Facts and Fiction in the Age of Covid-19

Posted by on Mar 17, 2020 in COVID-19, Uncategorized
Facts and Fiction in the Age of Covid-19

No matter where you turn, you are inundated with information about the coronavirus. This variety of virus is new so thatthere is very little scientific information, yet loads to ‘ponder’ by the news and other sources less in the know, which makes it difficult to separate the facts from the fiction and ignore the hype that is erroneous.

So, let’s start with the basics. Take a deep breath. Consider your source(s) and let’s learn a little about a new ‘kid’ in town, Covid-19. First off, before you venture into an ‘end of the world’ made for TV drama, realize that epidemics and pandemicshave been around for as long as people have existed and moved from their local habitats. Their frequency does seem to be increasing, not the least because of increasing infection form animals. Hopefully, by reviewing what we already know about other pandemics, we can get a better idea about the coronavirus.

Last year, if you had asked somewhat what pandemic was they probably would have given a somewhat generalized answer. Yet, a mere decade ago, we faced a pandemic in the form of H1N1, commonly known as swine flu. On December 10, 2009, the CDC reported an estimated 50 million Americans or 1 in 6 people had been infected with the 2009 H1N1 Virus and 10,000 Americans had diedRegardless, it has been COVID-19that has given people a more developed idea of what a pandemic is, in great part due to the enormous exposure (media not germ) that has been generated.

One factor which determines the characteristic of a pandemic is how many future people an infected patient will generate. The number that we use for contagiousness of diseases is called the r0. If the r0 is 1, that means that each person with a disease is expected to give it to one other person … so the higher the number, the more contagious it is. For the seasonal flu, the r0 number is about 1.3. Right now, the coronavirus r0 is about 2.2, so higher than the flu. But, to put this in perspective, measles, among the most contagious of all viruses has an r0 number of @ 18! 

As we know now, COVID-19 is transmitted through droplets from sneezing of coughing. Measures such as physical barriers, good hygiene, and reducing various situations where there is close contact amongst people. The COVID-19 experience in China is an example of how rapid, aggressive measures by a government can reduce the spread and size of a pandemic. The epidemic in China seems to have peaked in mid-January. The effectiveness of limiting person-to-person transmission can be seen in the February statistic from China. In Hubei with a population of 59 million, there were 65,000 cases and a death rate of 2.9%. But by imposing measures to limit the spread of the virus, the rest of Chine with 1.3 billion people had recorded only 13,000 cases and a death rate of 0.4%. The government of China has the ability to implement measures which would be difficult if not impossible in other countries but recent events in countries such as Italy have tried to copy the effective measures from China and time will tell is these measures will be effective.

An epidemic is the outbreak of a communicable (people can get it from people) disease that affects a larger portion of a local population (which can extend to an entire country). Now suppose a cruise ship docks in the country where there is an epidemic and a few people on the ship get the disease. The ship has a number of ports of call in a number of countries. The infected passengers leave the ship in the numerous ports and local inhabitants contract the disease. Anytime the disease of an epidemic crosses borders it is call a pandemic- same disease but spread across borders. On December 30th, 2019 in Wuhan Jinyintan Hospital in China, three lung lavages were taken from a patient with pneumonia of unknown cause and thus resulted with the identification of COVID-19 and the center of where this disease started.

Another pandemic which seriously affected the boomer generation was polio. Polio has been around since ancient times. However, in the first half of the 20th century, there were a number of pandemics. In 1952 in the United States there was an especially severe epidemic where 58,000 cases were reported with 3145 deaths. The development of vaccines by Koprowski (altered virus: attenuated) and Salk (inactivated virus) permitted the immunization of entire populations and thus, in theory, eliminate the virus and thus polio. Most countries use the inactivated virus-based vaccines. In 2019 there were 146 cases of polio worldwide and 21 to date in 2020. So which virus causes COVID-19and what lessons from history can be used to combat the current pandemic.

COVID-19 is a virus that belongs to a family of viruses called severe acute respiratory syndrome (SARS), which should sound somewhat familiar since it sounds like the SARS pandemic of 2002-2003. There actually are hundreds of varieties of the SARS family of viruses but only a couple can infect humans while the rest infect animals such as bats. In 2016, The World Health Organization (WHO) predicted that an epidemic caused by a coronavirus was likely. In November 2002 there was an outbreak of a SARS virus pandemic that originated in Foshan China. There were over 8,000 people infected with 774 deaths resulting in a death rate of 9.7%. As of March 7, 2020, there were over 100,000 cases of COVID-19 with over 3000 deaths for a death rate of 3-4% which is far less than that for the 2002 SARS outbreak. The flu, influenza, is also a viral disease that affects thousands of people every year. For example in 2019, 16.5 million people were diagnosed with flu, with 34,000 deaths for a death rate of 0.2%.

Viruses that cause respiratory disease are well-suited to cause a pandemic. The viruses are easily transmitted between people; they have a long period where the infected person can transmit the virus especially if the person is not symptomatic during a longer period of time and, have symptoms that are common to a number of similar viral infections. COVID-19 meets many of the pandemic promoting requirements. COVID- 19 spreads primarily from close person-to-person contact (less than 6 feet) and from droplets from coughing or sneezing. Another minor form of transmission is from direct contact with surfaces where the virus has survived and then the face or nose. It is estimated that the virus can survive for as little as 3 hours on surfaces or as long as 24 hours.

Long before you hit the panic button; consider that COVID-19 is a new variation off of an old theme. The measures put in place by the CDC will limit the spread of the virus in time. Within a year, a vaccine will be available, relegating COVID-19 to take its rightful place among other pandemics.