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The world is being rocked by COVID-19, the disease caused by a new type of coronavirus that emerged in late 2019 (SARS-CoV-2). The situation is concerning. A lot of people are sick. Many are hospitalized. Too many have died.

Nearly all of us are social distancing for at least a few weeks to slow the spread of the virus.

Routines are disrupted. Businesses are closed. Millions of people have been laid off, furloughed, or are finding ways to work from home. Kids are finishing their school year in virtual classrooms.

There’s severe strain on healthcare workers and healthcare systems.  

No one knows for certain when we will get back to normal, or what “normal” will look like once the initial COVID-19 crisis is more controlled.

If you only pay attention to media coverage of the COVID-19 pandemic, however, you might develop a biased or incomplete outlook of this situation. In fact, there is actually some positive information from trusted, scientific sources that’s worth paying attention to.

If you’re curious (like me) about the objective data, keeping a close eye on this type of information may help alleviate some of the anxieties you may be feeling – and even help you prepare for life after the initial COVID-19 crisis and social restrictions are lifted.

What is the situation, exactly?

Based on data available as of March 30, over 700,000 COVID-19 infections have been confirmed and over 35,000 deaths have been reported worldwide.

In the United States, at least 140,000 people have tested positive for COVID-19, and over 2,000 people have died from it.

Those numbers are staggering, and they’re expected to grow as more widespread testing becomes available throughout the initial wave of the virus.

There’s another way to look at the situation though: Nearly 7 billion people aren’t infected. As many as 322 million people in the United States don’t have COVID-19.

 

 

Based on current data, most people who contract COVID-19 will recover from it. The spread of infection will slow down.

The reality is, over a million Americans have been tested for COVID-19 and just under 16 percent of them tested positive. That means roughly 85 percent of those people who feel sick enough to get a test do not have COVID-19.

What are the known health risks of COVID-19?

The short answer is that there’s not enough hard data right now to know each individuals’ health risk from COVID-19.

The other short answer is the risk of serious morbidity and mortality is low, especially if you’re healthy.

If we look at the current situation through the epidemiological lens and based on reports from the most trusted sources, such as the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and other prominent medical researchers, we get a more accurate understanding of absolute risk than you may get from other sources.  

Risk of Exposure

Based on current CDC situation summaries, the risk of being exposed to the SARS-CoV-2 virus is still low for most Americans.  

If you live in an area with ongoing community spread of the virus, there’s obviously a greater risk of exposure. You’ve undoubtedly seen this unfolding in the greater New York City area and a handful of other densely populated areas around the country.

The highest exposure risk is in healthcare workers who are treating infected patients, first responders, those in close contact with someone known to have COVID-19, or people who’ve recently traveled to areas with high rates of infection.

For most other people, the risk of exposure is low, according to the CDC. How low? It’s impossible to quantify because there isn’t enough data yet. The best way to keep exposure risk low is to practice social distancing and washing your hands frequently.

Even if you are exposed, good handwashing hygiene might be enough to prevent you from becoming infected.

Key Data Points to Watch

COVID-19 data is emerging by the minute, and it can be overwhelming. In researching the topic, five key data points stood out: incidence, R0, morbidity, mortality, and recovery.

Incidence

Incidence refers to both the number of people with confirmed infection and the percent of the population infected.

In the United States, the current incidence is at least 140,000 cases or 0.04 percent of the population. In Minnesota, where I live, there are just over 500 confirmed COVID-19 cases, or 0.01 percent of the population.

While an infection is actively spreading, it’s common to see incidence increase initially. This is partially due to the infection spreading, but also — and perhaps mostly — because more tests are being conducted to identify cases.

We’re beginning to see the number of cases of COVID-19 increase daily because more people are being tested; this screening of larger portions of the population is vital for understanding actual incidence and controlling the spread of the virus.

Identifying cases early is also critical so contagious patients can be isolated to avoid spreading it, and seek treatment, if needed.

R0 (RNaught)

R0 (RNaught) is a calculation used to estimate the contagiousness of an infection. Most simply, it’s a ratio of how many additional people will be infected by each person who is confirmed to have the disease.

For COVID-19, people are thought to be most contagious when they are the sickest; some spread may be possible when someone is infected and asymptomatic, but this does not appear to be the main way COVID-19 is spreading.

An R0 of less than or equal to 1.0 means the illness is stable, contained, or on its way toward dying out.

If R0 is greater than 1.0, that means each person with the illness is likely to infect at least one other person, which indicates the infection is actively spreading.

For context, consider the contagiousness of these other conditions:

  • Measles has an R0 of 12 to 18 and is highly contagious.
  • Smallpox has an R0 of 3.5 to 6.
  • The common cold has an R0 of 2 to 3.
  • Seasonal strains of influenza are reported to have an R0 of 0.9 to 2.1, depending on the year.

Early data on COVID-19 estimate its R0 to be between 1.4 and 3.9. As new cases are identified and isolated, however, the R0 is expected to decrease. It’s a fluid number, especially in the early time period after emergence.

Since COVID-19 appears to still be spreading, people are concerned. No one wants to get sick, particularly with a disease that is known to be deadly, with no proven treatment.

It’s more important to keep in mind, though, that more people are surviving COVID-19 than are dying from it. Promising experimental treatments are underway. The entire world is focused on ending the crisis.

Morbidity

Morbidity is the state of being symptomatic or unhealthy because of a disease or condition.

If someone contracts COVID-19, they will most likely know it. They’ll experience fever, cough, and shortness of breath, often two days to two weeks after being exposed and contracting the SARS-CoV-2 virus.

Morbidity data for COVID-19 is rapidly evolving and incomplete at present, but several health experts and government officials regularly state that 80 percent or more of COVID-19 cases are resolved without any hospitalization or specialized medical treatment.

About 15 to 20 percent of COVID-19 cases require hospitalization, though not all states are reporting this information in real time. Minnesota, for example has 576 confirmed cases to date; of those, 92 required hospitalization (15.9 percent of cases).

If you do contract COVID-19 and don’t fall into the high-risk categories, odds are you will be able to fight off the infection, oftentimes without disease-specific treatment or costly medical intervention.

Mortality

Mortality explains the deadliness of a certain disease or condition, and there are a handful of ways you might see this reported.

Crude fatality rate describes the absolute number of deaths, either as a number or as a percentage of the total population. For COVID-19, as of March 30, the worldwide crude fatality rate is 0.0005 percent (5 deaths per 10,000 people). In the United States, it’s 0.0007 percent, and in Minnesota it’s 0.00018 percent.

For context, the estimated crude fatality rate in the United States for the seasonal flu is 0.0075 percent, or 7.5 deaths per one thousand people.

Sadly, crude fatality rate for COVID-19 will continue to rise as the current pandemic grows, stabilizes, and eventually subsides.

Case fatality rate is calculated based on the number of COVID-19 deaths divided by the number of confirmed cases; it’s a constantly evolving number as new cases are confirmed and active illnesses either resolve or lead to more loss.  

Early on, case fatality rates tend to be very high, but tend to decrease over time. Currently the worldwide case fatality rate is 4.69 percent, U.S. case fatality rate is 1.75 percent, and Minnesota’s is 1.74 percent.

If there are undiagnosed cases of COVID-19, then case fatality rate may overestimate the true risk of death. Conversely, because some people are sick with COVID-19 and could potentially die from it, the case fatality rate may be underestimating mortality risk. For these reasons, case fatality rate can sometimes be a misleading statistic.

There’s important age group and health-condition specific data emerging from some of the hardest hit countries that can help put the COVID-19 pandemic in perspective — at least it does for me personally.

Generally speaking, for those under 59 years of age, the case fatality rates are significantly lower than the numbers I just shared. Unfortunately, that means case fatality rates for individuals over 60 are considerably worse, at least in China, Italy, South Korea, and Spain.

Additionally, underlying health conditions significantly increase the likelihood of complications and death from COVID-19. Those with cardiovascular disease, diabetes, chronic respiratory disease, hypertension, and cancer have significantly higher mortality risk based on early data.

For context, heart disease kills nearly 1,800 people per day in the United States.

Again, the odds are in most peoples’ favor. Current data suggests that about 98 out of every 100 people infected with SARS-CoV-2 will not die from COVID-19.

Recovery

Every dire situation deserves some hope and this one is no different. While there hasn’t been much coverage or discussion about the recovery rates from COVID-19 so far, there is promising data about recovery.  

To date, over 165,000 people worldwide have recovered from COVID-19, including almost 6,000 in the United States and 260 of the 576 infected Minnesotans.

The recovery number will grow, and I urge you to make this the first COVID-19 related information you check each day.

Remember, nearly 7 billion people don’t have COVID-19, including over 320 million people in the United States.

That’s a lot of people who will be contributing to all aspects of recovery from this pandemic: rebuilding a stronger, better-prepared healthcare system; nurturing more connected families; facilitating vibrant, clean, and safe public places; and supporting the economy.

What can you do?

Listen to the experts and understand the statistics for yourself. If you feel your outlook turning negative, shift your attention to something positive and within your direct control.

Follow the directions of local, state, and federal health authorities. Currently, this includes some level of “shelter in place” or “only leave home for essential reasons” guidelines, which are the best immediate tactics to minimize the spread of infectious diseases.

If you feel sick, limit contact with others even more and call your doctor to figure out the best next steps.

If you don’t feel sick, consider how you can safely help those who are working hard to treat the ill or slow the spread. Give blood. Thank the essential workers who are carrying on despite the messy situation. Call a friend to catch up.

Or, make the most of this opportunity to spend energy and time on building or maintaining your own resilience and bolstering your immune system.

Eat a nutrient-dense diet based on an abundance of produce and ample protein. Get outside (safely) for 20 to 30 minutes a day for some vitamin-D therapy. Optimize your sleep. Take good supplements. Keep working out, even if you have to modify.  

We’re here for you.

Life Time’s Fitness Division team is working harder than ever so we can welcome you back to the club as soon as possible. It’s fair to say the team is cultivating a new level of moxie — the ability to face difficulty with spirit and courage. We hope we can help you do the same, from a safe distance of course.

Current models predict the peak of the pandemic will occur in mid-April, but experts aren’t speculating about when the crisis will be controlled well enough to lift all restrictions. While our clubs our closed, we’re busy creating free on-demand classes, workouts, and programs, and engaging members and friends in our Life Time Training Facebook Group.

We’re doing what we do best: We’re pursuing health, not fearing illness.

References

CDC. (2020, March 30). How it Spreads. Retrieved from CDC Coronavirus Disease 2019 (COVID-19): https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fabout%2Findex.html

CDC. (2020, March 31). Leading Causes of Death. Retrieved from CDC National Center for Health Statistics: https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

CDC. (2020, March 30). Situation Summary. Retrieved from Coronavirus Disease 2019 (COVID-19): https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html

CDC. (2020, March 30). Symptoms-testing. Retrieved from Coronavirus Disease 2019 (COVID-19): https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

Eisenberg, J. (2020, March 30). How Scientists Quantify the Intensity of an Outbreak Like COVID-19. Retrieved from U of M health lab blog: https://labblog.uofmhealth.org/rounds/how-scientists-quantify-intensity-of-an-outbreak-like-covid-19

Hernandez, J., & Kim, P. (2020, March 30). Epidemiology Mobidity and Mortality. Retrieved from StatPearls: https://www.ncbi.nlm.nih.gov/books/NBK547668/

IMHE. (2020, March 31). COVID-19 estimation updates. Retrieved from Institute for Heath Metrics Evaluation: http://www.healthdata.org/covid/updates

Johns Hopkins Univeristy. (2020, March 30). Coronavirus COVID-19 Global Cases by the Center for Systems for Science and Engineering. Retrieved from Coronavirus Resource Center: https://coronavirus.jhu.edu/map.html

Li, Q., & al., e. (2020). Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia. NEJM, 382:1199-1207.

MN Dept of Health. (2020, March 30). Situation Update for Coronavirus Disease 2019 (COVID-19). Retrieved from MN Dept of Health: https://www.health.state.mn.us/diseases/coronavirus/situation.html

Oke, J., & Heneghan, C. (2020, March 30). Global COVID-19 Case Fatality Rates. Retrieved from Centre for Evidence-Based Medicine: https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/

Our World in Data. (2020, March 30). COVID Mortality Risk. Retrieved from Our World in Data: https://ourworldindata.org/covid-mortality-risk

Our World in Data. (2020, March 30). What do we know about the risk of dying of COVID-19. Retrieved from OurWorldInData: https://ourworldindata.org/coronavirus#what-do-we-know-about-the-risk-of-dying-from-covid-19

Riou, J., & Althaus, C. (2020). Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020 . Eurosurveillance, 25(4):pii=2000058.

Wikipedia. (2020, March 30). Wikipedia. Retrieved from Basic Reproduction Number: https://en.wikipedia.org/wiki/Basic_reproduction_number

Keep the conversation going.

Leave a comment, ask a question, or see what others are talking about in the Life Time Training Facebook group.

paul-kriegler-registered-dietician-life-time
Paul Kriegler, RD, CPT

Paul Kriegler, RD, LD, CPT, CISSN, is the program developer for nutritional products at Life Time. He’s also a USA track and field coach.

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