Corona virus: some useful information
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In the last months a lot of wrong and confusing information about the Wuhan flu, aka "COVID-19" was spread by "alt" news sites and even by mainstream news media, organizations and governments. But I won't waste time on any of that! As many countries are now ending "lock down", all of us should be well informed about practical aspects of dealing with the virus.
The Wuhan flu mortality is likely similar to the Spanish flu: I estimate that currently ca. 1% of cases or about 0.5% of infected people die. Apparently about half of the infected persons are asymptomatic, see also here. The World Health Organization estimated a "case fatality rate" of 3.4%; however that number does not account for the huge number of people who have been infected but not tested. Further, the estimated infection reproduction number R0 was about 6 in Wuhan, that is, without special protective measures each infected person infected approximately six others. That is much more than with the common flu. Moreover, infected people can start infecting others a few days after they were infected, and before showing symptoms. It should be noted that already early on several strains emerged, which complicates the analysis. Addendum: Regularly new reports come out with different figures and estimations. Not only are those numbers still uncertain and debated, the situation may locally be truly different due to different populations and different virus strains. But overall, the great majority of diseased are elderly with existing illnesses; the risk for healthy young people in a good health care situation is very low.
The explosive infection rate, combined with severe illness in up to 20% of infected people, resulted in a shocking run on hospitals; first in Wuhan and later again in countries like Italy. And so it happened about six weeks ago that many countries scrambled to put their populations in "lock down" in order to reduce the huge burden on hospitals and to win time, in order to compensate for the lack of preparation. Even many borders were closed when the virus had already become indigenous. A number of public health advisors then suggested to "flatten the curve" at a maximal sustainable rate so that over the course of time a large part of the populations would be infected in the hope to achieve natural "herd immunity".
Those officials failed to mention the colossal estimated number of deaths that would have resulted from that policy. Even with a 0.5% mortality, allowing only half of the world population to be infected would still result in some 20 million deaths (ideally "vulnerable people" would be protected; however that's already being attempted and thus included in the estimation). Moreover, that plan implied stressing hospitals and society for many months; and there is even no guarantee that such a "herd immunity" can be obtained for this multi-strain virus. The whole world was dumbfounded it seems, as there was little opposition or protest against those outspoken governmental plans to allow the virus to infect peoples with a dangerous disease in a controlled manner. By now most if not all governments seem to have rejected (or abandoned) that concept and are working hard to seriously combat the spread of the virus.
Combating the virus
Just this Friday the European Union's president Ursula von der Leyen stated that "the only possibility to defeat this virus, is by finding a vaccine." She seems to ignore that the virus has already been practically eliminated (or mostly so) in China as well as in a little town in Italy, and that also South Korea shows impressive results. However, it will be extremely difficult to achieve the same in some poor countries. Hope for those countries lies in improved treatment by means of, among others, possible success with low cost medicines such as perhaps hydrochloroquine or Remdesivir (both are debated), until a vaccine is found. And there is evidence that the use of dietary supplements such as vitamin D3 and selenium may help, as well as several other supplements including vitamin C.
Now that people will be going out more, other ways will be needed to keep the reproduction number R below one. Coronavirusses are thought to transmit mostly by means of infected surfaces such as handles and buttons, as well as directly by means of droplets in the air. Thus regular hand washing with soap, alcoholic gels and face masks are indicated to combat the spread when we will try to lead a more normal life in the coming "post corona crisis" (but not yet "post corona") period.
A recent study in Nature Medicine gives more clarity about the usefulness of face masks. Ordinary surgical face masks were very effective in protecting the environment from expelled droplets by people who were infected with coronaviruses (not COVID-19, but that's likely irrelevant). As could be expected, many of those who coughed during sampling also spread viruses, but the four coronavirus infected people who didn't cough at all during sampling without masks, did not spread any viruses (in fact, the study aimed at detecting viruses in exhaled breath). The statistics is meager but looks quite clear. It suggests to me that staying close to someone without a face mask who is breathing normally (and not speaking, coughing or laughing etc.) is likely very low risk, and alternatively, when that person wears a mask it's still very low risk even when he or she is talking or mildly coughing.
Another recent study found that in practice (and contrary to claims by many health organizations), surgical masks protect the mask wearer rather well for influenza - even just as well as N95 masks - despite the fact that they were not designed for that purpose. It seems reasonable to expect them to also protect rather well for coronaviruses (although the N95 may still be better). That is good news as such masks are more available, cheaper, easier to carry and more comfortable to wear. In contrast, ordinary cloth masks generally protect much less well.
The reopening of schools has led to some disagreement. According to a Chinese study with contact tracing, children are as likely to be infected as adults; and according to a recent study by the Institute of virology in Berlin, children are also an infection risk ("may be as infectious as adults"). In contrast, some people take a recent Australian study as evidence that children are less likely to play a role in spreading the disease than adults. That study found that nine infected students and nine infected teachers apparently only infected two children and no adults. One child's infection was ascribed to one or two of the six infected children, and another child's infection was ascribed to one of the six infected adults. I do think that this indicates that virus transmission in a school environment can be kept very limited, if the schools are half empty - even so limited, that insufficient statistical data is at hand to conclude anything about the likelihood of infection path. For example, one could from those data not only draw the unwarranted conclusion that children don't infect adults, one could just as well draw the faulty conclusion that adults don't infect other adults!
The way forward
I feel reassured by the promising results of Korea, where efficient contact tracing and isolation helped to spectacularly bring down the daily infection numbers. Hopefully most of the world population will soon be able to get rid of the new virus by means of a combination of continued anti-transmission measures, testing and contact tracing.
In have in mind to discuss in a next post the possible origins of the virus.
Comments, corrections and criticism are very welcome! You can even comment anonymously, but anonymous comments cannot include web links (anti-spam).
Acknowledgement: The here included information was found with the help of a great variety of news sources, both "mainstream" news media and "alternative" sources. I plan to add some of them to this site at a later date.