Tuesday, January 28, 2020

What makes the coronavirus so scary?

SARS Coronavirus; C.S. Goldsmith, CDC

...Like, it's just a cold, right? The flu comes and goes and we never get used to it because from my limited knowledge, the flu tends to mutate so our bodies never recognize the virus the next year it shows up. The regular flu also has a chance to wreak havoc if left untreated, especially on infants and the elderly. The World Health Organization says it kills up to 650,000 people each year.

So what makes the Wuhan coronavirus so concerning?

To Start, Let's Look At Mortality Rates

Pulling data right out from cdc.gov, influenza has a death rate of approximately 2.0 per 100,000 for the U.S. population, as well as an oddly-specific 6,515 flu-caused deaths in 2017. A slightly more informal website, WebMD, gives approximately 5%-20% of the U.S. population that will get the flu. A quick back-of-the-napkin calculation gives:
  • Approximate U.S. Population: 327 million
  • Assuming flu death rate of 1 in 50,000 (2.0 per 100,000): Approximately 6,540 deaths per year. 
If you happen to get the flu, which is around 30 million of the U.S. population each year, give or take, the chances of you dying from the flu is around 0.0002, or 0.02%. Obviously age and health plays a large factor in this - your chances of surviving the flu are higher if you're healthy and in college than if you had just celebrated your 90th birthday, but the disease is common enough in the United States that we can begin to talk about generalities.

The Coronavirus Family (SARS, MERS, and Wuhan)

The first thing to know about the Wuhan coronavirus is that it's only a sub-strain in the coronavirus family. It's like saying, "The Asian Elephant" when other families, like the African Elephant, exists under a common Elephant family. The coronavirus is actually a catch-all term for a family of viruses because the shape of the virus looks vaguely like a crown, or Corona. Nothing to do with the beer brand.

Just like the regular flu, the coronavirus causes respiratory infections as a common cold would do - sore throat, a cough, feeling tired with a lack of energy, a fever. In fact, a fever is something that is a common trait for coronavirus patients - which is why a lot of airport screenings have temperature sensors looking for passengers with abnormal body temperatures.

You might have heard of MERS (Middle-East Respiratory Syndrome) before, and you probably have heard the SARS (Severe Acute Respiratory Syndrome) outbreak before. SARS and MERS are actually both members of the coronavirus family, and they have a fatality rate much, much higher than that of regular influenza. During the SARS outbreak, the case-fatality rate was a staggering 11%, and MERS had an even higher fatality rate - 36%!. A virus that had a fatality rate in the 30s begin to approach the fatality rate of certain ebola viruses, and ebola travels a lot slower and is a lot easier to detect. You know when a patient is bleeding from her orifices, but you don't think too much when someone has a cold nearby.

So Why hasn't SARS and MERS killed more people?

For those who don't remember, SARS actually had an outbreak before - back in 2002-2004. According to CDC, SARS typically transmitted via "close" person-to-person contact. Meaning that you typically have to live with someone who is already infected with SARS, sharing eating utensils, or being in an enclosed space when the person coughs or sneezes on you. 

For MERS, it seemed that the virus was even more difficult to transmit between people. It was easier to spread the virus between its original animal host - camels than people. A lot of people who were initially diagnosed with the MERS virus had close contacts with camels who already carried the disease. For example, a person could have touched the nose of a camel, which had mucus or other secretions that carried the MERS disease, and then touched their own face immediately after, and gotten infected there. 

There was, however, incidences of a person carrying the SARS coronavirus spreading it to strangers. The most famous case being a patient who was sick, but had stayed at a hotel in Southeast China. Because of the hotel's air ventilation system recycling air, during his stay he had actually managed to infect 16 other hotel guests who were on the same floor as him! This contributed to the global SARS outbreak. 

But MERS was contained, and SARS was eventually contained. Which brings us back to today.

Well, the Wuhan Coronavirus doesn't seem to be slowing down...

As of today, more than 6,000 people have been identified to have contracted the virus. It's close to the Chinese Lunar New Year, and a lot of people would have had to travel to Wuhan for transit. Imagining a virus breaking out at a central travel hub like Chicago - this is how critical Wuhan is to inter-country travel in China. As reported in my last blog post, apparently 5 million people had left Wuhan and are in other parts of the world before the city finally shut down. It could be possible that they were just passing by, but chances are that some of them have already contracted the disease and are risking becoming super-spreaders in their own right.

Right now the official confirmed number of deaths stand at 132 - roughly a 2% fatality rate. Much lower than that of SARS and MERS, but still very much higher than that of the regular influenza. Another concern about the coronavirus is that because of how it, too could mutate, maybe a strain of a much deadlier coronavirus could come out of nowhere and we wouldn't be able to react in time. We wait with bated breath for the next few days, as we get a better idea of if we'll eventually be able to contain the spread of the virus, or we shift from a containment to a management-strategy as the virus spreads out of control.


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