Eight months ago today, I wrote my first post on the current coronavirus pandemic, and in a headline asked, ‘The fire this time? Pandemic prose, and waiting and watching for the ‘big one’ (https://soundingsjohnbarker.wordpress.com/2020/01/23/the-fire-this-time-pandemic-prose-and-waiting-and-watching-for-the-big-one/).
I penned those words on a cold winter January night. At that time, COVID-19 hadn’t been invented by the World Health Organization (WHO), as the official moniker for what was then simply known provisionally as Novel Coronavirus 2019-n, or CoV2019-nCoV, designating it as a novel coronavirus discovered last year. The Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses, which is the entity within the International Union of Microbiological Societies, founded in 1927 as the International Society for Microbiology, and responsible for developing the official classification of viruses and taxa naming (taxonomy) of the Coronaviridae family, proposed the naming convention SARS-CoV-2. On Jan. 23, when I first wrote about it, the WHO was still a week away from designating the newly-discovered coronavirus a Public Health Emergency of International Concern (PHEIC). The WHO then waited another six weeks almost until March 11 to decide a global pandemic was under way.
As summer has given way to September’s still unseasonably warm autumn here in Northern Manitoba, the question mark, of course, can be dropped. It is indeed the fire this time. Except when it is not. That is the paradox of COVID-19. The vast majority of people infected with COVID-19 will recover. The elderly and those of any age group with comorbidities are at greatest risk. Except there will be apparently otherwise healthy young people who die of COVID-19, too. Many, in fact, although nothing like their elders.
People infected with the flu almost always get sick. They are rarely asymptomatic. Many people with COVID-19 are asymptomatic, presymptomatic, or only mildly symptomatic, but contagious in any of those three states, making them walking viral bombs. The estimate of a virus’s contagiousness is captured in a variable called R-naught (R0), or basic reproduction number, and is a key number used in infectious disease modelling for estimating pandemic growth rate. Seasonal flu has an R0 of 1.3, while measles is highly contagious with an R0 between 12 and 18. By way of historical comparison, the the R0 of the 1918 Spanish flu pandemic is estimated to have been between 1.4 and 2.8, which is within the range COVID-19 falls currently in many parts of the world.
COVID-19 has officially killed more than 200,000 people in the United States alone over the last eight months.
It is indeed the fire this time.
The 1918 influenza pandemic, widely known as the “Spanish Flu,” killed about 675,000 people in the United States, and perhaps 50 million worldwide, in a much less populated smaller world, As of mid-afternoon Sept. 22, the WHO reported there have been 31,174,627 confirmed cases worldwide of COVID-19, including 962,613 deaths.
COVID-19 in just eight months has killed almost 30 per cent of the number of Americans who died over three years between 1918 and 1920 of Spanish Flu, the worst global pandemic of modern times.
How does COVID-19 stack up against a more “normal” modern American five-to-six month flu season? The Atlanta-based Centers for Disease Control and Prevention (CDC) reports preliminary estimates from the 2018-19 flu season, the most recent data available, shows 34,157 deaths. Estimates from the 2018-2019 season are still considered preliminary and may change as data is finalized, the CDC notes. Looking back over the last decade to 2010, estimated influenza deaths in the United States ranged from a low of 12,000 to a high of 61,000.
The case fatality rate for COVID-19 in the United States is currently 2.9 per cent. The Johns Hopkins Coronavirus Resource Center (CRC) in Baltimore says Canada has reported 9,279 COVID-19 deaths with a case fatality rate of 6.3 per cent.
For seasonal influenza, mortality is usually well below 0.1 per cent, the WHO says. Countries throughout the world have reported very different case fatality ratios – the number of deaths divided by the number of confirmed cases. Differences in mortality numbers can be caused by:
- differences in the number of people tested: With more testing, more people with milder cases are identified. This lowers the case-fatality ratio;.
- demographics: For example, mortality tends to be higher in older populations;.
- characteristics of the healthcare system: For example, mortality may rise as hospitals become overwhelmed and have fewer resources.
As for either a vaccine or herd immunity being the magic bullet to defeat COVID-19, consider the so-called common cold. The U.S. National Library of Medicine, an institute with the National Institutes of Health, notes there are now seven human coronaviruses (HCoVs) associated with upper respiratory tract infections that sometime spread to the lungs and other organs. Epidemiological studies suggest that HCoVs account for 15 to 30 per cent of common colds.
Are you aware of a vaccine for the common cold? Are you immune to catching colds?
Coronaviruses are enveloped positive-strand RNA viruses from the Coronaviridae family. Making a safe and effective vaccine is far more complex than making batches of an annual flu vaccine. And while herd immunity has been a factor in mitigating some disease pandemics, including influenza, the evidence that could happen with a coronavirus such as COVID-19 is preliminary and inconclusive at best.
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