‘Unjustified fears’: When COVID-19 anxiety stops making sense

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The COVID-19 variants, it was roundly said, were attacking the bodies of young people with unprecedented ferocity.

German Chancellor Angela Merkel said that the U.K. variant had been “proven to be more dangerous in children and young people.” Saskatchewan Premier Scott Moe just this week said that the variants are “shown to be more dangerous to young people.”

But that’s wrong: The variants are more transmissible and have landed more young people in hospital due to  more cases, but there’s no clear evidence they’re deadlier or make people sicker. “We did not identify an association of the variant with severe disease,” reads a recent study in The Lancet which followed a few hundred patients hospitalized with the B.1.1.7  variant — the so-called U.K. variant, because it was first identified there. A more comprehensive study tracking nearly 37,000 Brits using the COVID Symptom Study found the same thing: “There was no evidence of an association between the proportion of infections with the B.1.1.7 variant and the number of symptoms reported over a 4-week period.”

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It is far from the first time that public fears about COVID-19 did not match the reality on the ground. B.C. anesthesiologist Pooya Kazemi is one of a community of Canadian doctors actively criticizing overzealous lockdown measures. As he told National Post, “there is definitely a huge mismatch between what the literature shows and how people are behaving.”

North America is now definitively entering the final days of COVID-19. Even in Canada — with ongoing third waves in both Ontario and Alberta — deaths remain way down from their January highs and mass vaccination is rapidly shielding whole sections of the population from lethal harm. But as our pandemic deliverance approaches, physicians and researchers are now warning of a new public health challenge: When normalcy arrives, many may refuse to accept it.

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A familiar pattern has emerged whenever a pollster asks the public to gauge the risks of COVID-19: Across the board, people think the disease is deadlier and more pervasive than it really is.

A recent survey from the Netherlands found that Dutch people think COVID-19 is about as dangerous as Ebola — a disease that kills 50 per cent of its patients.

A survey of pandemic anxiety among more than 6,000 Canadians last spring found that stress was particularly high among those of “younger age” — the one group that is relatively insulated from the epidemiological consequences of the disease. The same survey also found an “association between left-wing views and stress worsening.”

In February, a French survey saw respondents estimating that COVID-19 killed one in every six people who caught it. The actual figures are closer to one in every 400 — and that ratio plunges dramatically for people under 70.  “Respondents overestimated the probabilities to catch or die from COVID-19,” wrote researchers.

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In a July survey out of the United States, respondents estimated that about 40 per cent of U.S. COVID-19 fatalities were under the age of 55. Their estimate was wrong by a factor of six: Under-55s actually accounted for just 7.3 per cent of U.S. fatalities.

Poll responses were even more wrong when it came to COVID-19’s threat to children. Respondents said that around eight per cent of fatalities were under 24. In truth, it’s about 0.1 per cent. Notably, these overestimations were common to both Republicans and Democrats.

“Unjustified fears” of COVID-19 are “very, very real,” said Nova Scotia emergency physician Aris Lavranos. “It’s almost maddening trying to ch
ange the public perception.”

Ironically, much of the world entered this pandemic with the opposite problem: As COVID-19’s first wave silently surged through Canadian and the United States in early 2020, people and policymakers weren’t nearly scared enough about its potential for harm: Borders stayed open, travellers went unscreened and, in many cases, officials actively discouraged basic protective measures such as masking or social distancing.

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Now, as COVID wanes across the developed world, psychiatrists are warning of a wave of COVID-centric anxiety. “Those with severe health anxiety are likely to become abnormally avoidant, continuing to isolate and practise repeated hand washing, checking their body temperatures, respiratory function, and even testing their ability to smell … over and over again,” reads a paper on “COVID-19 health anxiety” in the journal World Psychiatry.

In October, U.K. psychologists devised a questionnaire to gauge the severity of what they called “COVID-19 anxiety syndrome.” One of the questions has respondents answering how many times in the past two weeks they “have read about news relating to coronavirus … at the cost of engaging in work.”

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Singapore has seen only 31 deaths from COVID-19, but even they are not immune to COVID-19 anxiety. A recent study examining “inflated risk perceptions” among an elderly community in Singapore concluded that “the affective symptoms of anxiety and depression should not be overlooked; if prolonged, these mental health consequences may result in longer-term problems than the pandemic itself.”

Mental health concerns aside, there’s the very real policy problem that if the public isn’t reckoning with the realities of COVID-19, they’re more apt to back restrictions that make very little sense.

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Governments have continued to order the closure of playgrounds despite no evidence for them as vectors of transmission. Stefan Baral, an associate professor of the Johns Hopkins School of Public Health noted back in February that of 99,226 COVID-19 studies to date, not one had identified playgrounds as “common sources in outbreaks.”

A similar phenomenon has been occurring across the continent through the continued closure of schools in jurisdictions such as Ontario and California. “We know that they’re not major sources of spread, we know that they weren’t major sources of outbreak and we know about the downsides of school closures,” said Ottawa ICU physician Kwadwo Kyeremanteng in a recent video calling for the reopening of Ontario schools.

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Pediatricians have similarly called out Ontario’s closures of summer camps. “There really are no medical or other reasons to delay further,” reads a recent statement by Pediatricians of Ontario.

Outdoor transmission of COVID-19 is estimated to represent only 0.1 per cent of cases. In one rigorous study that traced COVID-19 cases in Wuhan, China, only one of 7,324 infections occurred outdoors. Ireland performed a careful analysis of all 232,164 their confirmed COVID-19 cases and found that only 262 came from the outdoors.

Nevertheless, broad bans on outdoor recreation remain in place in Ontario, including continued forced closures of the province’s golf courses.

This week, the U.S. CDC reversed its recommendations that Americans should continue to wear masks even after full vaccination. No new evidence underlay the decision: Rather, it came months after it was already well-known that viral transmission was infinitesimally low among the vaccinated. As San Francisco-based physician and epidemiologist Vinay Prasad wrote in a Thursday tweet, “there was no credible evidence ever to ask vaccinated adults to wear a mask.”

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Nevertheless, mask mandates remain in place even for fully vaccinated Canadians. Health Canada is continuing to demand that vaccinated Canadians follow all social distancing restrictions until at least 75 per cent of Canadian adults have received at least one dose.

“The one thing I’m seeing is that the government refusal to provide a roadmap back to normal is actually worsening vaccine hesitancy,” said Kazemi. He pointed to a recent UCLA survey finding that Americans were significantly more likely to take the vaccine if it meant being free to go maskless.

It’s why, despite his fervent pro-vaccine stance, Kazemi says he strongly objects to any efforts to shame  people who are doubtful of the shot. When vaccination changes nothing in a Canadian’s life, “it makes people hopeless,” he said. “I think it’s time to be proactive in term of what our exit strategy looks like.”

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• Email: thopper@postmedia.com | Twitter: TristinHopper