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Dr. Faheem Younus: During coronavirus pandemic, leave denial, leave panic. Live in preparedness [Commentary]

Coronavirus is now a pandemic. As of Thursday, 107 Marylanders have tested positive for the virus. And based on the calls and texts that I am receiving, it seems many are living in denial or panic. As an infectious disease expert who helped manage SARS, H1N1 and Ebola, I suggest that between the extremes of denial or panic, there is a place called preparedness; we should live there.

Let’s tackle denial first. Social media posts question why we should care about the novel coronavirus when car accidents kill 30,000 Americans every year and influenza kills even more.

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Dr. Faheem Younus is the Chief Quality Officer and Chief of Infectious Diseases at the University of Maryland Upper Chesapeake Health.
Dr. Faheem Younus is the Chief Quality Officer and Chief of Infectious Diseases at the University of Maryland Upper Chesapeake Health. (Courtesy UMMS)

Car accidents are not contagious. They don’t threaten us with an exponential spread like coronavirus.

Yes, influenza kills anywhere from 12,000 to 61,000 Americans every year but there are major differences between the two: Influenza virus has been around for centuries, we understand it, and our bodies (due to repeated exposure) have varying degrees of immunity against influenza. In contrast, coronavirus is a novel agent, our bodies have no immunity against it. Unlike influenza, there is no vaccine or treatment for it. Coronavirus is nearly two times more transmissible and 10 to 20 times more lethal than influenza.

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But we should not panic either. By panic, I mean losing sleep over sold-out hand sanitizers. Or cleaning every doorknob and countertop with disinfectants. Or wearing facemasks in shopping malls and airplanes. Or spreading disinformation. Fear, it seems, is more contagious than the virus itself.

Knowing that traditional strategies still work against this novel virus quells my fear. Handwashing with soap and water is more effective in preventing infections than alcohol-based hand sanitizers. Unless you’re caring for a family member recovering from coronavirus, don’t be antsy about disinfecting doorknobs at home as no documented cases of the virus have been recorded due to surface contamination. And the CDC does not recommend healthy people wearing facemasks to protect themselves from respiratory diseases, including COVID-19.

“I don’t live in denial or panic,” you say, “I live in hope.” But hope is not a strategy. Hoping for a magic treatment or a timely vaccine is naivete. New drugs and vaccines typically need months and years in clinical trials to measure safety, efficacy and side effects. Granted, the government and pharmaceutical industry are working at an unprecedented pace. But just like we cannot bake a cake in 30 seconds when the recipe calls for 30 minutes, they cannot simply speed up this process.

So what should we do? First, have the right perspective. If 100 people caught the coronavirus, 80 will likely recover after experiencing a flu-like illness; they may not even have to get tested or visit a doctor; another 18 will likely recover after a hospitalization. Two out of 100 infected patients may succumb to this infection and they’re likely to be the elderly, with multiple medical conditions, or compromised immunity.

This should not make us complacent though. If we didn’t act swiftly, and if just 10% of the U.S. population caught this novel infection, that would mean 6 million hospitalizations and our healthcare infrastructure cannot simply handle that.

We should urgently ramp up novel coronavirus testing at all levels. Up until a week ago, the CDC and U.S. Public Health labs had done merely 8500 tests nationwide. South Korea, with a population that’s one-sixth of the U.S., had done over 210,000 tests in the same time. Identifying mild — yet contagious — cases, followed by aggressive quarantine, is the best public health strategy to control this outbreak. Testing is now also commercially available but check with your doctor’s office if they have the supplies and expertise to safely collect the sample. Availability is extremely limited and unpredictable.

Meanwhile, don’t panic. Get prepared. Wash your hands, cover your cough with an elbow, and cover your sneeze with a napkin; and wash your hands again after discarding the napkin. Avoid touching your nose or face. Stay 3 to 6 feet away from people with flu-like symptoms. If you develop fever, cough or flu-like symptoms, stay home and stay calm: most patients with such symptoms these days are suffering from known, much less dangerous seasonal viruses.

The virus doesn’t dwell upon conspiracy theories and has no political favorites. We must respond to this global threat by getting information from authentic sources like www.cdc.gov or www.who.int and rising above partisan politics.

Previous outbreaks of H1N1, SARS, Asian flu or the Spanish flu lasted anywhere from 12 to 36 months. The global coronavirus outbreak is currently in its third month and the virus has already infected over 200,000 individuals in more than 150 countries. We should neither deny nor freak out about this reality; we should prepare. This too shall pass.

Dr. Faheem Younus is the Chief Quality Officer and Chief of Infectious Diseases at the University of Maryland Upper Chesapeake Health. Reach him at fyounus@umm.edu.

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