“Everything we do before a pandemic will seem alarmist. Everything we do after will seem inadequate.”
– Michael Leavitt
Why are we writing this?
The COVID-19 pandemic has reached a point where containment is no longer possible. The COVID-19 threat is real, and rapidly getting worse. Many of you are very nervous; some are unsure of the validity of the information you are reading. As physician leaders, we felt it was important to craft a resource you can rely on as being scientifically accurate and one which contains as much actionable information and guidance as possible.
Accurate, actionable information during an epidemic can save lives. Physicians are on the front line of this epidemic. Not only are we treating the sick, but we are also cringing at the misinformation spread through both traditional broadcast and social media. Evidence matters. Unfortunately, evidence is often slow, methodical, and boring and has a tough time against clicky headlines and exaggeration. We believe that an accurate representation of the current COVID-19 pandemic followed by a set of actionable steps you, your loved ones, politicians, and local officials can utilize is of paramount importance and ultimately could save tens of thousands of lives.
COVID-19 isn’t just the flu?
COVID-19 has been described by some as “just a cold,” or just like the common flu. COVID-19 is not a common flu. COVID-19 is an order of magnitude worse than the flu. The fatality rate is approximately ten times worse than the flu.
The flu spreads from September through April in the U.S., and June through August in the Southern Hemisphere. Yes, it does cause severe illness in many, but it does so over a longer time course. Time is a variable that is working against us during this COVID-19 outbreak. COVID-19 victims will be presenting to a hospital in need of critical care at a rate that is far higher than occurs with the flu.
In addition, these patients will require hospital treatment over the course of a few weeks rather than the 3-4 months of a typical flu season. The health care system in the USA is not ready to handle tens of thousands or hundreds of thousands of people over a short time frame. In Italy, the health care system buckled under the strain, and the health care teams are now forced to make horrible life and death decisions.
There are only 2,177 cases: Why is everyone so worried?
If only a snapshot in time had relevance, then perhaps stating that only there are “only” 2,177 cases (March 14, 2020) would be relevant and somewhat comforting. Italy has over 15,000 cases today; they only had a few hundred cases a week ago. Stating that we only have 1,600 cases today is absolutely irrelevant in the face of a pandemic virus spreading under exponential conditions. We will help put the term exponential spread into context down below.
Immunologically naive populations
Viruses have been circulating around the globe for millennia. One family of viruses that have been circulating are referred to as Coronaviruses. About a quarter of common colds are caused by Coronaviruses. Our bodies form antibodies to foreign invaders, such as bacteria or viruses. If we have antibodies from a previous exposure, then we can rapidly ramp up the production of those antibodies if we are infected by that same virus at a later date. This is why you only get Chicken Pox and the Measles once. The first episode generates protective antibodies so you can’t get infected a second time. For other infections, previous exposures do not make you immune to future infections, but it does make subsequent exposures milder.
COVID-19 is a severe respiratory illness caused by the virus named SARS-CoV2. It is a novel virus, which means that no one in the world has antibodies to it because no one has ever been infected by it before. As such, when the COVID-19 virus invades our body, we do not have antibodies. We do not have a template to utilize from a previous exposure to rapidly create a defense against the virus. Because no one has antibodies, everyone is at risk for catching the virus, becoming ill, and spreading the virus so that it can infect those around you.
Exponential spread
Exponential math is very hard to grasp. Every person with the COVID-19 virus infects approximately two people. Some less, some more. The infection rate doubles every six days. That means that if 50,000 people have the virus today, then in 6 days, 100,000 people will have it. In another 12 days it’s 400,000 and less than two weeks later it’s over a million people. We have 330 million people in the US. The experts expect that 40-70% of people will be infected. Exponential growth does not take that long to get to those scary high numbers. Every six days, we delay the number of infections double. This YouTube video does a great job of explaining this.
Read the full article here: https://www.kevinmd.com/blog/2020/03/a-covid-19-coronavirus-update-from-concerned-physicians.html
