CORONA VIRUS: ANOTHER PRAGMATIC AND COGENT VIEW BY DR RICHARD SCHABAS.

CORONA VIRUS: ANOTHER PRAGMATIC AND COGENT VIEW BY DR RICHARD SCHABAS.
Photo by Ani Kolleshi on Unsplash
CORONA VIRUS: ANOTHER PRAGMATIC AND COGENT VIEW BY DR RICHARD SCHABAS. 2
Photo by Ani Kolleshi on Unsplash

From the Globe and Mail, written by Richard Schabas

This article was written by Richard Schabas, who is a retired physician and posted by the Globe and Mail. He was Ontario’s Chief Medical Officer of Health for 10 years and was chief of staff at York Central Hospital during the SARS crisis in 2003. He was the go-to-authority during the SARS Virus Crisis.

“In the three months or so since it started, the new coronavirus and its related COVID-19 disease – which emerged in the Chinese province of Hubei late in 2019 and now numbers more than 110,000 cases around the world – have caused more than 4,000 deaths, mostly in China. As the case numbers grow around the world, including in Canada, where there are now more than 70 cases, people have become concerned that a pandemic is inevitable.

But in the same three months, there have been about three million deaths in China from other causes, and about 14 million deaths worldwide. During the same three-month period, according to Health Canada, there have been almost 10,000 deaths in Canada from tobacco addiction, for instance – and just one from COVID-19.

Is COVID-19 a global crisis? Certainly for people who can’t add.

I learned some powerful lessons from SARS in 2003. Maybe the most important one was how important it was to focus on what has happened rather than on what might happen. In other words: “Just the facts, ma’am.”

I pay close attention to the daily situation reports issued by the World Health Organization, particularly the new cases and the new deaths. I pay no attention to the various pundits and talking heads because they are always wrong.

The information in the WHO reports is not perfect for many reasons, some technical and some political. Deaths are a more reliable measure, but deaths lag weeks behind the real outbreak. However, WHO is the best information we have, and it’s getting more complete and more reliable. And, as was the case with SARS, it paints a compelling picture.

The WHO started issuing daily situation reports on Jan. 21, six weeks ago. Initially, the numbers matched the perceptions: The new cases and new deaths, almost all from Hubei province, increased rapidly. Then, in the first week in February, the rate of new cases peaked at 4,083. Deaths peaked on Feb. 13, at 254. Then the number of daily cases dropped down quickly toward the end of February.

That’s because the Hubei outbreak peaked in late January. Indeed, it’s almost over.

Around the beginning of March, the number of new cases rose again because of outbreaks in South Korea, Italy and Iran. These outbreaks are smaller than the one that happened in Hubei. For the past week, the daily statistics have averaged fewer than 3,000 new cases and about 100 deaths worldwide.

Over the past month, the geography of COVID-19 has changed, but the global numbers have, if anything, become smaller. By the numbers, this is The Incredible Shrinking Pandemic. If we accept that testing capacity and vigilance have increased substantially in the past month, this observation is even more powerful.

CORONA VIRUS: ANOTHER PRAGMATIC AND COGENT VIEW BY DR RICHARD SCHABAS. 3
Photo by Louis Reed on Unsplash

A couple of important caveats:

First, far more cases are out there than are being reported. This is because many cases have no symptoms and testing capacity has been limited. There have been about 100,000 cases reported to date, but, if we extrapolate from the number of reported deaths and a presumed case-fatality rate of 0.5 per cent, the real number is probably closer to two million – the vast majority mild or asymptomatic.

Likewise, the actual rate of new cases is probably at least 10,000 a day. If these numbers sound large, though, remember that the world is a very big place. From a global perspective, these numbers are very small.

Second, the Hubei outbreak – by far the largest, and a kind of worst-case scenario – appears to be winding down. How bad was it? Well, the number of deaths was comparable to an average influenza season. That’s not anything, but it’s not catastrophic, either, and it isn’t likely to overwhelm a competent health-care system. Not even close.

The only plausible explanation is that COVID-19 is just not very transmissible among humans. Thank goodness. When it comes to pandemic potential, transmissibility isn’t the most important thing – it’s the only thing.

When COVID-19 finds a sweet spot – a cruise ship, a South Korean church, an Italian hospital – it can spread efficiently. And the bug has a nasty bite. But these are the exceptions and not the rule. The vast majority of infected people spread the disease to precisely no one.”

For further information:

Ontario Ministry of Health
https://www.ontario.ca/page/2019-novel-coronavirus#section-0

Toronto Public Health
https://www.toronto.ca/community-people/health-wellness-care/diseases-medications-vaccines/coronavirus/

Public Health Agency of Canada
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

World Health Organization
https://www.who.int/emergencies/diseases/novel-coronavirus-2019 

Centres for Disease Control (CDC) – United States
https://www.cdc.gov/coronavirus/2019-ncov/index.html

 

15 Replies to “CORONA VIRUS: ANOTHER PRAGMATIC AND COGENT VIEW BY DR RICHARD SCHABAS.”

  1. This man is a quack and a total idiot. He parrots a lot of big words that make him seem esteemed and trustworthy but he makes no sense. 10000 deaths from tobacco-the difference between tobacco smokers and Covid 19 is that you die by your own stupidity not as a result of unwillingly catching a virus. Influenza he says-well I know if I catch it, it won’t kill me but Covid 19 who knows. It might kill me, and anyone in my family. Thank God this man is no longer chief medical officer-his boomer attitude of downplaying and diminishing are not is what needed now.

    1. Thanks for your comments Diana but Dr Schabas speaks from experience. He was the voice of reason in 2003 with SARS. He chooses not to be hysterical about the future. If we work together we can affect the outcome.

      1. Dr Schabas took an almost identical stance during SARS and hospital workers died. He is also on record for suggesting that gay men who are active sexually (during the initial AIDS crisis) should be incarcerated. While he is a well known Dr, he is also known to be hyper conservative and ineffective. The rates of death for COVID-19 ARE NOT the same as the flu – and the damage to lungs and other organs, not to mention the burden on the healthcare system, are worthy of an abundance of caution.

        1. Sorry but the death rates for Covid 19 will likely look JUST like a seasonal flu. The death rate for EVERY SINGLE PANDEMIC IN HISTORY have always been revised down. Every. Single. One. Swine flu was originally touted as a 1.3 percent death rate and it ended up at .20. A difference of 65X higher than originally estimated.

      2. Dr Schabas took an almost identical stance during SARS and hospital workers died. He is also on record for suggesting that gay men who were active sexually (during the initial AIDS crisis) should be incarcerated. While he is a well known Dr, he is also known to be hyper conservative and ineffective. The rates of death for COVID-19 ARE NOT the same as the flu – and the damage to lungs and other organs, not to mention the burden on the healthcare system, are worthy of an abundance of caution.

        1. Thanks for your comment. This is very serious and everyone should be cautious. The most serious part is that this may just be the tip of the iceberg. However, I lived through the HIV/AIDS crisis and lost half of my friends. It was devastating but mental attitude is so important for everyone, those infected directly as well as friends and family. At present, I am in the most affected age group for CoronaVirus but I take all the precautions. I firmly believe that this virus will pass but also believe that another will surface. Stay safe!

  2. Thanks to Dr. Schabas for a reality check and a ray of hope. The Canadian numbers for positive cases and deaths due COVID-19 are tiny compared to other causes (esp. annual flu). Thanks for printing this article. Mass hysteria and panic is so tiring to sustain. The precautions we are being told to take should be complied with all the time, esp. during flu season, not just during this pandemic.

  3. I bet this Dr. Schabas is in self isolation. Thank god he is retired. People like him should keep his opinions to himself. He is probably one of the biggest hypocrites around and lets see whether he changes his opinion if he gets this Civid-19!

    1. WJ .. Unsubstantiated comments like this serve no purpose. If you don’t have anything constructive and objective to contribute, post elsewhere.

  4. Thank you Dr Schabas for your comments. I would appreciate an update to your article based on the numbers provided by WHO now. It seems to me for something not easily transmitted, this virus spreads quickly. In cultures who don’t take the advice of the WHO seriously, huge numbers of people are dying.

    Thank you
    Michael Kalyniak

  5. Since you’re promoting idiots like Richard Schabas, one might conclude that you’re more concerned about the real estate market than public health. I’m just glad this clown is retired. The claim that COVID-19 “isn’t likely to overwhelm a competent health-care system” would be laughable if stupid opinions couldn’t kill people. Tell this to ER workers in Italy and Spain right now.

    1. VR .. No need for name calling and hostility. Your inflammatory and emotional outbursts are not productive. Perhaps you should support your opinion with concrete facts and statistics, not childish temper tantrums.

  6. Interesting comments, but I agree, name calling is certainly uncalled for and not helpful. There are differing opinions out there and time will tell who is more correct. I was working at York Central hospital during the crisis and have spoken to Dr. schabas on a few occasions and heard him give several talks to the medical staff. He is definitely a very bright guy with a solid background in epidemiology. And he was correct about SARS, and it seems he’s recycling the same theory with Covid19. He may have underestimated the R naught value with Coronavirus in that it spreads from human to human with much greater ease than SARS. The numbers do support that. But even more problematic is the large pool of asymptomatic people out there spreading it without knowledge that they’re even infected. SARS declared itself more quickly and was spread by people who were already quite ill.
    Also SARS was more deadly once u were infected, hence it was easier to track it and shut down the transmission with contact tracing. Patients died more quickly from onset of symptoms than compared to Covid so there was less time for one sick person to give it to others. Covid is less deadly but because of its ability to quickly spread before we can get the chance to identify people and isolate. That’s why it’s so important to test widely and liberally to identify and contain those who carry it. The lower mortality of covid is a small consolation given the sheer numbers that will be infected. So even a 4% mortality of let’s say 10 million infected people will still result in 400 000 deaths, which is huge.
    SARS had an overall mortality rate of about 15%. But the total number of cases globally was only about 8000, with under 800 deaths. SARS virus did not have the fitness to persist in the human population so it died out after about 2 years. Dr. Schabbas may realize now that he is wrong about Covid because Covid is a different monster altogether. It is a real pandemic unlike SARS. Hopefully not to the same degree as the Spanish flu of 1918. As a front line worker, I was scared everytime a suspected case came in during 2003 and now, being 17 years older, I am just as scared if I have to intubate a Covid patient today….So, although fear mongering and panicking aren’t helpful, being mindful of physical distance and minimizing social contact and washing your hands and not touching your face certainly will be everyone’s main line of defence…be safe and stay healthy!

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