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Coronavirus - Facts or Fear

March 13, 2020
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Posted By: Apollonia Dental
Cartoon image of virus

Let me begin by saying I am not an infectious disease specialist. I am particularly motivated by my job as a dentist to be properly informed about this particular disease. I also realize that hype sells and we are in a world where boring doesn't make money. That being said, no infectious disease is to be laughed at. After all, the consequence is human suffering. 

As of 3/12/2020, we have approximately 4000 deaths worldwide from Covid-19 or "Coronavirus". The average flu season kills approximately 291,000 to 646,000 people worldwide (1). Just today, approximately 48219 people will die of cardiac disease (2).

A lot of so called media authorities are listing the mortality rate for Coronavirus as 2-3% while comparing it to a flu mortality rate of .1%. The high mortality rate for the Coronavirus mostly comes from isolated instances, such as the Chinese Wuhan data. The problem is that this data is only based on people known to be sick. That is not how mortality rate is calculated. Take for example the mortality rate on the Princess Cruise outside of Japan - this is the only place where you can be sure that everyone was tested  and remember this is a closed environment and cruise ships are known to increase respiratory illness - was .85% (3). On the cruise ship, there were about 4000 people and about 20% were positive for the disease (3). This seems like it is spreading more like a common cold or flu. It is important to remember that this is a very limited data set. But, if you look at other numbers coming out of countries like Korea and Germany where extensive testing will be done, I expect numbers to be more in line with the cruise ship as testing will include people who are infected but do not demonstrate serious symptoms. 

I believe that the statement that the virus is just as or more deadly for the elderly than the flu, especially those with underlying conditions, is accurate. It appears from preliminary data that it this is due to the fact that elderly are more often compromised otherwise and our health care systems are already overwhelmed by the seasonal flu. Additionally, more middle aged people seem to need intensive care compared to the seasonal flu. So, there is something to be said about the fact that this Coronavirus appears to be "more serious" when it infects middle aged and especially the elderly. 

So, let's look at Italy. As of 3/12/2020, there were 9172 known cases with 463 deaths. That's a 5% mortality rate. However, the average age of death from Coronavirus is 81.4 years (6). Again, the information is from folks who had severe symptoms and sought attention. This seems more like how the flu operates with mortality being higher in the elderly (8). The youth - for the most part - seem to have not as serious a problem, which is a little bit of good news. 

I've been hearing too much of this: "If you have cold symptoms, you probably have to the Coronavirus" - NO! 

The main symptoms are dry cough, fever, with or without shortness of breath. Focus on those. If you have those, you may have the Coronavirus. If you have noticeable shortness of breath, contact your physician or an ER immediately. If you don't have shortness of breath, stay home and isolate yourself. 

I read somewhere that everything done before a pandemic is considered overreaction and everything afterwards too little too late. I think if the result is saving lives of our citizens, we can afford to overreact a little. 

Disclaimer: this is not medical advice. It is my opinion and some cited data. This information may not be valid by the time you read it due to the novel nature of the Coronavirus, specifically Covid-19. You should contact your healthcare provider if you suspect you are ill so you are properly diagnosed and treated. 

   

(1) Iuliano AD, Roguski KM, Chang HH, et al. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study [published correction appears in Lancet. 2018 Jan 19;:]. Lancet. 2018;391(10127):1285–1300. doi: 10.1016/S0140-6736(17)33293-2

(2) American Heart Association. Heart Disease and Stroke Statistics-2019 At-a-Glance. https://healthmetrics.heart.org/wp-content/uploads/2019/02/At-A-Glance-Heart-Disease-and-Stroke-Statistics-%E2%80%93-2019.pdf Accessed 3/13/20

(3) Faust J. COVID-19 Isn’t As Deadly As We Think. Slate. https://slate.com/technology/2020/03/coronavirus-mortality-rate-lower-than-we-think.html Accessed 3/6/20.

(4) Der Tagespiegle. So leben die Menschen in der „roten Zone“. https://www.tagesspiegel.de/wissen/italien-kaempft-gegen-coronavirus-so-leben-die-menschen-in-der-roten-zone/25621354.html. Accessed 3/12/20.

(5) Kolate G. Coronavirus Is Very Different From the Spanish Flu of 1918. Here’s How. The New York Times. https://www.nytimes.com/2020/03/09/science/coronavirus-is-very-different-from-the-spanish-flu-of-1918-heres-how.html Accessed 3/11/20

(6) BBC News. Coronavirus: Italy in ‘massive shock therapy’ pledge to offset virus impact. https://www.bbc.com/news/world-europe-51799956 Accessed 3/9/20.

(7) The Centers for Disease Control. Coronavirus Disease 2019 (COVID-19)-Symptoms. https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html Accessed 3/13/20

(8) https://www.cdc.gov/flu/spotlights/2018-2019/hopitalization-rates-older.html accessed 3/13/2020

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