COVID-19 is an actual medical disease that will lead to tragic deaths. Although this seems obvious, it should be clear that no one involved wishes to express anything but sympathy to those affected and their families. Respiratory failure is a terrible way to die. That is true if that death is due to asthma, COPD, pneumonia, influenza, smoke inhalation, cystic fibrosis, ALS, or COVID-19.
Revised April 23 with updates to section regarding COVID-19 deaths and the addendum.
The Truth (and Lies) about Coronavirus
This is being written on April 19, 2020. Although there is a central author, it is being written on behalf of multiple physicians in West Alabama and will be distributed through multiple medical offices. Between us we have well over a hundred years of practice and have treated hundreds of thousands of patients suffering infectious diseases. Including mission trips we have treated patients on five continents. We planned this date for several reasons. First, most of our patients now realize there is something “funny” about the coverage and handling of this disease. Secondly, if it wasn’t being handled differently by April 19, we knew it would take action from us and our patients to change that handling. Finally, we were told in March by our state officials that experts predicted New York, Florida, Texas, and Alabama were projected to have the median most fatalities from the COVID-19 outbreak with the peak in Alabama expected to be April 19. On this date, Alabama was supposed to be on pace for 5,516 deaths and be short over 21,000 hospital beds. The information just listed, and every piece of information discussed below, can be verified with a quick internet search. Many of the sources will be directly referenced. So here goes:
TRUTH: COVID-19 is an actual medical disease that will lead to tragic deaths. Although this seems obvious, it should be clear that no one involved wishes to express anything but sympathy to those affected and their families. Respiratory failure is a terrible way to die. That is true if that death is due to asthma, COPD, pneumonia, influenza, smoke inhalation, cystic fibrosis, ALS, or COVID-19.
LIE: We don’t know much about coronavirus. This is one of the media’s favorite lies. It is much scarier if it is unknown. We know that coronavirus is a zoonotic disease. In other words, it’s natural hosts are birds and animals as opposed to humans. We vaccinate domestic animals for them. We know that four forms cause colds every year. We know it mutates and evolves just like the flu. We know it sometimes becomes deadly as it has in SARS and MERS. We have done medical studies on coronavirus as a coexisting illness in patients in the past.
LIE: COVID-19 is more infectious than influenza. This is one of two lies most often quoted by the millions who call national radio programs or post on social media. It is amazing how many people with absolutely no medical training somehow feel qualified to comment on this disease. Now, we want to be more fair than the national media so we are obligated to report there will never be a study where 1,000 people eat after people with the flu and 1,000 others eat after people with COVID-19 to see which one is more infectious. But the evidence is overwhelming. COVID-19 was first identified late December/early January. A little over three and a half months in, we have slightly over 2 million confirmed cases globally. By comparison, according to the National Center for Biotechnology Information (Google Influenza Update- NCBI), influenza is responsible for up to a billion infections annually. Flu season is basically from the start of October until April. At the flu’s three and a half month mark, that works out to 583 million cases globally. Even accounting for the fact COVID-19 is underreported that is a HUGE difference.
However, there is even further evidence influenza is more infectious. Drawing from our own (meaning everyone reading this) experiences, when influenza gets started in a daycare or elementary school, they often have to be closed for a short time because otherwise everyone gets it. All the kids, workers, teachers, and parents. The most students in one class we could remember was 23 of 25 out at the same time with the flu. Certainly, daycare classes in both Tuscaloosa and Jefferson counties have been closed this year. Contrast that to what you know about coronavirus. The NBA tested hundreds of players, staff, and media to come up with 14 cases. The vast majority did not contract the virus at all. The most extreme case in terms of possible COVID-19 exposure we could find was the aircraft carrier USS Theodore Roosevelt. If you have never toured a military ship, space is at a premium. Very tight and crowded conditions. Secondary to this, hundreds of crew would become infected. So 4,800 men and women were exposed to multiple individuals with the virus several times a day, day after day. Despite that constant exposure, 4,140 (or over 86%) of those sailors would never even contract the disease.
To address the possible rebuttals, it is absolutely true we don’t know the true number of COVID-19 cases. It doesn’t make the average person under 60 sick so we will never account for all of those. However, it doesn’t even infect the average person with a healthy immune system who comes in contact with it, so the number can only be so high. It is true that testing has not been available everywhere the entire three and a half months but we are making up for that by testing generously now. Locally, DCH had tested 3,105 by April 17, 2,958 of which were negative.
LIE: COVID-19 is more dangerous than influenza. The second lie of the medically uninformed. Even among those who do contract COVID-19, most under 60, including virtually everyone under 21, will never know they had it. On the USS Theodore Roosevelt, 60% were asymptomatic. Of the 2 million people who have tested positive for COVID-19 globally, most have had mild to no symptoms. By the three and half month mark of flu season, the flu had resulted in over 2 million severe cases requiring hospitalization. Influenza results in 290,000 to 670,000 deaths annually. COVID-19 deaths will be discussed below.
LIE: The fact one doesn’t know he or she has COVID-19 makes it more dangerous. All viruses shed and are primarily spread while the infected host is asymptomatic. Repeat, all viruses do this. We use the term virulence to describe how dangerous a virus is. The more virulent, the more likely to cause infection or more severe symptoms. One’s chance of becoming infected with anything is multifactorial. In other words, lots of things come into play. The infectiousness and quantity of the pathogen comes into play. Your level of rest, nutrition, stress, age, and general health come into play as well. In the case of influenza, if you contract it you are going to get sick. There will never be a time where the NBA tests hundreds of players and staff to find 14 cases of influenza – two with mild symptoms and twelve with no symptoms. If you get influenza, even if you are Michael Jordan (who had perhaps the most famous flu game of all time), you are going to know. That is because the flu is so virulent that in 24 to 48 hours it overwhelms even the immune system of a healthy adult and you develop symptoms. But in that 24 hours it is multiplying, everyone around you is at risk. Depending on the exact exposure, the risk goes from high probability to certainty of contracting. For instance, if a high school student kisses their boyfriend or girlfriend during that day, they are getting the flu, period. But COVID-19 is so much less virulent it usually never overcomes the immune system of a healthy adult. Yes, they will shed this virus for up to 2 weeks, but most people around them still won’t get it. Since we are in West Alabama, let’s use a football example. Think of the healthy adult immune system as Alabama’s 2019 football team. Influenza is LSU’s 2019 football team. It only took one exposure to LSU to record a loss. COVID-19 is closer to Arkansas’ 2019 football team, maybe Ole Miss. Alabama could have played them 14 times and were less likely to lose than the one game with LSU. It is possible to record a loss, with some fumbles and a blocked punt, etc. but way less likely.
TRUTH: COVID-19 is more dangerous to the elderly and immunocompromised.
TRUTH: That doesn’t really mean anything in and of itself because everything is more dangerous to those unfortunate individuals. It does mean we should try to protect those individuals from infections in general.
TRUTH: It is now almost impossible for anyone in the general public or general medical community to know the actual number of deaths from COVID-19. That is because sometime in March US hospitals started testing all ER patients and every patient who died, regardless of cause of death, for COVID-19. Those patients are being included by the media in COVID-19 death tolls. Yes, a victim of a car accident brought to a US ER who passes away will be tested for COVID-19. Two of the most egregious examples of misrepresentation involve infants. One of the fascinating things about coronaviruses from a medical standpoint is children are almost universally immune to deleterious effects. A study from back in 2004-2005 was conducted in which swabs were done in both controls and children hospitalized for respiratory illness. The incidence of coronavirus was the same for controls and hospitalized children and the conclusion was HCoV (coronavirus) infection was not associated with hospitalization or with increased severity of illness in those hospitalized due to other infections. Search NIH if you want to review these findings. Obviously, COVID-19 is not included in that study since it was first identified recently. However, COVID-19 has not been associated with pediatric illness anywhere. Not China, South Korea, Italy, or Spain. So on March 29 when BuzzFeed.News and an Illinois paper, The Guardian, led with the headline “The First Infant Has Died In The US After Testing Positive For The Coronavirus,” it caught our attention. The article goes on to say the infant’s death was announced by Governor JB Pritzker and, depending on which article you read, either Pritzker, or Dr. Ngozi Ezike, director of the Illinois Department of Public Health, said: “If you haven’t been paying attention (to COVID-19), maybe this is your wake-up call.” On April 2, CBS News reported Connecticut Governor Ned Lamont had announced “It is with heartbreaking sadness today that we can confirm the first pediatric fatality in Connecticut linked to COVID-19.” He went on to say it was likely one of the youngest deaths from the disease “anywhere.” The problem is neither death has actually been attributed to COVID-19. On April 3, the Hartford Courant correctly clarified that all patients who die in Connecticut hospitals were being tested for the virus, regardless of manner of death, and that Connecticut’s Chief Medical Examiner had not ruled COVID-19 to be the infant’s cause of death. Just yesterday, April 18, NBC 5 Chicago reported Chicago Department of Public Health Commissioner Dr. Allison Arwady said it is preliminarily believed the infant in Illinois did not die from coronavirus.
New York is also a source of great misinformation. On March 22, Sky News ran footage of a hospital in Italy. On March 25, CBS This Morning ran the same footage. However, they claimed it was filmed in New York. Citizen reporters by the dozens have recorded empty testing tents and idle ambulance crews when the national media has reported hours long waits at the same testing sites and overstretched ambulance crews. You can find those videos on Youtube, although they don’t always make it easy. But there are enough people interested in getting the truth out there they are consistently reposted. At the time of publishing this link was successful https://youtu.be/MOBKyCY2esw. On April 14, the New York Times reported New York City officials at the Health Department had increased its death toll by 3,700 who NEVER TESTED POSITIVE for the virus. They were “presumed” to have died from it.