Coronavirus really is that bad and you should work from home

Is coronavirus really that much worse than the flu? Yes, it is, and if the past is any guide, staying at home will help keep it from spreading.
Written by Steven Vaughan-Nichols, Senior Contributing Editor

You can't get the news anywhere now without hearing about how conferences are being cancelled left and right and companies, like Amazon, Facebook, Google, Microsoft and many others are telling employees in the Seattle area to work from home. Is the coronavirus really that bad? Do all the shut-downs and community quarantines, when we don't use these for flu outbreaks, really make sense? Is this all hype and panic? The answers are: Yes, it really is that bad. Yes, staying away from large group gatherings makes sense. And, no, this isn't hype and panic.

First things first. The World Health Organization (WHO) reports 3.4% of reported COVID-19 victims have died. The flu? 0.1 percent. That's a huge difference.

President Donald Trump dismissed this as "a false number." But, even if Trump is right and the mortality rate is 1%, that still makes it ten-times more deadly than a garden variety flu.  

There's only been one other modern pandemic disease with a similar death rate. The 1918 Spanish Flu had a mortality rate of 2.5 percent. So, as far as we know, COVID-19 is worse than the 20th century's most deadly disease, which killed 50 to 100-million people.  

Now, there are differences, of course. Today, we have antibiotics to deal with secondary infections, such as bacterial pneumonia. WHO experts also think COVID-19 is less infectious than the flu. Still, the bottom line is this is a killer virus and much more dangerous than the typical flu.

So, does staying and working from home make sense? Looking back again to the Spanish Flu, the answer is yes.

A 2007 Journal of the American Medical Association (JAMA) study found with the 1918 flu that cities which enforced school closures, public gathering cancellations, and isolation and quarantine saw significantly better mortality rates.

In particular, cities that implemented these interventions "had greater delays in reaching peak mortality; lower peak mortality rates; and lower total mortality. There was a statistically significant association between increased duration of nonpharmaceutical interventions and a reduced total mortality burden."

These cities' restrictions had a median duration of 4 weeks, with a range of 1 to 10 weeks. 

Why did it help then and how would it help now? The study's authors suggest, "Such measures could potentially provide valuable time for production and distribution of pandemic-strain vaccine and antiviral medication. Optimally, appropriate implementation of nonpharmaceutical interventions would decrease the burden on health care services and critical infrastructure."

Theoretical model studies of a possible pandemic, such as Strategies for mitigating an influenza pandemic found:

Border restrictions and/or internal travel restrictions are unlikely to delay spread by more than 2–3 weeks unless more than 99 percent effective. School closure during the peak of a pandemic can reduce peak attack rates by up to 40 percent, but has little impact on overall attack rates, whereas case isolation or household quarantine could have a significant impact.

Putting it all together, businesses aren't overreacting. This really is a serious health problem. Staying home from school, work, or large social gatherings, if you can, is a smart move. 

This won't be easy. But the possible alternatives are worse.

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