Why Is COVID-19 So Dangerous? A Spanish Healthcare Worker Explains

Explained by Roman Glushchenko, a Ukrainian doctor working in Spain.

Three factors determine the danger of an infectious agent:

1. Transmission vector;
2. Infectiousness (pathological susceptibility);
3. Mortality.

The transmission rate of COVID-19 is between 1.5 and 2.5, which is about three times higher than that of the flu. And with simple math you can guess that its spread follows a geometric progression: 1-2-4-8-16-32-64.

However, unlike the flu and SARS (severe acute respiratory syndrome, the last coronavirus epidemic, in 2003), COVID-19 spreads and you can catch it even during the incubation period, meaning it can spread even before any clinical symptoms appear.

When it comes to infectiousness and mortality in Europe, it is important to understand one very simple thing: within the next 3 months, we will all catch COVID-19, simply and easily.

Let’s pay attention to the following: of 1,000 infected people, 900 will pass it without a trace, including children and teenagers, while 100 will have symptoms and require hospitalization. Of these 100 people, 80 will go through the illness like a severe flu: dry cough, muscle and headaches, generally 2-3 weeks at home. Of the remaining 20 patients, 15 will develop bilateral pneumonia with respiratory failure, requiring hospitalization for oxygen, bronchodilators and corticosteroids.

Of the remaining 5, pulmonary fibrosis will develop, requiring immediate intensive care and mechanical ventilation. Of these 5  —  three will die. The other two will have consequences that can only be resolved with a lung transplant.

The figures above are the current official numbers, somewhat simplified for easier understanding of the matter.

After these figures, it doesn’t seem so dangerous and serious anymore, does it?

The problem is something else: unlike the flu, against which the population is vaccinated and which circulates for about 5 months of the year and has for the last 100 years, the coronavirus infection is a wave (look at Italy) that will infect everyone within 2-3 months, and to which our bodies are completely unprepared.

If we take Spain as an example, we see that of 40 million people, only 4 million will in principle have symptoms, of which 3.2 million will go through it like a severe flu. 600 thousand will need hospitalization with oxygen and 200 thousand will likely end up in intensive care.

So what’s the problem?

The problem is that in Spain, across public and private medicine combined, there are only about 200,000 beds and about 4,000 intensive care beds. Do you see the problem?

The problem is not the disease itself, even despite its infectiousness and mortality, but its epidemiological characteristics: it sweeps over almost the entire population within 2-3 months, as a result of which the medical system completely collapses. And we know that when beds are full, a military medicine protocol is activated, where the doctor personally decides who gets a bed and who is sent home with an oxygen cylinder (which surely won’t be available either).

This decision will be made based on age and general condition. That is, younger patients with greater chances of survival will be selected. Now let’s look at other urgent conditions that require intensive care every day: strokes, heart attacks, accidents, and all of this without beds and without intensive care. Everything described above sounds like a science fiction film, but this is exactly what is happening right now in northern Italy.

So what should we do?

It’s like a lottery: it’s hard to win, but the more tickets you buy, the better your chances. For the next couple of weeks, it is important to go to work and to the store only when necessary. Don’t eat out, don’t go to the gym, don’t call an ambulance just for nothing, don’t attend mass gatherings, and minimize public transport use to zero. All of this will take a couple of weeks.

You may ask: “If we are all going to catch it anyway, why so many measures and precautions?” Let’s dig a little deeper and find out that the difference between whether an infection passes asymptomatically or a person needs oxygen and intensive care depends on the person’s age and the state of their immunity. But it also depends on one concept called “viral load,” meaning the amount of virus that enters the body upon infection.

The greater the load, the more harm the virus can do to the lungs while our immune system is still organizing and producing antibodies for protection. Obviously, kissing an infected person, directly inhaling Flügge droplets with the virus from an infected person, or touching a place where those droplets landed about 3 hours ago and then touching your face are not the same thing.

Therefore, even if we do get infected, we must make sure the viral load is minimal. That is why it is not recommended to go to public places or avoid public transport and catering establishments.