Here is part of an article by Dr. Lisa Sanders, an internist on the faculty of Yale medical school, that appeared in the March 24, 2020 New York Times Science section:
The symptoms of Covid-19, the disease caused by the new coronavirus, clearly cover a broad spectrum of illness, ranging from life-threatening pneumonia to what seems like a really bad cold....
As a physician, a close look at these cases taught me new things. While I knew that there were milder cases of Covid-19, I didn't know what the mild form would look like. None of the Facebook cohort had a cough or chest pain. None felt short of breath. I thought these lower respiratory symptoms were the sine qua non of the infection. They're not. They are the characteristics of the serious edge of the illness.
These folks had none of that. They had body aches; most had a fever; many had nausea; some, vomiting. Widespread testing showed us the milder version of the disease, and that's been useful.
A rendering of the coronavirus provided by the Centers for Disease Control and Prevention. |
the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.
Here is part of a February 28 news article by Vivian Wang of the New York Times:
government officials and medical experts, in their warnings about the epidemic, have also sounded a note of reassurance: Though the virus can be deadly, the vast majority of those infected so far have only mild symptoms and make full recoveries.
It is an important factor to understand, medical experts said, both to avoid an unnecessary global panic and to get a clear picture of the likelihood of transmission.
"Many people are now panicking, and some actually are exaggerating the risks," said Dr. Jin Dongyan, a virology expert at the University of Hong Kong. "For governments, for public health professionals — they also have to deal with these, because these will also be harmful."...
Mild cases are inherently difficult for scientists to describe, because those with limited symptoms may not seek medical care. Scientists have also said that people can be infected but not show any symptoms at all.
For many with mild infections, the coronavirus could be virtually indistinguishable from the common cold or seasonal flu, said Dr. Jin of the University of Hong Kong...
"Some of these patients, they just go unrecognized," he said. "It could be just as small as a sore throat. Then one day, two days, it's gone."
Even among patients who do go see a doctor, "it could still be very mild, just like a flu," he added.
Dr. Jin had postdoctoral training at the National Institutes of Health in the United States, and Vivian Wang, the Times reporter who interviewed him, is a graduate of Yale.
Here is an article from the Lancet, the British medical journal, about the first known person-to-person transmission of SARS-CoV-2, or this novel coronavirus, in the United States. It reports,
Patient 1—a woman in her 60s—returned from China in mid-January, 2020. One week later, she was hospitalised with pneumonia and tested positive for SARS-CoV-2. Her husband (Patient 2) did not travel but had frequent close contact with his wife. He was admitted 8 days later and tested positive for SARS-CoV-2. Overall, 372 contacts of both cases were identified; 347 underwent active symptom monitoring, including 152 community contacts and 195 health-care personnel. Of monitored contacts, 43 became persons under investigation, in addition to Patient 2. These 43 persons under investigation and all 32 asymptomatic health-care personnel tested negative for SARS-CoV-2.
In other words, according to this article, "Person-to-person transmission of SARS-CoV-2 occurred between two people with prolonged, unprotected exposure while Patient 1 was symptomatic. Despite active symptom monitoring and testing of symptomatic and some asymptomatic contacts, no further transmission was detected."
The point of sharing these articles is not to suggest that anyone should stop washing their hands frequently. It's not to suggest that the novel coronavirus, or Covid-19, should be taken casually.
It is, though, enough to make at least two points that are worth making.
First, it isn't just former Fox Business Channel anchors like Trish Regan, or President Trump himself, or cranky libertarian bloggers, who are making or providing a platform to the flu comparison. It has been impeccably mainstream, establishment-credentialed physicians and academics and journalistic outlets.
Second, you'd have to be playing fairly close attention to notice these articles. One Times article appeared on page A12. Another appeared on page D6 under the yawn-inducing headline "Tracking a Virus's Path, a Case at a Time." The Times front page, meanwhile, is devoted to the more alarming, or alarmist, articles about the overwhelmed paramedics, Elmhurst Hospital in Queens, and "disaster mode" at Brooklyn Hospital Center. It's all much more gripping reading than telling about someone with a sore throat who recovers in two days.
My point here is not to criticize the Times for its story selection and placement or for telling the grim stories. The fact that "Most Coronavirus Cases Are Mild," as the Times headline over the Vivian Wang article put it, isn't much consolation to the families of the 672 New Yorkers whose deaths have so far been attributed to Covid-19. No one, myself included, wants to give anyone a false sense of security or imaginary sense of invincibility. But the warning by medical experts conveyed by the Times "to avoid an unnecessary global panic" is also one worth heeding. Context and perspective are crucial.