Infectious disease specialists and health experts say that while the number of cases of the new coronavirus will likely continue to grow in the United States, the current case fatality rate appears to be an overestimation.
Cases of the virus have jumped over the past few days, now with more than 1,000 confirmed across the United States, according to data compiled by the Center for Systems Science and Engineering (CSSE) at John Hopkins University. As of this writing, there have been at least 32 coronavirus-linked deaths.
WHO Director-General Tedros Adhanom Ghebreyesus said on March 3 that the global case fatality rate is “about 3.4 percent.” But a handful of public health experts told The Epoch Times that the case fatality rate in the United States is lower than the 2 or 3 percent currently estimated. The case fatality rate is “the proportion of persons with a particular condition who die from that condition,” according to the Centers for Disease Control and Prevention (CDC).
Harry Scholtz, vice president of infectious disease and infection prevention at BEAM Telemedicine and Healthcare, told The Epoch Times that the estimated fatality rate is “likely an overestimate.”
“It disproportionately includes elderly patients with medical conditions and not anyone who was untested and recovered fully,” Scholtz, an infectious disease physician, said.
At the same time, the incubation period for coronavirus can be as long as 24 days, according to the largest study analyzing patients of the disease so far. This is another indication that the number of actual cases is likely higher than reported. Some patients are also testing positive for the virus while showing no symptoms at all, according to a letter published in The New England Journal of Medicine.
“Young people (under 15) had no severe illness whatsoever,” Scholtz said. “It could be that they already possess antibodies that provide protection against COVID-19, or their immune systems are better able to fight off the virus.”
The outbreak of the virus first emerged in the central Chinese city of Wuhan in December 2019. A number of U.S. states across the country have also declared public emergencies over the virus.
Dr. Aimee Ferraro, a faculty member of Walden University’s Master of Public Health program who conducts research on infectious and vector-borne diseases internationally, also said the death rate of the virus is likely lower than any current estimates.
“As of March 10, there are 754 cases and 28 deaths from coronavirus in the United States, making the mortality rate 3.7 percent,” she told The Epoch Times via email. “However, this number does not account for asymptomatic and undiagnosed cases, so the true mortality rate is probably much lower.
“Mortality rate estimates will become more accurate as more data is collected on mild, moderate, and severe cases of coronavirus.”
On March 11, the numbers have already shifted in this direction, with 1,135 reported cases and 32 deaths, giving a mortality rate of 2.8.
Among the deaths in the United States, most stemmed from Washington state, specifically in King County, and involved older adults who already had underlying health conditions. Life Care Center, a nursing home in the county, is on lockdown over cases of COVID-19, and a number of staff members and residents have exhibited flu-like symptoms.
Of the 20 deaths reported in King County, 19 “are associated with Life Care Center,” according to local health officials. Many of the fatalities involved people over the age of 70.
Meanwhile, President Donald Trump called the 3.4 percent figure by the WHO “really a false number” in a March 4 interview on Fox News, saying he believes the actual rate is much lower.
“They don’t know about the easy cases, because the easy cases don’t go to the hospital. They don’t report to doctors or the hospital in many cases. So I think that that number is very high,” Trump said. “Personally, I would say the [mortality rate] is way under 1 percent.”
Scholtz said the coronavirus doesn’t appear to be very deadly “when compared with SARS and MERS, which had a mortality rate of about 9 percent and 34 percent, respectively.” But he said cases in the United States will continue to rise, “and probably more steeply in the coming weeks or months,” citing “increased availability of testing rather than an actual increase in infections.”
“As we gather more information about the total number of cases, my suspicion is that we will find this virus to be less deadly than currently thought,” Scholtz said.
“I do not think that the mortality from this will increase in the United States, and on the contrary, I expect that it will decrease as people present earlier and treatment becomes more standardized.”
Of the more than 121,000 confirmed cases of the virus globally, more than 66,000 have recovered as of this writing, according to data collected by Johns Hopkins University. More than 4,300 deaths have been reported globally, though data coming from China or Iran is thought to be more optimistic than presented.
Dr. Taylor Graber, a resident anesthesiologist at the University of California–San Diego, said most of the individuals who contract the virus will “experience nothing more than mild symptoms, similar to many other seasonal upper respiratory viruses.”
“More than 80 percent of cases result in very mild symptoms, which don’t require interaction with the health care system or hospital care,” he told The Epoch Times.
Mild cases are likely to not be reported in the total number of confirmed cases. Graber said more severe cases can lead to increased inflammatory stress on the body, possibly culminating in respiratory failure. The symptoms in more serious cases include fever, cough, and shortness of breath.
Dr. Rishi Desai, a former epidemic intelligence service officer at the CDC’s Division of Viral Diseases, told The Epoch Times that the most concerning difference between coronavirus and the flu is “how quickly COVID-19 spreads and its mortality rate.”
Desai didn’t dispute the official U.S. mortality rate.
“COVID-19’s R-naught is around 2.3, which means that for every one person that gets sick, 2.3 people will be infected,” Desai said via email. R-naught is also referred to as the basic reproduction number.
“During a bad flu season, influenza has an R-naught of 1.3 and a mortality rate of 0.1 percent,” he said.
Influenza also has vaccines that have 50 to 60 percent vaccine efficacy “and can be treated with medications like Oseltamivir,” Desai said, adding that the coronavirus has no vaccine, and a vaccine isn’t likely to be available for quite some time. Top U.S. officials have publicly stated that a vaccine could likely be developed by the end of the year or early next year.
CDC estimates that “so far this season, there have been at least 34 million flu illnesses, 350,000 hospitalizations, and 20,000 deaths from flu.”
The predominant way the virus spreads is when it is flung from one person to another as they “cough or sneeze,” Desai said. He said the most likely way a person can get infected is through the eyes, nose, and mouth, adding that if those areas were touched less, the risk is “significantly lower.”
Scholtz added that influenza can also be quite severe for young healthy persons.
While the coronavirus and influenza are both respiratory illnesses that are contagious and transmitted in a similar way—through droplets containing the virus—Ferraro said that “coronavirus may also spread through airborne transmission, which means the virus may remain in tiny droplets in the air even when the infected person is no longer near.”
U.S. officials are also urging Americans to travel less and to avoid large groups of people. Santa Clara County, a large area in California that includes Silicon Valley, on March 10 banned mass gatherings of 1,000 or more people due to the coronavirus.
Elderly and vulnerable Americans should travel less and avoid large groups of people, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on March 8.
“If you’re a person with an underlying condition, and you are particularly an elderly person with an underlying condition, you need to think twice about getting on a plane, on a long trip,” Fauci told NBC on March 8.
Fauci said while authorities are getting a “better sense” of the scope of the outbreak, “unfortunately, that better sense is not encouraging, because we’re seeing community spread.”