Deserted Streets of Wuhan

The concern of leaders globally regarding the Coronavirus is unprecedented. Every measure taken everywhere is to curb the impact of the virus and that seems to move along on a similar pattern– the lock down’s, curfews, limited hours out for essentials, layoffs, etc.

There is great fear amongst the people throughout the world about the virus. Life in reality has become stranded for every individual around the world and people are desperately wanting to know when this scenario would end.

In the beginning of the pandemic, Italy was in the news all the time due to the number of cases identified and the rising death count.

In March 2020 the scientific adviser to Italy’s minister of health, Prof Walter Ricciardi said that the reason of the high mortality rate was due to demographics as the nation has the second oldest population worldwide, and the manner in which hospitals record deaths (Newey, 2020). He further said:

“the way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus. On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,” (Ibid).

Experts say that Italy’s rise in the death toll has been largely due to the underlying health conditions of the patients, and other factors such as high rate of smoking and pollution (Ibid). There is evidence that air pollution has a significant impact on lung maturation and development, for instance, a Children’s Health Study found that children from communities with the highest levels of outdoor nitrogen dioxide (NO₂) and PM2.5 were nearly 5 times more likely to have reduced lung function compared to children from communities with the lowest levels of NO₂ and PM2.5 (Global Initiative for Chronic Obstructive Lung Disease, 2020).

In Italy, the majority of the deaths have been in the Lombardy region (Statista, 2020) which ranks among the most air polluted areas of Europe (Carugno et al., 2016). Some of the impact of air pollution on human health in the Lombardy region: “all-cause and cause-specific mortality is associated with PM10 and NO₂ exposure; cause-specific hospitalizations increase with increasing levels of air pollution; the effect of PM10 on respiratory hospitalizations increases with age; air pollution effects on cerebrovascular hospitalizations are greater before age 75 (Ibid).

Nitrogen dioxide (NO₂) inhalation inflames the lining of the lungs, and can reduce immunity to lung infections. This can cause problems such as wheezing, coughing, colds, flu and bronchitis. Whereas, PM10 exposure results in breathing problems, burning or sensation to the eyes, nose and throat, tightness of the chest, severe respiratory diseases, irregular heartbeat, lungs do not work, etc., (Goyal, S, 2018).  

Furthermore, with regards to the tobacco culture of Italy, the impact of exposure to environmental tobacco smoke (passive smoking), Forastiere et al. (2002) found that 21.3% of acute respiratory infections in the first two years of life were due to parental smoking (about 77,000 children); 27,000 cases of asthma, 48,000 cases of chronic respiratory symptoms, etc.    

The COVID19 is a respiratory disease that affects the lungs (WebMD, 2020). According to the World Health Organization (WHO, 2020) and Centers for Disease Control and Prevention (CDC, 2020), the most common symptoms for the Coronavirus disease are: persistent cough, shortness of breath or difficulty breathing, high fever, tiredness, sore throat, body ache, headache. The information that a common man gets about COVID19 pretty much revolves around; symptoms, measures to avoid contact/social distancing, treatment and the much feared news of the rising death count.  

According to the World Health Organization (n.d.) – Global Influenza Strategy 2019-2030, seasonal influenza/flu is a serious global health threat; every year, there are an estimated 1 billion cases and 290,000 – 650,000 related respiratory deaths (Gillespie, 2020).

The common symptoms for seasonal influenza is characterized by a sudden onset of fever, cough (usually dry), headache, muscle and joint pain, severe malaise (feeling unwell), sore throat and a runny nose (WHO, 2018).WHO compares influenza virus with the coronavirus and states that they both cause respiratory disease ranging from asymptomatic or mild through to severe disease and death (WHO, 2020a).

With regards to the spread, both influenza and Covid19 can be transmitted in the same way, that is; through contact, droplets and fomites; thus, the same public health measures such as hand hygiene and good respiratory etiquette (coughing into your elbow or into a tissue and immediately disposing the tissue) are important actions for preventing infection (Ibid). However, an interesting point to note is that WHO says that the influenza virus can spread faster than COVID19 (Ibid). WHO explains this:

“The speed of transmission is an important point of difference between the two viruses. Influenza has a shorter median incubation period (the time from infection to appearance of symptoms) and a shorter serial interval (the time between successive cases) than COVID-19 virus. The serial interval for COVID-19 virus is estimated to be 5-6 days, while for influenza virus, the serial interval is 3 days. This means that influenza can spread faster than COVID-19.” (Ibid)

With regards to Pneumonia, influenza is a common cause of pneumonia. Pneumonia is the inflammation of the lungs and the common symptoms are: cough, fever, sweating and shaking chills, shortness of breath, rapid, shallow breathing, sharp or stabbing chest pain that gets worse when you breathe deeply of cough, loss of appetite, low energy and fatigue. Pneumonia is spread by the direct contact with infected people. (American Lung Association, 2020).

Therefore, the same public health measures such as hand hygiene and good respiratory etiquette are important actions for preventing infection. 4 million people die from lower respiratory tract infections and pneumonia each year (Forum of International Respiratory Societies, n.d.). Even though pneumonia is preventable, still it is the world’s leading cause of death among children under 5 years of age (American Thoracic Society, n.d.). 

In 2018, the estimated number of pneumonia-related deaths in children under the age of five stood at 58,000 in Pakistan, 18,000 in China, and 802,000 globally (UNICEF, 2019). In the US about 1 million adults seek care in hospitals due to pneumonia every year, and 50,000 die from the disease (American Thoracic Society, 2019).

Now let’s look at Tuberculosis (TB). According to the Director General of WHO, Dr. Tedros Adhanom Ghebreyesus, “TB remains the top infectious killer worldwide” (WHO’s Global Tuberculosis Report 2019). TB mainly affects the lungs and tends to be highly contagious. Much like COVOD19 and influenza virus, TB is spread through the air in droplets when a person coughs, sneezes, spits, laughs or talks (McIntosh, 2020). In 2018, an estimated 43,000 people died in Pakistan, 440,000 in India, 37,000 in China and 1.5 million globally (WHO’s Global Tuberculosis Report 2019).

Now the troubling question that boggles the mind is; amidst the Coronavirus pandemic why the panic and why the global lock down? As a person with no background in medicine and its related fields, the answer seems to be just two. First, the contagion element of the virus.

But WHO (2020) says that “influenza can spread faster than COVID19”, and that TB remains the top infectious killer globally with 10 million people falling ill in 2018 (Dr. Tedros Adhanom Ghebreyesus- Director General, WHO, 2019). So why the fear from COVID19 and not from influenza, pneumonia or TB. Second, the number of the dead from the coronavirus. I do not see a 3^rd reason.

Now let’s look into some statistics regarding death.

	Total Number of Deaths in 2019 (source: UN World Mortality Data Booklet 2019)	Total Number of Deaths due to COVID19 (source: Worldometer) (As of August 8, 2020)
World   🌏	58,394,000 (58.4 million)	724,081
Pakistan	1,493,000 ( 1.49 million)	6,052
United States	2,909,000 ( 2.91 million)	164,094
Italy	642,000	35,190
UK	634,000	46,511
Spain	428,000	28,503

Furthermore:

• In 2016, the Global Burden of Disease collaboration estimated that globally 420,000 people died from asthma – more than 1000 per day. Asthma affects as many as 339 million people – and prevalence is rising. (The Global Asthma Report, 2018). 
• Non-communicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all deaths globally (WHO, 2018).
• According to the World Health Organization, the tobacco epidemic is one of the biggest public health threats the world has ever faced, killing more than 8 million people each year worldwide. More than 7 million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke. Smoking is the leading cause of preventable death. (WHO, 2020b).
  • Globally, around 65, 000 children die each year from illnesses attributable to second-hand smoke. (Ibid) 
  • Second-hand smoke causes more than 1.2 million premature deaths per year and serious cardiovascular and respiratory diseases. (Ibid) 
• Air pollution kills an estimated 7 million people worldwide every year. (WHO, 2020c)
• Indoor and outdoor air quality are two of the main environmental factors of concern for acute lower respiratory infections (WHO, n.d. a). Around 4.2 million people die each year as a result of exposure to ambient (outdoor) air pollution (WHO, 2020c).

The number of deaths quoted above are far from the latest death count from COVID19. Despite millions dying each year, there was never a global lockdown to our memory. There was something else that was missing, and that is the fear factor linked to the coronavirus. In comparison to the difference in the numbers – COVID19 deaths versus deaths due other factors (data above), the fear of the novel virus has been delivered to the people through one source only, and that is the media.  

The lock-downs globally are unheard of in our times. Staying at home as a safety measure is impacting the global economy; people have been laid off, the mental trauma caused due to the fear of the unknown surrounding COVID19, and the social isolation leading to increased stress and pessimistic behavior, etc. The prime concern of the world today only seems to be the coronavirus.

The global and the local media have been talking COVID19 24/7 as if all other issues have been resolved in the dawn of coronavirus. Even if the media has something to report on topics other than the novel virus, the intensity of its narration is noticeably weak.

The question how the media describes death and what we die from is interesting and does draw our attention. Let’s look into some evidence from research.

Coyle and MacWhannell (2002) studied the portrayal of suicide in Scottish newspapers and noted that there were patterns and conventions in the reporting of suicide stories: “the suicides which are most likely to attract publicity are the ones which take place in a public place; involve a celebrity; are achieved by violent means and involve males”.

Also, Walter et al. (1995) concluded that deaths reported in the news were more likely to be of public figures or of private figures who had died from extraordinary causes in public places. In a study conducted by Harcup and O’Neill (2001) found that news stories must generally satisfy one or more of the following requirements if they are to be selected:

1. The power elite: Stories concerning powerful individuals, organizations or institutions.
2. Celebrity: Stories concerning people who are already famous.
3. Entertainment: Stories concerning sex, show business, human interest, animals, an unfolding drama, or offering opportunities for humorous treatment, entertaining photographs or witty headlines.
4. Surprise: Stories that have an element of surprise and/or contrast.
5. Bad news: Stories with particularly negative overtones, such as conflict or tragedy.
6. Good news: Stories with particularly positive overtones, such as rescues and cures.
7. Magnitude: Stories that are perceived as sufficiently significant either in the numbers of people involved or in potential impact.
8. Relevance: Stories about issues, groups and nations perceived to be relevant to the audience.
9. Follow-up: Stories about subjects already in the news.
10. Newspaper agenda: Stories that set or fit the news organization’s own agenda (Harcup and O’Neill, 2001).

Singer and Endreny (1993) argue that: “A new hazard is more newsworthy than an old one. And a dramatic hazard—one that kills many people at once, suddenly or mysteriously—is more newsworthy than a long-familiar illness”. Eisensee and Stromberg (2007) found that for every person killed in a volcano disaster, around 40,000 people must die in a drought to reach the same probability of coverage in US televised news. Even the location matters. News networks in the US cover more than 15% of disasters in Europe and South Central America and show less than 5% of the disasters in Africa and the Pacific. (Ibid)

In a study conducted by McArthur, et al., (2001) found that: “the primary focus of local news is on events with high visual intrigue, for instance, air crashes, homicides.  And stories about deaths and injuries with lesser visual content are rarely shown.” Pinker (2018) argues that Plane crashes always make the news, but car crashes that kill far more people almost never do. Not surprisingly, many people have a fear of flying, but almost no one has a fear of driving. Similarly, people rank tornadoes (which kill about 50 Americans a year) as a more common cause of death than asthma (which kills more than 4000 Americans a year), presumably because tornadoes make for better television.

In a study to assess the emotional tone of a text – sentiment mining method was applied to every article published in the New York Times between 1945 and 2005 and to an archive of translated articles and broadcasts from 130 countries between 1979 and 2010. This technique analyzed the emotional tone of a text by tallying the number and contexts of words with positive and negative connotations like good, nice, terrible, and horrific. The study found:

“The New York Times got steadily more morose from the early 1960s to the early 1970s, lightened up a bit (but just a bit) in the 1980s and 1990s, and then sank into a progressively worse mood in the first decade of the new century. News outlets in the rest of the world, too, became gloomier and gloomier from the late 1970s to the present day.” (Pinker, 2018)

In 2016, 57.3 million people died worldwide (Ritchie, 2019). Terrorism accounted for 0.06% of global deaths in that year (Ritchie & Roser, 2018). This means that 34,380 people died due to terrorism globally in 2016. In a poll conducted in 2016, found that a large majority of Americans follow news about ISIS closely, and 77% agreed that Islamic militants operating in Syria and Iraq pose a serious threat to the existence or survival of the United States (Pinker, 2018). Pinker (2018) argues that consumers of negative news not surprisingly become negative.

In the United States the leading cause of death is heart/cardiovascular disease and cancer, whereas deaths from homicide and terrorism are extremely rare (Owen, 2019). However, mainstream news media devotes far more coverage to violent death than it does to death from disease. (Ibid) For instance, in 2017:

• The total number of deaths in the US stood at 2.7 million (Ritchie, 2019).
• Of the 2.7 million deaths, 31.57% deaths are attributed to cardiovascular disease, 24.47% to cancer, 0.7% to homicide and less than 0.01% to terrorism, respectively (Ritchie, 2018). Putting the percentages into perspective, the numbers are:

• Ritchie and Roser (2018) found that heart disease was 10 times underrepresented in the news media whereas homicide is about 31 times over-represented and terrorism is over-represented in the media by a whopping 3900 times. Similarly, Pneumonia and influenza are over-represented by 50%.

With less than 270 deaths attributed to terrorism in the US in 2017, the media over represents it by a factor of 3900 (Ibid). This is interesting! Despite so much said, I still cannot comprehend the scenario, why the fear, why the global “network” of lock-down?

Thank you and take care

Amer Bhaur (Lahore, Pakistan)

• MA Finland
• MSc Sweden
• MBA Pakistan

REFERENCES

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Categories: Health & Environment

Tags: China, Coronavirus