Coronavirus disease 2019: a cut through the misconceptions

At the end of December, public health officials from China informed the World Health Organization that they had a problem: an unknown, new virus was causing pneumonia-like illness in the city of Wuhan.  That was the beginning of what will be a pandemic that has held the world at ransom. Since the outbreak however, there has been word of doom and very little of hope. There is so much fake news out there that drives fear and panic across the world. This is possible because the organisations that should do the education are busy trying to understand the new outbreak. As the title suggests, we will cut through the misconceptions to understand Coronavirus disease 2019 in general and put the COVID-19 to perspective. I’m a medical scientist and I have been following the issue since it broke out.

What is coronavirus?

“coronavirus” is derived from the Latin corona, meaning crown from a viral family Coronaviridae. The new virus named SARS-CoV-2 remains relatively unknown. But scientist are using what they know about the super family and previous outbreak to learn about it.

There are many subspecies of corona virus but they have largely been grouped in 4 main classes based on activity. In effort to put the new virus into perspective we will discuss the four classes here.

  1. Common Human Coronaviruses: This includes types 229E, NL63, OC43, and HKU1 which are implicated in common cold. This virus is so common that a reported over 90% of adult population have been infected at least one time which is shown by the presence of antibodies to the virus. If you have hard common cold before, chances are that was caused by coronavirus (The common Human Coronavirus). The reason you never knew about this is that this class rarely lead to death in an immunocompetent person.  Image result for common cold Ghana
  2. Severe acute respiratory syndrome (SARS): It is a viral respiratory illness caused by a coronavirus called SARS-associated coronavirus (SARS-CoV). SARS was first reported in Asia (China specifically)  in February 2003. The illness spread to more than 24 countries in North America, South America, Europe, and Asia before the SARS global outbreak of 2003 was contained. Since 2004 SARS has not been reported anywhere in the world. You probably never heard of SARS because at that time there was no much of social media and proliferation of so many news sources. The disease resulted in more than 8000 cases and 800 deaths with around 10% fatality rates.
  3. Middle East Respiratory Syndrome (MERS): is a respiratory illness caused by a Coronavirus  called Middle East Respiratory Syndrome Coronavirus (MERS-CoV). This was first reported in Saudi Arabia in September 2012 2012. But scientist traced  back and later identified that the first known cases of MERS occurred in Jordan in April 2012. The largest known outbreak of MERS outside the Arabian Peninsula occurred in the Republic of Korea in 2015. MERS fatality rate is so high, 3-4 out of every 10 people who get the infection died. That is about 30 to 40 percent fatality rate.
  4. Coronavirus Disease 2019 (COVID-19: This is the current pandemic caused by the novel virus named SARS-CoV-2. The world is going frenzy on this because it is largely unknown and it’s rate of transmission is much higher than the known coronavirus groups.  We will be talking more about this.
How is it transmitted?

SARS is said to have originated from animals and jumped to humans but currently is being transmitted from human to human like Common human coronaviruses which usually spread from an infected person to others through;

  • the air by coughing and sneezing
  • close personal contact, like touching or shaking hands
  • touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands.
What is the fatality rate of COVID-19?

This is where there is gross misinformation which is responsible for the widespread fear of doom. The analysis here is done with information as at 12th March 2020. Because the virus is new, scientist learn new things every day but as it stands, the average fatality rate among confirmed cases ins 3%.

80% of confirmed cases are mild and about 15% are moderate. These numbers are specific to the confirmed cases but it is highly possible that there is large number of cases which are not flagged which will reduce the percentage of severe cases which currently stands at 5%. It appears that only about 50% of the critical cases results in death.

The above numbers is a weighted average but the age specific fatality rates tell another story.

Covid-19 fatality rates
The current fatality rates by age group (WHO) *Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%). The percentages do not have to add up to 100%, as they do NOT represent share of deaths by age group. (Source)

This means that for people from 10-39, 1 out of every 500 confirmed case dies and 1 out of every 250 confirmed cases dies among the age group 40-59. The high fatality is among the very old (80+) but research has shown that even among this group, only 1 out of every 110 cases results in death if the person had no preexisting condition such cancers and cardiovascular diseases such as diabetes, hypertension or chronic respiratory diseases.

Covid-19 comobidities
Source

To put things into perspective, if you are in Ghana and below age 50, without any chronic disease, you have 1 in 21,000,000 chances of dying from corona virus. You are more than 2000 times likely to kill yourself (suicide) than to die from COVID-19.

In 4 Months, coronavirus killed 4,638 people and within that period, Cardiovascular disease( diabetes, hypertension, stroke etc) killed more than 7 million people globally. You are 51,000 times more likely to die from Cardiovascular disease than coronavirus. You should worry more about the food you eat, what you smoke and how much you exercise. 207,000 people died from suicide globally within that same period.

Within that period road accidents have killed 440,000 people globally. Which means you are still about 10,000 times more likely to die from road accident than from coronavirus. So worry more about drunk-driving and disobeying trafic regulations than coronavirus.

likelihood of dying from covid-19 in the usa
Likelihood of dying from COVID-19 For those in USA. (Source)
Why then does the world care so much?

As humans, we are designed to fear what we don’t know. We know Cardiovascular diseases already so we are not too alarmed by it, we know the top 10 causes of death in the world which accounts for more than 54% of all deaths in the world but we don’t know much about the new virus.

Also, the rate of transmission is what is worrying. It is spreading so fast with cases doubling within short periods. If the fatality rate is low and the diseases spreads too much it will still cause very devastating effects. If 1 billion people were to get the infection globally(which is highly unlikely), at the current fatality rate of 3%, 3 million people would die. But even that is a small effect compared to the 2 world wars that killed a combined estimated 115 million people. You can keep yourself updated on COVID-19 using this map.

Does that mean I should not care?

No, it means there is absolutely no need to panic and worry. Worrying about health increases heart disease risk. A meta-analysis found that anxious people have a 48 percent higher risk of dying from a heart problem. This shows that you are even a few 100 times more likely to die from worrying about coronavirus than from coronavirus itself.

You should still protect yourself from the infection but do not panic. The way you protect yourself  from COVID-19 is not any different from the way you protect yourself from any flu. The CDC also recommends the following preventive actions:

  • Wash hands with soap and water for at least 20 seconds. If soap isn’t available, use a hand sanitizer with at least 60 percent alcohol.
  • Stay home if you’re sick
  • Avoid touching nose, eyes, and mouth. Use a tissue to cover a cough or sneeze, then dispose of it in the trash
  • Use a household wipe or spray to disinfect doorknobs, light switches, desks, keyboards, sinks, toilets, cell phones, and other objects and surfaces that are frequently touched
  • If you must touch something, use a tissue or sleeve to protect your hand.
  • Make sure you have a plan in case you get sick that includes a list of friends, neighbors, or community health care workers who can help.

There has been widespread misconception about wearing of nose masks. CDC stated that nose masks has very little to no protection against the infection and its not recommended for general public. However if you are infected, you can use it to limited chances of spreading the virus. The mask is therefore recommended for Health workers and sick patients to limit the rates of spread.

Take care of yourself, and stop worrying about COVID-19, it is far less dangerous than portrayed. Eat healthy, exercise more and worry less and you will be fine.

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