In a transcript dated February 24 2020, radio personality Rush Limbaugh claimed that novel coronavirus (COVID-19) is no more dangerous than “the common cold,” adding that he believed that concern over the new strain of disease was simply part of an effort to make United States President Donald Trump look bad:
RUSH: Folks, this coronavirus thing, I want to try to put this in perspective for you. It looks like the coronavirus is being weaponized as yet another element to bring down Donald Trump. Now, I want to tell you the truth about the coronavirus. (interruption) You think I’m wrong about this? You think I’m missing it by saying that’s … (interruption) Yeah, I’m dead right on this. The coronavirus is the common cold, folks.
The Drive-By Media hype of this thing as a pandemic, as the Andromeda strain, as, “Oh, my God, if you get it, you’re dead.” Do you know what the — I think the survival rate is 98%. Ninety-eight percent of people get the coronavirus survive. It’s a respiratory system virus. It probably is a [Chinese] laboratory experiment that is in the process of being weaponized. All superpower nations weaponize bioweapons.
According to Limbaugh, perception of novel coronavirus — COVID-19 — and its dangers did not stem from epidemiological data. Rather, he posited on his syndicated radio show, the death of 34-year-old doctor Li Wenliang (who both discovered and succumbed to the strain) was the cause of global concern over the virus’ risk.
In that excerpt, Limbaugh appeared to contradict himself, claiming that Li Wenliang “didn’t know what he was dealing with,” thus leading to his death:
It originated in China in a little — well, not a little town. It’s a town that is 11 million people, Wuhan, China. One of the reasons they’re able to hype this is that the doctor what warned everybody about it came down with it and died. So if a doctor got it, “Oh, my God, Rush! A doctor got it? You can’t possibly be right if a doctor can’t protect himself.” He didn’t know what he was dealing with. He discovered it back in December . I’m telling you, the [Chinese] are trying to weaponize this thing.
After alleging without any evidence that the novel strain of coronavirus was being weaponized by China, Limbaugh went on to assert that the reason for what he characterized as falsified or exaggerated worldwide concern was simply to “bring down Trump”:
But the way [COVID-19 is] being used … I believe the way it’s being weaponized is by virtue of the media, and I think that it is an effort to bring down Trump, and one of the ways it’s being used to do this is to scare the investors, to scare people in business. It’s to scare people into not buying Treasury bills at auctions. It’s to scare people into leaving, cashing out of the stock market — and sure enough, as the show began today, the stock market — the Dow Jones Industrial Average — was down about 900 points, supposedly because of the latest news about the spread of the coronavirus.
Limbaugh’s secondary claim — that stories about the novel coronavirus were overhyped or exaggerated to politically harm Trump — did not really hold water in the global context of a virus identified first in China. World health officials attended to concerns about and research into COVID-19, and focus on the strain was in no way exclusive or limited to the United States.
His primary claim was more solid as well as more verifiable. Limbaugh specifically said “the coronavirus is the common cold,” from which we ought to be able to reasonably deduce Limbaugh intended to suggest COVID-19 posed a risk equivalent to that of the common cold, which seemed incongruent with his own example of the youthful Dr. Li’s death from the strain.
Regarding “the common cold,” no one virus is typically responsible for the cluster of respiratory infections going by that name. Rhinoviruses in general are the most common culprit in colds, and symptoms tend to be restricted to fatigue, a stuffy nose, a sore throat, headache, coughing, sneezing, congestion, and low-grade fever. Rarely complications can result, such as ear infection, opportunistic infection (such as strep throat), and pneumonia.
According to The Conversation’s “Can you die from a common cold?”, rhinoviruses cause “about half of all colds, but other viruses can cause one or more of the symptoms of a cold, including adenovirus, influenza virus, respiratory syncytial virus and parainfluenza virus.” In most cases, colds are mild and inconvenient, but not always:
The common cold is normally a mild illness that resolves without treatment in a few days. And because of its mild nature, most cases are self-diagnosed. However, infection with rhinovirus or one of the other viruses responsible for common cold symptoms can be serious in some people. Complications from a cold can cause serious illnesses and, yes, even death – particularly in people who have a weak immune system.
A primary point of note in comparing known coronavirus strains and the cluster of viruses known as the common cold involves mortality rate. A 2011 article published in the medical journal BMJ Clinical Evidence indicated that colds cause “no mortality or serious morbidity”:
Common colds are usually short lived, lasting a few days, with a few lingering symptoms lasting longer, especially cough. Symptoms peak within 1 to 3 days and generally clear by 1 week, although cough often persists. Although they cause no mortality or serious morbidity, common colds are responsible for considerable discomfort, lost work, and medical costs.
For clarity on the difference, we turned to a January 2020 article in the Journal of the American Medical Association, better known as JAMA. That article’s headline was in fact “Coronavirus Infections — More Than Just the Common Cold.”
Noting that coronaviruses are “large, enveloped, positive-strand RNA viruses” which are “endemic globally and account for 10% to 30% of upper respiratory tract infections in adults,” the article began by stating that the viruses were often underestimated. However, citing previous coronavirus outbreaks (such as those called SARS and MERS respectively), the JAMA article reported that both led to “alarming morbidity and mortality” in those infected:
Human coronaviruses (HCoVs) have long been considered inconsequential pathogens, causing the “common cold” in otherwise healthy people. However, in the 21st century, 2 highly pathogenic HCoVs—severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV)—emerged from animal reservoirs to cause global epidemics with alarming morbidity and mortality. In December 2019, yet another pathogenic HCoV, 2019 novel coronavirus (2019-nCoV), was recognized in Wuhan, China, and has caused serious illness and death. The ultimate scope and effect of this outbreak is unclear at present as the situation is rapidly evolving.
As of the article’s January 2020 publication, authors described an uncertain scope for COVID-19, in a situation which was then “rapidly evolving.” Authors further stated that nearly two decades after the first outbreak of SARS in 2002, “factors associated with transmission of SARS-CoV … remain poorly understood.”
In 2012, a second novel strain of coronavirus known as MERS (Middle East respiratory syndrome) was identified in Saudi Arabia. Authors contrasted SARS’ rapid spread (“contained and eliminated in relatively short order”) with MERS having “smoldered,” spreading slowly. Nevertheless, of nearly 2,500 known MERS infections, 858 people died:
MERS-CoV has not yet sustained community spread; instead, it has caused explosive nosocomial [hospital-based] transmission events, in some cases linked to a single superspreader, which are devastating for health care systems. According to the World Health Organization (WHO), as of November 2019, MERS-CoV has caused a total of 2494 cases and 858 deaths, the majority in Saudi Arabia.
Based on those specific figures, MERS appeared to have a mortality rate of about 34.4 percent. The authors said it appeared that the fatality rate of 2019-nCoV was lower than that of SARS-CoV and MERS-CoV; “however,” they added, “the ultimate scope and effects of the outbreak remain to be seen.”
Throughout the article, authors demonstrate differences between coronaviruses (such as SARS, MERS, and COVID-19) and respiratory infections (among which is the “common cold.”) While respiratory infections can develop into pneumonia, an infection observed alongside coronaviruses, MERS patients in particular often present with “prominent gastrointestinal symptoms and often acute kidney failure”; SARS patients frequently presented with “fever, cough, dyspnea, and occasionally watery diarrhea.”
The article concluded by emphasizing nascent public health information about COVID-19, calling for immediate action and timely countermeasures to prevent a larger outbreak of the strain:
While the trajectory of this outbreak is impossible to predict, effective response requires prompt action from the standpoint of classic public health strategies to the timely development and implementation of effective countermeasures. The emergence of yet another outbreak of human disease caused by a pathogen from a viral family formerly thought to be relatively benign underscores the perpetual challenge of emerging infectious diseases and the importance of sustained preparedness.
Both SARS and MERS had years of epidemiology behind them; COVID-19 was not identified until December 2019. As of February 2020, the strain had been known for roughly three months. A February 12 2020 Vox piece explained why COVID-19’s mortality rate had been elusive:
The mortality rate, known to epidemiologists as the “case fatality risk,” is vital for assessing the possible impact of an outbreak. Unfortunately, most of what has been reported about the mortality rate of the novel coronavirus is wrong.
Many media reports simply compare the total reported number of deaths with the overall reported number of cases. This is, intuitively, the fraction of people who die from the disease. But early in an outbreak, this type of simple calculation is often misleading.
The first cases identified in an outbreak are typically people who are quite ill, which is how their disease comes to the attention of health authorities in the first place. For this reason, early mortality rates estimated from only those early patients who require medical care will be high.
Later in the outbreak, as physicians and epidemiologists get better at identifying cases, the opposite problem emerges. As the outbreak grows, more people are diagnosed each day than were diagnosed a week ago, meaning that most people are still in the midst of their illness. Mortality estimates that include those people who do not have an outcome yet will undercount the mortality rate.
Vox provided an example of how tenuous the estimated mortality rate for the novel coronavirus was:
For example, many outlets are reporting that the mortality rate of COVID-19 is around 2 percent, because 1,017 of 42,708 cases in China have died. But of those 42,708, about half were diagnosed just in the last seven days and are likely still experiencing symptoms, so their outcome is not yet known.
As of late February 2020, COVID-19 was often described as having a three percent mortality rate. But a study’s press release issued by the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP) and published in JAMA provided updated figures on February 24 2020, suggesting a 2.3 percent rate of mortality based on limited data collected after December 2019 by researchers in China:
Researchers from China’s Center for Disease Control and Prevention today describe the clinical findings on more than 72,000 COVID-19 cases reported in mainland China, which reveal a case-fatality rate (CFR) of 2.3% and suggest most cases are mild, but the disease hits the elderly the hardest. The study, published in JAMA, is the largest patient-based study on the novel coronavirus, which was first connected to seafood market in Wuhan, China, in December, and has since traversed the globe.
Another area where Limbaugh’s common cold comparison looked inaccurate was the case-fatality rate (CFR) in critical cases, which was 49 percent:
The overall case-fatality rate (CFR) was 2.3% (1023 deaths among 44 672 confirmed cases). No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8% CFR. No deaths were reported among mild and severe cases. The CFR was 49.0% among critical cases. CFR was elevated among those with preexisting comorbid conditions—10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for hypertension, and 5.6% for cancer. Among the 44 672 cases, a total of 1716 were health workers (3.8%), 1080 of whom were in Wuhan (63%). Overall, 14.8% of confirmed cases among health workers were classified as severe or critical and 5 deaths were observed.
Researchers added again that a complete picture was not available based on limited data and disparate CFRs. Study authors advised interpreting early numbers with caution, emphasizing that further research was required:
As of the end of February 18, 2020, China has reported 72 528 confirmed cases (98.9% of the global total) and 1870 deaths (99.8% of the global total). This translates to a current crude CFR of 2.6%. However, the total number of COVID-19 cases is likely higher due to inherent difficulties in identifying and counting mild and asymptomatic cases. Furthermore, the still-insufficient testing capacity for COVID-19 in China means that many suspected and clinically diagnosed cases are not yet counted in the denominator. This uncertainty in the CFR may be reflected by the important difference between the CFR in Hubei (2.9%) compared with outside Hubei (0.4%). Nevertheless, all CFRs still need to be interpreted with caution and more research is required.
Limbaugh claimed that a novel strain of coronavirus (COVID-19) was “the common cold,” and outbreaks were being exaggerated for political purposes. Common colds are typically caused by rhinoviruses, not coronaviruses. Information about COVID-19 remained preliminary, with researchers constantly emphasizing the need for additional information before drawing conclusions about factors such as case-fatality rate, or CFR. Common colds have no known rate of mortality (although in rare cases death can occur), and coronaviruses can have double-digit rates of fatality. The most recent estimate for COVID-19’s mortality rate was 2.3 percent, a number that could change and was described in published research as “crude” — but the severity of the novel strain of coronavirus was inarguably stronger than that of the common cold.