The Contagion of Fear – the Coronavirus Pandemic and Medicine

We are currently in the grip of a worldwide panic over COVID-19, or 2019-nCoV, the novel coronavirus pandemic.

As I write, supermarkets are being stripped of essentials like toilet paper as well as respiratory masks and canned goods as panic buying escalates. Events of all kinds and scales are being cancelled as one organisation after another jump on the bandwagon of fear and conformity. I myself am cancelling overseas flights to a conference under instruction for the same reason – whilst observing the madness unfold … again. Just like we did with SARS, MERS, ZIKA, EBOLA and all the other fancy-named viral calamities that dramatise our existence, only this time with even more obsessive media coverage.

Perhaps the most interesting aspect of this phenomenon is how the medical system as a whole has also over-reacted. On the one hand there is a call for calm collaboration, but on the other hand, there is a simple regurgitation of ‘information’ ad nauseum, given without context, which simply fuels the public paranoia and fear. A schizophrenic approach indicating a system in conflict with itself.

Workplaces, Institutions and Hospitals alike are inundated with numerous ‘helpful’ emails disseminating ‘facts’ about the latest coronavirus outbreaks and restrictions as well as requesting workers to stay home and generally live in as much separation to each other as possible. Doctors are being publicly vilified and threatened with disciplinary action (without a thought to protecting their anonymity) for daring to come to work (which our overstretched and understaffed medical systems usually demand) whilst recovering from a mild cold.

Perhaps, like me, you questioned why a virus that statistically kills fewer people on a daily basis than heart disease, cancer, war, domestic violence, suicide, or influenza, causes such an extreme reaction?  Maybe, like me, you are more than inconvenienced by the extreme separative measures that the ‘pandemic‘ demands of us. The imposition to conform and view our fellow humans and Doctors as irresponsible ‘pariahs’ should they have cold symptoms, refuse to don the mask (bodysuit!) or just test positive for COVID-19.  I am specifically reminded of the ‘whistle-blower’ Chinese doctor who alerted the authorities of the outbreak and underwent public pillory up to and despite his own death. (1)

Whilst it is important for us, as people and as health care professionals, to take whatever steps we can to plan for the eventuality of the spread of this virus and to do whatever we can to stop the spread ourselves, whether that be washing our hands, coughing into a tissue, or staying home if we are ill, it is also important that we help people to understand the truth of what is going on, to put things into perspective, and encourage people to take care of themselves in a way that will help to protect them from falling ill should they be exposed to this or any other virus.

To put things in perspective, the WHO coronavirus stats from 12 March 2020 state that:

• A total of 125,048 cases have been confirmed globally (6729 new in the last 24 hours)
• In China, there have been 80,981 cases in total (26 new)
• Of these, there have been 3173 deaths
• Outside of China, there have been 44,067 confirmed cases (6703 new)
• Of these, there have been 1440 deaths
• The virus has now been confirmed in 117 countries/territories/areas. (2)

These numbers are of course only based on the people who have been tested, and this varies from country to country, so the data are incomplete and probably an underestimate of what is truly going on in terms of infection rates, and possibly an overestimation in terms of death rates, as most people who are asymptomatic or only mildly ill are probably not presenting for testing.

By comparison, WHO estimates that seasonal influenza may result in 290,000 – 650,000 deaths each year due to respiratory diseases alone. (3)

The media is obsessively circulating anything and everything to do with ‘the virus’ – down to the minutiae of knife-fights breaking out in supermarkets over toilet-roll shortages. The circulating virus ‘jokes’ on Facebook, the ‘me-first’ hoarders, the scam-artists taking advantage of the situation and the conflicting media information all culminate in a super-distracting noise quality that drowns out all else. Why? To normalise our acceptance of the poisonous cocktail of Fear that is the real player behind the scenes.

So what is really going on here?

How is it that our current medical system, crumbles so easily when the fear-factor rises, demurely falling in step with the prevailing panic?

To answer these questions, let’s delve deeper into the nature of fear; unseen yet easily felt in the body by all of us, overtly or covertly contagious by our common human experience.  As medical professionals, we are taught only to believe in an ‘evidence base’ for all we do and say. But what is the evidence base for Fear? The consequences of fear are very real for patients and doctors alike, but fear itself has no real ‘evidence’. In the hospital and health-care systems it prevents us from bringing our best to our patients and may certainly help explain the horrific suicide statistics for doctors – a new ‘evidence base’ that is now un-ignorable. Fear undermines trust and confidence in ourselves and in others; it destroys the doctor-patient relationship and most tellingly, it facilitates manipulation of large groups of people. And yet still it has no direct evidence.

At its root, Fear is a poison to Love (also non evidence based). Fear eradicates the true care that is at the heart of Medicine’s purpose, promoting instead self-interest, conflict and separation. Just like a virus, fear is ancient and dormant until conditions are ripe.

Florence Nightingale observed during her wartime nursing duties: ‘How very little can be done under the spirit of Fear’ and Plato also offered us that ‘Courage is knowing what not to fear’.

In other words, we have the choice to become aware and discerning of each ‘fear-full’ situation, to observe and respond to it rather than react and infect each other. We could choose to hold steady and not jump onto its glittery bandwagon just to be part of the new ‘normal’.

Do we, as a world-wide medical ‘body’, dare dismiss the contagion of Fear while the evidence of its impact is crippling an already beleaguered Medical system?

The simple fact is that Fear is a choice of energy, an energy in motion (e-motion) that circulates and infects for one purpose – to separate us from ourselves and each other. The contagious consequences of which we see played out in the drama of a viral epidemic.

Perhaps it is those who consistently choose this Fear that most need the quarantine period, a space to stop the inner conflict and feel the evil an alignment to Fear brings us all.

Ultimately, Fear is an excuse to ‘normalise’ playing small, to ditch collective responsibility and behave with little integrity (or true care) for one another.

We could go one step further and say it is not the virus which has sparked Fear. It is the deep infection of Fear that has facilitated the spectacle of the virus pandemic – and held us tightly in the grip of separation and distraction – such that the true innate collaborative care we know we are all capable of – is lost in the mayhem.

Why do we normalise extreme ‘containment measures’ for one acute viral infection whilst casually dismissing the daily tragedy of mortality figures that is ischaemic heart disease or diabetes, to name just two chronic conditions. Could it be that the latter require a bigger dose of personal and collective responsibility?

Doctors of all flavours are still routinely encouraged to use their innate powers of observation.  And observation is both an antidote to Fear and a path to Truth. Perhaps we can apply this teaching both within our respective healthcare settings and within our lives. Having the courage to be aware, discern and choose observation over reaction, aligns us to Truth over Fear.

In general, the CDC recommends the following to prevent the spread of respiratory viruses, which include both coronaviruses and influenza viruses:

• wash your hands often with soap and water for at least 20 seconds
• clean and disinfect frequently touched objects and surfaces
• avoid touching your eyes, nose and mouth with unwashed hands
• avoid close contact with people who are sick (not practical when you are a doctor!)
• stay home when you are sick. (4)

While people are so fearful and so open to learning what they can do to take care of themselves, why not offer them sensible advice that can support them?

Why not suggest that they can support their own immune systems by getting good-quality sleep, eating a nutritious diet (and perhaps supplementing with Vitamin C), not smoking, not drinking alcohol, minimising their intake of sugar and processed carbohydrates, getting regular exercise and taking deep care of themselves, including managing their stress by getting support and supporting each other.

Not everyone who is exposed to a virus gets sick and dies, and the way we care for ourselves is vital. If we put as much effort into caring for ourselves on a daily basis as we are currently expending buying toilet rolls and masks and obsessing about this particular novel disease, we would collectively be a lot more healthy.

It is up to us to care deeply for ourselves at this time and to counsel our patients to do the same, and to support ourselves and each other – family, friends, patients, staff and colleagues – for we are all in this together. And rather than breathing a collective sigh of relief when the current panic abates and then going back to our old ways, we could continue to bring the same level of deep care to ourselves, each and every day.

References:

1. https://www.theguardian.com/world/2020/feb/06/whistleblower-chinese-doctor-dies-from-coronavirus
2. https://www.who.int/docs/default-source/coronaviruse/20200312-sitrep-52-covid-19.pdf?sfvrsn=e2bfc9c0_2
3. https://www.who.int/influenza/surveillance_monitoring/bod/en/
4. https://www.livescience.com/new-coronavirus-compare-with-flu.html#xenforo-comments-739