Epidemic, pandemic, outbreak. The media says all sorts of things, but what does Science have to say? What are the opinions, based on knowledge and data? What are the consequences of incorrect information?
In the last few hours the coronavirus emergency in Italy seems to have triggered an almost Hollywood-like psychosis from disaster movies, with food supply runs with the expectation of having to stay isolated at home for months, and supermarkets therefore plundered.
The latest statistics suggest that there are three confirmed deaths in our peninsula and more than 150 cases, turning Italy into the third country in the world with more cases (here are the official statistics).
But what do the experts say about the coronavirus, or rather SARS-CoV2, infections that cause the respiratory syndrome called COVID-19? I have collected several opinions that I’ve briefly summarized.
THE EXPERTS’ OPINION
Dr. Burioni, from the University Vita-Salute del San Raffaele in Milan says: “There is only one way to stop the virus: quarantine for those arriving from China“. The Professor also adds that “the potential mortality rate of COVID-19 is comparable to that of the Spanish Flu, which killed millions of people in Europe between 1918 and 1920“.
Dr. Gismondo, Director of the Complex Structure, Clinical Microbiology, Virology and Bioemergence Diagnostics at the Sacco Hospital in Milan says: “It sounds crazy to me. We mistook an infection barely more serious than a flu for a deadly pandemic. It’s not like this.” Then he adds: “Our lab has been running tests all night. Samples are coming in all the time.”
Dr. Capua, Director of the One Health Center of Excellence Florida University, says: “Italy is experiencing a more critical situation because it’s looking for cases more actively than others. It’s a flu-like syndrome caused by coronavirus. If it is a pandemic, we can only say when we will have diagnostic tests applied throughout Europe“.
Dr. Maga, Director of the CNR-IGM in Milan says that: “The infection, from the epidemiological data available on tens of thousands of cases, causes mild/moderate symptoms (a kind of flu) in 80-90% of cases. In 10-15% of cases, pneumonia can develop, the course of which is, however, benign in the absolute majority. It is estimated that only 4% of patients require hospitalization in intensive care“.
Dr. Lopalco, of the University of Pisa, argues instead that it is “presumable that the coronavirus SARS-CoV2 began to circulate in Italy towards the end of January, when the alert was not yet at its maximum and flights were not being blocked. Several subjects may have caught the infection without realizing it. So, what we are seeing is already the third-generation of cases“.
OPTIMISM SEEMS TO BE LEAKING OUT, BUT…
These are five authoritative opinions, and all agree that this is not an epidemic, given the number of known people infected and most of them agree that it is a serious flu. The only voice out of the chorus on the severity of SARS-CoV2 is Dr. Burioni’s, based on the fact that out of about 150 confirmed cases, 25 are recuperating.
However, for the sake of completeness of information, it must be said, as pointed out by Dr. Lopalco, that the number of infected is probably much higher, and this would drastically decrease the percentage of patients in recuperation.
Moreover, the mortality rate would also have to be reviewed, in light of the number of infected people who did not turn to hospital facilities in China and presumably also in this case, the mortality rate would decrease from about 2.5% to a percentage close to that of “normal” influenza.
Opinions are also back in favor of the available diagnostic systems. Dr. Burioni clearly states that molecular diagnostic tests, carried out in the first days after infection are not effective because the so-called “viral load” in saliva is not detectable by the test. Therefore, the number of infected people can easily be underestimated, as Dr. Lopalco claims.
SO WHAT ARE THE DIFFERENCES BETWEEN THE FLU AND THE CORONAVIRUS?
Both originate from RNA viruses but influenza is well-known, it repeats every year; in fact it is called seasonal influenza syndrome (it occurs in Winter). Our body is used to this infection, and even though the virus changes each year, our antibodies are partially active. In addition, a flu vaccine is available and is developed every year, based on changes in the RNA of the virus.
Although the influenza virus is quite well-known and there is a vaccine, we must not forget that each year, more than six million (6 000 000) people in Italy are infected, and there are between 300 and 400 direct deaths, while there are between three-and-four, to ten thousand (10 000) deaths among those who develop serious complications, due to influenza viruses.
SARS-CoV2, on the other hand, is a virus that presumably has just encountered our body for the first time, so our immune defenses have no memory and consequently there are no antibodies already active. Moreover, for the same reason, there is no vaccine already available.
A final (but significant) difference between influenza virus and SARS-CoV2 is that influenza weakens the body and makes it attackable by bacteria that are the cause of pneumonia. While it is the same SARS-CoV2 coronavirus that causes pneumonia without the need for bacteria to intervene. This perhaps makes it more aggressive than the flu virus, which has yet to be proven.
In conclusion, the situation is to be kept under control, but we should not worry about it to the point of looting supermarkets and locking ourselves indoors, waiting for the SARS-CoV2 coronavirus “event” to disappear as it did. Unfortunately, as Dr. Capua says, this will not be the last case, but because of globalization and the intense movement of people between continents, we must prepare ourselves to face similar situations in the future.
Rather, we follow the instructions of Doctors and the Ministry of Health very carefully (i.e. we avoid crowded places, we wash our hands often, we don’t touch our eyes, nose and mouth with our hands, we don’t take antiviral drugs or antibiotics unless prescribed by a Doctor). Let’s also remember that the people really in danger are the ones over 65, especially if they are diabetics, heart patients, heavy smokers, or the chronically ill. These are the people we must help the most.
FINALLY, A PIECE OF ADVICE ON MASKS
I would add that if we want to further protect ourselves with a mask, the only one that really protects against viruses is called FFP3; all the others, including green or blue surgical masks, are totally useless.
This post is also available in: Italiano