What if the new coronavirus is really mild, not virulent?
Recent statistics suggest that the novel coronavirus causing COVID-19 may actually be quite mild, not as virulent as originally feared. True mortality rate might be closer to seasonal flu, about 0.04%. The global hysteria must stop. The fear, panic, stress, and anxiety are causing more damage than the virus itself.
By Israel Zwick, March 17, 2020
About the author: Israel Zwick holds advanced degrees in biology, science education, and school psychology. He recently retired from working as a school psychologist for the NYC Department of Education. Before that he taught biology and chemistry for 15 years. Before that, he worked in the microbiology laboratories of the NYC Department of Health.
When news of the novel coronavirus outbreak first appeared about three months ago, I wasn’t very alarmed. After all, in just this century, there have been several outbreaks involving coronavirus or influenza virus. They all came and went without any significant panic or hysteria. So, I thought the same would happen with this one. However, soon I saw my neighbors walking around the street with surgical masks. I live in an Asian neighborhood in Queens that sees many travelers coming from Asian countries. In the last few years, three new hotels near the Long Island Expressway and Utopia Parkway opened to accommodate the many visitors from various Asian countries. I still wasn’t very concerned. I hadn’t seen any significant increase in ambulances or police cars circulating in the neighborhood, so I wasn’t very worried.
Within a few weeks, the reports became more ominous. Apparently, the disease had a high rate of contagion and mortality. Travelers who had been to China were spreading the disease rapidly around the globe to South Korea, Iran, Italy, and cruise ships. There appeared to be a high mortality rate, about 5%, mostly among the elderly and immunocompromised. Still I wasn’t too concerned. After all, I’ve had numerous bouts of respiratory illness of various types including upper respiratory illness, lower respiratory illness, influenza, bronchitis and pneumonia. I even tested positive for tuberculosis even though I never had it. That’s because in 1972 I worked in the microbiology laboratories of the NYC Department of Health where I was exposed to the airborne bacteria. In the two years that I worked in the microbiology labs, not a single person who worked with me contracted any of the virulent diseases that we were studying, despite working constantly with concentrated samples of these virulent pathogens. That’s because the two women who directed the labs demanded the use of precautionary measures and strict adherence to sterile technique in all our procedures. So, I still wasn’t overly concerned, I knew what to do to protect myself and my family.
All that changed when the news came that travelers brought the virus to the State of Israel. Now it hit closer to home because my children and grandchildren live there. I was more concerned for them than for me. Despite the small number of cases, the State of Israel went into panic mode, closing schools, shopping malls, and most public events. Several of my friends cancelled their planned trips to Israel and I feared that my upcoming trip would also be in jeopardy.
Then the virus started spreading in New York State and various parts of the United States. The resulting fear, stress, and anxiety that ensued was palpable. Panic spread quickly resulting in the closing of schools and cancellation of most public events including the venerable St. Patrick’s Day parade. Now I was starting to get concerned, I could no longer be apathetic to the situation.
I decided to study the numbers which is something that I am familiar with. As a former school psychologist, crunching numbers was a major part of my job. My decisions on providing services to children with special needs was largely dependent on interpretation of test scores from various sources. I also had to determine the frequency, intensity, and duration of a variety of behaviors. So, I realized that it was time to look at the numbers.
The best numbers that I could find came from the Johns Hopkins Center for Health Security https://coronavirus.jhu.edu/map.html and Wikipedia https://en.wikipedia.org/wiki/2019%E2%80%9320_coronavirus_pandemic.
On March 16, 2020, Johns Hopkins summarized the situation as follows:
“EPI UPDATE The most recent WHO situation report tallies 153,517 cumulative cases and 5,735 deaths globally including 10,982 new cases and 343 new deaths. The vast majority of new cases and deaths were generated in regions outside of China. As of 930 AM EDT, the John Hopkins CSSE COVID-19 map reported 169,387 cases and 6,513 deaths worldwide.
In Europe, outbreaks of COVID-19 continue to grow. The ECDC reported 51,771 cases and 6,507 deaths in the EU/EEA and the United Kingdom as of this morning. As of the evening of March 15, the Italian Ministry of Health reported 24,747 total cases and 368 new deaths, bringing the total deaths there to 1,809. Spain, France and Germany are all seeing increases in case numbers.
South Korea reported less than 100 new cases for two days in a row, continuing a decline there. Local reports express hope that the outbreak is coming under control, but there is also concern over new clusters of infections. In Japan, the Ministry of Health reported only 13 newly confirmed cases and 4 deaths. Malaysia reported 190 new COVID-19 cases in the country, many of which were tied to a mass gathering attended by roughly 16,000 people in early March. The Malaysian government reports having contacted at least 4,942 participants in recent days. Iran reported 1,209 new cases, raising the total there to 13,938 cases and 724 deaths.
The Johns Hopkins CSSE map reports 3,813 COVID-19 cases and 69 deaths in the United States across 49 US states. The largest outbreaks are reported in New York, Washington, and California, in addition to several other states topping 100 cumulative cases. Earlier today, Governor Andrew Cuomo announced 221 new cases in New York State, bringing the total there to 950. The Washington State Department of Health reports 769 COVID-19 cases and 42 deaths. Over half of the cases (55%) and deaths (88%) are tied to patients from King County. California’s Department of Health’s most recent report listed 335 COVID-19 cases and 6 deaths. ”
The numbers from Johns Hopkins and Wikipedia appeared to confirm the worst fears, that the virus was spreading rapidly around the globe with a mortality rate of about 5% mostly among the elderly. So, I decided to take a closer look and went to the John Hopkins CSSE map. This was very revealing. Despite the rapid global spread of the disease, there were less than 200,000 confirmed cases with fewer than 8,000 deaths. That’s a teeny, tiny number of cases for a rapid global pandemic. After all, the swine flu H1N1 global pandemic of 2009-2010 had about a billion confirmed cases and over 200,000 deaths in a little over a year. So how could COVID-19 spread so quickly around the globe in over 3 months yet have only 200,000 confirmed cases?
I saw a suggested answer to that question in an article from AP on February 18, 2020. https://abc7news.com/health/is-the-new-virus-more-deadly-than-flu-not-exactly/5945128/
The article stated, “Chinese scientists who looked at nearly 45,000 confirmed cases in the current COVID-19 outbreak concluded the death rate was 2.3%. But there are questions about whether all cases are being counted: Infected people with only mild symptoms may be missing from the tally. That means the true fatality rate may be lower.”
This is a crucial observation. If the COVID-19 virus produces only mild symptoms or no symptoms at all then the actual number of cases would be much higher and the mortality rate much lower. Let’s look at a representative sampling from Israel. The Times of Israel reported today, “The Health Ministry on Tuesday reported 26 more confirmed cases of the new coronoavirus since the previous evening, bringing the country’s total to 324. According to the ministry, five people are currently in serious condition with COVID-19, the disease caused by the virus, while another nine are moderately ill. Eleven patients have recovered. The vast majority of the confirmed carriers of the virus – 299 — are displaying only light symptoms.” The reports from Israel are significant because the disease was brought in by travelers from around the world yet there are only 300 mild cases in a country of 8 million people with no fatalities. Yet the State of Israel is almost in lockdown.
I would like to suggest that the number of global cases reported by Johns Hopkins University is significantly underestimated at least by a factor of 100. That is, instead of 200,000 cases of COVID-19 around the world, there has been probably at least 20 million with most of them going unreported. Is that a reasonable assumption? If the virus produces mostly mild symptoms or none at all then many of the early cases contracted in China, South Korea, Iran, and Italy probably went unreported. Most people living in those areas would probably not rush to seek medical attention if they were exhibiting only mild respiratory symptoms. Medical assistance is not readily available in many of those areas and the number of test kits for COVID-19 was grossly insufficient or not available at all. It is probably reasonable to assume that the global number of COVID-19 cases is at least 20 million, not the 200,000 reported by Johns Hopkins. That would drive the mortality rate down by a factor of 100 to 0.04% instead of the current 4%.
So, what should we do now? The personal hygiene recommendations from the CDC are always a good idea. We should continue sneezing and coughing into paper napkins and washing our hands frequently and thoroughly. However, the draconian measures implemented for social distancing need to be curtailed significantly.
To the eminent physicians who fueled this global hysteria, I would like to suggest and request the following: Please study the numbers carefully. The recent statistics from USA, Israel, and Europe are much better than the early stats from China, South Korea, and Iran. Then stop this global hysteria. The panic, fear, stress, and anxiety are causing more damage than the virus itself.
Sources: It would be appropriate for me to list sources for my information but it would be too troublesome and time consuming. Interested readers are urged to search Wikipedia, Johns Hopkins University, CDC, and Google to corroborate the claims made here.