I am seeing a lot of posts on social media, even from people I know and care about, comparing the H1N1 outbreak in 2009 to COVID-19 especially in regards to the level of concern in the media and the number of cases. The implication seems to be that people are overreacting to COVID-19. These comparisons are misleading at best and incredibly dangerous at worst (if they motivate people to ignore the CDC and WHO recommendations on how to respond).
Why? Here are a few reasons: 1. There were approximately 61 million cases of H1N1 in the US between April 2009 and April 2010. So far we have only around 3000 cases of COVID-19. This makes it appear like H1N1 posed a bigger threat, but it is not really a fair comparison. COVID-19 has only been spreading in the US for a few weeks and so far it is spreading much faster than H1N1. If the current rate of spread holds, we will cross the 61 million case mark in April less than 4 months after the first documented case. 2. There were approximately 12500 deaths due to H1N1 in the US during the same time frame. So far (as of March 14) only 59 people in the US have died from COVID-19. Again, this sounds like good news but it is actually not. The death rate due to H1N1 was around 0.02%. Estimates for COVID-19 are around 2%. That number could go down as doctors learn how to better treat patients with this novel virus, but at the current rate 61 million cases would lead to over 1 million deaths. COVID-19 differs from H1N1 in some concerning ways: 1. COVID-19 is novel enough that people do not seem to have any immunity to it. H1N1 strains have been around for a while, so some people already had resistance to it. This means that COVID-19 has the potential to spread further and faster than H1N1. 2. There is evidence that COVID-19 is already spreading much faster than H1N1. The basic reproduction ratio (R0) represents the average number of people that each infected person will infect. Any value greater than 1 can lead to a widespread outbreak. For reference, the value of R0 for H1N1 was around 1.5. For COVID-19, current estimates are around 2.2. This means COVID-19 is spreading somewhere in the ballpark of 50% faster. 3. COVID-19 appears to be contagious even when the symptoms are mild or non-existent. This means that you could get it and pass it on to someone else without even realizing that you have it! The symptoms of COVID-19 and the mortality rate diminish the younger you are. So, young people may be tempted to throw caution to the wind since it is not likely to affect them severely. The problem is that his sort of selfish behavior can accelerate the spread of the virus to vulnerable populations (the elderly and those with compromised immune systems) who have more severe symptoms and a MUCH higher mortality rate (around 15%).
So, what should we do? 1. Instead of making light of the cancelations and ignoring recommendations to avoid large gatherings and minimize social contact, we can actually listen. The value of R0 can be reduced by changes in behavior such as lockdowns, quarantines and voluntary social distancing. If we can get the average value below 1, then the COVID-19 pandemic will subside. If we wash our hands consistently, we can reduce the probability of picking up the virus AND transmitting the virus to others. If we stay in and avoid large gatherings, we reduce the number of interactions that give the virus a chance to spread. 2. We can stop spreading false and misleading information that causes others to question and ignore the doctors, scientists and government officials who are doing everything they can to fight this problem. Regardless of who is politicizing the issue, this is not a political issue; it is a public health issue. It is a loving your neighbor as yourself issue. So whether you are a republican or a democrat, a trump supporter or a never-trumper, you should do your best to set your political biases aside and focus on the facts. 3. We can stop judging the significance of the problem by the number of cases right now. If we wait to act until the number of cases reach H1N1 proportions, then it will be too late for thousands if not millions of people. Interventions like social distancing are only effective BEFORE the virus becomes ubiquitous. We have to slow the spread now before things get out of control. 4. We can keep in mind that pandemic predictions are meant to be the opposite of a self-fulfilling prophecy. If people believe a dire prediction and respond, then their response could stem the tide making the prediction appear foolish in hindsight. That is not a sign that the prediction was wrong; it is a sign that the response was effective. However, if we ignore those predictions, then they could very well come true and the consequences will be devastating. 5. Lastly, we can stop buying up all the toilet paper, masks and purell. For one, that takes them away from people who need them and two, the masks and purell may even create a false sense of security. Neither masks nor purell are 100% effective in keeping the virus at bay, but do you know what is 100% effective? Not being exposed in the first place. So, if you can avoid it (and not everyone can), please avoid putting yourself in a position where you could be exposed (unknowingly or knowingly) to COVID-19 and hopefully, a year from now we will all look back at the dramatic responses to COVID-19 and laugh and FEEL like it was an overreaction, even if it was the very thing that kept us safe.
Here is a link the original post: https://www.facebook.com/mark.panaggio/posts/10163053898230291