For me, one of the hallmarks of the OMS community we have created is the capacity we have developed to maintain our hope in the face of uncertainty. I can think of few other conditions where this matters more. Most people in the general community cannot imagine how they might cope in the face of not knowing from day to day whether they would wake up with some new symptom of serious neurological damage. That uncertainty would not be tolerable for most people. But out of our shared adversity, that is precisely the strength that we have cultivated.
Where did we find that strength? It was born of hope. Together we have found hope that we can be well. And it is a hope that is realistic, based on solid science. More than that, we have found hope that, even in the face of uncertainty or deterioration, we can maintain an equanimity that will sustain us, whatever the ups and downs in our lives. It is this skill, our shared strength, that will get us through the current challenges facing not only our community, but all communities everywhere. And again it is born of realistic hope that is based on credible science.
The coronavirus is one of a family of viruses, some of which cause generally mild to moderate respiratory illnesses in people, like the common cold. Other animals also suffer illness with coronaviruses, and sometimes one of these viruses jumps to humans from this animal reservoir. This happened in 2002 with SARS (severe acute respiratory syndrome) and again in 2014 with MERS (Middle East respiratory syndrome). Interestingly, despite over 8,000 people developing SARS in 2002/2003, the disease completely disappeared by 2004 and has not re-appeared.
This time the disease COVID-19, caused by another coronavirus that has jumped from animals to humans, has spread rapidly all over the world. This particular virus though is somewhat different, not only in resulting in a considerably lower death rate than SARS (nearly 10%) or MERS (closer to 35%), but also in largely causing deaths in the older age groups and in how easily and quickly it spreads.
It would seem that COVID-19 is a rather less serious disease than either of the previous two. Indeed, we really can’t be sure how many people die after becoming infected. In older populations, like Italy, around 8-9% of those tested and found to be positive have died. In contrast, in Germany for example only 84 people had died (by 23 March 2020) out of 22,364 people testing positive (0.3%)1, the latter figure being much closer to what we would expect from a severe influenza epidemic. Experts suggest that because we only test those people very likely to be positive for coronavirus in most countries, then we don’t really know how many people out there have the infection but have no or minimal symptoms2. This artificially raises the apparent death rate, which may in reality be quite low.
All that said, we do need to be extremely careful to take all precautions not to spread this disease to each other, particularly to our elderly, through very rigorous social distancing and personal hygeine. Even if the death rate is lower than SARS or MERS, there is no question that if very large numbers of people get infected in a short space of time, our health and hospital systems will get overwhelmed and many more people with die who otherwise might have lived. This is what happened in China and the northern part of Italy and now seems probable in parts of the USA like New York City.
For each of us individually, what is the best way to minimize the risk of getting viral infections? In addition to good personal hygiene, like washing hands, the known factors that lower risk of getting viral infections are those that improve immune function, that is being as fit as possible, getting adequate sunshine and having a good vitamin D level, and eating a very healthy diet. Sounds like the OMS Program!
But in addition to being more protected against developing COVID-19 than many others in the general population, our key skill of maintaining calm and equanimity in the face of uncertainty will serve all of us well in this global epidemic. As we have found with MS, in the face of uncertainty, there is nothing wrong with hope!