Data Dissection - Understanding Each Case Better
It seems to some extent that the initial panic has subsided. There have been enough cases looked at in detail to better understand what the risk profile is.
Countries with high per capita testing and good data collection are beginning to give us more insight into COVID-19. South Korea, Iceland and the Diamond Princess cruise ship have all given the researchers good information.
To date all the projections are based on computer models. The experts input the information they know - often not much - then make a number of assumptions, and then press calculate. As with climate modelling, we often find that some of the assumptions are not accurate.
A highly contagious deadly disease is a huge worry. Something like cholera is a very serious health problem. A highly-contagious, very mild illness is not nearly such a problem for the community at large. A not-very-contagious, serious illness will need good management, but may give us time to educate and change behaviours. Think AIDS - it has largely gone off the public radar. There are specific behaviours that put some defined individuals at risk so they are in general easier to manage.
So from the three populations mentioned the experts believe that the lethality (your likelihood of dying) is in the per mille range - between 0.1 - 0.9. This makes it very similar to a serious flu. The hospital system in most countries will get overloaded and stretched during a bad flu season. This was the case in the last few years in Europe and the US.
A French Study has concurred that COVID-19 is not particularly different to other coronaviruses.
It seems that we may already have a level of immunity to this new (novel coronavirus). In a very wide range 50-80% of those who test positive do not have any symptoms. 90% of the positive test individuals have between mild and at worst moderate symptoms. This would suggest that our existing immunity to other coronaviruses is lending us a level of wild or natural immunity to this bug also.
Wild immunity (you caught the actual bug) provides a much greater protection to future infections. Coming into contact with the actual bug (bacteria or virus) will spark both sides of the immune system: the bone response (humeral or white blood cell) and the cellular response (killer T-cells). There is good physiology backing for the proposition that if the sickness is mild for 90% of the population then getting everyone's immunity primed quickly will be the best way to protect the more vulnerable. That is the reasoning behind mass vaccination programs.
Pre-existing illness is a large factor in fatalities
Only 1% of those who have died with or from COVID-19 did not have a pre-existing illness. Some were undiagnosed. So they were "apparently healthy". This piece of information is crucial for each individual in assessing their individual risk factor. I would add that if someone is on a daily drug from their doctor then they have a pre-existing health condition and it increases their risk profile.
Professor Klaus Puschel is the head of forensic medicine in Hamburg. His findings to date are that not a single person who was not previously ill had died. The virus was the last straw in already grossly weakened system. He says "Corona in itself isn't a particularly dangerous viral disease".
Many experts are keen to distinguish the "died with" versus "died from".
A few weeks ago there were very few test kits in Australia and even the world. We do not have a test kit for everyone in the country. As more test kits become available and more tests are done the number of positive tests will increase. That is pretty obvious, but not mentioned in the daily reporting. What doesn't seem to change much is percentage of positive tests. That has been low in Australia, around 5%.
It is interesting that in the media reporting we are not hearing about how countries that have not gone into lockdown are doing. South Korea, Japan and Sweden have all taken a quite different approach and their infection rates are not much different to ours. They have all had more widespread testing and then thorough contact tracing when an individual tests positive.
We might take some comfort from the actual numbers, rather than the estimates. The Official US have overestimated hospitalisations by a factor of 8, ICU beds by 6.4 and the need for ventilators is 40.5 times the need so far.
Locally and internationally hospital staff are being asked to work shorter hours and take leave as the load in other areas is been slashed. Procedures have been cancelled and postponed so there is trained staff within the hospital system that are on short weeks, so they could feasibly be deployed to another area if there was an overwhelming need.
There is a concern here and overseas that the lockdown protocol will cause repeating waves of infections. Professor Knut Wittkowski from New York has advocated natural immunity to limit the occurrence of multiple waves of infection each time that the population is released from lock down. His advice is to put resources into protecting the groups of the community who are at risk if they contract COVID-19.
So what to do?
- Wash your hands - it is basic and will likely mean that you won't get a cold or flu for some time!
- Comply with the current guidelines: Keep your distance, only go out for food, work and medicine.
- We are making masks which have been recommended. You may feel more comfortable if you are out and others can see that you are making an effort.
- Relax in the knowledge that you are healthy enough to live through a cold or flu each year, so this is no different.
- Ensure that you are comfortable in your body - pain will increase stress