Are we overreacting to the coronavirus threat and merely creating bigger risks down the road?

The World Health Organisation estimates the case fatality rate for the novel coronavirus at 2 per cent. Other estimates range from 3.5 to 4 per cent. While the illness is life-threatening for some, most of those infected will experience only mild, flu-like symptoms.

Although WHO director Tedros Adhanom Ghebreyesus has declared a global health emergency, the concern, he said, was not due to health concerns in China but the inability of weaker public health care systems in other countries to manage the outbreak.

Regarding the case fatality rate, six factors should be considered. First, this virus has shown a capacity to mutate, which can affect the rate. Second, these are early days, and firmer estimates are likely to come a year or so later, once the outbreak has been contained.

Third, it may be dangerous to make assumptions given the experience of previous coronavirus outbreaks such as with severe acute respiratory syndrome (Sars) and Middle East respiratory syndrome (Mers), as well as the worry that new viruses can exploit weak immune systems with few, if any, antibodies to defend an infection.

Fourth, the case fatality rate may be low due to vast under-reporting or information suppression – although the WHO, other global health experts and America’s national security adviser Robert O’Brien have praised China for its transparency and information sharing during this outbreak, official cremation protocols have fed allegations of cover-ups in anti-China tabloids.

Meanwhile, more sober-minded experts worry, off the record, that China is shaving off numbers to keep the figures of those who have recovered far ahead of fatalities, and largely suppressing the number of deaths outside Hubei.

Fifth, the case fatality rate number might be low due to aggressive public-health responses. Sixth, conversely, the rate may be inflated as many of the infected are asymptomatic or have only mild symptoms that have escaped official attention.

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Nevertheless, while the outbreak is serious, with lives at stake, a comparison with other public-health concerns and available data suggests it is overblown as a health emergency.

For example, during the peak period in a “bad flu year” in the United States, such as in 2017-18, the case fatality rate for pneumonia and influenza was over 10 per cent, according to data from the US Centres for Disease Control and Prevention (CDC).

Additionally, for this year: “The latest FluView surveillance from the CDC reports that as of January 18, 2020, there have been 15 million cases of flu, 140,000 hospitalisations, and 8,200 deaths in the US this influenza season”, including 54 paediatric deaths.

This disparity has been acknowledged in the US, and government officials have said the regular flu is a much greater danger for Americans and that they should not be distracted from this fact.

So, have perspectives on this outbreak, however reasonably or unreasonably constructed, amounted to a gross exaggeration, and if so, has this produced overreactions that have created worse public health risks?

Furthermore, given the WHO’s declaration of a global emergency, what lessons might other countries draw from the Chinese response to date? These are difficult questions that beg even more difficult answers.

Public health law is based primarily on police power. Public health confidence is based primarily on public perception. In public health practice, generally, governments are not supposed to release or restrict information if doing one or the other might increase morbidity and mortality.

Furthermore, outbreaks start locally, and some localities, such as Wuhan, already face cultural prejudices including from other Chinese people, as well as their own local, systemic limitations, as the much-maligned leaders of Wuhan have conceded.

Each of these concerns pick at the strengths and weaknesses of the Chinese system, local versus national authorities, including issues of trust and access to reliable information, as well as an already overburdened health system and issues of access to care.

In the meantime, an unprecedented 50 million-plus have been kept in place, mass transit is halted, 62 countries have imposed restrictions on Chinese travellers, international airlines are stopping services, and many are not allowed to go to work or school.

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On social media, videos of authorities boarding up occupied homes have surfaced, and local blockades, even in rural villages have been reported. And this is just part of the impact on people in China.

Elsewhere, people are being quarantined on cruise ships, Chinese abroad are facing discrimination and, given economic globalisation, even locations such as Memphis, Tennessee, are likely to be affected financially, according to Memphis-based FedEx.

The impact on people’s lives is staggering, the economic and political costs are enormous and, as yet, incalculable, and are coming on top of economic challenges vis-à-vis ongoing economic realignment efforts and the US-China trade war.

Without question, Chinese foreign relations will suffer, with some advocates for decoupling already pointing to this “crisis” and patting themselves on the back.

Meanwhile, is there a relative neglect of potentially much greater outbreaks in China? For example, the human papillomavirus (HPV), which infects more than 100,000 a year, mostly women, with more than 47,000 deaths due to cervical cancer? More broadly, have concerns for freedom, human rights and global equity been upended in the name of public health?

It is too soon to judge whether the responses are balanced, heavy-handed or in some way insufficient, but it seems increasingly possible that they have created more problems than they are solving.

This might have been understandable given initial concerns, but the politicisation of both domestic and global health issues increasingly appears to serve contrary forces, and may run contrary to medical science and responsible public health practices, if available data is trustworthy.

While the numbers of infected and associated deaths continue to climb in the near term, both inside and outside China, and while ongoing care and support should be continued and even strengthened, the data suggests that both Beijing and the WHO might need to act quickly to reassess and adjust policies and perceptions, to ensure, as the WHO put it, that: “This is the time for facts, not fear”.

Robert Dingwall’s much criticised call to “de-escalate the war on the coronavirus” in a Wired editorial might have been premature and provocative, and Roger Bate’s argument that this is a media-driven crisis is a bit overblown, but the discussion deserves more careful attention.

Unfortunately, stepping back from the brink in the midst of a crisis is hard, and it will pose a great many challenges and risks for this outbreak in China and beyond.

Josef Gregory Mahoney is professor of politics at East China Normal University in Shanghai