Dispensaries Ltd Post
If we think about the novel coronavirus epidemic as a rapidly unfolding story, each new crisis reveals a great deal about the characters involved
WRITTEN BY DR. MARY FERNANDO ON MARCH 10, 2020 FOR CANADIANHEALTHCARENETWORK.CA
Every time a patient goes to a doctor with a new illness, the story of chasing down the diagnosis is like a mystery novel with one difference: everyone works hard to make the story short with as little excitement as possible.
In medicine, no one wants a long, twisted plot line and the best stories are the boring ones where the culprit is found quickly.
This desire for a short, boring storyline has done what nothing else has been able to: it has united the world, because citizens of every country want the story of the new coronavirus, COVID-19, to end before they get a starring role in the tale of this new epidemic.
On December 30, 2019, Dr Li, a 34-year-old ophthalmologist in Wuhan, China posted on Weibo that he had seen seven cases of a SARS-like virus and warned fellow doctors to wear protective clothing to avoid infection. This sensible and medically appropriate suggestion resulted in Dr Li being summoned to the Public Security Bureau four days later and he was made to sign a letter confirming he had made false statements. Before his death from the disease later dubbed COVID-19 on Feb 7, 2020, Dr. Li explained why he warned people initially despite the fact that he knew he might be punished for it: “I think a healthy society should not only have one kind of voice.”
Like the Chinese government who tried to put a lid on information about COVID-19, we have had many others who have tried to do the same for political and financial reasons. There’s nothing wrong with trying to protect businesses, however, there is a great deal wrong with stifling information. The only thing that protects people and saves lives is the truth. If certain activities or places are unsafe, people should know this.
Through the evolution of this disease, there have been many kinds of voices speaking out and, just like in any mystery novel, each new crises reveals a great deal about the character of those involved.
There are some people who want everyone to stay calm, as if one smidgeon of worry will muck up their world. They came out in force at the beginning of this epidemic grabbing every straw they could to dampen concern. Calls for calm are often appropriate but not when they are coupled with misinformation. Misinformation like how this is only spread by animals, or how it’s only spread by people who are symptomatic, or how the virus doesn’t live on surfaces for days, or how it is no more lethal than the flu. People cannot protect themselves if they don’t know the truth.
While some grasp at anything to calm people down, others have done the opposite and developed theories to fan all sorts of flames or start fires on their own. One theory floated around that this new virus was developed in a lab to destabilize the world. Right on the heels of this came another malignant theory that this is a virus that largely infects people of Chinese origin and that they are responsible for the spread of this. This has resulted in racist attacks on people around the globe.
There is another set of characters who have been emerging and speaking loudly: those with the smug reassurance that they know everything about the situation. Now this character is purely fictional character, since no one who knows everything about anything has ever existed, but this doesn’t stop some people from emulating them. If this person who believes they have all the information has a large pulpit, they can spread information that is inaccurate and possibly dangerous.
Who is the biggest, baddest, scariest culprit in the saga of COVID-19? Misinformation, spread by people whose need for calm, chaos or personal brilliance blinds them to the new facts emerging about this virus daily.
Some of those new facts are reassuring, some are worrisome and not one of us knows them all because it is an evolving story. For example, there has been some evidence that gastrointestinal symptoms such as nausea and diarrhea may precede respiratory symptoms during infection. This is crucial information that could lead people to seek medical attention earlier and therefore limit spread of the disease. Since we know that people without symptoms can spread the disease—unlike with SARS—we can’t assume we haven’t been exposed because no one around us was ill.
Just like in any mystery novel, we should remain suspicious of all the characters. Any one of them could spread misinformation, often not out of malice but because their character compels them to engage in certain behaviours that increase misinformation. Bottom line the only thing that will keep you and those you care about safe is information on how to avoid getting infected.
The heroes of this story? The first hero was Dr. Li who had a simple mission: to inform those around him; to use the information he had to keep them safe.
Inspired by the heroes in this coronavirus story, I recently told my children who were traveling with me that—given the fact that this disease can be spread by people without symptoms and the virus can live on surfaces for days—it would be safer to assume their hands are infected and not touch their face or food without disinfecting them first. This simple set of instructions was the best way I could summarize this disease to the people I care most about in this world. I also keep telling them that we are in the midst of learning about this disease so I’ll keep them updated. My children must have confidence in me because they grin every time I say this.
As of this writing, the World Health Organization reported that the number of confirmed cases of COVID-19 has surpassed 100K. The doubling time of this disease appears to be around seven days but the numbers, just like this disease, are fast moving. A peek at that study along with with data used gives an idea of why we need to take a deep breath and keep learning.