COVID-19 Update: Current Case Trends and Future Forecasting

You. It's great to be here with everybody again. Just going to do a few updates on COVID 19 and some of the most recent literature and articles I've seen. I don't usually refer to news articles, but there are a couple that came out two days ago from some very prominent physicians and researchers that I think bear note. The first one actually came out two days ago from the Wall Street Journal by Dr. Ben David and Dr. Bhattara at Stanford. So these are two well known respected physicians at Stanford and the article was looking at case fatalities. Now this article is interesting because probably two months ago for those of you who have been following us, you know I was mentioning that we were under testing and so the diagnosis was probably a lot more than what was being reported in the news. And we probably had 10 to 20, maybe even 50 fold more cases. Well, this was interesting because it's actually some stuff being put out there from other people thinking the exact same thing. And this they looked at the data from the cases of individuals who came on a plane from the Wuhan province of China to the United States. Now the reason I thought that was interesting is that a plane is where a lot of things get transmitted. You breathe the same recirculated air. So there's going to be a higher risk of transmission on a plane. Now on that plane flight that came over from Wuhan, there's about 0.9% of the people on the plane that were tested were positive. Now if you look back at Wuhan, you take that number and multiply it to Wuhan, there's about 178,000 infections in that area. If you use the data from the plane that came over in the United States about six to eight weeks ago. So that would mean that the actual cases in Wuhan were 30 fold greater than what were reported. I'm sticking with the 10 to 20 fold that I've been seeing for the last two months. But point is, there's probably a lot more cases in China there then were reported. And again that's something that we've been hearing the whole time. With this number, the case fatality would actually be 10 times less than what we're looking at in China right now. So that 5.4%, that 2.4% would be 10 times less. Another place I was mentioning this article was the Italian town of Vaux. There 90 people of the 3300 people that were tested were positive. Now this is a small Italian city, but it's in the northern area, the Lombardi area. The high risk Epicenter area. So that was about 2.7% of the population in that area actually already had COVID 19. So what that means is of a population of 950, 50,000, there should be 26,000 cases at that point time. They only had 198 cases reported the time this article was put together. So what that means is the case fatality using that number would be closer to 0.6%, not the 8% that's being reported right now. Now, I'm not questioning that data. What I'm saying ultimately is we just don't know here in the United States because we have not tested enough. But if we have 10 to 20 fold more people here, the case fatality rate here to be much, much less than what we're seeing currently. And it changes from day to day. You know, I feel like yesterday was 1.4%. You know, Virginia has actually had a little higher case fatality than the National. I live in Virginia. But that's mainly due to the fact that we haven't been testing as much as places like New York City, which has ramped up their testing exponentially. And we're seeing the cases skyrocket. New York State is actually now becoming the epicenter in the United States, and the United States is becoming the new epicenter worldwide. The WHO declared the other day that the United States is now an epicenter. So what that means is we expect the cases to skyrocket again. This is nothing unexpected. And as we do more testing, we expect those numbers to go up. But what does this mean for you? What it means is that it's not trying to minimize the fact that there'll be a lot of people getting sick. The expectation is 70, 80% of Americans will get this. So even looking at the numbers, I was looking at it, you know, 2.7% of the population in the or 0.9% in the Wuhan. We're expecting a lot, a lot of people to get this. So even if the fatality rate is less, our concern is still that the hospitals are overrun. It's just that we now have a little bit of a less concern that's going to be as lethal as it spreads throughout the community. We could know that now if we'd been testing six weeks prior, but we haven't. So the hope is that once we get the testing deployed, the results come back and we can learn what the actual fatality rate is here in the United States. With more actionable data, then we can use that to determine do we go back to work or not and do just people that go back to where ppe, masks, gloves, like what does our redeployment into our culture and society look like going forward? And we need some data for that now. Another interesting article, again I usually don't refer to news media was from the Washington Post and this was encouraging because it was actually looking at the mutation of the coronavirus. Again, these are all preliminary. The one thing you have to realize anything you're reading right now is preliminary. Usually in the practice of medicine, by the time something becomes standard of care, you're looking at 10 to 15 years sometimes after initial research. So it would be 10 to 15 years from now or with the SARS 2003. So you're looking at 15 years afterwards. We know a ton about it. Right. So this is all preliminary, which means we're in a moving river. It's moving, it's changing. But again, this is reassuring information. But basically they sampled over a thousand viral samples and this was at Johns Hopkins again great, great research institute. And they showed there's only about 4 to 10 genetic differences between the US COVID 19 virus and that from the Wuhan virus. So that, that would suggest that single vac. Now what this means is that there's not a lot of variation since January, I'm sorry, since November when this first popped up to now we're seeing here in March. What that means is a single vaccine potentially could last for several years. You have to have a lot of genetic change or antigenic shift. That's when the virus, like influenza changes enough that you have to make a new vaccine. With flu that happens every year. With hepatitis B you have one vaccine in your life and that's it. So maybe this coronavirus won't be mutating as much and we can get by with the vaccine maybe every couple years. I don't think for a coronavirus a one time vaccine is going to work just due to the history of coronavirus and other RNA viruses. But it's reassuring research that once we get a vaccine it might last for a while. Reality is by the time we get it deployed, two to three years from now, most of us, probably 70, 80% will already have had this and we'll kind of move forward from that. There a couple new findings as well from the English association of ENT or Ear, Nose and Throat Physicians. They actually, and I'll be posting this article actually wherever this video is put, showing that up to 40% of patients who got COVID 19 actually lost their smell called anosmia. And many Other reported dysgeusia or abnormal taste. So, so that was an interesting statement by this group of head and neck ENT specialists in England that loss of smell and abnormal taste was a symptom of up to 40% of individuals. And they're actually recommending now that if you lost your smell in the last one or two months, maybe you self quarantine for 7 to 14 days due to potentially you having had the COVID 19 again in the United States, we're thinking 6.5 of people have no symptoms. Maybe this loss of smell, you know, that those people actually have some kind of symptom that we can kind of help track them down a little better. But again, symptoms just appear not to be the best way to track this. We need tests, we need antibody tests, we need the reverse transcriptase PCR testing so we can see accurately who's had this. Another couple articles that came out, another one on using anti inflammatories and immune functions. And basically it was the gist that having a fever is good, having a fever is a boost for your immune system and if you don't need to treat the fever, don't. And that goes in line with what we talked about a week or so ago with some of the concern with anti inflammatories increasing morbidity. These articles actually were dating from about 10 to 15 years ago showing if we leave people alone with their fevers with influenza and other serious infections that their immune system boost that comes along with the fever is a good thing. We did as well talk about the BCG vaccine. That BCG vaccine is a vaccine that in the United States we actually it's more used for bladder cancer. It's actually a tuberculosis vaccine that's used worldwide to help prevent severe tuberculosis in places like India and China. We don't use it a whole lot here, but it is an immune modulator. It can actually prevent aggressive bladder cancer. Well, there's actually some literature coming out now from China and India that those who are being vaccinated with it actually has antiviral activity. One example was with yellow fever. If you actually had the BCG vaccine, your risk for yellow fever was much less. More studies to come, more studies need to be done. But actually there's a consortium of about 10 to 15 countries that have just joined together to start focusing on Research for COVID 19 as well. Another great piece of information. Things are going forward, we're getting lots more information and it's coming out quicker and quicker. So anyway, those are the updates for today. Hopefully it was helpful. I'm trying to put out some more positive stuff to let people know we're actually learning some good things about what's going on. Maybe it's already out there way more than we expect. And so things are going to get worse. Numbers will get higher, but the big question is the more how many people die from this? Again, until we get hard numbers, it'll be hard to know. We'll continue to do our updates on social media. Follow us there and I hope you have a great day. Stay safe and be well.