First, before we get to the juicy bits let's discuss what we know so far.

The Historical Context ... a little perspective can be helpful.

H1N1 is the annual flu that many have had the unpleasant experience of dealing with. 

"CDC estimates that so far this season there have been at least 32 million flu illnesses, 310,000 hospitalizations and 18,000 deaths from flu." 

The death rate from H1N1 is ~ 0.1%.  The death rate from the new coronavirus (COVID-19) is ~ 2.5% (~20x more deadly than the flu).

We've been here before with deadly versions of the coronavirus.

Severe Acute Respiratory Syndrome (SARS) raised its ugly head in February, 2003.  There were 8096 cases spread across 29 countries and resulted in 774 deaths giving it about a 10% death rate. 

And then there came Middle East Respiratory Syndrome (MERS). By November 2019 there were a total of 2494 cases of MERS with 858 deaths giving it about a 34.4% death rate.

In our modern world coronavirus is not the only concern. Over the past few decades there have been numerous emerging viruses.  Many of these, like coronavirus, are considered "zoonotic", originating with animals.  

Example of emerging viruses from the Virology Journal...

• Filoviruses (Ebola, Marburg)
• Henipaviruses (Nipah, Hendra)
• Lassa virus
• Lujo virus
• South American hemorrhagic fever viruses (Junin, Machupo, Guanarito, Chapare, Sabia)
• Crimean-Congo hemorrhagic fever virus
• Rift Valley fever virus
• Hantaviruses
• SARS coronavirus, MERS coronavirus
• Tick-borne encephalitis viruses
• Zika virus

How does COVID-19 Compare to SARS and MERS?

So far, COVID-19 has resulted in ~ 72000 cases with a fatality rate of ~2.3%.  The death rate in the critically ill is ~49% or higher.  One study of 52 critically ill patients in Wuhan confirmed that 32 of these patients died, which means the death rate was 61.5%.

COVID-19 is less likely to infect children and the thought is because they are constantly being exposed to minor coronaviruses throughout the year (common cold). Due to this children are more likely to mount an immune response to coronaviruses in general.

Although this new coronavirus is less deadly it is SIGNIFICANTLY more transmissible, which makes this virus much more concerning.

All of these coronavirus' aim for the respiratory system and this is what will eventually kill some, especially the elderly and/or those with compromised health.

There are no vaccines for SARS or MERS and it is idealistic to think there will be one any time soon for  COVID-19.

There are no antivirals for any of these three coronavirus'.

So where does the health of the average American stand?

About 10 million Americans are considered immune compromised and more than 35 million Americans have a chronic lung disease.

On NPR it was recently reported by one expert that 150 million people in the US have one or more comorbidities. The population of the US in 2018 was 372.2 million.  So, this is slightly less that 1/2 of the population. With the increased transmission rate and the mortality percentage of 2.3% this COULD BE devastating.

Where does this leave us regarding how we can protect ourselves?

Of course, you all know the normal things you can do throughout your day:

• Wash your hands frequently
• Use a hand sanitizer
• Avoid touching your face
• Avoid large crowds
• If you cough or sneeze do so in your sleeve and not your hands
• If you are sick PLEASE stay home

It is becoming clear that the majority of people who contract COVID-19 do not progress to a severe respiratory condition.  However, for those who are healthy and will survive this there are almost as many people who will struggle and may even develop severe and critical complications. We must do everything we can not only to protect ourselves but more importantly to protect others who may not do as well with COVID-19.  

CRITICAL NOTE: COVID-19 is a novel coronavirus and seems to break all the rules so please, do not misunderstand this to be applicable to COVID-19!!