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April 2, 2020

Perspective on Disease Outbreaks

Putting COVID-19 into context relative to other historical outbreaks.
Holly Sawyer, DVM, Regional Veterinary Consultant

Putting COVID-19 In Its Place 

(printable chart included)


In light of the massive global response to COVID-19—including the rise of telemedicine in the veterinary setting—it behooves us to ask why this disease is being treated differently than, say, Swine Flu from 2009 or MERS from 2012. World economies did not crash to a halt then. Why is it happening now? 


The short answer is the interplay between ease of transmission, carrier status, morbidity, and mortality. 


Swine Flu was only slightly more contagious than seasonal flu and far less fatal. Thus, while it resulted in many sick children and adults, it did not significantly increase the already “accepted” seasonal flu death toll. MERS, on the other hand, produced such severe disease in the host that infected patients landed in hospitals or on death beds immediately. Furthermore, most secondary cases of the disease occurred nosocomially. Thus strict post-infection hospital quarantines quelled outbreaks. 


Where does COVID-19 stand? 


SARS-CoV-2 is a novel virus in a naïve population that produces mild disease in 80% of the individuals. That is generally good news for the herd, but it is also the key to COVID-19’s sinister spread. The 80%-ers become asymptomatic carriers or recovered shedders who can seed the community with a virus that is twice as contagious as seasonal flu and 19-150x more fatal. It is this marked morbidity and mortality in the remaining 20% of the population that drives the WHO’s and CDC’s recommendations, which in turn informs government policy. 


Today’s media can alternately incite unwarranted fear and underplay the severity of this disease. What key ingredient is missing in the media reports? 


Perspective. 


It is our responsibility as veterinary professionals and leaders in our communities to educate ourselves about the risk COVID-19 poses to our communities relative to other pandemics the world has seen. Only in this way can we form logical conclusions and have a reasoned response when staff, clients, friends, and family ask us what we think about the strange times we now find ourselves in.


GuardianVets has compiled the following printable chart to provide you at-a-glance facts and numbers about recent pandemics.

Outbreak Comparison Chart

Sources: 

https://www.healthline.com/health-news/how-deadly-is-the-coronavirus-compared-to-past-outbreaks#1918-influenza

https://laist.com/latest/post/20200323/coronavirus-map-tracker

https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html

http://www.cidrap.umn.edu/news-perspective/2020/02/study-72000-covid-19-patients-finds-23-death-rate

https://www.cdc.gov/coronavirus/mers/clinical-features.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505341/

https://www.ctvnews.ca/health/how-contagious-is-covid-19-compared-to-other-viral-diseases-1.4836734

https://www.livescience.com/new-coronavirus-compare-with-flu.html

http://www.cidrap.umn.edu/news-perspective/2020/02/study-72000-covid-19-patients-finds-23-death-rate

https://www.worldometers.info/coronavirus/

https://www.euronews.com/2020/03/23/clinical-trials-starting-in-europe-as-new-drug-offers-hope-of-potential-coronavirus-treatm

https://www.healthline.com/health/r-nought-reproduction-number#rsubsubvalues

https://www.who.int/csr/sars/en/WHOconsensus.pdf

https://www.vox.com/2016/4/19/11450396/zika-virus-contagious-ebola-measles

https://www.medscape.com/viewarticle/927044

https://www.ecdc.europa.eu/en/middle-east-respiratory-syndrome-coronavirus/factsheet

https://www.barrons.com/articles/johnson-and-johnson-covid-19-vaccine-emergency-use-human-testing-51585573762

https://www.breitbart.com/health/2020/03/29/fda-gives-emergency-authorization-of-hydroxychloroquine-use/


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