the coronavirus outbreak this is no longer a problem for China it's a problem for the
world everyone wants to know what's going on I mean I don't want to panic but it could become
a global pandemic just how much will this novel coronavirus spread going forward the official
answer is only time will tell but in this video I'm gonna give you my prediction about what is
going to happen with the corona virus or Covid 19 as it's now being called as of right now there
are only 14 confirmed cases in the United States but unfortunately it looks like there's going to
be a wave of infection coming in the u.s. in other countries as well and I'm not the only
doctor who thinks this is the case dr. Nancy Missoni a director of the CDC's National Center
for immunization and respiratory diseases expects it to take a foothold in the US and quote at some
point we're likely to see community spread in the US or in other countries this will
trigger a change in our response strategy she says and what about dr. Tom Frieden the former
director of the CDC who just the other day wrote an article who also thinks said spread is likely
just look at this alarming study from JAMA the Journal of American Medical Association on how
fiercely it's spread in the Chinese hospital it quickly spread to health care workers and other
patients in the hospital specifically of the 130 patients who are in this Chinese hospital
with coronavirus pneumonia 57 of them caught the infection while already in the hospital for other
reasons and keep in mind these numbers are being underreported China is being accused of censoring
critical data about the corona virus which the World Health Organization now calls a grave threat
to the world according to scientists writing for The Lancet medical journal Chinese authorities
had preliminary information on the virus for more than two weeks before it was officially
released one citizen journalist documenting the outbreak in Wuhan that's the city at the center
of the outbreak has reportedly been arrested another has just disappeared Wow so you know
the numbers in China are really higher than what's being reported the numbers are also underreported
because it's actually hard to test everyone due to limited resources like testing kits etc they even
started making the diagnosis based on symptoms and cat scan results more on that at a bit but
based on the numbers that we already do have let's take a look so this is the Johns Hopkins coronavirus
tracker these are the numbers as of the making of this video so as of right now there's
sixty thousand three hundred sixty-three total confirmed cases in the world the vast majority
mainly in China fourteen are in the United States the leading country besides China Singapore with
50 year cases the total number of deaths globally 1370 so this data is based on numbers coming from
the World Health Organization the CDC and others as well this is the total number of deaths graphed
out so back in January 23rd you see the rise steadily this is an upward trend here and it
shows over a thousand as of February 12th then you have the number of daily deaths in this
graph and you can see that the number of daily deaths keeps increasing they took a big jump on
February 12th so based on the numbers in the study that I just showed you in other studies like this
one it's looking like there's gonna be a wave of secondhand spread of the virus meaning it's likely
only a matter of time before the spread occurs from someone who hasn't been directly connected
to Wuhan or directly connected to someone who has a confirmed case of coronavirus in fact
we already have evidence that it's spreading in people without even having symptoms so here is my
prediction unfortunately a certain percentage of the population will get hit with this wave
of corona virus fortunately most people who get infected will only have cold or flu-like symptoms
only a tiny fraction of infected patients will end up with pneumonia only a small fraction of those
pneumonia patients will end up with ARDS acute respiratory distress syndrome check out my video
on ARDS to get a better understanding of what it is in how we treat ARDS patients so here is a
normal chest x-ray the black represents air within the lungs and this is normal this is a chest x-ray
of a patient with coronavirus pneumonia in the state of Washington the first case
of coronavirus in the United States notice this opacification right here this white opacification
could that's indicative of an infiltrate and in the right clinical context you could call that
a pneumonia and because it's coronavirus in this case we call it coronavirus pneumonia so here's
another case of corona virus pneumonia this isn't a patient in Vietnam here this guy has extensive
pulmonary opacities extensive infiltrate in his left lung here extends all the way from his left
upper lobe linkeyla and left lower lobe right long pretty much nothing and now let's take a
look at what ARDS looks like on the chest x-ray here it is both lungs you could notice hardly any
black meaning pretty much all of his lungs are just completely ou pacified with dense infiltrate
now these bilateral patchy opacities or bilateral fluffy fluffy infiltrates is one part of making
the diagnosis of Aird yes so now we'll take a look at a cat skin of someone with healthy lungs at the
top working our way down from the head towards the feet all the black represents air those squiggly
lines are the blood vessels this is all normal it's all normal lung now this is a cat scan of
someone with bilateral fluffy infiltrates on cat scan so far the lungs look normal but as we come
down you start to see this grayish appearance this is what we call a ground-glass opacity
this ground-glass opacity represents prank amol disease printable inflammation that's where the
alveoli are partially or completely filling up with fluid and or inflammation so as we
come down further and further you'll notice more and more ground-glass opacification and you can
see air Bronco gram so this is the Airways and then when you get outside the airways into the
airspace without the olih are that's where you have this ground glass of pacification and you
see in both lungs and it's patchy ground glass opacities is a descriptive term referring to an
area of increased attenuation in the lung on a cat scan with preserved bronchial and vascular mark
it's a non-specific radiologic finding with lots of different ideologies so it only helps
in making a diagnosis in other words it doesn't make any diagnosis just by itself so truly you
never see pneumonia on chest x-ray or cat scan instead you see airspace opacification you can
only call it pneumonia if it fits the clinical context of the patient based on symptoms etc
now not every coronavirus patient with ARDS is guaranteed to die but they have a high likelihood
of dying based on the early numbers of all the patients with coronavirus it appears that the
mortality rate is around 2% or so but what can we do to make sure that this number is
as low as possible in my opinion there's four main factors one implement infection control
measures so this includes isolating infected patients using personal protective equipment
when necessary hand-washing etc okay number two early recognition of symptoms recognizing fever
runny nose sore throat cough body aches etcetera number three early diagnosis I realize right now
the CDC has certain criteria for who to test which is a person with symptoms in someone who
has recently been to Wuhan area or who's someone who's been in close contact with a confirmed case
but at some point will cross that threshold where we'll have to broaden the criteria of who we test
because some people will get the corona virus via secondhand exposure diagnosis is based on
symptoms travel and exposure history lymphopenia in the bloodwork getting a cat scan or chest x-ray
but the diagnosis is clinched when you do the real-time PCR testing okay number four possible
early antiviral treatment here meow compassionate use of the new antiviral drug REM des aveer that's
what I'm talking about I talked about this drug in another video so check it out for more details in
order to get this drug doctors have to apply for it they have to apply for compassionate use of the
drug this is because it hasn't even undergone a placebo randomized control trial yet in this drug
may only be available in limited amounts because it's new and is not undergone mass actually
update as of today it's now being mass-produced in China as well as the United States pharmaceutical
company Gilead and because this drug is likely to have very limited availability at least initially
we'll have to be very selective of who gets it will want to reserve it for patients who are most
likely to benefit from it in which the potential benefit outweighs the risk by the way it appears
to be safe but we just don't know just how safe it is so we're not going to want to give it to people
who only have mild illness but then again given to someone who is critically ill nice you with erred
yes might not have benefit either because lots of times with viral infections like influenza
they only respond to antiviral medication if given early in the disease course so the sweet spot if
you will of who to give it to would be those who have moderate or severe illness when the diagnosis
is made sooner rather than later the bottom line is the clinical decision to administer the drug
will be done on a case-by-case basis the problem with that is how many people are going to require
it will it be a few cases here and there or will it be hundreds or thousands so as of right now the
corona virus is an epidemic in the continent of Asia it's not a pandemic because it hasn't become
an epidemic in two continents hopefully it doesn't become a pandemic I think in the next week or so
we'll have a good idea of this epidemic is peaking or not if sustained transmission begins in other
countries which unfortunately seems pretty likely at this point if that happens it's unlikely that
it can be contained so I do think this will end up being a pandemic but I don't think it's all doom
and gloom I don't think every state will look like how nine province I don't think every big
city will look like Wuhan in the end I don't think it'll be as bad as the current flu which there's
actually 22 million cases this season and 12,000 deaths from the flu what I'm curious about what
you think leave a comment below on what you think is gonna happen also if you like this video give
it a like because it encourages me to make more videos anyway regardless of what happens let's
do our best to be prepared minimize the spread of disease and also let's stay educated check
out my video on how to prevent the flu because not only can you learn how to prevent the flu but also
those same infection measures are used to prevent getting the corona virus also for more details
on the new antiviral drug ram desi fear checking my video on that as well see you in the next one