Shortly after arriving in Portugal, the outbreak of the novel coronavirus-19 (COVID-19) began in Wuhan province in China. We've been following this expanding infection closely, and the question of concerned family members is, "When are you coming home?" [To protect the privacy of concerned parties, names have been withheld.] We ask that question ourselves every few days. If one looks at headlines, we should be getting out of Europe, right?
Factors in decision-making
We are trying to make a rational decision, based on:
1. How serious is this infecton?
2. The likelihood of us becoming infected, given known location and numbers infected
3. Our personal risk of serious illness or death in the event of infection
4. Our present location. Currently, this is northern Portugal.
5. Our planned itinerary, which presently, is to northern Spain, southern France, northern Italy (yikes!), Switzerland, SW Germany and Holland.
6. Consequences of our returning home, even being healthy, having traveled to one of these areas, especially with respect to quarantine and other hassles
There are two sources of information used to come to the conclusion that, at this point in time, we are going to continue traveling. For now.
1. The lay press - a good source for up to the minute information on present community transmissions in areas we've been or are going to go. As a good example:
As of yesterday afternoon, 13 cases in the country, all having traveled or having been in close contact with a known positive case. Italy being the suspected source for the first cases.
The NY Times website is also good:
Latest numbers, as of March 7, show global infections at 102,000 and 3500 deaths, with the vast majority (85%) in China. This article presents a fantastic look at the numbers
2. The medical literature - I am still receiving a steady stream of email related to the public health response in Canada, and from the medical journals that are reporting the scientific understanding we have of the behaviour of this virus. The New England Journal of Medicine is probably the most authoritative journal out there, kind of like the New York Times, but for health practitioners. It maintains a page: www.nejm.org/coronavirus, which shows its recent publications on this pathogen. About a week ago, a paper was published of the clinical course for about 1100 infected patients in Wuhan, China, the ground zero for the infection. Most were infected at the infamous animal market where the virus originated.
Looking just at today's emails, here are some other sources for the scientifically and morbidly curious:
1. BC Centre for Disease Control - mostly BC-based numbers: BC has 21 cases, as of March 6. http://www.bccdc.ca/about/news-stories/stories/2020/information-on-novel-coronavirus
2. World Health Organization - this organization declares the pandemic, defined as sustained human-human disease transmission over many geographic areas. See figure below. https://www.who.int/emergencies/diseases/novel-coronavirus-2019
So how serious is this infection? The mortality rate is 2%, according to multiple sources. Meaning a 2 in 100 chance of dying if infected, though largely in the elderly, those with immune deficiencies and those with lots of other health issues (like COPD, heart disease or diabetes).
What about the risk of getting infected? Our mingling in the general population is low. The best estimate for the risk of close contacts being
We have not spent time in close contact with any Portuguese, and our mode of travel is, for now at least, the bike. We are in areas with a low burden of illness. We are well rested, fit, young(ish), taking no medications and have no significant medical history. I think our current risk is close to zero.
What will we do differently?
Northern Italy is out, much to Sol's chagrin. His hero, Renaldo, plays in Turin, Italy, for Juventus. This city is in the no-go area. We're avoiding this area.
France and Spain are still ON. Once we bike to Santiago, arriving in 2 weeks, we will train to Bilbao, then to Bordeaux in France. The plan then is to bike to Narbonne on the Mediterranean. From there, as long as the coast is clear, we'll stay put for some time and then see. If the Canadian Government issues any travel advisories, we will follow them. We may be home well before June...