Over the last few years we have mused a great deal on the value of specific expertise. In an era when five minutes on the internet can help any of us briefly feign such expertise, the value of genuine expertise is often lost. A month ago most people on the planet had not even heard of the study of epidemiology. Now we find armchair infectious disease specialists outnumber the country’s collective toilet roll stash. This week, we report on what we are hearing from the specialists in infectious diseases and have a look at what to do in amongst rioting capital markets.
What are the real experts saying?
Probably the best information we have at the moment on fatality and transmission rates comes from South Korea. This is where the most extensive testing has been done so far. On this evidence the so called ‘case fatality rate’ looks to be about 0.6%. So 6 people in every 1000 who test positively for COVID-19 sadly die. Now you could argue that because of what the experts called a ‘severity bias’ that this still may overstate the real fatality rate of COVID-19. Essentially only people with relatively severe symptoms are going to get themselves tested. We know that the majority of infected with this disease experience very mild, cold like, symptoms.
So the point is that this is certainly more serious, more fatal than seasonal flu and for parts of the population, it is a very serious condition. On the other hand, it is a lot less fatal and transmissible than some are suggesting, so the difficulty for governments and authorities is how to respond proportionately. There are no easy answers here, but history suggests that any related panic is almost more dangerous. This is particularly the case in countries with already fragile health systems.
On seasonality, we can point to 4 coronaviruses currently in circulation that cause the colds and so on that regularly afflict all of our winter seasons. This new coronavirus and its associated illness, COVID-19, now joins this family of viruses. So although we don’t yet have firm evidence of seasonality, there is some potential for slower transmission as the northern hemisphere warms. This will potentially have the reverse effect on the southern hemisphere though.
In terms of treatment, we have the advantage of being able to look at several anti-viral drugs that have already been through some degree of testing. Remdesivir is one that was trialed in the fight against Ebola. It didn’t do so well there, but fared better against MERS. There are trials ongoing to see how effective it is against COVID-19. One interesting aspect here is that there is already quite a lot of safety data available from the Ebola trials. If it is proved to be effective, then we could see production ramped up in the next few months. There are other potential candidates too. Vaccines will inevitably take much longer, even if you are seeing some potential candidates entering Phase 1 trials already.