When a Virus Goes Viral

The virus first known as the Wuhan virus or Chinese virus, then the 2019 novel coronavirus, is technically called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease is called the coronavirus disease (COVID-19). Like influenza viruses and rhinoviruses, coronaviruses are associated with potentially severe respiratory infections. This essay identifies problems with the reporting of this virus by government sources and media outlets.

Rhinoviruses (HRVs) were discovered in the 1940s and are estimated to be responsible for more than one-half of all cold-like illnesses. There are three genetically distinct HRV groups (A, B, and C) and they are traditionally associated with upper respiratory tract infection, otitis media, and sinusitis. However, calling them “cold-like” downplays their severity in the public mind. They are, in fact, recognized as a lower respiratory tract pathogen. As such, the represent a serious threat to individuals with asthma, the elderly, and those with compromised immune systems. There are presently neither vaccines nor (to my knowledge) antiviral therapies for rhinoviruses. The CDC puts it this way: “The common cold is normally a mild illness that resolves without treatment in a few days. And because of its mild nature, most cases are self-diagnosed. However, infection with rhinovirus or one of the other viruses responsible for common cold symptoms can be serious in some people. Complications from a cold can cause serious illnesses and, yes, even death.” That is, it is a source of flu-like illness.

Like rhinoviruses, coronaviruses are a family of viruses. There are many more types and they widespread in many animal species. They are usually associated with mild to moderate upper-respieratory tract illnesses, i.e., the common cold. However, like rhinoviruses, coronavirus are also a lower respiratory tract pathogen. At least three times during this century, serious coronavirus disease outbreaks have occurred as a result of a coronavirus jumping from non-human species to humans: SARS (severe acute respiratory syndrome) in 2003, MERS (Middle East respiratory syndrome) in 2012, and, currently, COVID-19. All three were associated with panics, but the panic over COVID-19 is historically outstanding.

We hear a lot about how SARS-CoV-2 is uniquely contagious. “Everybody’s catching it,” I was recently told. But the numbers reported so far are far less than the numbers of influenza cases every year (tens of millions in the United States alone), or rhinoviruses every year, which are more common than the flu, as everybody knows intuitively. The common cold rampages every season (viruses want cooler temperatures, shorter days, and people congregating in enclosed spaces), and they’re responsible for scores of lethal respiratory ailments. Yet we hear nothing about that in the media even though it is recorded in the medical literature. And you won’t hear in the media that many of these cold-like illnesses are caused by the coronaviruses that represent between 5% to 15% of the viral mix that circulates every year. You do hear about the flu, of course, but the stories are not framed like COVID-19. The CDC estimates an average of up to 60 thousand influenza deaths every year. Whether you or I have lost somebody to the flu, tens of thousands of people have. Every year. In fact, far more people likely die from influenza viruses than from corona viruses. Yet we do not shutter society and socially isolate on account of these lethal threats.

I don’t want to be misunderstood, SARS-CoV-2, like influenza A and B (the prevailing influenza virus this season is our old 2009 nemesis influenza A [H1N1pdm09]), is a serious health challenge. But in light of the fact that we have these challenges every year, we have to ask what is the novel circumstances that ask us to risk potentially long term damage to the economy, measures that deprive people, especially tens of thousands of people at the end of their days, of a quality social life and the company of their loved ones. Life is more than keeping hearts beating as long as possible. Life is about living. For thousands of people, they don’t have that much living left. We are also being asked to give up a considerable degree of personal liberty. Indeed, it is rather astonishing to see the way a cult of safety has produce so many people prepared to sacrifice a lot of liberty for a false sense of security. Why false? Because viruses have burdened mankind and our fellow species since time immemorial. And they won’t let up any time soon. Probably not ever.

The problems with the government and media hysteria were clear from the beginning of this panic if one worked logically through evidence and inference. Readers would be astonished by the numbers of people who die from rhinoviruses every year. Indeed, according to the World Health Organization (WHO), “rhinovirus is an underappreciated cause of severe pneumonia in vulnerable groups” (see Hai and associates 2012). The WHO estimates that some two million children die each year from acute respiratory tract infection associated with rhinoviruses. It’s not listed as the cause of death. But Coronavirus is. That’s because we now have a test for it. Moreover, it was not widely reported in the media at the time, nor has it been brought in the context of the current situations, but up to 80,000 people died of flu in the winter 2017 in the United States. That is the highest death toll in 40 years. A lot of those who died were elderly.  “I’d like to see more people get vaccinated,” the director of the Centers for Disease Control and Prevention, Dr. Robert Redfield, told the Associated Press in September 2018. Like to see more people get vaccinated? That’s it? Why didn’t he say that we should shut down the economy and shelter in place to save tens of thousands of lives? Was Redfield asked about which older person in his life he was prepared to sacrifice to keep society open?

As testing SARS-CoV-2 has expanded, the proportional death rate from COVID-19 has dropped. A lot. This was expected. The vast majority of cases are asymptomatic or presenting with mild symptoms. The problem with government and media reporting mobility and mortality in this situation is that they’re taking the death rates from confirmed cases. Those who have cold-like illness from SARS-CoV-2, or who have no symptoms at all, are not likely to be tested. It is widely recognized by scientists that the number of unreported cases of SARS-CoV-2 are 10-20 times greater than the numbers of confirmed cases. If we take the 10 percent figure, the calculations put SARS-CoV-2 at flu mortality rates. Why, for example, are Germany’s numbers so much better than those of Italy or Spain? “The biggest reason for the difference, infectious disease experts say, is Germany’s work in the early days of its outbreak to track, test and contain infection clusters. That means Germany has a truer picture of the size of its outbreak than places that test only the obviously symptomatic, most seriously ill or highest-risk patients.” If we tested a large representative sample we would find the death rate to be lower everywhere. Moreover, in tests for the suspected virus, most come back negative, which means others viruses are making people sick, in some cases, very sick. The media isn’t telling you the numbers of those who die from rhinoviruses and other flu-like illnesses. Moreover, it is one thing to die with SARS-CoV-2. It is another to die from it.

I just visited the CDC website. Based on a sample of 8.5% of the population, it is estimated that, for flu season 2019-2020, there are between 38–54 million flu illnesses (various influenza viruses), 18–26 million flu medical visits, 400–730 thousand flu hospitalizations, and 24–62 thousand flu deaths. This is from March 27, 2020. This is real-time surveillance. (Supposedly.) Why isn’t the media curious about this? Why aren’t they informing the public? This is an extremely important question to pursue. If coronavirus turns out to be as dangerous as we were told—so dangerous that we had to wreck the economy to mitigate its burden—it will be said that the swift action of the United States government prevented the full extent of the pandemic predicted. Indeed, the precautionary/preventative action will need to have produced dramatic effects to derail the apocalyptic forecast by the government and media. But given the magnitude of that effect, why would the CDC project essentially the same flu numbers as they have over the last decade? If shutting down society will sharply reduce the coronavirus pandemic, then it must sharply reduce the numbers associated with influenza, or seasonal flu, since the transmission mechanism is the same. The order of magnitude should be very great. Yet, if these CDC numbers are in real time, it is not having an effect. The numbers are the same as the yearly average. What is going on? Is there no association between isolation and quarantine and influenza infections, hospitalizations, and deaths? If so, there is no association between isolation and quarantine and coronavirus infections, hospitalizations, and deaths. Given this, the only rational conclusion would have to be that the burden of the coronavirus pandemic has been fantastically miscalculated. 

Now, the CDC might claim that—if they revise the influenza numbers downward (and I will get closer to actual real-time numbers in a moment), which they will have to if isolation and quarantine work—the dramatically lower numbers indicate that the vaccine was more effective this flu season. But this still won’t make sense, because the flu vaccine, efficacy statistics problematic to begin with (for one reason because people are vaccinated against prominent strains for which they already have natural immunity), becomes less effective as the season wears on because influenza viruses (like most RNA viruses) mutates rapidly and the vaccine is produced only at one point in time. 

Let’s go deeper into this. First, I want to emphasize something the government and media aren’t but should be. When we’re talking about serious respiratory infections, we’re actually talking about pneumonia, which is the catchall term for a lung infection that ranges from mild to so severe that a person has to be hospitalized. I have reported twice to the doctor with severe respiratory infections that were diagnosed as pneumonia. What was the cause? Unknown, although both were treated a bacterial. I just had a flu-like illness last week (still affected it by it). Was it influenza? Maybe. But it could have been a rhinovirus. It also could have been a coronavirus. I may be one of the thousands—or tens of thousands—of unreported coronavirus cases. The causes of pneumonia may be bacterial, viral, or fungal. Flu viruses (influenza A and B), cold viruses (half of which are rhinoviruses), RSV viruses (respiratory syncytial virus, which affects children), and bacteria (Streptococcus pneumoniae and Mycoplasma pneumoniae). But among the causes of pneumonia are also coronaviruses, which, again, make up an estimated 5% to 15% of the viral mix every year. The media isn’t telling you this. What this means is that of the pneumonia deaths reported by the CDC every year, a proportion of them are from coronaviruses. Why influenza is often paired with pneumonia in the statistics is because influenza types, unlike rhinoviruses and coronaviruses, have vaccines and are monitored closely for vaccine production. This changes the way we perceive the threat.

Now, suppose there are 70,000 deaths one year from pneumonia. We are unsure of the mix of viruses implicated in these deaths. It could be 30,000 influenza viruses cases, 20,000 rhinoviruses cases, and 20,000 coronaviruses cases. Change the percentages if you want. It doesn’t matter. We’re dealing with huge numbers, numbers so huge that they should have panicked the public years before. This speculation isn’t off the hook. Remember, up to 80,000 people died of flu in the winter 2017 in the United States alone. The point is that all of these are implicated in lethal pneumonia. But since the CDC estimates these numbers, and since they test for influenza and not for rhinoviruses or coronaviruses, the numbers of all those who die from flu-like illness are thrown into the hopper with the influenza label, thus obscuring the numbers of people who die every year of the common cold, the assumption is that these are flu deaths. Now that we have a test for a coronavirus, it makes it appear as if a new virus is responsible for deaths that coronaviruses caused in years past that were not tested because there was no test and therefore not recorded as the cause of death. So, if the total number of pneumonia deaths this season are lower than the total number of pneumonia deaths of, say, the previous season, then whatever caused them, we are (over)reacting to the now-possible identification of a virus not to an actual new viral threat.

Based on that CDC report I noted earlier, The viral burden may actually be less this year than before. Maybe because of isolation and quarantine, but also because the death rates from pneumonia fluctuate annually. But if it is less or turns out to be the same as last year or the worst past year, you now know that influenza is not exclusively responsible for the tens of thousands of deaths every year from pneumonia. In other words, this may not be an extraordinary event, but rather a panic induced by being able to identify a virus by name thus making it appear as a new lethal force not actually a new lethal force, or at least no more of a new lethal force than every mutated virus implicated in pneumonia deaths. It will still be the case that the largest share of pneumonia deaths every year will be caused by influenza and rhinoviruses. But if we treated those threats the way we treat the threat of the less common coronaviruses, we would have to shut down society every year for the same reason we are claiming we have to do so now. That is what is novel here: the societal reaction.

Currently, the number of those estimated to who have died from pneumonia this flu season is around 24,000. Suppose we add 10,000 deaths attributed to coronavirus. That’s 34,000. That still less than half the pneumonia deaths from 2017. The death toll from coronavirus would have to be quite high to match the estimated up to 60,000 average annual pneumonia deaths. We have separated in the public’s mind the coronavirus from pneumonia deaths by a method that, for the first time, singles out the coronavirus as a special disease. This makes it feel like a novel event. But in fact coronaviruses are a mix in the viral burden annually and have always carried lethal consequences for vulnerable populations.  

As I said, this was a health crisis. Influenza is a health crisis. Diabetes (which kills more people than influenza) is a health crisis. But there may be no extraordinary event justifying shutting down society. The societal reaction may be induced by a new definition not a new threat. This would be consistent with the social profile of previous mass hysterias, such as serial killers, satanic ritual murders, child abductions, and so on. 

What strikes me as remarkable in all this—along with what is happening right now in real time—is how the H1N1 subtype of Influenza A in 2009, a variation on the virus implicated in the Spanish flu that killed so many people almost 100 years earlier, didn’t spark hysteria to the extent this coronavirus has. The CDC estimates that 151,700-575,400 people worldwide died from (H1N1)pdm09 virus infection during the first year the virus circulated. Perhaps it was because there was a vaccine available (which I did not receive). But had we panicked then as we are right now (not me, but clearly a lot of people), just think of how many lives could have been saved—if there is an association between social isolation and quarantine and infection rates.

The media is reporting that Italy has passed the 10,000 death mark. This is terrifying. But it will help to keep calm by keeping in mind that Italy always shows a higher rate of influenza-attributable excess mortality compared to other European countries, especially in the elderly. This is because of very poor air quality in Italy, a country known as the China of Europe. Consider that a study of the winter flu seasons 2013/14 to 2016/17 found an estimated average of 5,290,000 cases with more than 68,000 deaths attributable to flu epidemics estimated in the study period. That’s more than 17 thousand deaths annually. It is important to keep in mind terrain, life style, and the adequacy of health services when considering the impact of infectious agents. Almost 15,000 coronavirus victims—more than half the world’s total—have died in Italy and Spain. See the International Journal of Infectious Diseases. I would be greatly surprised to see these numbers replicated in other Western industrialized societies.

Stories emphasize how different SARS-CoV-2 is from the flu virus. Technically, this is true, because coronaviruses are not influenza viruses. They are not rhinoviruses, either. But all of these are a cause of pneumonia deaths. So when stories tells us its different, they are not wrong. However, what they are not telling us is that coronaviruses have always been different, have always been a cause pf pneumonia, and that therefore the situation is different for a different reason. And the way people are shaming those who question the government and media narrative makes this societal reaction a classic moral panic. When you are not allowed to ask reasonable questions about a scientific matter, when skepticism is treated as heresy, then you know you are in the midsts of a moral panic.

I am not denying that coronavirus is a burden. Influenza and rhinoviruses are also burdens. All of these pathogens kill people every year. Nobody wants anybody to die. So we need to deal with these burdens. What I am arguing is that shuttering an economy on account of coronavirus is novel will have serious consequences for jobs and livelihoods, not to mention emotional and psychological needs and human liberty, and, moreover, that wanting to get back to a normal life as soon as possible is not remotely the same as saying we want to kill old people. The societal reaction is following a pretty standard sociological explanation, except on steroids. It is proceeding on the basis of a novel definition of the situation more than a novel virus.  The panic is viral.