Coronavirus Disease 2019 aka COVID-19 which is caused by SARS-CoV-2, is at the time of the making of this video, still considered an epidemic and not a pandemic.

Now with these numbers, it’s fair to say that they are being underreported.

But something you have to keep in mind is that the ones here that are being disproportionately underreported, are the total number of cases.

Here’s why.
Its easier to track a death, because, death is obvious. It’s easy to track deaths from coronavirus in hospitals. And if someone dies at home, it’s relatively easy to make a post-mortem diagnosis with the autopsy.

So the number of deaths from coronavirus disease is more accurate than total cases because it is a lot harder to make the diagnosis in someone who has little to no symptoms. The ones that are most likely to be diagnosed are the ones who seek medical attention.

“Clinically diagnosed cases,” are patients who demonstrate all the symptoms of COVID-19 but have either not been able to get an RRT-PCR test, or are believed to have a false negative test.

In about 14% of cases, the virus causes severe disease including pneumonia and shortness of breath.

In about 5% of cases, patients were critically ill with respiratory failure, ARDS, septic shock, and multiorgan failure.

Of the 44,672 confirmed cases, there were 1,023 deaths, which gives us a case fatality rate of 2.3%. But because lots of cases being missed due to infected patients having only mild to no symptoms, the case fatality rate, in reality, is much lower, and likely around 1%.

The total number of deaths is going to be CFR times the number of people infected. So the more contagious the virus, the more deaths there will be.

In 2003, SARS had CFR of 9.6%, which is much lower than CFR or MERS, which was 35%.

But because SARS was much more contagious, it caused almost the same (774) amount of deaths as MERS (SARS 774, MERS 828).

The virus that’s causing COVID-19 has infected at least 20% of people so far (an assumption), and so despite it having a lower CFR than SARS and MERS, it has actually caused more deaths than those other coronaviruses combined.

With the influenza virus, the CFR is 0.1%.

But so far, influenza has killed 12,000 Americans this year. And on average, it’s responsible for 500,000 deaths worldwide, every year. And those numbers would be much worse if we did not have vaccinations and antiviral treatment for influenza.

That speaks to just how contagious the influenza virus really is.

With Coronavirus – many of those deaths have been among older people, and/or those with medical conditions that make them more susceptible to being critically ill from viral infections.

Now, in China, the number of new cases per day is starting to trend down. Will it continue to trend down? Don’t know yet. Will there be more and more cases of person to person transmission in other countries, at which point becoming a pandemic? Too early to tell. I think we’re about to find out in the next week or so.

Dr. Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine

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