Why a Medical Doctor is Not Worried About Coronavirus

You can’t turn on a computer screen, a TV, or look at a phone without dozens of new stories about how the deadly Coronavirus is lurking like a silent killer waiting to end millions of lives. You hear terms like “pandemic”, ICU”, and “Emergency Funding”.

The shelves at COSTCO are bare. Any sane person would be scared and freaked out at this point. However, I’m neither. Why? Because if you look at the actual science emerging and read through the media hype machine designed to whip up a frenzy, what you see is VERY different than a deadly pandemic killing spree, you see something much less lethal and more like a nasty flu bug. Let’s dig in.

Coronavirus

To quickly review, the Coronavirus disease is much like the flu. Its scientific name is COVID-19. ‘CO’ stands for ‘corona,’ ‘‘VI’ for ‘virus,’ and ‘D’ for disease. The “-19” indicates that it was first detected in 2019. The common name often used for this disease, called “Coronavirus” is really medical slang as that’s just a common virus type. The virus that causes the disease has been named SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). Now let’s dig into why is everyone so freaked out.

The 1918 Pandemic

If you’re a virologist or epidemiologist, the “big one” happened just after World War I. This was called the 1918 Spanish Flu Pandemic. This influenza virus had a 2-3% mortality rate and killed an estimated 30 million people worldwide (1.7% of the world’s population). That number is hard to compare to today because this was before modern medicine and intensive care techniques that began in the Korean War and Vietnam. Now we have ventilators, anti-viral, drugs, and modern life support. In 1918 we didn’t even have simple things that can save lives like the widespread use of oxygen.

How Lethal Is the Regular Flu?

The average seasonal flu kills between 291,000 to 646,000 people worldwide each year (1). Before I dive into the Coronavirus you need to think about that for a second. Half a million people die from the average flu bug each winter.  The CDC recently announced that the seasonal flu has killed 20,000 people in the United States this year with 350,000 hospitalizations (5). To date, worldwide, less than 4,000 people have died of Coronavirus. That’s less than 1% of the number of people who die from the seasonal flu.

Why Then the Panic?

The panic is over the death rate per 100 patients reported out of Wuhan China, where the Coronavirus began. At one point, we heard very high numbers like 3-4% of everyone who contracted the disease or even twenty percent or more of the elderly. The average seasonal flu has much lower death rates.

How Lethal Is Coronavirus?

So just how lethal is this Coronavirus disease (COVID-19) versus the average flu? After all, if it’s a real killer of healthy young and middle-aged people you should be freaked out. If it’s really just like a bad flu bug, you should just go about your business, wash your hands frequently, and not be concerned. Hence, this is the multi-billion dollar question.

How Lethal Is the Average Seasonal Flu?

This is a really interesting one. From the paper above, mortality rates as low as 0.05% to as high as 3.5% have been reported. The fact that the high number is from southeast Asia is important (see below). The new death rate for seasonal flu worldwide, based on the most recent models, is 0.03% for people under 65 years of age and about 3% for the elderly over 75. You also need to keep in mind that most of the young who die from the seasonal flu have problems like a significant respiratory disease.

How Lethal Is COVID-19?

The most accurate data on case fatalities is from the only natural experiment that exists, the Diamond Princess cruise. Why a cruise ship? Because this is a closed environment where we can accurately measure every person who gets sick and know the real number of people who perish based on that exposure.

The cruise ship data shows a fatality rate of 0.85%. All of the people that perished were over 70, which is much more like the seasonal flu. In addition, the ability of the virus to spread was again, not that impressive as only about 20% got the virus. So while this bug is nasty, it’s NOT the middle-aged killer that the media has been making it out to be.

[3/11/20 update] Here’s some new data since this post first published:

  • The outside of Wuhan Chinese death rate reported by their CDC is 0.4% (6)
  • The South Korean death rate being reported is 0.65% (7)

Why the Huge Difference in Death Rates?

First, the death rates in the first part of any outbreak are always wildly inflated. Why? They are based on only the number of people who are sick and are tested for the virus while ignoring the greater number of people who contract the virus, get a little sick for a few days, and never get tested. When you add in all of those healthy people who shrugged the virus off, the death rates almost always plummet. Here are a few science-focused articles on this topic:

Second, there are other factors that could explain the differences. For example, 2/3rds of Chinese men smoke (compared to 15% of US men) (4). China also has severe air pollution compared to the US:

China is also significantly denser (4-5X the US), which facilitates viral transmission. In addition, China has many “Wet Markets” where live animals are kept in tight conditions and then slaughtered on the spot to be sold as food. You honestly couldn’t create a more perfect animal to human viral transmission model. In fact, it’s believed the coronavirus began in an animal sold in these markets called a pangolin.

What Should You Do?

If you’re healthy and under the age of 70 without any known respiratory problems or other serious health conditions, then the list below applies to you. If you’re elderly and/or have respiratory or other serious health problems like heart disease, then you’re in a higher risk category, more on that below.

Don’t:

  • Panic and go clear out your local grocery store shelves!
  • Buy masks unless you’re the one that has a cough
  • Cancel trips

Do:

  • Wash your hands frequently with soap for 20 seconds!
  • Use hand sanitizer when you can’t wash your hands (must be >60% alcohol)
  • Stay home if you’re sick
  • Ask for a local COVID-19 test if you think you have the flu (the symptoms of this one are a fever and a dry cough)
  • Observe strict quarantine rules if you test positive

Why Canceling Trips Is a Bad Idea

We’ve seen major conventions canceling their events and the airlines are all battening the hatches for a bad spring. Am I canceling any of the travel I have planned for March or April? Nope! But I will enjoy the empty seats!

Why? The elderly death rates for the coronavirus are strikingly similar to a bad flu bug. While those patients that are severely impacted will need aggressive medical care, the number of people in that category is very small.

In addition, check out the CDC graph below that shows that viral flu transmission goes way down after March (3). While the coronavirus isn’t the seasonal flu, transmitting it seems to obey the same rules as viral influenza.

High-Risk Individuals

Again, if you’re in a high-risk category, you may want to be more careful. For now, if you’re over 70 or have a respiratory problem that’s being actively treated (like COPD), you might want to consider limiting travel and contacts. However, even then, you have to put this in context. You need to ask yourself if you would cancel trips and stay indoors if you knew that it was a bad flu season with a bad bug or would you just go about your business and wash your hands frequently? That’s a choice only you can make.

Finally, authorities will make local recommendations for high-risk individuals based on the evolving data being collected here and elsewhere, so pay attention to those public health advisories. For example, in the US this may take the form of limiting nursing home visits. As another example, in Italy, they have recently closed down tourism to the Lombardy region. 

The upshot? At the end of the day, the media is doing what they always do, not letting a good tragedy go to waste when there are eyeballs to sell to advertisers. However, after a deep dive into the best data we have, I am NOT concerned about the Coronavirus. I am, however, looking forward to some empty planes and airports!

[ We usually allow comments on this blog, but the comments on this post have not generally been constructive, so they will be suspended.]. 


(1) Iuliano AD, Roguski KM, Chang HH, et al. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study [published correction appears in Lancet. 2018 Jan 19;:]. Lancet. 2018;391(10127):1285–1300. doi: 10.1016/S0140-6736(17)33293-2

(2) Faust J. COVID-19 Isn’t As Deadly As We Think. Slate.  https://slate.com/technology/2020/03/coronavirus-mortality-rate-lower-than-we-think.html Accessed 3/6/20.

(3) Centers for Disease Control. The Flu Season. https://www.cdc.gov/flu/about/season/flu-season.htm Accessed 3/8/20

(4) Chen Z, Peto R, Zhou M, et al. Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies. Lancet. 2015;386(10002):1447–1456. doi:  10.1016/S0140-6736(15)00340-2

(5) Centers for Disease Control. Weekly U.S. Influenza Surveillance Report https://www.cdc.gov/flu/weekly/index.htm Accessed 3/8/20

(6) Chinese Center for Disease Control and Prevention CCDC Weekly. The Epidemiological Characteristics of an Outbreak of 2019 Novel
Coronavirus Diseases (COVID-19) — China, 2020. Vol. 2. No. 8. http://weekly.chinacdc.cn/fileCCDCW/journal/article/ccdcw/2020/8/PDF/COVID-19.pdf

(7) Kolate G. Coronavirus Is Very Different From the Spanish Flu of 1918. Here’s How. The New York Times. https://www.nytimes.com/2020/03/09/science/coronavirus-is-very-different-from-the-spanish-flu-of-1918-heres-how.html Accessed 3/10/20

About the author: Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.

Read more at regenexx.com


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Comments (15)

  • Avatar

    Tom O

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    I tend to agree that there probably is an overreaction to the virus, and I have seen enough of these “back and forth” reports from “medical doctors” that say it is bad, it is not. I actually haven’t gone on a panic buying binge, and I haven’t decided to not go to restaurants or groceries stores or any of the other places that I go.

    I do not, however, care much for these “doctors” that say “don’t worry, be happy.” Why? Because this does seem to be quite contagious, and if every one runs around doing the “don’t worry, be happy,” routine, it will spread to people that can’t cope with it, instead of dying out because people reacted responsibly and with common sense. You think it overblown or “nothing more than a bad cold?” If that is the case, why are there people in ICU being treated for it? Just because of the insurance? Seriously?

    For some, obviously the virus is NOT something to take lightly. We need a balanced approach – yes it is something to consider seriously, but it is not the black plague. But I am tired of both, the “The sky is falling!” and “don’t worry, be happy” articles.

    Reply

    • Avatar

      Squidly

      |

      It is far more dangerous for me to drive to work than to contract Coronavirus. Should I stop going to work?

      The entire Coronapocalypse is utter bullshit. One only need look at the numbers of a variety of seasonal diseases and then contrast to what we have been fed by the ene-media every other year for the past decade (coincidentally always during an election year .. rather strange, isn’t it?). We have continually been told thing like “1.6 million people will die during the next 6 months” .. but nobody actually died (happened in 2012 with Ebola) .. I could go on with similar examples for every election year since at least 2000 or earlier.

      No, this is not Coronageddon, it is a farce once again. This is becoming one of the biggest economic and political scams in history. The mass hysteria is by far the most dangerous part of this so-called “pandemic”. Absolute bullshit.

      FYI, while I have been typing this response, at least 2 people in the United States and 12 people worldwide, have died from the common flu while ZERO died from the Coronapocalypse!

      Reply

      • Avatar

        Norman

        |

        Denier! Next you’ll be telling us that atmospheric CO2 doesn’t cause global warming or that the Big Bang is a figment of the imagination or that Jerry Krause isn’t a rambling nincompoop. I have it on good authority from the fairies at the bottom of my garden that all are true.

        Reply

        • Avatar

          einstein

          |

          Hi Norman
          Ever considered you might be wrong….. or is that out of the question?
          In other words, do you think you are always right?
          If there is a ( ever so slight) possibility in your own mind that even you, The Norman, could be wrong every once a year, then you should be careful with ad hominem remarks like calling Jerry Krausse a nincompoop.
          ….. you could both be wrong.

          Reply

        • Avatar

          geran

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          Norman relies on his garden fairies for most of his beliefs.

          Reply

        • Avatar

          Squidly

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          Well Norman, I have good news for you, not only does CO2 not “cause global warming”, there is no such thing as a so-called “greenhouse effect” in this universe, a universe that was not created from some magical “singularity” of nothing, whether Jerry is a nincompoop or not.

          Have fun with your virus!

          Reply

  • Avatar

    geran

    |

    Dr. Centeno’s point about the cruise ship statistics is salient. Over 3000 people trapped in a “laboratory”. A perfect closed system to study the virus. Less than 25% even caught the virus–so much for the “super-contagious” aspect. The only fatalities were in the over-70 group, which is consistent with typical flu. I also heard that some of those that have recovered indicated their symtoms were mild.

    The virus is no worse than average. It is the fear that is dangerous. Panic is both contagious and destructive.

    Reply

    • Avatar

      geran

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      ‘symptoms’!

      Reply

  • Avatar

    Bob of Bonsall

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    Looking at the panic over this Wuhan Flu and the way people are running around like headless chickens, it is certainly makes a case for the old saying, “Where ignorance is bliss, ’tis folly to be wise.”

    Reply

  • Avatar

    Dan Paulson

    |

    Not sure why comments would be suspended. Other than a couple smart alec remarks, there is no deterioration from the norm here.
    Good article, with which I agree 100%. Personally, I have had 2 vacations cancelled out from under me over covid18. I am not happy about this!

    Reply

  • Avatar

    Dan Paulson

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    covid19

    Reply

    • Avatar

      Squidly

      |

      No worries Dan, we knew what you meant … cheers and Happy Coronageddon to you!

      Reply

  • Avatar

    Brian James

    |

    Big Pharma is not about to let a great manufactured crisis go to waste.

    03/12/2020 Human GUINEA PIGS: Volunteers offered $4,500 to be infected with coronavirus to test a VACCINE

    Scientists in Great Britain are on the hunt for 24 human guinea pigs who will agree to be deliberately infected with the Wuhan coronavirus (CoVid-19) in exchange for about $4,500 cash.

    https://www.newstarget.com/2020-03-12-volunteers-offered-4500-to-be-infected-with-coronavirus-vaccine.html

    Reply

  • Avatar

    Andy Rowlands

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    I’m not unduly concerned about it myself, but my parents are in their late 80s and have underlying health conditions that make them in the most at risk category. What is perhaps more concerining to me is that if we enter a ‘lockdown’, there will be no food being delivered to shops, so within a few weeks, people will start to starve to death.

    Reply

  • Avatar

    James

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    Seems governments in Europe like to adopt the “precaution” principle: do all you can, even if unnecessary, to avoid accusations of not doing enough and maybe getting cited for damages. It’s not their personal cash getting spent in any case. The principle is applied to everything from climate change to OGM, to such an extent that they become standalone leisure-luxury industries with lots of workers who have their rights and can’t be sacked. Same as cosmetics. Panem et circenses.

    Reply

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