Fear

Coronavirus, Food, and Why I May Be Eaten by a Shark

100+ people per day are dying of the coronavirus. Should we quake in fear?

Posted Feb 13, 2020

I'm writing this on 2/13/2020, over one week since the WHO declared the new Coronavirus a health emergency. A few days ago, China had its first 100+ deaths from infection day, virus stories are taking over the news cycle, and anxiety is building in the public mind. We fear the worst.  As more fear creeps in, we become less present for our lives and our loved ones. There are economic consequences, but worse yet, we fear human contact and retreat from life.

This article is intended to provide reasoned perspective on managing virus fear. Before diving in, it's important to note that notwithstanding my attempt to prevent overreaction, nothing herein should be interpreted to mean we shouldn't abide by precautions advised by trusted agencies. The Coronavirus is not a hoax and requires a modest amount of attention to minimize risk. Llearn the facts and make suggested adjustments. I do not mean to suggest you fear the virus less than a group of angry kittens, but by the same token, I don't think we should be treating it like a zombie apocalypse and/or living our lives as if we were featured guests in an episode of The Walking Dead. 

The point is, we face dozens of similar risks on a daily basis without constantly agitating our primal fears. For example, according to the World Health Organization, we are already living with several epidemics:

Worldwide obesity since 1975 has tripled! More than 1.9 billion adults are overweight and 650 million obese.

Diabetes has increased by 80.8%. Diabetic adults live with double the risk of heart attack and stroke, as well as a seriously increased risk of blindness and kidney failure. Yet "simple lifestyle measures have shown to be effective in preventing or delaying the onset of type 2 diabetes," most notably to "achieve and maintain a healthy body weight," "eat a healthy diet," and "be physically active."

Cardiovascular disease is now responsible for 31% of global deaths! But "most cardiovascular disease can be prevented by addressing behavioral risk factors—primarily "unhealthy diet, obesity, and lack of exercise."

30% to 50% of cancers can be prevented, and dietary modification is an important approach to cancer control. "There is a link between overweight and obesity to many types of cancer such as esophagus, colorectum, breast, endometrium and kidney [...] Regular physical activity and the maintenance of a healthy body weight, along with a healthy diet, considerably reduce cancer risk."

We have a 1 in 6 chance of dying of heart disease, 1 in 7 from cancer, and 1.5 million people die of diabetes each year. Yet despite these relatively high risks, most of us not only do not walk around terrified on a daily basis, but don't make the dietary adjustments proven to reduce these risks. These diseases are already killing more people each year than the Coronavirus likely ever will, yet most choose to face life "without masks" and safety precautions on the dietary landscape.

Something else you may find interesting:  In graduate school, I recall a professor explaining that the amount of media attention for a given health risk was inversely proportional to the odds of dying from that risk! For example, approximately 145 people per year die of botulism poisoning in the USA, representing less than 0.0001% of the population.  Yet the moment there's a case in your local area, the odds are very good you'll find a feature story in the news which dramatically raises people's fear of this very low probability health risk. On the other hand, 647,000+ people die each year from heart disease (one person every 37 seconds), yet these deaths aren't at all newsworthy. Even death from slipping and falling (about 19,500/year) is a lot more frequent than botulism, but when was the last time you saw dozens of people dying from slipping in the tub featured in the news?

As a result, most people walk around disproportionately frightened about low likelihood events and pay way too little attention to high probability risks which they could (and should) do more about. The public is more terrified of Coronavirus and terrorist attacks than heart attacks and diabetes, when, factually, it should be the opposite.  

So, should we just ignore the virus and go on with our lives?   Not quite. I'd contend we should objectively assess the risks, make appropriate adjustments, and go on with life in a productive, loving, and engaged manner. But we should be fact-based in our assessment and pay attention to all risks, allocating our energy in proportion to their relative size and probability.

So, from that perspective, what are the odds you're going to die from the 2019 virus? 

There are a lot of unknowns, but more than two-thirds of patients so far have had only mild symptoms, and the death rate is well under 3%. Which is not to say it isn't a complete tragedy if you or your loved ones happen to be in that 3%, but still, the odds are pretty good that if you do get it, you're not going to die. The Spanish Flu (1918), one of the worst in history, had a death rate of 10%+. 

The infection rate the 2019 virus isn't known, but so far it seems relatively safe to estimate it at less than half the Spanish Flu. This could vary greatly over time, but serves to illustrate my point.

Now, if the Coronavirus infection rate is less than half that of the Spanish Flu, and the death rate less than one third, by multiplication we'd estimate the odds of dying from the new virus at less than one-sixth of the Spanish Flu. But we need an exponential function to handle the difference in infection rates, not a multiplicative one. For example, beginning with 1,000 cases and assuming the new virus has an infection rate of 1.5 vs. 3.0 for the Spanish Flu, then after five generations there will be 7,594 cases (1,000 x 1.5 x 1.5 x 1.5 x 1.5 x 1.5) as compared to a whopping 243,000 cases (1,000 x 3.0 x 3.0 x 3.0 x 3.0 x 3.0) of the Spanish Flu!   
 

On a practical basis, this means there may be significantly more time for countries and the WHO to  contain the new virus. How do we incorporate this admittedly back-of-the-napkin analysis? Let’s cut our estimate again by a factor of three, concluding any given individual's risk of dying of the 2019 Coronavirus is probably less than one-eighteenth of Spanish Flu.

The 1918 flu was estimated to have killed approximately 4% of the population. Following the line of reasoning above, we conclude that, if not contained, the 2019 virus may kill 0.22%. That's not an insignificant number, especially on a planet with seven and a half billion people, but it is roughly the same as the percentage who'll die of cardiovascular disease this year, and about 80% less than car accidents. Plus, the deaths from Coronavirus in this analysis are speculative, whereas the deaths from heart attacks and car accidents are very real and historically proven!

The point is, the virus is worth your attention, but not necessarily more so than any of the other risks we face. Just as we drive to work each day without being terrified of an accident, we need to manage our virus fear without panicking. Learn the rules of the road, pay attention, but try to relax while driving. And if you want to feel safer in your life, in addition to masks, more frequent hand washing, and minimizing close-proximity contact with strangers, you might consider eating healthier and wearing a seat-belt.

I'd like to end with a little story about how I personally manage fear: "Why I Will Almost Definitely be Eaten by a Shark!" See, the risk of dying from a shark attack in your lifetime is 1 in 3,748,067, the odds of death by drowning are 1 in 1,134, dying by a car accident 1 in 84, being done in by the flu 1 in 63, and heart disease 1 in 5. But really, none of this applies to me because:

I take ridiculously good care of myself so heart disease or flu is unlikely to bring death to my door.

I'm an awesome swimmer. Not fast, not skinny, just awesome. I passed life-saving when I was way too young to get the certificate (10 years old), and I took ocean survival courses when I was a kid. So the odds of going down the pipes are pretty slim.

I drive like an 86-year-old nun with an insurance adjuster's license, so I'm pretty sure death by car accident isn't going to be my fate either. 

Plus, I love going in the water. I live on the beach so I'm in there all the time, and let's face it, I'm way too cool to have any kind of boring, common death like slipping in the bathtub and/or dying of natural causes in my sleep.

Plus, I'm delicious!  

So it's settled. One day, I probably will be eaten by a shark, and I'm totally OK with that. I think it's pretty cool, really. When it happens, and mark my words, it will, please be sure my tombstone says "Here lies Dr. Glenn Livingston, a radical psychologist and author who helped millions of people with binge eating, only to become a shark's binge himself."

That would be an awesome ending to an awesome life!

All kidding aside, I do continue to swim in the ocean despite living near the shark attack capital of the world, but I take precautions. I swim near others and don't stray far from the shore. I don't wear shiny objects or bright, contrasting colors. I don't go in the water with an open cut, and I don't swim during the Shark's feeding time. But once I've done what can be done to minimize the risk, I fully enjoy the water and don't think about the sharks at all. Moreover, this is symbolic of my overall life philosophy: Take reasonable steps to educate yourself about risk, expend a modest amount of energy reducing that risk, and then engage in life with gusto. I don't let fear ruin my experience or eat away at the quality of my life. And in this way, I find peace in a risky world.

That's the mindset I think we all need to take with the new virus. Assess risk, educate yourself, and take reasonable precautions, but by all means, stay engaged with your life. Hug your kids. Love your spouse. Pet your dog. Call your friends. Go to work. Make your contribution. Be present. Do whatever it is you did best before every other story in the news was about how many people died of the virus this week. 

Am I wrong?

Food for thought!

References

What Are Your Odds of Getting the Flu?  [Blog post.  Retreived from https://www.webmd.com/cold-and-flu/flu-statistics ]

Mazzei, P.  (2019) Opioids, Car Crashes and Falling: The Odds of Dying in the U.S.  [Blog post.  Retreived from https://www.nytimes.com/2019/01/14/us/opioids-car-crash-guns.html ]

Heart Disease Facts.  Centers for Disease Control and Prevention.  [Blog Post retrieved from https://www.cdc.gov/heartdisease/facts.htm ] Obesity and Overweight (2018).  World Health Organization.  [Blog post retrieved from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight ] Diabetes (2018).  World Health Organization.  [Blog post retrieved from https://www.who.int/news-room/fact-sheets/detail/diabetes ]

Annual Risk of Death During One's Lifetime.  [Blog post. Retrieved from https://www.floridamuseum.ufl.edu/shark-attacks/odds/compare-risk/death/ ]