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Center for Health Policy

Corona Virus Scare in Delaware

Dr. Christopher Casscells, Policy Director | 3/18/2020

Being a small state with a chronic shortage of hospital beds and a history of excessively long wait times in the emergency rooms, Delaware is at a higher risk for societal disruption than states with more diverse and extensive resources. As such, an epidemic of fear and anxiety might be worse here. Currently we are awash in a 24/7 media hysteria where there is a risk of panic. A rush on the emergency rooms with few available beds for admission to the hospital in Delaware would be very difficult to handle.
 
Why are we seeing such a panic about this new virus? In fact, not many people died attributable to the virus. Less than 0.1% have died compared to last year's flu. The national response to the H1N1 flu and the Ebola virus only occurred after 1000 US citizens had died. As of today we have 50 deaths, largely a nursing home on the West Coast which may be attributed to the new virus. The national response began in midJanuary well before any United States infections, with the travel ban from China and Wuhan Province. Those who have since succumbed in this country were already very old, immune compromised, sickly and generally unhealthy. The presumption is that most of those would not have survived the next year under any circumstances. Internationally, the worst death rates were in countries with inferior health services. The health effects in this country have been minimal. Economic effects however, have been gigantic.
 
By comparison, daily motor vehicle deaths fastly surpass Corona virus. Similarly, every yearly flu is far more deadly, as is urinary tract sepsis infections and heart attacks and hip fractures and cancer. The list is actually quite extensive with more prevalent and deadly problems.
 
So why the panic?
 
Firstly, the new virus is newly discovered and more widely publicized than prior outbreaks even compared to the scares of Ebola, Avian and Swine flu.
 
Secondly, we have a virus with some different characteristics. The virus lives a bit longer without causing symptoms in the prodrome phase so many infectious people do not know that they are in fact contagious with the virus. In addition, the virus remains infectious in the patient longer than our usual viruses, often up to 10 days or 2 weeks. Following initial recovery there is often somewhat of a relapse which appears to be fairly minor. Nevertheless, the patient may still be contagious. After this the patient generally has immunity and is no longer a risk.
 
Thirdly, the virus is communicable not just by respiratory transmission but in other ways. It may be transmitted by food, and it appears to be able to live on surfaces longer than the usual cold viruses, which are often other species of Corona viruses. Fourthly, the massive increase in mobility of the world's population compared to the pandemic devastating flu of 1918, mathematically translates to the potential of 1 billion infections in a very short time frame. Extrapolation of the mortality of 1918 is truly terrifying. Control of the spread is everything.
 
While knowing that the current outbreak is a seductive shiny object to the media in a highly politicalized climate, we should do everything possible to minimize the secondary effects of fear, anxiety and panic which could overwhelm our emergency Hospital system, and for that matter the general economy. At the risk of appearing insensitive, according to the Centers for Disease Control, and the head of epidemiology, Dr. Anthony Fauci, we will see at the worst a slight one or two percent increase of slightly accelerated death in patients who already are very sick and have foreshortened life expectancies. Some very small fraction of the elderly will die a little bit earlier because of this. The rest of the population will have a stronger immune system.
 
In a few weeks, according to the CDC, the health risk of this will be over, and hopefully we will have learned just how important it is to wash our hands, cover up your cough and sneeze, stay home if you are sick and avoid crowds, shaking hands, and ceremonial cheek kissing. Essentially, for anyone who is healthy under the age of 60, this is all you have to do, other than stay hydrated. Please don't panic, and please leave the emergency rooms and the hospital beds for our elderly, weak, and vulnerable in the community. This is not the apocalypse.
 
C.D. Casscells, MD
Center for Health Policy
Caesar Rodney Institute


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