COVID-19 and the thousand natural shocks that flesh is heir to

Like many people, I have been following the Coronavirus pandemic statistics on the Worldometer website, where some other startling figures are also available. It is the end of April and there have been 18 million deaths around the world in the first four months of 2020, not including an unthinkable 13 million abortions conducted in the same period. Of these 18 million deaths, over 2 million (roughly 10 percent) were from smoking and alcohol, and over half a million from AIDS/HIV. Following closely, road accidents and suicide each accounted for about 420 thousand and 330 thousand deaths respectively.

Such statistics boggle the mind. These are potentially avoidable deaths, and it is hard not to wonder why we are usually so complacent and uncaring about these countless wasted lives. When they are not invisible, they are often seen as regrettable but inevitable externalities of our economic freedom and well being, along with hunger, homelessness, and family breakdown. People care enough to give money once a year to a charity when prodded hard enough, but there is little we would personally sacrifice or change to make a real difference to these figures.

Suddenly the entrance of a new respiratory infection on the world stage has changed all our lives, before we knew what was even happening. As we all know, many people are getting sick from the Coronavirus disease (COVID-19), and many of these are dying from the complications of pneumonia. A terrible death, as anyone who has lost a loved one to emphysema or COPD would know. As the media continuously spreads news of the pandemic to an increasingly anxious public, a feedback loop is formed that generates increasing amounts of noise rather than real information. Fear spreads through the polis as the instinct of self-preservation kicks in, and governments react, calling for their expert advisors who are waiting in the wings. Worst case scenarios are posed, based on anecdotal evidence and theoretical projections quickly drawn.

Political leaders order the populace to shelter in place, avoiding physical interaction with others at all cost. Schools close, businesses shut down, many for good. Countless jobs are lost in the midst of a depressing economic stagnation. But people are happy to have strong leadership in times of crisis, and the authorities are saving lives after all. The media are helpful in spreading the word that 'we are in this together', promoting quarantine lifestyle trends for the affluent even while some continue to play grievance poker for 'oppressed' groups. The economic cost is savage and the endgame is unclear. Is the threat being suppressed until a vaccine rescues us in a year or more, or until we simply learn to live with our fears in the teeth of the virus?

Apart from its inscrutable eastern origins, the fatal attraction of the Chinese Virus or Wuhan Flu, as it is often known, is the swiftness of its global spread since January. It has quickly become an iconic cultural marker which has fired the public imagination unlike any reality television show. It is seen as anything from an Old Testament biblical punishment to a virulent alien disease, striking our soft human underbelly like Michael Crichton prophesied fifty years ago in The Andromeda Strain. In a sense, we can see the lack of meaning in our lives being flooded with the fear of our own extinction. There is a gaping whole at the heart of society where our self-belief, confidence, and resilience should reside. The Internet and social media have created an illusory world of reflecting mirrors, where nothing is stable and nothing is really there.

So in the midst of an historic economic lockdown, a form of quasi-house arrest for our own good, let us put the risk in perspective. Compare the harrowing avoidable deaths mentioned in my opening paragraph to the seasonal flu, a deadly yet familiar part of lives which so far has caused about 150 thousand deaths around the world this year, despite the availability of flu vaccines since the Second World War. Next, take SARS-CoV-2, the new member of the coronavirus family that has everyone scared of their own shadow.

Not wishing to minimize the gravity of the pandemic, it is for the most part a relatively harmless addition to the 320,000 different viruses that infect mammals. In a minority of cases it is the cause of COVID-19 or Coronavirus disease. Symptoms include fever, coughing, a sore throat, fatigue, and shortness of breath. It has been responsible for almost 180 thousand deaths globally, both young and old, including a number of health workers on the front lines, though clearly the elderly and people with existing health problems are most at risk.

A recent study in The Lancet (March 30) puts the international case fatality rate at 1.4% for people under 60, and 4.5% over 60 years of age. Case fatality is the percentage of people with reported symptoms of the Coronavirus disease that die as a result. In contrast, the infection fatality rate is based on the total number of people infected with the virus, and is bound to be much lower due to the unknown number of asymptomatic carriers of SARS-CoV-2. However, a clear picture of the overall spread of the virus is impossible at this stage. Estimates I have seen range from 6 to 10 times the number of reported Coronavirus cases. Until the broad infection rate is determined we will be unable to predict the ongoing threat with accuracy, and plan accordingly in a sensible, informed way.

How rational are the extreme reactions of governments across the world? "Coronavirus pandemic could push half a billion into poverty," stated a headline in The Age (April 9). This would be the global effect of an extended economic shutdown in the West. But when influenza kills an average of 389,000 every year around the world according to conservative estimates, life goes on. Lockdown is the 'safe space' mentality on a global scale, attempting to minimize all risks including those that humanity has faced down countless times before.

Seeing the Coronavirus in perspective doesn't mean downplaying the seriousness of the threat. It may be more lethal than influenza under current conditions, but the principles of managing public health in a rational way should not change. We could have a lockdown every flu season if we chose. After all influenza killed 900 Australians in 2019, and many of these flu deaths will not happen this year thanks to the COVID-19 bans. There is no end to the things we can do to reduce overall risk, the 'thousand natural shocks that flesh is heir to', but the trade off is unacceptable and the result will be impoverished and stunted lives under a social tyranny. Instead of draconian restrictions based on guesswork, we need sensible policy based on solid research, along with measures targeted to protect the most vulnerable in our community.