COVID-19: Things to consider before you panic.

With China showing no new cases over the weekend, I thought it might be useful to go through a few things so you can continue living free of panic. I've spent a huge amount of time reading lots of actual science and CDC reports to get these nuggets in one spot for you, so if you have any additional questions, please let me know. I put a few of the articles below the list if you want to read for yourselves. Things to keep in mind:

1.     Pandemic just means the condition is world-wide. So even though COVID-19 is a pandemic, so are ALLERGIES, for example. “Epidemic” is a title that is more reflective of a deadly condition. A death rate of 7.3% defines a condition as “epidemic”. Flu falls just short of this at 7.1% this year. Global death rate of COVID-19 is 4.1%. USA death rate of COVID-19? 1.4%.

2.     The Peak of Disease in the USA still looks like it was on March 9^th, according to the CDC reports of CONFIRMED CASES. This was 3 weeks after the first cases appeared, which reflects the 14 day incubation period. We are now further out than that by nearly 2 more weeks. Continue to be careful that you aren’t reading information on websites or the news that are using estimates because they make the data look like it’s still rising when the reported cases to the government (which hospitals are required to report) do not support that.

3.     More than 80% of the cases reported in China were MILD. This is the same observation made here. It probably also speaks to the likelihood that most of us have already been infected, just never showed signs that were concerning.

4.     In the USA, 508 people are sick enough to be hospitalized right now. So while there are over 15,000 cases UNCONFIRMED to date in the USA, that means around 3% of people showing symptoms are ending up in the hospital.

5.     There are nearly nine thousand beds in intensive care units in Texas ALONE. So even if all 508 COVID-19 patients hospitalized right now in the USA were here in Texas, we would not be overrun.

6.     Of those ending up in the hospital, 80% of the deaths are in people older than 65 WITH UNDERLYING MEDICAL CONDITIONS. These are the folks that need to stay home without question and you should not go visit them because it puts them at risk.

7.     Population density plays a huge role in the spread. High density populations can expect higher spread. Korea, China and Italy have some of the highest population densities in the world. Korea is at 1,366 people per square mile. Italy is at 532 people per square mile. China is at 397 people per square mile. In the Wuhan Providence where the virus originated, it’s 3,200 people per square mile. In the USA? 94 people per square mile. The range is large however, as in New York, it’s 28,000 people per square mile. No wonder the virus spread so fast there.

8.     The first clinical trial is active already. There are 4 drugs being considered and early reports indicate they are working. One of them, Chloroquine, is a tablet that people who are traveling to places where malaria is prevalent take to prevent infection. It’s a pill they take once a week. Chloroquine changes the ability of the young malaria parasites to digest food properly, and so they die. Researchers showed last week that chloroquine stops the Coronavirus from thriving in the cells they were infecting and stops the Coronavirus from infecting new cells. This was NOT done in animals or humans, but in a cell line. Still, the results are promising enough that major pharmaceutical companies are donating their Chloroquine stocks to the government for use in patients fighting COVID-19.

9.     Limitation: Testing is still not wide-spread, so the confirmed cases may be low. However, as over 80% of those with the virus probably don’t even realize they had it, there is no way to get a true estimate of who was infected. It is likely then that the death rate is even lower than what I calculated above.

10.  Caution: Continue to follow the CDC guidelines for how to operate. Wash your hands because soap and water for 20 seconds kills the virus. Stay home when you are sick so you don’t infect anyone else. Do not visit those at high risk because you could be carrying the virus (but are fighting it successfully with your good immune system and you probably didn’t even know you had it!). Hug those living with you often.

Morbidity and Mortality Weekly Report on COVID-19

https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w

The in vitro data that prompted USA off-label use of Chloroquine and H-Chloroquine

https://www.nature.com/articles/s41421-020-0156-0

Details of the 4 drugs in the Solidarity Trial by WHO

https://www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments

COVID-19: how to get the CONFIRMED case numbers

I have been using the CDC to get information on COVID-1919, because the CDC reports confirmed cases, NOT ESTIMATES. I highly recommend you do the same, but the website can be somewhat intimidating for those note familiar with it. I normally use this website to get information related to my career as an Immunologist, so I am very familiar with it. So I thought it might be useful to give you a step-by-step on how I get my information on COVID-19 from the CDC website.

Step 1: go to www.cdc.gov

Step 2: Click on “Learn more about COVID-19” which is the light blue button to the right of the virus picture. There are many things that you can read about here, such as symptoms and current living guidelines. But I generally like to stick to the numbers, such as current number of confirmed COVID-19 cases, NOT ESTIMATES as that tends to be inaccurate.

Step 3: So for that type of information, I have 3 choices. I can either view USA cases per day, certain state cases per day, or details per state.

FOR ALL THREE TYPES OF INFORMATION

Once you get to the “Learn more about COVID-19” page from Step 2 above, scroll down to see the USA map which is color coded per state for ranges of confirmed cases. The “Latest Updates” list of links if very informative, but the link we are looking for to stick with our goal is not there. Just above the map, click on the link that says “Cases in U.S.”

Step 4: You will now be taken to your control center, which looks like this. The first thing you will see at the bottom of your screen in light blue is the “COVID-19: U.S. at a Glance*” and it will freak you out because the number of total cases is huge. In this screenshot, that was 10,442. Keep in mind this is the ESTIMATED NUMBER not the confirmed number and is consistently about 5 times larger than the actual CONFIRMED CASE number. Also keep in mind that the testing kits are still limited and that's why these two numbers (estimated and confirmed cases) are so different. The confirmed number of deaths is below that. In this screenshot, that was 150.

Step 5: Continue scrolling and you will find the same map you saw at Step 3, but this time, if you put your arrow over the state you are interested in BUT DON’T CLICK (JUST HOVER OVER IT), it gives you the current number of cases for that state (it also tells you what state it is, in case you don’t know your geography very well).

If you are interested in details about a particular state, you can get that by clicking on the state you are interested in. You will then be sent to the state’s individual “CDC-like” institution to get additional information such as what counties are reporting positive cases.

Step 6: If you want total number of CONFIRMED cases in the U.S., you scroll a bit further to get to the graph below. In the title of this graph is the current number of U.S. CONFIRMED CASES time and date stamped so you know how current it is. For the snapshot I took below, the total CONFIRMED CASES on March 18^th at 4PM Eastern Time (ET) was 1,891.

You can also hover over each bar for the total number of cases reported for any particular day. One note on this CONFIRMED CASE number. The CDC updates the numbers per day as the states/counties report them. So even though the below graph looks like the last 4 days have declining CONFIRMED CASE numbers, it is more likely that all states/counties have not reported them yet on these last 4 days. They have those dates shaded out with a note on the graph that says “Illnesses that began during this time may not yet be reported”.

Step 7: Do NOT panic. As a country, we have not ignored this new virus, but are instead facing it with a unified goal to slow the peak of infection so that our hospitals are not overrun by those who are most susceptible to it (those over 65 with underlying health conditions). This is a much more responsible approach and should slow the peak of infection. Stay safe out there. Pray for our medical teams as they stand in the battle field for our loved ones. Pray that we will continue to have the necessary supply of medications to treat their respiratory illness. Pray for those who have the flu, that they will not be left behind as their death rate is 3-times more likely than those infected with this coronavirus.