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How many people actually have COVID-19? woman who transmitted COVID-19 to 5 other people
The number of COVID-19 cases and deaths are may have had an incubation time of 19 days.
increasing every day, so these numbers are a moving
target. As of March 11, 2020, the World Health Organization What are the symptoms of COVID-19?
has officially announced that COVID-19 is a global What is important to remember is that the vast
pandemic. majority, likely over 80%, of infected people appear to
I have been looking at the global Coronavirus have mild infections – with mild cold-like symptoms and
COVID-19 tracker from Johns Hopkins for accurate daily fever, and likely many who have no symptoms. As noted
numbers. which synthesizes data from 5 different sources: above, there are case reports of asymptomatic carriers.
WHO, CDC, European Centre for Disease Prevention and However, most people who contract COVID-19 do seem
Control, China’s National Health Commission, and ncov. to develop symptoms of some sort.
dxy.cn, an independent data source maintained by Chinese Reported symptoms include:
physicians.
** In a way, the actual numbers don’t really matter. • Fever (which may not be present in the very young
What matters is that we know that COVID-19 is here, or very old, or immunocompromised)
and that we do our best to stay calm & rationally • Uncomplicated upper respiratory symptoms
prepared. I do not recommend checking numbers daily – (Cough, sore throat, nasal congestion, malaise,
that will only serve to heighten your anxiety. ** headache, muscle aches)
As of March 12, 2020, there have been at least 127 863 • Difficulty breathing
global confirmed cases, 80 932 of which are in mainland • Mild pneumonia
China. The rate of new daily cases in China is slowing • Severe pneumonia (the severe pneumonia caused
down while the rate in other countries has been increasing. by COVID-19 is now named severe acute
Italy, Iran, and South Korea have the next highest number respiratory infection (SARI))
of COVID-19 cases, at 12 462, 10 075, 7869 cases • Acute Respiratory Distress Syndrome (ARDS)
respectively. As of March 12, 2020, there are 1323 cases of • Sepsis and Septic shock
confirmed COVID-19 in the US. 2 • Death
Infection from exposure to COVID-19 from within the
reporting country is far surpassing infection from exposure Death is of course what we are all worried about. So
due to travel from another country, with an increasing let’s look at that a little more closely in the next section.
number of infected persons with no history of international What is interesting to note is that children seem less
travel or close contact with a patient with known infection. vulnerable to infection and appear to have milder symptoms
Domestic community spread is becoming an increasing than adults. There have been NO reported deaths in
concern in the US and in other countries, and we need to children 0-9 years of age. One very small study of 9 infants
have more strategies for early detection, containment and under 1 year of age infected with COVID-19 found that
treatment than just closing our borders. none of the infants had severe illness or complications. In
fact, 1 had no symptoms, 2 had mild upper respiratory tract
How is COVID-19 transmitted? symptoms, and 4 had fever. 5
It is now clear that human-to-human transmission of Pregnant women also do not appear to be at greater
COVID-19 is possible and is occurring. Transmission is risk for complications. In a small study of 9 women in
mainly through respiratory droplets and close contact– Wuhan in their 3rd trimester of pregnancy with confirmed
similar to how influenza is spread. The CDC defines close and symptomatic COVID-19 infection, none developed
contact as being within 6 feet or within a room or care area severe pneumonia or died. All gave birth via c-section to
for a prolonged period without personal protective healthy-appearing babies with normal Apgar scores. No
equipment OR having direct contact with secretions of a virus was found in amniotic fluid, cord blood or breastmilk. 6
person with COVID-19 infection. There is some evidence
that fecal-oral or blood transmission may be possible, What is the COVID-19 mortality rate?
even when COVID-19 is not detected in oral swabs. Unfortunately, we don’t really know. As stated above,
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Investigation is underway to determine how long COVID- we need real case numbers to know real death rates. The
19 can survive on various surfaces and possibly be high number of deaths in China is devastating, but may
transmitted through “fomites” (a fancy word for objects or not be reflective of mortality rates in other parts of the
materials that can carry infection, such as tabletops, world given the tragic lack of hospital staff, medical
keyboards, clothes and utensils). supplies, ICU beds, and test kits that China is facing. And
The incubation period is thought to be 2-14 days, this may similarly be the case in other countries like Iran.
with a median incubation period of 4 days. Patients are If we just look at our current numbers, the death rate
thought to be most contagious when they are symptomatic. appears to be quite high. The reported mortality rate is
However, a recent report found that an asymptomatic highest in Italy at 6.6%, in China it is 3.8%, in Iran
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Song—Coronavirus Pediatrician's Perspective Integrative Medicine • Vol. 19, No. 2 • April 2020 29