How serious is this bug really?

We still see people arguing that this epidemic is overhyped and that we should not be closing the country down to fight it. Do they have a point?

One advantage of socialized medicine is that you get a consolidated database. Data from the Intensive Care National Audit and Research Center in London offers some perspective on how COVID-19 compares to the flu.

A recent report compares 2249 recent COVID-19 patients, whose mean age at admission was 60 years, compared to 4759 patients with non-COVID-19 viral pneumonia, most of them caused by flu with an average age of 58, who were hospitalized over the three complete years 2017-2019.

Of the 2249 COVID patients, 346 (15%) have died, 344 (15%) have been discharged alive, and 1559 (69%) are still in critical care. The case fatality rate, as a fraction of all closed cases admitted to intensive care, is a little over 50%, compared with only 22% for the non-COVID viral pneumonias of the past three years.

Among those requiring ventilation, two-thirds die by the end of their critical care and only one-third survive. Therefore, the case fatality rate for closed cases where ventilation was required is more than 67%, compared with only 16% for non-COVID viral pneumonia cases requiring ventilation.

Worse, advanced respiratory support for COVID virus cases is typically maintained for between 4 and 9 days (average 6 days), while it is not needed at all in most non-COVID-19 viral-pneumonia cases, which typically require only basic respiratory support, and require it only for 2-4 days (average 3 days). These cases tend to require advanced rather than basic support, and to require it for twice as long. And yet, even after all that extra care, the case fatality rate is many times higher than for non-COVID viral pneumonias.

Thus, the COVID-19 is about six times more fatal than typical viral pneumonias, including those caused by flu. As the data is compiled we will see how the US data compares but it is likely to be similar.

In the past three years, non-COVID viral pneumonias have put 43% of patients requiring it on to ventilators within the first 24 hours. The COVID virus, however, is worse: it puts 63% on to ventilators within the first 24 hours. This is a far greater demand, both in advanced rather than basic care and in days of treatment, than other viral-pneumonia cases.

This disease is a lot worse than flu. It puts more people into intensive care, where they require costlier and more advanced treatment, where they will be in intensive care for twice the time required by other viral pneumonia-patients, and where they are more than twice as likely to die as those other patients.

Everyone with pre-existing comorbidities should keep in mind that "bending the curve" really means that we are expected to eventually become ill. This effort preserves the ability of the medical system to let us into the hospital when we become ill, but the same grim statistics will apply until we have therapies and a vaccine, so don't become impatient.

This bug is a killer that will be with us for a while