What do Trump and Yale Medical School have in common? Both were duped about hydroxychloroquine

Hydroxychloroquine, promoted just a few short weeks ago as a cure for COVID-19, is useless.

Actually, it's worse than that. Hydroxychloroquine causes heart arrythmias, which can be fatal. Data from early trials of hydroxychloroquine show that it is killing people, not saving them.

Why, then, are so many people talking about hydroxychloroquine? The answer is a tale of scientific hubris and incompetence bordering on fraud. It's also a tale of how Yale Medical School and the Trump administration both fell for it.

Part 1: the hubris of a French "science star."
Last week, the New York Times ran a lengthy profile of Didier Raoult, a French microbiologist who the Times lauded as a "science star." Raoult vaulted into the public eye in March, when he published a very small study claiming that a combination of hydroxychloroquine, an anti-malarial drug, and the antibiotic azithromycin could cure COVID-19. Claimed Raoult:
"We know how to cure the disease" (Didier Raoult, quoted in the NY Times)
Actually, Raoult's proclamations began earlier, on February 25, when he posted a video on YouTube called "Coronavirus, game over." Not surprisingly, the world took notice. (Note that as the evidence for his so-called treatment evaporated, he re-titled the video "Coronavirus, towards a way out of the crisis.")

Raoult's study was deeply flawed, and it has been taken apart by multiple scientists, so I won't repeat all their points here. A good summary of many of the flaws was written by Elisabeth Bik, first on Twitter and then in a blog article, back in late March. Among other flaws, the study dropped 6 of the 26 patients who were given hydroxychloroquine without explaining why. One of those patients died. “My results always look amazing if I leave out the patients who died,” Bik commented.

Raoult is not happy with Dr. Bik. He recently called her a "witch hunter" on Twitter. This apparently is not unusual for Raoult; the NY Times compares his psychology to that of Napoleon. I wonder what he'll call me after this article appears.

In addition to its serious flaws, the paper was published in a journal whose editor-in-chief, Jean-Marc Rolain, was also a co-author on the paper. Even worse is the fact that, as the journal itself notes, the paper was accepted just one day after being submitted. Clearly, this paper did not undergo careful peer review, and it reeks of extremely sloppy science.

Since then, several larger, better-run studies have either found no benefit for hydroxychloroquine, or found actual harm. To be specific, a study of 368 patients in US Veterans Administration hospitals found that the mortality rate in patients given hydroxychloroquine was 27.8%. Patients who received both hydroxychloroquine and the antibiotic azythromycin had a mortality rate of 22.1%. But patients who did received neither one had a mortality rate of 11.4%.

In other words, giving patients hydroxychloroquine doubled their risk of dying.

One final note about Didier Raoult: he has a truly unbelievable number of scientific publications, over 2,800 according to PubMed. From 2012-2019, he averaged 176 papers per year, or about one paper every two days. Speaking as a scientist, it simply isn't possible that he made any real contribution to the vast majority of these papers. The NY Times explained that Raoult puts his name on every paper published by his institute, which employs hundreds of scientists. Again, speaking as a scientist, this is grossly unethical. No scientist should put his/her name on a paper unless they made a genuine scientific contribution to it. At many universities, Raoult's behavior would be grounds for dismissal.

Part 2: Trump and Yale Medical School fall for it.
As the NY Times reported, and as most of the U.S. knows, Trump began touting the benefits of hydroxychloroquine at a news conference on March 19:
“I think it’s going to be very exciting. I think it could be a game changer and maybe not. And maybe not," Trump said.
Right. Soon after that, the FDA, "under what appears to have been strong pressure from the Trump administration," issued an emergency use authorization for hydroxychloroquine.

Medical experts, including NIAID director Anthony Fauci, quickly injected a note of caution, pointing out that the evidence was very preliminary, and that we needed better studies. Nonetheless, Trump and his political allies ran with the news that a "cure" was available. They were wrong.

Perhaps most disturbing, though, was the behavior of some highly regarded doctors, who also fell for Didier Raoult's hype. One might excuse politicians for being fooled–they don't have the training–but the same excuse doesn't work for a medical expert.

And yet on March 26, Yale Medical School boldly tweeted out its "Treatment algorithm for COVID19," promoted with two megaphone icons:
Attached to the tweet was a graphic of a flowchart, showing that the first steps in their treatment algorithm were hydroxychloroquine and atazanavir. At the time, I replied to their tweet and warned them that there was no good evidence for their recommendations. Their response:
"While there are no FDA approved treatments for COVID19, this protocol is based on available knowledge, personal observations & communications from other institutions. In the absence of firm evidence for best treatments, this is intended as a working document & subject to change."
Well, at least they responded. But in their response, they admit that their protocol is based on anecdotal evidence and little else. This is seriously disappointing, coming as it does from one of the nation's top medical schools. It also displays hubris not that dissimilar from Didier Raoult's.

Now that more evidence has emerged, and we know that hydroxychloroquine doesn't help and probably harms COVID19 patients, has Yale updated its treatment protocol? Well yes: they tweeted out a new algorithm on May 15. Now it says:
"Consider hydroxychloroquine x 5 days with close cardiac monitoring."
This is truly appalling. The only evidence of efficacy was the small, badly-run study promoted by Didier Raoult, which has now been contradicted by much larger, better run studies. We now know that hydroxychloroquine is harmful. Others on Twitter quickly questioned the new Yale recommendation, but it's still there as of this writing.

So there you have it. As of this writing, many so-called experts are still pushing the use of an ineffective, dangerous drug that doesn't help, and may harm, people infected with the SARS-CoV-2 coronavirus. A bogus claim promoted by a self-important, egotistical scientist who published a sloppy study in a journal run by one of his co-authors turned into millions of doses of medication wrongfully prescribed.

And for now, Yale Medical School still hasn't admitted any error. I'm waiting.

[Note: I am an alumnus of Yale University, and I have long been one of its biggest fans. I did not attend medical school there, but their unscientific behavior is nonetheless especially disappointing to me as an alum.]

The WHO's endorsement of TCM may have helped cause the coronavirus pandemic

About a year and a half ago, I wrote an article titled "WHO endorses Traditional Chinese Medicine. Expect deaths to rise." It went somewhat viral, with over 100,000 views, and then went quiet until last week, when it was revived on Twitter, which has driven thousands of new views to it. Multiple people asked me to re-visit it, in light of the coronavirus and its possible origin in a live animal market in China.

The deaths I was referring to in that title were the deaths of animals (as I'll explain below), not people. What I didn't write about–and what Twitter is buzzing about now–is the possibility that live animal markets in China, such as the one where the Covid-19 virus may have first infected humans, include bats sold for their use in traditional Chinese medicine, or TCM. We now know that the coronavirus almost certainly originated in bats. It's entirely possible–indeed, it seems very likely–that TCM is responsible for the emergence of the Covid-19 coronavirus.

The title of my article might have been more prescient than I guessed at the time.

Indeed, a just-published scientific paper pins the blame for Covid-19 squarely on TCM. The paper argues that
"a live or recently deceased infected bat species was handled by traders because of its value in TCM, and that such an infected individual, or the still infective bat or bat products, may have been the route by which the virus entered the exotic meat market in Wuhan."
Let's back up a bit and review the World Health Organization's involvement in this debacle. Just one year ago, the WHO added a chapter on TCM to its official International Classification of Diseases (ICD-11) for the first time. It apparently took this action after strong lobbying pressure from China: as a 2018 story in Nature pointed out:
"Over the past few years, [China] has been aggressively promoting TCM on the international stage both for expanding its global influence and for a share of the estimated US$50-billion global market."
This action by the WHO was the result of a long effort by its previous director (she left in 2017), Margaret Chan, who "worked closely with China" to get the WHO to endorse TCM.

Many scientists decried this action. The editors of Scientific American called it a "bad idea." Nature warned that it could "backfire," writing that it
"risks legitimizing an unfounded underlying philosophy and some unscientific practice.... Whatever its aims, the WHO’s chapter [on TCM] is unlikely to do anything other than fuel the expanding sales of largely unproven treatments."
TCM is not medicine. It's little more than a set of traditional beliefs (or a philosophy, as Nature called it) about various concoctions and their effect on one's health. Most of these beliefs have no evidence whatsoever that they provide any health benefits. Many of them derive from a pre-scientific view (which is not at all unique to China) that eating an animal gives one some of the properties of that animal. This is utter nonsense, of course.

Unfortunately, TCM is far from harmless, as I pointed out in my 2018 article. TCM has led to the horrific slaughter of the last remaining rhinoceroses in Africa in order to hack off their horns, which are sold to become part of elixirs that some people mistakenly think confer strength, virility, or other health benefits. Two years ago, National Geographic ran a heart-wrenching photo essay showing some of the awful results of rhinoceros poaching in Africa; take a look at these photos here (warning: these are very graphic).

TCM is behind the slaughter of the last remaining wild tigers, which are virtually extinct now in Asia, so that men can foolishly eat their bones, claws, and genitals in the mistaken belief that tiger parts will make them virile. Here too, National Geographic has details and photographs of cruel "tiger farms" that are almost too painful to look at.

TCM has also nearly wiped out pangolins, a completely harmless, gentle animal that has been killed in vast numbers because TCM practioners believe, wrongly, that its scale have some medicinal value. (They don't.) For more about this harmful practice, see this article I wrote in 2017.

And donkeys too: the Independent reported last November that "half the global population of donkeys could be wiped out in just five years, due to a surge in demand for their hides, which are used in traditional Chinese medicine." The world's donkey population is now in a state of crisis, according to the article, because of soaring demand in China for donkey hides, which are used to make eijao (donkey hide glue), a popular TCM product with no evidence that it has any medical benefits. Literally millions of donkeys are being slaughtered for nothing.

Before people accuse me of cultural insensitivity, let me add that there's no legitimate reason to use terms such as "Chinese" medicine, or American, Italian, Spanish, Indian, or [insert your favorite nationality] medicine. There's just medicine–if a treatment works, then it's medicine. If something doesn't work, then it's not medicine and we shouldn't sell it to people with false claims.

TCM has been a scam for decades: it was revived and heavily promoted in China by former dictator Mao Zedong, who didn't believe in it himself, but pushed it as a cheap alternative to real medicine. I won't go over that again here, but see these stories from Alan Levinovitz in Slate and David Gorski at Science-based Medicine.

The WHO is under new leadership now, but I see no sign that it's revising its endorsement of TCM, which is still lauded on the WHO website. Now we see that, in addition to the pointless slaughter of thousands of animals, some of which are likely to go extinct as a result, TCM might also create conditions that lead to new human pandemic diseases.

The new scientific paper that I mentioned above–the one that explains why trading in bat species for TCM may have caused the current pandemic, concludes that "a change in these practices is highly recommended."

That would be the understatement of the year.

It's sadly ironic that the WHO, which has in many ways been leading the fight against the Covid-19 virus, may have contributed to the conditions (live animal markets trading in wild animals) that allowed the virus to jump into the human population. It's too late to prevent that, but it's not too late for the WHO to take steps to prevent the next pandemic: they can and should remove TCM from their official guidelines.

As for China, they should recognize that the profits they make from the sales of animal parts for TCM are vastly outweighed by the harm these practices cause. China should stop promoting TCM, and it should ban the killing of wild animals for spurious medical reasons.

The first at-home coronavirus test is out, and it's useless

The FDA and a major laboratory testing company, LabCorp, just announced the first FDA-approved at-home test for COVID-19.

The problem is, it's almost useless. Here's why.

1. It's far too expensive, at $119 per test. Only wealthy people will be able to take advantage of this.
2. The kit itself (called the Pixel) is little more than a long Q-tip and saline solution. As the FDA describes it:
"LabCorp’s molecular test permits testing of a sample collected from the patient’s nose using a designated self-collection kit that contains nasal swabs and saline."
Your $119 pays for FedEx shipping both ways and for the actual test, which is done at LabCorp's facility.
3. It's far too slow. You have to apply for the kit, get it authorized by a physician, wait for the kit to arrive, ship it back, and only then will LabCorp run the test. You find out the results online. This sounds like it will take at least 5 days, probably a week. Much faster tests are available already for those who can drive to a testing site.
4. LabCorp doesn't have many of the kits available yet. Their own website, citing "limited quantities," says they will only sell the kits to healthcare workers and first responders for now.
5. For unexplained reasons, the company states that the kits aren't available at all in New York, New Jersey, Maryland, and Rhode Island. As everyone knows by now, New York has more cases than any other state in the country.

I was briefly excited when I saw this announcement. It turns out to describe a low-volume, overpriced test that will likely have little or no impact on the pandemic. We need millions of tests, freely available to everyone, not a small number of expensive tests only available to a few.

A possible treatment for COVID-19?

Amidst all of the unproven and ineffective treatments being promoted for coronavirus treatment, a new possibility has just emerged.

Scientists around the globe are devoting enormous resources to trying to develop new treatments for COVID-19, the pandemic that is sweeping across the world. So far, though, we don't have any effective therapies or vaccines.

That might be about to change. What's particularly exciting is that this new treatment uses a widely-available drug that has already been shown to be safe in humans.

In a new preprint, a team of my colleagues at Johns Hopkins University School of Medicine, led by Maximilian Konig, Bert Vogelstein, Joshua Vogelstein, Susan Athey, Shibin Zhou, and Chetan Bettegowda, describe the potential of prazosin to slow down and possibly prevent one of the worst effects of COVID-19: the cytokine storm.

[Some background: a cytokine storm is an extreme immune response of your own body. When coronavirus (SARS-CoV-2) enters the lungs, your immune system responds with virus-fighting cells that release small proteins called cytokines. In some cases, the immune system just keeps amplifying its response, sending more and more cytokines even though the infection might be under control. If it gets too bad, the cytokine storm itself may be fatal. Cytokine storms have been implicated in other viral diseases, including influenza and SARS.]

Let me start with a caveat: if prazosin works, it isn't a cure. However, it might prevent the need to go on a ventilator, which would be a huge benefit in a country (and a world) that has a severe shortage of ventilators right now. Even more important, it might save patients with severe COVID-19 from dying.

Several of the scientists involved in this new study have shown previously that drugs like prazosin (which are known technically as alpha-1AR antagonists) can prevent a cytokine storm–in mice. They realized that results in mice often fail to translate to humans, but in the current pandemic, how could they find time to do a new study?

They didn't: instead, they looked at a medical database and collected records from 13,125 men who had acute respiratory distress (ARD) from a variety of causes in the years 2007-2015. ARD is not the same as COVID-19, but it's similar; and if a cytokine storm occurs in ARD, patients are more likely to require a ventilator and/or die. Because prazosin is widely used by men (most commonly for enlarged prostates), they were able to compare the outcomes of men who had incidentally been taking prazosin to men who hadn't.

The results: men who had been taking prazosin had a 22% lower risk of either needing a ventilator or dying. That's not a huge effect, but it could be a game changer for our overwhelmed hospitals in the midst of this pandemic. Even a modest reduction in the number of patients needing ventilators–or dying–would be a huge win for public health. Also, the patients in this retrospective study weren't taking prazosin to treat their respiratory distress, and it's possible that higher doses might have a larger effect.

There are many more caveats here. First, the study I'm describing is a medRxiv preprint, meaning that it has not been peer-reviewed. In addition, the data are from a retrospective study of men who had a different disease, not COVID-19. So maybe prazosin won't work to prevent cytokine storms caused by the coronavirus.

But maybe it will. My colleagues shared their preprint with me because they are convinced that, if nothing else, their hypothesis needs to be examined by as many scientists and doctors as possible. They are starting their own clinical trial, but they hope that these preliminary findings "will inspire immediate clinical trials in countries now desperate for new ways to reduce hospital admissions, ventilator needs, sickness, and death."

Prazosin has been in medical use since 1974 and is widely available and inexpensive. It's one of the most promising treatments I've heard of, far more promising than hydroxychloroquine. Even if it only slightly reduces the need for ventilators, it may have a huge impact on this pandemic. We need to start investigating it right away.

(Note: I've made it a rule not to write columns about my own or my colleagues' scientific accomplishments. Many rules are being broken in this pandemic, and I decided the urgency of this potential treatment was more than sufficient to break my usual rule.)

No, megadoses of vitamin C won't cure a coronavirus infection

The world is awash in treatments for COVID-19, the illness caused by coronavirus. Or at least that's what you might think if you just searched the internet.

The truth is, we don't yet have any effective treatments for COVID-19, although thousands of scientists are working furiously to try to create them.

Today we'll look at just one of the supposed treatments, which is being actively promoted on social media and many websites: vitamin C.

For those who don't want to read further, I'll start with the conclusion: vitamin C won't help to prevent or to treat coronavirus infection. I wish we had such a simple solution, but we don't.

Now let's back up a bit. Why would anyone think that vitamin C might be effective in treating this terrible virus? Vitamin C is an essential nutrient, and we all need it, but most people get plenty of vitamin C in their normal diet. As I've written before, taking vitamin C supplements is unnecessary but probably harmless, although megadoses carry the risk of kidney stones.

The modern craze with vitamin C started with Linus Pauling, a brilliant chemist and a Nobel Prize winner. Late in his career, he wrote a book promoting vitamin C as a miracle cure for many illnesses, including the common cold (which is caused by a virus). He had very little good evidence for this belief, but his promotion of vitamin C led to hundreds of studies testing his hypothesis. The bottom line: vitamin C doesn't work at preventing or curing the common cold. (See Paul Offit's book if you want more details on this and many other "miracle" cures.)

But wait, someone might object: haven't some of those vitamin C studies (as in this review paper) shown a benefit against the common cold? Well yes, but when you run hundreds of studies of a treatment that doesn't work, this is what happens: negative studies are hard to get published, but positive studies are easier. Run enough studies, and a few of them, merely by chance, will show a small positive effect. That's what we've seen with vitamin C.

Today, though, everyone is looking for a cure for COVID-19, and not surprisingly, many people (even some doctors) are claiming vitamin C is the answer. I've seen Twitter users explain, very confidently, that you just need to take 12,000 mg of vitamin C and you'll get better. This website comes right out and states that high-dose vitamin C will cure coronavirus, based on a widely-shared video from a doctor in China. (I won't provide the link because it has already done enough damage.)

It's almost impossible to disprove a claim that a treatment works. For example, I could claim that ginger snap cookies helps to prevent coronavirus infection. That's right! Ginger snaps, made with real ginger, which seems to have magical curative properties. If you object, I could demand that you prove me wrong–but the onus is on me, as the one making the claim, to first provide some genuine evidence. We haven't seen anything like that for vitamin C.

We need well-controlled experiments to know with any confidence that a treatment works. Some doctors at Wuhan University have started a trial of vitamin C to see if it has any benefits for COVID-19, but results won't be available for many months. I'm skeptical, but at least they're approaching the question the right way.

Dozens of studies of new treatments for COVID19 are being launched right now, with remarkable speed due to the urgency of the pandemic.The WHO has just launched trials of the 4 most promising existing drugs (which don't include vitamin C, I should add). To obtain a believable, positive result, we need to see evidence that a carefully administered treatment provides a significant benefit over what we're doing now–which is little more than supportive care, unfortunately.

Meanwhile, we'll have to wait and hope that one of the plausible efforts currently under way will yield an effective treatment. We've been down this road too many times with vitamin C, though, and the chances that it will have any effect are, based on past experience, close to zero.

FDA to coronavirus scammers: watch out!

The coronavirus pandemic has the whole world's attention. For now, there's no treatment and definitely no cure for COVID-19, the disease caused by the virus.

That hasn't stopped charlatans and scammers to claim that they have treatments, and to offer them for sale. I often wonder (sometimes in this column) whether people selling bogus cures truly believe their own statements, or whether they are just liars who know they're selling nonsense. In the former case, they are merely misinformed or ignorant. In the latter case, they are con artists who deserve our scorn. In either case, though, we shouldn't be buying their products.

Let's look at a few marketers who have gotten the attention of regulators just this past week. In the U.S., the FTC and the FDA announced that they just took the following action:
"The FTC and FDA have jointly issued warning letters to seven sellers of unapproved and misbranded products, claiming they can treat or prevent the Coronavirus. The companies’ products include teas, essential oils, and colloidal silver."
That's right, scammers: you better clean up your acts, or else we're going to ... write you a letter!

To be fair, it's not the fault of the FTC or the FDA that their enforcement powers are so weak. Congress has severely limited the ability of the FDA to regulate businesses who sell supplements and other scams, as I've written before. The supplement industry is big business, and they've lobbied Congress–very successfully–to prevent any truly effective regulation.

So here are the seven scammers whose claims were so outrageous that the FDA and the FTC have already (in just a few weeks, record time for these agencies) notified them that they must stop their false advertising:

The products offered by these dishonest marketers include essential oils, teas, and colloidal silver. None of them work at all against coronavirus. The FTC warning letters point to their websites, Twitter, and Facebook.

I checked them out to see if the claims are still there, and here's what I found.

Twitter suspended the Quinessence account for violating its rules, but the N-ergetics Twitter account is still live, and it features a claim that "Colloidal Silver Benefits against Antibiotic resistant ZIKA, Viruses, Superbugs, Flu." (That claim is false.)

Vivify Holistic was using Facebook to promote false claims (according to the FDA letter), and Facebook has apparently shut down that page. GuruNanda's FB and Twitter accounts are both active, but they seem to have removed their claims about coronavirus.

Vital Silver's FB page has a posting from March 9, apparently prompted by the FDA letter, stating that "These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease." This is the standard disclaimer that all supplement makers use. But then they added this "The content of this page are based on my religious beliefs as protected by the First Amendment." That's a new one to me. Nonetheless, their product still can't cure coronavirus.

Herbal Amy promotes her products through Facebook and a website: the FDA told her to take down her "Coronavirus protocol" products (she had many of them), which she seems to have done. Her FB page is still active, and she explains there that "we have had a Coronavirus protocol for sale for the last 2.5 YEARS. This is not a new herbal formula or a new virus." Huh? So her argument is that she has been making a false claim for a long time now?

Jim Bakker is another story. For those too young to remember, Bakker was a popular televangelist in the 1970s and 1980s who was convicted of 24 counts of financial fraud. He served five years in prison and resumed his television preaching in 2003. One of the ways he makes money is selling colloidal silver (tiny silver particles suspended in liquid), which he recently claimed could cure coronavirus. This led the FDA, the FTC, and the NY Attorney General to order Bakker to stop his false advertising.

The state of Missouri has gone further than the feeble FDA: they are suing Jim Bakker to stop him from harming people. The Missouri attorney general charged that Bakker is
"falsely promising to consumers that Silver Solution can cure, eliminate, kill or deactivate coronavirus and/or boost elderly consumers' immune system and help keep them healthy when there is, in fact, no vaccine, pill, potion or other product available to treat or cure coronavirus disease 2019."
Good for the Missouri AG. Time will tell if all of these demands will change Bakker's behavior.

I should add that colloidal silver doesn't treat anything, and in fact it can be truly harmful. A JAMA Dermatology article a few years ago described it as "dangerous and readily available." Stay away from this stuff.

This article wouldn't be complete if I didn't add one more scam artist: the far-right conspiracy theorist Alex Jones has claimed, ridiculously, that he has a toothpaste that can “kills the whole SARS-corona family at point-blank range.” No such toothpaste exists, and the New York attorney general has ordered Jones to stop.

As I wrote at the beginning, I can't know for certain which of the people selling these products truly believe they have a treatment for COVID-19 and which of them are knowingly lying. But consumers should beware: false claims will continue to appear as long as there's money to be made.

No one has a treatment for coronavirus infection. The WHO has a site up now, which I recommend, that dispels many of the myths. I'll close with a quote from that site:
"To date, there is no specific medicine recommended to prevent or treat the new coronavirus (2019-nCoV)."

Coronavirus: time to panic?

The world is starting to panic over the 2019 coronavirus outbreak. Are we over-reacting?

Here are 3 reasons why we should panic, followed by 4 reasons why we shouldn't.
  1. The virus, 2019-nCoV, is completely new to humans, and we don't know exactly how bad it will get. As of 29 February, it has already killed nearly 3,000 people, over 2,700 of them in China. 
  2. It appears to be very infectious. Cases are now appearing in people who didn't travel to China, and who didn't have any contact with known cases. Coronavirus illness (newl named COVID-19) has now been reported in over 60 countries, on every continent except Antarctica. No matter where you are, it is probably coming your way.
  3. The mortality rate has been reported to be as high as 2%.  The Johns Hopkins University tracking site makes it appear even higher, with 2,933 deaths out of 85,688 cases, which is over 3%. By comparison, the 1918 Influenza pandemic had a mortality rate of around 2-3%, and in that epidemic, the worst in modern history, 30–50 million people died, which was 1.7% of the world's population at the time.  Extrapolating to today's population of 7.7 billion people, a virus that deadly would kill 130 million people.
This seems really bad. So perhaps we are not overreacting.

On the other hand, there are several very good reasons why we should stay calm.
  1. The mortality rate is probably much, much less than 2%. The rapid spread of COVID-19 suggests that many more people are infected than those who have confirmed cases. The number of people who have no symptoms or very mild symptoms is likely to be ten times as high as the number of reported cases. (This is only a guess.) That would mean the mortality rate might be only 0.2%, or even lower. We still don't know. (The cruise ship that was quarantined in the Japan had just over 700 cases, and 6 people have died, suggesting a mortality rate of 1%.)
  2. The reported mortality rate is dramatically lower in young people. If you are under 30, you can probably relax a bit. However, if you are over 70, the mortality rate is frighteningly high, 8-15%
  3. 2,933 deaths is a tragedy, but it's a tiny number compared to the annual deaths from the influenza virus, which we have learned to live with. In the U.S. alone, the CDC estimates that 12,000–61,000 people die each year from the flu (the number varies a lot because the virus itself changes from year to year), and 9-45 million people get sick. The worldwide totals are far higher. So in terms of numbers, the world is definitely over-reacting to the new coronavirus.
  4. Infectious viruses tended to become milder over time. At least 4 other coronaviruses already circulate among humans, causing little more than mild cold symptoms. It is quite possible that the virus causing COVID-19, nCoV-19, may mutate to become a milder disease as well. RNA viruses mutate extremely rapidly, and from an evolutionary perspective, viruses adapt to their hosts by becoming milder. (My perspective is based in part on my past research on the influenza virus.) From the virus's point of view, it can't spread itself around if the host is too sick.
What can we do? A few things:
  1. Panic isn't helpful. Don't panic.
  2. In the short term, the best response will be to develop a vaccine. (Dr. Peter Hotez and colleagues at Baylor College of Medicine are already working on one.) We need to dramatically increase government investment in vaccine development. It seems that the U.S. is doing that, although not quickly enough.
  3. If you feel sick, stay home.
  4. It's probably best to avoid travel to a location where COVID-19 is known to be circulating widely. Right now this list includes China and Iran, but it could grow in the coming weeks.
  5. In the longer term, we need to increase rather than cut biomedical research funding. Even if we get a vaccine, we still need actual treatments, not only for COVID-19 but for other viruses. (Most viruses are incurable with current technology.) The recent proposal out of the White House aims to cut NIH funding by 7% and CDC funding by 16%. As anyone following the coronavirus news now realizes, the CDC is responsible for tracking the virus in the U.S. and for coordinating our public health measures to respond to the outbreak.
Finally, I should add a note of caution about the bogus treatments already being hawked by peddlers of pseudoscience. There are multiple websites and Facebook pages, including some anti-vaccine sites, already claiming they know how to treat coronavirus illness. (I won't link to any of them, as I don't want to give them the traffic.) These are complete scams. No one has any treatment that will prevent or cure COVID-19, but if we make the investment, we'll get a treatment one day.

(Note: the WHO has renamed the virus SARS-CoV-2, but The Lancet article that first described its genome calls it nCoV-19.)