Health officials said this week that a novel coronavirus outbreak in the United States is a question of “not if but when,” and we should all prepare. But how?
Boston-area experts on public health preparedness answered in a chorus that can be summed up as: Don’t panic, but do practice the usual methods to avoid illness and do get ready for possible disruption of daily life.
A striking analogy offered by a Harvard disease preparedness expert: Think of a potential outbreak as something like a possible snowstorm on steroids, one that could disturb business as usual for an extended period.
Why Shouldn’t We Panic?
Let’s begin with emotional preparation. David Ropeik, author of “How Risky Is It Really? Why Our Fears Don’t Always Match The Facts,” said the very newness of this virus makes it scarier because we don’t feel as sure that we can protect ourselves against it.
Ropeik’s reassurance: “This will spread here and everywhere, but be effectively the same as kind of a bad flu season,” or so it appears at this point. “And we’ve experienced those, and we’ve lived through those.”
“Those sorts of awarenesses, which we don’t normally pay attention to for the flu, are healthy to have. And … that gives us a sense of control, which reassures us against the fear and tones the fear down.”
In fact, the familiar flu has already killed many more people than the new coronavirus has this winter. Concern about coronavirus could serve the helpful purpose of spurring more of the precautions we should normally take against spread of flu: copious hand-washing, staying home when sick, laying in some supplies in case the virus knocks you down for a couple of weeks.
“Those sorts of awarenesses, which we don’t normally pay attention to for the flu, are healthy to have,” Ropeik said. “And when we have them and enact them, the very act of doing that gives us a sense of control, which reassures us against the fear and tones the fear down.”
‘Snowstorm On Steroids’
Of course, the flu doesn’t close down whole regions the way the new coronavirus has done in China. So we have to prepare not just for illness, but for the societal disruption it can bring.
There are many unknowns about how the virus will play out here, said Dr. Leonard Marcus, co-director of the National Preparedness Leadership Initiative at the Harvard Chan School of Public Health.
But the key is to be prepared to adapt to whatever comes, Marcus said, and it could be helpful to imagine preparing for the disruption of a major outbreak as something like preparing for a possible snowstorm. A big one, like the famous Boston blizzard of 1978 — “but on steroids,” he said.
“Because this could be weeks,” Marcus said. “If we want to know what it could look like — because nobody can predict exactly what it’s going to look like — just look to China and imagine what it would be like to live in Wuhan, where that was the center of the cases and people were asked to stay in their homes for weeks.”
At the individual level, preparing for such disruption means making sure you can do without buying anything in stores for a while, he said.
“So if there are any essentials that you have in your home — that includes food, if there are medicines that are absolutely essential for you, or if there are personal items that are essential for you — make sure you’ve got enough of a stock that could hold you for two or three weeks should we be asked to stay at home.”
At the institutional level — workplaces and schools and health care facilities — preparations may include plans for telecommuting if need be, for school closings, for “social distancing” — avoiding close contact with potentially contagious others — of various sorts.
“This is a great time to do that planing because we don’t have cases here in Massachusetts,” he said. “Once we start getting cases, it will move into a very, very different stage.”
Meanwhile, hospitals and other essential services have been planning for exactly this kind of scenario for a long time, Marcus said.
“We do have plans in place for interruptions in our supply chain,” he said. “This just could very well be a big interruption in our supply chain. And most businesses do have continuity of business plans in place.”
Massachusetts health authorities emphasize that right now, the risk here is low, and everyone should be going about their usual lives.
But health commissioner Monica Bharel noted: “For all of us, it’s a good reminder that we should always be prepared for an emergency, and we should always have enough supplies of our medications in our home, and food supplies, to be prepared for any storm — whether it’s something more likely, such as a winter storm, or something less likely, such as a pandemic response.”
Speaking with reporters on Wednesday, she struck reassuring notes: “We want you to know that Massachusetts is prepared for this potential outbreak,” she said, and has adequate resources to cope.
Bharel encouraged residents to check the state’s website on the coronavirus for official news.
“We want you to know that Massachusetts is prepared for this potential outbreak.”
She declined to specify what might trigger state authorities to close schools, cancel events or impose other sorts of shutdowns to limit spread of the virus, saying only that the state would follow federal guidance if the need arose.
More than 600 Massachusetts residents who could have been exposed to the virus have been monitored at home in “self-quarantine,” Bharel reported, and 377 have already been released from a two-week stint.
“The level of cooperation has been just remarkable,” she said. The state has seen only one confirmed case of the virus, in a student who recently traveled to China, and he’s recovering well, Bharel said.
Good Behavior And Good Common Sense
In the best-case scenario, Marcus said, it could be that “there are a few cases here. They’re identified very quickly. People are on really good behavior in that if they have symptoms, they’ve self-identified” and sought medical care.
The first and only confirmed case of the coronavirus in the state did just that, setting a good example of virtuous virus-related behavior. Marcus said a student of his acted similarly after returning from China: he voluntarily “self-quarantined,” even though he had no symptoms, because he didn’t want to be “a spreader.”
If people follow recommendations when they may have been exposed, “if you stay at home and other people who have been exposed do what they’re supposed to do, we can keep this very limited,” Marcus said.
Another virtue that could help in a time of coronavirus: Honesty.
“I always feel the optimal messaging is honesty about what we know and what we do not know,” said Sandro Galea, dean of the Boston University School of Public Health.
It is simply honest to say that that the new coronavirus can be expected to spread in the United States, he said. “It is also honest,” he added, “to say that there are no particular novel measures that can be taken beyond the measures that we take to avoid the spread of other flu-like illnesses, and that institutions and localities need to be responsive and adaptive.”
“Good common sense probably should be the order of the day,” he said. “And we should be appropriately cautious without at the same time succumbing to the dangers that these type of events can trigger — stigmatizing and overreacting and abrogating people’s rights and freedoms.”