Sunday, March 15, 2020

How deadly is the coronavirus?

Short answer: the mortality rate is in the region of 0.2%.

How did I get this number?

Country       Cases      Critical       Dead      Mortality %
Germany 5176 9 9 0.17
Sweeden 992 2 2 0.20
Denmark 864 2 2 0.23
Austia 800 1 1 0.13
Norway 1205 27 3 0.25
Total 9037 41 17 0.19

Germany, Sweden and Denmark have good healthcare systems and have conducted tests liberally. They tested mostly healthy people and found many exhibiting COVID-19 patients that exhibited mild or no symptoms. These patients generally go on to recover without ever requiring critical care.

On February 4th, China reported a mortality rate of 0.16% outside Hubei. The healthcare authorities also hunted travelers and tourists with some connection to Wuhan and tested them. Healthy people were found to have mild symptoms of Covid-19 and they went on to recover with a mortality rate of 0.2%.

OK, but we frequently see higher mortality rates? 

 The mortality reported in Wuhan was 4.9%. Many other countries reported mortality rates comparable to Wuhan. 

Below are the numbers from March 14:

Country Cases Critical Dead  Mortality %
Italy 21157 1518 1441 6.81
Iran 13838
724 5.23
China 88049 3226 3119 3.54
Spain 6821 272 208 3.05
France 4499 300 91 2.02
USA 3045 10 60 1.97
UK 1140 20 21 1.84
S Korea 8162 59 75 0.92

Thus, is this particular cold 10 times more deadly in America and England compared to Germany and Sweden? 

In Wuhan and Italy, the health care system is overwhelmed. Tests are precious and the supplies run low. Thus, they test only the patients most at risk. Many of these patients later die. 

The rest of the countries showing a mortality rate close to 2% are notoriously low on tests. For political reasons or otherwise, they've managed to test only one American in one million by March 1. At the same time, China was testing vast numbers.

There could also be multiple strains of the coronavirus with the more deadly ones burning out and the others affecting most of the population.

How many people die every year?
Every year, about 1% of us die. That number will be higher if you are in Italy where old people greatly outnumber the young. It will be lower in Nigeria where, despite the lower life expectancy, a larger fraction of the population was just born. 

These 1%  due to die in the next year are people walking among us or lying in bed if they are too sick to be in a wheelchair. 

My father is one of them. He's got his pre-existing conditions -- a stroke, heart disease, overweight, with high blood pressure. He has tried to die multiple times, but, my mother is a great doctor who didn't let him go. Will he live until next year? Maybe. Maybe not. Could he survive pneumonia? He did it a few months ago. Common colds cause pneumonia  too in people like my father. 

If  we look at the people who died of Covid-19, we see that they were mostly old (the median age of the dead in Italy was 82; 90% of the dead were over 70) and most of them had pre-existing conditions. Only 1% had no pre-existing conditions. Sure, many of these healthy people were old, as many old people are healthy.

The average age of the people killed by Covid-19 is not far from the average life expectancy of the country they come from. One could still think of the Coronavirus as part of the natural dying process in humans.

COVID-19 is a bad cold. It is more likely to result in pneumonia. Pneumonia does kill. My great grandfather died of pneumonia. He was 62 years old and had no other co-morbid conditions. This was roughly the normal life expectancy in a Romanian village half a century ago. Pneumonia was a common way to die. 

Are the measures taken reasonable?
Spreading this cold, and any other cold, is a bad thing. If someone takes 100 Euro from my pocket, we can punish that thief. If a doctor, a teacher or a policeman comes to work sick and infects me, I end up losing time way over 100 Euro, and, yet, there is no way to discipline the policeman who comes to work with a cold. Wouldn't it be reasonable to treat the sick policeman as a thief who steals 1000 Euro from every person he infects? Or 10 Euro from every person he meets and has a 1% chance to catch his cold? 

Staying home and drinking tea is strongly associated with better outcomes for general colds -- and, most likely, for this one as well. Thus, treat yourself and your family with love and the virus with care. Avoid getting sick for no good reason and get well if you do get sick. 

If you do get the COVID-19, you are probably much more likely to develop pneumonia and require medical care if you do the following while sick
-- go to work
-- go out and do sports 
-- are tired or hungry
-- drink vodka and sleep under the bridge
-- have other illnesses
-- are old
Some of the above can be avoided. We cannot change our age or pre-existent conditions resulting from a combination of genetics and life choices. 

Any cold can result in pneumonia and death, in almost anyone. For example, if I was to drink vodka and sleep under the bridge in the winter when I catch a cold, I'm sure I'd develop pneumonia after a few days and die a short while later.

At 0.2% mortality rate, the coronavirus remains about 10 times as deadly as the flu. You can think of the flu as being a stress test where you ask people to run 10 meters. If you can't run 10 meters, you die. The Coronavirus would ask people to run 100 meters. Those who can't run, die.

As long as the average age of the people killed by Covid-19 is not far from the average life expectancy of the country they come from, one could still think of the Coronavirus as part of the natural dying process in humans.

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