Thursday, 30 January 2020

What Is Coronavirus - And Are We All Going To Die From COVID-19? (Updated 17/02/20)

I've been following the 2019-nCoV Coronavirus outbreak since the beginning of January. I've always been interested in epidemics and more so since my partner had Meningitis and I began looking at the negative effect the anti-vax movement was having.

The 2019 novel Coronavirus emerged with ideal location and timing, just before the world's biggest annual migration of people for the Chinese New Year, meaning that it always had the opportunity to spread rapidly and get really big.

I've added updates on 03/02/20 and 17/02/20 (latest figures below) because this is a changing situation and estimates for transmission, death rate, incubation etc, are still changing. You can also read my interview with a UK national who returned from a severely affected area of China in early February.

IMPORTANT: 13/02/20 China: After spending 3 days removing cases where the patient has a CT result showing pneumonia symptoms, but no nucleic-acid testing (blood test) to confirm, China backtracked. It replaced those removed and is now again including these cases in figures as 'unconfirmed'. THIS is why there was an apparent surge in numbers. 

Image showing ways to reduce the chances of contracting coronavirus - as given below

I've read absolutely tons of scientific papers, government information, different viral models and personal stories, there is masses of information out there from genuine scientists and people who know far more than me, but what follows is my break down of all that I've read - in a language we can all understand.

All we all going to die from COVID-19 Coronavirus? 

Absolutely not. The mortality rate appears at this point to be around 2% or 1 in every 50 (17/02/20). This is not a particularly powerful illness, it's just incredibly good at spreading and because it's new, no-one already has immunity. (The mortality rate from seasonal flu is around 0.1% or 1 in every 1000).

Should I panic about Coronavirus? 

No. What use would that do? It's not helpful if a handful of people stockpile enough face masks for 15 lifetimes, and then don't even get ill. Empty shops and fuel stations won't save any lives. At most you'd need enough toilet roll, paracetamol and soup to last 2 weeks.

Should I worry about Coronavirus? 

No. Worrying does not give immunity and it is not an effective cure. It won't alter your chances of catching Coronavirus. Worrying eats your life up and then you will definitely die of something in the end anyway. You need to live first.

Should I take precautions to protect me from Coronavirus? 

Yes. You should take the same precautions you usually take with your health and the health of those around you.
  • Wash your hands regularly, and always before and after handling food or other people.
  • Wash hands before you touch your face - rubbing your eyes, touching your lips or picking your nose can introduce virus and germs from your hands. 
  • Sneeze into a tissue and throw it away, or if you really don't have one handy, sneeze into the crook of your arm. Then wash your hands - and your arm. 
  • If you are ill, don't mix with other people unnecessarily. Likewise don't mix with people who are ill unless it's unavoidable, in which case follow home advice for carers of people who have flu
  • If you are ill with a cough and cold, have a temperature and are struggling for breath, ring your Doctor and they will advise you what to do next.
  • Wipe down surfaces regularly and use anti-bacterial cleaners on tables, food preparation areas and bathrooms, and high traffic areas such as doorknobs and light switches. 


How bad will the Coronavirus outbreak get? 

No-one knows. This is your classic 'how long is a piece of string?' question.

Based on what we know about previous virus outbreaks and how they progressed, current estimates are that right now, there may already be millions of people with the virus incubating inside their bodies, or it could be less than 100,000. Every infected person could pass it to 1 other person, or many, but it's likely they'll pass it on to around 3 to 4 (at 010/02/20).

What are the symptoms of COVID-19 Coronavirus?

Unusually patients with 2019-nCoV don't seem to suffer very badly with runny noses or sneezing. The virus sits in the lungs, rather than causing a reaction throughout the whole respiratory tract. Patients usually have a fever, a cough and possibly difficulty breathing, but may not even have all of these symptoms.

Catching 2019-nCoV does not mean you will definitely become ill, let alone seriously ill. Evidence so far suggests the majority of people will not need extensive medical support, and lots will need none. Many people who catch Coronavirus will never even feel a need to go to a Doctor, let alone have a positive confirmation of Coronavirus. This is especially true of younger, healthy people.

Coronavirus is a flu-type virus which causes pneumonia in around 14% of people who have confirmed cases - or 1 in every 7 (17/02/20). Pneumonia is your own body's immune reaction to a virus. The air sacs in the lungs inflate and are able to fill with fluid, which means there is less room for Oxygen and you struggle to breathe.


  • Less than 1 in every 7 confirmed cases currently become ill with pneumonia and shortness of breath (14% at 17/02/20). 
  • Around 1 in 20 confirmed cases become very sick with critical diseases including respiratory failure, septic shock and multi-organ failure (5% of total at 17/02/20). 
  • Around 1 in every 50 confirmed cases or 2% of the total are estimated to be at risk of death (at 17/02/20). 
  • Your risk of serious illness and death increases with age.


This is all based on what we know about viruses and what we can work out so far, but thousands of people are still ill, and it's really too early for precise figures. You can be hospitalised with pneumonia for several weeks before you recover or succumb. (The mortality rate for pneumonia is generally around 1% for people under age 40, and under 5% for people under 65).

Children are not at greater risk of serious illness than adults. Often with disease outbreaks young children are particularly vulnerable, but in the case of COVID-2019 less children have so far become ill and we don't yet understand why. It is known children are generally less likely to develop the reaction which causes pneumonia. They are NOT immune, but as a parent it gives you a little extra confidence about the safety of your young family.

According to China's National Health Commission, about 80% of those who have died are over age 60 and 75% had pre-existing health conditions. People over 80 are not coping well with the novel Coronavirus. People under 48 years old seem to be coping best overall with the novel Coronavirus. The older you are, the more likely you are to become seriously ill. This is in line with known figures for any general pneumonia.

Many asymptomatic patients have now been discovered, feeling perfectly healthy, but carrying the virus.  It's worrying for health officials because it's much harder to contain a virus which infects people who don't have symptoms.

What is the incubation time for COVID-19 Coronavirus? 

COVID-19 seems to have a regular incubation of around 2-14 days. This is 2-14 days where you have caught the virus, aren't feeling ill and don't have any visible symptoms, but may be able to pass it on to other people. On 10/02/20 new research from Zhong Nan-Shan suggests incubation can be up to 24 days, but a median average is 3 days. (Source link below).

2019-nCoV transmits fairly easily through your respiratory system. When we breathe out, some of the fluid from inside your lungs also escapes into the air, and with it any virus we might have. Sneezing propels it up to 8 feet, and even coughing can spread germs and virus up to 6 feet away.

Usually virus can't live very long without a host body. Coronavirus has been found alive on some common nonbiocidal surfaces (Teflon; PTFE, PVC, ceramic tiles, glass, silicone rubber and stainless steel) for up to 5 days in perfect temperature and humidity conditions - this is presumably why massive spraying operations are taking place in Chinese streets.

What will happen next with COVID-19? 

A race to make a vaccine is already happening and how fast that is put into use will depend on several factors, including how fast nCoV spreads. At least 4 labs have already created a vaccine they believe will work and are testing.

The virus could mutate into something more powerful, or the moves in place to keep it contained could be entirely successful.

Given that the population of the Earth is 7.76 billion then the numbers who are eventually diagnosed could be anywhere between 75,000 and 7.76 billion.


(1700 GMT 30/01/20)
  • There are no known cases of 2019-nCoV in the UK. 
  • Worldwide there are 8,246 confirmed cases of pneumonia caused by 2019-nCoV (8124 in mainland China)
  • In China 170 people have died because of 2019-nCoV
  • In China 133 people who were seriously ill have recovered and been sent home. 
  • 2019-nCoV has been confirmed in 22 different countries. 
(1100 GMT 03/02/20)
  • There are 2 confirmed cases of 2019-nCoV in the UK. 
  • Worldwide there are 17,486 confirmed cases of pneumonia caused by 2019-nCoV (17,302 in mainland China)
  • Worldwide 362 people have died because of 2019-nCoV (361 China / 1 Philippines)
  • In China 496 people who were seriously ill have recovered and been sent home. 
  • 2019-nCoV has been confirmed in 27 different countries. 
(9:00 GMT 12/02/20)
  • There are 8 confirmed cases of 2019-nCoV in the UK. 
  • Worldwide there are 45,171 confirmed cases of pneumonia caused by 2019-nCoV ( 44,653 in mainland China)
  • Worldwide 1115 people have died because of 2019-nCoV (1113 China / 1 Philippines / 1 Hong Kong)
  • Worldwide 4787 people who were seriously ill have recovered and been sent home. 
  • 2019-nCoV has been confirmed in 28 different countries. 
  • Chinese authorities announced 07/02 Doctors no longer need a CT scan to confirm Coronavirus
  • Chinese authorities announced asymptomatic cases will no longer be counted in the official total on 10/02. This has led to figures rising and falling at will, including 5500 suspected cases removed from the total last night. 
(UPDATE 01:00 GMT 13/02/20)
  • China re-added all new cases from the last 3 days and previously removed cases where the patient has a CT result showing pneumonia symptoms but no nucleic-acid testing to confirm. THIS is why there is an apparent surge in figures.
( 9:00 GMT 17/02/20)
  • There have been 9 confirmed cases of 2019-nCoV in the UK, 8 fully recovered.
  • Worldwide there are 70,810 confirmed cases of pneumonia caused by 2019-nCoV ( 70,553 in mainland China)
  • Worldwide 1775 people have died because of 2019-nCoV (1113 China / 1 Philippines / 1 Hong Kong)
  • Worldwide 11,258 people who were seriously ill have recovered and been sent home. 
  • 2019-nCoV has been confirmed in 28 different countries and locations. 
Lots of very clever people have created models which give estimates of how COVID-19 will develop over time, but they are all guesses. We don't know if a random sufferer on a plane will infect 200 more and cause a big outbreak, if the virus is stronger in people with red hair, or if people in colder countries have more natural immunity. We don't know if or when it will mutate, and we can't even say that everyone in the world won't catch it at some point. It could die down by next week and be old news by April.

What we can say is that COVID-19 will put massive pressure on local medical facilities and staff wherever it occurs, and in large outbreaks this could mean access to even everyday medical help isn't possible. Most African and 3rd world countries will not be able to cope with the sheer numbers in an outbreak, and that is what could really raise the death toll.

Every single person who dies is not just a number. They are people, who will leave behind loved ones who will miss them forever.

To keep track of where 2019-nCoV has been diagnosed, John's Hopkins University have an almost live 2019-nCoV map.


Sources:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
http://wjw.hubei.gov.cn/fbjd/dtyw/202001/t20200129_2015921.shtml
https://www.cdc.gov/coronavirus/2019-ncov/summary.html
https://www.medrxiv.org/content/10.1101/2020.01.23.20018549v2
https://www.bbc.com/news/world-asia-china-51226494 - foreign nationals in China
https://www.bloomberg.com/news/articles/2020-01-29/10-year-old-boy-raises-fears-wuhan-virus-could-spread-undetected?utm_source=url_link (paywall 3 articles a month)
https://www.dailykos.com/stories/2020/1/25/1913998/-Wuhan-Coronavirus-An-Update-and-its-Prognosis
https://www.gov.uk/guidance/wuhan-novel-coronavirus-information-for-the-public
https://www.sciencealert.com/how-worried-should-we-be-about-the-wuhan-coronavirus-outbreak
https://www.the-scientist.com/news-opinion/lab-made-coronavirus-triggers-debate-34502?archived_content=9BmGYHLCH6vLGNdd9YzYFAqV8S3Xw3L5
https://www.bloomberg.com/news/articles/2020-01-23/several-china-coronavirus-victims-didn-t-even-have-a-fever
https://twitter.com/WilliamYang120/status/1226784315133980672
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4659470/ (incubation rates 10/02/20)
https://erj.ersjournals.com/content/41/4/917 (pneumonia study)
https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-covid-2019-outbreak-on-17-february-2020

If you know more or better than me, please feel free to speak up!! Information changes constantly at the moment and I'm interested in truth, not scandal or misinformation. 


6 comments:

  1. Very informative Jenny. We had someone taken into hospital a few miles away the other day and the staff where wearing masks and the news spread like wild fire that it was the Coronavirus. He was ok though, probably just normal flu or pneumonia. We didn't hear anything else. Basic hygiene is the best way forward.

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    1. Thanks Anne - I'm glad you found it useful. It's hard to know whether you make sense until someone says you do! Basic hygiene is definitely our best defence - and even if it doesn't stop you getting coronavirus, it'll mean you haven't got lots of other bugs and germs to fight off at the same time.

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  2. Some seriously good points - the main one at the moment... don't panic! The media is definitely drumming us up into a frenzy, just be aware. It is quite addictive reading about it though, certainly very interesting finding out more about it and how different countries are reacting. Did you see how quickly the Chinese built a hospital? Builders in the UK take note! Sim x

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    1. I can't imagine the UK managing to put up a 1000 bed tent city in the time they're building their hospitals!
      The lack of quick reaction will come back to bite a lot of countries. Allowing free movement from affected areas and not tracking the people afterwards has to be a massive error when you don't know what you are up against. I think when China first shouted fire, everyone else just stood by and stared for too long. It's always about money.

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  3. This is a very informative and excellent post. Definitely common sense and good hygiene will be our best defence xx

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  4. Thank you for this post Jenny. The figures you have provided show just how small of a scale this virus currently is against the population of the world. Also simple steps in hygiene could help prevent the spread. I’ll be sending this to my mum to read as she’s so paranoid at the moment.

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