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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Infectious Ignorance: Complacency in a Pandemic

By Gary Evans, Medical Writer

Is the greatest trick of the COVID-19 pandemic — as the adage goes about the devil — to convince people it does not exist?

Even as the pandemic virus rages in some areas of the United States, there has been marked complacency in others, where public health pleas to stay at home and practice social distancing have been ignored and flaunted.

Karen Hoffmann, RN, MS, CIC, FSHEA, FAPIC, a clinical instructor of infectious diseases at the University of North Carolina’s School of Medicine in Chapel Hill, recalls the near-panic and fear during the emergence of AIDS in the 1980s.

“With the COVID-19 outbreak in the U.S. population, it appears mixed messaging by media and federal agencies has led to a large percentage of the country not wanting to believe this is a real outbreak,” she says. “This resulted in a slow rate of compliance — or even open noncompliance — with social distancing and stay-at-home recommendations.”

This is due, in part, to an insidious aspect of the novel SARS-Cov-2 virus. It can spread from people who have mild illness or appear to be asymptomatic, yet still can cause severe disease and death in the elderly and those with underlying medical conditions. In addition to the mild and asymptomatic cases, the majority of people recover after the infection and illness, many without knowing if they had the coronavirus because of the lack of available testing.

There has been confusion and mixed messaging on coronavirus testing, which has gone through a series of exasperating changes, from largely unavailable, announced and delayed, and then rolled out as if anybody could be tested. A shortage of testing reagents, swabs, and viral transport media followed in some areas, exacerbated by concerns of using scarce personal protective equipment during testing that is needed by frontline staff.

Given the stealth nature of the virus and the considerable chaos that has accompanied its emergence, it is perhaps not surprising that some people find it counterintuitive that they actually are in a pandemic, even as it accelerates in the United States — the nation that now has the highest number of COVID-19 cases in the world. Many will know soon enough.