Ask the Expert: Risk of and Response to the Coronavirus
By Brian Hiro
Perhaps no Cal State San Marcos students were as clued in to coronavirus threat and its potential impacts on the United States as clearly and as early as those in the statistics class taught by business lecturer Bill Burns.
Burns has been teaching part-time at CSUSM since 1999, but his primary focus is as a research scientist at Decision Research, an Oregon-based institute that focuses on judgment, decision-making and risk perception. For three different periods between 2013 and 2015, he served months-long stints inside the Department of Homeland Security as a scientific adviser.
Burns specializes in analyzing risk and how the public responds to crisis, meaning his students were kept well-informed as the coronavirus first began to spread in China and then throughout the world. Now that the virus has infected thousands of Americans and is deeply affecting nearly every aspect of our daily lives, we sought out Burns to draw on his decades of expertise.
Question: What are your thoughts so far on the public response to this crisis, both worldwide and in the U.S.?
Answer: It's hard to know what went on in China because it’s difficult to get really good information. And their response was largely dictated by the government – stay home and all that. We have a little more information about public response in Europe, and particularly the United States. At Decision Research, we've looked at this stuff for 40 years – not me, but people who have gone before me. And it's quite understandable that when you have a threat like the coronavirus, it pushes all our buttons. It has the ability to kill lots of people, to make a lot of people sick, it travels unseen. The symptoms don't show up for a while; you may have it and don't know it, so you're always kind of living on the edge. There's a lot of uncertainty about it. There were some initial missteps in the United States about how to handle it. It didn't help at all that many people were calling this a hoax. So what this does is create a lot of fear.
Q: What’s the antidote to that?
A: One is trust. For example, when President Trump declared a state of emergency last week, the Dow bounced back to the tune of almost 10%. Our research would have predicted that because what the public is looking for right now is a certain amount of certainty. They want people at the national level, the state level and the local level to be saying, “Look, here's what we know about the crisis, here's what we don't know yet but we're investigating, and here's what we're doing about it. And here's what you can do about it.” Because deep within every one of us is the desire to control our fates. And when it's unclear what we should be doing or what the government is doing, people are filled with fear, and that gets expressed in a lot of ways.
I would predict that, for a while, the public is going to remain very, very concerned. What people naturally pay attention to is not so much the levels – the total number of people who have been infected or the total number of people who have died. We're amazingly insensitive to those kinds of large numbers, and that's been well-researched. What we are very sensitive to are changes in those levels. As we see these reportings continue to climb, that makes us nervous, that hits the fear bell. Particularly if we see these numbers begin to accelerate, and we will see these numbers accelerate for a while, because this is what we mean by exponential growth. As soon as you see the numbers start to come down, turn in the other direction, even if the number of reported infections or deaths is very high, that will begin to quell fears. It sends a signal to people that we've got our hands around this, it's under control. There's light at the end of the tunnel.
Q: For a lot of people, this feels like something without precedent in their lives. Do you feel the same way?
A: There's certainly no recent precedent, and by recent I mean decades of history. I'm looking back 40 or 50 years, and at no time have I seen something like this. I've lived through the Cold War, when we were always on the alert for Russian bombs. With 9/11, there was a huge amount of fear, and people were not getting on airplanes. The difference between then and now is that, post-9/11, the risk of you been killed or affected by a terrorist act was always vanishingly small. And yet, we wouldn't get on airplanes, and the financial losses were staggering. But when you look at studies that examine how we recovered from 9/11, we were resilient. People are amazingly resilient once they understand that it’s a controllable situation. Even with the financial crisis of 2008, there was no good news for the entire fall season, but when we tracked people through a national panel, their perceptions of risk came down, their fear came down, because we have a natural tendency to recover. We have good psychological mechanism that says the sky isn't falling.
For most of our students here, this is the first global crisis they've faced. Many were too young to remember the 2008 financial crisis. They’ve already been affected by this. It's no small thing to go from in-class teaching to virtual instruction, because a lot of these students build relationships with their classmates and their professors. They rely on that, and now they have to adapt. But as I've said to my students, you're going to learn through this crisis something that we as professors would be hard pressed to teach: Adversity can be a good thing. It can make you better, it can make you stronger, it can give you a more balanced perspective on your life.
Q: You mentioned some early missteps in the U.S. crisis response. What do you think those are?
A: The State Department, the CDC and NIH were all getting reports about what was going on in China. I think all these experts knew that those numbers were underreported, and even the underreported numbers were very, very grim. Because of the draconian measures that China took early on with massive quarantines, it bought the rest of the world possibly a month or more to prepare. They slowed down the spread of the virus, flattened that curve as much as they could. Some nations took that time and made good of it: South Korea, Singapore, for example. We were very slow to respond. And it isn't that the CDC or NIH was slow. It was people at the top who didn't think it was as serious as some of their medical experts were saying. This isn't me being partisan; go Google all the statements surrounding this.
What you really want to do in any crisis is get on top of it as soon as you can and communicate very clearly with the public about what you know and what you don't know. You should speak with one voice, and if there's disagreement among experts, you can say that there's disagreement, you can express the uncertainty. But you shouldn't be saying one thing one day, another thing another day and have it appear like it's politically motivated, as opposed to a genuine concern for welfare. People are amazingly tolerant to uncertainty if they feel like they're being told the truth.
Q: As an expert, how do you analyze risk when it comes to the coronavirus?
A: It has three components to it. There's the threat of exposure, meaning what's the chance that the virus will make its way to my eyes, nose or mouth? Second is vulnerability. How vulnerable am I? How sick will I be if I actually come in contact with the virus? And then there's the consequences. Suppose that you do get very sick. Well, that probably means you're going to end up in the hospital, in the ICU possibly, on a ventilator possibly, or even die. The reason it's important to break risk up like this is that our greatest leverage is reducing the probability of exposure. How do we do that? Social distancing, washing our hands, avoiding touching our face. That's where we flatten the curve. Vulnerability, we have less control over because it's hard to change our underlying conditions, of which I consider age one. Though we can to a certain degree. This is why we always tell college students not to burn the candle at both ends. Get rest, eat sensibly, manage your stress level, drink plenty of fluids. That actually does influence your vulnerability to some extent.
Q: By this point, we’ve all experienced or seen pictures of long lines at grocery stores, hoarding, runs on certain products. Is that something that should be expected in a crisis like this?
A: Yes, absolutely. These types of responses are understandable. It can become a problem if a select portion of the population has all the goods and there are no more canned goods to buy. As long as the shelves can be reasonably replenished, this is a natural human response. It's one thing people can do to comfort themselves that they're doing something.
You want a signal about a crisis, have long lines at the grocery stores. We often take our cues about how risky something is by what other people are doing. The fact that people are hoarding food is neither here nor there about the real risks. But most of us are not medical experts, so we're going to take our cues where we can get them, and that's a big one. If I were a public health official, I would be reminding the public that it's perfectly fine to stock up food. But let's not take that as a signal that the sky is falling.
Q: What do you say to what I assume is a rapidly dwindling number of people who think this is overblown?
A: I would have accepted that a month ago, maybe three weeks ago. I would have said, “Well, maybe it is. Let's hope it is.” It would have been understandable. Now I would hope that if people have any doubts about the overblownness, go to the CDC, John Hopkins, NIH, your local public health department and look at what the facts are. These folks have expertise and have no other motivation than to help solve this problem, period. All the rest of the people have mixed motivations. The people peddling conspiracy theories, they either have economic motivation or they’re motivated by malicious mischief. They just like to scare people and create havoc. For others, they buy into and share these conspiracy theories because that is their way to wrap their mind around the problem, feel like they have some control over the situation. Now that's not harmless – like the way stocking up on food is – because if you tell people it's a hoax, maybe they won't take it as seriously as they should.
Q: What are your biggest concerns going forward?
A: First and foremost is the race to flatten the infection curve before the U.S. and other nations hit their health care capacity thresholds. This is the top priority right now. We need to take all reasonable measures to slow down the spread of the virus because otherwise we could be looking at truly horrific public health statistics. Second, we need to take appropriate actions, including clear communication, to restore public confidence to mitigate the likely economic consequences that are coming, including loss of jobs and the closures of small businesses. When there's severe economic fallout, the people most vulnerable are those who are most affected. And finally, I fear the stigmatization of certain groups. It won't be limited to the Chinese. It could be Iran. It could be Italians. It could be, in general, foreigners. Our nation already has big fears about mass immigration, people overrunning our borders. In the aftermath of this, people will look for scapegoats. All of us have a strong tendency to want to hold people culpable for things. It is true we could have handled things better. But it's no nation's fault, it's no ethnic group's fault.
There are going to be big lessons learned. If there's a silver lining here, we all knew it was a question of when, not if, a pandemic would come. And now we figured out we weren't as prepared as we thought we were. This is a wakeup call.
Brian Hiro, Communications Specialist
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