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The Emerging Global Problem: COVID-19
Mar 24, 2020
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What is COVID-19

More than 180 countries are currently battling with the pandemic of an infectious disease called coronavirus disease or more accurately COVID-19 (i.e. CORONA VIRUS DISEASE 2019). It is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Isaac et al., 2020). People with COVID-19 generally develop signs and symptoms including fever, cough and shortness of breath. According to World Health Organization, most estimates of the incubation period for COVID-19 range from 1 to 14 day, with an average of 5-6 days after infection.

Development Timeline

The outbreak started in late 2019 and developed into a global pandemic by March 2020 (Max et al., 2020).

COVID-19 Deaths Worldwide as of 22 March 2020

As of 22 March3, 2020, the outbreak of the coronavirus disease (COVID-19) hasd spread to 6 continents, and approximately 12,944 people have died after contracting the respiratory virus. Around 3,267 of these deaths occurred in China (John, 2020; WHO, 2020a).

Case Fatality Rate (CFR) as of 22 March 2020

Infection Fatality Risk (IFR) is the number of deaths from a disease divided by the total number of cases. However, the total number of cases is not known as not everyone with COVID-19 is tested. This makes it difficult to accurately discuss the statistics since a lot more people may be infected, which would ultimately reduce the case fatality rate (Max et al., 2020).

The case fatality rate (CFR) is a reflective value of the severity of the disease in a particular context at a particular time in a particular population. The probability that someone dies from a disease is not only dependent on the disease itself, but also the social and individual response to it, for example: the level and timing of treatment they receive, as well as the ability of the individual to recover from it. CFR can decrease or increase over the time as it can vary by location and by characteristics of the infected population including age, sex and pre-existing conditions (Max et al., 2020).

As of 22 March, the global CFR according to data from WHO website is currently 4.4%, and is based on 294,110 confirmed cases and 12,944 deaths. In China, the CFR is 4.0% based on 81,499 confirmed cases and 3,267 deaths, whereas for the rest of the world, the CFR is currently 4.6% based on 212,611 confirmed cases and 9,677 deaths (WHO, 2020a).

Elderlies are at the highest risk

Data currently available revealed that individuals aged 18 years old and under have a relatively low fatality rate. Individuals at highest risk for severe disease and death include people aged ≥ 60 and those with underlying conditions such as hypertension, diabetes, cardiovascular disease, chronic respiratory disease and cancer (WHO, 2020b).

The mortality increases with age with the highest mortality among people ≥ 80 years old with CFR of 21.9%. Data revealed that the CFR is higher among males compared to females (4.7% vs 2.8%). On top of that, COVID-19 patients who reported to have no comorbid conditions (i.e. denoting a medical condition that co-occurs with another) had a CFR of 1.4%. Patients with comorbid conditions currently have much higher CFR with 13.2% for those suffering from cardiovascular disease, 9.2% for diabetes, 8.4% for hypertension, 8.0% for chronic respiratory disease and 7.6% for cancer (WHO, 2020c).

Similarly, by referring to the data collection in China, the elderly is at the greatest risk of dying if infected with this virus. 14.8% of those who are ≥ 80 years who were infected by COVID-19 died. This seems to be because this age group has more underlying health conditions such as cardiovascular diseases, diabetes, chronic respiratory diseases, hypertension and cancers. However, data in the graph presented below does not represent the correct share of people in the entire population who die from it, since not all suspected cases are tested (Max et al., 2020; The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team, 2020).

Adopted from: Max et al., 2020.

On March 20, the CDC (Centers for Disease Control and Prevention) reported a total of 15,219 COVID-19 cases in the US (CDC, 2020a). According to data analyzed by CDC between February 12 and March 16, multiple cases reported among older adults were living in long-term care facilities. Overall, 80% of deaths associated with COVID-19 were among adults aged ≥ 65 years with the highest percentage of severe outcomes among elderly aged ≥ 85 years. In contrast, no ICU admissions or deaths were reported among persons aged ≤ 19 years. Similar to reports from other countries, this revealed that the risk for serious disease and death from COVID-19 is highest in older age group. The hospitalization rate for patient below 19 is ranging from 1.6 to 2.5% whereas patient aged between 20 to 44 years old accounted for 14.3 to 20.8% (CDC, 2020b).

Adopted from: CDC, 2020b.

In Italy, there were 36 out of 3,199 (1.1%) deaths reported for COVID-19 positive patients as of March 20. In particular, 9 of them were younger than 40 years (8 men and 1 women), 2 of them were under 40 and the remaining 7 had serious pre-existing diseases including cardiovascular, renal, psychiatric pathologies, diabetes and obesity. On the other hand, there are 1,607 out of 3,200 of deaths reported for patients above 80 (50.2%) (Istituto Superiore di Sanità, 2020).

Adopted from: Istituto Superiore di Sanità, 2020.

WHO: COVID-19 is not a trivial infection for young people

On 20 March 2020, the WHO’s Director General Dr Tedros Adhanom Ghebreyesus addressed the media and stated that “Even though the older people are the hardest hit, younger people are not spared. Data from many countries clearly shows that people under 50 make up a significant proportion of patients that requiring hospitalization. Today, I have a message for young people: you are not invincible. This virus could put you in hospital for weeks or even kill you. Even if you don’t get sick, the choices you make about where you go could be the difference between life and death for someone else”. As the WHO’s Director General said “Solidarity will defeat COVID-19. Solidarity between countries, but also solidarity between age groups” (WHO, 2020d).

References

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