Coronavirus: Pandemic perspectives from U of M expert, Mayo Clinic doctor

A Mayo doctor says 80% of people who get the virus won't even know they have it.
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More than 4 million people have watched or listened to Joe Rogan's podcast discussion with University of Minnesota infectious disease specialist Michael Osterholm, who said the American people need "straight talk" about the coronavirus pandemic. 

"It's just beginning. In terms of what hurt, pain, suffering, death has happened so far, is really just beginning. This is going to unfold for months to come yet yet, and that's I think what people don't quite yet understand," said Osterholm, who is the director of the Center for Infectious Disease Research and Policy at the U of M.   

On the other hand, the head of Mayo Clinic’s Vaccine Research Group, Dr. Gregory Poland, says fear levels should go down knowing that most people who get COVID-19 won't even know they have it. 

"The majority of people who get infected with this virus will never know it. Maybe 80 percent – they will have no or very minimal symptoms," said Poland in a Mayo Clinic podcast published March 10

Poland added that it's certainly possible to pass it on even if you're not experiencing symptoms, but it's likely that it'd be much harder to do so compared to someone who has physical symptoms. 

Meanwhile, Osterholm's claim that the number of confirmed cases in the U.S. could double every four days is proving accurate so far. In Minnesota, the confirmed cases jumped from 5 to 9 in one day. 

"If you go from 2 to 4 to 8 to 16, it takes a while to build up. But when you start going from 500 to 1,000 and 2,000 to 4,000 – that's what we're seeing happen in places like Italy. We're beginning to see it in some ways up in Seattle, it's what happened in China," he said. 

"Suddenly, this low-risk phenomena everybody talks about isn't so low anymore, and that's what we need to prepare people for."

He recommends avoiding close contact in public places, especially if you are over the age of 55 or have an underlying health condition. 

"If you don't have as much close contact, you can not transmit as much. If I'm sitting in a room with 100 people and we're sharing air, the transmission is remarkable," he said, citing the coronavirus outbreaks in the close quarters of cruise ships. 

On that note, Dr. Poland says the death rates that are highly publicized with the coronavirus don't also contextualize who is dying. He cited the following death rates for people in China who contracted COVID-19. 

  • Age 80+: 15%
  • 70-79: 8%
  • 60-69: 3.6%
  • 50-59: 1.3%
  • 40-49: 0.4%
  • 30-39: 0.2%

"In general, the fatality rate for influenza is 0.1 percent. So COVID-19 is about double influenza, but it depends on a patient's age, underlying conditions and what type of care you receive," Poland added.

Another major factor is underlying health conditions.

"The overall case fatality was around 2-plus percent (in China). If you had cardiovascular disease it went up to 10.5 percent. If you had diabetes, 7 percent. If you had respiratory disease, 6 percent. Hypertension, 6 percent. It is very context-dependent in terms of age and other diseases that you have." 

Other notes from Osterholm: 

Will 20 minutes in a hot sauna kill the virus? No.  

Will the summer heat make it go away? No. Another coronavirus in China in 2003 (SARS), wasn't impacted by change of seasons so there's no reason to think spring/summer in America will change things. "If it does (clear up), it won't be because there's a model for it." 

Shore up your immune system: Keep in good shape. Don't miss your daily medications (like high blood pressure pills). Get sleep and eat a healthy diet. 

How effective are hand sanitizers against COVID-19?: "Hand sanitizers actually are a great thing for stopping a lot of infectious diseases ... but don't think it's going to have a big impact on this bug," he said. 

Touching your face and washing your hands: "The thought was that there are receptors around your eye that actually for this virus could get into your body. The data we have on this is so sparse to say that's the case," he said. "We're not being really honest with the people. It's really just about breathing air. Keep doing the hand washing, but don't think that that's going to stop this disease."

Do masks help?: "Surgical masks are not made to protect people from bugs coming in. If you are sick, they may help a little bit from you transmitting," he said, while adding that the N95 respirator masks are "very effective" but there is a shortage of them in the U.S. 

That said, the Centers for Disease Control says the N95 masks are not helpful: "For the general American public, there is no added health benefit to wear a respiratory protective device (such as an N95 respirator), and the immediate health risk from COVID-19 is considered low."

"This is going to be challenging, but we are going to get through it," Osterholm concluded. 

Advice from Dr. Poland: 

Get a flu shot if you haven't already: "It is very important to get a flu vaccine. If you have not yet had a flu vaccine, that's the No. 1 thing to do on your priority list today. The reason being is that those symptoms will be confused with COVID and it's going to cause you and your health care workers some anxiety. So let's remove that one off the table by getting a flu vaccine." 

How long can coronavirus live on surfaces? "What the data show with these coronaviruses is that it is possible for them to persist on surfaces for as long as nine days. That's the really outside-the-envelope finding. Most of them will be in the context of hours to maybe a few days. But we don't know if that will always lead to transmission." 

Rules to live by during the pandemic: Have a "no handshake, no hugging" rule. Commonly wipe down and disinfect things in your household that you commonly touch. 

"What I think we should do is appropriately prepare for widespread infection while hoping that we're able to contain it," he concluded. "The longer we go with this just sort of simmering and not blossoming, and the closer we get into the spring and summer time, in general with the behavior of these viruses, the better off we are.

"There's no reason to panic. Take appropriate precaution." 

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