Short Wave - No, The Coronavirus Isn't Another Flu

Episode Date: March 27, 2020

President Trump has compared the coronavirus to the seasonal flu. NPR reporter Pien Huang speaks to host Maddie Sofia about why the coronavirus appears deadlier and more transmissible — and why it poses such a risk to our healthcare system. Here's Pien's story. Email the show at [e-mail]. See pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. Maddie Safai here with NPR science reporter Ping Huang. Hey, Ping. Hey, Maddie. How's life working at home for you, Ping? Well, glad you asked Maddie. Good to hear your voice. It's all right. You know, I am trying to work right next to a construction zone right now. You might be able to hear a little bit of that noise in the background. But I do have a little pillow fort here to help.

So from my closet to your pillow fort, Today, we are going to talk about an idea that's been in the air a lot lately, that the coronavirus is basically no worse than the flu. 36,000 deaths a year. People die, 36 from the flu. But we've never closed down the country for the flu. So you say to yourself, what is this all about? That was the president on Tuesday of this week. And so the estimated death toll last flu season in the U.S. was about 34,000 people. And experts say it can range from around 12,000 deaths a year to 61,000 deaths a year. By contrast, the coronavirus has killed 1,124 people in the U.S. That's as of Thursday when we're taping this, according to a Johns Hopkins count.

But there is a problem with comparing the two diseases in this way, especially at this point in time. Yeah, it's true, Maddie. And one of the reasons is that our health care system is set up to deal with the flu every year. but what it's not set up for is to deal with the coronavirus on top of the flu. And so, yeah, like on purely raw numbers, more people have died from flu this year. But there is a lot of science and data that we've learned in the past three months. And it suggests that the coronavirus is not only a more dangerous disease. It's one that could hurt more people if it spreads unchecked.

So this episode will talk about that science and data, how the coronavirus differs from the flu, and why it could, and emphasis on could, be even more dangerous to public health. Okay, Ping, like we always do with these coronavirus updates, we need to be clear that the information in this episode is based on what we know right now as of March 26th. And most of what we're talking about today are estimates based on information that's still evolving. Yeah. So let's start with some symptoms, flu versus coronavirus. So this is one of the things that makes containing this illness,

so tricky. The most frequent symptoms of coronavirus are fever, dry cough, fatigue, and shortness of breath. And those show up in both coronavirus and the flu. And people can also get diarrhea, but that's pretty rare. And it's also something that can happen with flu. And that's all information from the World Health Organization. And of course, it's very possible that there are symptoms out there that we haven't identified yet. So, for example, there's been some talk about people with coronavirus losing their sense of taste. But that hasn't really been proven yet. Right. And of course, a huge concern is people who can pass this virus on as someone else without even knowing that they have it. Yeah. So let's talk about that. Let's talk about transmissions. So basically how flu and coronavirus are passed from one person to another.

So flu and coronavirus are both thought to be spread mainly through close contact with other people who have it. So you can kiss them or they can cough on you and the droplets that come out of their noses and mouths can get. into your nose and your mouth and make you sick. So that's why the CDC is recommending keeping a physical distance of about six feet away from other people right now. Right, right. But there is one big difference, and that's that flu can be transmitted through what we call airborne transmission. People can cough or sneeze in a room, and then other people can come in and breathe in like super tiny particles of virus and get sick. And obviously that type of transmission can be really hard to protect against. Exactly. And while public,

Public health officials have said they don't think that's what's going on with the coronavirus out in community so far. They are still trying to figure that out. Okay, Ping. So let's talk about how many people one person can infect. Figuring that out is part of figuring out how contagious a disease is. There's some numbers that have been reported on a lot. You've been seeing them in the news. But we're going to put some of that sweet, sweet shortwave nuance in there for you.

Yes, shortwave where caveats are very welcome. They're always welcome. Okay, so Maddie, if you look at the data from China, it looks like each person infected with coronavirus seems to give it to two or two and a half other people on average. And that is higher than the flu. So a person with flu only spreads it to about 1.3 other people. And again, that's on average. Yeah, and we have to be really careful with those numbers. How many people one person will infect is this average based on an equation?

And for coronavirus, a lot of the factors that go into that equation, like how long somebody's contagious, how much virus it takes to get people sick, are still unknown. So that 2 to 2.5 number is a rough number and it is extremely likely that that number will change for better or for worse. Right, yeah. And this one was calculated again looking at populations in China, not the U.S. And things like whether people ride crowded subways to get around or whether cheek kissing is a car. common greeting, you know, things like how people behave and how many people they come in contact with, that can change that number. And that's why social distancing is so key right now. All that being said, today, Dr. Anthony Fauci, one of the top public health officials in this country, told Steph Curry, an NBA point guard, because that's the world we live in now,

that the coronavirus is much more transmissible than the flu. And part of that has to do with one of the most important and honestly scary things about the coronavirus. that people can be contagious before they have symptoms. So before they themselves know they are sick. This also happens with the flu, but it's only for about a day. Right. That's what we were just mentioning, Maddie. And with coronavirus, it seems like people can walk around for longer not knowing that they're sick and potentially getting other people sick.

So we still don't know a lot about this yet, but one study looking at a bunch of provinces in China found that about 13% of their cases, were likely caused by people spreading the coronavirus to others before they started coughing or having a fever or getting achy. Yeah, and what's really wild about it, and I've only seen this in this one study, is that some of the people who got infected had symptoms before the person that infected them. So, Ping, it would be like if I was contagious and I didn't know and I came to work and infected you, and you had symptoms before I ever did. And if you think about it, Maddie, from a public health perspective, that is so hard to deal with. It's part of the reason why some people are really advocating for testing a lot of people who may have been exposed to the coronavirus and not just the symptomatic ones. So let's talk about when you do get sick enough to go to the hospital.

There's some evidence based on data from China that more patients wind up in the hospital with coronavirus than when it comes to the flu. Right. It looks like about 20% of patients with COVID-19. get seriously ill enough to be sent to the hospital, and that's about 10 times the rate for flu. Here's Parker Hudson, an epidemiologist at University of Texas at Austin's Dell Medical School. What's particularly concerning are the number of people who are progressing to need hospital-level care

and then eventually critical care and who are dying, especially at the extremes of age. And we also have some data from China, from Wuhan, about how long people with the coronavirus need to stay in the hospital, once they wind up there. Yeah, so based on information from Wuhan in January, the average hospital stay is 11 days for coronavirus, and that's compared with five or six days for an average flu case. And when you have a patient using a hospital bed for that length of time, that's a bed that

can't go to a flu patient or someone with a heart condition or someone in a car accident. So just because this is a new disease for a health care system, it doesn't mean that all the other reasons people end up in the hospital usually just magically go away. Yeah, and not only that, based on the stories we've been hearing from ER doctors and hospital nurses, caring for a coronavirus patient takes a lot of work. Yeah, it's true. So an expert at the World's Health Organization says that taking care of intensive, really unwell coronavirus patients, it can take two to three medical staff at one time all in protective gear for hours and hours. And that is super stressful work. And don't even get me started on the amount of disposable gloves, masks, and gowns that takes, because we've all been hearing about that shortage and it's a whole separate issue.

Yeah, Ping, I'm not going to get you started on that because I know how you feel about it. Okay, so we mentioned at the beginning of the episode that about 34,000 people died last flu season in the U.S. So let's talk about how that compares to coronavirus. So stay with me here. If you think about it in terms of percentages, the flu kills one out of every thing. thousand people who get sick from it. So remember that number one in a thousand. That's 0.1%. Got it. So for coronavirus, Anthony Fauci, he said the coronavirus is estimated to kill at least 10 people for every thousand infected. That probably brings the mortality rate down to somewhere around

1%, which means it is 10 times more lethal than the seasonal flu. I think that's something that people can get their arms around and understand. Now again, a caveat. We are obviously still looking at new data every day as the testing ramps up. And we don't know a lot about people who might have mild symptoms or no symptoms at all because we really haven't tested a lot of them. Right. So that death rate might not be that high. It might not be as high as it looks now. Yeah. Yeah. But still, the death rate does seem to be higher than the flu by some significant measure. And that gets at the need to contain it. Yeah. So the flu on pure, raw numbers may kill more people, but that's because a lot more people get the flu to begin with. And so the message here is that if we do not contain

the coronavirus, if it's allowed to spread the way that the flu does, one viralologist I talked with told me that the number of severe cases and deaths will be worse than the flu hands down. Yeah. Okay. So knowing all that, let's talk about vaccines. Obviously, we have. those for the flu, but not for coronavirus yet. Yeah, and probably a lot of people have heard this by now, but it's just going to take some time. So the timeline right now is at least a year to a year and a half to develop a vaccine that we know is effective and safe. But Ping, there is a little bright note here. Ooh, lay it on me.

So there are things about this virus that could indicate that it's a good candidate for a vaccine. perhaps a vaccine that's even more productive than our current flu vaccine. Yes, that is true. And if we get a good vaccine for this thing, one that really keeps it from spreading between people, that could really change a lot of what we've talked about today. So let's wrap up where we started. The idea that the flu is just something we deal with every year. So what's the big fuss about dealing with coronavirus in the same way?

Because that line of thinking is essentially saying, okay, let's just let the coronavirus become another flu. Yeah, it's true. That is a line of thinking that's out there, and that would actually be very bad. So the flu is a huge problem every year because it's constantly circulating in our populations. That's what we really don't want for coronavirus if we can still help it. Because everything that we know so far about the coronavirus shows that even if it doesn't spread to as many people as flu has, it seems to be more deadly. And people can be carriers and they can spread it for days before they have symptoms.

And it could also cause a major stress to our health care system and put lots of doctors and nurses in danger. So those are all reasons to take it very seriously right now. Okay, Ping, I appreciate you. I appreciate you in your pillow for it. Thank you. I appreciate you too, Maddie. We've got a link in the episode notes to Ping's reporting on this topic that you can share with others, in addition to sharing this podcast, of course.

I'm Maddie Safaya. We're back next week with more shortwave from NPR.