Enemy at the Gates: The Emerging Threat of COVID-19

Philip Seo, MD, MHS

On Dec. 30, 2019, an ophthalmologist named Li Wenliang notified his colleagues about an illness that was reminiscent of severe acute respiratory syndrome (SARS) in a city in the Hubei province of China called Wuhan. As an ophthalmologist, this was not directly relevant to his practice; he merely wanted to warn colleagues that they might want to be more careful about contact precautions. Soon afterward, the Wuhan Public Security Bureau forced him to sign a statement recanting the warning and admitting he had made a false statement to disturb public order.

By that time, however, it was too late. You have, by now, heard the oft-repeated phrase that COVID-19 is apolitical. Despite multiple press releases insisting that COVID-19 would die out, the virus has spread like the wildfires that affected California and Australia in 2019.

By March 11, 2020, the World Health Organization (WHO) announced that it was classifying COVID-19 as a pandemic. This is the first time the WHO has declared a pandemic since the H1N1 swine flu in 2009. This extraordinary action reflects the extraordinary speed with which COVID-19 has spread worldwide. At the time of this writing, COVID-19 has been reported in 114 countries and killed more than 4,000 people; by the time you read this, these numbers will have increased.

On March 13, President Trump declared the pandemic a national emergency.

The Johns Hopkins Center for Systems Science and Engineering is tracking cases of COVID-19 in real time. These data are being shared in an interactive, web-based dashboard that is updated every 15 minutes, using data from the China CDC (CDCC), Hong Kong Department of Health, Macau Government, Taiwan CDC, European CDC (ECDC), the World Health Organization (WHO), the U.S. Centers for Disease Control & Prevention (CDC), the Government of Canada, and the Australian Government Department of Health. The dashboard also incorporates reports from local municipalities and organizations, most prominently, DXY, a crowdsourced platform run by the Chinese medical community.

According to the Johns Hopkins Coronavirus Resource Center, more than 322,000 cases of COVID-19 have been confirmed worldwide (as of 3/22/2020). The highest number of cases have been reported in China (81,397), Italy (53,578), the U.S.(30,285), Spain (28,603) and Germany (23,974). All 50 states have reported at least one case of COVID-19; West Virginia was the last to fall, on March 17.

All of these numbers, of course, are wrong; they reflect the number of identified cases and do not take into account the large number of patients who will never be identified, either because they were minimally symptomatic or they were never tested.