Revisions done 2/27/20
Based on the initial data out of China when this incident first started, which is completely dodgy, about 17% of those contracting the virus will require hospitalization. Of those who are hospitalized, assuming a pandemic with medicine and oxygen shortages, about 1 in 3 will die. So that means about 5.5% of those contracting the virus will die. You could drop this down to 3% if people are able to get the care they need without shortages.
Now those numbers are almost certainly inflated because China has explicitly stated that they are only testing the most severe cases. Further, the current test kits only have an 80% accuracy rate, so there are a lot of false negatives. The only test that has been shown to have a high accuracy rate (97%) is a CT scan along with symptomatic diagnosis. Obviously testing everyone with CT scanners is an impossibility.
On February 13th, UC San Diego Health put out a video arguing that actual mortality rate from COVID-19 is probably closer to .3%, which is about 10 times more deadly than the flu. The argument is that, if you were to count all the undocumented cases, it would lower the mortality ratio down to more realistic levels. At .3%, the virus could potentially kill a million people in the US.
I think a good case study is to look at the infected cruise ship passengers, which currently stand at 700 infections and 4 deaths, leaving the fatality rate at 1 in 175 or .5%, which is close to what UC San Diego was predicting. As data comes in, we are seeing higher death rates for people with co-morbidities and compromised immune systems, such as the elderly. It’s clearly far more deadly than the flu, about 10 to 20 times more deadly since the flu death rate is around .03%, but at least it’s not like SARS or MERS.
Based on global birth/death rates, a city the size of Wuhan (11 million) would expect to see about 775 people die per month. If 60% of the city were to be rapidly infected, that would mean 20,000 additional people would be dying in a very compressed time frame, perhaps on the order of the next few months. They are going to be burning bodies like mad over there. Current reports say funeral homes are doing 5 times the normal business, which puts the monthly toll at around 3,900.
According to one Hong Kong medical official, current estimates say it has the potential to infect 60% of the global population if it remains uncontained and without a cure or vaccine. I’ve also seen Harvard researchers saying 80%+ of people will become infected at some point in the future. Quarantines and extra hygienic practices can slow the spread down, which is what we need in order to buy us time to develop a vaccine and test anti-viral medications, but they will not stop the spread.
As far as I can tell, this will go global. Eventually everyone will get it, much like chicken pox or the common cold. The corona virus can spread as an aerosol, meaning the virus can spread like smoke through a room, suspended in air. You don’t even need to touch something to contract it. Hopefully quarantine and safety precautions will slow the spread down long enough for a vaccine to be developed. There are new technologies that might be able to get a working vaccine to the public rapidly. One company, MIGAL, is reporting they could have an effective vaccine developed in as little as a few weeks.
JAMA put out an article today (2/27) reporting that 4 people in China who were previously hospitalized for COVID-19 pneumonia, who then apparently fully recovered and showed no further symptoms of the virus and were discharged to home quarantine, continued to test positive for the virus 13 days after discharge. While they didn’t infect any family members during their quarantine, this news obviously complicates tracking the spread of the virus.
I’ve also seen recent reports of people who have recovered, tested negative after recovery, then coming back a month later with symptoms and tested positive again. This also further complicates tracking the spread of this virus. It’s possible some people could hold this virus dormant for long periods of time without symptoms, yet still be spreaders of the disease.
The virus kills by inducing a cytokine storm focused on lung tissues. A cytokine storm occurs when the immune system suddenly realizes what an infected cell looks like. The immune system suddenly goes on a rampage destroying infected cells in an over-zealous manner. This can be very damaging to the body if it happens too rapidly. This intense reaction by the immune system ends up destroying lung tissue and causing a viral pneumonia to set in. The destruction of lung tissue results in a compromised lining of the lungs that can then lead to a bacterial pneumonia complication on top of the viral pneumonia. So basically it kills you by drowning you in your own bodily fluids.
Nicotine is known to mitigate some of the effects of a cytokine storm by down-regulating the immune response. So perhaps stocking up on Nicorette gum and popping some the minute you feel sick might not be a bad idea. Of course, this could lead to further issues given the toxicity and addictive nature of nicotine. As a side note, the current fatality profile indicates smokers and former smokers are at a higher risk of dying due to the lung damage the virus induces, so don’t use this as an excuse to start smoking again.
With the current assumed death rate and a 80% infection rate, that means we’ll probably see between 1 and 2 million people die in the US (about 1 in 150 to 1 in 300). Given what we’ve seen in Wuhan, it’s probably a good idea to stock up on N95 masks, bulk dry foods, paper towel, toilet paper and detergents. If you can get your hands on an oxygen concentrator, I’d grab one of those as well, because the hospitals will likely be too overwhelmed to give you oxygen should you develop pneumonia.
On 2/18/20 the WHO put out a report saying the virus has a 2% death rate and a 5% severe case rate, which is more in line with my initial predictions, but I think this data is also suffering from the under-reporting of cases. Dr. John Campbell is putting out daily videos on this subject that are worth watching. He cuts through a lot of the BS and sticks to documented facts. He also get’s a lot of anecdotal data from his colleagues overseas that others don’t have access to.