The Corona Virus Pandemic has brought America, and the world, to a halt. In a world-wide reaction unseen for any previous pandemic, the lives of nearly every human being on the planet have been impacted. All of this has been done in the interest of slowing the spread of the virus, containing the pandemic, and saving lives. But is the cure worse than the disease?

The answer to that question depends entirely on the virulence of the virus – best measured by the mortality rate. The mortality rate can be calculated in many ways but the simplest is the number of deaths divided by the number of infected patients. For EBOLA virus the rate is generally believed to be 50 – 90% depending on the outbreak. For MERS the rate is about 35% and for SARS the rate is around 10 percent. These high mortality rates surely warrant measures as stringent and pervasive as what we are experiencing with COVID-19 (Corona).

But recent statistics show that COVID-19 has a mortality rate of less than two percent. As I write this post Sunday, the 29th, the U.S. mortality rate is 1.7%.The Corona Virus Task Force recently announced testing in the U.S. has exceeded testing in South Korea for the first time.  As testing increases, the likelihood is the mortality rate will decline as the denominator in the equation gets larger. Even so, there are many more people probably infected with mild or no symptoms who are not being tested, yet should be included in the accurate calculation of a mortality rate. The true mortality rate is therefore more likely much less than 1.0%.

The United States now has more cases of infection than anywhere in the world. This reflects our large, diverse population and mobile society, but more importantly, our widespread testing. We are now testing over 100,000 Americans per day and even though only those with symptoms and a fever are being tested, only about 9% test positive.

The South Korea mortality rate is 1.5%. The rate in Germany is 0.8%. Rates are higher in other countries such as China, Italy, and Iran where medical treatment systems are not up to the standards of countries like the U.S. and South Korea. Once again, accurate mortality rates are difficult to calculate unless all citizens are actually tested and all positives are included in the calculations. Results from totalitarian states like China and Iran are especially unreliable.

South Korea is perhaps the best model of Corona Virus response in a highly developed medical system. Corona virus statistics from there are considered highly reliable and have given us much needed information. For example, we know that 99% of actives case in the general population are “mild” and do not require specific medical treatment. These people are staying home and recovering in approximately 14 days.

We also have learned that the small number of cases requiring active treatment are highly concentrated in the older population. The risk of mortality is 3 times higher for people over 70 than for those ages 60 to 69. The risk of mortality is 2 times higher for those over 80 than for those ages 70 to 79.

Dr. David L. Katz, a specialist in preventive medicine and public health, writing in The New York Times, says the time has come to focus our resources on testing and protecting all those people the data indicate are especially vulnerable to severe infection: the elderly, people with chronic disease and the immunologically compromised.  Those that test positive could be the first to receive the first approved antiviral therapies.

However, he says the rest of society should return to life as usual while maintaining good hygiene, washing hands regularly, and self-isolating when sick. Healthy children could return to school; healthy adults go back to their jobs. Travel should return to normal. Theaters and restaurants could re-open, though very large social gatherings like sports stadiums and concerts might still be wise to avoid.

Dr. Katz says, “So long as we were protecting the truly vulnerable, a sense of calm could be restored to society. Just as important, society as a whole could develop natural herd immunity to the virus. The vast majority of people would develop mild corona virus infections, while medical resources could focus on those who fell critically ill. Once the wider population had been exposed and, if infected, had recovered and gained natural immunity, the risk to the most vulnerable would fall dramatically.”

There is a point in this Pandemic when the extreme measures being taken now to prevent spread of the virus even to healthy individuals will come at tremendous expense to the economy and the lives of millions of Americans. When economic depression sets in, the number of deaths related to suicide, drug addiction, alcoholism, and domestic violence will escalate and may greatly exceed those caused by the Corona Virus. We are rapidly approaching that situation and all Americans should be prepared to accept a higher risk of a mild viral infection in return for resumption of a more normal life style existence and restoration of our economy.

 

Our world has been turned upside down in the last couple weeks due to the Corona Virus Pandemic. Schools are closed, sports have come to a grinding halt, travel is greatly restricted, and everyone is fighting hard not to panic.

Everyone is acutely aware of their own health at this moment which raises some legitimate concerns. How do you know if you have the Corona Virus? How can you tell the difference between the Corona Virus, the Flu virus, or just a seasonal allergic reaction to Spring with all the trees and flowers blossoming and hay fever season in full swing?

These are good questions and affect many individuals. Before you call your doctor, who is probably overwhelmed right now with others calling, check your symptoms against this guide to differentiate which might be the source of your trouble:

Testing is not necessary unless you’re pretty sure you have the Corona Virus. Even then, the test results are only needed to measure how contagious you are to others. In all three situations, drink plenty of fluids, get plenty of rest, treat symptoms with OTC remedies, wash your hands frequently, and self-quarantine if you believe you have either Corona Virus or the Flu. Notify your doctor’s office and follow their recommendations.

Remember, over 80% of both Corona Virus and Flu cases can be treated at home. For seasonal allergies, the number approaches 100%. Keep calm and use good judgment. We’re going to get through these difficult times if we all work together and follow the CDC guidelines.

 

Webster’s dictionary defines the word Panic as: “a sudden overpowering fright; terror, consternation, dismay, alarm, dread, fear.” By that definition, the world is certainly in a panic. Schools are being closed, professional sports leagues are suspended indefinitely, cruises are cancelled, airplane flights are cancelled, even the NCAA men’s basketball tournament (better known as March Madness) has been cancelled. This really is March Madness.

My family has been greatly impacted by influenza pandemics in the past. My maternal grandmother, Mary Louise Brownlee Boyce, died in the 1918 Spanish flu pandemic that took the lives of an estimated 50 million people world-wide. My mother was a little girl of five with a sister who was only three. Their lives would never be the same. That year the world was justified in being in a panic.

2009 H1N1 Influenza Virus Pandemic

In 2009, the H1N1 influenza virus emerged and a pandemic was declared by the World Health Organization (WHO). In the year from 4/12/09 to 4/10/10, the CDC estimated there were 60.8 million cases in the U.S. alone and 12,469 deaths attributed to the virus. The CDC also estimated between 151,700 and 575,400 deaths occurred world-wide. Globally, 80% of the deaths occurred in people under the age of 65 years. This contrasts greatly with the number of typical seasonal influenza deaths which are 70-90% in people over the age of 65 years. The mortality impact on the world’s population was 0.001 – 0.007%.

The CDC website says initial testing for the virus was done only at the CDC. On May 1, 2009, the CDC shipped more than 1,000 test kits to 120 domestic and 250 international laboratories in 140 countries.  But there was no panic for testing kits as we’re seeing today even though we have millions more kits now and more are coming.

2017 Influenza Virus Season

In 2017, 959,000 Americans were hospitalized with the flu and 79,400 died. That’s a death rate of 8% of those hospitalized. But there was no panic in this or any other country. There were no school closings, sporting competition cancellations, or airline suspensions.

How important is testing?

The media is currently focused on the number of testing kits available. Dr. Anthony Fauci, the director of the NIAID, has described the current preparation of the system as “failing” because there is a relative shortage of testing kits. The media jumped on this description and wants everyone to believe our government is “failing” in its response to the virus.

This is very misleading. Testing is normally ordered by your doctor in response to signs and symptoms consistent with the virus. Testing is not done just because patients demand it. This is just as true for Xrays, MRIs, and lab work. All of these tests require a doctor’s prescription. But under the present panic circumstances, patients are demanding testing out of an abundance of fear and politicians with political motivations are demanding we provide them. Already we have “drive-thru” testing centers where you don’t even have to get out of your car. You just drive in, get a swap taken from your mouth, and the test is sent off. While this may ameliorate the panic for some, it is unlikely to impact virus treatment.

The medical reality is that testing is unnecessary for treatment. Most influenza patients are never tested but they receive appropriate medical treatment, usually in their home, and they recover without complications. Those who are hospitalized receive supportive care including IV fluids, respiratory therapy, anti-viral drugs and antibiotics if there is evidence of pneumonia. All of these treatments can be done without testing. This is just as true for the corona virus as the flu. The test results mostly help epidemiologists and infectious disease experts, like Dr. Fauci, document and analyze widespread viral pandemics for the benefit of the population at large; not for the benefit of individuals. If you have symptoms consistent with any virus, avoid spreading it to others. Stay at home and call your doctor.

2020 Corona Virus Update

That brings us to our current virus pandemic. People are in a panic mostly because of their fear of the unknown. Despite annual losses of tens of thousands of Americans from influenza, no one panics because influenza is a known virus. Despite years of experience with the mortality of the flu; perhaps because of this experience, people just don’t take the flu seriously. Despite available vaccines that are mostly effective, only 60% of the vulnerable population over the age of 60 gets a flu shot. Only 37% of those under age 60 believe it’s worth the trouble.

The media is filled with facts about the corona virus, mostly inaccurate, and often intentionally frightening. Here are some real facts about the virus taken from the CDC and from the website worldometers.info as of 3/15/20. Follow this website for updates. Another website with similar data is the Center for Systems Science & Engineering (CSSE) systems.jhu.edu which is based at Johns Hopkins University.

Total Corona Virus Cases World-Wide:

162,501

Deaths

6,068

Recovered

75,968

Active Cases

80,465

The following graphic gives a breakdown of the number of cases by country for those countries most affected by the virus. The current U.S. statistics are:

• Total cases – 3,083
• New cases – 372
• Total deaths – 60
• New deaths – 3
• Total cases recovered – 56
• Active cases –2,967
• Serious cases – 10
• Total cases/1 million population – 9.3

 

 

The Corona Virus is certainly a serious world-wide health concern. But there is no need for panic. We have weathered such storms before and the risk is still quite low for anyone to contract the disease. Those who are older and have chronic medical conditions such as heart disease, diabetes, respiratory disease, or obesity are at greatest risk and should take stringent precautions. These include frequent hand washing, avoidance of crowds, avoidance of unnecessary travel, and getting a flu shot. These are common sense measures we should take every flu season, not just when a new virus like Corona Virus rears its head.