Coronavirus ‘not something to panic about,’ says Berkeley health expert

Passengers line up for thermography to check body temperature at Beijing Station. (AP Photo by Yomiuri Shimbun)

Note: For updated information about COVID-19, read Berkeley News’ March 17 interview with John Swartzberg.

Since news first broke of an outbreak of a new coronavirus in Wuhan, the capital of China’s Hubei province, the world has been on high alert amid the threat of an emerging global pandemic. As of Tuesday, the pathogen has infected an estimated 20,500 individuals worldwide and claimed 427 lives.

Here in Berkeley, face masks are flying off the shelves at local drug stores, and community members want to know how to protect themselves and their loved ones.

In an interview with Berkeley News, infectious disease specialist John Swartzberg, a clinical professor emeritus in the UC Berkeley-UCSF Joint Medical Program, assures readers that, while coronavirus may be “a very serious problem,” and the numbers of infected individuals in China may far outnumber current reports, the pathogen is unlikely to become a major concern for those living in the United States.

John Swartzberg is clinical professor emeritus of infectious diseases and vaccinology in the the UC Berkeley-UCSF Joint Medical Program.

Berkeley News: Experts point out that the flu virus has killed more people in the United States this year than coronavirus has killed worldwide. Is our level of concern over coronavirus justified, or are we getting distracted because it’s new?

John Swartzberg: I think that’s a really important question. Our familiarity with influenza makes us complacent about it, even though we know it’s a killer – more than 8,000 people have died of it so far this year in America. On the other hand, this particular strain of coronavirus is brand new, and new things that are not well understood are far more frightening than old things that are well understood.

Coronavirus is a very serious problem, and we don’t know how serious it will become. But right now, it’s not something to panic about in the U.S. And frankly, I think we have the tools to prevent it from ever rising to the level of something we should really worry about seriously in the U.S.

Last Friday, the first confirmed case of coronavirus in the Bay Area was reported in Santa Clara, California. How concerned should the Berkeley community be about the discovery of coronavirus in our region?

There is no reason to be concerned about that one case because the patient has been identified and is isolated, so he or she is not going to spread the disease. It is hard to imagine there won’t be more cases occurring in the Bay Area. But again, we have the tools and we have the knowledge base to deal with that fairly well.

The spread of the coronavirus has sparked a worldwide media frenzy, with every new case in the United States receiving breaking news coverage. Do you think this sort of press attention ultimately helps or hinders efforts to contain the virus?

I think (the media) should be giving the maximum amount of solid information. And the reporting that I’ve seen from major media outlets has been that. I haven’t seen sensationalism.

But the problem is not communicating solid knowledge. The mistake that I think China makes when it censors a lot of information is that they do it from the perspective of not creating panic. But I think nothing creates more panic than not knowing. I was trying to imagine myself sitting in Wuhan today, isolated from the rest of the world, and having the only source of information be the Chinese-approved media. I’m sure that most people are aware that that’s not always accurate. That would create a tremendous panic, and the way to dispel panic, I think, is through responsible reporting.

Last week, the U.S. issued a travel ban on foreign nationals who have recently visited China and a quarantine on all U.S. or permanent residents returning from the country. Are these travel bans justified or appropriate, given what we know about the virus and how it spreads?

The effectiveness of these kinds of travel bans is limited, and I think (the bans) play a lot toward assuaging people’s fears, as opposed to real preventative health policies. That said, a public health policy needs to be developed in the face of what is surely to turn out to be a pandemic of significant proportions. And to err on the side of quarantining people coming from an area where there is the disease is not an unreasonable approach.

After the SARS epidemic, Chinese officials were criticized for keeping the contagion under wraps until well into the outbreak. How does communication among international public health officials about coronavirus compare with past outbreaks like SARS or MERS? Is it possible that China is downplaying the true scope of the threat?

We’re so immersed in the outbreak right now that it’s hard to give an accurate answer. I feel comfortable saying that the Chinese central government this time has done a better job (communicating) than it did with SARS. But I am also getting the sense that the problem doesn’t lie so much with the central government, but with the provincial governments. There is pretty good evidence that the provincial government has been suppressing a lot of information.

But here is what I think the main problem is: We have about 17,000 cases reported (as of Feb. 3), and the only cases that have been identified have been people who have been tested for the virus. The only people who would likely be tested for the virus are symptomatic, and the vast majority of those are likely to be quite ill or moderately ill — enough to bring them to the health care establishment. We know that about a third of all colds are caused by coronaviruses, and people don’t run to the doctor for a cold. So, I suspect there could be manyfold more than the 17,000 cases today that are reported. I read one epidemiologist posit that there may be as many as 100,000 (people) already infected, maybe more. So, it’s an iceberg, and we can’t see below the surface of the water, but I think it’s an enormous number.

What can members of the Berkeley community do to protect themselves and each other?

Some of the things we should be doing are, to the extent that we can, good hand hygiene, trying to avoid people who are ill and trying to avoid crowds. None of those things are easy. I don’t think wearing a mask is going to be helpful, and it may actually theoretically raise a problem. Masks don’t always fit well, so air comes in from the sides. People are also filtering a lot of air through their mask, and then they take the mask off with their hand and there is the possibility of being a lot of virus there. And because you have to breath in harder with a mask on, you bring in more air, so you are bringing in more volume.

One of the things we shouldn’t be doing is stigmatizing or blaming others. The other thing that’s important, not so much for prevention, but for control, is to be educated about what this disease looks like and to communicate with your health care provider if you are worried that you might be sick with (coronavirus). There are tests for it, and you should get tested, and if you are found to be positive, then, yes, you would be quarantined, and your contacts would be watched carefully. But that’s the way to help prevent more people from getting it.

To learn more about the coronavirus outbreak, attend The Novel Coronavirus: Why are these outbreaks so difficult to prevent and where do we go from here?, a conversation between San Francisco Chronicle reporter Erin Allday and Berkeley epidemiology professor Arthur Reingold, on Thursday, Feb. 6, 5:30 – 7:30 p.m. at the UC Berkeley School of Public Health, 2121 Berkeley Way West, first floor colloquia.