Charles Teves
The World Health Organization (WHO) has said COVID-19 has an estimated death rate of 3.4 percent.
US President Donald Trump doesn’t believe this. In an interview with Fox News, President Trump said that it might actually be lower than the current estimation.
“I think the 3.4 percent number is really a false number. Now, this is just my hunch, but based on a lot of conversations, I’d say the number is way under 1 percent.”
WHO computed the case fatality rate by dividing the number of deaths by the total number of cases.
But President Trump might actually be right, as experts in epidemiology say that 3.4 might be too far off and that 1 percent is more accurate. The WHO says that the estimate will decrease over time.
Public health officials depend on the fatality rate heavily when responding to disease outbreaks. Deadlier diseases cause more disruption to people’s lives.
Marc Lipsitch, a professor of epidemiology at Harvard, says predicting possible outcomes is very important.
“It’s essential for understanding how big our response should be. All responses have costs. If we think the risk is higher, then we should be willing to tolerate bigger costs, more inconvenience and the mental health loss from social distancing.”
The fatality rate might look overwhelming, but that is only because there is not enough testing being done. There are also deaths that are not attributed to the new coronavirus. These are few of the reasons an exact number cannot be given by experts.
The fewer people are tested, then the fewer diseases are examined. Initially in the US, only those who recently traveled to China were tested, as well as those who were in contact with ill people. Now it is clear that a lot of potentially infected were not getting tested.
Determining the number of confirmed cases will most likely drive down the fatality rate.
Mark Lurie, an associate professor of epidemiology at Brown University, admits that there needs to be more effort when it comes to testing.
“Since most cases are mild, and testing has not been universal, almost by definition we are failing to detect and therefore count all of the cases.”
The infection fatality rate, which shows how many people are infected by a certain disease, is done by blood testing where immune systems of people in a certain community are tested. This is able to produce a real infection rate and a better fatality rate.
Deaths are actually easier to count than those who are infected. But health experts say not all deaths related to the new coronavirus are reported nor counted.
Justin Lessler, an epidemiologist at Johns Hopkins, was studying COVID-19 cases in Shenzen, China, when he found out that most people who died had been sick for longer than 30 days.
Lessler thinks there is more to be known about the virus and its effects.
“Think of when all the cases outside of Hubei have occurred. If it’s 30 days or even two weeks, we’re really at the tip of the iceberg.”
Epidemiologists usually measure the fatality of a certain disease within a certain duration, but they haven’t done it with COVID-19.
Health experts say that the analytics will differ with countries and the number one main factors would the healthcare systems these countries have and their population.
But what is evident is that older people tend to have higher risks of getting the virus, and is a good explanation on why a lot of Italians are dying from it. There have only been a few children that have been confirmed to be infected with the Chinese virus.
Current findings suggest that smoking also increases risk, as well as being diabetic, having cardiovascular disease, and respiratory ailments like asthma. People infected usually need respiratory treatment and intervention. These people require constant ventilation, and the level of treatment they get depends on the staff and availability of supplies.
Dr. Thomas Frieden, who has been to China, says more people die when resources are insufficient.
“When facilities got overwhelmed, there were more deaths.”
Hospital capacity in the US will depend on the rate that the virus spreads.
Dr. Ashish Jha, the director of the Harvard Global Health Institute, also doesn’t believe the 3.4 percent.
“When I looked at the 3.4 percent number and where they got it, I thought this is both wrong and irrelevant. It’s not relevant to nearly any single person. This is a worldwide average.”
Many people are still confused about what the virus does to the body, and what the signs and symptoms are.
Fever, cough, shortness of breath, are usually the common symptoms, but they can also be indicators of the flu.
The virus is transferred when droplets are transmitted into the air then makes contact with other peoples’ nose, mouth, and eyes. The particles will then attach themselves to the back of the throat, and eventually penetrate the cells.
Dr. William Schaffner says from there on out, the human cells are forced to multiply the virus, which affects other cells nearby, causing sore throat and dry coughs.The mucous membranes of the lungs become inflamed the virus reaches it which makes it harder for the lung sacs to supply the body of oxygen.
Dr. Amy Compton-Phillips, the chief clinical officer for the Providence Health System, says, “If you get swelling there, it makes it that much more difficult for oxygen to swim across the mucous membrane.”
The swelling and the lack of oxygen causes the lungs to be filled up with liquid, pus, and dead cells which then causes pneumonia, an infection in the lungs. Acute Respiratory Distress Syndrome happens when the lungs are filled with so much liquid that not even ventilators can help the patient. Death is then expected.
Dr. Shu-Yuan Xiao, a professor of pathology at the University of Chicago School of Medicine, says that the virus first affects both side of the lungs, then moves up to the trachea and other upper respiratory tracts. The reason why many died in Wuhan was because health workers did not focus on the problems concerning the peripheral lungs.
“They’d either go to other hospitals to seek treatment or stay home and infect their family. That’s one of the reasons there was such a wide spread.”
The virus can spread from mucous membranes from the nose down to the rectum. The virus can also infect the bloodstream and gastrointestinal system, which is why many who are infected report of diarrhea or indigestion.
Dr. George Diaz, section leader for infectious diseases at Providence Regional Medical Center in Everett, Washington, added that bone marrow and other organs such as the liver can be infected as well.
“The virus will actually land on organs like the heart, the kidney, the liver, and may cause some direct damage to those organs,” Shaffner said.
The immune system will then have a heightened defense which will hurt other systems too. SARS and COVID-2019 are very similar, but past studies show that those who were affected with SARS also had problems with their brains. It is still unclear whether COVID-19 can affect the brain, but no possibility is being ruled out.
80 percent of those infected only show mild symptoms while the other 20 percent have it worse. It really depends on the person’s immune system. Those who are diabetic or are suffering from chronic illnesses are very likely to develop severe symptoms.
Patients can develop pneumonia within a week, some recover first then get symptoms that are worse than the previous ones. Xiao said that some patients in China died because they had damaged and vulnerable lung tissue that was constantly attacked by a bacterial infection.
There are now 254,654 confirmed cases worldwide and 10,440 have died from COVID-19.
