Coronavirus Preparation (Part II)
Introduction
Since our first blog post addressing the novel coronavirus (Coronavirus Preparation, Part I), we've learned more about this virus and how it spreads. Here's a quick update.
How does coronavirus stack up?
The new coronavirus (now being called CoVID-19) has been spreading quickly, with now 49,053 cases globally. 48,548 of those cases are in China, which represents 99.97% of the total cases [1]. Many other cases are under investigation, but these statistics outline the laboratory confirmed cases.
There have been a total of 1383 deaths, all but 2 in China. This produces a mortality rate of 2.81%.
In comparison to infections we’re more familiar with (and for which we currently have vaccines), the coronavirus is still relatively rare. For reference, the CDC states there are an estimated 26 million flu illnesses this year in the USA alone [4]. There have been 14,000 deaths from the flu, 92 in children. This is on par with the typical mortality of flu, in the range of 1-2%.
In the USA there were 1,282 cases of the measles in 2019 with a mortality rate of 0.1% to 0.2% [5]. Compare this to an estimated 9,769,400 measles cases worldwide in 2018 with 142,300 deaths [6] for a worldwide mortality rate of 1.5%.
The past scares of strains of coronavirus, the 2003 Severe Acute Respiratory Syndrome (SARS) and the 2012 Middle Eastern Respiratory Syndrome (MERS) had mortality rates of ~10% and 34.5% respectively.
How infective is the new coronavirus?
The Basic Reproduction Ratio (BRR) of an infection refers to the infectivity of the organism. The value generated refers to how many people, in an unprotected/non-immunized environment, would be expected to have the infection transmitted to them from one infected case. This number is NOT affected by immunizations or changes in people’s behavior, because it is a constant inherent to the infection. However, if people change their behavior and immunizations are developed, the number of protected people in a population goes up. As an example, measles is an incredibly infective virus, with a BPR of somewhere between 12-18 [7]. This means that 1 person with measles can be expected to infect 12-18 other people. Factors affecting this include how easily the vector is transmitted, how long someone survives with the infection, how long someone is contagious before they develop symptoms, and how fatal the infection is. An infection that killed you within hours wouldn’t have a large BPR because you wouldn’t survive to transmit it.
The BRR for the coronavirus is 2.68 [8], with estimates from 1.4 to 3.9.
Where has the coronavirus spread?
Below is a graph of the cases outside of China over time from the WHO.
The coronavirus is almost exclusively in China, however, there are a few cases outside of China. Almost all of those travelers had some travel directly to Hubei (the province containing Wuhan). There are now 15 cases of coronavirus in the US [2]. You can use this map to see if there are any reported cases in your country or state.
Were the initial predictions about coronavirus true?
Most estimates published in the Lancet [3] and other publications have overestimated the current number of cases. However, patients may not be diagnosed until up to 2 weeks after they have the infection, so public health epidemiological data may not fairly represent the current prevalence. The accuracy of epidemiologic data coming from China has also been questioned.
What should I do to prevent infection? Is there any treatment? Is there a vaccine?
There are no current updates as far as how to prevent the infection. Continue hand washing, protecting coughing and sneezing, and avoiding travel to specific regions in China. Treatment remains the same, with supportive care. Many nations are working on a vaccine but there is no timeline that would have a vaccine made before the year 2021.
What's next?
There is a lot we still don't know. We will provide additional updates as the situation develops. You should also refer to the CDC website at www.cdc.gov for additional up-to-date information.
Please contact us at hello@durationhealth.com if you have any questions.
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