The Covid-19 Coronavirus Outbreak : Should You Be Worried?

Symptoms of a Covid-19 virus infection – other than breathlessness, very similar to other flu symptoms

Please click here for a listing of all our Covid-19 articles.

There’s never been such a massive response to any previous infectious outbreak as there has been to what was originally generically termed and described as a new type of coronavirus, and which has now been officially named as Covid-19.

Is this massive response, all around the world, necessary, or is it a panicked over-reaction?  Is the outbreak now almost under control and the threat it originally posed receding, or is it remaining present, and maybe even growing?  What should we be doing – and not doing – in order to minimize our own risk of contracting the virus?  And just exactly how infectious and how dangerous is it?

The answers to all four of those questions are of course important, but none of them are clear.  Let’s start at the beginning and see if we can at least clarify some of the issues and possible/probable outcomes.

Background

As you may already know, the virus first emerged in the Chinese city of Wuhan, in their Hubei province, probably very early in December 2019.  It was identified as a type of corona virus, so-called due to its shape under an electron microscope.  The common cold is also a corona-virus, but this one is more dangerous because it infects the lower rather than upper respiratory tract, which means it can lead to secondary complications such as pneumonia and bronchitis.

The origin of the virus is subject to conjecture at present.  The two main schools of thought are that it was a semi-random mutation that somehow got passed from bats to humans through a fish market in Wuhan, or that it is a man-made virus that escaped from a nearby bio-research/warfare laboratory (the Wuhan Institute of Virology) that was known to be researching bat viruses.

At first the Chinese denied there was anything to be concerned about, and it seems generally accepted that they lied to an extreme extent to downplay the nature and scope of the new virus.  Most astonishingly, they threatened one of the doctors involved with the initial detection/diagnosis of the virus with imprisonment if he continued to publicize his findings.  He proved the validity of his concerns in the most definitive – but tragic – way possible.  He subsequently died of the disease, himself.

China only admitted it had a problem on 31 December.  By mid January, it was becoming clear that something new and scary was happening in China on a frightening scale and with global implications, although this dawning realization was emerging as much through unofficial social media channels as it was through official Chinese government announcements and disclosures.  The World Health Organization finally declared a Global Public Health Emergency on 30 January, and most people considered this declaration to be overdue and unnecessarily delayed (it is thought the reason for the delay is because WHO didn’t want to upset or offend the Chinese government).

The virus was only named on 11 February.  Normally, this would be no big deal.  But, astonishingly, in this case, even its name is controversial.  Who’d have thought that the name of a virus would be controversial?  But these days, we can apparently no longer name things in forms such as “swine flu” or “bird flu” because those names are prejudicial to the animals involved, and similarly, we can no longer have Spanish Flu or Middle Eastern Flu, because those names are prejudicial to countries.  Instead, we have to have a very neutral name so as not to upset any groups, be they human or animal, anywhere in the world.

The name was officially designated by scientists as SARS-CoV-2, because it is a variant of the SARS virus that was prevalent in 2002-3.  But WHO – an organization increasingly crippled by a desire to be politically correct rather than medically on the ball – doesn’t like that name, because it might be too scary (we kid you not).  Instead, WHO wishes it to be known as “the virus responsible for Covid-19” – you couldn’t make this up, it is so ridiculous, but here’s an article explaining this further.  To be technically exact, it seems Covid-19 is the name of the outbreak rather than the name of the virus, but most people are now referring to the virus and the outbreak interchangeably as Covid-19.

Fatality Rate

The actual fatality rate or lethality of the Covid-19 virus is still being calculated.  Early statistics laughably understated its lethality by suggesting that perhaps 2% of people infected would die, so much so as to make it seem as if the authorities were deliberately lying.  Now that there is more history, it seems the lethality may be in the order of 10%, with influencing factors being the age and health of the patient and of course the quality of the healthcare they receive.

You might wonder how/why there’s any ambiguity about the death rate.  Counting deaths is a fairly easy process, it would seem.  The problem isn’t in counting the deaths, it is in what to measure the deaths against.  Total people infected, total people surviving, and if so, at what time do you match deaths to survivors, or some other measure.

Initially, medical authorities were calculating fatality rates by expressing total deaths as a percentage of total infections as at the same date, but in the early stages of the infection, people had not yet had a time to start dying, so the death rate was unrealistically low (a bit like saying “the survival rate for cancer is 100%” but based on how many people survive for a week after diagnosis).

It is only now that there is starting to be time for people to work through their infections and either recover or die, and so we can start to build up a more meaningful figure by comparing the number of people who died compared to the number who have recovered.

Using this statistic, and the latest figures (Feb 20) shows a total of 20,808 closed cases.  Of those cases, 2,247 people died and 18,561 survived, which suggests an 11% mortality rate.  (See our update for the changing percentages, which happily are trending towards more survivors and fewer casualties.)

We’ve noticed this daily statistic has been trending to a lower and lower mortality percentage over time.  A week ago it was more like 20% mortality rate.  Of course, the statistic is also dependent on how accurate diagnoses are of the infection – obviously people who die of it are likely to be diagnosed, but people contracting mild cases have been slipping under the radar, although now there are better tests for it, and that is probably why the lethality rate is dropping – because more mild cases are being detected and added to the statistics.  So, at present, we can say that people who got to the point of being diagnosed with the disease have an 89% chance of surviving.  That’s a fairly encouraging number, and all the more so because many (but not all) of the people who succumbed to Covid-19 were people who already had severe health problems.  So if you’re currently healthy, and neither very young nor very old, and if you’re able to get quality health care, your chances of surviving are very positive.

Transmission Rate

In addition to the lethality of a virus (or any other disease), the other key consideration is its transmission rate – how effectively it propagates, how easy it is to catch from someone who has already been infected.  Most cancers, for example, while having high lethality rates, have zero propagation – in almost all cases, you can’t catch a cancer from someone who already has it.  Other things, like the common cold, have low lethality but readily spread through communities.

It is perhaps acceptable to have a high score on one of these two factors, as long as the other factor is balancingly low.  A high score on both is cause for alarm.  It seems that the Covid-19 virus has a fairly high transmission rate.

A factor/rate of 1 means “each infected patient passes it on to one more person”, and that is a “steady state” where the number of cases neither rises nor falls.  If the transmission rate drops below 1, then the disease dies out, because each infected person is passing it on to less than one more person.  But if the rate rises above 1, then we start to see a growth in cases.  For example, a rate of 2 means that “Patient zero” (probably better called patient one) causes two more infections, then they in turn each cause two more (that is four new cases), then we go to eight, 16, 32, 64, 128, 256, and so on.

To give a couple of comparisons, the transmission rate for common influenza is 1.3 and for SARS it was 2.0

The transmission rate for Covid-19 is still being fine tuned and calculated.  WHO estimated it to be between 1.4 and 2.5 back on 23 January.  Since then, other credible studies and with much more case data to base them on have come out, assessing rates as low as 2.24 and as high as 4.0.

This is a high rate.  If we say we start with 10 infected people, and assuming a week from when a person gets infected to when they pass the infection on, and a transmission rate of 3.12 (midway between 2.24 and 4.0) then it would take less than 19 weeks for every person on the planet to be infected.

So we can understand the concern expressed by public health authorities.

Of course, this transmission rate is not just a factor of how efficiently the disease can spread itself – how infectious it is – but also the opportunities present for the infected person to come into “contact” (ie get close to) other people and effectively infect them, which is where the concept of quarantine comes into play.  It is because of quarantine measures in China that the counts of infected people haven’t continued their earlier geometric progression.

Transmission Considerations

There are two aspects to considering how an infection is transmitted.  One of them is how to detect people who are passing the disease, and the other is the actual ways it can be passed.

The news is bad on both these fronts.  It is usual for people to show some signs of their infection when they are capable of passing it.  Think of a common cold/cough.  The coughing and sneezing is simultaneously a symptom and also a method for the disease to pass itself on.  A person with no cough or cold might be in the early stages of developing an infection, but they are not yet infectious.  When they are infectious, it is obvious they are infected, and so it is easier for both the person and other people coming into contact with them to modify their behaviors.

But the Covid-19 virus can be passed before a person shows signs of infection – what is called asymptomatic transmission.  That makes it very much harder to “nip it in the bud” because by the time a person has been detected as being infected, they might have already passed the infection on to several other people.  Asymptomatic transmission also means that the pyrometer devices at airports to measure people’s temperature as they walk past are of much less value than they might otherwise be (and some health authorities believe them to be of little use at the best of times anyway).

You might meet a friend who seems perfectly healthy, and you close in for a hug and kiss or whatever, without giving it a second thought, because you “know” the person and trust them to be free of infection, because they seem their usual robust and cheerful self.  But you don’t know what they did yesterday and the day before, and what the other people they interacted with had done and their condition, and so on.  It is a bit like the issue of sexual disease transmission (another often asymptomatic thing) – as the saying goes, you’re not just sleeping with your new mate, you’re also in essence sleeping with all their past partners too.

The other bad news element is that Covid-19 appears to be a very effective self-propagator.  It can pass itself in droplets and in finer aerosol form (stays suspended in the air longer and can be breathed directly in).  It will remain viable on exposed surfaces for at least some hours – depending on temperature, humidity, and surface type.  And it also can be passed through fecal contamination, too.  You in turn can transfer the virus into your system through your mouth or nose or even eyes.

Update 2/22 :  The “fecal contamination” route has now been broadened to possibly also including urine.  The issue of course being someone who doesn’t wash their hands after a toilet visit, possibly has their hands contaminated with their urine, then transfers that contamination to something (perhaps food) that you then come into contact with, and now you’re infected too.

The Chinese Response

The world should be very grateful that this disease developed in China, because when China finally came to acknowledge there was a full-blown medical disaster in the making, they responded in a way which would have been impossible or unacceptable in most other countries.  They locked down much of the country, imposing quarantines on more of the country than has been publicly acknowledged.  (We say this because people we correspond with in other parts of China, not just Wuhan and the area in Hubei province surrounding Wuhan, have told us how they’ve had their cities quarantined too, even though we’ve seen no mention of this in the news.  Even today, people in Guangdong are telling us they remain restricted to their apartments.)

Much of the country remains on lockdown, with people confined to their apartments, and only one person allowed to go out, once every two (or sometimes three) days, so as to shop for food (which is often hard to find, because the entire food supply chains have been disrupted too).  When people go out of their apartment, they are required to wear a face mask – more to prevent themselves spreading the disease than to protect them against infection from others) and must stay at least five feet away from anyone else on the streets.

This five foot (1.5 meter) separation distance would have been utterly impossible in the very dense cities that it is being applied to, but pictures show almost empty deserted streets – scenes that formerly would have shown the sidewalks with crushes of people, and the roads jam-packed full of cars.

People who do not comply are chased, beaten, and likely arrested and spirited away to some far-away jail.  Perhaps unsurprisingly, the jails are posing a problem – they are proving to be great breeding grounds for the virus.

The Chinese government is even destroying banknotes for fear they may be contaminated and act as another way for the virus to pass from person to person.

This broad and incredibly assertive approach to quarantine, while offensive to the delicate sensibilities of many in the west, seems to actually be working, and rather than criticizing the Chinese government for their somewhat draconian measures, we should all be very thankful because it is the sacrifices of the Chinese that are allowing us to continue to lead our lives in more or less unaltered form.

Is Covid-19 Increasing or Decreasing?

That’s a key question we’re all keen to know the answer to.  But it is very hard to accurately understand what is happening.

The most distinctive thing about the outbreak is that it is (currently) almost entirely confined to China.  75,465 of the known 76,738 cases (ie 98.3%) are in China.  Perhaps amusingly (if you have graveyard humor!) and a sign of our modern world, the second largest outbreak, of 634 cases, is not in a country, it is on a ship – the Diamond Princess.  That leaves only 639 cases for the rest of the world.  (A week later, things are very different.  See our update.)

So almost our entire understanding is dependent on what the Chinese tell us.  They’ve refused to allow US CDC staff to come and evaluate and understand the situation in China, and while they tell us that they’re being open and honest, in the early days of the outbreak, it seems clear they were neither open nor honest, and at times when China was reporting low numbers of cases and even lower numbers of deaths, residents of Wuhan were posting terrifying pictures of people collapsing on the streets and bodies left untouched or piled high, in public areas and in hospitals, that completely contradicted the official version of the truth.  Some computer simulations of expected levels of spread of the disease have also suggested that the Chinese have massively understated things, and it has been credibly suggested that total cases in China might be ten times higher than disclosed.

Making things even harder to track is that the Chinese have twice now changed their counting methodology for how they determine if a person has the virus or not.  They first changed it in a manner that caused a leap in reported cases, and now they have changed it back again to a manner similar to the original methodology, causing a great drop in daily reported cases.  This page has lots of great statistics, or at least, statistics that are as great as the numbers reported by the Chinese.

Our focus is not so much on the case count in China, but rather the count of cases elsewhere in the world.  With so much of the world having greatly reduced their interactions with China, and with China’s own effective internal measures, it seems, as astonishing as it may be, that China is moderately well walled off from the rest of the world.

At least based on the current figures from China, it seems that the rate of new cases being disclosed each day is decreasing.  But there was still another 889 new cases reported yesterday in China, so while that is much better than the 1700 or so a couple of days before, two things to keep in mind.  The first is that this plunging count in new cases is due to China changing, again, how it counts new cases, and the second point is that a rate of 889 new cases every day still points to a very active disease spreading through China.  So we’re happy that at least China’s numbers do not seem to be increasing every day, as they formerly had been, we’ll not be fully satisfied until the number drops to 0 new cases per day, and for a sustained period of several weeks.

Keeping in mind the ability of the disease to spread quickly in countries where the strict Chinese quarantine measures are not present, we’re very concerned that it could get established in other areas in other countries, the same way it did in Wuhan, and, most of all, that these other areas will not have the same level of government shutdown/quarantine imposed on them as China has done.

The good news?  The total number of cases outside China remains low.  The bad news?  These cases are growing at an increasingly rapid rate.

Looking at the country you are most likely to be reading this within, we’re back to good news again.  Neither the US nor UK have had many cases, and no recent new cases have been added to their respective counts of 15 and 9 cases.  Canada has a fairly stable count of 8 cases.  Most of the growth is in South East Asia – South Korea, Japan, Singapore and Hong Kong.

Ooops – while writing this article, news broke of a new case being reported in both the US (northern California) and in Canada (British Columbia).

But, whether in our backyard or not, the disease is actively spreading outside of China, and in countries that we don’t have such stringent travel restrictions on.  Yesterday there were 53 new cases in South Korea and another 45 today (which is now calling for voluntary restrictions on movement), and 10 in Japan and another 3 today – two countries that the rest of the world has a great deal of international connectedness with.  What are the chances of a 54th Korean or an 11th Japanese person also having contracted the disease immediately prior to flying to your home town, at a stage prior to developing detectable symptoms?  The closer you are to an airport with nonstop flights to Seoul or anywhere in Japan, the stronger your chances are (but please note the chances are still very very low).

So, to answer the increasing/decreasing question, it seems that the outbreak is decreasing its rate of spread in China, while increasing it in the rest of the world.

Should You Worry?

This is another important question, and one of the hardest of all to answer.  Perhaps one pointer is to note the degree of alarm and response instituted by countries across the world, with a concerted rush to shut themselves off from China, even if at considerable inconvenience.  A further factor to note are the preparations for mass quarantine camps that are being made across the US.

That alarms us at many levels, and we’d hate to be consigned to one of those camps.  Think about the implication of such camps.  They are collections of people who may or may not have Covid-19; quarantined from the rest of the country, but not so much from each other.  How would you like to find yourself suddenly being placed in a camp, with a bunk bed in a converted airplane hangar or sports stadium, and surrounded by people having a high probability of being infected.  There’ll be “space suited” healthcare workers hopefully moving around and helping people, but you – you’ll probably not have such protection, yourself.

But what is the alternative?  There’s the “voluntary quarantine” that is being adopted in some parts of the US already – quarantine on the “honor system”.  And there’s “monitoring” whereby health authorities monitor the health of “at risk” individuals (such as people recently returned from China).

Oh, one more point of concern.  Everyone is talking about fourteen day quarantines.  But, here’s the thing.  It is starting to seem like it can take the virus as long as 24 days to incubate and become a “thing” in an infected person.  So all those people released after two week quarantines?  There might be ten more days of danger, to them, and to the people they are now released back to be with.

Update 2/22 :  There have now been two cases in China of people getting the disease after 27 and 38 days of quarantine.  Perhaps these are outlying cases and insignificant.  Perhaps there was some leaked contamination into their environments.  Perhaps better besting would have detected it sooner.  But perhaps it really can take 38 days (and who knows how much longer) for the disease to become apparent.  Does that mean that the currently laughably short 14 day quarantine should double to 28 days?  Treble to 42 days?  The social and economic implications of isolating people for four or six weeks are enormous.  Two weeks is bad, but six?

Even if not quarantine camps, scare stories such as this suggest the authorities are very concerned about what might happen.  The stories aren’t just to scare us.  The reality is that our healthcare system these days has been made so “efficient” that it has very little “surge capacity”.  It is designed to be almost exactly the size needed for the normal ordinary requirements of the populations they serve, and the slightest “blip” in the public health landscape can see them with problems.  These problems aren’t just running out of hospital beds, but that is certainly part of the problem.  The problem extends to running out of staff, and running out of supplies, too.  (True story – I tried to buy a several week supply of bandages locally when recovering from an injury a few years back, and no pharmacy/drug store could assist – they all stocked only one or two days of product.  Another true story – try buying face masks, anywhere, today.)

Our feeling is that at present, while the count of new cases each day remains at zero (or even if at one or two or three or ten or twenty or thirty) the chances of you interacting with such a person and picking up their infection is so close to zero as to be impossibly too small to measure.

But, if that number starts to increase, or if there is a regional outbreak and you’re in that region (and it is likely that the spread of Covid-19 will be in patches, with some concentrated outbreaks and some areas skipping it almost completely) then you should start modifying your behavior.  Furthermore, we suggest you “practice” by observing “best practices” to a reasonable not extreme degree now, so that it is second nature if/when the time comes that it is important.

Oh, one last thing in this section.  The happy-making statistic that there are very few new cases of Covid-19 being reported at present (in the US, etc)?  Maybe that’s just because we lack the resources to test and identify the infection, as this article suggests.

What to Do to Minimize Your Risk of Infection

There are a number of steps you can take to keep your chance of becoming a Covid-19 statistic to a minimum.

The first is to minimize your contact with other people as much as possible.  If you’re not close to other people, you’re much less at risk (but remember that the infection can remain suspended in aerosol form in the air for a while, or on surfaces (especially hard surfaces in moderate and reasonably humid environments).

If you commute to work on mass-transit, it will be difficult to keep away from hundreds/thousands of other people each day.  But maybe you can vary your working hours so you travel in off-peak times (go to work earlier rather than later, before the buses and train have a chance to be covered in coughed out germs).  Maybe you can work at least one day a week from home (if you’re not in a public-facing type of job).  Indeed, you should suggest that your company develop a plan for skeletal on-site manning if/when that becomes necessary.

If you have discretionary air travel coming up, see if you can cancel or delay/defer your plans (see our point below on air travel risks).

Consider wearing some sort of outer coat when in uncontrolled areas with high concentrations of people, and take it off when you’re in a more controlled environment.  That can be your protective outer layer – not as conspicuous as the white plastic “space suits”, but almost as effective, so that your everyday clothing underneath it doesn’t attract a quantity of viral particles which you then touch, transfer to your hand without realizing, and then transfer via food or whatever to your eyes, nose, or mouth.

Similarly, consider keeping your hair as short as possible and wear a hat of some sort when outdoors.  That’s another risk – how often a day do we touch our hair?  And our hair is right at “cough level” and so at risk of being infected.

Every time you transition from an uncontrolled to a controlled environment, be sure to minimize the risk of bring the infection with you.  Take off your outer layer of clothing in your home’s entry way and leave it there.  Immediately wash your hands (and possibly face too).

If you’re going from a high risk to a lower risk environment, you should do the same.  For example, when arriving at work after your morning commute, that might be a case of going from high to low risk.

We’ve found we often forget this – the classic scenario being we drive somewhere (our car is a controlled environment) and then go into a store to buy something.  But when we go from that uncontrolled environment back into the car, we forget to immediately use hand sanitizer to wash our hands before touching the steering wheel, gear lever, and everything else.  So, for the times you forget, make sure you have small containers of hand sanitizer available for use.

Encourage the people you associate with to do the same thing.  For example, have hand sanitizer dispensers prominently placed at the entrances to your work environment, and if you have an office of your own within your workplace, have more hand sanitizer dispensers at its doorway.

If you are out and about, consider washing your hands (or using sanitizer) from time to time “just because”, rather than due to a certain known need.  As long as you are in an uncontrolled environment, you really don’t know what is happening around you, and so an occasional extra hand wash doesn’t go astray.

Consider infection possibilities when choosing the food you eat and liquids you drink.  The food bar at a buffet or in a supermarket is probably less desirable now than it was before, especially those food items kept warm.  But don’t go thinking the salad bar is fine, because think about what has happened to that food.  It has traveled an unknown distance from an unknown source (quite likely thousands of miles and maybe some countries away), then it may have been given nothing other than a cursory wash before being chopped up or in some other way prepared and then placed on display for you to pick from and then eat.  There’s been no sterilization at any point, and dozens of possible opportunities for infection.

And be fastidious about washing your hands before touching food.  If you’re eating somewhere in public, be very suspicious of the hygiene present with their eating utensils, too.  Perhaps give them a quick clean with hand-cleanser before using them, especially if you are simply taking them out of buckets like at IKEA.

What About Air Travel

We’re regularly reassured by airlines that flying is perfectly safe from an epidemiological point of view.  Equally regularly, statistics come out that show people have a very much higher than normal incidence of coughs and colds and other minus infections after long flights.  So much for the airline reassurances.

Here’s a study that suggests you’re at a moderate degree of risk if you’re within a seat or two (ahead, behind, or to the side) of an infected traveler.  We suggest it is worse than that – the study ignores the added risks of when the traveler boards the plane, or if he goes to the bathroom or for any other reason gets up and walks around, and then when he leaves the plane again at the end of the journey.  Plus, extra “bonuses” like his time in the gate area before the flight, going through security, collecting his bags after the flight, and so on.

So, definitely, yes, be careful on how much you fly.  But there’s no need to be quite as extreme as this anxious couple.

Planning Ahead

What would you do if a China-style quarantine was imposed on you and your home/neighborhood?  If you were in essentially a lock-down situation where you couldn’t leave your apartment or home/property other than one person, once every two or three days, and only for the purpose of buying food?  And, as is being seen in China, your ability to actually find any food for sale on those occasions would be problematic?

Maybe it is time to slowly grow your inventory of at-home food supplies?  Next time you’re at Costco, buy some extra canned and dried goods.  Get a big bag of rice.  Some cans of chili and soup, and other long lasting items that you’ll eat anyway.

And, also while at Costco (or Walmart, etc), don’t forget the other necessities of life.  Toilet paper, for example!

Perhaps you should treat yourself to a second or larger freezer in your home, and start to fill it with frozen food, both raw and cooked/prepared.  It is likely that basic utilities such as electricity will continue in a quarantine situation, so you don’t need to channel your inner “backwoodsman”.  Simply filling a freezer and adding to your store of canned and dry goods is probably sufficient.

Keep your vehicle gas tanks reasonably full, and maybe even keep some containers of gas in your garage or in your vehicles.  If infrastructure starts to fail, this will include deliveries of gas to gas stations as well as deliveries of food to supermarkets.

Don’t forget your pets as well.  Get another carton of cat food, another bag of kibble for the dog, and so on.

Possibly apocryphal studies suggest the average household only has about three days of food on hand.  We’re not saying you should become like members of the Mormon Church and adopt their recommendation of keeping a one year supply of food on hand, but we are saying that you’ll actually benefit and save money and hassle if you start strategically buying in bulk and holding more inventory at home.  Next time you see soup on sale at your local supermarket, don’t just buy one can.  Buy six (or more!).  Your cost of food will drop, and as long as you’re careful at rotating your supplies (we love these units), you’ll eat everything, anyway, with no wastage.

Looking into the Future

We just totally can’t start to guess at what the future holds.  Each day sees a new and different scenario.  For example, on Thursday we were first getting reports of about 450 new cases in China, but then the new day’s reporting advised of 889 cases for the new day in China.  An almost doubling.  So is China trending up, or down, or staying the same?  (Answer – it seems, a week later, that China’s new case counts are steadily decreasing.)

South Korea’s numbers are growing at an alarming rate, with an increase of 45 overnight (from 111 to 156).  Update a week later – the most recent day saw South Korea now with 650 new cases.  That’s a terrible increase in daily new cases.  And while only one each, both Canada and the US had a new case appear as well, and in Canada’s case, it was from a lady recently returned not from China/Asia, but from Iran, where there has been an outbreak over the last few days.

It is a bit like a bone-dry forest with strong winds on a hot summer day.  It just takes the smallest of sparks and all of a sudden, there’s a conflagration.  And the spark, if/when it comes, may not be the one we’re protecting against and expected.  It was a mild surprise to see the infection appear in Iran, and then it jumped from Iran to BC, Canada, and potentially could continue circling the globe in new unexpected ways.

With air travel these days, nowhere in the world is far from anywhere else, and a carrier of the infection can travel from the point they were infected to anywhere else, and start infecting people in the most “safe” seeming of remote places before they start to display symptoms of the disease.  Worse still, they might infect people on their flights who are traveling to different destinations, and all of a sudden, you have two or ten new outbreaks in quite different locations.

While the rate of new cases in China may now be flattening, this could change in an instant, and airlines are continuing to cut back service – for example, Qantas and Jetstar announced new service cuts to Asia on Thursday.

Major international trade shows have already been cancelled, and more are either at risk of being cancelled, or if still proceeding, doing so without some of their major participants attending and new rules such as suggesting you “bump elbows” instead of shake hands.  These cancellations risk having lasting effects if it causes the start of a new approach to trade shows and international meetings – doing these things “virtually” through internet based video-conferencing instead.

Some experts have a very gloomy view of the near future, for example, a Harvard School of Public Health professor projects that potentially 40% – 70% of the world’s population may be infected within a year.  Other projections have come up with similar numbers, and others are not quite so gloomy, but still far from positive.

A Vaccine?

The very good news is that with the astonishing modern tools for virus analysis, researchers are well on the way to developing an effective vaccine against this infection.  Some facilities already have experimental vaccines (see, for example here and here).

The not quite so good news is the possibility that the virus will mutate in the manner that the annual flu virus does (and many scientists fear that this virus may become an annual event like other winter flu type outbreaks), but getting any type of vaccine into the field will be a wonderful step forward.

Updates – first, the time from identifying a probable vaccine to getting it approved and deployed was stated at a Wednesday 26 Feb briefing by the CDC to be in excess of a year.  So that isn’t going to do a lot for us in the foreseeable future.  But in some encouraging news, there are some new anti-viral drugs that might help combat the virus after someone contracts it.  It is thought it will take less time to get these into the pharmacies and hospitals, if the current testing is positive.

Summary

This is a very fluid situation, and so none of us really know what to expect, or when to expect it.  For that reason, we should take some prudent steps now to anticipate, mitigate and minimize the impact and risk of Covid-19 in our lives.

To put this all into perspective, currently during the normal/regular annual “flu season” there have been an estimated 14,000 deaths in the US alone.  And Covid-19 deaths in the US?  None.  So far.

Truly lastly, some good news?  This man claims to have a cure.  Hmmmm……

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9 thoughts on “The Covid-19 Coronavirus Outbreak : Should You Be Worried?”

  1. Great article David! Our local Chinese New Years celebrations were cancelled here in SE Michigan which I thought was insane. Now after reading your articke I understand it better. Apparently a few dozen folks in the area who were active on the organizing committee had recently returned from a major Shanghai Automotive conference in January and were on unofficial “work from home for 2 weeks” quarantine.

  2. lifegotinteresting

    Not to be a fear-monger, but in the worst case situation, there are some other factors to consider. Chinese stats that I have seen mentioned 2% fatal cases, 5% critical, and 13% severe (likely all pneumonia-related). If Covid spreads widely, medical resources will be strained and available resources minimal. I suspect, without significant treatment, many of these critical and severe cases will end badly. So, could mortality go to 20%; I don’t know, but it seems possible.

    Remember, more than 1700 Chinese medical workers have been infected (and I assume they had protective equipment and training). Hospitals may become overwhelmed and/or lose staff. One other stat – something like 90+% of most medicines or precursor chemicals come from China. That includes NSAIDS and antibiotics, both important in treating pneumonia. If this Covid-19 “fire” spreads widely, I fear a repetition of Spanish Flu mortality. My Wife has asthma, so I am especially concerned. Just make all the preparations you can. And pray.

    1. David Rowell – Seattle, WA, USA – New Zealander now living in the United States.

      Thanks for your comments. Not to be a fear-monger either, but as I discussed in the article, the 2% death rate claim doesn’t seem to be remotely credible. The actual rate, while surprisingly hard to exactly establish, currently looks to be more in the order of 10%.

      Stats about critical/severe cases become even more subjective, and while they give an indication of stress on medical services, are of little use without additional information such as how much medical resource a critical or severe case consumes. How many days in hospital, what in the form of meds and monitoring, etc.

      I didn’t know that 1700 medical workers have been infected. That’s very surprising. As for the sourcing of medicines, that’s yet another example of how just about anything and everything ends up with a dependency on China these days. Astonishing, isn’t it, and an issue that very few people really completely comprehend.

      Since I wrote the article, not yet two days ago, we’ve seen an acceleration of cases in Iran and a virulent new outbreak in Italy, and the virus getting solidly established in South Korea. I was astonished at how the situation changed, literally before my eyes, as between 3am Friday morning when I finally went to bed and 8am when I got up again. We now have Italy “inviting” the people in growing parts of the country to stay inside, and who only knows what is really happening in Iran, because based on the fatality rate disclosed so far, it is clear that there is a massive failure to detect or report cases prior to reaching a very severe/critical point.

      Anxious times, indeed…..

  3. Hi David,

    I’m a longtime Joe Sent Me member, and very much enjoyed reading your recent Covid-19 Coronavirus article.

    My wife and I have an upcoming South America trip (scheduled for next week to Mendoza, Cordoba, Santiago, Bogota, and Mexico City), and are happy, and somewhat intrigued, by there not yet being a single confirmed case of the Covid-19 reported in that part of the world.

    My (admittedly self-serving) query is based on our experience with our annual flu season (we are based in New York City), which seems to end each spring/summer with the arrival of warm weather.

    I’d appreciate your thoughts of whether these types of flu outbreaks are likely to be more contagious in colder climates during wintertime, and that summery southern hemisphere locations are less likely to be affected at this time of year.

    1. David Rowell – Seattle, WA, USA – New Zealander now living in the United States.

      Hi

      Always nice to hear from a JoeSentMe.com member. Thank you for your very sensible question.

      Two comments, and a necessary disclaimer, ie, please keep in mind I’m utterly not any sort of expert on this topic. So take everything I say with a grain of salt. 🙂

      First comment – the weather issue would seem to be rebutted by incidents in tropical countries such as, for example, Malaysia (temperatures in the 90s this week). But on the other hand, most of these cases seem to be of people who contracted it somewhere else (ie China) and then returned home. I’ve read articles suggesting there is a hope that the virus may be(come) seasonal, but there’s no consensus that this will be exactly the case. However, on balance, it seems slightly more likely than not.

      The second comment – the zero case counts in most countries. Two concerns. First, there’s an ocean of difference between no cases and no reported cases. This is an infection that can take up to 39 days in its incubation period (even though we’re only quarantining for 14 days which seems very short-sighted), and for some of that period, while the carrier is asymptomatic, they are still infectious. Even when a person does start to manifest symptoms, how robust and reliable are the healthcare systems and how certain can we be that we are being quickly advised of such cases? My sense is that this is what happened in Iran, where we went from no cases to suddenly fatalities, and even today, with 12 of the reported 61 cases being fatalities, it is clear that the cases there have been massively under-reported and only started to be disclosed when people were finally dying.

      The other/related concern is that a country can go from zero to hundreds of cases in just a couple of days. Look at Italy – 3 on Thursday, and now on Monday with 229 and large swathes of northern Italy on lockdown.

      So the truth is changing, massively, on a semi-random basis. Today, there seems no cause for concern heading to Central/South America. But tomorrow and the next day? Who only knows. As Joe said in a conversation with me a few days ago, the good news about all of this is that the virus is not particularly lethal, and seems mainly to be of concern to people who are already in poor health and with compromised immune systems.

      Sorry I can’t give you a definitive answer. For now, keep an eye on what is happening, and reserve the right to cancel at any minute right up to boarding the plane!

  4. David,
    Excellent article. You clearly spent time writing and I appreciate the work you have done here. Thank you for your notations and references to other articles.

    I work for a major airline, and am watching our bookings fall apart to Asian destinations that are outside China. There was a major tech conference in Barcelona cancelled this week.

  5. eddiebourke6439

    A warning. The French Health ministry and an Irish hospital are reporting clusters of severe (ICU-style) Covid-19 cases in young adults without any previous pathology whatsoever.

    The only common feature is NSAID or steroid use; in Ireland they all appear to be Rugby players (extreme contact without body armour) treating ongoing injuries.. Be careful and avoid anti-inflammatories of all types if you have symptoms of a flu-like illness.

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