Transmission, Containment, Control

"[Community spread] is going to be wide-spread. It's going to be severe, young people will get ill, and we have to prepare for all of this."
"You can't pull your punches with some of the messages. This is going to be a challenging situation."
Dr.Marc Loeb, infectious disease specialist, McMaster University

"If transmission is very rapid, the interventions to try and slow down that spread are interventions that will have significant implications for communities and families."
Dr.Amy Greer, Canada Research Chair, population disease modelling, University of Guelph

In a way, it's good news, isn't it, that people aren't running around panicking too much? I've seen some evidence on social media of panicking -- buying toilet paper and other bizarre items."
"My gut feeling is that this is what a 1918-style pandemic might look like today. People have talked for years now about the 'big one'. Well, the big one doesn't necessarily have to have catastrophic mortality, off-the-scale figures like 1918."
"What we're seeing now rhymes. Strip away the media and social media, all of which didn't really exist in 1918. Most people wouldn't really be aware of a thing called Spanish flu until you actually had this mortal wave and lots of people were sent to hospital."
"It's not the zombie apocalypse. You don't need to go up and fill up your car or stock up with toilet paper, but I think it would be wise to make sure you have ibuprofen and basic medical supplies. Not because you might necessarily need them now, but you want to make sure you have them before people panic-buy them."
"That's the kind of bind we're in."
Dr.Mark Honigsbaum, medical historian

"[Since its Wuhan debut eight weeks ago, the virus has infected our global psyche, spawning an] epidemic of catastrophizing [hammering the stock market, stranding cruise ships, cutting oil output, shutting down schools and] increased social conflict and xenophobia."
"[To appreciate the] full and very real -- power of the coronavirus, we need to enter the rabbit hole of evolved human psychology."
"Cues that signal the presence of pathogens tend to elicit automatic disgust responses, so as to help us avoid strangers."
Samuel Paul Veissiere, anthropologist, cognitive scientist

"When conditions are right, epidemics can potentially create a medical version of the Hobbesian nightmare -- the war of all against all. [It begins with fear] fear that I might catch the disease and the suspicion that you may already have it and might pass it on to me."
"The whole environment, human, animal and inanimate may be rendered potentially infectious. If we do not know what is happening, who knows where the disease might spring from?"
Philip Strong, 'epidemic psychology'

Community-acquired COVID-19 signals that the disease has surpassed its original infection sources, that communities far from the origins of the infection have now acquired the means to transfer the novel coronavirus among a population; a second front of contaminated sources. And the moment that a community recognizes that the virus is ensconced within itself, not merely transferable from people who were infected at its original source passing the virus on to others, it becomes inevitable that the infection rate will grow.

The scientific-medical community, once it became aware of the presence of a new communicable virus, focused its resources on containment. Ensuring that the primary victims of the virus were kept well away from others, to stem the tide of communication. Once community-acquired infections begin surfacing, it is acknowledged that containment must switch to control. Assembling all possible medical/scientific resources in an effort to control and stem the outbreak where some people exhibit no symptoms yet are carriers able to infect others.

Dozens of cases where the source of infection is unknown are under investigation in the United States. Predictions resulting from mathematical modelers appear fairly dire that the virus has the capacity to infect between 40 to 70 percent of adult humanity. Projections that saw a downward revision to 20 to 60 percent. But that too is a high prediction of a potential infection rate in any population. Containment was involved in identifying imported, travel-related cases then isolating the infected, tracing their contacts to keep from generating new clusters.

Mitigation was meant to retard the virus's trajectory of infection rate through reducing contact of people with other people. Suspicion of infection meant self-isolation for a two-week germination period. In China, cities were placed in lockdown, no one permitted to enter or to leave. People leaving their homes were expected to wear containment masks to aid the goal of minimizing illness and the death rate. In the West, the focus will be on curtailing "social disruption", while at the same time persuading people to avoid crowds, observe the niceties of personal hygiene, and self-isolate if required.

 The coronavirus outbreak has hit particularly hard in Italy. Francesca Volpi/Bloomberg

Through observation and experience it is expected that people who are healthy will experience mild infections; they will become ill, then speedily recover, while those over 65 and the elderly, those with heart disease, diabetes, asthma, cancer, hypertension and other chronic illnesses and underlying medical conditions have the highest risk of acquiring severe pneumonia, acute respiratory distress syndrome, sepsis, septic shock and death. Health and emergency response authorities pray that a major outbreak will not arrive until flu season departs, when hospitals will be better able to cope.

Substantial hospital resources would be strained under pandemic conditions, leading to a surge of patients to be tested and treated. "A surge of cases appears inevitable", wrote doctors from eight Toronto hospitals, in an article published in the Canadian Medical Association Journal. The World Health Organization adjusted the case fatality rate to 3.4 percent, much more severe than expectations with a typical influenza season. What remains a puzzle is that so few children have been reported infected. Might they be somehow immune to infection, or do children become mildly infected only, while becoming efficient spreaders?

Scientists are working in their laboratories around the world, feverishly looking for an antidote to this virus, but it will be at least a year before a safe vaccine against COVID-19 may be available for wide distribution and use. According to a new DART & Maru/Blue Poll, many people in Canada are trepidatious they may contract the virus. 32 percent of 1,513 randomly selected Canadians representing about 10 million Canadians, responded they were very or somewhat concerned of infection. Five percent of Canadians avoid public transit and an increased number of people are buying hand sanitizer washing their hands more frequently, avoiding sport events, movies, theatres and restaurants.

Coronavirus pop-up store in Washington, DC  Nicholas Kamm/AFP via Getty Images

There were over 98,000 confirmed cases of COVID=19 and at least 3,380 confirmed deaths as of Friday. Frightful statistics to be sure, and growing, but as cognitive scientist Samuel Veissiere put it, a deeply inbuilt negativity bias is in play here; the human tendency to focus more keenly on the negative than the positive, its source in evolutionary reasoning. As for the opinion of Dr.Steven Taylor, professor and clinical psychologist at University of British Columbia, anxiety will be ramped up once the pandemic is officially declared.

Psychological problems involved in persuading people to comport themselves in ways such as to reduce risk to themselves and vulnerable others through societal measures to slow community spread may inevitably increase public anxiety when efforts to slow community spread with travel restrictions, movement restrictions quarantines, will serve to exacerbate people's anxiety levels. Dr. Taylor cautions that we should be listening to health care authorities, but on the other hand, should not be losing sleep over COVID-19.