welcome to another MedCram update on the coronavirus for January 29 2020 and
overnight what we've been looking at is the number of deaths reported has gone
from 106 to 132 and the number of confirmed cases has gone to 5000 974
that's about a 32% increase the number of confirmed cases overnight now I want
to make sure that we put this in perspective because it's easy to kind of
get lost in this there is a little bit of a probably misunderstanding in terms
of how accurate these numbers are if anything these numbers are probably
underrepresented and that could be a good thing or it could be a bad thing
and I say that with a little bit of trepidation in terms of being
misunderstood but if you're looking here you're gonna see that there is a ratio
okay if you look at the number of deaths - the number of confirmed cases you're
gonna get a general mortality rate of about 2.3 percent here on this
particular day versus the most recent data that we have is about the same at
2.2 percent here's the thing both the numerator here and the denominator need
to be confirmed by testing to confirm that this is specifically from the 2019
corona virus and it's possible that we're under counting in these areas in
fact I think everybody agrees that we're under counting here there's probably
more deaths than 132 and there's probably more than 5000 974 confirmed
cases the question is is where are we missing it
a death is a pretty obvious thing it's hard to miss the only question about
whether or not it's from this virus or another particular virus but it's really
possible and if you think about it there could be cases out there of corona virus
that are completely missed and they're in asymptomatic individuals who maybe
just got a little bit of a cold and they may be completely asymptomatic which
means that this number may be far larger it could be 50 thousand in which case
this mortality rate is going to be much much lower
then is being reported here so keep that in mind that's a possibility
furthermore if you've looked at some of our other videos and specifically why
the corona virus can kill and how it kills we talked a lot about ard s
obviously not everybody that gets corona virus goes into ard S which is acute
respiratory distress syndrome in fact of all of these cases there's only a
fraction that end up in the hospital and of those there's only a fraction that
needs to go to the ICU and there there's a fraction that get a RDS and some of
those end up dying I think in the most recent Lancet article of those that
ended up in the hospital that were confirmed to be cases the mortality
there was about 15% so that doesn't mean that 15% of people who get corona virus
infections are going to die it just means those that are sick enough that
end up in the hospital they may go on to get a RDS 15% of those at least in The
Lancet article pass away okay and so to put this in perspective let's look at
SARS now SARS as you may recall was another variant of corona virus it was a
different mutation and it had come from bats and total over about a year to
period of time the number of deaths in that was 774 and the total at number of
infections was 8090 eight confirmed cases that was for SARS in 2002 so you
can see here when we're looking at the numbers already for corona virus these
numbers are getting up there fairly quickly and we're only just a number of
weeks into this epidemic okay so what are they doing about this
well famously you may know that china is actually working on building a 1,000 bed
hospital in about ten days and it's actually quite interesting to look at
we'll post in the description below a link of a live webcam that you can look
at on YouTube as they are actually building this hospital and just a few
days ago it was a big feel the dirt and now they've already poured the concrete
slab and they believe that day morning they'll be admitting their
first patients to that hospital so that's quite remarkable but we wanted to
get into some other numbers about what's going on outside of China and what about
this person-to-person transmission because we've got some updates there as
well so as it stands right now in the United States there are about five
confirmed cases two of them in Southern California by the way there is a little
side note to this that we had talked about about 240 people are being
transported back these are diplomats and there is a chartered plane that is
traveling back from China that is going to land in Anchorage and then was
scheduled to fly down to Ontario International Airport in Southern
California where they would be screened that has slightly changed and that is
going to be going to March Air Force Reserve which was March Air Force Base
that is in Riverside County that has been a last-minute change but probably a
better choice from a political standpoint because these people are
going to be monitored at a Air Force Base that was turned into our Air Force
Reserve Base as opposed to a fully functional civilian airports now
something that is concerning is the recent story in Germany and this is a
story where a woman from China who was asymptomatic and visited in Germany was
not symptomatic until apparently she flew back on the plane to China and it
was only after that that the man who had never traveled to China was found and
confirmed to have the corona virus that is a concern for a couple of reasons
number one it's the first evidence that we have outside of China of
human-to-human transmission number one number two it seems as though this
transmission occurred when the woman was asymptomatic fortunately we can say this
at this point that none of the deaths involved with corona virus have occurred
outside of China at this point and if you look at the number of cases that are
being reported including the United States there are about 73 confirmed
cases outside of China as January 29 and in all of those cases
there have been no deaths so this sort of goes along with the possibility that
we may be under estimating the denominator in the mortality rate and
that that denominator is possibly far larger than we know and therefore would
be a bad thing of course in terms of the number of people who might be infected
but as more and more people are infected and the number of deaths stay the same
the mortality rate goes down something to think about and also something to put
in perspective as we talked about the number of people to date that have died
as a result of coronavirus is 132 that is in Contra distinction - let's just
look at the regular flu in California which is where I practice medicine and
specifically we're having a real issue right now with the h1n1 flu from 2009
and I've seen a number of those patients on ventilators in a RDS here in the last
couple of weeks where I work and California State Public Health
Department put out that the number of deaths from the flu this year in the
state of California have doubled from the previous year and we are already up
to a hundred and forty nine deaths so just the number of deaths from the
regular flu in California is more than the number of deaths worldwide for
corona virus if of course you believe what they're telling you in China but
just again to put this in perspective so thank you for joining us for this update
more updates as they come hopefully better news as we go and hopefully we
start to see a slowdown of the number of reported cases and also the number of
reported deaths of course thank you for joining us