The incidence of COVID-19 has shot up dramatically in the first two months, overtaking the speed with which previous epidemics spread.
- A terrifying graph shows how the spread of coronavirus overtakes previous epidemics like Ebola, SARS and MERS.
- However, the clip is only part of a longer video – and conveniently cuts off before swine flu surpasses COVID-19.
- The wider context: the coronavirus outbreak remains relatively small and is comparatively non-lethal.
How to lie with statistics
How is the #coronavirus compare to #H1N1, #MERS, #Ebola and #SARS ? #COVID19
— COVID19 (@COVID_19_News) February 21, 2020
WATCH THIS VIDEO GRAPH:
pic.twitter.com/KsXMW0NoYF
This video, posted on Twitter on 22 February, shows how the coronavirus (COVID-19) epidemic compares to that of other recent outbreaks. Terrifyingly, the line for the coronavirus skyrockets, leaving those for SARS, MERS, ebola and swine flu far behind.
Alarming? Yes. But not the whole story. As Mark Twain once said: There are three kinds of untruths: "Lies, damned lies and statistics." If he were around today, he might add a fourth: video edits. The 30-second clip is part of a 10-minute video with exactly the opposite message: Do not panic!
When the video was posted, the coronavirus was less than two months old, and had already travelled from its ground zero—a so-called 'wet market' in the Chinese city of Wuhan—across several continents, infecting more than 40,000 people. It had just killed its 1,000th victim.
The no-panicking message still holds, even half a month and more than double the number of cases later. As of 1 March, we've passed 86,900 people infected, with just under 3,000 deaths reported. Why? Because context is everything.
Virus speed comparison
Mexican police officer wearing a face mask during the swine flu outbreak of 2009.
Image: Eneas De Troya, CC BY 2.0
First, the standalone clip, which has been seen more than two million times. It compares the speed of the coronavirus outbreak to that of a few other recent ones:
- SARS (started in Hong Kong in March 2003),
- swine flu (started in Mexico in March 2009),
- ebola (started in Western Africa in March 2014), and
- MERS (started in South Korea in May 2015).
- At first, Ebola is the scary one. Not only had it infected the most people after just one day, it had killed two thirds of those.
- By comparison, SARS killed its first victim only after three days (out of 38 people infected).
- By Day 10, SARS had overtaken Ebola as the most infectious of the outbreaks (264 vs. 145 patients), but the latter was ten times more lethal (91 dead from Ebola vs. 9 from SARS). At this time, the coronavirus had infected 39 people, killed none, and was still playing in the same minor league as the swine flu and MERS.
Exponential rise
Day 262: swine flu dwarfs the other epidemics.
Image: Abacaba
- Day 20, and SARS cases are skyrocketing: 1,550 people are ill, 55 have died. That's a death rate of 3.5%. Ebola has affected only 203 people by now, but killed 61.6% of them, a total of 125. Meanwhile, the coronavirus has taken Ebola's second place, but is still far behind SARS (284 infected). At this time, the coronavirus has claimed the lives of just five people.
- But now the coronavirus cases are exploding; by Day 30, the new virus has infected 7,816 people, killing 204. That's far more infected than any other virus (SARS comes a distant second with 2,710 patients), and significantly more killed (Ebola, though still just 242 people ill, has killed 147, due to its high fatality rate). Meanwhile, MERS is stuck in triple digits, and the swine flu in double digits.
- Day 40: coronavirus cases (40,553) dwarf those of SARS (3,550). The swine flu (369) has overtaken ebola (243), at about the same level as MERS. Also in terms of fatalities, coronavirus now far supersedes SARS (182), ebola (164) and the swine flu (5).
About here, the clip cuts out. The editing aims to focus the attention on the exponential rise in coronavirus cases. But as the longer version goes on, the story changes.
The FULL video of that viral Twitter snippet
- By Day 60, it's the swine flu cases that have exploded, to more than 60,000 people ill and 296 people killed—surpassing Ebola (183), if not SARS (513).
- The swine flu numbers keep growing exponentially: by Day 80, they've passed 362,000 cases (and 1,770 deaths), far surpassing any of the other diseases.
- Day 100: swine flu cases are approaching 1 million, deaths have surpassed 5,000. That's far more than all the other diseases combined—they have merged into a single line at the bottom of the graph.
- By Day 150, swine flu hit 5.2 million patients, with 25,400 people killed. By the time it was declared over, a year later, the outbreak would eventually have infected more than 60 million people and claimed the lives of almost 300,000.
Swine flu was caused by the H1N1 virus, which also caused the Spanish flu. That outbreak, in 1918/19, infected about 500 million people, or 1 in 3 people alive at that time. It killed at least 50 million people. It was the combination of extreme infectiousness and high fatality that made the Spanish flu such a global, lethal pandemic.
None of the other infectious diseases comes close to that combination. The swine flu, although more infectious than other diseases, was less infectious than the Spanish flu, and also less deadly (0.5%). Unlike COVID-19 or its fellow coronaviruses SARS and MERS, Ebola is not spread via airborne particles, but via contact with infected blood. That makes it hard to spread. Ironically, it may also be too lethal (39.6%) to spread very far. And COVID-19 itself, while relatively lethal (2.4%), is well below the deadliness of the Spanish flu, and does not seem to spread with the same ease.
Best strategy
WHO dashboard on the spread of COVID-19.
Image: World Health Organization.
Providing further context to the relatively small danger that the coronavirus poses to your personal health, the video ends by comparing the virus's most deadly day so far (108 people killed on 10 February) to the average causes of death worldwide for that day.
On average 151,600 people die every day. On 10 February, the coronavirus killed a lot less than people were killed by
- Influenza (650, in the US alone)
- Drowning (877),
- Homicide (1,095),
- Suicide (app. 3,000)
- Car crashes (3,287)
- Stroke (13,689)
- Heart disease (24,641)
- Cancer (26,283).
- focus your attention on beating more likely causes of death by eating well, exercising enough and driving safely.
- beat the coronavirus by staying informed and cautious rather than obsessed and panicked.
Video produced by Abacaba and found here on YouTube. See also Snopes.com for more on the veracity of the shorter clip.
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Due to stigma, their illegal status and difficulty in finding control groups, research with psychedelics has been a challenge. But research increasingly shows that this class of drug has legitimate medicinal uses, and they may be just as good or even better than more traditional therapies.
Now, the Centre for Psychedelic Research at Imperial College London reports in the New England Journal of Medicine that when pitted against escitalopram (brand name: Lexapro), psilocybin was as effective as the popular SSRI (selective serotonin reuptake inhibitor) in treating moderate to severe depression. Perhaps most significantly, these results were obtained when comparing 6 weeks of daily doses of escitalopram to just two administrations of psilocybin.
Robin Carhart-Harris, head of the center who has published over 100 papers on psychedelics, is confident this study represents another step forward in applying psychedelics to mental health treatment protocols while also reducing fears a lot of citizens have around these substances. In a press release, he said:
"One of the most important aspects of this work is that people can clearly see the promise of properly delivered psilocybin therapy by viewing it compared with a more familiar, established treatment in the same study. Psilocybin performed very favorably in this head-to-head."
As depicted above, the phase 2 clinical trial included 59 volunteers. The escitalopram (control) group received six weeks of daily escitalopram in addition to two tiny (1-mg) doses of psilocybin — a dose so low that it is unlikely to produce hallucinogenic effects. The psilocybin (experimental) group received two 25-mg doses of psilocybin three weeks apart with placebo given on all the other days.
At the end of the study, both groups saw a decrease in depressive symptoms, though the results were not statistically significant. (That isn't necessarily bad because if the two drugs have similar effects, then they would not produce statistically significant results. Still, a larger study is needed to confirm that psilocybin is "just as good as" escitalopram.)
Additionally, several other outcomes favored psilocybin over escitalopram. For instance, 57 percent in the psilocybin group saw a remission of symptoms compared to 28 percent in the escitalopram group. This result was significant.
Psychedelics without tripping
As psychedelics become decriminalized and potentially legalized for therapeutic use, however, a large population of people might desire the antidepressant effects without the hallucinations. For example, the psychedelic ibogaine may be useful for treating addiction, so the company Mindmed is developing an analog that works without producing the unwanted hallucinogenic side effects.
A new research article, published in the journal PNAS, investigated the antidepressant effects of psilocybin on a group of chronically stressed mice. (Under immense stress, mice develop something resembling human depression.) As with humans, depressed mice lose a sense of joy, which can be assessed by determining their preference for sugar water over tap water. Normal mice prefer sugar water, but depressed mice simply don't care.
Once the mice were no longer juicing up on the sweetened water, the team dosed them with psilocybin alongside a drug called ketanserin, a 5-HT2A serotonin receptor antagonist that eliminates psychedelic effects. Within 24 hours of receiving the dose, the mice were rushing back to the sugar water, indicating that tripping is not necessary for psilocybin to work as an antidepressant.
While the team is excited about these results, they realize it needs to be replicated in a different population.
"The possibility of combining psychedelic compounds and a 5-HT2AR antagonist offers a potential means to increase their acceptance and clinical utility and should be studied in human depression."
The future of psychedelic therapy
Psychedelics such as psilocybin and LSD have a long track record of efficacy in clinical trials and anecdotal experiences. Almost all volunteers of the famous Marsh Chapel experiment claimed their experience on Good Friday in 1962 was one of the most significant events of their lives — and this was a quarter-century after the fact. A more recent, controlled study found that a single dose of psilocybin showed antidepressant effects six months later.
Proponents of macrodosing and ritualistic experiences sometimes argue that the full-blown mystical trip is the therapy, though this is anecdotal, not clinical research. As the Maryland team noted, a number of people are contraindicated for psychedelics, whether through a family history of schizophrenia or current antidepressant treatments.
Senior author Scott Thompson is excited for future research on this topic. As he said of his team's findings:
"The psychedelic experience is incredibly powerful and can be life-changing, but that could be too much for some people or not appropriate… These findings show that activation of the receptor causing the psychedelic effect isn't absolutely required for the antidepressant benefits, at least in mice."
Hopefully, with more research occurring in psychedelics than even in the 1950s (when studies predominantly relied on anecdotal evidence and little government support), the longstanding stigmatization of psychedelics is beginning to recede. This could open up new possibilities for both clinical research and, for those curious about the ritual effects, a continuation of introspective experiences.
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Stay in touch with Derek on Twitter and Facebook. His most recent book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."
