By Dr. Thomas LaGrelius
Contributing writer
The big medical news is novel coronavirus disease (COVID-19). Four similar coronaviruses cause about one third of our common colds. We see them all the time, mostly in the Winter, going away by Spring or Summer. This is number five.
The outbreak of COVID-19 that began in Wuhan, China has spread to other countries. The cases here returning from China have been quarantined, but others have popped up. At this writing there have been six deaths attributed to this virus strain. We have lost 45,000 Americans to the flu this season. Did you notice?
Astute observers now recognize there are hundreds or thousands of unrecognized mild and asymptomatic cases or COVID-19 virus, maybe many more. This is a minor cold for most who get it.
So far the problem has not been very significant, but it is certainly causing a lot of angst. Travel has been curtailed. Airlines and cruise ships have seen drops in business and stocks have fallen on world markets. (Some see this as a buying opportunity!) School closures occurred in Japan. One city in China was essentially shut down to isolate the disease. Apple closed all its stores and plants in China, but has now reopened them as case reports there diminish. The consequences of virus fear may be worse than the virus itself.
How dangerous is this virus?
Many or most people infected with COVID-19 will have no symptoms at all and will never be identified. It looks like about 80% of identified cases are mild, either having few symptoms or acting like the common cold. Less that 15% are severe, like a horrible cold, and only about 5% cause “critical” illness, mostly in the elderly with serious lung or heart disease to begin with.
Though the fatality rate in one Chinese area was reported to be 2.9 % mild cases and symptom free cases were not identified. The overall reported fatality rate in China is more like 0.4%, and health care there is rather primitive. In areas where good intensive care is widely available, such as here in the United States, one would expect the fatality rate to be much lower. I’d guess here that fatality rate here would be well under 0.1%.
Remember, seasonal flu here in the USA has a mortality rate of 0.1%, one in 1,000. Many people get the flu of course, so quite a few die of it. The Centers for Disease Control estimate that in the past ten years there have been between 9 million to 45 million cases of flu each year, resulting in between 140,000 and 810,000 hospitalizations annually and 12,000 to 61,000 deaths. Hundreds of thousands of Americans have thus died of the flu and many millions hospitalized, yet few seem to be very frightened by this virus.
It is even hard to get Americans to bother to get flu shots which are probably about 60% effective in completely preventing the disease and blunt its severity in most of the other 40%. Fewer than 40% of Americans bother to get flu vaccine, though it’s essentially free at any corner drugstore and is heavily encouraged and endorsed by every medical authority on earth. The smartest thing we could do to reduce our respiratory diseases death rate this year is get the other 60% of Americans who have not done so to immediately get a flu shot. We would save thousands more lives that way than by shutting down the country out of coronavirus fear.
How do you avoid getting any virus?
Most viruses are spread by hand to mouth transfer. The victim touches a surface on which there is virus. Most of these viruses, including COVID-19, will live on a surface for about 30 minutes and then die. So the virus is placed on the surface by an infected person who coughs on his hand and touches a door handle, for example. The next person to touch the handle gets the virus on his fingers. He then picks up a pretzel and pops it in his mouth and gets infected. Or, he just puts his finger in his mouth to pick a piece of pretzel out of between two teeth.
How often do you touch your face and mouth? That has actually been studied. It’s about 15 times per hour! Every four minutes. Before touching your face, clean your hands! Before eating food, clean your fingers. Carry and use hand sanitizer. Use spoons and forks to eat. Push elevator buttons with your knuckle. In other words, work hard on not putting the virus in you mouth or nose.
Sitting here writing this paragraph I just reached up and found myself scratching my nose. Even when we are thinking about not doing it, we do it. Probably there is no benefit from wearing a mask, but if there is any it would be because it might prevent us from touching our own faces with our hands. A paper mask won’t work though. Perhaps we should all wear Darth Vader helmets till Summer when this virus too will fade away.
Live long, be well. Don’t be paranoid about coronavirus.
Dr. Thomas W. LaGrelius, M.D., F.A.A.F.P., is a certified specialist in family medicine and geriatric medicine. He is the founder and president of Skypark Preferred Family Care, a concierge primary care/geriatrics practice based in Torrance www.skyparkpfc.com. He is a staff member at Torrance Memorial Medical Center and Providence Little Company of Mary Torrance Hospital. Email questions and topic suggestions to office@skyparkpfc.com or call 310-378- 6208.
