COVID-19 is a highly infectious and deadly disease, even if it may not be the most fatal. Moreover, accurate death rates are unknown since it has taken, and will continue to take, some time to correctly identify all the existing cases. Currently reported death tolls and prevalence rates are inaccurate because most states and countries do not have enough testing kits for everybody. Further, some deaths, that happened earlier in the year, may be attributable to the virus but were never diagnosed. Thus, the fatality rates we are seeing are unreliable. The total fatality rate could be higher or lower, depending on the actual number of cases that occurred.
For example, if a 100 people died from COVID-19 but only 10 deaths were attributed to the disease, the death rate would be deemed lower than it should have been. Similarly, if only 2,000 cases of COVID-19 were identified out of an actual 10,000, the resulting mortality will appear to be much higher than it should be. Taking, perhaps, 200 deaths out of 2,000 yields a 10% mortality rate while 200 deaths out of 10,000 yields a 2% mortality rate. For this very reason, we need to have the correct denominator of the total number of cases, or close to it, to get an accurate report of the percentage of people dying.
Some researchers have made assumptions, based on modelling, that mortality rates could be between 1-2%. While that number sounds small, think about what that would be if everyone in the world was infected. A 1% worldwide mortality would be 70-80 million deaths in one year. Think about that number when compared to the mortality rate for AIDS, one of the worst diseases the world has dealt with. Around 32 million of those infected with AIDS have died since it was discovered. The number of people dying in one year from COVID-19 would be equivalent to the number of people who have contracted AIDS over 40 years. Even if COVID-19 has a 1% fatality rate and the whole world was infected that is still more than two times the number of AIDS related deaths over a 40-year period.
To assume that this disease is not a threat is a gross understatement of its deadliness. Though it is unlikely that everyone will get infected, it could become a real possibility if people continue to disregard the measures advised. Relative death rates have been higher in some states where they did not administer actions fast enough to prevent the spread or due to a lack of compliance after reopening. Going back in history, any unchecked spread of diseases has led to a massive death toll. The bubonic plague killed 60% of Europe’s population at the time. Luckily, due to increased awareness from modern science and the increased ability to treat such diseases through modern medicine, a high death rate is very unlikely. Nonetheless, everything depends on what we do to prevent the spread of this disease.
The less we follow regulations the more likely such kinds of outcomes are possible; underestimating the disease’s severity will lead to loss of life that could have otherwise been prevented. This has already been exhibited in the American, Swedish, Brazilian, and Mexican responses. Since adequate steps were not taken, the disease spread rapidly and now in some places, due to lack of capacity for individual burials, massive graves have been dug up. While this could be seen as fear mongering it is not; we currently do not know the extent of this pandemic or its deadliness so we must be prepared for the worst-case scenario and do everything in our power to stop it from becoming a reality.
This is where testing and contact tracing come in. Ideally if testing and contact tracing had been adequately carried out early on, there would be no pandemic. All cases would have been tested immediately, any infected individuals could have been put under mandatory quarantine, and anyone affiliated with those infected could have been deterred from infecting others. The exact fatality rate would also be known as there would have been a small and finite number of cases. Now we are in a difficult situation because there could be millions more infected, many of whom may not know it and may not be following prevention guidelines. No country in the world currently has the capacity to test all of its citizens and so the spread of the disease can easily continue, making it likely for the death toll to rise.
Further, opening up too early and not enforcing adequate precautions could allow COVID-19 to spread more, giving the disease more opportunities to mutate into an even deadlier disease.26 While initially it was suspected that the U.S. had cases from the same virus strain as the original outbreak in Wuhan, it is now suspected that many cases in the U.S. may have come from a virus strain that initiated in Europe meaning the virus has already mutated.
With each person infected, the virus has opportunities to replicate and to make errors in its genetic code allowing it to create strains that are more deadly. We are essentially fuelling the virus by allowing it to spread and giving it an opportunity to potentially become stronger.
Currently, many health officials and experts feel that the economy is opening up too quickly, because the pandemic has not been reduced enough to a manageable level. Social distancing is a necessary measure used to reduce the number of new cases quickly. Social distancing, when properly followed, keeps those infected separated from everyone else and if followed perfectly could theoretically bring down the number of new cases to 0 as no one with the disease would be able to infect anyone else. If administered well, quarantined individuals would be kept separate from everyone reducing all spread of disease. However, administering such a strict quarantine, when cases are already so high, without appropriate quarantining facilities available is virtually impossible. This is why the disease spread to frontline workers (lacking access to suitable PPE in initial phase) to family members of those infected, and to members of the public, taking inadequate safety precautions. A continued shutdown, now that facilities have been made and strategies have been developed, would help to further reduce the number of cases to a level at which it would be manageable by the contact tracers and testers who are already working.
Unfortunately, this may not be realistic as there is a completely reasonable fear of economic failure, especially if unemployment rates continue to skyrocket. Therefore, countries have started opening up gradually. But some have already seen a spike in cases and if this spike is as great as it was during the first wave, another shutdown may be necessary. Everything has and continues to depend on how many precautions we take as individuals to prevent further spread.
Stay posted for part three of our COVID-19 Blog series!