IS THE NOVEL CORONAVIRUS NO MORE LETHAL THAN THE FLU?

By Stewart Lonky, M.D.

Is the novel coronavirus no more lethal than the flu?

It could be, at least, according to Stanford University Medical School researchers. In a just-published study of thousands of Santa Clara County, California residents, a majority—as many as 81,000—were likely to have been infected by SARS-CoV-2, the virus that causes COVID-19.

These data are critical in helping guide public health officials to get a better handle on just how lethal the coronavirus is. If this research is accurate, it might be no worse than seasonal influenza. Currently, the U.S. coronavirus case mortality rate—the percent of people with confirmed COVID-19 diagnosis who die - is 5.2 percent. However, a significant proportion of people who are infected are going undetected because they don’t feel sick, are asymptomatic, or have only mild, nondescript symptoms. Recent research out of Iceland suggests that about 50 percent of people infected with the virus have no symptoms.

In the new study, the researchers performed antibody tests on 3300 volunteers. After making various statistical and demographic adjustments, the researchers calculated the likely prevalence ranged from 2.49 to 4.16 percent. At the time that these tests were administered, there were about 1,000 confirmed COVID-19 cases and 32 deaths from the disease in Santa Clara County. The researchers said that “these prevalence estimates represent a range between 48,000 and 81,000 people infected in Santa Clara County by early April, 50- 85-fold more than the number of confirmed cases.”

If we extrapolate the Santa Clara County data to the rest of the country, then it’s likely that millions more are infected than the 707,000 of which we know for sure.

Why are these numbers important? Because the only way to gauge the actual mortality rate for this novel coronavirus is to divide the total deaths from the disease by the number of folks actually infected. Using the Santa Clara example, 32 deaths out of 48,000-81,000 infections corresponds to an infection fatality rate of 0.12-0.2%, said the Stanford researchers, making the infection fatality rate for COVID_19 comparable to seasonal influenza.

Putting aside Santa Clara County study limitations, the researchers said their results “demonstrate the feasibility of seroprevalence surveys of population samples now, and in the future, to inform our understanding of this pandemic’s progression, project estimates of community vulnerability, and monitor infection fatality rates in different populations over time.”

* Seroprevalence refers to the proportion of a population whose blood serum tests positive for a given pathogen.

What these results also underscore is the need for widespread testing, which I’ve been saying since the pandemic began. The only way to get a handle on the virus’ lethality, and start putting our lives back together, is to implement a program of widespread testing that emphasizes those folks who appear healthy. Testing people with all the telltale symptoms or those who’ve been hospitalized doesn’t do much good. We should assume they’re COVID positive. Our focus needs to be on the symptom-free because it’s from this group that the next wave of sick people will emerge. Also, you can be infected with a virus and not get sick, as we learned from the example of Good Morning America co-host George Stephanopoulos.

Assuming they’re accurate, findings like these could help bring a quicker end to the pandemic. Thus, it’s time the federal government, specifically the CDC, gets its act together and conduct widespread antibody screening to determine the prevalence of the novel coronavirus. There are 335 million people in this country and a majority of them need to be tested. Individual states can't do it alone. 

There’s no time to waste.