Confronting the Coronavirus

Dr. Stephen Morse, professor of epidemiology at the Mailman School of Public Health at Columbia University, has spent his career confronting outbreaks of infectious disease, including the SARS global outbreak of 2003. Morse spoke with Straus News about the novel coronavirus, COVID-19 and what New Yorkers need to know as the crisis unfolds.

How big of a risk is public transportation to a healthy New Yorker under age 60?

It really depends on your point of view. The risk to someone under age 60 who is otherwise healthy is probably small for that individual. So the question is, what is the possibility that they could become infected and pass it on to someone else? And that’s a much harder thing to answer ... If you want to protect others, take measures to protect yourself.

Are people who live in large apartment buildings or building complexes at increased risk for the coronavirus?

Yes and no. Anytime you have large numbers of people coming in contact, that always increases the risk. Of course, that depends on whether anyone has the virus. But we’re seeing a lot of people who, unknowingly ... turn up positive. This is still rare, but there’s enough of it.

Of course, in any high-density setting the risk is always going to be increased simply because of the density. So if there is something there, it’s more likely someone can get it. Now, in an apartment building, that depends. Elevators are enclosed spaces, but we don’t spend that much time in them. Most of the spread is going to be much like the flu, which is face-to-face, through droplets where someone coughs or sneezes or maybe talks too emphatically, as I sometimes do.

Are there particular groups or populations in New York City who are increased risk, such as the homeless?

What we worry about with the homeless is, given the fact that they may be in shelters, which are high-density settings, there may be greater risk of becoming infected. The other concern we have, of course, is if they need help, where do they get it? And that’s a problem, because we don’t really want people to go to the emergency department, which is what the homeless are used to doing, essentially as their primary care. Because if you do have it, it’s quite possible you’ll pass it on to others [in the ER] who don’t. And if you don’t have it ... there’s a chance that you could get infected if you aren’t yet infected.

There are some who feel that cancelling certain events and other measures that individuals, institutions and governments are taking, may be an overreacting to the coronavirus. Are we overreacting?

It’s not so much an overreaction as the feeling that we don’t want to take a chance and underreact only to discover that we should have done more. But people should not necessarily take that to mean that we expect it to be a lot worse.

Obviously, it’s not appropriate to be frightened to death, to lose much sleep over it, simply because what we’ve seen so far looks very much like the flu pandemics we’ve lived through and taken for granted in the past, though I can’t say what’s going to happen after this.

Flu is hard enough to predict ...This is a coronavirus belonging to a family of viruses that is distinct from the flu ... Our past history with this [kind of] virus makes us very wary of it. So I think it’s more caution ... Because we know so little about this kind of coronavirus that’s related to SARS, which was bad, and spreads from person to person, which SARS never did. So it has the potential for really spreading, and it will. If we have 100,000 cases, we probably have ten times that many actual infections.

People are frightened and we want to reassure them, but it doesn’t reassure people when they see all these [precautions] happening. That’s the problem. But the effort is really to try to assure people that a lot is being done to try to keep on top of it.

Interview was edited for space and continuity.