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IN Illness as Metaphor, Susan Sontag wrote: “Any disease that is treated as a mystery and acutely enough feared will be felt to be morally, if not literally, contagious.” Although the Covid-19 situation is changing rapidly by the day — at the time of writing, five people have died in Britain and there are 319 confirmed cases — the disease has not yet truly arrived.

Normal life continues, nervously. For most people, Covid-19 remains a mystery and the main contagion is fear. So far, the government has held off putting in place drastic public health measures. Major disruption has not yet arrived. But with evidence from the spread elsewhere, it is certain that it will, and soon.

This period is therefore one of anxious waiting. A feeling of powerlessness can take hold. Unless you have recently travelled back from specific places (such as northern Italy) or had close contact with a confirmed case, following government guidance to the letter (for now) means nothing beyond increased handwashing and attempting not to touch your face — although both are useful and should now be routine.

All this naturally provokes anxiety. It is easy to feel that “something must be done.” Yet without government advice to cancel events, individuals are left to make their own decisions about what action to take, while nervously watching out for symptoms.

Among the Science and Society team, two of us are infectious disease researchers; one even actively working on modelling the spread of Covid-19. But knowledge doesn’t prevent us from having nagging worries about catching the disease. Even if the risk to ourselves is low, the thought of transmitting it to others who may be more vulnerable — close contacts who are older, immunosuppressed or with underlying health conditions — is distressing. We also find ourselves thinking about how we’re feeling and considering things as possible symptoms: is that light headache the start of Covid-19 or simply a sign that we should have a coffee?

Knowledge about the symptoms is crucial. The spread of Covid-19 has shown how quickly the global scientific community has been able to produce answers, to the best of our knowledge, to such important questions. Fever appears to be the most common symptom, seen in 87.9 per cent of laboratory-confirmed cases in China up to February 22.

A dry cough was seen in 67.7 per cent of cases. Importantly, Covid-19 seems to rarely cause a runny nose; this symptom is currently far more likely to indicate a cold or flu. This knowledge is immensely valuable but insufficient on its own. Unfortunately, this still leaves a great deal of room to wonder.

We have heard anecdotal reports from doctors of some people deliberately lying in A&E about having other conditions in order to be seen. It is only at this point that they then reveal that they want to be tested for from doctors, having presumably been told on NHS 111 that they were very unlikely to have it based on their symptoms and did not meet the testing criteria. Behaviour of this sort is disappointing and bad for the NHS, but we understand the desire for certainty that motivates it.

The growing awareness and unhappiness is palpable. As time passes, one bleak positive is that this uncertainty about what to do will be eliminated, as the government gives progressively stronger advice. Chief Medical Officer Chris Whitty has said that in eight to 12 days, even people with mild respiratory tract infections will be asked to self-isolate, because the probability of having Covid-19 will have grown enough to make this recommendation worth the disruption.

While currently the probability that a random person’s symptoms are caused by Covid-19 is low (as of March 9, 319 out of the 24,960 people tested in Britain and Northern Ireland were found to be infected), a doubling time of cases of about four to five days means that the probability of having Covid-19 doubles at roughly this rate too. Hence the plan to start asking anyone with mild symptoms to self-isolate.

The fact that concerns have been raised previously about viruses which did not in the event lead to much harm, such as influenza A virus subtype H5N1 (bird flu), should not be taken as reassuring evidence that “it’s never as bad as they say.” It cannot be stressed enough that the evidence from other countries shows that the local effects of Covid-19 can be extremely bad when measures aren’t taken: as cases rise quickly, the healthcare system will be inundated.

We can mitigate against this by taking drastic action to slow the spread (see image), but it means quickly accepting the situation, then changing our behaviour. Evidence from China and South Korea suggests that this is possible.

Dr Daniele Macchini, an Italian doctor involved in the response in Bergamo who wrote an account of the situation on March 8, published online in Bergamo Corriere, described working on a night shift a week earlier and waiting for a call.

“If I think about it, my agitation for one possible case seems almost ridiculous and unjustified, now that I have seen what is happening… The war has literally exploded and the battles are uninterrupted day and night.”

Italy’s nationwide lockdown is a response to this awful situation. We expect something similar here.

We all have a part to play to mitigate Covid-19. It is not an apocalyptic scenario, but most people in Britain will have never experienced disruption like it. Already it is difficult to recall the recent past of two weeks ago, when every new case in Britain was afforded huge individual attention, amid speculation about whether it would take hold here. That phase is over. This current waiting period is difficult. It is sobering that it will probably be very difficult to remember it in a few weeks.