Post #4: Update on the Coronavirus

The funny thing about a new disease is that the information you had in one week is going to change by the next, especially if the disease continues to spread. When it comes to coronavirus—now dubbed COVID-19—we are getting new information every day, and that information has slowly become more alarming.

So, lets list out some of the new facts both good and bad:

  1. Good news: the virus is still spreading but the number of new cases every day has appeared to slow, especially in China, which means that the public health techniques deployed are working. So, is the world still seeing new cases every day? Yes. But at the same magnitude? No (1)
  2. Bad news: This disease, though not classified as a pandemic right now, is working its way toward a pandemic classification. (2) The last pandemic that we saw was H1N1 in 2009, which ended up being a mild disease. (3) Not to mention, H1N1 was first discovered in America during a time when information flowed freely and public health departments were funded relatively well. Unfortunately, COVID-19 is much more lethal than H1N1 and was first discovered in China, which is a country full of brilliant people but less transparency. Additionally, our country is currently running on underfunded and understaffed pandemic response teams. (4) These two facts combined make COVID-19 more alarming and more dangerous for the United States.
  3. Good news: Children and people less than 30 do not seem to be significantly impacted by COVID-19. This is good news for pandemic response because we really just do not have the resources to respond to a pandemic that also affects children and young adults. (5)
  4. Bad news: We’ve seen other coronavirus outbreaks like SARS and MERS. Are SARS and MERS more deadly? Absolutely, they have a ~10% (8) and ~30% (7) mortality rate respectively while COVID-19 has around a 2% mortality. However, SARS and MERS do not spread from person to person easily, whereas COVID-19 does, which makes it more dangerous. (6) Also, epidemiologists believe that COVID-19 is contagious before symptom onset AND that many people who contract the disease are asymptomatic. (6)
  5. Good news: Roughly 80% of people who contract the disease have mild symptoms. (9)
  6. Bad news: The 20% of individuals who have the disease go into the hospital and require ventilators. (9) Our country does not have enough ventilators to sustain a country-wide outbreak. That is a simple fact. Sure, we have a good amount and of course we have some stockpiles. But ventilators are expensive and require full-time staff to operate. So, do we have enough to cover all Americans? Absolutely not. Do we even have enough to cover 20% of Americans? Absolutely not. Ethically, we’re going to have to make some pretty big decisions if we have a sustained outbreak. (10)
  7. Good news: We are developing a vaccine quickly. (11)
  8. Bad news: even if we had a vaccine tomorrow it would still need to be tested and that takes, at a minimum, 9 months to validate which means that we’re looking at 12-18 months BEFORE a vaccine would be readily available. (12) And once the vaccine was available my guess would be that the highest risk individuals would receive the vaccine first. Aka: the elderly, women who are pregnant, and those with compromised immune systems.
  9. Good news: We are testing antivirals against COVID-19 with some promising results. Luckily, antivirals have to go through less clinical trials than vaccines so we could have somewhat of a treatment for COVID-19 within the next 2-3 weeks. Are antivirals like antibiotics? No, they will not be some magical cure and make people better within days. But they could shorten the duration and severity of the disease for our most vulnerable patients and that is important! (11)
  10. Bad news: Have any of you heard about the 1918 influenza? If not, I will give you a brief overview. The 1918 influenza was a pandemic that wiped out nearly a quarter of the worlds population and knocked 12 years off of life expectancy. Guess what its mortality rate was? 2.5% that’s only 0.5% higher than that for COVID-19. (13) To put it into perspective, even on a bad year the common flu has a mortality rate of 0.1%, which means COVID-19 is 20X more lethal than the common flu. Another point of reference, if you have 300 friends on Facebook, 6 will die. If you have 600 friends, 12 will die. If you have 900 friends, 18 will die. The United States has about 327 million people if 80% of the people got infected that would be 261 million people ill of those 261 million, 209 million would have a mild disease, 52 million would have severe disease and of those 52 million, 1 million people would die. Even with a bad flu season we average around 40,000 deaths. The cold hard truth is that if we have sustained spread of this disease in America, you will know someone who dies by COVID-19.
  11. Good news: there are steps that you can take to prevent contraction and/or slow the spread in your community: (14)
    1. If you are sick, STAY HOME: I know that it is a privilege to be able to stay home from work. But, do your best to make it happen.
    2. If you cannot stay home while sick: BUY HAND SANITIZER, cover your cough, stay away from healthy individuals as much as possible.
    3. If you are healthy: keep your hands away from your face. (easier said than done) Buy hand sanitizer and use liberally. Wash your hands often. Cover your cough and keep your distance.
    4. Stock up on supplies in the chance that you need to quarantine. In general, you will need 2 weeks of food for your family and any pets, 2 weeks of medication, 2 weeks of toiletries, and lots of hand soap. Luckily, this is not a natural disaster so we should have running water, electricity, and WIFI. Again, I know that privilege plays a huge role in being able to stockpile and feel secure. And it is important to acknowledge that not everyone in our community can do this. So, if you are in a place of privilege: donate some regular food, baby food, cat food, toiletries, pharmacy supplies, soap, money, or anything else that you might deem beneficial.
    5. If you are healthy do not, I repeat DO NOT stockpile masks. We are already running low. Individuals who are at highest risk should be the ones who get the masks. So, put that box of masks down. You do not need them. Check yourself before you wreck everyone else.

I know that this update feels a little abysmal and much less encouraging than the last thing I wrote. But this is what we face and it is better to face it head on together than bury our heads in the sand. It is a fact that you might end up knowing someone who contracts COVID-19 and that just has to be okay for right now. We will get through this, maybe not unscathed. But together we will come out on the other side. So, buckle up friends because we’re in for a year of the unknown

Sources:

  1. https://www.youtube.com/watch?v=ABHZbLGCdV8
  2. https://www.cnn.com/2020/02/25/health/coronavirus-pandemic-frieden/index.html
  3. https://www.cnn.com/2020/02/25/health/coronavirus-pandemic-frieden/index.html
  4. https://nymag.com/intelligencer/2020/02/what-we-know-about-the-trump-admins-response-to-coronavirus.html
  5. https://www.contemporarypediatrics.com/infectious-disease/kids-and-covid-19-illness-appears-mild
  6. https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html
  7. https://www.who.int/emergencies/mers-cov/en/
  8. https://www.who.int/csr/sars/en/WHOconsensus.pdf
  9. https://www.who.int/news-room/q-a-detail/q-a-coronaviruses
  10. http://www.centerforhealthsecurity.org/our-work/events/2018_clade_x_exercise/pdfs/Clade-X-ventilator-availability-fact-sheet.pdf
  11. https://time.com/5790545/first-covid-19-vaccine/
  12. https://www.theatlantic.com/health/archive/2020/02/covid-vaccine/607000/
  13. https://wwwnc.cdc.gov/eid/article/12/1/05-0979_article
  14. https://www.cdc.gov/coronavirus/2019-ncov/php/preparing-communities.html

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