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Covid 19: Let’s take a breath

3/24/2020

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The grocery shelves are empty and most of us have been to at least 3 different places just to find toilet paper.  Many of my new moms can’t even find formula for their babies.  Is there a shortage?  No, but there is a manufactured shortage fueled by hysteria.  At this point, one might wonder what is more dangerous the coronavirus (COVID 19), or the fear and anxiety that has been generated by the media?
  1. So, let’s compare COVID 19 to the flu for a second.  Which is more likely to kill you? The answer is the flu.  As of March 7, 2020, 38 million people in the U.S. have been affected by the flu.  Somewhere around 390,000 have been hospitalized, and somewhere around 23,000 people have died.  In fact, the hospitalization rate for influenza in children 0-4 and adults 18-49 is the highest ever, even higher than H1N1.  To date, Covid 19 has affected nearly 50,000 people in the US and about 650 people have died.  The mortality (or death) rate from the seasonal flu is typically around 0.1%.  The mortality rate for Covid 19 currently stands at a little over 1% in the US.  What this means is if you get COVID 19, you are more likely to die than if you get the flu; however, you are far more likely to get the flu than COVID 19.  So, statistically, at this point, you are far more likely based on probability to die from influenza than you are from COVID 19.  Despite these numbers and the big push for a coronavirus vaccine, only around 40% of the population is amenable to the influenza vaccine that could potentially save more lives.
  2. That being said, I am definitely not telling you to ignore the current recommendations of social distancing or taking appropriate sanitary precautions and following guidelines set by the governments.  Even though up to 20% or more of those infected may have no symptoms, coronavirus is still a very serious illness for those who become ill.  Who does this virus affect?  Those most at risk of death are the elderly, especially those with chronic disease.  The mortality rate for those over age 65 with chronic diseases is 16%.  By following these precautions, we are decreasing exposure and the chance that this age group will contract a disease that is way more deadly for them than a healthy 20-year-old (the chance of a healthy person younger than 55 dying from coronavirus is <1%; for those 85 or older, it could be anywhere from 10-27%).  As for pregnant women, the good news is that coronavirus does not appear to cross the placenta to the baby, but just like for the flu, pregnant women are at a slightly higher risk for severe respiratory symptoms because their immune system is a bit compromised in order to prevent rejection of their growing baby.
  3. One of the biggest concerns for many is a comparison of our healthcare with Italy-they don’t have enough ICU beds, ventilators or even enough space to bury the dead.  Fortunately, there are a lot of differences between Italy and the US.  In Italy, 25% of its population is over the age of 65 (thank you Mediterranean diet!).  In the US, only 16% of the population is over the age of 65.  The number of critical care beds per 100,000 people in the US is 34.7.  The number of critical care beds per 100,000 people in Italy is 12.5.  So, not only is there a disparity in patient population, but it is also present in the healthcare infrastructure that is contributing to the higher mortality rate that we are seeing in Italy compared to the US.  These factors contribute to a mortality rate in Italy is currently at 9%!  This does not mean that we should be falsely reassured, though.  The U.S. population is 5 times higher than Italy, and this is going to be a huge strain on our health care system.  Covid 19 has also shown that we may benefit from reassessing our production/supply chains for medical devices/pharmaceuticals as we find decreased availability of medical supplies and medications for sick patients and healthcare providers. 
  4. There will be lots of lessons to learn from COVID 19.  This will test our preparedness in adversity, and it will teach us how to be better equipped for large-scale health crises in the future.  Importantly, though, we cannot lose our humanity and touch with reality.  Stocking enough toilet paper for 1 year is not going to make you immune to COVID 19, and in fact, it may help facilitate its spread.  If the rest of us have to go to three different stores to find a roll of toilet paper, it increases our exposure to others.  This could negate the effects of social distancing that we have been practicing for the past week.  All those hours of being cooped up in the house and driving each other crazy, and the only benefit will be a really clean bum 😉 
Dr. Pam
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