Is COVID-19 just another flu?

With the first case of COVID-19 now confirmed in Ireland, many people are wondering if it's all just a case of much ado about nothing. Surely it can't be as serious as the media are portraying it to be,... or can it?

To answer this question, we need to take a look at the numbers we know so far about COVID-19 to see how it compares to seasonal influenza.

Image 1: SARS-CoV-2

There are three key figures to compare here: reproduction number (R0), mortality rate and rate of compilations. Please keep in mind that all these are just estimates and are subject to change as we learn more about this new 2019-nCoV (SARS-CoV-2) coronavirus.

R0 (reproduction number)

The R0 number indicates how transmissible a virus is, i.e. how many people get infected from a single carrier. Because this is a brand new strain of the virus there is no herd immunity in the population and it can spread very rapidly.

Current best estimates place it between 1.4 and 6.49 with the average of 3.28 and a median of 2.79. WHO's R0 estimate is 1.4–2.5.

If an infected person takes part in a massive public gathering or visits a healthcare facility, school or creche, this number can easily grow far beyond just three new cases per infected individual.

Anything above 1 is bad as it means the spread will continue to grow, less than 1 means it will slow down.

Mortality rate

Mortality rate of COVID-19 is estimated between 0.4% and 3%, compared to 0.05% for seasonal flu epidemic, which is at least 8x worse at best and potentially as bad as 60x worse.

Rate of compilations

We've saved the worst for last, because this is where this new virus is really scary. The regular flu has a rate of compilations requiring hospitalisation of about 0.9% compared to 19% for COVID-19, with 5% being critical.

Up to 50% of critical patients die even with the best treatment readily available. It's hard to imagine what would happen if ICU units became overwhelmed.

Incubation period

It is widely reported that the incubation period for SARS-CoV-2 is between 2 to 14 days, however there are also reports of up to 24 days or more before the symptoms develop. The average incubation period appears to be less than 7 days and in some cases as little as 24 hours.

Coupled with suspected asymptomatic transmission this makes the virus very difficult to stop.

Test kit sensitivity

RT-PCR test kits which are widely used for confirming COVID-19 infections have been shown to be only around 70% sensitive, meaning that 30% of infected cases are not detected with this testing method. It can also take up to 2-3 days to receive the results because this is a fairly complicated and slow test.

A more reliable and faster method is a chest CT scan, where the presence of ground glass opacity has been shown to have 98% sensitivity for COVID-19 disease.

Conclusion

COVID-19 is NOT just a slightly worse case of the regular flu. If SARS-CoV-2 coronavirus is not contained and starts to spread unimpeded, our healthcare sistem would simply not be able to cope with the rapid influx of new patients, which would have disastrous consequences.

While there's certainly no need to panic, good preparation is vitally important. Be sure to practice good hygiene standards and social distancing to delay the spread of the new coronavirus as much as possible in order to allow sufficient time for testing of promising new medicines (2-3 months), development of the vaccine (12-18 months) and for the healthcare sistem to maintain control of the more severe cases of this disease.

Please avoid spreading conspiracy theories about unnecessary media hysteria and instead look at the real numbers above and help spread the awareness of the seriousness of this situation (share buttons are below).

We are in uncharted waters with this virus and our best hope is to stay vigilant and to mind ourselves and each other. This way, there is a good chance that we can keep this outbreak manageable and loss of life and disruption to a minimum.

Diligently follow advice from the healthcare professionals, call out conspiracy theorists and false bravado on social media and above all, stay safe.

UPDATES:

Should you continue taking ACE inhibitors (-prils)/ARBs(-sartans)?

20th March 2020: The official recommendation from the European Society of Cardiology is to continue treatment with ACE inhibitors/ARBs unless instructed otherwise by your doctor.

Source: Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers [1])