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Coronavirus Update: China, Hong Kong, the United States, This Virus, and Us

By Dr. Arthur Lavin

Our last post on coronavirus was just a few days ago, and sent out while we were in Hong Kong.  This post is being sent out now that we are back in the United States, so I am in the country, but not yet in the office, where I am excited to return to work this Thursday.  I wanted to take this moment to thank the many people who expressed concern for my wife and I while we traveled with family, and reassure them we were never really at risk, and certainly not at risk at the current moment from the new coronavirus, the Wuhan coronavirus.

That is not to say there is no danger looming.  What follows is what we know about the threat as of now.

Background

A detailed account of what is the  Wuhan coronavirus was in that recent post.

Briefly, the name of a virus refers to the species the virus is.  Viruses have species just like plants and animals.  Some familiar viral species include herpes viruses, pox viruses (e.g., smallpox), and now coronaviruses.  Everyone reading this has been infected by common types of the coronavirus.  This sort of the coronavirus have been around for over 8,000 years, and cause a huge chunk of all common colds, as many as 25% of all our colds.  In this sense, the common cold coronavirus is more than familiar, everyone has had colds from it, all our ancestors too.  It makes clear that coronaviruses are cold viruses, and all cold, or respiratory, viruses spread in the air, and some by contact with sneezed and coughed on and touched surfaces.   This coronavirus spreads like many cold virus.

But the Wuhan coronavirus is not a typical common cold virus.  First, it appears to have infected people for only a month or two, compared to the common cold coronaviruses which as noted have infected people for close to 10,000 years.

New viruses in humans are a special experience.  Since they are new on our scene, they often have to figure out how to spread and infect, and so how well they do these things is not clear when they first arrive.  Also, our human immune systems do not know this enemy, so new viruses have a chance to outfox our defenses, or in  a word, be deadly. But as time goes on, our immune system often adapt making the new viruses less deadly.

Where is this Coronavirus, the Wuhan coronavirus?

There are two answers to the question, where is the Wuhan coronavirus?

  1. As of now, nearly all the infections are happening in mainland China, 40,000 of the 40,573.  So 98.5% of all reported Wuhan coronavirus infections are in mainland China.   And most of those cases are around Wuhan, a city in mainland China.  We say mainland China to distinguish this area from Hong Kong, which is Chinese, but still separate in important ways.  There are hardly any Wuhan coronavirus infections in Hong Kong, at last count 24 cases, far less than mainland China’s 40,000 cases.
  2. The virus has demonstrated active infection in people around the world, with about 573 cases known across over 28 countries, but in no country outside of China have the numbers anything approaching an epidemic, not one.

Two regions to mention are Hong Kong and the US.  In Hong Kong the total number of cases is 38 in a city of 7 million, still very few cases.  In the US the total number of cases is 12, again in a nation of 320 million people, very, very few cases.

The question is, now that 28 countries have recorded cases of Wuhan coronavirus infection, which will blossom into massive numbers of infected?  Clearly if current distributions fail to change, there will be no Wuhan coronavirus epidemics of any sort anywhere but mainland China.

But.

In many countries, reports are emerging that new cases are emerging from people in that country getting a Wuhan coronavirus, from someone in that country, while in that country, without the new case traveling to China. That means the Wuhan coronavirus does have the ability to spread in Asian countries outside of China, in England, and in Spain, as of now.   And, it makes sense if the same virus can ramp up to 40,000 cases in China, it can do so in any other country, too.

But.

The Wuhan coronavirus has not done that in any country, yet.  So we don’t really know that it will ramp up outside of China.  It has demonstrated it could, but not that it has.

How Contagious is  Wuhan Coronavirus?

All viruses have a contagion index, namely, now many people on average will get infected from one person?  The most contagious virus known is measles, which has the number 12, meaning on average 12 people catch measles from one infected person and get measles when infected.

The current flu epidemic is caused by the influenza virus, whose number is 1.4 or so, so fewer than 2 people get infected from one person with influenza infection.  I know that number seems low, but it speaks to how crazy contagious measles is.  Influenza spreads to less than 2 people for every one person infected, yet spreads across the globe quite well.

The Wuhan coronavirus appears to have a contagion index of 3-4, making it possibly 3 times more contagious than influenza, but only 1/4 quarter as catchy as measles.

Again, this is a new virus, so the contagiousness may, and likely will, change.  If it stays at 3-4, that’s plenty catchy to spread around the world.  We will see.

How Deadly is the Wuhan coronavirus?

Let’s  think of this in two answers.

First, what’s the chance if you get infected with  Wuhan coronavirus it will be a deadly outcome?  Right now that number is 2%.  But again, this particular virus is new to humanity.  The virus may change, humanity may change, so that number is not stable, it may go up or down over time.  But at 2%, that means it’s a virus that could kill a very large number of people, IF a very large number of people get infected.  Again, we will see.

That leads us to the second answer, what’s the total number of people the  Wuhan coronavirus will kill?

That total number relies on other numbers, namely:

  1. The total number of people infected
  2. The chance one person with this infection will be killed by it.

Let’s think about this for a moment.  Right now the world has about 40,000 cases of  Wuhan coronavirus known.  Put that into perspective with the good ‘ol influenza virus.  Just in the US, the influenza virus infects about 10-50 million Americans, every year.  If the  Wuhan coronavirus causes about 50,000 cases a year, that would make it a very tiny infection combined with the influenza virus which infects hundreds of millions worldwide every year.

But we just observed that the  Wuhan coronavirus spreads better than influenza, so let’s say that turns out to be how it goes, then around the world, we could see tens of, even hundreds of, millions of cases.

So far less than 1000 people have died from their  Wuhan coronavirus infection, many are healthy adults with no medical problems.  If the 2% mortality rate holds, then of the currently 40,000 or so people infected, about 800 would be expected to die, pretty close to the current facts.  Of course, if the mortality rate goes up that number will climb, and if it goes down it will declines.

Can We Stop the Spread of the Wuhan coronavirus?

The record for most cold viruses on this question is terrible.  No one has found a way to stop the spread of colds and flus without a vaccine, with only one exception.

A new coronavirus in 2003 called the SARS virus was discovered when not too many people had it.  Strict quarantine stopped its spread.  It is the only infection I know of, in all of history, whose spread was stopped by quarantine.

China has sealed off the areas where 98.5% of all cases in humanity are known to have happened, maybe this massive regional quarantine will work.  But the virus is in 28 other countries, in very, very low numbers.  So we will see.

Other techniques to stop it would include a medication to kill the virus in those infected, and/or a vaccine to keep anyone from catching it.  Neither are known to exist as of now.

What do We Know

  1. Most importantly, we simply do not know just how many people in the world will end up infected with the  Wuhan coronavirus, we really have no idea.  Let us hope it remains around 40,000, but trends over the last few weeks suggest that at least in China that number is only poised to grow.
  2. We simply do not know if large epidemics of  Wuhan coronavirus infection will take place outside of China, including Hong Kong.  It seems likely, it is a cold virus that spreads and spreads well, but it hasn’t caught fire beyond a few dozen cases in any nation outside of China for some weeks now.  We simply do not know.
  3. The Wuhan coronavirus has demonstrated the potential to be cause real danger and catastrophe, it can spread, it can kill.  If it spreads wildly, it will kill many, but it has not done so yet.
  4. And so, we do really do not know how dangerous this new virus will end up being.
  5. We do know this, here in NE Ohio, and really across the US, and really across the world except mainland China, the virus remains very, very rare.  Again, here at home, the chance of catching this Wuhan coronavirus remains extremely rare, unless one goes to the Wuhan area or is with someone from there recently.  Hong Kong is like Ohio, only a handful of infections present, no real danger of infection there, as of today.  The main difference between Hong Kong and Ohio is that Hong Kong is literally right next door to mainland China, and we are further away.

BOTTOM LINES

  1. There is a new virus in the world of humanity, the Wuhan coronavirus.
  2.  It has proven it can spread, it has proven it can kill.
  3. As of today, it has not caused more than a handful of cases in ANY nation but mainland China.  IF China contains it, and the handful in 28 other countries fails to create new epidemics, the Wuhan coronavirus will be a mild phenomenon.  IF the Wuhan coronavirus is not contained, goes on to ignite huge numbers of cases in many countries, AND maintains a mortality rate at 2% or more, it could be a catastrophic pandemic.
  4.  It takes a new virus establishing a wide range of properties in how it infects and spreads in humans to be a real danger, and for that reason, the vast majority of new viruses never succeed in becoming catastrophic. Therefore, chances are that this new virus, the Wuhan coronavirus, will also fail to hit the bullseye of a deadly pandemic.  But its steps are not yet all known, so it remains a very, very real potential danger.  This is the basis of the World Health Organization’s designation of this virus as a global health emergency, not because it is an established mass killer, but because it might be.

For the people of Wuhan and surrounding provinces in mainland China, I only hope this virus is now contained, that it does not evolve into a more contagious or deadly enemy, and that their suffering comes to an end soon.

For the nations and regions surrounding mainland China, including Hong Kong, that HAVE NOT experienced Wuhan coronavirus as an epidemic, my hope is that this virus never establishes epidemics there, ever.

For the rest of humanity, further from mainland China, including here where we live, I of course hope the same, that the Wuhan coronavirus, which presents essentially no danger to any of us as of right now, continues to remain extremely rare.

Finally, should none of these hopes materialize, I hope real control, prevention, and cure abilities are developed very, very soon.

I am of course very pleased to be back in the US safe and sound, continue to hope our family in Hong Kong remains so, thanks again to all who have expressed their concern.  I look forward to being back in the office this Thursday.

To your health,
Dr. Arthur Lavin

 

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