Coronavirus (COVID-19) . . . Questions to Ask, part 1

2020 Questions “From the Heart” Series

As the world wraps its focus on this latest virus outbreak, what questions and concerns have occupied your thoughts? Ever since the outbreak originated from Wuhan, China in December last year, we daily hear many confusing and contradictory reports from the news media. We also hear disproportionate commentary from those who really don’t have their facts straight, are not the experts, provide just sketchy and questionable soundbites, blame others, and only add to the fear surrounding us.

Fortunately, I do see some folks attempting to report what the experts say and not their own commentary, leaving it up to us to do the homework ourselves. Since the stats change daily, doing our own homework is definitely prudent. Asking questions also provides a forum for constructive dialogue to emerge. And as we avoid the “blame game” with our questions, we can more effectively spend our energies seeking essential information and accurate resources for this ongoing challenge and our own wellbeing.

Questions to Ask

As you watch experts attempt to assess, clarify, and now evaluate the current situation, are they helping you move beyond your fear and even panic? Let’s see what questions may help us evaluate what we are hearing from the media and expert resources, and how to respond. Here are questions you may have thought about:

  • How many coronaviruses are there and how serious are they?
  • How does the seriousness of COVID-19 compare with other corona viruses and typical seasonal flu viruses?
  • What are the latest infection and mortality rates for COVID-19?
  • Who do I seek to gain the most accurate and up-to-date local, national, and global perspectives on this outbreak?
  • How do I evaluate the personal and political agenda of the media on the coronavirus?

COVID-19 compared to Other Coronaviruses

First, the new coronavirus disease caused by SARS-CoV-2 was recently termed COVID-19 by the World Health Organization. The name, COVID-19, was chosen to avoid stigmatizing the virus’s origins in terms of human populations, geography, or animal associations.

There were seven known coronaviruses that infect people: 229E, NL63, OC43, HKU1, MERS-CoV, and SARS-CoV.[1] People around the world commonly get infected with the first four human coronaviruses. Sometimes coronaviruses that infect animals can evolve and jump to a new host—us humans! The SARS-CoV-2 is one of these “jumpers” and is now a new coronavirus causing Coronavirus Disease 2019, or COVID-19, in people.[2]

This large family of viruses, according to the CDC COVID-19 Summary, are common in people and many different species of animals, including camels, cattle, cats, and bats. “Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2).”[3]

WHO reports most people infected with COVID-19 virus in China have a mild to moderate case and recover.[4] Globally, as of February 23, about 80% of laboratory confirmed patients have had mild to moderate disease, which includes non-pneumonia and pneumonia cases (who recover without special treatment). “Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough and difficulty breathing should seek medical attention.”[5] As of March 3, with some simple arithmetic, slightly more than 3% of COVID-19 infections globally were estimated fatal.[6]

To gain a comparison of the COVID-19 and Seasonal Flu Virus group, I have offered a table outlining the stats. Keep in mind the world population is about 7.6 billion and US population is 329,356,187.[7]

CDC/WHO Stats# of Cases# of Deaths
COVID-19:
Global cases (as of March 3, 2020; 72 countries outside China)[8]90,870
(80,304 China
10,566 outside China)
2,946 (China)
166 (outside China)
US cases (as of March 4, 2020; 13 states)
California, Oregon, Washington, Arizona, Wisconsin, Illinois, New York, Massachusetts, New Hampshire, Georgia, Florida, North Carolina, Rhode Island[9]
No reported cases in Texas[10]
809
INFLUENZA VIRUS:
Global cases (Type A,B,C virus groups) Global Influenza Strategy 2019-2030 – Estimated Annual[11] 1 billion (3-5 million severe) 290,000-650,000
US cases (Type A,B,C virus groups)
(October 1, 2019 thru February 22, 2020; 14-21 million medical visits, 310-560,000 hospitalizations)[12]
32-45 million18,000-46,000

As you can see, the numbers of seasonal flu cases and deaths worldwide are typically estimated about one billion cases and deaths averaging 500,000 each year. At this point the number of COVID-19 cases and deaths worldwide is considerably lower. We hope it stays that way. Also, the mortality rate appears lower for COVID-19 than MERS (34% death rate)[13] or SARS-CoV (15% death rate).[14]

However, none of us should just assume this particular coronavirus strain is no big deal. Following the stats is an ongoing and arduous effort by the CDC and the World Health Organization (WHO[15]), and they estimate the numbers will continue to change. Yet, both consider the risk low for the US as containment/prevention and mitigation/treatment are pursued.

Also, the CDC and WHO have not defined this outbreak as a pandemic as of March 4, since it has not yet reached the global spread and level of infection sufficient to warrant that classification.[16] The operative word continues to be “Yet.” With global effort, containment, and mitigation, that level will hopefully not happen.

How COVID-19 Spreads

Viruses can be highly contagious and spread easily, like measles and the common flu. Others may not easily spread nor be sustained. However, according the CDC, “COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in some affected geographic areas. Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected.”[17] Another distinction possible is tiny infectious droplets linger in the air even after the ill person is no longer nearby.[18] This is why it is important to stay more than 1 meter (3 feet) away from a person who is sick.[19]

So what are those symptoms? Some cases have been mild to severe and appear 2-14 days after exposure. Symptoms such as fever, tiredness, dry cough, and shortness of breath. Some may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea.

Part 2 coming soon . . .

As we do our homework in the days ahead, be sure to ask more questions to further the conversation. No matter how difficult, your efforts will give each of us the opportunity to genuinely listen, assess more deeply beyond our biases and fears, and seek to clarify what is really going on. Since more than our health can be impacted by this COVID-19 outbreak, we will then be able to better evaluate the best course of action for the health and wellbeing of our families, community, and nation.

With the next article, part 2, we will explore ways we can contribute to the containment and lessen the fear and impact any illness would have on us all.

Resources/Endnotes:

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[1] CDC-Human Coronavirus Types
[2] CDC-Coronavirus Disease 2019 (COVID-19)
[3] CDC-Coronavirus Disease 2019 (COVID-19) Situation Summary
[4] WHO-Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)
[5] WHO-Q&A on coronaviruses (COVID-19)
[6] WHO-Coronavirus disease 2019 (COVID-19) Situation Report – 43
[7] U.S. and World Population Clock (US Census, as of March 4, 2020)
[8] WHO-Coronavirus disease 2019 (COVID-19) Situation Report – 43
[9] CDC-Coronavirus Disease 2019 (COVID-19) in the U.S.
[10] Current Situation: Coronavirus Disease 2019 (COVID‑19) Outbreak (DSHS-Texas)
[11] WHO-Global Influenza Strategy 2019-2030
[12] 2019-2020 U.S. Flu Season: Preliminary Burden Estimates
[13]WHO-Middle East respiratory syndrome coronavirus (MERS-CoV)
[14] WHO-Consensus document on the epidemiology of severe acute respiratory syndrome (SARS)
[15] WHO Director-General media briefing March 2, 2020
[16] CDC Pandemic Resources
[17] CDC How COVID-19 Spreads
[18] Coronavirus Disease 2019 vs. the Flu (Hopkins Medicine)
[19] WHO-Q&A on coronaviruses (COVID-19)