Mass Panic, Public Health and the Economy: How the Coronavirus Scare Exposed Our Wrong Priorities

A selective approach to self-quarantine is another inconsistency the coronavirus scare has exposed. If the virus really is as threatening as the media portrays it (although it is not), then what about tourists?

by Alexander Clayman

Collage by the IotL Magazine

 

[dropcap]A[/dropcap]t this point in time, everyone must have heard of COVID-19. It is the sexy-sounding name given to an infectious disease caused by a coronavirus which was first identified in late 2019, in the Chinese province of Wuhan. Coronaviruses are single-stranded RNA viruses which commonly cause acute upper respiratory tract infections.

Common symptoms include a runny nose, fever and cough. Less common and more worrying features which occur more often in elderly patients or in those with other health problems (e.g. diabetes, asthma or immune system diseases) include shortness of breath, sepsis and organ failure—these patients are at greater risk of morbidity and mortality as a result of a COVID-19 infection.

 

No Reason to Panic

In reality, there is nothing special about COVID-19. As veteran virologist Dr Christopher Barbara put it, “We should absolutely not be worried about COVID-19. I have been handling viruses for years on end… many more dangerous viruses”.

Most patients with COVID-19 will recover like they would after any regular cold. Those who are seriously affected by COVID-19 are few in number and are the same kind of patient who would suffer serious harm from an influenza infection. So far, we haven’t had any confirmed COVID-19 cases in Malta, but even if we do, there’s not much chance of it out-doing influenza in terms of magnitude or severity.

Since we as a scientific community are already familiar with coronaviruses, we already know how to minimise the risk of catching infections from them. Obviously, prevention is easier said than done, but in a nutshell:

 

 

Public health guidance internationally and locally now says that those returning from COVID-19 affected regions should “self-quarantine” for two weeks. This means staying at home and avoiding contact with other humans.

Despite all of the above, we as a society (not just Malta, but as a global community) seem to be very panicked about COVID-19. I’m not, and neither is Malta’s top virologist, but that hasn’t stopped the general public, the media and certain individuals who ought to know better from exacerbating collective panic. COVID-19 might not be anything overtly concerning, but the shockwaves we have created around it might be. 

 

 

The recent news that an unscrupulous “entrepreneur” was actively spreading false information in order to benefit from panic-stricken purchases of surgical-masks by members of our society with low scientific literacy is a sad example of the non-medical harm that coronavirus has already done to Malta, in spite of not even being here (yet). 

 

Panic as a Means to Claw Back Control

The mass panic that we saw during the final week of February in Malta (and earlier on, in Italy) could appear paradoxical. For the most part, we humans suffer from so-called optimism bias. This is the idea that we tend to view the future as unrealistically positive.

We under-predict negative events (e.g. the smoker who believes they will not get lung cancer, and the drink-driver who believes they will not crash) and we over-predict positive events (e.g. the modern-day Del Boys who believe in the future explosive financial success of their businesses, and the countless couples who plan their lives together without considering that their relationships might eventually crash and burn). 

Why, then, have we welcomed our doom so willingly with COVID-19? Perhaps it is because we do not feel that we can control a virus, whereas we perceive control in other areas of life. I cannot satisfactorily answer my own question here, however, I’ll repeat myself: let us not panic.

 

 

A story in local media about dock-workers refusing to unload a container ship’s cargo sparked a supermarket rush for long-life products such as canned food and toilet paper, presumably because people feared a World War II-like situation where Malta would run out of supplies. I do not wish to dwell on whether the acts of the avid supermarket-goers were really as selfish as they seem, though it is a good example of people attempting to claw back control from a situation that they feel otherwise powerless about.

 

Public Health vs Economy

We are often told that a growing, dynamic economy requires a healthy population. Seen from this perspective, public health advice—such as self-isolation—threatens to harm the economy. Two weeks of mass quarantine will undoubtedly cause some degree of disruption to a society and its economy.

Adults who are quarantined (supposedly) cannot go to work. Quarantined elderly or dependent patients need somebody to deliver them food. A quarantined teacher’s class must be looked after by somebody.

A general practitioner from Gudja, Dr Jan Chircop, recently pointed out that the government’s department of health charges €10 for a coronavirus personal protective equipment kit. The same government has also asked private GPs to be at the front-line of this potential epidemic by advising that patients with suspected coronavirus contact them directly—essentially outsourcing the Ministry of Health’s work to the private sector, without agreeing terms or conditions.

 

 

Dr Chircop, like two thirds of Malta’s primary care doctors, is self-employed. Who, indeed, will compensate the self-employed for not going to work for two weeks? A number of jobs can be done from home and without need for direct contact with other humans (the blessed iGaming industry, other office workers in the public and private sector) but many jobs require people to interact with one another or to be outside their homes (e.g. healthcare workers, construction workers, the hospitality and catering industry).

Just as individual doctors have been left to fund their own personal-protective equipment, individuals have been left to fund their own quarantine. Negotiations between trade unions, the private sector and the government have not reached a conclusive agreement.

 

 

Working from home could be great for those who can afford to order food online, those whose employers encourage preventive measures and those who can work remotely. But what about everyone else? Let’s admit that, for those who cannot afford to or manage to order food and those who cannot cope financially without going to work, the situation is not so rosy. In order to make ends meet, some individuals might be willing to embrace a health risk for themselves and the public by ignoring quarantine. 

A selective approach to self-quarantine is another inconsistency the coronavirus scare has exposed. If the virus really is as threatening as the media portrays it (although it is not), then what about tourists?

 

 

The elephant in the room, which is so elephant-like that I haven’t bothered to mention it until now, is that tourists are not expected to self-quarantine, which makes a relative mockery of the quarantine advice charade. Admittedly, expecting tourists who have just arrived in a country to stay in their hotel-rooms is unrealistic. The contradiction exposed by this recommendation proves that the authorities prioritise economic matters (specifically tourism) over public health.

While a robust economy can help to maintain a high standard of public healthcare, citizens must not put their health at risk for the sake of safeguarding economic growth. It should be evident: public health is more important than the economy. Hence, the authorities should organise delivery of food to quarantined people in need and guarantee financial compensation to all those whose obliged leave is not paid by employers. 

Whilst there is glaring hypocrisy in the way our authorities have managed this COVID-19 threat so far, I still do not think that there is any reason to be alarmed because of the virus itself—it’s no more sinister than the annual influenza threat, which half of us don’t take seriously enough to even have the vaccine. But if this were a drill for a more serious disease, we would not be doing very well.

 

 

If COVID-19 really were a deadly plague, and this were the government’s response to it, they would be exposing the population to harm because of the obsession with safeguarding the tourism industry and because of refusing to give family doctors free gowns and masks.

I believe that the state must step up its game and prioritise public health over economic matters, and not just with regard to COVID-19. Does the economy serve our health, or does our health serve the economy? Once again, we have big choices to make as a country.

Alexander Clayman is a medical doctor currently working in (but not representing) Mater Dei Hospital’s Accident & Emergency department. He graduated twice from the University of Malta—first as a medical doctor (MD) in 2017, and second with an M.Sc. in Public Health in 2019. He is part of Doctors for Choice, Malta’s first pro-choice group of medical professionals, and has been a vocal critic of privatisation in healthcare.