fbpx
23312

Coronavirus vs COVID-19

Coronavirus is the virus and COVID-19 is the infection it causes.

The term “coronavirus” is a subfamily name for a group of viruses named by the latin term corona, meaning “crown”, because of protein spikes surrounding the virion center that look like a halo or crown. This subfamily of viruses has been around for a long time and is correctly listed on the labels of many disinfectant cleaners (including Lysol), however, the current threat comes from a novel (“new”) strain of the virus that has showed up for the first time in humans. The current theory is that this strain “spilled over” from a bat used in live animal trade in China. Spilling over is the proper term to use when describing an infectious organism that was contained to a different species and is transferred into a new species now creating a new line of infection. This is precisely why the entire human race was so unprepared for this explosion of infected patients and why this new infectious disease is being called “new” when you hear that coronavirus has been around for a long time and is on the Lysol bottle. This new infectious disease caused by a coronavirus named “SARS-CoV-2” is called COVID-19 (COronaVIrus Disease – 2019).

 

How serious is this?

To be determined, but it needs to be taken seriously to prevent it from becoming a bigger problem for the sick and elderly.

This question will only be accurately revealed in hindsight. As of noontime March 13th, there were 1,629 confirmed cases in the U.S. with 41 deaths. These numbers must be looked at with perspective. You will hear a lot of people throwing around many different numbers as to the mortality rate or case fatality rate which tells us one part of it's severity. The problem with ANY of these numbers is that we don't know the denominators. A confirmed case can only be counted if a test was submitted and confirmed as positive. We have had a problem with testing materials early on and are still only testing a fraction of those with symptoms. Furthermore, there are carriers of the virus that do not show symptoms or are so mild they do not seek medical attention and will not get tested. This means there are far more cases of COVID-19 than are being reported. If the number of cases increases than the case fatality rate decreases (see example below). Also, we do not fully understand which patients have died as a result of the infection versus their underlying illness. If a patient with severe heart failure and COPD was at a decline and headed for ICU when they became infected with the illness, do we count that in the column for COVID-19 or as a result of the COPD? Currently, all deaths with a postmortem positive result of COVID-19 are counted as a death as a result of the COVID-19.

The table below illustrates how the inaccurate reporting process affects these numbers, which leads to misinformation, and has provoked much of the hysteria you see today. The first column are confirmed cases and confirmed deaths as reported by the CDC. This tells us we have a 2.52 case fatality rate, which is very high and is very concerning when comparing that number to other serious pandemics (the 1918 Spanish Flu had a CFR of 2.5). However, we must keep in mind there are far too many extra factors to consider than just relying on those simple numbers. First, and foremost, we have a much better health care system than we did in 1918, including diagnosing, testing and treating. Next, these are early numbers we are getting, before the mass availability of tests and before the majority of those infected show symptoms. We are still traveling up the curve, so to rely on the current numbers is extremely premature.

If you consider that for every 10 people infected, maybe 5 are showing any symptoms and only 1 has been severe enough to seek medical attention and get tested, then the second column illustrates a possible outcome showing 10 times the confirmed cases as unconfirmed (this is merely for illustration and has no data to back this math up.). If this were true, we see a ten fold decrease in the CFR. The actual number will be somewhere below 2.52, but will not be confirmed until after this episode is behind us. The last column includes the assumption that unconfirmed cases exist and have not been reported but also reduces the deaths to include coincidental death with a positive test result but not as a result of COVID-19.

 

Confirmed

CDC DATA – March 13, 2020

Unconfirmed

Exaggerated assumptions for illustration only

Unattributed

Exaggerated assumptions for illustration only

Deaths 41 41 35
Cases 1629 16290 16290
Case Fatality Rate 2.52 0.25 0.21

 

So, what does all this mean?

Just because you don't get sick doesn't mean you aren't passing it someone else that will.

It simply means that we currently do not know how severe this virus is. What we do know is that it is spreading very rapidly. Regardless of the severity of the severe cases, those that are affected the most will be best served by limiting exposure. Healthy adults and children seem to be less affected than the elderly or those with underlying health conditions (especially respiratory illnesses and those with compromised immune systems). So, you may have heard your young friends say they aren't too worried about this. If they catch the virus they may not have symptoms, or may have mild symptoms that resemble a cold, or even worse symptoms that resemble influenza. However, our goal is also to protect the spread to our community.

 

What is Social Distancing and how does it “Flatten the Curve”?

Social Distancing prevents large groups from congregating together, which increases the rate of spread, while preventing those groups slows the transmission exponentially and “flattens the curve” of transmission rate.

In order to protect the community we must institute Social Distancing. In simple terms, this is a method of keeping people away from other people. We are not talking about quarantining every American at this point. But, keeping large groups from coming together in close contact and limiting nonessential travel is important to keeping the virus from spreading unnecessarily. This is why you are seeing sporting events, concerts, colleges and other large events being canceled. Traveling should be done at a minimum to contain the spread within its own areas. If we are successful at this we will slow the rate of transmission and “Flatten the Curve.” I'm sure you have seen the pictures on social media of the comparison of infection rates rising at an alarming rate without social distancing and a much smaller rate when it is used properly. This illustrates the point that we can control the rate of spread. It is important to understand that this will not stop the spread, that is not the goal. It is to slow the spread. If we do not slow the spread the amount of critically ill patients needing medical assistance will overwhelm our current ability to care for the sick. If we can simply spread that infection out over a longer period of time we will have a better chance at caring for those who need it most.

What can we do to protect ourselves and our families?

Wash you hands and disinfect commonly touched items and surfaces.

The coronavirus is spread via respiratory droplets. This means a droplet of mucous from the lungs is coughed, or sneezed, up and lands on a surface. This surface could be a countertop, their hand, your face or anything really. Then, if you touch that surface you now have the virus and can spread it to yourself and others. If you have the virus on your hands, before you wash them, and touch your face, mouth, nose or eyes you have now introduced that virus into your body. It should be known that this virus is not airborne. It can travel through the air, but cannot stay afloat and live in the air. This has a been a point of confusion.

The absolute best answer is to wash your hands and disinfect all commonly touched surfaces. Hand sanitizers should be utilized when you come in contact with someone sick or if you do not have soap and water available. However, hand sanitizer is NOT a substitute for hand washing. If you sneeze or cough it MUST be done into a disposable catching device (Kleenex) or else in the elbow of your shirt and be followed by a prompt and thorough hand washing. Every time you enter a new space you should wash your hands, including entering and leaving work, your home, the bathroom, your vehicle. Also, when touching items commonly handled, such as your phone, pens, door handles, items at shopping centers and grocery stores, etc., you should wash your hands.

Beyond hand washing, utilize social distancing, avoid nonessential travel and check on those that need help and offer assistance.

 

Why are people worried about having enough toilet paper?

No Clue – People are apparently misinformed