Today was yet another active day in the rapidly expanding spread of #COVID-19. At this writing there are 126,135 confirmed cases, 4,630 deaths and 68,216 recoveries. In the United States there are 1,311 cases, 38 deaths and 8 recoveries.

Today the World Health Organization (WHO) declared coronavirus a global ‘pandemic.’ WHO Director-General Dr. Tedros Adhanom Ghebreyesus noted that over the past 2 weeks, the number of cases outside China increased 13-fold. and the number of countries with cases increased threefold.

While the difference between epidemic and pandemic is somewhat nuanced, this does represent a watershed moment. Epidemic describes any problem that occurs over a wide geographic area and affects an exceptionally high proportion of the population. A pandemic is more descriptive of the geographic spread and describes a disease that affects a whole country or the entire world.

As an illustration of the rapidity of change, earlier today Dr. Anthony Fauci, recommended that “there not be large crowds. If that means not having any people in the audience as the NBA plays, so be it.” Well, the NBA just suspended their season as a Utah Jazz player had a presumptive positive coronavirus test. (LINK)

At this time, it is also helpful to provide some perspective and context. Thus far the overall case fatality rate (CFR) of COVID-19 is estimated to be 2.3% with data indicating a lower overall mortality rate outside of the outbreak epicenter in Hubei, China. As we have noted previously, more than 80% of infected patients experience only mild symptoms and recover without significant medical intervention.

However, mortality rates increase significantly with age with a CFR of 8.0% among patients between 70-79 years and 14.8% in patients over 80. Of interest, data from the Chinese Centers for Disease Control indicate that patients with concurrent chronic conditions have not only a poorer prognosis but also a heightened risk of viral acquisition. Between 25%-50% of cases have a concurrent chronic illness.