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Coronavirus mystery deepens: COVID-19 may not be what people thought

There could be bad outcomes with the new virus initially until the patients get the hang of how to manage it.

PTI|
Last Updated: Feb 28, 2020, 01.53 PM IST
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How deadly is new coronavirus? Experts say it's still too early to tell.
WASHINGTON: If there's one thing about Coronavirus which has become a point of contention for various scientists, it's the deepening mystery about how deadly the virus really is. Scientists can't tell yet because the fatality rate differs even within China.

As infections of the virus that causes COVID-19 surge in other countries, even a low fatality rate can add up to lots of victims, and understanding why one place fares better than another becomes critical to unravel.

"You could have bad outcomes with this initially until you really get the hang of how to manage" it, Dr Bruce Aylward, the World Health Organisation envoy who led a team of scientists just back from China, warned on Tuesday.

In the central China city of Wuhan, where the new coronavirus first exploded, 2 per cent to 4 per cent of patients have died, according to WHO. But in the rest of hard-hit China, the death rate was strikingly lower, 0.7 per cent.

There's nothing different about the virus from one place to another. Instead, the never-before-seen strain of coronavirus struck Wuhan fast — before anyone knew what the illness was — and overwhelmed health facilities. As is usual at the beginning of an outbreak, the first patients were severely ill before they sought care, Aylward said.

By the time people were getting sick in other parts of China, authorities were better able to spot milder cases — meaning there were more known infections for each death counted.


And while there are no specific treatments for COVID-19, earlier supportive care may help, too. China went from about 15 days between onset of symptoms and hospitalisation early in the outbreak, to about three days more recently.

Still, Aylward expressed frustration at people saying: "'Oh, the mortality rate's not so bad because there's way more mild cases.' Sorry, the same number of people that were dying, still die."

Until the past week, most people diagnosed outside of China had become infected while travelling there.

People who travel generally are healthier and thus may be better able to recover, noted Johns Hopkins University outbreak specialist Lauren Sauer. And countries began screening returning travellers, spotting infections far earlier in places where the medical system wasn't already strained.

That's now changing, with clusters of cases in Japan, Italy and Iran, and the death toll outside of China growing.

Aylward cautioned that authorities should be careful of "artificially high" death rates early on: Some of those countries likely are seeing the sickest patients at first and missing milder cases, just like Wuhan did.

A cousin of this new virus caused the far deadlier severe acute respiratory syndrome outbreak in 2003, and about 10 per cent of SARS patients died.

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WHO says people with mild cases recover in about two weeks, while those who are sicker can take anywhere from three to six weeks on an average.

Flu is a different virus family, and some strains are deadlier than others. On average, the death rate from seasonal flu is about 0.1 per cent, said Dr Anthony Fauci of the US National Institutes of Health.

That's far lower than what has been calculated so far for COVID-19. But millions of people get the flu every year around the world, leading to an annual death toll in the hundreds of thousands.

Older people, especially those with chronic illnesses such as heart or lung diseases, are more at risk.

Among younger people, deaths are rarer, Aylward said. But some young deaths have made headlines, such as the 34-year-old doctor in China who was reprimanded by communist authorities for sounding an early alarm about the virus only to later succumb to it.

In China, 80 per cent of patients are mildly ill when the virus is detected, compared with 13 per cent who already are severely ill. While the sickest to start with are at highest risk of death, Aylward said, a fraction of the mildly ill do go on to die — for unknown reasons.

On average, however, WHO says people with mild cases recover in about two weeks, while those who are sicker can take anywhere from three to six weeks.

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