How Concerned Should We Be About COVID-19?
At this point you are likely familiar with the 2019 novel coronavirus and its disease, COVID-19. The most common questions we hear from patients are, “How serious is this, and how worried should I be?” We are also asked, “Isn’t this just like the flu?” The answers to these questions are complicated and depend on multiple factors, but there are some basic facts that can make this easier to understand.
First, I’ll address how COVID-19 compares to the seasonal flu. Regarding the risk of infection, the novel coronavirus has a higher rate of transmission. One reason for this is in the term “novel.” It is a virus that we as a population have not been exposed to and that we don’t have a vaccine to prevent. For those reasons, a higher percentage of people are expected to be infected with this virus as it spreads through our communities. Estimates of the percentage of our population that will be infected vary. A Harvard University epidemiologist, Dr. Marc Lipsitch, estimates the figure at 40 to 70 percent of the global population within the coming year(1). The other number that is frequently discussed relates to illness severity. Hospitalization rates have differed by nation, but of 44,000 cases in China, about 15 percent required hospitalization (2). At the most severe end of this is the question of how many people will die. The mortality rate has been somewhat variable in other countries but is generally considered to be at least one percent. In some locations, including Italy, the apparent mortality rate is substantially higher. Using a mortality rate of one percent, COVID-19 is ten times deadlier than the seasonal flu. So, based on how infectious it is and how deadly it can be, COVID-19 is not “just like the flu.”
Why Are the Number of Reported Cases Lower Than Those for the Seasonal Flu?
If COVID-19 is a serious disease that is expected to infect many people, why do the number of official cases and the growth of these cases still seem relatively low compared to the seasonal flu? Two major factors are at play here. One is the extremely low rate of testing. The other is exponential growth. First, there has been and, at the time of this post, remains a shortage of test kits in the United States. Thus, testing in the United States has been limited. We are just now beginning to see other testing options open, and the amount of people being tested will increase. This will lead to a significant increase in the number of official cases.
The other factor at play in the number of cases is exponential growth. Understanding this rate of growth will help you understand how a small number today can become a much larger number within just a few weeks. Experience in other countries tells us that the number of cases of COVID-19 will double approximately every six days (3). As of today, there are over 3,500 confirmed cases in the United States. Based on that figure and based on the exponential growth rate of the virus, there will be about 8,000 cases this time next week and about 18,000 the week after. Without intervention, that growth will continue until today’s small number of cases becomes far larger in just a few weeks. And, without intervention, exponential growth may not slow until millions are infected.
What Should We Do?
What should we do with this information? Don’t panic. But treat the COVID-19 pandemic as a serious matter that requires proportionally serious planning. All of us can take actions to significantly affect the outcome, making both ourselves and our fellow citizens safer. And the sooner we act, the more positive effect we can have.
The most important action you can take as an individual is to follow the commonsense infection control procedures such as handwashing, covering your cough, and staying home if you are sick. You should immediately practice social distancing. The more we limit interaction with others, the more likely we are to slow the spread of the disease. While social distancing may not lead to lower overall infections, it can – and this is critically important – decrease the amount of people that get sick at one time. This phenomenon is generally referred to as flattening the curve. By flattening the curve, we reduce the risk of overwhelming the limited resources of our hospitals and health system. When these resources are overwhelmed, as we are seeing right now in Italy, people die who would not die otherwise. Overwhelmed resources do not only impact those who contract COVID-19. Consider that it also means if you or a loved one have a heart attack or are involved in a car wreck, hospital staff and critical care may not be readily available.
So, my recommendations to you are as follows.
- Do not panic but do treat COVID-19 as the serious matter that it is.
- Follow commonsense infection control procedures, especially frequent handwashing.
- Practice the powerful tool of social distancing to delay COVID-19’s impact.
What we and our fellow citizens do over the coming weeks will determine the extent to which COVID-19 affects all of us.
For additional information, please visit the CDC FAQ page at https://www.cdc.gov/coronavirus/2019-ncov/faq.html.