Let Us Put  the COVID-2019 in Perspective

​In several days, the current 125K worldwide cases of the novel coronavirus disease COVID-2019 will turn into at least a million and will keep on growing. Just like flu, which results in some 500 million cases a year, coronavirus is here to stay and multiply. In the meantime, mass media will thrive on showcasing in red fonts the growing infection numbers. 
 
Personally, I am not worried about the CoV-2019 disease. I am worried about the impact that the fear of the disease and the ensuing panic will have on our society and economy. So, let's analyze this. By rationally looking at the statistics and math.

In January, I started coming across coronavirus news posted by some of my contacts on social media. After that I started keeping an eye on the statistics on the COVID-2019 development. The latter is not a typical behavior for me as my news consumption is minimal at the best.
 
The day after a major increase in the number of the diagnosed cases in the USA I found myself buying five bags of coffee in Costco. That was followed by my posting a couple of semi-sarcastic thoughts on buying N95 masks,  hoarding toilette paper, and washing hands.
 
Upon contemplation, I concluded that my sarcasm was in part a mechanism of coping with the mass media and social media induced coronavirus anxiety, that I am not alone in worrying, that the emotional distress and panic will continue escalating, and that maybe it's time to put together facts and numbers.

​The mechanism of how we get affected psychologically 
 
You may be familiar with the psychological fact that majority of our fears are veiled and transformed descendants of the original and primal fear of death. When confronted with information on death around us we are likely to experience a variation of fear even if we cannot put a finger on it.
 
Also, a normal reaction of our psyche to any uncertainty regarding a potentially harmful event is an anxiety.
We have a perfect storm of uncertainty right now -- conflicting messages even from experts, no clear suggestions from the authorities, no reliable future forecasts, all of which is aggravated by rumors and speculation in all sorts of media.
 
The media outlets are insinuating an apocalypse and crafting emotional disturbances that will keep readers returning to those outlets to obtain more information, thus increasing the media ratings. One of the tools media employs is showcasing of the COVID numbers taken out of the context of the full picture of our life and death statistics. 
Some mass media go as far as misquoting experts or providing their statements out of the context or using disturbing subliminal imagery. And so on. 
 
Once the anxiety sets in, the normal reaction of our psyche is to try to gain control over the situation by 1) obtaining more information, 2) undertaking actions, 3) venting what we feel. Given that we are social creatures, this creates a snowball of a reaction. 
 
By the way, being aware of the natural desire of our mind to regain control over a worrying uncertainty also allows understanding why people are buying bulks of toilette paper and laundry detergent. They are having a normal reaction, an attempt to alleviate the anxiety.

Keeping the  sanity 

​Let us be conscious of the fact that the social and economic issues we will all soon experience will have roots in the psychological factors, and those psychological factors stem from our fear of the disease and death and from attempts to cope with the anxiety from uncertainty.
So, having a calm look at the numbers and rationally putting things in perspective is the best thing we can do. Let's address the roots. The less we panic, the better off we will all be.

​If you prefer raw data, scroll to the bottom -- I have listed all the data and information sources (e.g., CDC, WHO). Looking at the numbers you will arrive at the same conclusions. 
 
So, COVD-2019: Facts, Statistics, and Estimates
 

• Statistics on how severe COVD-2019 is and the death rates
• The infection rates: how contagious is the virus?
• The worst and unrealistic case ceiling
• Realistically
• Age factor in COVD-2019
• Statistics in comparison: see the full picture
• Putting it all together: if you are opposed to death, your best bet is to fight hunger (6-7 million deaths a year) and aging (about 35 to 50 million deaths a year), not the coronavirus
• Data and Information Sources

How Severe the Virus  Is and the Death Rates 

​Death rates can be accurately calculated only after an epidemic event is over. At this point, we only have estimates --
* The official estimates put the death rates at about 2 to 4 % (of the diagnosed, not of the population total and not even of the total infected);
* The above rates are overestimated because the denominator does NOT include many people who did not get tested and diagnosed: people with mild symptoms and people with no symptoms;
* For example, 17.9% of the Diamond Princess cruise ship passengers who tested positive for COVD-2019 had no symptoms; 
* 81% of the infected (and diagnosed) in China had a mild illness (think -- a cold); 
* The following pre-existing conditions increase the risk for the COVD-2019 mortality: cardiovascular disease, diabetes, chronic respiratory disease, hypertension, and cancer. For younger population without pre-existing conditions, the rates are lower than for the population-by-age-group averages. 

As you can see, this not SARS and this is not MERS and this is not Ebola.

How contagious is the virus? The  Infection Rates

Case Study 1. Wuhan is a densely populated city with over 11 million people and little under 80K cases of COVD-2019. The ruthlessness of the quarantine measures implemented by the government there will not happen in the Western world, meaning that we are likely to have higher infection rates. 
Nonetheless, assuming China reported their numbers truthfully, this puts the infection rate there at less than 0.72% of the population. 

Case Study 2. The case of the Diamond Princess cruise ship provides a glimpse into how contagious the virus is when you are forced to be exposed to the infected people and no protection is possible. 
There were 3,711 people on the cruise ship. 705 people contracted the virus. That is roughly 19%.
​This number is peculiar because 100% of the population was tested, which would not be the case in the real world, thus yielding a significantly lower infection rates (in the real world testing scenario) and also producing a much higher than actual death rate estimate.
​
Further, keep in mind, that younger population is underrepresented on cruise ships; therefore, the infection rates we see on the Diamond Princess are higher than they would have been in the population average off the ship.
Therefore, the infection rates are under 19% even in the very worst (and unrealistic) case scenario. 

Case Study 3. Over 44,600 health workers in China have been assigned to deal with the COVD outbreak. We can assume that the medical workers were taking precautions against getting infected while also being consistently and extensively exposed to the sources of infection.
1,717 medical workers in China got infected and 5 have died (0.3%). This translates into the infection rate of about 3.8%.

What impacts the infection rate
​

• COVD-2019 can travel about six feet from an infected person. It is unclear how long it can live on the surfaces; compare that to measles that can travel about 100 feet.
• Basic reproduction number (R0) for coronavirus is 2.2 - 2.8, which means that the virus will be spreading, and we are more likely to get infected with it than with a flu. 

​
What the high infection rate means for us

What it also means that to prevent the spread of the virus to the vulnerable elders and immunocompromised, until we have some sort of a herd immunity, whether natural or through vaccination, for some two - three weeks we may have to close down public gatherings and stay at home, and that is all there is.
​Staying at home just means we'll be watching more TV or will get a chance to work out more or to do housework or spend time with our kids. That does not mean an apocalypse. ​

An  unrealistic   worst case ceiling 

No predications and forecasts at this points are reliable. We can only talk about various projection scenarios.

In 2018, the Gates foundation created a simulation with a flu pandemic due to a virus both more contagious and more deadly than the coronavirus is. That simulation produced 33 million deaths worldwide over a 6-month period. If we extrapolated that into, for example, the USA population, that would give us about 1.54 million. 

The reason why I am even including this number is to have a mental anchor of a ceiling in numbers that will NOT happen because the COVD-2019 is neither as virulent, nor as deadly as the one used in the simulation.  

And before even that number (that will not happen) may raise your eyebrows, compare it to the annual death rates from aging and other disease that are shown below.

Realistically

As of right now, there are over 128 thousand cases of COVD-2019 registered worldwide  and over 4,400 deaths. That includes the worldwide total of 37 thousand cases outside China, and 1.2 thousand deaths outside China. 

The realistic scenario is that we'll live alongside the COVD-2019 just like we live alongside colds and flu. ​Very soon there will be millions of cases just like with the cold and flu. Hospital beds may be overloaded.  
Many of us will at some point have COVD-2019. Many of us won't even know that they have it because they won't be even sneezing. 

There won't be any apocalypse, there won't be any zombies to fight, but there will be fear, xenophobia, stigmatization, and a major economic slowdown if we choose to listen to the panic spreading media. 

Age Factor in the  COVD-2019  Mortality

Despite the fact that there is a lower proportion of people over the age of 70 in the society total, this Chinese study shows that over 50% of deaths occurred in people over the age of 70.

A preliminary Chinese study used a cautious language and suggested that, "Poorer outcomes in lord people may be due in part, to the age-related weakening of the immune system and increased inflammation that could promote viral replication and more prolonged responses to inflammation, causing lasting damage to the heart, brain, and other organs". ​

The median age of people who died of coronavirus is 75 years.
That is in line with the overall picture of mortality on our planet. The true cause of death is aging. The reason for death is the disease that happened to get to the person first.

If we are to wear masks, I believe we should do so around older people who are more susceptible and are in the risk group, for THEIR protection. 

Full  Picture. Statistics in Comparison

Some 200 years ago, death used to be a part of everyday's existence. Many generations lived in the same household, and seniors were not moved to 'senior housing' -- assisted living communities and alike. Except for leprosy and extreme mental cases, dying people were mostly dying at homes, not in hospices and hospitals. Our exposure to all aspects of life was giving us a somewhat realistic idea of the death rates. 

In the past century, in the Western world, not only did we see an objective decline in the disease and associated mortality, but we also became largely separated from people who are in the later stages of their lives. Many of them are hidden away from our eyes in the hospitals, hospices, and senior assisted living places. Neither are we discussing suicide; never once have I heard people sustaining a lengthy conversation about deaths from hunger. And so on. 
Out of sight, out of mind. Death became mostly invisible. We are not used to it.

We live oblivious to the fact that about 158,000 people worldwide die every day. If you saw Lord of the Rings, with the scenes of dark armies swarming all the way to the horizon, that is maybe what the 158,000 looks like? That many people die every day. We are just not exposed to that.  

We are eventually exposed to the older generations in our families passing away. And. We are exposed to mass media that happens to be very selective in what it covers, to not provide the full picture, and to intentionally use the fear inducing language. And that is why 4.4 thousand of COVD-2019 death that we are exposed to due to the mass media are causing the panic.

Being aware of the full picture would have allowed to react with more calmness to this outbreak. 

Some statistics --

Out of about 57.8 million people who will die this year, 28.3 will die past the age of 70 (both numbers are projections). Regardless of the officially stated reason for death in each case, cardiovascular disease or a cancer etc, that disease will be just the last straw on a person's overall failing health. The true reason is aging. 

I am NOT saying that even one death from COVD is to be ignored and that we should not feel empathy. I am saying that our psyche is reacting with a panic because our baseline reality picture is not complete. And that panic leads to hoarding the toilette paper and to stock market crashes and an economic slowdown. ​

So, Let's  Put It All Together and  In  Perspective

​​First of all, when this epidemic is over, when you look at the worldwide breakdown of the mortality by reason, you will see a structural change between percentages of reasons of death.
The total number of deaths per year will not be significantly higher by the number of coronavirus deaths; but the total numbers will be split differently by reason, with the coronavirus percentage (and likely it will be just buried in the lower respiratory infections total) taking away from the other mortality causes.  

The breakdown of the COVD mortality by age group clearly points that the primary reason behind the COVD mortality is the failing immune system and the old age frailty. And if we do not want to hear about death, the public gaze and funding should be directed towards R&D of major anti-aging efforts: gene therapies, telomere extension, epigenetic reversal etc. 

Think about this. The US Senate only allocated 8.3 billion dollars to deal with the COVD-2019. Had those 8.3 billion dollars been allocated to the age reversal R&D, there is a realistic likelihood that we would have NO need to fight coronavirus or other reasons of death because there would have been no such deaths... 

Just something to ponder when the panic is over. 

Coronavirus is here to stay. The best course of action we can take is to remain calm and rational by looking at the full picture and to avoid exposure to the panic spreading sources.

Data and Information Sources 

​
https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html
https://www.who.int/healthinfo/global_burden_disease/estimates/en/
https://www.who.int/health-topics/cancer#tab=tab_1
https://www.cdc.gov/nchs/fastats/deaths.htm
http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51
https://www.rsna.org/news/2020/January/Coronavirus-Update
https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center
http://www.idmod.org/news/node/296
https://www.gatesfoundation.org/Media-Center/Speeches/2018/04/Shattuck-Lecture-Innovation-for-Pandemics
https://www.worldometers.info/coronavirus/
https://www.worldometers.info/
https://www.thelancet.com/lancet/article/s0140-6736(20)30566-3
https://www.medrxiv.org/content/10.1101/2020.02.08.20021162v1
https://www.medrxiv.org/content/10.1101/2020.02.20.20025866v2
https://jamanetwork.com/journals/jama/fullarticle/2762130 
​https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf