SARS-CoV-2: fear versus data
Authors: Christine Zandotti
Yanis Roussel
Audrey Giraud-Gatineau
Didier Raoult
Marie-Thérèse Jimeno
Philippe Colson
Jean-Marc Rolain
Journal: International Journal of Antimicrobial Agents (2020)
Discipline: PHARMACOLOGY & TOXICOLOGY
Keywords: COVID-19; Coronavirus; SARS-CoV-2.
Affiliations: Institut Hospitalo-universitaire Méditerranée Infection, Marseille, France; Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Microbes Evolution Phylogénie et Infections, Marseille, France., Institut Hospitalo-universitaire Méditerranée Infection, Marseille, France; Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs - Infections Tropicales et Méditerranéennes, Marseille, France; Centre d'Epidémiologie et de Santé Publique des Armées, Marseille, France; Assistance Publique - Hôpitaux de Marseille, Marseille, France., Assistance Publique - Hôpitaux de Marseille, Marseille, France., Institut Hospitalo-universitaire Méditerranée Infection, Marseille, France; Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Microbes Evolution Phylogénie et Infections, Marseille, France. Electronic address: .

Abstract:  SARS-CoV-2, the novel coronavirus from China, is spreading around the world, causing a huge reaction despite its current low incidence outside China and the Far East. Four common coronaviruses are in current circulation and cause millions of cases worldwide. This article compares the incidence and mortality rates of these four common coronaviruses with those of SARS-CoV-2 in Organisation for Economic Co-operation and Development countries. It is concluded that the problem of SARS-CoV-2 is probably being overestimated, as 2.6 million people die of respiratory infections each year compared with less than 4000 deaths for SARS-CoV-2 at the time of writing. 

Retracted: No

PubPeer comments:
 The claim of this study is that the mortality rate for common coronaviruses is not significantly different to that for SARS-CoV-2. This estimate is based on a worldwide mortality rate of SARS-CoV-2 estimated on data available on March 2 2020, the mortality rate for common coronaviruses identified at the study hospital in France, and a Chi2 test comparing the two. In the Introduction: The aim of this study was to share the experience of a reference laboratory representing approximately 1% of serious and diagnosed respiratory infections, particularly seasonal, in France. The reference laboratory here is the IHU Mu00e9diterranu00e9e Infection diagnostic laboratory testing samples in which respiratory viruses are suspected from Assistance Publique-Hu00f4pitaux de Marseille (AP-HM) covering all public hospitals in Marseille. The number of approximately 1% of serious and diagnosed respiratory infections is based on the fraction of people dying in AP-HM compared to all people dying in care establishments in France (0.8% = 2854 deaths in AP-HM compared to 351 648 deaths in French care establishment). Next, the mortality rate for common coronaviruses was based on the following data: From 1 January 2013 to 31 December 2019, 21 662 samples were tested by the IHU Mu00e9diterranu00e9e Infection diagnostic laboratory. Among these, 770 samples were positive for coronavirus, with eight deaths (mortality rate 1%). Viruses from the coronavirus family are known for a while and mostly cause respiratory infections in the common cold. During the testing period, none of the dangerous virus strains (SARS-CoV-2, SARS-CoV and MERS-CoV) were circulating in that region. So what was done here was to test patients that were in hospital treatment in common hospitals in Marseille with suspected respiratory viruses for the presence of coronaviruses that cause the common cold. From those tested positive, it was assessed how many had died. From this number of hospitalized patients who have died and were positive for coronavirus infection, the mortality rate was assessed. This assumes that these patients were dying from the coronavirus infection. There is no information provided why these patients were in hospital treatment, as people are generally not hospitalized for the common cold. There is also no information how many of the 20u2019892 patients tested negative for coronavirus have died. If any of these has died, what would have been the cause following this logic? Further on: Systematic testing ... for SARS-CoV-2 was performed from 1 January 2020 to 2 March 2020. In total, 7059 samples from patients presenting with infectious symptoms were tested u2026 Among them, 543 samples were positive for coronaviruses, with two deaths (mortality rate 0.36%): 277 samples were HKU1, 146 samples were NL63, 77 samples were OC43 and 43 samples were 229E. No cases of SARS-CoV-2 were identified among these samples. So also for the 2020 data none of the dangerous coronavirus strains was detected, but the deaths are attributed to coronavirus infection assuming causality There is again no information available on patient history and the number of deaths in the patients that were tested negative for coronavirus. In summary, without the number of deaths in coronavirus virus negative hospital patients, no background distribution and hence no over-representation can be calculated, and assuming causality of infection with coronavirus strains causing the common cold for patients dying in hospitals is not legitimate. In the discussion it is stated: u2018Of course, the major flaw in this study is that the percentage of deaths attributable to the virus is not determined u2026 u2019 The authors are right that this is a major flaw, and it is so major that it actually does not allow for any conclusions. Such unfounded statements as in this article are in fact dangerous in a situation in which limiting the spread of the virus depends on people adhering to recommended containment measures. , 
 #1 I agree that u201cassuming causality of infection with coronavirus strains causing the common cold for patients dying in hospitals is not legitimate.u201d But folks are doing this with SARS-CoV-2 as well! ,