I thought a lot whether I should talk about COVID-19 on my site or not – I have a strong background in biostatistics and epidemiology, but in the end of the day I’m a psychiatrist, not infectious disease specialist. On the other hand, there is so much confusion and misinformation that I simply feel obliged to provide my followers with at least some guidance. So, I am starting a new series of short blogs and videos on COVID-19 – I'll be talking about various aspects of the problem, one at a time, as they emerge. Please, keep in mind that though I’m a practicing physician, the things that I share here are not medical advice. If you need such please talk to your family doctor, your specialist or your local emergency room department.
Today, I would like to talk about the key aspects of the virus, to lay down the foundation for better understanding of what is going on in the world. First of all, we already have a pretty good understanding of what this virus is – it’s the 7th virus discovered in the coronaviridae family and it has a scientific name of SARS-CoV-2, which differentiates it from previously described coronavirus that was responsible for the SARS outbreaks several years ago.
The virus is a positive-sense single-stranded RNA virus and it has several properties that make it very likely to spread – the reproduction number or R0 of the virus is estimated to be between 2.2-3.1, which means that if a person has this virus, they will pass it to 2-3 other people. Of note, there is a chance (12-23%) that people who don’t have any symptoms would still pass it to others. It has a pretty long incubation and infectious period of up to 2 weeks (in some publications numbers are higher, but 2 weeks is a realistic estimate). The attack rate i.e. the chance of contracting the virus when exposed is also quite high – around 30-40%, which means that 1 out of 3 exposed will get the virus. The routes of transmission are primarily via droplets and fomites, but also fecal-oral and airborne (sic!) routes are considered. Personally, I am starting to doubt my understanding of the term “airborne” when people are “considering” whether it is the case or not as these droplets are airborne and we inhale them as well as a good amount of fomites. In any case, irrespective to the terminology, I would advocate for wearing personal protective equipment – masks (despite recent resistance of WHO to admit that they help) and gloves as well as sanitizing the surfaces that are likely to be exposed such as door knobs, your keyboards and desks etc.
Also, it must be noted that lots of people have asymptomatic course and up to 80% of infected have mild forms, which is obviously a good thing on one hand, but along with the lack of testing equipment it creates lots of difficulties with proper estimation of the real numbers of infected (which are likely to be grossly underestimated). We will talk about numbers in another blog very soon. Approximately 15-20% of infected will develop severe cases and might require hospitalization. Current estimate is that 5% will require intensive care treatment, but in view of the existing mortality numbers this number appears to be somewhat off (more on that subject soon).
So, what do we have now? We are in a pretty dire situation with well over a million confirmed cases of coronavirus infection and this number is expected to grow. The mortality rate also appears to be very high, much higher than seasonal flu. I will talk about numbers in my next blog and I plan to show that while situation being very serious, these numbers are likely to be very biased i.e. the number of infected people is much higher and accordingly the fatality rate is much lower. In any case, this situation should not cause any panic, but at the same time it must be taken very seriously – we have to act responsibly to mitigate the risks associated both with the virus and the pandemic in general.
So, stay tuned, follow the existing recommendations such as minimizing contacts with others, using personal protective equipment, using proper hygienic procedures etc. Please support my YouTube channel by subscribing and feel free to make suggestions or ask questions – we all are in this situation together and we must stay focused, safe and healthy.
PS. I would like to remind you that though I’m a practicing physician, the things that I share here are not medical advice. If you need such please talk to your family doctor, your specialist or your local emergency room department.
Link to the Johns Hopkins Interactive Map: