Dear Brittany:

I read your post here and the thread you started and answered you on your own thread. I hope that you reply to me there, and that we communicate further on your thread.

Dear Brandy:

So good to read from you and to know you’ve been following my thread, and that we are on the same page! If you find that we are not on the same page on any particular topic or detail, let me know.

Your grandparents were young people during the Spanish pandemic, how very interesting. I too wish you asked them about it, but back then, you had no idea that you will be finding yourself in a pandemic, so maybe it didn’t feel relevant to you at the time. But the concerned look on your grandmother’s face was telling!

There is a book, I didn’t read it, about the Spanish flu, with the testimonies of people who lived through (don’t recall the title, but it’s easily goog-able. I may read parts of it if I can find it online.

anita

Dear Reader:

The current huge difference in the Covid-19 mortality rate by age  is not a reason whatsoever for younger people to feel confident. This trend of age difference in mortality rate can change if social distancing, quarantines and shut downs are not enforced because the more infections=> the more the virus mutates, and it can mutate to a form that will kill younger people, which is what happened a 100 years ago during the second wave of the Spanish flu pandemic, (Jan 1918- July 1918, was the first wave, the second wave started in August 2018), Wiki:

The second wave of the pandemic was “much deadlier than the first. The first wave had resembled typical flu epidemics; those most at risk were the sick and elderly, while younger, healthier people recovered easily. By August, when the second wave began in France, Sierra Leone, and the United States, the virus had mutated to a much deadlier form. October 1918 was the deadliest month of the whole pandemic… the second wave was far more deadly; the most vulnerable people were those like the soldiers in the trenches – adults who were young and fit”.

* A bit of an encouraging info regarding the Spanish flu: “After the lethal second wave struck in late 1918, new cases dropped abruptly – almost to nothing after the peak in the second wave. In Philadelphia, for example, 4,597 people died in the week ending 16 October, but by 11 November, influenza had almost disappeared from the city.… Another theory holds that the 1918 virus mutated extremely rapidly to a less lethal strain. This is a common occurrence with influenza viruses: there is a tendency for pathogenic viruses to become less lethal with time, as the hosts of more dangerous strains tend to die out”- this is about Influenza, not Covid-19, different virus, but it is good to know that a virus can mutate to a lesser lethal form.

anita

Dear Reader:

It just so happened that I found out only a  moment ago, that I am not Covid-19 positive, just received that call- what a relief! I was prepared for a positive result and for a total lockdown in the house for two weeks, fearing of illness and death.

Unfortunately, I am still at a risk of dying from other diseases (as we all are). Because I live in the U.S., I looked at the CDC’s (Center for Disease Control and Prevention) numbers for 2017: population close to 326 millions, total deaths, close to 3 million (863.8 deaths per 1000,000 population, which is, rounded: 8.64%).

I will compare WHO’s estimation (March 3) of Covid-19 mortality rate of 3.4% (no consideration to age in death, or prior medical conditions prior to death), to the top causes of death in the US in 2017 (no consideration of age or prior medical conditions): Heart disease 0.2%, cancer 0.18%, unintentional injuries/ accidents 0.05%, chronic lower respiratory diseases 0.049%, Stroke 0.045%… Influenza and pneumonia 0.017%.-

This means (considering 3.4% is an estimation, not a fact, and referring to facts regarding the US, 2017): the chance of dying from Covid-19 once infected is 17 times greater than dying from heart disease, 19 times greater than dying from cancer, 68 times greater than dying from accidental injuries (including traffic accidents).. and 200 times the chance of dying from influenza and pneumonia.

Therefore, a seemingly low number of 3.4% mortality rate is in the grand scheme of things (US/ global population) translates to a huge number of deaths. Considering the high contagiousness of the virus, without social distancing and isolations, the number of deaths globally can easily be in the many millions, and.. considering that the more infections-> the more the virus mutates, and can mutate to a far more aggressive strain or strains, the number of global deaths can be even greater.

I have more of an understanding today about the necessity of shutting down the global economy so to prevent a global death catastrophe-  way, way greater than the current(as I am about to submit this post) 79,152 deaths.

anita

Dear Reader:

Currently, there are over 1.6 million global Coronavirus cases, and over 97,000 deaths globally. Most cases and deaths are in the U.S. (approaching half a million cases and 20,000 deaths, and most of these are in New York City).

In  the worldometers Comparison section, it reads that “Every year an estimated 290,000 to 650,000 people die in the world due to complications from seasonal influenza”, so the comparison, very roughly,  is between less than 100,000 coronavirus deaths currently, in less than half a year, to almost 150,000 seasonal flu deaths, at the low end of the estimate,  in half a year.

The reason the world economy is shut down is because this coronavirus, SARS-Cov-2, is  more contagious and more deadly than the seasonal influenza viruses, and because there is no vaccine or treatment for it, and because it is a new virus whose behavior is not well known and is still being studied, for example: it wasn’t known if it will mutate significantly within a short time and become way more contagious and deadly (it hasn’t), and because it spread too much before governments alerted the public and enforced adequate isolation practices.

The current Covid-19 disease is a SARS disease (Severe Acute Respiratory Syndrome), a viral respiratory disease of zoonotic (animal) origin, caused by the virus SARS-Cov-2. The previous SARS was caused by the another coronavirus, SARS-Cov-1. It took place in Nov 2002-July 2003, originated in Beijing, China, and spread to 29 countries. There were 8,096 total global cases  (compared to current 1.6 millions), and 774 deaths (compared to current 97,000), a fatality rate of 9.6%, compared to WHO’s March 3 estimate of 3.4%  for this virus.

MERS (Middle East Respiratory Syndrome), in 2002 (new infection cases still happening, not an epidemic),  was an epidemic of another viral respiratory disease of zoonotic origin, caused by another coronavirus called MERS-Cov. There were 2,494 cases and 858 deaths, fatality rate of 34.4%

The transmission rate, or basic reproduction number of a virus (Ro), is a measure of how contagious the virus is. The Ro of MERS-Cov was 0.3-0.8. The Ro of SARS-Cov-1 was 2-5. The estimate of the Ro of the current SARS-Cov-2 is 1.4-3.8.

Even though MERS’s fatality rate was much higher than the fatality rate of the current SARS, it was way less contagious. I figure, that’s one reason why MERS didn’t spread globally much, compared to the current SARS.

anita

Dear Reader:

Regarding #1 and 2 above: the infection cases in different areas within one country varies greatly, even in small countries. The areas most populated, with a bigger influx of people before lockdown measures, are the worst hit. So relaxing movement restrictions has to be custom made for each area within each country. The numbers in Worldometers, regarding the cases of infection in each country, as well as the graphs of daily new cases (reflecting the peaking and flattening of the curve), are averages. In reality, a flattening graph for a country, does not indicate a flattening graph in each and every area in that country.

Regarding #3 above, coronavirus in the Scandinavian countries, according to Wikipedia which has an entry for coronavirus in each country:

Denmark’s first confirmed case of Covid-19 was on Feb 27: it was a man who had  been skiing in Lombardy, Italy and returned to Denmark Feb 24. Denmark was among the first European countries to introduce lockdown measures, starting March 13.

Norway’s first confirmed case of Covid-19 was on Feb 26: a woman who returned from China the previous week. A national lockdown was announced on March 12: schools, kindergartens, fitness centers, hair salons etc. were closed, sport and cultural events and gatherings were banned, and restrictions applied to restaurants, in line with those introduced in other European countries like Denmark and Italy.

Finland’s first confirmed case of Covid-19 was on January 29: a Chinese tourist from Wuhan touring Finland tested positive for the virus. The Finnish government declared a state of emergency on March 16: all schools were closed, not including early education, theatres, libraries, museums, etc. shut down, public gatherings were limited to 10 people, and people  over the age of 70 were to avoid human contact, if possible, outsiders were forbidden from entering healthcare facilities and hospitals, including relatives of critically ill people.

Sweden’s first confirmed case of Covid-19 was on January 31: a woman returning from Wuhan tested positive. On February 26, following outbreaks in Italy and in Iran, multiple travel-related clusters appeared in Sweden.

But “Sweden has, unlike many other countries, not applied any lockdown, with most measures being voluntary.. The Public Health Agency and government of Sweden issues recommendations to work from home, if possible;  for people above 70 to stay at home; and issued general recommendations to avoid unnecessary travel within the country and to promote social distancing between people. Those with even minimal symptoms which could be Covid-19 are recommended to stay home”.

An April 9 article (time. com/ 5817412/ Sweden- coronavirus) reads: “As many public spaces throughout Europe empty out- with citizens only leaving for essential groceries or medication- life in Sweden is carrying on, mostly as usual. Children walk to school while adults meet up for dinner at their local bar.. Only the vulnerable have been advised to  isolate and some are working from home… The Swedish Public Health Agency.. does not call for lockdown measures”.

“Anders Tegnell, Sweden’s chief epidemiologist overseeing the government’s response to Covid-19 has said the government should allow the virus to spread slowly through the population, an approach initially employed by the United Kingdom and the Netherlands before both countries rapidly changed strategy… Tegnell told Swedish TV on April 5 that Covid-19 could be stopped by ‘herd immunity or a combination of immunity and vaccination.’ (A vaccine for Covid-19 is likely at least 14 months away). But many experts throughout Sweden say the current strategy is dangerous… the current approach will ‘probably end in a historical masacare’.

A doctor working in a hospital, who asked to remain anonymous, said that “healthcare workers at his hospital who have tested positive for the virus but are asymptomatic have been advised to continue working… Opinion polls show that citizens trust the Public Health Authority, with 48% saying they have very high or high confidence in the institution.. Swedes have above-average confidence in their politicians, who in turn, trust citizens to follow their advice.”

“Even though 40% of Swedish households are single-person households without children, some experts say that Covid-19 can still spread rapidly and widely in these conditions. Sweden has the second lowest number of critical care beds in Europe after Portugal, with only 5 beds for every 100,000 inhabitants, and the healthcare would likely be unable to handle a severe Covid-19 outbreak.”

Healthline. com/ health/ herd- immunity # takeaway, reads regarding herd immunity: “Herd immunity happens when so many people in a community become immune to an infectious disease that it stops the disease from spreading. It can happen in two  ways: 1. Many people contract the disease and in time build up an immune response to it (natural immunity). 2. Many people are vaccinated against the disease”.

“For some diseases, herd immunity can go into effect when 40 percent of the people in a population become immune to the disease, such as through vaccination. But in most cases, 80 to 95 percent of the population must be immune to the disease to stop its spread. For example, 19 out of every 20 people must have the measles vaccination for herd immunity to go into effect and stop the disease.”

“Natural immunity can help create herd immunity, but it doesn’t work as well as vaccinations. There are several reasons for this: Everyone would have to contract the illness once to become immune; Contracting an illness can have health risks, sometimes serious; You may not know if you’ve contracted an illness or if you’re immune to  it.”

“For most healthy people, herd immunity isn’t a good alternative to getting vaccinated.. You can help  build herd immunity to certain diseases in your community by making sure you and your family have up-to-date vaccinations.”

But of course, there is no vaccine for Covid-19.

“There are several reasons why herd immunity isn’t the answer to stopping the spread of the new coronavirus:

1. There isn’t yet a vaccine for SARS-Cov-2.

2. The research for antiviral and other medications to treat Covid-19 is ongoing.

3. Scientists don’t know if you can contract SARS-Cov-2 and develop Covid-19 more than  once.

4. People who contract SARS-Cov-2 and develop Covid-19 can experience serious side effects. Severe cases can lead to death…

8. Hospitals and healthcare systems may be overburdened if many people develop Covid-19 at the same time.”

Back to Worldometers:

Sweden had 10,151 cases yesterday, and 10,483 cases today (an increase of  332)

Norway had 6,403 cases yesterday, and 6,485 cases today (an increase of  82).

Finland had 2,905 cases yesterday, and 2,974 cases today (an increase of  69).

Denmark had 5,996 cases yesterday, and 6,174 cases today (an increase of 178).

anita

* Thank you for the note, sonu.

Dear Reader:

There will be lots of numbers in the following, many of these numbers are taken from worldometers, and from worldpopulationreview. com. For anyone who tends to get dizzy when exposed to many numbers, this is a warning!

The population density in the USA is 35 people per square kilometer. New York City (NYC) is the most densely populated city in the United States. According to 2018 numbers (Wikipedia), with over 8 million people, its population density is about 10,713 people per square kilometer. NYC is the reason why 34% of all US Covid-19 cases and 42% of all US Covid-19 deaths are in the state of New York.

The population density in Italy is 206 people per square km, 2,029 in Milan in the north, 2,263 in the most populated Rome. The population density in Spain is 91, and 779 in Madrid, the most populated city in Spain.

Let’s look at the Scandinavian countries: of the four, Denmark is the most densely populated: 134 people per square kilometer, 6 times more than Sweden (22 people per square km), almost 8 times more than Norway (17 people per square km), and more than 8 times than that of Finland (16 people per square km).

Oslo (Norway), has the population density of 1,400 people per square km, and part of Oslo (the Urban municipality) has the population density of 3,300 people per square km. Stockholm is the most populated city in Sweden with a population density of 4,800 people per square km. The most populated city in Finland is Helsinki with a population density of 3,050 people per square km, with a 16,494 people per square km in the inner city.

Most of the Covid-19 cases are in Sweden, almost 11,000 cases, next is Norway, just over 6,500, next  is Denmark, just over 6,300, and last is Finland with just over 3,000.

In Sweden the current number of deaths is 919:  91 deaths per one million (M) population.  Denmark: 285 deaths, 49 deaths per M, Norway: 133 deaths, 25 deaths per M, Finland: 59 deaths, 11 deaths per M,

Globally, 95% of the active cases are in mild condition and 5% of the cases are in a serious or critical condition. This 95%- 5% ratio has been consistent for the longest time. In Sweden, 91% are in mild condition, and 9% are in a serious or critical condition.

Leaving the Scandinavian countries for a moment, the USA, leading the world in numbers of cases and deaths, there are currently 22,115 deaths, 67 deaths per M. Spain: 17,489 deaths, 374 deaths per M. Italy: 19,899 deaths, 329 deaths per M.

My comment: there is a disproportionate number of Covid-19 deaths in Sweden: roughly 8 times that of Finland, 4 times that of Norway, and twice that of Denmark (even though Denmark is 6 times more populated than Sweden).

Going outside Scandinavia, Sweden has more deaths per M than the USA (91 compared to 67), but less than that of Spain and Italy (91 compared to 374 and 329 respectively).

Sweden is very different from Italy and Spain: 40% of Swedish households are single-person households without children, and 23% of households are of cohabitating or married couples living without children. On the other hand, Spain and Italy are known for their high rate of multi-generational families, all living together. In Spain, over half of people  between the ages of 25 and 29 are still living with their parents. In Italy, about 67% of 18-34 year old Italians live with their parents.

-it is a sort of a high population density within the home, which includes the aging, which are way more vulnerable to Covid-19 than the young.

Taken all the above into account, what is working for Sweden’s advantage is the overall low population density and rarity of multi-generational households (a sort of low population density outside and inside homes): the Daily New Cases in Sweden, worldometers, shows a decline in new cases since April 9, four days ago.

Sweden’s lax attitude toward the pandemic (having issued minimal restrictions on people’s movements, no lockdowns, and their herd immunity attitude), seems to correspond with more severe symptoms in  those infected and in more deaths.

It remains to be seen if Sweden’s new daily cases continues to decline (the flattening of the curve), and whether the significantly high number of deaths continue to rise.

anita

Dear Reader:

A follow up on Scandinavia, today’s numbers (worldometers):

Sweden: 11,445 cases, total deaths: 1,033 (9% of the number of cases), an increase of 114  deaths from yesterday (an 11% increase).Currently 102 deaths per million. 9% of patients are in serious or critical condition, 91% are in mild condition.

Denmark: 6,511 cases, total deaths: 299 (4.6% of the number of cases), an increase of 14 deaths from yesterday, (a 4.7 % increase). Currently 52 deaths per million. 3% of patients are in serious or critical condition, 97% are in mild condition.

Norway: 6,623 cases, total deaths: 139 (2% of the number of cases), an increase of 6 deaths from yesterday (a 4.3% increase). Currently 26 deaths per million. 4% of patients are in serious or critical condition, 96% are in mild condition.

Finland: 3,161 cases, total deaths: 64 (2% of the number of cases), an increase of 5 deaths from yesterday (a 7.8% increase). Currently 12 deaths per million . 3% of patients are in serious or critical condition, 97% are in mild condition.

anita

Dear Reader:

In this post (and future posts) I will refer to the coronavirus responsible for the 2002-2003 SARS epidemic as Cov-1 (short for SARS-Covid-1), and to the coronavirus responsible for the current SARS pandemic as Cov-2, short for SARS-Cov-2. I will refer to the SARS epidemic of 2002-03 as SARS,(Severe Acute Respiratory Syndrome), and to the current SARS pandemic as Covid-19 (Coronavirus Disease 2010).

www. businessinsider. com/ china-Wuhan-coronavirus-compared-to-sars-2020-1(paraphrased by me, plus quotes): The two viruses: Cov-1, responsible for the SARS epidemic of 2002-2003 (WHO declared the epidemic contained on July 5, 2003), and Cov-2, responsible for the current SARS pandemic (Covid-19) of 2019-?, share 80% of their genetic codes. The two viruses are zoonotic, meaning, they jumped from animals to humans. The original hosts of both were bats. Both were passed through the saliva and poop of bats to intermediate animals before jumping into humans.

Both Cov-1 and Cov-2 enter the host cell of animals/ humans by bonding to receptors in the animal/human lung cells, receptors that are called ACE2. But Cov-2 forms a bond with ACE2 that is ten times stronger than the bond Cov-1 formed with same receptor. This 10 times stronger bond between Cov-2 and the human lung receptor ACE2, can explain why Covid-19 is “so much more contagious than SARS and more easily jumps from person to person”.

Cov-2 “is nearly identical to other coronaviruses circulating in Chinese bat populations- 96% of the genetic codes match”.

www. medicalnewstoday. com/ articles/ how-do-sars-and-mers-compare-with-covid-19:

A summary comparison of SARS vs Covid-19:

* total number of cases-  SARS: 8,439 (87% of all cases were in China and Hong Kong, 29 countries and territories total); Covid-19 (current): 2,228,784. (264 times the number of SARS total cases, in 210 countries and territories).

* Number of cases in the U.S-  SARS: 73; Covid-19 (current): 686,431. (9,403 times the number of U.S SARS cases).

* Total number of deaths- SARS: 812; Covid-19 (current): 150,708. (185 times the number of SARS deaths).

* Case Fatality Rate (CFR)-  SARS: 9.6% (11% according to Wikipedia); Covid-19 current estimates: varies, most about 1.38%- 3.4%, SARS therefore has “significantly higher case fatality rates than Covid-19. Yet Covid-19 is more infectious” (Wikipedia: SARS Ro= 2-4, Covid-19: “Initial studies suggested ..a basic reproduction number of 2.2-2.7, but a study to be published on April 07, 2020 calculated a much higher median Ro value of 5.7%”). Ro is a basic reproduction number indicating how many people are infected by one infected person.

* The following are the same or similar for both: mode of transmission (droplets produced by breathing, talking, sneezing, coughing), mean incubation period (5 days), key symptoms are similar, and in both people with underlying medical conditions were/ are a risk group.

www. webmd. com/ lung/ news/ ..sars-timeline-of-outbreak(quotes):

Nov 16, 2002: the first case of an atypical pneumonia is reported in the Guangdon province of Southern China.

Feb 26, 2003: first cases of unusual pneumonia reported in Hanoi, Vietnam.

..March 11, 2003: a similar outbreak of a mysterious respiratory disease is reported among healthcare workers in Hong Kong.

March 12, 2003: WHO (World Health Organization) issues a global alert about a new infectious disease of unknown origin in both Vietnam and Hong Kong.

..March 15, 2003: CDC (US Center for Disease Control and Prevention) issues a travel advisory stating that persons considering travel to the affected areas in Asia (Hong Kong, Singapore, Vietnam and China).

March 17, 2003: an international network of 11 leading laboratories is established to determine the cause of SARS and develop potential treatments. And CDC holds its first briefing on SARS and says the first 14 suspected SARS cases are being investigated in the U.S.

..April 28, 2003: WHO removes Vietnam from list of SARS affected areas, making it the first country to contain SARS successfully. WHO also lifts travel advisory to Hanoi, Vietnam.

May 6, 2003: the CDC lifts its travel advisory for Singapore because no new cases of SAR had been reported in 20 days.

..May 17, 2003: WHO extends its travel warning to include Hebei Province, China.

..May 20, 2003: the CDC lifts its travel alert for Toronto, Canada, because more than 30 days have elapsed since the last case of SARS was reported there.

May 23, 2003: the WHO lifts its advisory against all but essential travel to Hong Kong and the Guangdong province of China saying the SARS situation in those areas has  improved significantly.

..June 24, 2003: WHO removes its last remaining SARS travel warning for Beijing, China.

My thoughts based on the above:

1. Coronaviruses, like all viruses, mutate. Cov-2 has 80% of the genome of Cov-1 which has been contained 17 years ago. Cov-2 has 96% of the genome of coronaviruses recently found in bats. This means that (very roughly and in a very simplified way), the virus mutated 16% in 17 years.

2. Both SARS and Covid-19, started in China: SARS started in China’s Guangdong Province, November 2002, and Covid-19 started in China’s Hubei Province (Wuhan), December 2019. SARS spread mostly in China and Hong Kong, and to total 29 countries and territories. Covid-19 spread to 210 countries and territories, and produced 9,403 more cases of infections so far, 185 times more deaths so  far.

Even though a higher percentage of Covid-1 infections ended in death (its mortality rate/ Case Fatality Rate/CFR is higher), Covid-2 produced 185 times more deaths than Covid-1, so far, because it is more contagious:

A lower percentage/CFR of a higher number of infections (because of a higher Ro) gives a bigger number of deaths than does a higher percentage/CFR of a lower number of infections (because of a lower Ro). In other words, a higher infection rate when not contained, and a lower mortality rate results in more deaths than a lower infection rate and a higher mortality.

3. The events of Nov 2002 through June 2003, a few of which I included above, are similar to what I expect to happen next during this pandemic, in that WHO, the CDC and other official organizations in different countries, will announce, as time goes by, new travel alerts, travel advisories, social restrictions, removals of alerts, removal of advisories, removal of restrictions, re-establishing alerts and restrictions and so on and on, in different areas within a country, in different countries, according to changing data, until a vaccine becomes readily available to the world population.

* On May 20, 2003, the CDC lifted its travel alert to Toronto, Canada  because “more than 30 days have elapsed since the last case of SARS was reported there”. There were about 400 cases of SARS infection in Canada, but more than 31,000 Covid-19 cases of infection in Canada currently. I imagine the CDC will not wait 30 days of having no new Covid-19 cases in any area before lifting a travel alert. I imagine alerts and restrictions will be lifted when the number of new infections per day, in an area, over time (the flattening of the curve) lessens, rather than the unimaginable, pre-vaccine situation of having zero new cases anywhere.

* In March 17, 2oo3, for the first time “an international network of 11 leading laboratories” was established to determine the cause of SARS (Cov-1) and develop potential treatments. Seventeen years later, a whole lot more laboratories, and international networks are working on studying Cov-2, developing treatments (shorter term) and vaccines (longer term). A lot more attention and resources are put in the effort now than 17 years ago.

More later.

anita

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