UPDATED! Learning About the Adjustment Reaction to News of a Potential SARS-CoV-2 Coronavirus Pandemic (and Why You Need to Prepare Now)

Novel Coronavirus SARS-CoV-2
This scanning electron microscope image shows SARS-CoV-2 (orange)—also known as 2019-nCoV, the virus that causes COVID-19—isolated from a patient in the U.S., emerging from the surface of cells (gray) cultured in the lab. Credit: NIAID-RML

It would appear that outbreaks of SARS-CoV-2 virus (and the disease it causes, COVID-19) are springing up in places far from its birthplace in Wuhan, China: in South Korea, Iran, and Italy, among many other nations, with the coronavirus infection showing up in dozens of people who cannot be easily linked to China.

The Washington Post newspaper reported yesterday, in story titled Coronavirus outbreak edges closer to pandemic (original, archived copy):

In South Korea, coronavirus cases quadrupled over two days, as 144 people linked to a religious sect tested positive. In Singapore, clusters of infection have been traced to two churches, a hotel business meeting, a health products shop and a construction site. In Iran, an outbreak has seeded new cases in Lebanon and Canada — a worrisome sign the disease could be spreading more widely than realized.

There are outbreaks. There are epidemics. And there are pandemics, where epidemics become rampant in multiple countries and continents simultaneously. The novel coronavirus that causes the disease named COVID-19 appears to be on the verge of that third, globe-shaking stage.

Amid an alarming surge in cases with no clear link to China, infectious disease experts believe the flu-like illness may soon be impossible to contain. The World Health Organization has not declared COVID-19 a pandemic and the most devastating effects, including more than 2,200 deaths, are still in China. But the language coming from the organization’s Geneva headquarters has turned more ominous in recent days as the challenge of containment grows more daunting.

“What we find is that this virus is going to be very difficult to contain,” said Jeffrey Shaman, an infectious disease researcher at Columbia University and co-author of the study posted Monday. “Personally, I don’t think we can do it.”

Harvard epidemiologist Marc Lipsitch estimates that 40 to 70 percent of the human population could potentially be infected by the virus if it becomes pandemic. Not all of those people would get sick, he noted. The estimated death rate from COVID-19 — roughly two out of 100 confirmed infections — may also drop over time as researchers get a better understanding of how widely the virus has spread.

That death rate, estimated at 2% of cases at present, is significantly higher than that posed by regular seasonal influenza, at 0.1%. While many people (especially the young) have only a mild response to this virus, the latest scientific research shows that approximately 20 percent of those who land up in hospital with COVID-19 are severe cases that often require intensive care. Those who are older, overweight, or have underlying health conditions such as asthma, heart disease or diabetes are more likely to have a severe or even deadly reaction to this virus.

UPDATE Feb. 24th: The BBC reports in an article today titled Coronavirus: World should prepare for pandemic, says WHO, in answering people’s questions about the virus:

The current fatality rate is less than 0.5% for people under the age of 50. But it rises to 8% for people in their 70s and 15% for people over 80. Meanwhile, nearly 11% of people with diseases of the heart died when infected. As did 7% of people with diabetes and 6% of people with long-term lung problems. The average for healthy people is 0.9%.

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID) in the United States, explained in a recent CNN interview why we’re nearly at the brink of a global pandemic with the novel coronavirus outbreak:

Yesterday, the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota reported:

Today officials from the Centers for Disease Control and Prevention (CDC) warned that although the agency is taking historic measures to slow the introduction of COVID-19 into the United States, the country should prepare for the possibility of community spread, as seen in China and neighboring Asian countries.

“The day may come when we may need to implement such measures as seen in Asia,” Nancy Messonnier, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases, said in a press conference, referencing the closing of businesses, schools, and churches in multiple countries where transmission is now occurring within the community.

This is no longer a “what-if” scenario for us in North America, or an “over there on the other side of the world” problem that we can ignore. This potential pandemic is already wreaking unprecedented havoc in Chinese society, and that havoc is spreading to other countries now—South Korea, Japan, Hong Kong, Singapore, Iran, and Italy all have documented cases of human-to-human transmission.

In other words, you need to prepare yourself—emotionally, mentally, and physically— for a pandemic. The time to begin preparing is NOW.

Part of the mental and emotional preparation for a pandemic is understanding something that risk communication expert Dr. Peter Sandman refers to as an adjustment reaction:

When someone first learns about a new and potentially serious risk, the natural, healthy, and useful reaction is, in a sense, an over-reaction:

– You pause
– You become hyper-vigilant
– You personalize the risk
– You take extra precautions

These responses are signs of what psychiatrists call an adjustment reaction. They are part of the process of adjusting to the new risk. Here are the key characteristics of the adjustment reaction to crisis:

1. It is automatic
2. It comes early
3. It is temporary
4. It is a small over-reaction
5. It may need guidance
6. It serves as a rehearsal
7. It reduces the probability of later over-reaction

This is just a summary; I very strongly suggest you go over and read the whole thing yourself, it’s not too long and it is fascinating. Dr. Sandman goes on to say:

This is the teachable moment! Instead of criticizing or ridiculing people’s adjustment reactions to emerging crises, smart crisis communicators encourage the adjustment reactions, legitimize them, ally with them, and guide them.

It’s okay to tell people that they’re jumping the gun a little – that there is still time and you advise them to hold off on particular precautions until the risk gets closer, bigger, or clearer. It’s okay to recommend substitute precautions – precautions that are more useful or less burdensome or less likely to backfire than the ones they’re attracted to. It’s okay to remind them that nobody knows yet whether the situation will worsen or blow over, that they should try to stay poised to ramp up or ramp down their level of concern. That’s all part of guiding the adjustment reaction.

What isn’t okay is to suggest that people shouldn’t be worried yet, that they shouldn’t take any precautions or even think about what precautions they want to take until you give the word. It isn’t okay to tell people that their normal and useful impulse to rehearse is irrational or panicky. Healthy people are going to rehearse. They are going to imagine the worst before it happens and before we know for sure if it’s coming. They are going to take premature precautions. An adjustment reaction is a big improvement over being caught unawares. Don’t try to tell people not to have one. Help them have a good one.

In other words, an adjustment reaction is normal, it helps you to begin to take the risk of a pandemic seriously, and it gives you the kick-start you need in order to begin preparing for it.

At this point all the experts are now saying the same thing: that the Wuhan coronavirus will continue to spread worldwide. It cannot be contained, either within the city of Wuhan, the country of China, or the region of south-east Asia. The best that countries outside China can do at this point is to use case isolation and contact tracing to slow down the spread of the virus within their countries, and implement quarantines and social distancing policies to buy more time in order to prepare. As Dr. Amesh Adalja says above, “It is not a matter of if—it is a matter of when”.

Remember, there is no vaccine against the Wuhan coronavirus, and there is unlikely to be one for at least a year. Also, no one has any natural immunity to the 2019-nCoV virus. Scientists still don’t know exactly what percentage of the people who catch this virus will develop only mild symptoms, and what percentage of infected people will land up in hospital. It has already been reported by Dr. Anthony Fauci of NIAID that approximately one in four people who are hospitalized so far have severe cases, requiring intensive care.

No hospital system, anywhere in the world, has enough intensive care beds to deal with a surge of tens of thousands of serious 2019-nCoV cases, as we have already seen happen in Wuhan, China.

As I have written before, throughout history there have been eight tactics used to combat infectious diseases. It is possible—some would say, likely—that national, state/province, and city governments will impose quarantines and social distancing policies in order to try and contain 2019-nCoV outbreaks.

What this means for you, reading this now, is that you need to prepare yourself and your family for the possibility that you will need to stay in your homes for a period of several weeks, avoiding contact with as many other people as possible, as a wave of illness caused by the Wuhan coronavirus sweeps through your community, forcing schools, businesses, and public transportation and public gathering places like movie theatres and shopping malls to close (as we already seen in Wuhan and many other cities in China). The time to prepare for this is NOW.

That means that you need to prepare by stocking up on food and other supplies to last you at least two or three weeks. Start by reviewing the Personal Health Preparedness lists provided by the U.S. Centers for Disease Control and Prevention here and the Pandemic Preparations list by Ready, an official website of the U.S. Department of Homeland Security.

You will need to have on hand:

  • At least two weeks of food and other supplies (toilet paper, first aid supplies, soap and hand sanitizer, garbage bags, etc.). There are already reports of panic buying in places such as Hong Kong, Singapore and Italy. You do not want to leave it to the last minute! For example, both my local drug store and my local grocery store are now completely sold out of hand sanitizer, and the manager at the grocery store said they’ve been out of stock for two weeks now.
  • Refills of all your presecription medications, plus a stock of over-the-counter medicines (talk to your doctor and pharmacist about creating an emergency supply of your prescription medication).
  • Power sources (flashlights, extra batteries, car chargers and adapters for your mobile devices, etc.).

Other things that you should do:

  • Sign up for any local alerts from your city, state/province, or federal government (or know where to find the information on the Internet). Find out what plans your employer is making (and if they’re not making them now, they should be).
  • If you haven’t yet, get your seasonal flu shot. It can’t hurt, and it will help to figure out whether or not you do have 2019-nCoV if/when you do become sick. Many areas now give out the flu shot for free.
  • Train yourself NOT to touch your eyes, nose, and mouth! The SARS-CoV-2 virus can remain viable on hard surfaces anywhere from 2 hours to 9 days (scientific journal article source), and you can transfer the virus from your infected hands to your mouth, nose, and eyes by touching or rubbing them.
  • Watch the following video from the World Health Organization on how wash your hands! Yes, I know I have posted it before. You may think you already know how to wash your hands properly, but you still might learn something you didn’t know before. Proper hand hygiene will also help you avoid catching regular seasonal colds and influenza, so there’s a net benefit to society.

Good Sources of Information on SARS-CoV-2 and COVID-19

Here is my updated list of good, credible, authoritative resources to learn more about the Wuhan coronoavirus (formerly called 2019-nCoV and now officially called SARS-CoV-2; the disease the virus causes is now called COVID-19):

If you want a quick, up-to-date overview of the current situation, here are three good places to check:

Stay informed, get prepared, and stay healthy!

Wuhan Coronavirus Update, February 20th, 2020: Coursera and Imperial College London Are Offering a Free, Eight-Week Course on SARS-CoV-2 and COVID-19 to the General Public

This scanning electron microscope image shows SARS-CoV-2 (orange)—also known as 2019-nCoV, the virus that causes COVID-19—isolated from a patient in the U.S., emerging from the surface of cells (green) cultured in the lab. Credit: NIAID-RML

I decided it was time for a quick update on the SARS-CoV-2 virus outbreak. (The Wuhan coronavirus had an interim name of 2019-nCoV, but it is now known officially by scientific researchers as SARS-CoV-2, and the disease it causes is now referred to as COVID-19.)

In the past few days, there have been various worrying reports of human-to-human transmission of the virus in countries outside of China: Japan, South Korea, Hong Kong, Singapore, and, for the first time, Iran. It would appear that despite our best containment efforts, the virus, which seems to be as easily transmissible as regular seasonal influenza, is slowly spreading worldwide. Scientists are studying these outbreaks outside China in an effort to better understand the virus.

Coursera is offering a free eight-week online course with Imperial College London, called Science Matters: Let’s Talk About COVID-19:

Welcome to this Science Matters on the Novel Coronavirus (COVID19) – a free course to learn about the science underpinning the outbreak response.

On January 30th, the World Health Organisation (WHO) declared an outbreak of the Novel Coronavirus, now officially referred to as COVID19.

As the epidemic seems to spread to more and more countries, people around the world are wondering about the trajectory of the epidemic and whether they should be concerned. Media reports of the epidemic often focus on the more eye-catching events: governments evacuating their citizens from Hubei province, passengers on cruise ships being stopped from disembarking following a detection of a case, or images of supermarket supplies running out in areas perceived to be at high risk. On social media, other reports about the epidemic range from unsupported rumours to deliberate disinformation are increasing a sense of panic many individuals are experiencing. Robust, reliable analysis is vital at this stage not only as a way to give concerned members of the public a sense of perspective, but also to support governments and other stakeholders in planning their responses.

Researchers at the MRC Centre of Global Infectious Diseases Analysis (GIDA) and the Jameel Institute for Disease Emergency Analytics (J-IDEA) have been working hard on coming up with reliable estimates of the spread of the epidemic and its prospects, and are doing this in close collaboration with a number of global stakeholders, including the World Health Organisation (WHO).

You will hear directly from the experts conducting the analyses. You will be able learn about the current state of the epidemic, while also learn about the epidemiological and public-health principles and challenges that underpin these analyses. This will include understanding how the spread of the epidemic is modelled, how transmissibility of infections is estimated, what the challenges are in estimating the case fatality ratio, and also learning about the importance of community involvement in responding to the epidemic.

Today I finished the first two weeks of the online course, and I can recommend it very highly! You do not need to have a science background in order to understand the concepts, which are clearly explained.

Good Sources of Information on SARS-CoV-2 and COVID-19

Here is my updated list of good, credible, authoritative resources to learn more about the Wuhan coronoavirus (formerly called 2019-nCoV and now officially called SARS-CoV-2; the disease the virus causes is now called COVID-19):

If you want a quick, up-to-date overview of the current situation, here are three good places to check:

Stay informed, get prepared, and stay healthy!

How a Potential Coronavirus Pandemic Will Help (and Hurt) Virtual Reality in 2020

This scanning electron microscope image shows SARS-CoV-2 (yellow)—also known as 2019-nCoV, the virus that causes COVID-19—isolated from a patient in the U.S., emerging from the surface of cells (blue/pink) cultured in the lab. Credit: NIAID-RML

Although I said I would no longer write daily updates about the Wuhan coronavirus (now officially called SARS-CoV-2), I feel that now is a good time to talk about how a potential global pandemic could impact the still-nascent virtual reality market.

The world may be facing a situation not encountered in 102 years, when the 1918/1919 Spanish influenza pandemic swept around the globe in three successive waves in 18 months (in an era before commercial air travel), infecting one third of the world’s population and killing over 50 million people, more than the total number who died in World War I.

Not too long ago, I blogged about the eight tactics used to limit the spread of infectious diseases throughout human history. Of those eight tactics, two—quarantines and social distancing—are already being heavily used in China.

Yesterday, The New York Times reported (archived version):

Residential lockdowns of varying strictness — from checkpoints at building entrances to hard limits on going outdoors — now cover at least 760 million people in China, or more than half the country’s population, according to a New York Times analysis of government announcements in provinces and major cities. Many of these people live far from the city of Wuhan, where the virus was first reported and which the government sealed off last month.

Many infectious disease experts have already stated that they believe that the SARS-CoV-2 virus can no longer be contained to China. Indeed, we are already seeing cases of human-to-human transmission in many countries and areas, notably Hong Kong, Singapore, and Japan, including 355 confirmed cases on a cruise ship docked at Yokohama (the largest single infection site outside mainland China). The virus is spreading.

Humanity has no natural immunity to this coronavirus (despite the hucksters taking advantage of the situation to sell you various “immunity boosters”). There is no vaccine against SARS-CoV-2, and there will not be one for at least a year. The World Health Organization has already stated that existing pneumonia vaccines are useless against the specific kind of pneumonia caused by SARS-CoV-2.

In other words, you really can’t prepare your body for this infection. It is true that some people seem to have very light or no symptoms at all (but are still able to infect others). The virus appears to be deadlier to older people, overweight people, and people with pre-existing health conditions, such as asthma and diabetes. (In other words, I am a sitting duck.)

Researchers are still trying to calculate the infectiousness (R0 or R-naught) and case fatality rate (CFR) of this new viral outbreak, and experiments with various treatment options are currently being conducted on infected patients to see what works and what doesn’t. However, all the preliminary reports suggest that the SARS-CoV-2 is about as easily transmissible as the regular, seasonal influenza we see every year.

As an interim measure, it is possible (some would say, likely) that we will begin to see the same kind of social distancing and quarantine policies currently seen in China being implemented by governments around the world. Travel between countries has already been and will continue to be negatively impacted. Major international conferences, such as the Mobile World Conference, are already being cancelled.

All of the preceding discussion is merely preamble to the point I am trying to make: that a potential pandemic will both help and hurt virtual reality.

How will a potential coronavirus pandemic help VR?

I believe that this truly unprecedented combination of circumstances might actually drive more people to embrace virtual reality technology and social VR platforms as a way to safely attend conferences, training sessions, and other events, where it is not physically possible due to pandemic quarantines and social distancing policies. In other words, more people will be exposed to VR, and sooner than predicted, due to the impact of SARS-CoV-2.

Some people (who might not be aware of social VR) are already tweeting about the need for this:

To which I replied:

This situation might even lead to a boom in the use of various social VR platforms (and perhaps even non-VR virtual worlds such as Second Life). We will probably begin to see many more conferences held partly or completely in virtual reality, such as this week’s Educators in VR 2020 International Summit, where presenters and attendees can share ideas and mingle without the worry of being exposed to an infectious virus!

How will a potential coronavirus pandemic hurt VR?

Many factories have shut down production of goods in mainland China, where many of the computer gadgets we use everyday are manufactured. While a potential pandemic might strengthen demand for VR headsets, it might also make it much harder to get your hands on one.

For example, I have already written about the impact that the Wuhan coronavirus is having on availability of the popular Oculus Quest headset, which is now completely sold out in most consumer markets. We can expect to see similar problems crop up with other VR hardware that is fully or partially manufactured by those countries affected by SARS-CoV-2. Tony (a.k.a SkarredGhost) of the VR newsblog The Ghost Howls reports that Beijing-based augmented reality headset maker nReal has completely shut down production, for example.

So, the coronavirus is a double-edged sword with respect to virtual reality.

Good Sources of Information on SARS-CoV-2

Here is my updated list of good, credible, authoritative resources to learn more about the Wuhan coronoavirus (formerly called 2019-nCoV and now officially called SARS-CoV-2; the disease the virus causes is now called COVID-19):

If you want a quick, up-to-date overview of the current situation, here are three good places to check:

Stay informed and stay healthy!

P.S. Effective today, I have created a new blogpost category called Virtual Reality (General), under which I will put those blogposts that talk about VR in a general way that don’t fit under a more specific existing category. I will try to go back and add this category to older blogposts, but obviously, at 1,700 blogposts written to date, I can’t go back and do them all!