The WHO sent 25 international experts to China to study the Coronavirus. Here are some interesting facts about COVID-19 that aren’t being reported by the media.
The WHO sent 25 international experts to China to study the Coronavirus. Experts from eight different countries including Bruce Aylward, Senior Advisor to the Director-General of the WHO, Clifford Lane, Clinical Director at the US National Institute of Health and Aleksandr Semenov, Deputy Director of the St Petersberg Institute.
- The most common (78–85%) way to get infected was by being in close contact with a family member. Transmission through the air over long distances was not the main cause of infection.
- Most of the healthcare workers that contracted the disease were infected at home or in very early stages of the outbreak before safety protocols were in place.
- The new virus is 96% identical to a known coronavirus found in bats. It’s 86–92% identical to a known pangolin coronavirus. The transmission of the virus from animals to humans is the most likely source but the animal source remains unknown.
In the face of a previously unknown virus, China has rolled out perhaps the most ambitious, agile and aggressive disease containment effort in history. The strategy that underpinned this containment effort was initially a national approach that promoted universal temperature monitoring, masking, and hand washing. However, as the outbreak evolved, and knowledge was gained, a science and risk-based approach was taken to tailor implementation. Specific containment measures were adjusted to the provincial, county and even community context, the capacity of the setting, and the nature of novel coronavirus transmission.
These are the symptoms and how commonly they occur:
- Fever (88%)
- Dry cough (68%)
- Exhaustion (38%)
- Mucus when coughing (33%)
- Shortness of breath (18%)
- Sore throat (14%)
- Headaches (14%)
- Muscle aches (14%)
- Chills (11%)
- Nausea and vomiting (5%)
- Nasal Congestion (5%)
- Diarrhoea (4%)
- Coughing up blood (0.9%)
- Bloodshot Eyes (0.8%)
- No cases presented with a runny nose.
Only 2.4% of all cases were under 19. There were no cases in which a child infected an adult.
COVID-19 is not SARS and it is not influenza. It is a new virus with its own characteristics. For example, COVID-19 transmission in children appears to be limited compared with influenza, while the clinical picture differs from SARS. The COVID-19 virus is unique among human coronaviruses in its combination of high transmissibility, substantial fatal outcomes in some high-risk groups, and ability to cause huge societal and economic disruption. For planning purposes, it must be assumed that the global population is susceptible to this virus. As the animal origin of the COVID-19 virus is unknown at present, the risk of reintroduction into previously infected areas must be constantly considered.
- China is producing 1.6 million test kits per week. Test results can be delivered the same day.
- The Chinese Government mobilised 1800 teams of epidemiologists, with 5 members per team to track tens of thousands of people that had been in contact with a confirmed case every day. A high percentage of people who were identified as having been in close contact with an infected individual had to complete a medical evaluation. (If tests were mandatory, this explains those videos of people being seemingly kidnapped from the street by police)
- Contacts were traced all across China. In Sichuan Province 25,493 were identified as having been in close contact with an infected person. 99% of them were traced,72% of them completed a medical evaluation and 2.8% were confirmed to be infected.
- Government protocol: anyone going to the doctor with a fever is tested for the virus. In Guangdong province, 320,000 people were tested and just 0.14% were confirmed infected.
- The majority of cases classified as asymptomatic eventually developed symptoms.
- A total of 40,000 government employees including nurses from other provinces and military doctors were sent to Hubei (The province that contains the city of Wuhan) to fight the spread of the virus. 45 hospitals in Wuhan are at full occupancy caring for COVID patients, 6 of those for patients in critical condition, 39 for seriously ill patients and for infected people over the age of 65.
- Two new hospitals with 2,600 beds were built in a week.
- Ten temporary hospitals were set up in public spaces to care for those with mild symptoms.
Much of the global community is not yet ready, in mindset and materially, to implement the measures that have been employed to contain COVID-19 in China. These are the only measures that are currently proven to interrupt or minimize transmission chains in humans. Fundamental to these measures is extremely proactive surveillance to immediately detect cases, very rapid diagnosis and immediate case isolation, rigorous tracking and quarantine of close contacts, and an exceptionally high degree of population understanding and acceptance of these measures. Achieving the high quality of implementation needed to be successful with such measures requires an unusual and unprecedented speed of decision-making by top leaders, operational thoroughness by public health systems, and engagement of society.
Disease, Risk Factors and Fatality Rate
- 80% of laboratory-confirmed patients were classified as having mild to moderate disease which included pneumonia and non-pneumonia.
- 20% of patients required hospitalisation.
- 15% of patients needed to breathe highly concentrated oxygen for 3–6 weeks.
- 5% needed artificial respiration.
Side Note: The hospitalisation and intensive care requirements of people infected with COVID-19 is very high. For comparison, only 0.2% of people diagnosed with the flu require hospitalisation.
I wrote an article about why that is so dangerous for our healthcare systems here. I highly recommend reading it to see why focusing on the death rate of the virus is missing the real danger.
As of 20 February, the crude fatality ratio (CFR) was 3.8%. It was much higher in people with pre-existing conditions.
Pre-existing conditions and their CFR
- Cardiovascular disease (13.2%)
- High blood sugar (9.2%)
- High Blood Pressure (8.4%)
- Chronic respiratory diseases (8%)
- Cancer (7.6%)
People without pre-existing conditions died in 1.4% of cases.
Age and Gender
The younger you are, the less likely you are to be infected. Only 2.4% of cases were under the age of 19. Only 0.2% of them were critically ill.
Over the age of 80 the CFR increases to 21%.
Women are just as likely as men to catch the disease, but less likely to die.
2.8% of infected Chinese women died compared to 4.7% of men.
9 pregnant women that were infected with the coronavirus were monitored. The children were born by caesarean section and were all uninfected and healthy.
The median age of those infected was 51 years old. The majority (77.8%) of cases were aged between 30–69.
The oldest was 100 years old. The youngest patient was 2 days.
The COVID-19 virus is a new pathogen that is highly contagious, can spread quickly, and must be considered capable of causing enormous health, economic and societal impacts in any setting. It is not SARS and it is not influenza. Building scenarios and strategies only on the basis of well-known pathogens risks failing to exploit all possible measures to slow transmission of the COVID-19 virus, reduce disease and save lives.
Treatment and Recovery
An increasing number of patients are recovering.
18,264 (24%) reported cases have recovered.
26.4% of severe cases have recovered and been released from hospital.
46.4% had improved and were reclassified as having mild/moderate disease.
Among severe cases reported, 13.4% died. Early identification of cases and contacts allows for earlier treatment.
China’s bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic. A particularly compelling statistic is that on the first day of the advance team’s work there were 2478 newly confirmed cases of COVID-19 reported in China. Two weeks later, on the final day of this Mission, China reported 409 newly confirmed cases. This decline in COVID-19 cases across China is real.