CORONAGEDDON vs CORONA CONSPIRACY

I hope I'm not the only person skeptical and confused about what is happening. As I mentioned last week my first thoughts on this virus was there was some sort of manipulation occurring but as I did more research I began to buy in to the concept that this is a highly dangerous disease. As last week progressed my anxietycontinued to rise. I read about a surgery in China in the nose to remove a tumor of the brain that infected every healthcare worker in the room with Corona virus. This was followed by the revelation that the two groups of doctors in Italy and China most infected by the virus were ENT, which I am, and Ophthalmology. I have spoken with colleagues in San Francisco and at Stanford and have dramatically curtailed visits in my office, stopped all elective surgery, and begun wearing a mask full time in the office.

Those of you who know me are aware I usually look at Facebook about once a month but as I have exhausted news outlets, cdc website, university postings I have turned to Facebook to see how all of my friends are doing and to get a feel on perspective. I have learned a lot! Although none of it has really answered my questions. So now I go back to the tried and true, my own logical analysis of what is happening. I am not going to provide references for the information I am going to share but if you have caught some of my shared reports and if you are willing to check out the main purveyors of statistics you will see that I am doing my best not to share false information.

The first item on my list is whether this virus is apocalyptic and by that I mean likely to infect 50% of the US population with deaths in the millions. Let's look at the numbers. As of today the world total confirmed infections is about 330,000 with about 15,000 deaths. Of course we don't know how many deaths are being missed and we don't know how many people have had the virus but not tested. The overall mortality rate claimed is about 1% with transmission rate or Ro of 2.5-3. Ro means that each infected person will infect 2.5 to 3 other people. By the way one of the articles I reposted claimed this was the rate per group encounter which is not correct.

Let's focus on the US. As of today about 400 deaths with 33,000 confirmed cases. We also know that we have done at least 275,000 tests. We know the testing has been restricted to people who are suspicious to have the virus. So, based upon this if you feel pretty sick in the US you have about 1 in 6 chances of being positive. We know the virus has been here at least since late January.

Now I am faced with two diverging issues. Either we are vastly undercounting the number of people who have been exposed or overcounting the mortality rate. Working backwards if we have 400 deaths with a 1% mortality rate and we allow 2 weeks for a death to occur after infection we should have had about 40,000 people positive 2 weeks ago and if everyone did their job infecting 3 others we would have 120,000 people positive today. We know 80% show mild to moderate symptoms and that we have not tested nearly enough people to capture all the positives. But our current count of 33,000 positive means miraculously we caught everyone of that 20% group plus a few more. That makes no sense to me. The other thing to keep in mind is that the tests are for active virus shedding. If your negative it neither answers whether you were infected in the past or whether you will be in the future. My only logical conclusion is that far more people have been infected than we assume and therefore the mortality rate is much less than 1%.

What can we say to support this? The highest rate of mortality has been in China, Italy, and Iran. I don't know anything about the healthcare systems but I can draw some conclusions about lifestyle. Wuhan has a population of 1200 per square mile with a male smoking rate of 52% and I fear to guess the level of air pollution especially prior to the start of the endemic. Regarding Italy even though the Lombardy region is not densely populated Italy has one of the highest densities at 200 per square kilometer. Italians do tend to live in tightly clustered towns with multiple generations in the same household. Regarding Iran, the country is known for high density religious gathering as well as less than optimal sanitation.

The next question is what is the correct Ro? This is much more difficult to assess. I think this may be more related to how healthy an individual is and how many close contacts with an infected individual occur. This is supported by reports that most transmission in China was among family members. And don't forget density. In the US the density in our cities is around 615 per square kilometer and outside cities a remarkably low 13 per square kilometer. This explains why the US hotspot is New York City with a density of 10,000 people per square kilometer. Based upon these facts I believe the Corona virus will most severely impact the large cities with high density, aging population, and high rates of smoking, lower density populations that are healthy will likely have small clusters of severe infections like nursing homes.

Now that I have convinced myself the virus won't be the end of the world what about all of the conspiracy theories? I shared a pretty long winded one the other day that tied Bill Gates, University of North Carolina, the Chinese and some undescribed cabal as the creators and manipulators of this pandemic for world dominance. Based upon the level of convolution I vote that one down, on the other hand it would make a great novel. I am more concerned regarding the massive power grab governors and the President are taking to subvert free will and democracy. Every day there are threats of martial law and increasing activation of the National Guard. I am concerned about the massive impact this is having on our world economy and I am not convinced based upon the first part of this post that this is a response that is relative to the threat.

When all is said and done and the forensics of this are complete in a couple of years I suspect that if this sizzles out leaders will claim it was only a success due to their difficult decisions in difficult times. If it ends up that the virus runs rapid destroying the world they will say they did their best in a horrible situation. In the mean time what constitutional rights will we have forfeited?

Regardless of the outcome the economic damage is done. We will just have to hunker down in our homes, keep our six foot distance, and of course crack open a bottle of fine wine or your preferred beverage.