Are We All Doomed?
Coronavirus - How worried should we be?
Over the past week, we have seen the coronavirus infect a number of public figures, including the Australian Home Affairs minister, Peter Dutton, the very well-known actor Tom Hanks & his wife whilst filming in Australia (life is like a box of chocolates, you never know what you’re going to get), Justin Trudeau’s wife, Sophie & paradoxically, the English public health minister, Nadine Dorries.
The first case of coronavirus was detected in Wuhan China on December 31, 2019. We are now midway through March 2020 and there are well over 150,000 cases worldwide with the majority of cases and deaths being in China followed by a rather large outbreak in Italy.
Governments all around the world are bringing in stringent restrictions on travel, large gatherings typically involving more than 500 people and cancellation of most major sporting events or at least playing them behind closed doors with no spectators.
We have seen the ridiculous panic buying of toilet paper in Australia with people fighting in the aisles over this necessary commodity. Many foods that can be stored for a period of time have been panic bought and we are now seeing the ever-present facial masks being worn by people concerned about contracting the virus. Unfortunately, the studies suggest the masks are of no benefit.
I was the keynote speaker for a major financial group presenting for a roadshow around Australia. I gave my first talk in Canberra to around 100 people on March 7th but since then the talks in the other capital cities have been cancelled because of the virus.
We must ask ourselves whether all this concern & panic is really necessary? How lethal is the condition and also how contagious is the virus?
Let’s look at the facts to date. Firstly, to purely consider the Australian data, the figures as of Friday, 13 March were that there are still only three deaths in very sick elderly people and 199 cases across Australia with New South Wales having the most. By the time you read this the figures will have definitely increased. This is despite the virus being in this country for around two months, with the rigid restrictions only being implemented in the last week & seriously kicking in on Monday 16th of March. Therefore, it appears on the surface that this is not a particularly contagious condition, unlike influenza. The mortality rates outside of Australia have been around 3% although in Italy with the second oldest population in the world, this does appear significantly higher. At present our mortality rate is only 1.5%.
Covid-19 infections are doubling in Australia every 6 days, so if this is not contained, we may see around 10,000 cases over the next six weeks. The NSW Chief Health Officer, Dr Kerry Chant made the rather alarmist prediction that 1.5 million people in NSW alone are likely to be infected with the virus and if this happened our already over-stretched medical system will certainly not cope. But, this is certainly not the experience in China where the infections are now slowing down & life appears to be returning to somewhere near normal.
My explanation for this would be that the virus is more virulent in much colder climates such as China, Northern Italy, South Korea and Iran, during their winter. The Chief Medical Officer, Prof Brendan Murphy has suggested that the virus was expected to peak towards the middle of the year probably because, as I have already mentioned, we are headed for winter. The virus may (the operative word being "may", not "will") become more of a concern as Australia moves into colder weather but now that the government is bringing in these restrictive measures there is a very good chance that the virus will be contained rather quickly.
The major concern with Covid-19 is the 80:20 rule. In 80% of cases Covid-19 is a minor illness that typically causes a fever, cough and a degree of shortness of breath with some other viral-like symptoms e.g. sore throat, runny nose, aches & pains. But, in around 20% of cases, there may be a more severe illness which has typically affected the lungs. The worst version is honeycomb lung where the virus reacts with the immune system significantly damaging lung tissue. But, it is important to realise this is almost always in the very elderly or people with other serious medical conditions.
I believe the concern over the coronavirus, albeit unprecedented, is certainly reasonable but there is definitely no need for panic. We do need the restrictions, quarantine and isolation and probably, for a short period of time, prevent large gatherings such as sporting events. But, I suspect as the months go on we will see the virus dwindling off as we have seen with all other viral epidemics in the past.
This is a serious condition but probably no worse than the more severe strains of influenza so I’m not sure why we don’t have the same degree of panic every year when influenza occurs.
I could be wrong but I suspect that we will see the virus dwindling over the next few months if the restrictive measures are maintained with the caveat that this may change with winter approaching. As an event like this is unprecedented in the modern era, no health authority really can make an accurate call on what will happen.
I sincerely hope I’m right and we don’t see the overwhelming numbers predicted by a number of health authorities. In the meantime, keep away from anyone you know who has a respiratory illness or has just arrived back from an area where the virus is rife, avoid large crowds which are now banned regardless, don’t bother with the masks and wash your hands for as long as it takes to sing happy birthday, once if you are a normal person but twice if you’re the British Prime Minister!
Providing stress echocardiography heart health services for more than 25 years, Dr Walker is an expert in the field of preventative cardiology and has published seven best-selling books about the subject. Dr Walker is a member of the Miskawaan Health Group medical advisory board.