Coronavirus: An Update on the Current Danger

White-coated person with gloves holding up a thermometer and pointing at the camera.
Photo by leo2014 on Pixabay

By looking at the data we can determine how bad the situation truly is and if we need to be scared or not


The danger of nCoV-2019 seems omnipresent. Following the news, we can easily think that our lives are very much at risk. But are they? How dangerous is the Coronavirus really?

To determine the risks the Coronavirus poses on us we need to silence our emotions for a second and look at the data we have so far.


Controlling our emotions

While I am no virologist and not the biggest expert on the field, I used to be an anesthetist who has worked with countless of isolated patients. But much more than that, in my years of emergency medicine I have learned not to trust my emotions.

Emotions can be deceiving. They make you light-headed and act recklessly. Making choices based on emotions very often makes you pick the wrong ones and you end up in a place where you don’t want to be.

So to decide if something is a current risk to our lives — which is a big thing to decide, by the way — we need to take a step back and evaluate the situation without our emotions shouting at us.

The problem is that silencing your emotions becomes pretty damn hard when the news constantly bombards you with how many people have died and how quickly the infection is spreading.

The news does not help us in taking a step back. They try to pull us in, get us on the emotional rollercoaster again. After all, fear sells.

So it’s even more difficult to look at the situation objectively. That’s why we need another tool in our belt that we can work with.

If you’ve worked in healthcare then you probably have this tool at the ready. If not, I suggest you go out and get it for yourself. This tool is called data and damn, it’s one heck of a help.

Data is like the Swiss Army knife of understanding the world.

So, for a second let’s silence our emotions. Let’s try to forget everything we’ve heard about the Coronavirus so far and start from scratch. Let’s form our opinion again, not based on emotions but a more reliable source.

The devil is in the detail/data

So, I invite you to start with a blank page now and let’s get to the core of the matter:

Understanding the current risks.[1]

Data is like the Swiss Army knife of understanding the world.

So first we have to make one thing clear:

We are very early

When calculating the severity of a pandemic we can only do so by looking backward. Calculating the definitive case fatality rate (CFR) is only possible when an epidemic has already ended.

CFR = deaths / cases

That’s a pretty easy calculation. It’s how many of the infected have died from the disease.

The problem we have if the pandemic has not ended yet is that we can only make estimates based on the data we have so far. So if we are looking at the current number of people who have died we need to know the number of people who were infected at the same time as them. Which we don’t.

But there’s something else we can do that will help us.

Calculating the CFR from the cases that have ended

What we can do is calculate the CFR based on the outcome of the people who we know to have been infected and who have reached the endpoint of the infection. [2]

There are two possible outcomes for the Coronavirus:

  • recovery
  • death

So based on the cases that have one of those two endpoints already we can calculate an estimated CFR.

I will give you two calculations here: One including the data we got from China and one without. Why? Because I’m not the biggest believer in the fact that the data we get from China is completely reliable.

  1. Including China:
    At the time of this writing, we have 3,996 people who have recovered and 1,016 who have died from the pandemic.
    This gives us a total of 5,012 completed cases. Calculating the CFR means that we now have to divide the 1,016 people who have died by the number of total cases that have reached the endpoint.
    This gives us the calculation of 1,016/5,012 = ~0.20.
    What does that mean? Of all the cases that have reached the endpoint globally — including China — we so far have around 20% of people who have died from the disease while 80% have been cured.
  2. Excluding China:
    Leaving China out of the equation has the benefit of the data probably being more reliable but on the other hand, we have the problem that the data of cases outside China is scarce.
    What data do we have from outside of China? We have 47 people who have recovered while 2 have died. Using the calculation explained above we get 2/49 = 0.04. That means outside of China the CFR that we can calculate so far is around 4%.

 

To be scared or not to be scared

… that is the question.

Looking at the data from outside of China, 4% doesn’t seem that much. Including China, it’s every 5th infected person who has died from the infection. That’s quite a difference.

The question is: Where does it come from?

The problem with nCoV-2019 is that it has a high transmission rate. That means the infection is spreading quickly. While in most cases (~80%) the symptoms are mild, like coughing and sneezing they can get pretty vast.

ARDS (acute respiratory distress syndrome) can be one of the reasons why you’d need a bed at the ICU (intensive care unit) with a respirator to help you breathe. If there’s a lot of infected people in need of a bed at the ICU but there is no more space there, things can get pretty messy.

So if you have a lot of very sick patients as you have for example in Wuhan the mortality will be higher due to limited resources.

But one big question remains in all the equations and which is extremely important to factor in: Who are the people that have died and what was their medical condition prior to the infection?

Are you at risk?

That’s probably the biggest question you have now.

Around 80% of people who have died from the infection have been above the age of 60 years. 75% have had an existing medical problem prior to the infection.

So if you are under the age of 60 years old (which is 20% of the 20% that have died of the total cases), this leaves you with a current risk of death when you’ve caught the infection with around 4% (calculated including China).

If you don’t have any prior medical conditions as in cardiovascular problems, lung diseases like COPD, or diabetes and your immune system is not compromised then this number shrinks even further.

So… Do we need to be scared nCoV-2019 now?

Probably not. If you are a healthy individual with no prior medical conditions and are under the age of 60 your chances of dying from the infection — if you were to catch it at all — would be in the low single-digit percentage area.

If you are young (under the age of 60) and healthy (no prior medical conditions) your current risk of death when infected is (0.2*0.25*1016)/5012 = ~1%.

If you are a healthy male, aged 35 and don’t have any prior medical conditions your risk of dying within the next 10 years is 2.13%.[3] And you are not going crazy about that either, are you?


What does all of that mean? It means that judging from the current data we have it’s probably safe to assume that the Coronavirus does not pose a great risk to most of us at the moment.

That does not mean that things could not change in the future. If the virus mutates it could become a greater threat than it is already.

Do I want to downplay the relevance of the outbreak? No. It’s concerning from a health perspective on a global level. It’s not for no reason that the WHO has declared it a Global Public Health Emergency. Many people have died and many more will die.

But judging from the data, no, I am not scared of it being a threat to my own health and well-being currently, and you probably should not be either if you fall under the category stated above.

If I may, I’d like to suggest something that will give you a little more ease of mind if you’re struggling to turn off the thought-machine in regards to the Coronavirus:

Stop reading every headline there is about nCoV-2019. Stop obsessing over it. You bring negativity into your life that has no benefit for you.

Instead, why don’t you bookmark a website that lists the current data and check that once every one or two days? You’ll be properly informed on the actual danger without being sold your own emotions by the news and — using the method above — can properly calculate the current risk.

For this article I used the website below but you can find the same information on many other ones as well.

https://www.worldometers.info/coronavirus/

So relax. Take a deep breath. Use data instead of emotions to calculate your current risk and stay up-to-date. Try not to be obsessed with catching every headline there is to catch and you will be just fine.


Sources:

[1] All data used to calculate the metrics in this article was taken from https://www.worldometers.info/coronavirus/
[2] A. C. Ghani, C. A. Donnelly, D. R. Cox, J. T. Griffin, C. Fraser, T. H. Lam, L. M. Ho, W. S. Chan, R. M. Anderson, A. J. Hedley, G. M. Leung, Methods for Estimating the Case Fatality Ratio for a Novel, Emerging Infectious Disease, American Journal of Epidemiology, Volume 162, Issue 5, 1 September 2005, Pages 479–486, https://doi.org/10.1093/aje/kwi230
[3] https://www.finder.com/life-insurance/odds-of-dying


https://www.anewpathblog.com/why-i-stopped-reading-the-news/

Thanks for reading, have a wonderful day.

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