I had some concerns about the pandemic sweeping through the world right now, so I went down the internet rabbit hole to read and understand the science and the facts. Just so you don’t have to. Having more information and knowledge helps reduce panic.

As much as possible, I tried to present the information without injecting personal bias, and based on the best available research/studies at the moment, from expert perspectives and official sources, and not just from Singapore but globally (even from Wuhan itself). The pandemic is still unfolding, so as new data emerges, the information here might change. This does not mean that previous information were fake news… There’s an urgency for action and communication, so going with the best available data is just expedient. So keep an open mind that things will evolve. Not trying to provide any particular political/moral/behavioural positioning here, or advice on how one should think or act. Feel free to interpret this information to suit your situation - it’s not my place to judge or care. I’m only after the facts as much as I can, to make up my own mind about things. Sharing it so that you can do that too.

Q: It’s contagious and spreading fast! Should I be worried?

A: Yes it’s more contagious but it’s thankfully less lethal - the fatality rate (outside of Wuhan/Hubei) so far is pretty low, as announced by Singapore’s Prime Minister as at 9 Feb 2020 was 0.2%. Previous early estimates by other experts/orgs were around 0.8%-2%, possibly because under-reported cases inflates the fatality rate.

A bit of pathology 101: Viruses toggle between virality and lethality.  The more lethal the virus, the less viral it is. Killing its host too quickly means it cannot propagate.

For comparison, normal flu is 0.1%, while SARS is 10%, and MERS 34%. So if you put coronavirus on a spectrum between normal flu and SARS/MERS, coronavirus is much much closer to flu in terms of how lethal it is. Think of it like a severe flu/pneumonia. It still sucks to get infected and having to live through the symptoms (below), but the estimates for the fatality rate do provide some solace.

“The most common symptoms at onset of illness were fever (136 [98.6%]), fatigue (96 [69.6%]), dry cough (82 [59.4%]), myalgia (48 [34.8%]), and dyspnea (43 [31.2%]). Less common symptoms were headache, dizziness, abdominal pain, diarrhea, nausea, and vomiting.” [source]

Counterpoint: WHO suggests that it’s still early to be certain about the fatality rate as the spread is still ongoing. So don’t take things for granted yet, keep a lookout for  new updates, and continue to practice good hygiene.

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Q: Am I at risk of dying from it?

A: So far the ones more susceptible to the virus are elderly above 60 years and have existing medical conditions like heart disease, diabetes, hypertension, etc. Co-morbidities raise one’s risk to having more serious symptoms from the coronavirus. 

“Compared with patients who did not receive ICU care (n = 102), patients who required ICU care (n = 36) were significantly older (median age, 66 years [IQR, 57-78] vs 51 years [IQR, 37-62]; P < .001) and were more likely to have underlying comorbidities, including hypertension (21 [58.3%] vs 22 [21.6%], diabetes (8 [22.2%] vs 6 [5.9%]), cardiovascular disease (9 [25.0%] vs 11 [10.8%]), and cerebrovascular disease (6 [16.7%] vs 1 [1.0%]).” [source]

Besides existing medical conditions, quality of care and infrastructure capacity also affect the fatality rate. Overwhelmed hospitals and staff likely means poorer care, and poorer recovery. Thankfully in Singapore, hospital capacity is still ok.

Good to point out that the numbers from Wuhan might skew the reality elsewhere and here in Singapore. Outside of Wuhan, the fatality drops by a lot. 

• Mortality rate in Wuhan was 4.9%.
• Mortality rate in the Hubei Province was 3.1%.
• Mortality rate nationwide was 2.1%.
• Fatality rate in other provinces was 0.16%.

“Asked why Wuhan was so much higher than the national level, the NHC official replied that it was for lack of resources, citing as an example that there were only 110 critical care beds in the three designated hospitals where most of the cases were sent.” [source]

Q: Do I need to wear a surgical mask to protect myself?

A: The surgical mask is not designed to keep viral particles out. It fits loosely on nose and cheeks, and without a tight seal, it’s modest at best in protecting against the coronavirus. It’s more for keeping things in, especially for surgeons to keep from spreading pathogens to patients during surgery. 

Wearing a N95 mask with a tight seal might be more effective, but it’s very uncomfortable to wear for long hours - which you need to in order to not get exposed. Just the N95 mask in and of itself is not a cure-all, as the virus spreads not by airborne methods. It spreads mainly by small fluid droplets when someone infected coughs or sneezes, and it doesn’t float in the air for long. It settles on surfaces like door knobs, table-tops, handles, etc. If you touch those surfaces and then rub your eyes and nose, you get infected, even with a tightly sealed mask. So hand sanitation is a better tactic against infection. 

In fact, wearing a mask gives a false sense of security, and you start to get lax on the other but more critical countermeasures like hand washing. Without a mask, you might feel emotionally more exposed and insecure, but you’re more alert to people and surroundings, and that alertness is more helpful when it comes to instilling discipline of personal sanitation, or say, walking away when you see someone is visibly coughing/sneezing. 

Lastly, using and hoarding up masks deprive those who truly need it - people who are sick and healthcare workers. Yes, it’s not easy to go against one’s survival instinct and think for the greater good during scary times like this, but do try. It does end up being good for you on a larger systemic level.