Advertisement

Hysteria is the most dangerous coronavirus symptom

Woman wearing a mask in Leicester  - PA
Woman wearing a mask in Leicester - PA
Coronavirus Article Bar with counter
Coronavirus Article Bar with counter

The symptoms of coronavirus should by now be well-known: a high temperature, a new, continuous cough and - in a recent official addition - problems with your sense of taste or smell. But another symptom has reared its head - affecting those who haven’t even been infected - which may be too troubling for authorities to handle. Some bill it as mere public anxiety, but others see the levels of fear as tantamount to full-blown hysteria.

The rush back in March among shoppers to stock up on essential goods, with some around the world even coming to blows in the aisles over items as basic as toilet paper, showed how pervasive the panic had become. Four months on, Ipsos MORI found after surveying opinion across 27 countries that the British were more likely to be concerned about Covid (59 per cent) than the global average (43 per cent).

Such findings have prompted Tory MPs to wonder whether the Government’s ordering of the public to “stay home” has been too effective, given how embedded the nervousness has become. Research commissioned that July by the firm Kekst CNC showed how far public perceptions about the pandemic had been skewed, finding they were inclined to believe the spread and fatality was more than a hundred times worse than the reality.

For example, the average Briton was found last month to estimate that the disease had wiped out as much as 7 per cent of the United Kingdom, which would equate to around 4.6 million people, rather than the actual rate in the tens of thousands. They estimate just over 22 per cent of the population have had Covid-19, which at just over 14.6 million people would be well over the current confirmed case tally of 322,000.

When people estimate risk, they overestimate it massively,” says King College London’s Professor Neil Greenberg, who works with Public Health England as part of the Health Protection Research Unit for Emergency Preparedness and Response. “We are very poor as a public at estimating what risk really means.”

That does not mean the threat posed by Covid-19 can be summarily dismissed, but experts are keen for a sense of proportion.

Prof Udi Qimron, the incoming head of clinical microbiology and immunology at Tel Aviv University, recently highlighted that 99.9 per cent of the world's population has so far survived the virus, as the total number of coronavirus deaths does not exceed 0.1 per cent of the total population anywhere around the world. (See the table below for the latest data on European deaths)

He warned: “In a world where decision-makers, their advisers and the media were able to admit their mistake and the initial panic that gripped them, we would have long since returned to routine. The ongoing destruction due to the inability to admit this mistake, despite the epidemic’s small mortality numbers, is outrageous. History will judge the hysteria."

A lesson in Swedish sangfroid

Despite the much-debated trade-off between the economy and lives lost to Covid-19, recent figures suggest the world has a lot to learn from Scandinavian nations like Sweden.

The Swedes’ strategy of keeping schools open and avoiding any sort of lockdown has paved the way for considerable economic benefit, with their economy only shrinking in the second quarter by 8.2 per cent - more than twice as small a fall as suffered by the British (20.9 per cent). All the while, they have had a death toll that - according to the John Hopkins University - has been proportionally less than the British (at 56.98 per 100,000 people compared to 62.98).

What’s more, Sweden’s neighbours like Denmark and Finland suffered even smaller economic drops (7.40 and 3.2 per cent respectively) and have notably smaller death rates. Both nations pursued notably shorter lockdowns than the UK, with the Danes moving faster to send their children back to school.

While British ministers fought in vain to send children back by June, the Danes did so from April. Experts dismissed concerns soon after that the reinfection rate would rise - with Copenhagen University’s Allan Randrup Thomsethere observing soon after that “hasn’t been any effect that we can see”.

The scars left by the Covid are visible on the popular psyche. Kekst found in its survey of international public opinion that the UK remains the most concerned about a second wave - with 76 per cent expecting one in the next year or so. By contrast, Sweden is the only country recorded as being increasingly less worried about a resurgence in the virus.

Coronavirus Sweden Spotlight Chart - Cases default
Coronavirus Sweden Spotlight Chart - Cases default

The Swedes have continued to defy international trends, such as the shift in countries like the UK and France to insist on the public wearing face masks. Sweden’s chief epidemiologist Anders Tegnell told a newspaper this week that evidence of their effectiveness was “astonishing weak” and warned that it was “very dangerous” to believe that wearing them “would change the game”.

This attitude is reflected in Swedish behaviour, with polls finding as few as 14 per cent were masks when out and about, while other countries have large majorities preferring them.

Keep calm and carry on?

Why has Covid-19 left the British so unwilling to follow their stereotypical stoic attitude summed up by the old wartime mantra 'keep calm and carry on'? Prof Greenberg strikes a sympathetic tone: “Anyone at the moment who isn’t feeling anxiety is a bit strange, because this is an anxiety-producing event.”

He argues the “best way to combat anxiety is to understand the enemy” and take greater stock in “hard factual information” rather than “speculation”.

Are Covid-19 cases rising or falling in your area? All local authorities with lookup. Updates automatically
Are Covid-19 cases rising or falling in your area? All local authorities with lookup. Updates automatically

Perhaps then it is worth reflecting on how past outbreaks have proven to be much more anticlimactic than the feverish speculation they attracted suggested at first.

Just over a decade ago, the World Health Organisation pulled no punches in decrying “the greatest single health challenge to mankind”, with its director general Lee Jong-Wook bewailing its “relentless spread”. The disease they had in mind then in 2005 was not Covid-19, but H5N1 - which came to be better known as “bird flu”.

It was feared that this avian influenza could go on to kill 150million people, as the World Bank estimated that such a pandemic would cause a “deeply disruptive and far-reaching shock” that could cost up to $800billion. Bank economist Milan Brahmbhatt warned that most of the damage would be caused by “panic and disruption” as he expected people to avoid travel and stay home more.

Chief medical officer Sir Liam Donaldson weighed in with his own gloomy forecast for the UK, warning that it could kill around 50,000 people as its mutation from a strain affecting birds into one that could target humans was “now a biological inevitability - no longer a matter of 'if' but 'when'”. A report by a House of Lords select committee went further, warning that up to 75,000 Britons would die in an "inevitable" flu pandemic.

Such pronouncements led to birds becoming public enemy number one. Pictures emerged of chickens being set alight in Bali, while websites sprang up offering advice on preparing “quarantine rooms” and flu packs for sale that included hand sanitizer, latex gloves and masks.

GPs said they were being “inundated” with requests for the seasonal flu vaccine, as a Department of Health official lamented to the Telegraph: "There are a lot of worried people... Part of the problem is that you tell people not to panic and that's when they start to panic."

In the end, bird flu failed to trouble anyone in the UK besides poultry, leading then Telegraph columnist Boris Johnson to quip on 30 October 2005 that "the only victims are the poor Thai fighting-cock enthusiasts who have engaged in direct osculation with their birds in an effort to revive them for the fight.” For its part, the WHO estimated that by May 2015 just 840 people had been infected worldwide.

Reflecting on this in his memoirs, Tony Blair admitted "we nearly had a vast panic over the approaching flu pandemic". He added on his own approach: "I'm afraid I tried to do the minimum we could with the minimum expenditure. I understood the risk, but it just didn't seem to me that the 'panpanic' was quite justified"

Pandemic or panpanic?

Within just a few years, another “panpanic” burgeoned over the outbreak of the H1N1 virus. The so-called “swine flu” was estimated to be capable of killing around 50,000 people.  A “reasonable worst-case scenario” mooted by the Government, based on advice from Imperial College’s Neil Ferguson, was that it would kill up to 65,000 Britons. This was not the last time Mr Ferguson would be credited with dramatic predictions, given his current notoriety after persuading ministers to pursue a lockdown with his estimate that Covid could have otherwise resulted in 250,000 deaths.

However, the virus turned out to be barely a tenth as virulent as seasonal flu, causing no more than 457 deaths across the UK - a death rate of just 0.026 per cent in those infected rather than the 0.3-1.5 per cent feared by Mr Ferguson and his team. Reported contingency plans, which included banning crowds from sporting events and creating emergency crematoria out of shipping containers, were fortunately not required.

These experiences will have led many Britons to conclude that hysteria can be one of the worst symptoms of a pandemic. Prof Greenberg argues this is evidence of people’s innate “precautionary approach”. “It’s a good thing because it keeps people safe in the short-term, but the downside is that you won’t take risks, anxiety is fuelled as well as behaviour that would stymie the economy.”

Such concern can be effectively eased by clear official communication. Steve Reicher, a professor of social psychology at the University of St Andrews who advises the Government as part of its Scientific Pandemic Influenza Group on Behaviours, tells the Telegraph: “When you look at the literature on fear and risk, it’s not pointing out there is a danger which causes people to be terrorised by fear. If you tell people what the risks are and give them a clear understanding of what the mitigation is, you don’t get dread and anxiety as people know what to do.”

He wants ministers to show clarity about their strategy, warning: “In a vacuum, when people are already concerned, they’ll imagine the worst circumstances.”

Although Covid-19 sparked a more draconian response from the British Government, its effectiveness will remain open to question given the UK’s better death rate and economic performance can still be compared unfavourably with Sweden, which eschewed any lockdown whatsoever.

When the winter draws near, speculation about whether strict measures like local lockdowns may be necessary to clamp down on Covid will no doubt run rife. In response, many Britons will undoubtedly be tempted to focus on keeping calm and follow what the Prime Minister hails as “good British common sense” - with a bit of Swedish sangfroid.