Coronavirus FAQs: Will we get through this?

Here are the three most asked questions I’ve been getting about the coronavirus pandemic.

To answer them, I will digress in this post from this blog’s core mission of advocacy for U.S. healthcare reform.

What Are Worst-Case and Best-Case Scenarios?

The worst case scenario was the 1918 Spanish flu pandemic.  This graphic depicts its three waves occurring over 12 months.  Spanish flu ultimately infected 500 million people, effectively 25 percent of the world’s population, and killed at least 50 million and up to 100 million by some estimates.

Source:  Vaccines Today

The best-case scenario was the 2003 SARS (severe acute respiratory distress) coronavirus pandemic. The 2003 SARS coronavirus was less easily transmitted. Thus, despite being more lethal, it was less widespread and caused fewer total deaths.  SARS was contained within four months. SARS infected only a total 8,100 individuals, with 774 deaths. COVID-19 has already surpassed this best-case scenario.

Source:  World Health Organization

Here’s a graphic depicting the relative transmissibility and lethality of the Covid-19 virus.

[Graphic is taken down March 19, 2020, at the request of the copyright owner — please visit https://www.thesun.co.uk/news/11156025/coronavirus-mortality-rate-higher-pandemic/  to view this informative image.]

 

This shows that SARS-CoV2, the COVID-19 virus, is in the mid-range of transmissibility and case fatality compared with other pandemic viruses, enough to bring it into the top ranks of serious global public health risks.

Here’s a summary of deaths in past influenza pandemics, for comparison.

Note:  Added March 19, 2020

New York Times health columnists rank the number deaths from Covid-19 as potentially as high as those from heart disease and cancer, far exceeding the total annual deaths from seasonal influenza.  Readers are directed to their New York Times interactive report for a graphic tool for estimating Covid-19’s deaths under different assumptions for infection rates and case fatality rates.

Bottom lines:

• Covid-19 could potentially cause as many deaths and cancer and heart disease
• Covid-19 has already exceeded the duration and mortality of the 2003 SARS pandemic
• The worst-case scenario could look similar to the 1918 Spanish flu; aggressive public health measures are needed to avert this devastating outcome
• The Spanish flu epidemic curve illustrates that Covid-19 could ebb and flow in waves over a long as a year or more, even with strict public health actions.

Will the Coronavirus Epidemic Just Blow Over?

Epidemics eventually subside naturally, but only after enough people recover and become immune.  This is referred to as herd immunity. Respiratory virus epidemics such as Covid-19 can take anywhere from a few months to a year to run their course.  Washington Post health reporters posted a video graphic illustrating transmission, recovery, and herd immunity, and how public health actions can determine the ultimate epidemic curve. Meanwhile, public health officials are hopeful for the development of anti-viral drugs that could help reduce the severity and case fatality of Covid-19. And they hope for a vaccine which could artificially boost herd immunity. Nevertheless, any vaccine would take a year or more to develop and deploy.

Will We Get Through This?

The short answer is, Yes. There are two parts to this answer. But just how quickly and completely we get through this pandemic depends on all of us.

First, it depends on leadership. Leaders will need to make tough decisions and take bold action. They will need to rely on best available scientific information. But in many cases they will need to make decisions with limited data, possibly inaccurate preliminary information, or absent information. This is a situation in which leaders should err on the side of caution with early, proactive actions to get ahead of the epidemic curve and flatten it. Let the second-guessing and Monday-morning quarterbacking be saved for later.

Second, it depends on followers to set an example of cooperating with the guidance from leaders. Followers need to adopt an attitude of shared sacrifice and brother-keeping, especially towards the elderly and other vulnerable neighbors. To do so, followers need to boost our mental resilience and raise our spirits.  Here are two links that can help, among many others:

• Mental resilience: Sue Varma, NYU psychiatrist –
  • Mindfulness – self-care
  • Movement – safe exercise indoors or outdoors
  • Mastery – activities that give a sense of control and joy
  • Meaningful engagement – keeping in touch by phone, digital, or 6-foot-separated face-to-face contacts
• Spiritual uplift: Carey Nieuwohf, Pastor, Connexus Church, Barrie, Ontario –
  • Practice leadership, not reactionship
  • Embrace sacrifice, not selfishness
  • Gather wise counsel to check your natural instincts
  • Deepen trust
  • Broker hope
  • Look for opportunity in the midst of all the obstacles.

 

 

References

• Finnegan, Gary. “100 Years after ‘Spanish flu: Is the world ready for the next pandemic? Vaccines Today 2017. URL: https://www.vaccinestoday.eu/stories/100-years-spanish-flu-world-ready-next-pandemic/ (Accessed March 18, 2020) (Copyright 2017 Vaccines Today – Used under Terms of Use with link to copyright owner)
• World Health Organization. Epidemic curves – Severe Acute Respiratory Syndrome (SARS). URL: https://www.who.int/csr/sars/epicurve/epiindex/en/index1.html (Accessed March 18, 2020) (License: https://creativecommons.org/licenses/by-nc/3.0/igo/ )
• Mullins, Gemma. Coronavirus mortality rate is ‘70% HIGHER than first feared’ – as bug declared a pandemic. London: The Sun, 2020. URL: https://www.thesun.co.uk/news/11156025/coronavirus-mortality-rate-higher-pandemic/ (Accessed March 18, 2020)
• Saunders-Hastings PL, Krewski D. Reviewing the History of Pandemic Influenza: Understanding Patterns of Emergence and Transmission. Pathogens 5(4): 66, 2016 URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198166/ (Accessed March 18, 2020)
• Roser, Max. The Spanish Flu (1918-20). URL: https://ourworldindata.org/spanish-flu-largest-influenza-pandemic-in-history (Accessed March 19, 2020)

 

Image Credit

Title: Daily new confirmed cases of COVID-19 per million people, March 17, 2020

By:  Max Roser, Hannah Ritchie and Esteban Ortiz-Ospina, University of Oxford Martin Programme on Global Development

Source: WHO COVID-19 Situation Reports

URL: https://ourworldindata.org/coronavirus

License: All of Our World in Data is completely open access and all work is licensed under the Creative Commons BY license. You have the permission to use, distribute, and reproduce in any medium, provided the source and authors are credited.