How dangerous is the coronavirus, really?

An American Jesuit who specializes in relations with the Church in China fears that too many people are underestimating the real threat of COVID-19

his photo taken by the Centers for Disease Control and Prevention (CDC) on Feb. 5, 2020, shows a laboratory test kit for severe the Coronavirus, (COVID-19). (Photo by UPI/MAXPPP)

There are many mixed signals being given about the coronavirus known as COVID-19. Some articles provoke panic, as if catching the virus were a death sentence. It is not, at least not for most people.

But equally misleading are those articles that are comparing the virus with seasonal flu.

The problem with many of these comparisons is that they are not symmetrical. For example, we are told that only some 4,000 people have died of coronavirus, while each year in an economically privileged country such as the United States, tens of thousands die of the common flu.

The difference is that in the case of the common flu, the pathogens are already circulating in the general human population, while in the case of COVID-19, that is precisely what we are trying to prevent. For that reason and a number of others, comparison with the common flu is extremely unhelpful.

This is not the flu

Unfortunately, the early response to the virus in the United States seemed to suffer from such fundamental confusion.

For example, in his testimony to a U.S. Senate committee working on funding appropriations to fight the disease, Chad Wolf, the acting secretary of Homeland Security, stated that the mortality rate of the ordinary flu and COVID-19 are roughly on par.

He protested that he had not checked the figures, so he could not be sure. As it turns out, he was way off the mark, so far off the mark that one wonders about the competence of the administration he represents.

I am not an epidemiologist. However, as the director of an organization that works with the Church in China, I have been watching the progress and containment of the COVID-19 outbreak there.

I am concerned that the highest levels of the U.S. government have shown such nonchalance about the disease.

Correcting the misconceptions

In terms of mortality, COVID-19 is far deadlier than influenza.

The World Health Organization (WHO) recently announced that coronavirus has killed 3.4% of the people it infected (which is considerably higher than the 2% estimate that had previously been released). Meanwhile, for the United States, the Center for Disease Control (CDC) estimates that the mortality rate for the seasonal flu hovers at around 0.12%.

In both cases, older people and people with other serious medical conditions are more likely to suffer catastrophically. In the case of COVID-19, the mortality rate for older persons rises dramatically with age, approaching almost 15% among people 80 and above.

At the same time, COVID-19 has also claimed the lives of middle-aged people in otherwise good health, or whose medical circumstances were not life threatening. In these respects alone, the virus is a substantially more serious threat than the flu.

The risk of death is not the only concern

At the same time, the mortality rate of any disease is only part of the picture. One must also take into account its prevalence or spread, the seriousness of treatment required (such as hospitalization) and any long-term health impact of the disease on people who survived.

In terms of spread, many more people have contracted the seasonal flu than COVID-19 (so far). And for that reason alone, the flu has had a much greater health impact.

For example, CDC of the United States estimates that 45 million Americans caught the seasonal flu in 2017-18. That number is far greater than the mere 650 confirmed cases of novel coronavirus in the United States as of right now.

It is worth noting that 45 million seasonal flu victims only represent approximately 14% of the total U.S. population of some 331 million people.

The flu is transmitted by viruses that travel throughout the general population. The number of people who come down with it would, in fact, be higher if it were not for the fact that some people have built up immunities.

For instance, they may have had prior exposure to the flu or may have been vaccinated. Such people will not readily carry the disease to others, and that slows its spread.

A disease that spread fast and indiscriminately

Meanwhile, COVID-19 spreads easily and surreptitiously. Since people cannot be vaccinated against it, and since few have the natural immunity that results when one has recovered from a viral infection, virtually everyone can catch, incubate and pass along the coronavirus.

Therefore some scientific estimates are that if left unchecked (which is not the case, of course), COVID-19 could spread to 40-70% of the world's population. That's somewhere between 3.3-5.5 billion people. A midlevel estimate would be 4.4 billion.

That would mean between 130-230 million people in the United States. A midlevel estimate would be 180 million U.S. citizens.

In other words, failure to exercise proper containment measures on an individual and collective level (proper exercise of personal safety and hygiene, limiting travel, precautionary isolation, canceling gatherings and putting in place appropriate communal containment measures when needed) would result in far more people contracting CORVID-19 than the common flu.

Unchecked, COVID-19 could kill tens of millions worldwide

If the coronavirus were to infect 4.4 billion people worldwide (and 180 million in the United States), the deaths resulting from a 3.4% mortality rate would utterly dwarf those resulting from the seasonal flu.

An estimated 150 million people worldwide would die: 6 million in the United States alone. Those who are older or living with other health risks would suffer disproportionately.

The impact of COVID-19's progression is just as serious. That is to say, it is not simply the case that only a few of those who are infected die, while the others go on merrily as before.

Some people do not develop symptoms immediately, while others may beat the disease without any serious treatment. But that's not the case for everyone. In fact, it is estimated that upwards of 18% of those infected require serious care or even hospitalization.

The figures are unclear because criteria for hospitalization differ between circumstances. A country with only a few cases will place them all in isolation wards, while in China's Hubei Province, the epicenter of the outbreak, people have been sent home because their symptoms were not deemed serious enough.

Serious problems with hospitalization and long-term effects

Nonetheless, if we use the 18% figure, with all its ambiguity, and apply it to the number of people who would contract COVID-19 were it to spread uncontained in the United States, some 32 million people would develop very serious symptoms, even requiring hospitalization.

Using similar crude figures, the number worldwide would be 790 million people. That volume of patients would strain healthcare systems to the breaking point.

In China's Hubei Province, where people with such run-of-the-mill diseases as cancer have been left to fend for themselves, it is not just the death rate from COVID-19 that's significantly higher than elsewhere. So is the death rate from other causes. The entire healthcare system has been overwhelmed.

Finally, for those who have come down with a serious case of COVID-19, recovery sometimes comes with long-term complications, such as permanent lung damage. I have not seen the all the figures here, but the anecdotal reports are sobering.

It is imperative to slow down the spread of coronavirus

Last year, the common flu killed more people than have been struck down so far by COVID-19. That's because there was far more widespread, at least until now.

But it is imperative that the spread of COVID-19 be slowed – and stopped, if possible. If containment fails, slowing the spread of the virus will at least allow medical facilities a better chance to keep up. And eventually develop an effective vaccine.

China missed the chance to contain the virus early on in Hubei Province, but nationwide the numbers of those infected are going down. In all provinces outside of Hubei, there are no new cases being reported.

Few countries can put in place the same containment measures as China.

The United States is built up of a patchwork of hierarchical jurisdictions. That allows for great flexibility on many matters. But it also raises the question of how best to deploy an effective, coordinated approach in the face of this particular threat.

We cannot be complacent

In an era of rapid mobility, an inadequate response in one state threatens all the rest. What we need is effective leadership at the top, leadership that heeds science, works in a collaborative way and focuses on the common good.

I have been disappointed to see a halting initial response from the national administration here. There has been a disregard for medical and scientific facts, and the outbreak has been used for partisan political ends.

For the good of our country and the world in which we play an integral role, the United States needs to prioritize containment of COVID-19.

Young and middle-age people who are in otherwise good health should do all they can to avoid carrying and transmitting the disease to those who are more vulnerable.

No one should be complacent. COVID-19 is nothing like the seasonal flu.

Michael Agliardo is a Jesuit sociologist and executive director of the US-China Catholic Association (USCCA) in Berkley, California.