Introduction
When it comes to the coronavirus, the key questions for most people are how bad and how long.
I make no claim to any medical expertise, but I do understand numbers and can read graphs. To address these questions, I am assisted by Gregory Travis, a software executive with twenty years experience developing patient-centric systems for the US healthcare industry. His work can be found on his personal site and his business site.
An Overview – How Many
Table 1 provides coronus data for the world and the 20 countries with the most cases. While the US has more reported cases than any other nation, the numbers per capita are not as large as in most Western European countries. The reported case numbers are likely much lower than the actual numbers in China and Iran. Testing inadequacies in the US are reflected in the relatively low tests per million population numbers.
Table 1. – The Corona Virus, Leading Countries
Source: Worldometers
How Dangerous Is It?
Two measures of “danger” are presented in Table 2. The R0 stands for the number of people an infected person is likely to infect: a value of 1 means 1 person, a value of 2 means 2 people, etc. The mortality is deaths as a share of the number infected. The data suggest that the current virus is very infectious with one person likely to infect more than two others. The mortality rate of those infected in the US is still in doubt due to inadequate test data. Even though the virus started in the US back in January, some labs are not yet reporting their infections data to the Centers for Disease Control and Prevention.
Table 2. – Pandemic Dangers
Source: CNBC
Elliott:
Until two days ago, there was no official word from the Federal Government on whether you should wear a mask. In all likelihood, this was is because the government feared hoarding and they wanted this protective gear to go first to medical personnel. The Centers for Disease Control and Prevention (CDC) now recommends that the general populace should wear cloth masks in public.
Gregory:
It is becoming increasingly clear that airborne transmission is a significant infection vector. The best thing we can do now would be to strongly enforce a mandatory public mask wearing law. Anyone in a public space (outdoors or a commercial establishment like a supermarket, etc.) not wearing a mask should be subject to an immediate fine and possibly arrest.
How Long?
Having the virus is like a vaccine, at least for a limited period of time. That is, it makes you immune from getting the virus and going through the virus cycle again. That means that after a considerable period of time there will be enough people immune so infections will fall. But this will take some time.
So what can we learn from past epidemics? Consider the Influenza Flu graphed below. It took 27 weeks to go through its “cycle”.
The US is the 11th week of the coronavirus. Using its flu profile would suggest that the US will get through it in late August. However, there are parts of the US that have been hardly touched to date and that suggests each US region will have its own cycle.
In an earlier piece, I looked at the profile for the Chinese outbreak. Assuming the data are accurate, it took 4 months to run its course.
Greg:
1. The 1918 pandemic was three waves. There was the initial wave in spring of 1918. It then “disappeared” for a while. Then there was a second, MUCH MORE DEADLY, wave in late fall of 1918. Finally, there was a third wave in winter of 1919 that was also fairly deadly. We don’t know how this pandemic will go — i.e. will it consist of multiple waves or just die out?
2. There a chance that this virus, as the President said, will simply “go away” like a miracle. That’s what happened with SARS-CoV-1 in 2003-2005. It was quite deadly for a while and then disappeared for reasons no one really understands.
3. Speculation about #2 is that SARS-CoV-1 virus was just not that hardy in the environment. Moreover, and this is me reading between the lines, primary transmission vector of SARS-CoV-1 was airborne transmission — NOT contact, particularly contacting a contaminated surface. Thus once people in the SARS-affected countries started wearing masks, the virus could not propagate with an R0 of more than 1 and just died out.
As days go on I am feeling that COVID-19 may be similar in that the main infection vector may be airborne, being in the same enclosed place (i.e. subways, airplanes) as an infected person for an extended time. If so it would suggest that reasonable mask-wearing precautions plus the arrival of warmer weather (allowing indoor spaces to be opened up to the outside, increasing ventilation) and we could see this one die out just as quickly.
4. Insidious characteristics of COVID-19 are:
- A long incubation period — time between infection and onset of symptoms and
- The fact that one can be infectious for a significant amount of time before developing symptoms.
In the 1918 influenza, the onset of symptoms was extremely rapid (in comparison) — 24 hours between infection and serious illness being not at all uncommon — and people were not infectious before they began to themselves show symptoms. This is a real accelerant to how easy the virus can gain a foothold in a community since it can spread infectiously for a long time before anyone knows it’s even there.
How Bad?
Elliott:
US authorities are saying if we follow its guidelines, US deaths will be at best between 100,000 and 225,000.
Gregory:
I don’t know where the administration is getting this 200,000 dead number. Again, the rate of new infections is still rising, rapidly and deaths are a simple function of a percentage of the infected. As for how many Americans will die, really hard to say with any authority at all and anyone who does is pulling one over on you. So far the propagation model has fit the 1918 propagation reality fairly closely — at least in the western democracies. If it continues like that, 2-3 million dead in the US I think.
On the other hand, if the COVID-19 behaves more like the SARS-CoV-1 virus — i.e. just stops — then obviously far less. As I said above, I believe that some of the reasons why SARS-CoV-1 stopped were because it was not hardy in the environment and relied on airborne transmission to maintain its reproduction. Airborne transmission is the scariest sounding of all methods of transmission since we hear it as “If you breath, you will die” but it is actually one of the most easily stopped through a set of very straight-forward steps, including always wearing a mask in public, no large congregations of people, etc.
I am very hopeful (and that is all it is, hope) that the empirical data coming out of the SARS countries, where they have managed to keep the spread of COVID-19 from becoming exponential, is due to their prior experience with SARS-CoV-1. And that experience taught them to mask up early and often. That MAY be all that it takes, here, to put a lid on this thing and put it on quickly.
Elliott: Here is the latest from the Johns Hopkins Database. No evidence of an inflection point yet.