A Facebook post by Sean Mahan from Sunday, April 26, 2020:
Source: Johns Hopkins Coronavirus Resource Center
Confirmed Cases: 939,249 (+33,884)
Total Deaths: 53,934 (+1,985)
Total Recovered: 105,818 (+6,739)
Case Fatality Rate: 5.7% (no change)
Total Tested: 5,184,635 (+234,259)
Shrinking or Spreading: (new cases)-(new deaths)-(new recovered) = 25,160 (+9,098)
“The numbers have continued to remain steady, as they have for the past 3 weeks. Confirmed cases continues to rise by 25-35,000. Deaths and recovered continue to rise at similar rates. The Case Fatality Rate has risen, but less than a tenth of a percent, so it is unchanged.
We are testing more people than we were testing 3 weeks ago, so there have been improvements in testing, but it is still generally much less than what is recommended, and it is less per population than most other industrialized nations. However it is showing improvement, meaning we are catching up.
I added the image of daily cases for today. I want to point out two things, because I keep reading and hearing things referring to us being on the “backside of the curve,” and “we have been living with this disease for 3 months.”
There are two realities that you can see in this graph that dispute these phrases.
(1) We are not on the downside of the curve. The number of new daily cases is FLAT, and it is flat at a very high level, with 25-35,000 new cases a day. This is the way it’s been for about 3 weeks.
(2) We haven’t been living with this disease for the past 3 months – not really. The disease really didn’t start taking off until mid-March. Prior to mid-March, most people were either unaware of COVID-19, they were thinking it was a hoax (and some still do), or they were thinking that it was not going to be a problem.
When you see how we have controlled this disease, it is important to take into account the drastic measures we have taken, and the result of these drastic measure is not “beating the disease,” but rather “controlling the disease at a very high level.”
Because very little has changed in the past few days – except that a few states are starting to lift their stay-at-home restrictions – I wanted to take this opportunity to ask some hard questions. I want it to be clear that I don’t have the answer to these questions.
1. QUESTION: Once you are infected with COVID-19, are you immune?
We don’t know this answer. It “seems” that there is at least a temporary immunity, because people are recovering and not getting sick again – but the reality is that we don’t know for sure. There are a few cases where people are recovering and getting sick again. This number is very small, but it is not insignificant. 2% of South Korea’s recovered patients ended up testing positive again. This may be a reflection of a 2% false positive rate in testing, or it may represent reactivation or relapse of the original infection. Regardless, we know that the virus mutates, and it is unlikely that antibodies to one infection with work with mutations. This is why we need to keep getting flu shots – because influenza mutates, and immunity to one version does not provide immunity to another mutation.
That’s a problem. This is especially a problem for discussions regarding “herd immunity,” because herd immunity may only be possible for one mutation. Once the virus mutates, you would have to start this whole herd immunity thing all over again.
The World Health Organization came out strongly on this when discussions for creating “Immunity Passports” was mentioned. The W.H.O. came out strongly against this idea, but then later backtracked, saying that
This story from CNN has an excellent video by Dr. Sanjay Gupta, in which he describes how antibodies and antibody testing work – and it also touches on the idea that these antibodies may or may not provide protection. But he touches on something very important: if you have antibodies, it may or may not suggest that you have immunity, but it DOES imply that you got the disease and your body was able to deal with it in a successful manner.
2. QUESTION: When will the vaccine be ready?
Let me start with a very harsh reality – it could be never. We don’t even know for sure that we will ever have a working vaccine. We have all been functioning with the idea that a vaccine may be available in a year – but the reality is that this virus may mutation many times in the next year. By the time they create a working vaccine for the version that came out in March of 2020, there may be so many mutations that the vaccine is essentially useless. The honest answer is that we just don’t know.
3. QUESTION: When you recover from COVID-19, do you truly recover, like the flu? Or will it cause a chronic permanent disease, like hepatitis B, HIV, or herpes virus?
It is even possible that the virus can live inside of you forever, like the Chicken pox virus (which is a herpes virus), and reactivate at a later date like shingles. We just don’t know.
These questions establish the very harsh reality that we don’t know very much about this disease – and it is possible that the way we are living is going to be our new reality – forever. We may have to learn to live with this disease for the rest of our lives. When we look at our current reality, most of us are looking at this as a bad time in which many people are dying, many people are being economically devastated, and we are giving our scientists time to create vaccines and treatments that will eventually make this go away, and it will just be a bad memory.
The fact is we don’t know that is going to happen. This could also be a new disease that lives in our society forever, and every year a new mutation of the COVID-19 will spread in our community and devastate our elderly population, and also our population of people with pre-existing disease. In fact, there may be new mutations that develop that are equally devastating to young people in the future.
We just don’t know.
What is most likely? This is a SARS virus (it is actually called SARS CoV-2). If we can apply models based on what we know about other SARS viruses, and other coronaviruses, it is MOST LIKELY that the people who are infected are developing at least a temporary immunity. It is also most likely that we can develop a herd immunity if enough people are infected. Also, it is likely that we will develop a vaccine for this disease.
But we don’t know if any of these are true. Not yet.
WHAT WE CAN DO TODAY:
My suggestion is to continue to stay-at-home, and continue to observe at the results of these states who are lifting these restrictions. If their results show a disastrous rise in cases and deaths, then we will know it was a bad idea.
But if these states show results of mild increases in these numbers – and when you combine this with the reality that we don’t know if we are going to have to live with this forever – then it is possible that these states are making a decision that turns out to be the right decision.
I can’t predict the future, but I believe that these states are likely jumping into this decision too quickly. The Federal Government has a 3-stage plan on how to reopen the economy, and these states are jumping the gun. As a result, they may have bad results because they were too eager to get things open. But the idea is probably the right idea. We need to (1) face the reality that this IS our new reality, and (2) we need to make GOOD and CALCULATED decisions in how we are going to reopen the economy. It would be a better idea to FOLLOW THE FEDERAL GUIDELINES in reopening.
As we have governors who are allowing their states to be exposed, we should use the data in these experiments to learn more about the disease so that the rest of us can make good decisions. As to how we are going to reopen our economy in a calculated fashion, this is a very complex decision – and there is no “answer book” as to what the right answer is. The only way to find out whether or not it is a good decision is to wait and watch.
The good news for most of us is that we won’t have to make the decision ourselves. We can all stay at home and watch what happens – and in fact, that is my recommendation at this time. Stay home, and stay safe.”