Knowing the virus - Quoting the Pros

Developing clarity, and not echoing panic

From time of actual events surrounding an illness to reporting these in the medical literature, there is an understandable delay. So now out of China, what transpired there with COVID-19 begins to appear and to teach the world essential truths about this virus.


Here is one of several such reports, written for physicians and scientists, and published in the NEJM February 28, and updated March 3. "Clinical Characteristics of Coronavirus Disease 2019 in China" by W. Guan et al. It is appropriately highly technical and not for a general public audience. 


With these and other results, Anthony Fauci, Director of Allergy and Infectious Diseases section of NIH, has gathered together some important points. That editorial is at this link. As his title indicates in his NEJM editorial, it is about navigating the uncharted passage through COVID-19, and back to health.
It is short and comprehensible for the not medically initiated. I have quoted here three areas from this editorial. 

"The median age of the patients was 59 years, with higher morbidity and mortality among the
elderly and among those with coexisting conditions (similar to the situation with influenza);
56% of the patients were male. Of note, there were no cases in children younger than 15 years
of age. Either children are less likely to become infected, which would have important epidemiologic implications, or their symptoms were so mild that their infection escaped detection, which
has implications for the size of the denominator of total community infections."

"The efficiency of transmission for any respiratory virus has important implications for containment and mitigation strategies. The current study indicates an estimated basic reproduction
number (R0) of 2.2, which means that, on average, each infected person spreads the infection to
an additional two persons. As the authors note, until this number falls below 1.0, it is likely that
the outbreak will continue to spread. Recent reports of high titers of virus in the oropharynx
early in the course of disease arouse concern about increased infectivity during the period of
minimal symptoms."


" Li et al. report a mean interval of 9.1 to 12.5 days between the onset of illness and hospitalization. This finding of a delay in the progression to serious disease may be telling us something important about the pathogenesis of this new virus ..."


Why bother with these details? 

As Bruce Aylward, assistant director general of the World Health Organization underscored in a recent interview, three things are essential to beat COVID-19: (1) understanding the virus and its behavior as accurately as possible. This, not just in clinics, but in the population at risk; (2) speed of response. (3) developing clarity about what will be of use and effective, and what is less likely to get us there. Here is a link to my French translation of that interview.


So Doctor Fauci's information is quoted here with those 3 goals in mind. Especially number (1) above.


A lesson on compassion, in real time.

You can think what you want when you see younger and younger children texting their friends on a Smartphone. Now is the time to text a bit less your dear friends on Facebook, and more to report useful information, and that can be confirmed, about COVID-19 events in the community. Use your phone to save a life. What do you think? And CDC, Mayo Clinic, Johns Hopkins or should get together and open a place where your information can be sent, confirmed, and used to make a potentially life-saving difference.


In that same spirit of sharing essential and potentially life saving information,

I have also translated this page into French, for those closer to where I live. 




I hope that the New England Journal of Medicine can understand, and tolerate this breach of ownership by one of its subscribers, but for a good cause in these globally challenging times.

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