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Most Coronavirus Cases Are Mild. That’s Good and Bad News. Most Coronavirus Cases Are Mild. That’s Good and Bad News.
(about 16 hours later)
HONG KONG — As a dangerous new coronavirus has ravaged China and spread throughout the rest of the world, the outbreak’s toll has sown fear and anxiety. Nearly 3,000 deaths. More than 82,000 cases. Six continents infected.HONG KONG — As a dangerous new coronavirus has ravaged China and spread throughout the rest of the world, the outbreak’s toll has sown fear and anxiety. Nearly 3,000 deaths. More than 82,000 cases. Six continents infected.
But 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.But 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.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.”“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.”
Much about the virus remains unknown, and the danger could intensify as it travels through the rest of the world. But based on existing information, here’s what experts say about the severity of the virus.Much about the virus remains unknown, and the danger could intensify as it travels through the rest of the world. But based on existing information, here’s what experts say about the severity of the virus.
Of the 44,672 coronavirus cases that were confirmed in China by Feb. 11, more than 36,000 — or 81 percent — were mild, according to a study published recently by the Chinese Center for Disease Control and Prevention.Of the 44,672 coronavirus cases that were confirmed in China by Feb. 11, more than 36,000 — or 81 percent — were mild, according to a study published recently by the Chinese Center for Disease Control and Prevention.
[Read: 10 Chinese readers share their stories of the coronavirus crisis.][Read: 10 Chinese readers share their stories of the coronavirus crisis.]
Cases were considered mild if they did not involve pneumonia, defined as infection of the lungs, or involved only mild pneumonia, the authors wrote in the study, which is among the largest to date of the new coronavirus.Cases were considered mild if they did not involve pneumonia, defined as infection of the lungs, or involved only mild pneumonia, the authors wrote in the study, which is among the largest to date of the new coronavirus.
There were two other categories of cases, severe and critical. Severe cases featured shortness of breath, low blood oxygen saturation or other lung problems. Critical cases featured respiratory failure, septic shock or multiple organ dysfunction.There were two other categories of cases, severe and critical. Severe cases featured shortness of breath, low blood oxygen saturation or other lung problems. Critical cases featured respiratory failure, septic shock or multiple organ dysfunction.
Just under 14 percent of patients were severe, and just under 5 percent critical.Just under 14 percent of patients were severe, and just under 5 percent critical.
The overall fatality rate in China was 2.3 percent. But that number was inflated by the much higher fatality rate in Hubei Province, of 2.9 percent, compared with a rate of just 0.4 percent in the rest of the country. The seasonal flu, by comparison, has a mortality rate of about 0.1 percent.The overall fatality rate in China was 2.3 percent. But that number was inflated by the much higher fatality rate in Hubei Province, of 2.9 percent, compared with a rate of just 0.4 percent in the rest of the country. The seasonal flu, by comparison, has a mortality rate of about 0.1 percent.
The true fatality rate could be even lower, given that many mild or asymptomatic cases may not have been reported to the authorities.The true fatality rate could be even lower, given that many mild or asymptomatic cases may not have been reported to the authorities.
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.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.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.”“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.Even among patients who do go see a doctor, “it could still be very mild, just like a flu,” he added.
As the Chinese Center for Disease Control’s study showed, some mild cases may involve pneumonia. They may also include mild fatigue and low fever, according to a treatment plan released by the central Chinese government.As the Chinese Center for Disease Control’s study showed, some mild cases may involve pneumonia. They may also include mild fatigue and low fever, according to a treatment plan released by the central Chinese government.
A small study of 99 confirmed coronavirus patients in Wuhan, published in the medical journal, The Lancet, found that most of the patients had fever or cough when they were admitted to the hospital, and some had shortness of breath or muscle ache. The study did not distinguish between mild, severe and critical cases.A small study of 99 confirmed coronavirus patients in Wuhan, published in the medical journal, The Lancet, found that most of the patients had fever or cough when they were admitted to the hospital, and some had shortness of breath or muscle ache. The study did not distinguish between mild, severe and critical cases.
There is no doubt that the virus can be dangerous, especially for critical cases. Of those patients, 49 percent died, according the study by the Chinese Center for Disease Control.There is no doubt that the virus can be dangerous, especially for critical cases. Of those patients, 49 percent died, according the study by the Chinese Center for Disease Control.
But critical cases made up just a tiny fraction of the total caseload in the study.But critical cases made up just a tiny fraction of the total caseload in the study.
By Thursday, of the 78,487 confirmed cases in China, 32,495, or 41 percent, had been discharged from the hospital, according to China’s National Health Commission. About 8,300 of the remaining patients were in serious condition. More than 2,700 people have died in China.By Thursday, of the 78,487 confirmed cases in China, 32,495, or 41 percent, had been discharged from the hospital, according to China’s National Health Commission. About 8,300 of the remaining patients were in serious condition. More than 2,700 people have died in China.
Many of the deaths have occurred in Hubei Province, where the outbreak began, and where the demand for care has overwhelmed medical staff. The high mortality rate there could have dangerous implications for developing countries. Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, has warned repeatedly of the toll the virus could exact in places with weak health systems.
Updated June 22, 2020Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Many of the deaths have occurred in Hubei Province, where the outbreak began, and where the demand for care has overwhelmed medical staff. The high mortality rate there could have dangerous implications for developing countries. Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, has warned repeatedly of the toll the virus could exact in places with weak health systems.
But for mild cases, the virus is likely “self-limiting,” Dr. Jin said, meaning that symptoms will go away on their own, as with the flu and common cold.But for mild cases, the virus is likely “self-limiting,” Dr. Jin said, meaning that symptoms will go away on their own, as with the flu and common cold.
The number of mild cases, though, creates its own complications for curbing the virus’s spread.The number of mild cases, though, creates its own complications for curbing the virus’s spread.
Those with mild or no symptoms may not know they have contracted the virus, or may pass it off as a seasonal cold. They may then continue in their daily lives — traveling, kissing, coming into close contact with others — and spread the virus without anyone knowing.Those with mild or no symptoms may not know they have contracted the virus, or may pass it off as a seasonal cold. They may then continue in their daily lives — traveling, kissing, coming into close contact with others — and spread the virus without anyone knowing.
“In this manner, a virus that poses a low health threat on the individual level can pose a high risk on the population level, with the potential to cause disruptions of global public health systems and economic losses,” a group of five scientists wrote in the New England Journal of Medicine last week.“In this manner, a virus that poses a low health threat on the individual level can pose a high risk on the population level, with the potential to cause disruptions of global public health systems and economic losses,” a group of five scientists wrote in the New England Journal of Medicine last week.
There are, broadly speaking, two possible outcomes of the current outbreak, Dr. Jin said. The new virus could, like SARS, another well-known coronavirus, become less and less transmissible as it spreads around the world, eventually dying out.There are, broadly speaking, two possible outcomes of the current outbreak, Dr. Jin said. The new virus could, like SARS, another well-known coronavirus, become less and less transmissible as it spreads around the world, eventually dying out.
Alternatively, the new coronavirus could become well established in humans, becoming a kind of recurring, seasonal nuisance, like the flu, Dr. Jin said. In that situation, people would learn to live with it, and sometimes would contract illnesses from it; but the virus would most likely also lose some of its dangerousness as time went on. Experts could also develop a vaccine, Dr. Jin added.Alternatively, the new coronavirus could become well established in humans, becoming a kind of recurring, seasonal nuisance, like the flu, Dr. Jin said. In that situation, people would learn to live with it, and sometimes would contract illnesses from it; but the virus would most likely also lose some of its dangerousness as time went on. Experts could also develop a vaccine, Dr. Jin added.
Several medical experts have said that those who have been infected with the coronavirus will not become infected again, as their bodies will produce antibodies that provide immunity.Several medical experts have said that those who have been infected with the coronavirus will not become infected again, as their bodies will produce antibodies that provide immunity.
“As long as the virus doesn’t evolve, there is no chance of being infected again,” Dr. Lu Hongzhou, a public health professor in Shanghai, said on Tuesday in an interview with Beijing News.“As long as the virus doesn’t evolve, there is no chance of being infected again,” Dr. Lu Hongzhou, a public health professor in Shanghai, said on Tuesday in an interview with Beijing News.
And that immunity should extend even to those who had mild or even asymptomatic infections. “Anyone recovered from the infection should have useful antibodies,” Dr. Jin said.And that immunity should extend even to those who had mild or even asymptomatic infections. “Anyone recovered from the infection should have useful antibodies,” Dr. Jin said.
The body’s natural immune response is the reason the Chinese authorities have asked recovered patients to donate blood plasma, in the hopes that their antibodies could be used to treat sick patients. The government has also prescribed antiviral drugs and traditional Chinese medicine as treatment methods.The body’s natural immune response is the reason the Chinese authorities have asked recovered patients to donate blood plasma, in the hopes that their antibodies could be used to treat sick patients. The government has also prescribed antiviral drugs and traditional Chinese medicine as treatment methods.