Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now”

by Jody Lanard and Peter M. Sandman

NOTE FROM IAN: The expert risk communication team of Lanard and Sandman has given me permission to post their very well-considered reply to my question of them just on 24 hours ago, here. I’m not an expert in this space so I sought their very experienced thoughts about changing my tone around the COVID-19 multi-country epidemic before I started doing so yesterday. Here is what they had to say…

We are starting to hear from experts and officials who now believe a COVID-19 pandemic is more and more likely.  They want to use the “P word,” and also start talking more about what communities and individuals can and should do to prepare.  On February 22, Australian virologist Ian Mackay asked us for our thoughts on this phase of COVID-19 risk communication. 

Here is our response.

Yes, it is past time to say “pandemic” – and to stop saying “stop”

It’s a good time to think about how to use the “P word” (pandemic) in talking about COVID-19.  Or rather, it is past time.

It is important to help people understand that while you think – if you do think so – that this is going to be pandemic in terms of becoming very widespread,  no one knows yet how much severe disease there will be around the world over short periods of time.  “Will it be a mild, or moderate, or severe pandemic?  Too soon to say, but at the moment, there are some tentative signs that….”  

The most crucial (and overdue) risk communication task for the next few days is to help people visualize their communities when “keeping it out” – containment – is no longer relevant.  The P word is a good way to launch this message.  

But the P word alone won’t help the public understand what’s about to change: the end of most quarantines, travel restrictions, contact tracing, and other measures designed to keep “them” from infecting “us,” and the switch to measures like canceling mass events designed to keep us from infecting each other.  

We are near-certain that the desperate-sounding last-ditch containment messaging of recent days is contributing to a massive global misperception about the near-term future.  The theme of WHO’s and many governments’ messages – that the “window of opportunity” to stop spread of the virus is closing – is like the famous cover page of Nevil Shute’s On the Beach: “There is still time … Brother.”

For weeks we have been trying to get officials to talk early about the main goal of containment: to slow the spread of the virus, not to stop it.  And to explain that containment efforts would eventually end.  And to help people learn about “after containment.”  This risk communication has not happened yet in most places.

So here is one more pitch for openness about containment.  Officials: Please read Containment as Signal, Swine Flu Risk Miscommunication, which we wrote in 2009.  

One horrible effect of this continued “stop the pandemic” daydream masquerading as a policy goal: It is driving counter-productive and outrage-inducing measures by many countries against travelers from other countries, even their own citizens back from other countries.  But possibly more horrible: The messaging is driving resources toward “stopping,” and away from the main potential benefit of containment – slowing the spread of the pandemic and thereby buying a little more time to prepare for what’s coming. 

We hope that governments and healthcare institutions are using this time wisely.  We know that ordinary citizens are not being asked to do so.  In most countries – including our United States and your Australia – ordinary citizens have not been asked to prepare.  Instead, they have been led to expect that their governments will keep the virus from their doors.

Take the risk of scaring people

Whenever we introduce the word “pandemic,” it’s important to validate that it’s a scary word – both to experts and to non-experts – because it justifiably contains the implication of something potentially really bad, and definitely really disruptive, for an unknown period of time.  This implication is true and unavoidable, even if the overall pattern of disease ends up being mild, like the 2009-10 “swine flu” pandemic.

Validate also that some people may accuse you of fear-mongering.  And respond that hiding your strong professional opinion about this pandemic-to-be would be immoral, or not in keeping with your commitment to transparency, or unforgivably unprofessional, or derelict in your duty to warn, or whatever feels truest in your heart.

It may help to consider the “damned if you do, damned if you don’t” fallacy.  Feel free to say that “Jody Lanard and Peter Sandman say” that officials or experts – in this case YOU – are “darned if you do anddamned if you don’t.”  You’re only darned if you warn about something that turns out minor.  But you’re damned, and rightly so, if you fail to warn about something that turns out serious.  

It’s simply not true, in principle or in practice, that you are damned if you do and damned if you don’t!  Over-alarming risk messages are far more forgivable than over-reassuring ones.

Push people to prepare, and guide their prep 

This is the most culpable neglected messaging in many countries at this point.

The main readiness stuff we routinely see from official and expert sources is either “DON’T get ready!” (masks), or “Do what we’ve always told you to do!” (hand hygiene and non-mask respiratory etiquette).

The general public, and many categories of civil society, are not actively being recruited to do anything different in the face of COVID-19 approaching.

A fair number of health care workers and communication officers tell us their hospitals and healthcare systems are just barely communicating about COVID-19. They want to be involved in how to prepare for “business not as usual.”  We’re guessing that many hospital managements are in fact preparing for COVID-19, but we worry that they’re doing it too quietly, without enough effort to prepare their staff. 

Lots of businesses, especially smaller ones, are doing off-the-cuff pre-pandemic planning.  Several trade journals have articles about how specific industries should prepare for a likely pandemic.  Around February 10, the U.S. Centers for Disease Control and Prevention posted interim guidance for businesses.  But we have seen almost nothing in mainstream media citing this guidance, or recommending business continuity strategies like urgent cross-training so that core functions won’t be derailed because certain key employees are out sick, for instance.

Pandemic planning research suggests that employees are likeliest to say they will show up for work during a pandemic if three specs are met – if they think their family is reasonably safe; if they think their employer is being candid with them about the situation; and if they have a pandemic-specific job assignment in addition to or different from their routine “peacetime” assignment.

Hardly any officials are telling civil society and the general public how to get ready for this pandemic.

Even officials who say very alarming things about the prospects of a pandemic mostly focus on how their agencies are preparing, not on how the people they misperceive as “audience” should prepare.  “Audience” is the wrong frame.  We are all stakeholders, and we don’t just want to hear what officials are doing.  We want to hear what we can do too.  

We want – and need – to hear advice like this: 

  • Try to get a few extra months’ worth of prescription meds, if possible. 
  • Think through now how we will take care of sick family members while trying not to get infected. 
  • Cross-train key staff at work so one person’s absence won’t derail our organization’s ability to function.
  • Practice touching our faces less. So how about a face-counter app like the step-counters so many of us use? 
  • Replace handshakes with elbow-bumps (the “Ebola handshake”). 
  • Start building harm-reduction habits like pushing elevator buttons with a knuckle instead of a fingertip. 

There is so much for people to do, and to practice doing in advance.

Preparedness is emotional too

Suggesting things people can do to prepare for a possible hard time to come doesn’t just get them better prepared logistically.  It also helps get them better prepared emotionally.  It helps get them through the Oh My God (OMG) moment everyone needs to have, and needs to get through, preferably without being accused of hysteria.

It is better to get through this OMG moment now rather than later.  

Offering people a list of preparedness steps to choose among means that those who are worried and feeling helpless can better bear their worry, and those who are beyond worry and deep into denial can better face their worry.  

Yet another benefit: The more people who are making preparedness efforts, the more connected to each other they feel.  Pandemic preparedness should be a communitarian experience.  When a colleague offers you an elbow bump instead of a handshake, your mind goes to those lists of preparedness recommendations you’ve been seeing, and you feel part of a community that’s getting ready together.

This OMG realization that we have termed the “adjustment reaction” (see http://www.psandman.com/col/teachable.htm) is a step that is hard to skip on the way to the new normal.  Going through it before a crisis is full-blown is more conducive to resilience, coping, and rational response than going through it mid-crisis.  Officials make a mistake when they sugarcoat alarming information, postponing the public’s adjustment reaction in the vain hope that they can avoid it altogether.

Specific pandemic preparedness messages

Below are links to specific preparedness messaging we drafted for a possible H5N1 pandemic.  The links are all from our 2007 website column What to Say When a Pandemic Looks Imminent: Messaging for WHO Phases Four and Five.  Each item is in two parts – a draft message (a summary sentence followed by a few paragraphs of elaboration), then a risk communication discussion of why we think it’s an appropriate pre-pandemic message.  Because these were written with H5N1 in mind, the pandemic they contemplate is more severe and less likely than the one we contemplate today.  So some changes may be called for – but frankly, in our judgment, not many.

One of the scariest messaging failures in the developed world is not telling people vividly about what the end of containment will look like, for instance the end of contact-tracing and most quarantines. 

The FAQs on the Singapore Ministry of Health webpage (https://www.moh.gov.sg/covid-19/faqs) can serve as a model that other developed countries can adapt to start talking to their publics about this now, to reduce the shock and anger when governments stop trying to contain all identified cases. 

What’s working for us

We’d like to share with you some of our recent everyday life experiences in talking about pandemic preparedness with people who perceive us as a bit knowledgeable about what may be on the horizon.  Some of this overlaps with the more generic comments above.

1.      We’ve found it useful to tell friends and family to try to get ahead on their medical prescriptions if they can, in case of very predictable supply chain disruptions, and so they won’t have to go out to the pharmacy at a time when there may be long lines of sick people.  This helps them in a practical sense, but it also makes them visualize – often for the first time – how a pandemic may impact them in their everyday lives, even if they don’t actually catch COVID-19.  It simultaneously gives them a small “Oh my God” moment (an emotional rehearsal about the future) – and something to do about it right away to help them get through the adjustment reaction.

2.      We also recommend that people might want to slowly (so no one will accuse them of panic-buying) start to stock up on enough non-perishable food to last their households through several weeks of social distancing at home during an intense wave of transmission in their community.  This too seems to get through emotionally, as well as being useful logistically.

3.      Three other recommendations that we feel have gone over well with our friends and acquaintances:

  • Suggesting practical organizational things they and their organizations can do to get ready, such as cross-training to mitigate absenteeism.
  • Suggesting that people make plans for childcare when they are sick, or when their child is sick.

4.      And the example we like the best, because it gives every single person an immediate action that they can take over and over: Right now, today, start practicing not touching your face when you are out and about!  You probably won’t be able to do it perfectly, but you can greatly reduce the frequency of potential self-inoculation.  You can even institute a buddy system, where friends and colleagues are asked to remind each other when someone scratches her eyelid or rubs his nose.  As we noted earlier, someone should develop a face-touching app – instead of a step-counting app to encourage you to walk more, how about an app to encourage you to auto-inoculate less!  And track your progress, and compete with your friends, even!

The last message on our list – to practice and try to form a new habit – has several immediate and longer-term benefits.

Having something genuinely useful to do can bind anxiety or reduce apathy.  You feel less helpless and less passive.

And you can see yourself improving. 

And you can work on your new habit alone, and also in a pro-social communitarian way.  Others can help you do it, and you can help them. 

And it yields real harm reduction!  It is arguably the endpoint of what washing your hands is for, and it helps when you can’t wash your hands out in the world.

Like all good pandemic preparedness recommendations, it helps you rehearse emotionally, as well as logistically. 

The bottom line

Every single official we know is having multiple “Oh my God” moments, as new COVID-19 developments occur and new findings emerge.  OMG – there is a fair amount of transmission by infected people with mild or subclinical cases!  OMG – there is a high viral load early on in nasal and pharyngeal samples!  OMG – the Diamond Princess, how can that have been allowed to happen!  And on and on.  

Officials help each other through those moments.  They go home and tell their families and friends, sharing the OMG sensation.  And then what do they tell the public?  That they understand that “people are concerned” (as if they themselves weren’t alarmed), but “the risk is low and there’s nothing you need to do now.”

Ian, it sounds like you want to argue on behalf of preparedness.  Encouraging all stakeholders to prepare logistically should start now, if not sooner.  And you are in a position not just to encourage logistical preparedness, but also to encourage government sources and other experts like yourself to do the same.  Perhaps even more important, in our judgment: You can try to encourage emotional preparedness, and try to encourage other official and expert sources to encourage emotional preparedness – guiding people’s OMG adjustment reactions instead of trying to stamp them out.

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316 thoughts on “Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now””

  1. I have been following Dr. Mackay for a few weeks on twitter. He has been the only professional that has been level headed and certainly trying to communicate that we could very well see a Pandemic. I’m here in the US and we are being kept in the dark from CDC and other institutions. Currently we don’t even have test kits that work let alone them being sent to healthcare facilities and hospitals. I really want to commend you and your staff on this very well written article and being transparent with your followers!!!

      1. We’re at the critical stage of OMG reactions & the test kits are not reliable?! The United States government really need to get off the picket fence that everything is peaches & creme. Trust The people as they want us to trust our government, hog wash! Thank you for your article on top of another informative article. U.S. government needs to get real, besides The people deserve to know in real time not government time. Sincerely in Southern Oregon.

      2. The test kits actually do work – the problem was that the negative controls failed in some labs. The test kits contain a negative control and a positive control. The negative control ensures the test won’t call something positive if it is negative. The positive control ensures that the test can actually pick up positives. Both controls need to be run – and pass – in order for the test to be performed.

        In several of these labs (but not all of them), the negative control was positive, so the tests could not be performed. There’s a few possibilities as to why this was the case. The test is extremely sensitive, which means it can detect very small/low amounts of the virus. The negative controls could have become contaminated either in the manufacturing process or at the lab while the test was being performed. The fact that the negative control was positive in only some labs while was negative in others suggests to me (I’m a clinical laboratory scientists) user/technician error – although it is also possible only certain lot numbers were affected in the manufacturing process.

  2. Thanks for taking the time to publish this. Your site has some very practical advice on how to prepare for if CovId-19 spreads in Australia or anywhere.

    Please keep updating and sharing.

  3. I am so frustrated that this message is not out there (another US resident here). I had thought last week of stopping in to our local EMC and ask what I can volunteer to help do. I have been giving this message to my family and friends for the past 2 weeks. I am certain many thought I was being alarmist, including a nurse at our local hospital, but I feel obligated to step in and convey this message as our community leaders are not doing do. Please everyone pass this information along.

  4. Dr MacKay has been a light in the darkness. He has accepted the concern I have as a non clinical professional. He has been honest and helped me understand issues in layman’s terms. He has not sensationalised things. Nor has he played down their potential severity. He is a credit to his role. I wish more followed his example.

  5. if you could be less posh when you select the words to use to convey the message then maybe also non mother tongue people can understand what you write. bloody ego always get in the way.

    1. respectfully, rewrite the main points in your own language and make it available to your community members, perhaps along side the original post….It could make all the difference to your community.

  6. The best positive action all readers here can take is to share this pages as widely as humanly possible. Start doing it NOW. Doing so will in the long term save some lives and more than that help everyone who reads it adjust emotionally to what is coming. Share…..Share…..Share…..Share….. OK folks?

  7. I forwarded this to my family and asked them to consider forwarding to others- “The best article I have that speaks to the public and actions to take”… THANK YOU

  8. Thank you Dr. Mackay, Dr. Lanard and Dr. Sandman for this very informative response and the reassurance that directing people to start preparing is the right thing. People are pretty much acting like we live in an impenetrable bubble and we have a low risk of this virus causing any harm. I have already started preparing this week by buying non-perishable foods and extra toilet paper (yes, that became quite the commodity in China). Hopefully it won’t come to needing to self quarantine at home but just in case we have already prepared for worst case scenario ahead of time. Not like the food or TP will go bad, can always use it later if it wasn’t needed for this viral outbreak.

    As a community pharmacist, I am a bit concerned over the complete lack of preparedness in the US. There has been absolutely zero instructions, training, preparation, and no PPE distributed. If this hits our communities we are the first ones who will encounter sick patients and be exposed to possibly spread to others. Then who will run our pharmacies and provide life sustaining medications to the public? It’s not like each company has a surplus of standby pharmacists. It’s quite disturbing we don’t seem to be included in the healthcare professionals that need to be provided PPE. I sure know our companies won’t provide this. I have encouraged my patients who say they still have some of their medication and don’t need to pick up their refill that it’s a good idea to have an extra supply of medications in case of environmental or biological disaster. 😉

    Just putting it out there how ill prepared we are in our communities for this virus. We should have prepared our country for viral pandemics years ago – there should have been mandatory storage of PPE at identified areas of importance in communities (not just hospitals) and procedures/guidelines/training in place. Why are we scrambling now? We knew something like this could happen on a global scale.

    1. There are caches overseen by local health departments, most hospitals that I have worked with over the past 15 years (east and west coast US) have caches of PPE. The Strategic National Stockpile (SNS) has caches of medications that can be deployed in pandemic. Have you checked CDC and SNS websites? I agree with most of the sentiments here but feel compelled to add that there actually is planning in place. Messaging to the public which is what I believe this article correctly points out has not addressed the need for community-wide personal, family and business preparedness and continuity planning. Thank you.

    2. There was a plan set up during the Obama Administration to prepare for the Ebola outbreak; but President Trump did away with ALL the preparedness & let goo all the experts simply because it had Obama’s name attached to it. NOW, the U.S. is TOTALLY unprepared. RIDICULOUS!

  9. Excellent advice hopefully it will be well distributed in time.
    The potential for panic might well add to the casualty numbers.
    Thank you👍

  10. Masks still help to reduce the risk for all nearby people to get infected, because infected but asymptomatic people have to wear them too.

  11. may I say that while I appreciate the sentiment of the article in getting comfortable with the “p” word, the fact of the matter is that none of the suggestions that you have given are any different from what people are doing whether you use the Pandemic word or not. We’ve had people panic buying in Hong Kong; face masks being hoarded; hand sanitizers being used more frequently – other than changing the habit of face touching (which feels like a stretch that you can educate and train in time) – there’s no practical information here. So, if I were a person of an excitable nature (!), saying “p” is not at all useful – I will panic because I will immediately see that the measures that you are giving are generic ones that I hear every year for the flu, and there is no cure.

    So if I were a public health official – this advice is actually more harmful than not uttering the pandemic word – there is no upside. It will only exacerbate the panic and chaos and lead to even more panic buying and social segregation (and racism).

    1. Hi…you can get on a Facebook page, there are several “prepper” sights that help eachother out..one is Intelligent Prepper the other is Casual Prepper, lots of good information on what you should be doing. Good luck

  12. Fantastic piece of information and advice! It should be shared by all who read it, even if just the “what’s working for us section”. Thanks!

  13. OMG! Very thoughtful comments and useful ideas. I am sharing this article with my extended family so we can all start our pre-pandemic preparation NOW. Thank you.

  14. Hi,
    Is there any particular mask we should buy? And does alcohol gel kill the virus? One of the parents from my son’s school was on that China plane, and although the principal says they is no need for concern, should I take him out of year 9? And if I should, how long for?

    1. Masks that aren’t fit well or disposed of and used really carefully, can can actually increase the risk of you getting infected.
      I wouldn’t take my child out of school based on that description. If the person wasn’t showing signs at the time, and wasn’t sitting close to your child if they were symptomatic, and your child washed their hands if they used the plane toilets then there’s not much to worry about. There haven’t been a lot of plane-acquired cases reported thus far.

  15. Canada here and although we don’t have many cases today we know that could change in a heartbeat, despite what our Top Doctor says.So a few weeks ago I bought two N95 masks. Still can’t find any disinfectant soap but I did buy some disinfectant wipes.Tonight started buying non-perishable food. Quite worried about prescriptions because if I ran out I probably wouldn’t survive.

    Thank you so much for this. It’s the sort of practical advice that ordinary people must have to help them prepare. Simply telling us that Canada is at low risk over and over again gives people a false sense of security, which is unacceptable.

    1. Standard hand soap and water are fine for handwashing. 20 secs of washing and dry well. Get a surface spray for cleaning surfaces in your home. You don’t need special wipes. Talk to your Doctor about prescriptions.

    2. I’ve read that if the public buys N95 masks that will create shortages for the medical professionals who are treating the infected, and need them more than the rest of us. Anyone know for sure whether that’s true?

  16. Excellent, rational advice. Too bad the CDC isn’t taking it. As far as I’m concerned they’re falling down on the job. Communication, communication, communication is the most important thing at this point. And they’re not doing it.

    They should be out there holding press conferences if not every day, then at least twice a week, conveying rational information to people, stamping out as ignorant and dangerous all these wacky conspiracy theories going around, repeatedly banging into people’s heads accurate info (and yes, I know that not all people are willing to absorb rational info, but you still have to do it).

    Even if Covid-19 isn’t “The Coming Plague,” as the superb Laurie Garrett wrote about 25 years ago, there will be one sooner or later. And all the information that should be conveyed now will still be useful in the future. But it’s not being conveyed.

    If this thing spreads in the U.S., I’m afraid we’re in for a world of hurt, not lease because Americans aren’t as docile and obedient as the Chinese. We have a lot of gun-toting yahoos running around who won’t take kindly to being told they have to self-quarantine nor that they can’t buy whatever they want whenever they want. I can see them holding up drugstores, supermarkets, hospitals, clinics at gunpoint, demanding whatever their lunatic minds have told them to demand. It won’t be pretty.

  17. I am new to Twitter and still figuring out how it works but I am happy to have come across this and I will now be “following” you! Thank you so much for putting it into totally understandable terms for we common folk!

  18. Thank you!!!

    We created MOWSA-Make Our World Safe Again on Facebook to try to identify potential risks and have people work together to provide ideas how to reduce those risks or suggest others.

    By slowing the spread rate may buy us the time we need to create a vaccine which right now is likely too late in coming. A controlled spread also makes hospital admissions easier to deal with and provides better care for everyone. Along the way be may be able to develop better treatments too further reducing the impacts this virus may have.

    I thank you for being honest with people. We need to understand, deal with the omg times and begin working together to slow it down as much as possible.

  19. Very informative article; are there longer term implications that might make it more of a problem to warn of a crisis that does not play out.

  20. I’m a food courier. I tried to make other couriers on facebook aware of the possible danger, and got laughed off the site. Well, I’m going to start using gloves, or rather a glove, to open doors and such, and my clean hand to pick up the food. And hand sanitizer (which I did before).

  21. If the virus “goes pandemic”, would this mean millions get infected, or billions? Could you provide a rough estimate?

    I’ve seen claims that it could infect as much as 40%-70% of the global population. Is this really plausible?

  22. If this “goes pandemic”, does that mean millions or billions infected?

    I’ve seen estimates that this could infect 40%-70% of the world population. Is that alarmist, or a realistic/plausible prediction?

  23. Thank you for your straight forward advice on preparing for pandemic. I have stage 2 emphysema and servers persistent asthma. I have been quietly terrified of this virus. I feel calmer now by reading and taking your advice. Again, thank you.

  24. Been following this outbreak since I first heard of mysterious pneumonia cases back at the end of December/early January in a small little snippet on the radio. I have to say, I have become increasingly alarmed..not so much by those “numbers” *cough cough* China is giving us..but the sheer magnitude of that countries response. In my lifetime I have never seen the like in response to a virus. I knew then, this has to be one hell of a virus for China to risk everything to tamp it down.
    So here we are, a couple months later and despite the efforts in China, looks like we all get to ride the virus on parade train.
    I have been preparing quietly, in the past couple weeks as it looks more eminent I have been telling my family and friends; who thanks to the US Government, CDC and the political dog and pony show in the press everyday, had absolutely no idea there was even an epidemic going on in China..sheesh.
    People need to be made aware, or there is going to be such panic. They should have been doing this slowly and deliberately, instead they totally shut it down..

  25. Thank you for your amazing transparency, and encouragement to prepare. And too, thank you for addressing the faction of our fellow humans who refuse to believe Anything beyond the ‘its ok’ CDC and ‘WHO official address.

    I’d like to take a moment to touch upon the latter if I may, as it’s heaviest in my heart. The basic law of science is ‘everything effects everything else’. With Covid-19, a clearer example of what this demonstrates in practical cause and effect couldn’t be clearer. Which is to say—when those in our closest family units refuse to believe there is a problem until someone actually gets sick—it’s to late. Those family members have the potential to infect the rest of us who have already embraced the usage of protective barriers (face masks, gloves, hair nets, goggles) whilst out. It does no good at all, if we are living with those in absolute denial. They’re disbelief, can effectively kill the rest of us…and there is no remedy for it. None.

    I believe that medical Marshal law will absolutely become our reality in the United States. To control panic and riots and gate crashing of stores. This is what being LIED to will result in. All they’ve done is delay the consequence until they make the announcement of Medical Martial, Law to control the consequences of their own deliberate lies. Well done.

    I will close this by admitting my frustration and confess further that it is tinged with a healthy dose of fear. I am not afraid of the virus. I am afraid of the people who refuse to see the truth and deliberately place others in danger by becoming super spreaders…at least—until they become sick…along with the rest of their family. And all but for an ounce of prevention for a real-or imagined cause. The truth will out. God save us all.

  26. ce message est arrivé jusqu’en France aujourd’hui, merci beaucoup, je me sens moins seule ! Je viens de traverser une semaine “OMG” et je me suis appliquée à préparer tout : les remèdes, la prévention, quelques provisions, les conseils de base pour enfant, et pour moi-même. Maintenant, je suis plus calme. merci !

    1. “This message arrived as far away as France today, thanks very much, I feel less alone! I have just been through an ‘OMG’ week and have been starting to prepare everything: remedies, prevention, supplies, basic advice for children and for myself. Now I’m calmer. Thank you!”

      I’ve translated this in case someone can’t read it. I’ve shared your article widely too. Thanks very much for this sensible case for preparation and doing as much as we can before things become grave.

  27. Thank you for the information. The knuckle on the lift button, the stocking up on presciption items, planning on how we will do our utmost to protect ourselves.

  28. There is an intense focus worldwise on wearing an assortment of facial masks for infection control. I am a 50 year old medical scientist who has worn for many years gloves (latex gloves) at work and literally cannot remember the last time I have been sick (over 15 years ago at least). My family has URTIs etc at a normal rate, particulary my teenage daughter who has acne and touches her face constantly. I know that an anecdote is not data, but if generally the point of masks outside of hospitals is to stop people touching their faces then this is a valid point.
    There is a significant habit breaking effect of wearing gloves (any sort). There is a medical scientist joke that illlustrates the point:
    How do you tell if you work in a lab? Scratch your nose right now.
    Most people scratch their nose with their hands.
    Medical scientists will scratch their nose with their upper arm.
    I would advise people to invest in a box of gloves, rather than a box of masks (which is what I have done). I know if you are unlucky enough to have someone sneeze in your direction then that is it but I seriously think the hand to face thing is most of transmission.

  29. Thank you for sharing. The coronavirus is scary, but needs to be discussed given many countries are not even testing for it.

  30. Strategically, does it make sense to try to be infected early and self quarantine? I am over 50 and have hypertension, it seems that it would make sense to get sick before medical resources are heavily taxed. I could then be through it and be available in my business and broader family leadership roles. It seems the biggest flaw to this logic is the potential of a secondary infection which some are saying is more likely to be lethal.

    Thank you for your post and analysis.

  31. Thank you very much for telling the truth. I had my OMG moment today and now, I feel better reading what I feared. I know now that I am right to prepare for the pandemic and that I should be strong for my family and my collegues. From Germany.

  32. I tweeted about your post just now. Wade Schuette
    @shuweide
    ·
    Here’s an excellent blog post on whether #Coronavirius is a #pandemic and #PandemicPreparedness in general. Seems like a better answer than @who gave to @JacqEHoward question this morning.

    [ She asked at the daily briefing whether this was a “pandemic” yet, and if not, what would have to happen for it to be one? ]
    and i put a link to the url to the post here

  33. The public deserves the truth, the instant it is known. Waiting until the last moment drives panic. This is why store shelves are emptied at the last moment with no hope of being replenished prior to a quarantine. People should understand now to buy what they need in that event. If health agencies see the possibility of a 2 week or 1 month quarantine, people should be informed so that they can plan accordingly. This gives people the opportunity stay home when they are asked to instead of having to venture out in the search for supplies.

    Informing people now allows them to prepare in a rational and deliberate manner, on their own time, over a longer period. This puts less stress on retailers and logistics companies to maintain supplies.

    The people are paying for this information. It is theirs to do with as they see fit.

  34. Also, people need to stop coughing and sneezing into their HANDS and then grabbing doorknobs, handles, subway train poles, etc. Gross! If you have to, cough and sneeze into the crook of your arm.

  35. Isn’t the language on the whole of this article slightly weird and with several obscure references that the authors seem to assume everyone knows? Also, and more importantly, what happens if there’s no pandemic in the end? Does anyone keep track? Do we know how many times it was got right and how many wrong? Can we know that now already for previous cases?

  36. Please do include some recommendations about pets., like
    “Suggesting that people make plans for petscare when they are sick”.
    Thnak you for the great job

  37. Thank you so much for this article, Dr. Mackay! Question for you (I tried via twitter but well… you know what’s happening there).

    Do you think Cytokines storm is coming into play and if so, how do we prevent?

  38. I found you when you were on the old site 2013? I think? When ever the swine flu thing was a thing. I consider you a level headed and informative person to check on, along with flu trackers, Croft’s blog (as I know it) and one other, whose name escapes me (Avian diaries? Bird flu diaries?) any hoo, keep up the good work. I appreciate it.

  39. Good luck finding a health insurance company that will allow you to stockpile prescriptions. Aetna won’t. Blue Cross won’t. Cigna won’t. Unless these companies agree to waive their controls in ‘pandemic situations,’ the dreaded line at the pharmacy will include all of us.

  40. Thank you for an informative, honest assessment of Australia’s current situation and what we should be doing to prepare ourselves.

  41. Thank you for the straightforward and valuable information. As an American, I’m truly concerned that our current administration is both incompetent and unreliable. I happen to be in the most vulnerable population – 67 years old and a transplant patient on immunosuppressant drugs – so I take this virus very seriously. You make the point about buying 2 months worth of Rx, but almost all US health insurers limit you to a one month extra supply. Even that is financially difficult for many but buying special anti-rejection drugs at cost is simply not feasible. I believe I can at least make an effort to handle all the other issues, but being cut-off from those drugs would be much more deadly for some of us than the virus itself!

  42. As an ER doctor I see colleagues reporting difficulty getting patients tested. I also suspect I may have it, 14 days fever flu symptoms neg flu, neg resp viral panel. Dept of health won’t test me without having confirmed exposure or travel. I think it’s here already

  43. Thanks for the good advice. However I don’t think our government officials are taking it seriously.Its time we stop relying on China. Their communist government until now is still trying to hide the magnitude of this virus outbreak. We still keep on importing cheap Chinese goods that maybe contaminated.

  44. There are two types of people one who gets scared of being the mentioned the very name of pandemic and the other type wont give hoots about disease and they think they are immune to it, they will continue with their routine activities. I believe it is justified in namingCoronavirus! as a pandemic, atleast those who are bothered will learn about the disease and be mindful.

  45. Nice Article! The coronavirus has had unprecedented impacts on the world — and the worst is yet to come. Companies must act today if they are to bounce back in the future. Doing so will help the world as a whole recover — and, we hope, become more resilient in the process.

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