Update on Corona Virus 19

By | April 3, 2020

( The New England Journal of Medicine Editorial 3/26/20 A.S. Fauci, MD., H. Clifford Lane,MD, and Robert R. Red field , MD., pages 1268 to 1269.
The effect of the virus is measured by its
transmissibility( Ro) x severity of illness
Transmissibility(Ro) 2.2
This means that on average each infected individual transmits the infection to just over 2 uninflected people.
A value of 1.0 or higher means the virus will continue to spread.
By social distancing and quarantining the population we act to reduce the Ro value to 1 or less, meaningful the virus can not spread at a rate to sustain itself and it ultimately comes under better control.
Severity:  estimates of rates of death of those infected vary widely from 1.4 to 2 %. Because we do not know the overall number of infected cases in the US, and because it is likely to be greater than presently know, the rate of death may be less than 1%. The problem is so many people will get the infection, whether symptomatic or not, that the overall number of deaths is estimated to be 100000 to 250000 people with the best adherence to stay at home and social distancing.
The sooner these measures were initially instituted, and the better our adherence to them now, the sooner the virus is eliminated. We all need to adhere to these measures, in fact it is our social and moral obligation. However, the severity of our current predicament would have been less  severe if our government had acted proactively (including the specifics of this virus, our inability to test, and the need for protective equipment).
Now it is up to us, our State and local governments.
An additional piece of information for all of our sick patients at home. Be aware that the need for hospitalization is rare, and averaged 9 to 12.5 days after onset of illness (Li, et al). If a fever develops,  it is also delayed , usually occurring several days after illness develops.

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