120 people in the queue, of virus tests being unavailable – a situation much less under control.
Managing panic
History of past health crises points to the urgency of managing panic. In 2009, when a dangerous new flu emerged in Mexico city, parents rushed to Benito Juarez Airport to get their children on flights to family in the US.
The Mexican tourism industry, worth $13.3 billion in 2008, was effectively shut down for months, even though the epidemic was far from many of the tourism regions.
In June 1918, the Spanish flu pandemic began to take hold in Ireland. Newspapers had been warning of its imminent arrival for weeks, as it spread around Europe. Major panic broke out, as people puzzled over the best options for their families.
Children were sent from the cities to relations in the country, where it was hoped they would have a better chance of evading the disease. Adults huddled in groups out of the earshot of their children, worriedly discussing this terrible disease that was about to arrive.
History also tells us that despite the scare stories, the vast majority of people who caught the 1918-19 flu virus survived, some only experiencing mild symptoms.
The same seems true with the data so far from the Wuhan coronavirus. Even if it is eventually declared a pandemic, it seems likely that most of us will survive.
Dr Ida Milne is a social historian of disease and history lecturer in Carlow College St Patrick’s. She is the author of Stacking the Coffins, Influenza, War and Revolution in Ireland, 1918-19, published by Manchester University Press in 2018