Corona Virus Pandemic; a Review and Perspective

May 1^st is a traditional spring holiday in many European countries. This year’s May 1^st is different than any in my memory because the corona virus pandemic is in the minds of most people in the world. (Photo of Porto Rafti, Greece)  

Since its beginning in December 2019, in Wuhan city in Hubei province of China, nearly 3,450,000 cases and 250,000 deaths due to Corona virus have been reported in 210 countries.  During this period, confirmed cases in select countries, are as listed in round numbers; U.S. 1,100,000, Spain 250,000, Italy 210,000, UK 180,000, France 170,000, Germany 165,000, China 84,000, Netherlands 40,000, Sweden 22,000, Ireland 21,000, Austria 16,000, Japan 14,300, S. Korea 10,800, Greece 2,600, and Taiwan 432.(Wuhan and Yangtze river) 

During the same time the deaths per million of inhabitants in the above-mentioned countries are: Spain 532, Italy 467, UK 409, France 364, Holland 267, Sweden 260, Ireland 240, USA 194, Germany 80, Austria 41, Greece 14, S. Korea 5 and Japan 3 and Taiwan 0.3.  Interestingly, while China enacted strict quarantine of the 60 million inhabitants of the Hubei province, Japan let individuals and businesses continue as in pre Covid-19 period but instituted lockdown when the cases spiked.  S. Korea instituted extensive testing early and reported no new cases as of yesterday.  Sweden also allowed its citizens continue their lives and businesses as in the pre Covid-19 epoch with minor exceptions such as not permiting gatherings of more than 50 people.  The vast majority of the remaining countries enacted lockdown schemes of different severity.  

There is no doubt that the total number of individuals infected maybe 10 times higher to the reported due to the large number of asymptomatic patients and also because the tests have a false negative rate as high as 30%.  Mortality statistics from France show deaths 30% in excess of normal levels, over the same time period.  

The Covid-19 shutdowns and lockdowns have been based on the premise that the disease would kill 240,000 million Americans or up to 2 million as the Imperial College of London predicted.  Some models predicted death rates as high as 1-3% while the World Health Organization (WHO) estimated a death rate as high as 3.4%. 

Thee newer studies though refute these dire predictions.  The study from Stanford University tested 3,300 individuals for presence of antibodies in their blood that would show if they had previously been infected with the novel coronavirus.

The researchers found that between 2.5% and 4.2% of individuals tested had antibodies against the virus. That translated into 50 to 85 times higher number of  infections comparing to the known cases.  This suggests that the large majority of people who are infected by the corona virus remain asymptomatic. The authors also estimated that the death rate due to the Covid-19 is somewhere in the range of 0.12% to 0.2%.

A study from China that was published in BMJ found that 130 of 166 new infections (78%) were asymptomatic.  

A study from New York published in the NEJM examined 215 women entering two hospitals to give birth. Of expectant mothers who tested positive for active infections, 88% were asymptomatic at the time of admission.

If the findings of the three studies are true one may wonder why do we lockdown, if the disease is so widely spread and has infected large number of people worldwide.  

The IHME of the University of Washington projected 82,141 deaths from Corona virus in the U.S. by August 4, 2020. While the CDC estimates that in 2019-2020 season in the U.S. which just ended, there were 39 to 56 million flu cases and 24,000-62,000 deaths.

The more I look at the number of confirmed cases and deaths due to the pandemic the more I realise that certain unique patterns from different countries begin to evolve.  I think we should all learn from the Swedish, S Korean and especially Taiwanese experiences.  The deaths per million of inhabitants in Sweden are 260, in S Korea’s are 5, while Taiwan’s is a mere 0.3 per million.  It is axiomatic that we study how Taiwan’s tamed Covid-19, with sound hygienic practices like wearing masks and/or avoiding congested places, washing our hands and coughing or sneezing into our elbows and the most important early diagnosis of an impeding endemic. If more countries can replicate those, we can achieve death rates as low as that of Taiwan while waiting for a vaccine and/or drugs against the virus to be developed.