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  • Dr. Bob

COVID-19

You cannot turn on the news without hearing about the coronavirus. As I watch the news today, the New York Stock Exchange has plunged almost 1000 points in the first two hours of trading because people fear the coronavirus and the prospect, or the potential, for a pandemic.


The World Health Organization (WHO) has abbreviated disease associated with the coronavirus as COVID-19. You will hear that acronym increasingly in the news.

We should always take communicable disease seriously, but panic over the coronavirus is unwarranted and silly. The impact on the world economy is almost understandable in that supply chains which are dependent upon China have been interrupted, but the Apple production plants are back up to speed this morning.


The weaponization of the news to blame Pres. Trump is as amusing as it is predictable. I think that Trump was also directly responsible for an earthquake last month.

Here are some facts on which you can hang your hat.


Symptoms of infection appear between two and 14 days after exposure. Look for fever, cough, and shortness of breath. Of course, exposure to anyone who has been to China or to any place in the world where infections exist is a risk factor. It is airborne, so it is easily transmitted from person to person.


Bear in mind that very few people who have fever, cough, and shortness of breath will have this virus. There is a quick detection test available to identify actual cases.


The Trump administration has an excellent team put together whose primary purpose is to protect Americans. The Centers for Disease Control (CDC) changed their approach to screening yesterday to allow medical personnel to test anyone they think might have signs and symptoms of infection rather than blindly following a rigid protocol as they did the day before yesterday.


There are only 15 cases in the United States confirmed. There are 45 cases quarantined on a cruise ship, and one case in California which does not appear to be related to any travel or exposure to people who have traveled to China. With the spread of the virus to countries with less organize defense then hours, particularly India and Iran, we now have more cases outside of China that we have inside China. Just over 2300 cases have been reported in South Korea with only 13 fatalities, and these cases are linked to a religious sect.


At this writing, there are 83,774 confirmed cases worldwide with 2867 confirmed fatalities. Of course, this is dynamic and will change by the time I post this.


If you write down the total number of confirmed cases and then divide that number by the number of deaths associated with those confirmed cases, you get a ratio called the case fatality rate, or CFR. Right now that rate seems to be 2.3%, compared to influenza that runs about 0.1% in the United States. An alarmist will point out that is 23 times deadlier than flu, but it is 23 times a very small amount.


And the CFR depends on where you are. Some countries have better healthcare than others. Also, the CFR was higher near the epicenter of the outbreak in Wuhan. It will be higher in places like Iran and many African countries whose healthcare systems are woefully inadequate.


COVID-19 prefers older victims. The death rate of those over 80 runs about 14.8%, falling to 8% for those 70-79, 3.6% for those 60-69, 1.3% for those 50 – 59, 0.4% for those 40 – 49, and 0.2% for those between 10 and 39 years of age. There have been no deaths for children under nine years.


It might be helpful to compare this to something we know about. While COVID-19 has affected over 80,000 people so far worldwide, influenza has affected between 9 million and 45 million with illnesses annually since 2010. Influenza puts between 140,000 and 810,000 in hospitals annually, and it kills between 12,000 and 61,000 annually, all since 2010. When compared to influenza, COVID-19 is a rank amateur.


How can we protect America as this spreads across the globe? One of the most important things is the control of travel (travel restrictions) to contain the virus. The Trump administration is on top of that. Of course, there will be some very ignorant and bigoted people who equate travel restrictions with racist policy. We should remember that a virus is not political.


How can you protect yourself? The answer is disappointingly easy. There is nothing sexy about this. Here is a list of the most powerful interventions available to you.


- Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer. I would suggest washing your hands with soap and water and using the alcohol-based sanitizer if you are concerned about exposure. Do this as a precaution, for example, after being in a crowded place.


- Avoid touching your eyes, nose and mouth with unwashed hands.


- Avoid close contact with people who are sick.


- Stay home when you are sick. Please do not share this with coworkers.


- Cough or sneeze into your elbow or use a tissue to cover it, then throw the tissue in the trash.


- Clean and disinfect frequently touched objects and surfaces. Consider keeping some alcohol wipes to use on the handle of the basket when you go grocery shopping. Hundreds of people touch those handles every day.


- The surgical mask will not protect you from an airborne virus. It might, however, keep you from infecting someone else.


- Be observant, take your vitamin C, and stay healthy.


Every plague known to man has run its course. Even polio was on the way down before the vaccine was ever invented. This one will be no different. Spring is coming, the weather will change, and it will be okay.




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