Coronavirus: Facts and Figures

There are a lot of questions flying around about the current coronavirus; How does Covid-19 compare with previous coronaviruses and the flu virus? What do infection numbers and the death rate tell us? Does the race for vaccine development make sense? What are the chances of success? Will the vaccine be safe?

It is only after answering these questions, and others like them, with sound information and substantiated facts that we can form an educated opinion on the corona crisis. Dr. Bhakdi and Dr. Reiss have set out to do just that. 

The following excerpt is from Corona, False Alarm? Facts and Figures by Karina Reiss Ph.D. and Sucharit Bhakdi MD. It has been adapted for the web.

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The first months of the year 2020 were characterised worldwide by a single nightmare: Corona. Dreadful images took wing from China, then from Italy, followed by other countries. Projections on how many countless deaths would occur were coupled with pictures of panic buying and empty supermarket shelves. The media in everyday life was driven by Corona, morning, noon and night for weeks on end. Draconian quarantine measures were established all over the world. When you stepped outside, you found yourself in a surreal world – not a soul to be seen, but instead empty streets, empty cities, empty beaches. Civil rights were restricted as never before since the end of the Second World War. The collapse of social life and the economy were generally accepted as being inevitable. Was the country under threat of such a dreadful danger to justify these measures? Had the benefits that could possibly be gained by these measures been adequately weighed against the subsequent collateral damage that might also be expected? Is the current plan to develop a global vaccination programme realistic and scientifically sound?

Our original book was written for the public in our country and this translated version is tilted toward the German narrative. However, global developments have advanced along similar lines, so that the basic arguments hold. We have replaced a number of local events in favour of pressing new issues regarding the question of immunity and the postulated need for development of vaccines against the virus.

Our intent is to provide readers with facts and background information, so that they will be able to arrive at their own conclusions. Statements should be regarded as the authors’ opinions that we submit for your scrutiny. Criticism and dissent are welcome. In scientific discussions, postulation of any thesis should also invite antitheses, so that finally the synthesis may resolve potential disagreement and enable us to advance in the interest of mankind. We do not expect all readers to share our points of view. But we do hope to ignite an open and much needed discussion, to the benefit of all citizens of this deeply troubled world.

How everything started

In December of 2019, a large number of respiratory illnesses were recorded in Wuhan, a city with about 10 million inhabitants. The patients were found to be infected with a novel coronavirus, which was later given the name SARS-CoV-2. The respiratory disease caused by SARS-CoV-2 was designated COVID-19. In China, the outbreak evolved into an epidemic in January 2020, rapidly spreading around the globe. ^{1, 2, 3}

Coronaviruses: the basics

Coronaviruses co-exist with humans and animals worldwide, and continuously undergo genetic mutation so that countless variants are generated. ^{4, 5} “Normal” coronaviruses are responsible for 10–20% of respiratory infections and generate symptoms of the common cold. Many infected individuals remain asymptomatic. ⁶ Others experience mild symptoms such as unproductive cough, whilst some additionally develop fever and joint pains. Severe illness occurs mainly in the elderly and can take a fatal course, particularly in patients with pre-existing illnesses, especially of heart and lung. Thus, even “harmless” coronaviruses can be associated with case fatality rates of 8% when they gain entry to nursing homes. ⁷ Still, due to their marginal clinical significance, costly measures for diagnosing coronavirus infections are seldom undertaken, searches for antiviral agents have not been prioritised, and vaccine development has not been subject to serious discussion.

Only two members of the coronavirus family reached world headlines in the past.

SARS virus (official name: SARS-CoV) entered the stage in 2003. This variant caused severe respiratory illness with a high fatality rate of approximately 10%.

Fortunately, the virus turned out not to be highly contagious, and its spread could be contained by conventional isolation measures. Only 774 deaths were registered worldwide. ^{8, 9} Despite this manageable danger, fear of SARS led to a worldwide economic loss of 40 billion US dollars. ⁸ Coronaviruses subsequently faded into the background. A new variant, MERS-CoV, emerged in the Middle East in 2012 and caused life-threatening disease with an even higher fatality rate of more than 30%. But contagiousness of the virus was also low and the epidemic was rapidly brought under control. ¹⁰

China: the dread threat emerges

When the news came from China that a new coronavirus family member had appeared on stage, the most pressing question was: would it be harmless like its “normal” relatives or would it be SARS-like and highly dangerous? Or worse still: highly dangerous and highly contagious?

First reports and disturbing scenes from China caused the worst to be feared. The virus spread rapidly and with apparent deadly efficacy. China resorted to drastic measures. Wuhan and five other cities were encircled by the army and completely isolated from the outside world.

At the end of the epidemic, official statistics reported about 83,000 infected people and fewer than 5,000 fatalities, ¹¹ an infinitesimally small number in a country with 1.4 billion inhabitants. Either the lockdown worked or the new virus was not so dangerous after all. Whatever the case, China became the shining example on how we could overcome SARS-CoV-2.

More disturbing news then came from northern Italy. Striking swiftly, the virus left countless dead in its wake. Media coverage likened the situation to “war-like conditions.” ¹² What was not reported was that in other parts of Italy, and also in most other countries, the “fatality rate” of COVID-19 was considerably lower.^{13, 14}

Could it be that the intrinsic deadliness of one and the same virus varied, depending on the country and region it invaded? Not very likely, it seemed.

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References:

1. “Coronavirus Disease (COVID-19) Weekly Epidemiological Update and Weekly Operational Update,” World Health Organization, last accessed August 26, 2020, https://www.who.int /emergencies/diseases/novel-coronavirus-2019/situation-reports.
2. Chih-Cheng Lai et al., “Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Coronavirus Disease-2019 (COVID-19): The Epidemic and the Challenges,” International Journal of Antimicrobial Agents 55, no. 3 (March 2020): 105924, https://doi.org/10.1016/j.ijantimicag.2020.105924.
3. Catrin Sohrabi et al., “World Health Organization Declares Global Emergency: A Review of the 2019 Novel Coronavirus (COVID-19),” International Journal of Surgery 76 (April 2020): 71–76, https://doi.org/10.1016/j.ijsu.2020.02.034.
4. Shuo Su et al., “Epidemiology, Genetic Recombination, and Pathogenesis of Coronaviruses,” Trends in Microbiology 24, no. 6 (June 2016): 490–502, https://doi.org/10.1016/j.tim.2016 .03.003.
5. Jie Cui, Fang Li, and Zheng-Li Shi, “Origin and Evolution of Pathogenic Coronaviruses,” Nature Reviews Microbiology 17 (2019): 181–92, https://doi.org/10.1038/s41579-018-0118-9.
6. Yanis Roussel et al., “SARS-CoV-2: Fear Versus Data,” International Journal of Antimicrobial Agents 55, no. 5 (May 2020): 105947, https://doi.org/10.1016/j.ijantimicag .2020.105947.
7. David M. Patrick et al., “An Outbreak of Human Coronavirus OC43 Infection and Serological Cross-Reactivity with SARS Coronavirus,” Canadian Journal of Infectious Diseases and Medical Microbiology 17, no. 6 (November–December 2006): 330–36, https://www.ncbi.nlm.nih.gov/pmc/articles /PMC2095096.
8. Kelvin K. W. To et al., “From SARS to Coronavirus to Novel Animal and Human Coronaviruses,” Journal of Thoracic Disease 5, no. S2 (August 2013): S103–8, http://doi.org/10.3978/j.issn .2072-1439.2013.06.02.
9. “SARS (Severe Acute Respiratory Syndrome),” National Health Service (UK), last reviewed October 24, 2019, https://www.nhs .uk/conditions/sars.
10. “Middle East Respiratory Syndrome Coronavirus (MERS-CoV),” World Health Organization, https://www.who.int/emergencies /mers-cov/en.
11. “COVID-19 Coronavirus Pandemic,” Worldometer, https://www .worldometers.info/coronavirus.
12. Benjamin Reuter, “Coronavirus lässt in Italien Ärzte verzweifeln—Entscheidungen wie in Kriegszeiten,” Der Tagesspiegel (Berlin), March 12, 2020, https://www.tagesspiegel .de/wissen/drohen-in-deutschlanditalienische-verhaeltnisse -coronavirus-laesst-in-italienaerzteverzweifeln-entscheidungen -wie-in-kriegszeiten/25632790.html.
13. Ciro Indolfi and Carmen Spaccarotella, “The Outbreak of COVID-19 in Italy: Fighting the Pandemic,” JACC: Case Reports 2, no. 9 (July 2020): 1414–18, https://doi.org/10.1016/j.jaccas .2020.03.012.
14. Max Roser et al., “Coronavirus Pandemic (COVID-19),” Our World in Data, last updated August 26, 2020, https://ourworld indata.org/mortality-risk-covid.

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