Coronavirus in the U.S.: How Bad Will It Be?

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Here's a Q&A on the impacts of the coronavirus in the USA, and other countries around the world.

About a week ago, the World Health Organization decided that the coronavirus outbreak in China was not substantial enough to be declared a global health emergency. We criticized it at the time as a "perplexing" decision. Roughly six days later, the WHO reversed course.

What changed the WHO's mind? According to the BBC, the decision was mostly based on the fact that the virus has spread to so many other countries. The latest count is 18.

How bad will this outbreak get? Should Americans be concerned? The following is a Q&A on coronavirus in the USA and beyond.

Q: How bad will the coronavirus outbreak get?
A: As the saying goes, it's difficult to make predictions, especially about the future. The best we can do is compare the new coronavirus (dubbed 2019-nCoV) to other, similar viruses. In 2002, the SARS (severe acute respiratory syndrome) virus emerged, infected 8,098 people and killed 774 within a year or so, then largely vanished. In 2012, the MERS (Middle East respiratory syndrome) virus emerged, and to this day, it has infected 2,442 people and killed 843. The case-fatality ratios for SARS and MERS were 9.6% and 34.5%, respectively.

The new 2019-nCoV has surpassed both in terms of total number of people infected. As of this evening, the New York Times reports approximately 9,800 cases and 213 deaths. However, the case-fatality ratio is far lower at 2.2%.

It should be kept in mind that data collection on infectious disease can be tricky. Many people who get a mild case of the respiratory disease never show up to the hospital, so it is possible (if not likely) that there are far more cases than we actually know. That would mean the case-fatality ratio is a lot lower than reported.

Q: Is coronavirus worse than the flu?
A: No, not even close. In just this current flu season (which isn't over yet), the CDC estimates between 15 million and 21 million infections and 8,200 and 20,000 deaths. However, the estimated case-fatality ratio would be roughly 0.05% to 0.1%, which is much lower than for 2019-nCoV. Though a person is 20 times likelier to die from the new coronavirus than seasonal flu, the sheer number of influenza infections makes the flu a far bigger public health threat.

Q. Where did the virus come from?
A: Coronaviruses are zoonotic, which means they circulate among animals before they "jump" into humans. SARS probably spread from bats to civet cats to humans; MERS from bats to camels to humans. In both cases, close contact with animals (e.g., in marketplaces) and/or consumption of civet cats or raw camel milk or meat may have been responsible for infecting people. Thus, it is quite reasonable to assume that bats are once again partially to blame for 2019-nCoV, but nobody really knows. It's probably not snakes. It's definitely not bat soup

Q: How is the virus spread?
A: The virus is spread like most other respiratory viruses; that is, person-to-person via respiratory droplets or fomites. (A fomite is an object, like a doorknob, that serves as an indirect way for infectious microbes to spread.) However, coronaviruses don't generally survive long outside the body, perhaps only a few hours. Because of this, the CDC says that "there is likely very low risk of spread from products or packaging that are shipped over a period of days or weeks at ambient temperatures." In other words, don't worry about getting sick from Chinese imports, unless it's some kind of animal (or food product) that could be hosting the virus. According to Foreign Policy, Chinese food safety standards are atrocious.

Q: Who is susceptible to coronavirus?
A: Anyone can become infected, but older people and men seem to be especially vulnerable. A study in the New England Journal of Medicine concluded that, of the first 425 known cases, the median age of patients was 59 years and 56% were male. As with most infectious diseases, people who have other underlying illnesses are also more susceptible.

Q: Will 2019-nCoV spread in the United States?
A: It already has spread from person-to-person in the U.S., but it probably won't go far. The U.S. is on alert and screening incoming passengers. Doctors know to be on the lookout for this disease. And the American healthcare system is excellent at dealing with this sort of problem. (Remember the Ebola outbreak that never manifested in the U.S.?)

Q: Can wearing a surgical mask help prevent you from becoming infected?
A: If there is any benefit, it is probably minimal. A person who is infected should wear a mask (to help catch respiratory droplets as he or she exhales), and a person who is in close proximity to a sick person should also wear a mask. But an uninfected person walking around outside probably won't benefit much from wearing a mask. The CDC doesn't recommend it, either. Just be sure to wash your hands.

Q: Will coronavirus harm the economy?
A: Probably. It will absolutely hammer the Chinese economy. Even though Secretary of Commerce Wilbur Ross bizarrely claimed that the virus would boost the U.S. economy, it's quite likely to have the opposite effect. China's massive quarantines, international travel restrictions, and disruptions in the global supply chain likely will set back the global economy, including America's.

For more information, see these articles:

Chinese New Year 2020: The Year Of The Coronavirus
Fearing the Coronavirus