In the study of
epidemiology, the basic reproduction number can be thought of as the number of
additional cases we can expect one case in the population to generate. This is
usually denoted as R naught or R0.
This number determines
how fast a virus spreads. If the R0 is less than one, it doesn’t spread well
and dies out pretty quickly.
If it’s two, then one
person infects two more people, those two people infect four more, and so on.
This is the classic doubling that we see in exponential growth.
According to research
from the University of Bern in Bern, Switzerland, the R0 of COVID-19 in Wuhan,
China, was believed to be somewhere between 1.4 and 3.8.
We obviously know now
that the R0 is nowhere near 1. We are clearly experiencing exponential growth.
It’s likely that every person infected with COVID-19 will pass it to about two
to three other people.
We know the virus first
appeared in late 2019. And we can safely assume that hundreds of, if not more
than a thousand, infected people arrived in densely populated cities like New
York, San Francisco, and Seattle in early January. From there, the virus spread
unhindered for nearly a month.
With an R0 of 3, here is
what exponential growth in the spread of COVID-19 would look like:
· Day 5: 81 new people would be infected.
· Day 10: Nearly 20,000 more people would be
infected.
· Day 15: Almost 5 million new cases.
· Day 18: An additional 129 million would be
infected.
· Day 20: Over 1.1 billion new cases.
And here is the problem
with determining the spread of COVID-19… Most people have no idea that they
have it.
68% of the Population Infected
Strong research out of
Iceland determined that around 50% of those who tested positive are
asymptomatic. In other words, they have none of the symptoms associated with
COVID-19.
Most of the remaining
people who have tested positive have only mild or moderate symptoms that do not
require hospitalization.
How did Iceland
determine these statistics? It did something smart. It tested about 5% of its
entire population… whether or not individuals were sick.
And the results are
incredibly valuable for understanding COVID-19 and the actual mortality rate.
The World Health
Organization did not recognize the situation as a public health emergency until
January 30. That means the world was actively, and unknowingly, spreading
COVID-19 at an exponential rate up to that point.
New research out of the
University of Oxford supports the idea that COVID-19 is already well dispersed
among the population.
Its research models
determined that COVID-19 has already infected somewhere between 36% and 68% of
the U.K. population.
That’s not a typo.
For context, the
population of the U.K. is about 67 million. That implies as many as 45 million
people in the United Kingdom are already infected with the virus.
It’s also likely that
99% of them don’t know it because they are asymptomatic or have very mild
symptoms.
We have every reason to
believe that similar infection rates exist in the U.S.
I know that may sound
terrifying, but here is where the good news comes in.
The mortality rate of a virus is
calculated by determining the number of deaths relative to the total infected
population.
The mortality rate for COVID-19 is usually cited as being 2–3%.
This rate is based on confirmed cases, not on
the total infected population.
These numbers do not account for the number of people who have
contracted the virus but have not developed symptoms, or have mild symptoms not
requiring medical care and a test.
It means that the actual mortality rate may be far lower… perhaps
even lower than 0.1%. Compare that to the mortality rate from influenza in the
2017–2018 season (0.14%).
And research from other countries supports this.
Again, Iceland is unique because it has tested about 5% of its
entire population for COVID-19. Only 45 have been hospitalized out of the
country’s 1,364 confirmed infections. And there are only four deaths as of this
writing.
As the U.S. collects more data on infection rates, the fuller
picture of COVID-19 will emerge. And that time is coming quickly.