COVID-19, caused by the novel coronavirus, has been sweeping across the globe at an unprecedented speed. As the number of confirmed cases continues to climb on a daily basis, more and more people are becoming concerned for their own safety and the safety of their families, and are asking the question: “what is my risk?”
It is difficult for health officials to nail down the exact mortality rate of the coronavirus, however, most estimates range between three and four percent. This number, however, is not a great estimate of the actual mortality rate, because the total number of cases is difficult to track.
The vast majority of cases, approximately 80 percent, are actually mild or asymptomatic, and for that reason make calculations challenging. The higher the number of “estimated mild cases”, the lower the mortality rate will seem. However, if you remove that estimate and base the mortality rate off of confirmed, symptomatic cases only, it becomes significantly higher [1,2].
It has been widely reported that the largest percentage of severe and/or fatal cases of COVID-19 are seen in elderly populations, or in people who have compromised immune systems. While this is certainly true, health officials are starting to see more and more cases in younger, otherwise healthy people, and the conditions these patients are in is terrible.
How is the Coronavirus Affecting People?
Professor John Wilson, the president-elect of the Royal Australasian College of Physicians and a respiratory physician, says that almost all serious consequences of the virus feature pneumonia and coronavirus patients can be placed into four broad categories:
Subclinical patients are those who have the virus but who are not showing symptoms.
Patients with an upper respiratory tract infection usually have a fever and a cough, and may also have a headache or conjunctivitis. They are still able to transmit the virus, but may not be aware of it.
Patients with the flu. This is the largest group of people who test positive for the virus, and are the most likely to present at a hospital.
Patients who develop severe illness are in the fourth group. These are the ones who develop pneumonia.
“In Wuhan, it worked out that from those who had tested positive and had sought medical help, roughly 6% had a severe illness,” said Wilson .
Pneumonia develops in patients with COVID-19 when the infection reaches the respiratory tree, where the air passages that conduct air between the lungs and the outside are located. This causes the lining of the tree to become inflamed. If the condition worsens, it goes past the lining and into the gas exchange units.
“If they become infected they respond by pouring out inflammatory material into the air sacs that are at the bottom of our lungs,” explains Wilson.
Once the air sacs become inflamed, you have pneumonia. If the lungs are unable to get enough oxygen to the bloodstream, the body cannot rid itself of carbon dioxide, which is usually the cause of death in severe cases .
COVID-19 “Much More Frightening” than the Flu
One medical worker, a respiratory therapist whose job it is to make sure patients are breathing properly, recently described his experience with the novel coronavirus, and it is harrowing.
Normally, most of his patients are older, with chronic health problems or bad lungs. Since the coronavirus hit, however, he is starting to see patients in their forties and fifties with minimal preexisting health conditions, if they have any at all. The ICU where he works has now more or less become a COVID-19 unit, and out of the dozens of confirmed cases that have already been admitted, about one-third of them have ended up on ventilators.
Initially, he, along with many other staff members didn’t think it would be that bad. They deal with the flu every year, and they all assumed it would be more of the same. Since working with these patients, however, his opinion has completely changed.
He is particularly stunned by the speed with which the virus can take over someone’s body.
“This is knocking out what should be perfectly fit, healthy people,” he said. “Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.” 
When a patient goes into respiratory arrest that suddenly, it is known as acute respiratory distress syndrome or ARDS. This means that their lungs, which should be filled with oxygen, are now filled with fluid instead. Patients with ARDS are extremely difficult to oxygenate, which makes the mortality rate very high. The only way to manage the condition is through the use of a ventilator .
“Normally, ARDS is something that happens over time as the lungs get more and more inflamed. But with this virus, it seems like it happens overnight,” said the respiratory therapist .
The respiratory specialist says that most of their coronavirus patients need the ventilators on the highest settings- the highest he’s ever seen.
“In my experience, this severity of ARDS is usually more typical of someone who has a near drowning experience — they have a bunch of dirty water in their lungs — or people who inhale caustic gas. Especially for it to have such an acute onset like that. I’ve never seen a microorganism or an infectious process cause such acute damage to the lungs so rapidly. That was what really shocked me.” 
He explained that many of their patients have to be restrained because they begin to hyperventilate. Many of them are delirious with fever and feel like they’re suffocating. They don’t realize that the medical staff is trying to help them, and they try to rip out their breathing tube because they feel like it’s choking them.
He described the colors of the patients’ secretions, which are usually pink because they’re filled with red blood cells that are leaking into their airways- they are essentially drowning in their own blood and bodily fluids.
He said that even patients who survive ARDS will experience long-lasting damage to their lungs. They get filled up with scar tissue, and in some cases, it can lead to cognitive decline. Some people experience muscle wasting, and it can take them a long time to recover after being on a ventilator .
The Dangers of a Bed Shortage
One of the biggest fears facing medical professionals across the country right now is the threat of running out of ICU beds, which could significantly drive up the mortality rate.
“There is a very real possibility that we might run out of ICU beds and at that point I don’t know what happens if patients get sick and need to be intubated and put on a ventilator. Is that person going to die because we don’t have the equipment to keep them alive? What if it goes on for months and dozens of people die because we don’t have the ventilators?” 
This is why governments and health officials are urging citizens to stay at home and self-isolate. It is absolutely crucial that we slow down the spread of the virus, or “flatten the curve”, to a rate that our healthcare system can manage.
If we can achieve this, we can significantly decrease the number of deaths caused by the novel coronavirus, while also giving scientists and researchers more time to develop an effective treatment to prevent more people from contracting the disease.
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