Corona: An Epidemic of Mass Panic

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Almost everyone I talk to, lay people and colleagues (I am a specialist in internal medicine and have worked for two years at a department of infectious diseases) consider the Coronavirus pandemic a pandemic of panic, more than anything else.

On 8 March, I published in the BMJ about this. I wrote:

“What if the Chinese had not tested their patients for coronavirus or there had not been any test? Would we have carried on with our lives, without restrictions, not worrying about some deaths here and there among old people, which we see every winter? I think so.”

The WHO estimates that an influenza season kills about 500,000 people, or about 50 times more than those who have died so far during more than 3 months of the Coronavirus epidemic.

I also wrote:

“Is it evidence-based healthcare to close schools and universities, cancel flights and meetings, forbid travel, and to isolate people wherever they happen to fall ill? In Denmark, the government recommends cancellation of events with over 1000 participants.”

It is much worse now. All gatherings in Denmark of more than 10 people are banned, even outdoors, and you can get a fine of 1500 kr (about $250) if you violate this rule. What a dream scenario for any ruler with dictatorship tendencies; all democratic demonstrations are unlawful. Football matches are still allowed, if there are only 5 players on each team and no spectators.

I joked about my tennis, but now my four times a week of tennis is gone even though we cannot be more than 4 people on the court at a time. Next I joked about golf, as I could not imagine anyone would forbid golf. They did, even though there are loads of people walking or running in the forest around our golf course, and even though you may still walk on the fairways, if you do not look like a golfer. Our CrossFit gym also closed as per government orders.

I had only one joke left, which I fired when my wife told me that in the lunch room of the department of clinical microbiology where she works, every second chair should be left empty while the conference room is overcrowded as usual, also in the intensive care unit at our hospital! I replied she should tell her colleagues that from now on, our prime minister will only allow one person at a time in Danish double beds. Keep the distance is our mantra, and people we meet in the forest make big bends to avoid coming too close to us. It is kind of funny.

In Italy, they borrow the neighbour’s dog to get a little fresh air because it is still allowed to walk the dog.

We closed our borders with Germany and Sweden, although we have more Coronavirus than they have. It was like when I saw they sprayed an Air India plane flying out of Heathrow to avoid bringing Heathrow malaria mosquitos into India. Why not close the island of Fyn, in the middle of Denmark, which is easy, as there is a bridge on each side that can be blocked by the military? Where does this stop? Logic was one of the first victims.

I shall not discuss here why the mortality is so different in Italy and South Korea, but I do find it very prudent that they told people to stay in their homes in South Korea if they fall ill, and only if they become very sick, will a car come and bring them to a hospital that is not overcrowded. If the infectious dose is high, mortality will also be higher because there will not be sufficient time to establish an immune response. Therefore, overcrowded hospitals will have higher mortality rates. The panic does just that: leads to overcrowded hospitals.

The panic looks like an unfortunate overreaction. We don’t even know if the risk of dying if you get infected with Coronavirus is higher than if you get influenza, or so many other virus infections, and most of those who die are old and suffer from comorbidity, just like for influenza.

Our main problem is that no one will ever get in trouble for measures that are too draconian. They will only get in trouble if they do too little. So, our politicians and those working with public health do much more than they should do. No such draconian measures were applied during the 2009 influenza pandemic, and they obviously cannot be applied every winter, which is all year round, as it is always winter somewhere. We cannot close down the whole world permanently.

Should it turn out that the epidemic wanes before long, there will be a queue of people wanting to take credit for this. And we can be damned sure draconian measures will be applied again next time. But remember the joke about tigers. “Why do you blow the horn?” “To keep the tigers away.” “But there are no tigers here.” “There you see!”

The harms include suicides that go up in times of unemployment, and when people’s businesses built up carefully over many years lie in ruins, they might kill themselves. The panic is also killing life itself. John Ioannidis’ article from 17 March is the best I have seen so far: “A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data.”

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