Yes, COVID-19 is real. No, you should not panic.

In today’s world, the fear of Covid has become bigger than the virus itself and wrong actions can lead to even more damaging outcomes. Instead, can we turn this crisis into an opportunity by looking deeper into the underlying problems?

May 2020

Early on, in the beginning of the COVID-19 outbreak when the virus was just starting to spread from its original location in China to other geographies, we had very little information about it and how it could affect each of us. “Novel coronavirus” meant that there was little understanding of this new virus, how it made people sick, how dangerous it was, how long it lasted after someone got it, how infectious and lethal it was, how long it stayed active in different environments, and what were the chances of getting re-infected. There were too many questions and not a lot of answers. It was making all of us feel worried, anxious, unprepared, and fearful about the future. Novelty of this virus introduced new risks into our daily lives and defined what the society would be doing about it.

Three months since we largely became aware of the seriousness of this problem, we still do not have all the answers and probably have even more pressing questions, yet many brightest scientists around the world have collected a lot of valuable information on COVID-19 to help us become better judges and decision-makers for ourselves and our communities. With the rising levels of information, mis-information and the overwhelming coverage of COVID in mass media, our biggest challenge remains putting our emotions and fears aside and instead use a clear mind and rational thinking to take proper actions. At the local and federal levels, it is the government’s role to make decisions and implement new standards, rules and regulations how people and businesses shall interact with each other to minimize the devastating effect from the pandemics. We, as individuals, have a responsibility to ourselves, our families, and our communities to remain alert, clear-minded, respectful and responsible; and when we reach the other side of this crisis, we’ll be stronger than ever before. We always have done this in the past and we shall do it this time. All together.

Earlier “reality”

In the beginning of the COVID-19 pandemic — in January, February and even March — when there was no history and little data on which to draw any conclusions, most of us were thinking of this virus to be one of the deadliest infections existed in the modern times and a major killer of humans since the Spanish flu outbreak in 1918. The comparison between the two seemed very relevant at the time. 50 million people who died from the 1918 Spanish influenza pandemic looked like something that could happen again in our modern world, despite 100 years of advances in medicine and technology. In the US alone, Spanish flu infected 28% of the entire population with a mortality rate of 2.5%. An estimated 675,000 Americans died of influenza during the pandemic. Similar, if not even larger numbers seemed probable in 2020 according to many models projecting the COVID-19 trajectory. In fact, the common prognostic was that the novel coronavirus was so dangerous that everyone who got in contact with it would become ill and anywhere between 4% and 8% of all who became infected would shortly die. We are talking about many millions of people. This was truly scary.

Given such reality, it’s normal for us, people, to prepare for the worst-case possibilities. Which basically was: If I get exposed to the virus (regardless of what my health, age, or gender was), the virus will make me very sick, I will experience the most horrible symptoms and eventually I have a 4–8% chance of dying. Even if I miraculously survive, COVID would likely kill or damage someone among my family, my friends, my colleagues and my neighbors — my life would change forever for the worst. This will happen to everyone on our planet, sooner or later.

This thinking has been taking over our lives. It introduced new fear, panic, anxiety, depression, and many other destructive feelings in our daily lives. The reality of this extreme negative scenario dominated just a few weeks ago. In fact, it felt like it was just yesterday and for many it still exists today.

Today’s “reality”

It’s been now four or so months since the vicious virus has been known to the world as the deadliest and commonly spread pathogen known to the modern people. Many doctors, scientists and analysts have been carefully capturing data and studying the outcomes of those who became victims of COVID-19 across many countries and various demographics. We now have a much better understanding of the virus and its impact on people. It is important to apply this information in the right way, minimize the pressure created by fear, misinformation and special interests, and make accurate assessments of the situation. Our understanding may change again as we continue to learn more and analyze new information. Accordingly, we shall continue to adjust further our decisions, plans and actions.

What we know

Not everyone who gets exposed to the virus becomes sick with COVID-19.

Of those who have the virus (test positive), many show no symptoms. This means while these people might be carrying coronavirus, it may be harmless to the host. Early results from numerous antibody studies in the US, showed that about 10–15% of all people who participated in these surveys already had the antibodies and many of these people were never visibly sick. In places like NYC, the number is 24% and higher.

Another category of people who gets infected experience only light or mild symptoms. While they become sick and may take a few days or even weeks to feel better, these people feel similar to having regular cold and do not require serious medical attention.

All of the categories above fully recover, do not have any significant adverse effect on their long-term health, and move on with their normal lives. These are the majority of all people.

There are people who become seriously ill after contracting the virus and these people require medical help, including hospitalization. The majority of these individuals are those with underlying medical conditions, who have a compromised immune system, excessive inflammation and often a series of general health problems. Still many of these people recover, yet some of them do not.

Lastly, there are very few cases when someone of a relatively young age, visibly in good health with no underlying conditions, gets infected, becomes very ill and does not survive the virus. This is highly uncommon. It happens approximately in 0.4% of all deaths caused by COVID-19.

While every death is too many and we shall not understate the seriousness of this disease, it is important to clearly separate the category of high-risk individuals from the majority of healthy individuals who are unlikely to have any significant harm if they get in contact with the virus. We also acknowledge that even though there is still a risk for healthy individuals, the likelihood of a fatal outcome is so small that it is no higher than the risk of dying from a car accident.

“The majority of people who become infected are expected to be asymptomatic or recover without needing special treatment,” according to the World Health Organization.

Who is at risk?

The Centers for Disease Control and Prevention (CDC) believe that according to currently available information and clinical expertise, older people and adults of all ages with serious medical conditions, such as heart disease, diabetes, lung disease, asthma and obesity have a greater risk of becoming severely ill if they get infected with coronavirus.

A quick analysis of the COVID-19 mortality data from NY, MA and hospitalizations for all US, we have found one key risk factor and it is the presence of underlying conditions. This precisely matches the CDC observations. While variables such as age, gender, poverty, and whether or not someone resides in a nursing home or in a correction facility do matter, they all highly correlate with one single fact — the existence of serious health problems. These people are at higher risk of becoming ill and even dying from COVID-19. These people are also at a much higher risk of dying earlier, compare to those who are healthy. Unfortunately, this group is quite large as approximately 37% of all adults in the US would potentially fall into this category, according to Global Health Policy. Even further, CDC estimates that 6 in 10 adults in the US have a chronic condition and 4 in 10 have two or more chronic conditions.

The bad health situation in our country is the real problem and it is the true pandemic that we need to fight against. Why no one is talking about it?

Data, data, data

Let’s take a closer look at the statistics and what makes someone a higher-risk for coronavirus. For the purposes of this work, we will mainly focus on infection fatality rate due to COVID-19 and how likely it is that someone will face such a risk.

Let’s look at the data from NYC, MA (top hotspots in the country) and then US Total. We’ll notice that the key factor is underlying medical conditions (UC). Of course, elder people have a disproportionally higher rate of health issues, however, at least 98% of all people who die from COVID-19 had serious medical conditions prior to becoming infected with the virus. These data are true for the population in the US but other countries show similar, if not the same outcomes.

Example 1: NYC COVID-19 Deaths among confirmed cases (as of May 5, 2020)

Total deaths among confirmed cases — 13,724

Those with underlying conditions (UC) — 99.4% of all deaths

Those without underlying conditions (No UC) — 0.6% of all deaths

Example 2: MA COVID-19 Deaths among confirmed cases (as of May 5, 2020)

Total deaths among confirmed cases — 4,212

Those with underlying conditions (UC) — 98.3% of all deaths

Those without underlying conditions (No UC) — 1.7% of all deaths

Example 3: U.S. COVID-19 hospitalizations and underlying conditions

The case numbers and death numbers change daily for the US. It is common across the country that the majority of the COVID-19 serious cases occur in those who have at least one underlying medical condition.

Conclusion

The COVID-19 pandemic is still going strong in the U.S. in early May 2020, considerably affecting our lives and creating a new reality. The situation is challenging and it may get worse before it will become better. However, what we initially feared about the novel coronavirus — being the deadliest infection since the Spanish flu killing many thousands of people — has become a more manageable health crisis. There are many people at risk and there is yet no cure, but our government is taking measures and the health care system has sufficient capacity to handle all critical patients. At the same time, the availability of good data and scientific research are helping us be more informed to make better decisions. Yes, it is still bad and we need to remain patient until it is over. No, there is no need to live in constant fear and panic. The majority of all people will be fine and it appears that by now more than 20% of the population may have already developed antibodies. Those, with serious medical conditions shall be extra careful and take good care of themselves. It is good to remain cautious but reasonable and not over-react.

As the data show, every person is not equal when it comes to a bad outcome in this pandemic. The virus highly discriminates against those with poor health. Age, gender, poverty and other characteristics, while contributing factors, are not responsible for the outcome. The only thing that matters is your health! And by the way, health is what we, people, have some level of control over. In fact, our health is not something that happens to us. It is something that we choose to have, to a large degree — either bad health or good health. It is a process in which we can engage daily, weekly, monthly… always. You can begin now a new path to a healthier living.

Author: J. A. Graf (email: graf.ja@icloud.com | Twitter: @jgrafnews)