2019 Coronavirus: What You NEED TO KNOW – Dr. Peter Openshaw on The James Altucher Show

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Key Takeaways

  • The 2019 Novel Coronavirus (2019-nCoV), as of writing, is thought to have a 2% fatality rate 
    • Given the fact that not everyone who’s infected seeks treatment at a hospital, this number could be much lower  
  • Compared to SARS, the coronavirus seems to be less fatal (SARS had a 10% fatality rate) but more infectious 
  • On the Chinese containment efforts:
    • “I think it’s too early to give up on containment. It’s important that we continue to try to contain the coronavirus as best we can. The best outcome we have is that we manage to contain it. But we have to plan for the reality that it might not be containable because it just seems to spread so well.”Dr. Peter Openshaw
  • If you think you have the coronavirus:
    • DON’T go to a hospital and sit in a crowded waiting room, infecting tons of other people
    • DO call your local medical hotline, explain your situation, and quarantine yourself
  • On the coronavirus epidemic: “There’s no point in getting panicked over this, but I do think we need to be concerned.” Dr. Peter Openshaw

Intro

  • Host – James Altucher (@jaltucher)
  • Dr. Peter Openshaw (@p_openshaw) is a clinician and scientist specializing in lung immunology

Let’s Be Clear

  • Scientists identify the form of the coronavirus that originated in Wuhan, China as the “2019 Novel Coronavirus (2019-nCoV)”
    • In the remainder of this post, we’ll simply refer to the 2019-nCoV as the “coronavirus”

The Stats

  • As of writing, 40,660 people are thought to have been infected with the coronavirus; 910 have died
  • Given this data, the coronavirus has a fatality rate (the chance of death if infected) of 2%
    • (Fatality rate = number people infected/number of people killed; we only)
    • That said, there’s a high chance the estimated 2% is inaccurate; we have no idea of the exact number of infections—not everyone who’s infected goes to a hospital. Thus, the fatality rate could be much lower.

How does the coronavirus kill people?

  • It triggers an overreaction of the immune system in the lungs
    • “A lot of the disease is actually a reaction of your own immune system, which causes the inflammation and pouring out of cells/fluids into the lung tissue” – Dr. Peter Openshaw

Comparing the Coronavirus and SARS

  • “Coronavirus is quite like SARS—it seems to be more infectious virus, but maybe a little less severe.” Dr. Peter Openshaw
    • (SARS had a 10% fatality rate)
  • Both are closely related to known viruses found in bats
    • SARS most likely originated in bats and passed through “civic cats” before making its way to human hosts
    • The coronavirus’ exact path is still undetermined

How do scientists define “infectious”?

  • The critical factor is known as R0 (pronounced “R naught”)
    • R0 = how many cases you get per index case (i.e., how many people each person with the virus infects”
  • If R0 drops below 1, the disease can be eradicated (this is what happened with SARS)
  • Coronavirus seems to have an R0 value between 2 and 3

The Coronavirus Timeline

  • The virus appears to have an average incubation period of 5 days (i.e., it takes 5 days after exposure to first develop symptoms)
    • Once symptoms show, the host is contagious
  • Then, the severity of symptoms begins to increase up until the 10-14 day mark
  • After this, symptom severity stays constant for ~1 week before starting to subside

How long can the coronavirus live outside a host?

  • It depends on the conditions—temperature, UV light exposure, etc.
  • Generally, a few hours

How might this all play out?

  • There are a few likely scenarios:
    • Over the next year, everyone on Earth gets exposed to the virus
    • The human population adapts, and the virus becomes milder with time, eventually leading to its eradication
  • This point is essential: There are 7 human coronaviruses, a few of which are equivalent to the common cold
    • Over time, their symptom severity decreased (something similar could happen with the 2019-nCoV)

Was the coronavirus human-made?

  • Many think it was, but not with ill-intent—its creation is believed to, by some, be an accident, brought on when studying bats and their immunity to SARS (the theory is that the virus was accidentally released into an animal, which then infected a human)
    • “I don’t think there’s any evidence for that at all”Dr. Peter Openshaw
      • More specifically, the virus’ genetic sequence doesn’t indicate it being human-made

How far has the coronavirus spread?

  • As of writing, it’s spread to 28 countries
    • Most cases have a direct link to Wuhan, China, but we’re beginning to see new cases arises with no such link 

How does the coronavirus compare to the flu?

  • The flu’s fatality rate is < 1/1000 (0.1%)
    • The World Health Organization estimates 250-500k people die worldwide from the seasonal flu

How does age affect coronavirus symptom severity?

  • If you’re <15-years-old, it seems you’re less likely to develop severe symptoms (if infected)
  • People >25-years-old tend to develop more severe symptoms, often resulting in hospitalization
  • People >65 years of age tend to develop the worst symptoms
  • Risk factors: Diabetes and existing heart disease

Will the Chinese containment efforts work?

  • “It’s a great shame that the coronavirus wasn’t recognized a week or two earlier in Wuhan, and they weren’t able to enforce containments at that time. I think, really early on, all these containment efforts would have been successful, but now that we’ve got thousands of cases, and the virus has spread to so many Chinese cities, and it’s managed to get outside of China … It just seems sensible that we have to plan for the scenario that the coronavirus can’t be contained completely and will eventually circulate and become one of those conditions that we consider when we see someone turning up at a hospital with pneumonia-like symptoms.” –Dr. Peter Openshaw
    • That said: “I think it’s too early to give up on containment. It’s important that we continue to try to contain the coronavirus as best we can. The best we have is that we manage to contain it. But we have to plan for the reality that it might not be containable because it just seems to spread so well.”

Is the coronavirus treatable?

  • As of now, no
  • Some Chinese trials indicate that Aluvia, a combination of several HIV drugs, may prove useful, but the hunt for a cure is still in full force

If You Think You Have the Coronavirus…

  • DON’T go to a hospital and sit in a crowded waiting room, infecting tons of other people
  • DO call your local medical hotline, explain your situation, and quarantine yourself

How do doctors test someone for the coronavirus?

  • It’s a complicated process, and it takes many labs ~48 hours to get results—an extremely long interval

If Peter or His Family Were Infected with the Coronavirus, What Would He Do?

  • First, they’d self-quarantine at home to avoid affecting others
  • He’d relieve symptoms with ibuprofen and acetaminophen, all the while keeping up fluid intake

All in All, Keep This in Mind

  • “I’ve lived through many scary outbreaks, and none of them have turned out to be as bad as we feared.” – Dr. Peter Openshaw
  • “There’s no point in getting panicked over this, but I do think we need to be concerned.”Dr. Peter Openshaw

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