Earlier this week, a pair of hospitals near Atlanta closed their doors to new patients (except severe trauma cases) because malware had infected the hospitals’ computers. Despite years of doomsday threats like “cybercriminals will shut down the power grid” and “malware will release toxic chemicals into the drinking water,” there have only been a small number of newsworthy incidents where malware very visibly had an impact on the physical world. (Others include Stuxnet, which damaged Iranian nuclear systems, and this recent story about malware that could be used to remotely open prison doors.)

While sensational incidents like the ones listed above and those described by scaremongers are few and far between, the reality is that nearly all malware has an impact in the “real world.” Anyone who has been scammed out of $59 by scareware or worked for a small business that lost thousands to unauthorized transfers can tell you that the effects of malware extend beyond the screen. In fact, in 2010 Consumer Reports estimated the costs of spyware and malware to consumers alone at nearly $4 billion!

It’s not just financial losses, either. In a society where stress beyond comfortable levels is the norm for many people, the added fear and aggravation of learning your computer has been infected is a very real cost. So too is the time spent running AV scans, searching online for solutions, and taking the computer to the store (and waiting in line, and being without your computer for several days, and going back to pick it up…). Then there are the opportunity costs: the things you could have been spending your time doing when instead you were stressing out about your infected PC.

It is still the case that many people think of malware as an “online” threat. There is a false distinction made between cyberattacks that affect the physical world and those that don’t. But next time you hear someone whose voice is shaking because his PC is infected and he doesn’t know what he’s going to do, remember that malware affects the physical world every day.