Dr Helen Petousis-Harris is a vaccinologist and Associate Professor in the University of Auckland’s Faculty of Medical and Health Sciences

Week in Review

Coronavirus a global ‘misinfodemic’

Never before has there been so much true - and false - information exploding through our media channels as an unprecedented flow of information about coronavirus reaches almost every community on earth

The emergence of 2019 novel coronavirus is not an exceptional event, after all, infectious diseases have to come from somewhere. What is new is the fact we have the technology to identify it fast, track it, stop it, cure it, and vaccinate against it: We are literally watching the birth of a new human infection in real time.

But what is also new is that never before has there been so much true, and false, information exploding through our media channels, of which there are vast numbers, reaching almost every community on earth.

This unprecedented flow of information has enabled remarkable progress to be made in both controlling this outbreak as well as potential cures and vaccines, all in a month.

However, along with useful facts have come rumours, and misinformation. This has led to confusion, politicking, stigmatisation, hysteria, and worst of all, xenophobia. The WHO is extremely concerned and pouring efforts into addressing the misinformation. However, WHO can’t do it alone. This is a problem that requires effort at all levels – from government, to health sector, to communities, key influencers, and the public.

While not all of us can find a cure or invent a vaccine, we can be part of the solution to the misinfodemic and not part of the problem by fact-checking before sharing, and sharing good information from a reputable source. Try Snopes or some other fact-checking website.

Risk communication

This leads nicely into the importance of risk communication, always a vital part of any crisis. Risk communication is defined as an interactive process whereby information that helps people understand their risk is exchanged between experts and affected people. In short, it helps protect people’s health during the crisis.

If the key messages do not reach everyone, then people lose trust in the leaders who are there to protect them, which is why all stakeholders should be involved in a coordinated team effort. The public should expect regular proactive communications from their governments and health ministries, even when there are lots of things not yet known. They should be told what is being done and why. These messages should not only come from the officials in government, but through a variety of expert sources, as well as through the community. For example church leaders, local doctors, and other trusted people in the community.

Also, many people don’t watch TV or listen to the radio anymore - they have Netflix and Spotify. News and information comes through Facebook, Twitter, YouTube, WeChat, and so on. So no matter how textbook perfect the official communication on TV news is, many people will either not have seen it, not understand it, or have no trust in the messenger. Social media feeds are tailored to the individual’s interests so messages need to be targeted to the local community.

Through effective risk communication, people in New Zealand will understand that right now there is:

- almost zero chance of them contracting 2019nCoV

- regular surgical face masks are of little value

- most people do not die

- in fact it is likely most people do not even get very sick

- influenza kills about 400,000 people in the world each year

- The global response we are seeing is unprecedented and based on the best information available as it comes to hand.

Of course, you would probably like some further detail, for example:

How infectious is coronavirus?

This is one of the most important questions, and there is as yet no clear answer. To accurately estimate infectiousness we need to know how many people have been infected and who they got it from.

Since quick testing became widely available (in the last couple of weeks) more people can be diagnosed. Epidemiologists (medical experts who deal with the incidence and spread of disease) can model transmission of the infection and estimate how many people might have it, but are not sick enough to visit a hospital or maybe have no symptoms at all.

There are probably lots of mild cases that are not being tested. Modelling from the Imperial College in London has estimated around 100,000 (30,000 – 200,000) are likely to be infected. Of course the more you test the more you are likely to find.

Several research groups have provided estimates of the infectiousness of this virus and they generally land in the vicinity of one infectious person infecting 2-3 other people. That is a little bit more than your average influenza (about 1.4 – 4 other people), but way less infectious than measles (12-18), whooping cough (12-17), chickenpox (8-10) and many other infections.

It is not yet established whether the infection can be spread by a person who has no symptoms, but this is a question of burning importance. Infections like flu and the common cold can be spread by people who have no symptoms. In these cases the viruses are carried into the air when they breathe and speak.

How deadly?

To answer this question we really need to know how many people have actually been infected. If we only include notifications, then around 2 to 3 percent die. If far more have been infected then this percentage will be much lower. Worst case scenario, this is still much less deadly than many infectious diseases we see every day and possibly more akin to seasonal influenza. Time will tell.

Those most severely affected tend to be older and frailer than the general population. Of the first 99 cases hospitalised in Wuhan, the average age was 55, 67 were men, and half had underlying chronic diseases. There were no children in this group, the youngest was 21 and 90 percent were over 40.

Just to put this in perspective, each year there are an estimated 84,000 – 92,000 influenza-related deaths in China.

Of course, how deadly also depends on the health systems available. The recent measles epidemics in New Zealand and Samoa illustrated this grim reality very clearly. No one in New Zealand died thanks to fancy modern medicine (although there were some close calls). However, we exported it to our Pacific neighbours, in particular Samoa, where more than 80 young people died. The consequences of this coronavirus getting loose in countries with poorly developed health systems is frightening and something we must all do our part in helping to prevent.

Can it be controlled?

Maybe. Because there are not yet any medicines or vaccines, control relies purely on quick detection and isolation of people who have symptoms. Again, much depends on whether people with little or no symptoms can transmit this infection, and we do not really know the answer to this yet. The effort to contain this infection in the province of Hubei, where most cases have occurred, is unprecedented. Never before we have seen such intensive control measures. It remains to be seen if this will work.

Will there be a cure?

Probably. The WHO along with laboratories and governments all over the world are working on treatments. There are a range of approaches for effective drugs and the bonus is there are several already in the pipeline for other infections that might easily be adapted for this coronavirus.

Will there be a vaccine?

Yes, if this thing does not go away. The technology is there. Numerous laboratories and pharmaceutical companies have shifted resource to focus on a 2019 coronavirus vaccine. However, vaccines must undergo more extensive testing than other medicinal products as they are usually used in healthy rather than sick people. Best guess is at least a year, but if we can’t get this infection back in its box, then vaccines will be the ideal long-term solution.

So what is the current situation?

The situation is changing daily in terms of the numbers of notified cases, deaths and the countries that have been affected, but China is moving heaven and earth to contain this within its borders. For a reliable view of the latest statistics, the Johns Hopkins CSSE map is tracking the spread of 2019-nCoV in real-time.

Changing constantly too is the extent of this serious misinfodemic – fake news, unsubstantiated rumours, and crazy talk are spreading way more than the coronavirus. This is concerning and the World Health Organization (WHO) has all hands to deck to try and counter the nonsense.

Be part of the solution – don’t panic and fact check before you share.