Current Numbers & Mortality Rate vs SARS and Influenza (coronavirus lecture 5)
Welcome to another MedCram update on the coronavirus for January 29, 2020. And overnight, what we’ve been looking at is the number of deaths reported has gone from 106 to 132, and the number of confirmed cases has gone to 5974, that’s about a 32% increase of the number of confirmed cases overnight.
Now, I want to make sure that we put this in perspective because it’s easy to kind of get lost in this. There is a little bit of a probably a misunderstanding in terms of how accurate these numbers are. If anything, these numbers are probably underrepresented, and that could be a good thing or it could be a bad thing. And I say that with a little bit of trepidation in terms of being misunderstood, but if you’re looking here, you’re going to see that there is a ratio. Okay, if you look at the number of deaths to the number of confirmed cases, you’re going to get a general mortality rate of about 2.3 percent here on this particular day, versus the most recent data that we have is about the same at 2.2%.
Here’s the thing: both the numerator here and the denominator need to be confirmed by testing to confirm that this is specifically from the 2019 coronavirus, and it’s possible that we were undercounting in these areas. In fact, I think everybody agrees that we were undercounting here. There are probably more deaths than a hundred thirty-two, and there are probably more than 5974 confirmed cases.
The question is, where are we missing it? A death is a pretty obvious thing. It’s hard to miss. The only question about whether or not it’s from this virus or another particular virus. But it’s really possible, and if you think about it, there could be cases out there of coronavirus that are completely missed. And there is an asymptomatic individual who maybe just got a little bit of a cold, and they may be completely asymptomatic, which means that this number may be far larger, could be 50,000, in which case this mortality rate is going to be much, much lower than is being reported here. So keep that in mind. That’s a possibility.
Furthermore, if you’ve looked at some of our other videos, and specifically why the coronavirus can kill, and how it kills, we talked a lot about ARDS. Obviously, not everybody that gets coronavirus goes into ARDS, which is acute respiratory distress syndrome. In fact, of all of these cases, there’s only a fraction that end up in the hospital, and of those there’s only a fraction that need to go to the ICU, and there there’s a fraction that get ARDS, and some of those end up death.
I think in the most recent Lancet article, of those that ended up in the hospital that were confirmed to be cases, the mortality there was about 15%. So that doesn’t mean that, 15 percent of people who get coronavirus infections are going to die. It just means those that are sick enough that end up in the hospital, they may go on to get ARDS, 15% of those, at least in the Lancet article, passed away.
Okay, and so to put this in perspective, let’s look at SARS. Now SARS as you may recall was another variant of coronavirus. It was a different mutation, and it had come from bats, and total over about a year or two period of time, the number of deaths in that was 774, and the total number of infections was 8,098 confirmed cases. That was for SARS in 2002. So you can see here when we’re looking at the numbers already for coronavirus. These numbers are getting up there fairly quickly, and we’re only just a number of weeks into this epidemic.
Okay. So what are they doing about this? Well famously you may know that China is actually working on building a 1000-bed hospital in about 10 days, and it’s actually quite interesting to look at. I will post in the description below a link of a live webcam that you can look at on YouTube as they are actually building this hospital. And just a few days ago, it was a big field of the dirt, and now they’ve already poured the concrete slab, and they believe that on Monday morning, they’ll be admitting their first patients that hospital. So that’s quite remarkable.
But we want to get into some other numbers about what’s going on outside of China, and what about this person-to-person transmission because we’ve got some updates there as well.
So as it stands right now in the United States, there are about five confirmed cases; two of them in Southern California. By the way, there is a little side note to this that we had talked about: 240 people are being transported back. These are diplomats, and there is a chartered plane that is traveling back from China that is going to land in Anchorage, and then was scheduled to fly down to Ontario International Airport in Southern California, where they would be screened that has slightly changed, and that is going to March Air Force Reserve, which was March Air Force Base that is in Riverside County.
That has been a last-minute change, but probably a better choice from a political standpoint because these people are going to be monitored at an air force base that was turned into our air force reserve base as opposed to a fully functional civilian airport.
Now something that is concerning is the recent story in Germany. And this is a story where a woman from China who was asymptomatic and visited in Germany was not symptomatic until apparently she flew back on the plane to China, and it was only after that that the man who had never traveled to China was found and confirmed to have the coronavirus.
That is a concern for a couple of reasons. Number one: it’s the first evidence that we have outside of China of human-to-human transmission. Number two: it seems as though this transmission occurred when the woman was asymptomatic.
Fortunately, we can say this at this point that none of the deaths involved with coronavirus have occurred outside of China at this point. And if you look at the number of cases that are being reported, including the United States, there are about 73 confirmed cases outside of China as of January 29. And in all of those cases, there have been no deaths.
So this sort of goes along with the possibility that we may be underestimating the denominator in the mortality rate, and that that denominator is possibly far larger than we know and therefore would be a bad thing of course in terms of the number of people who might be infected. But as more and more people are infected, and the number of deaths stay the same, the mortality rate goes down.
Something to think about, and also something to put in perspective, as we talked about. The number of people to date that have died as a result of coronavirus is 132. That is in contradistinction to, let’s just look at, the regular flu.
In California, which is where I practice medicine, and specifically we’re having a real issue right now with the H1N1 flu from 2009. I’ve seen a number of those patients on ventilators in ARDS here in the last couple of weeks where I work. And California State Public Health Department put out that the number of deaths from the flu this year in the state of California have doubled from the previous year, and we are already up to 149 deaths. So just the number of deaths from the regular flu in California is more than the number of deaths worldwide for coronavirus. If of course, you believe what they’re telling you in China, but just again to put this in perspective.
So thank you for joining us for this update. More updates as they come. Hopefully better news as we go, and hopefully we start to see a slowdown of the number of reported cases and also the number of reported deaths, of course. Thank you for joining us!