Coronavirus: Macro Analysis
We have enough data available on coronavirus to be able to do some macro analysis on its progress and to understand the protective measures that are needed to manage its impacts.
Fatalities
There are currently few reported fatalities for coronavirus for people below 50, although for those from 30 to 50, about 20% of identified cases have been hospitalised and about 1% have gone into intensive care (ICU).
For those between 50 and 70, there are varying numbers, but it would appear that about 1.5% of reported cases of coronavirus have died. About 20% of identified cases have been hospitalised and about 5% have gone into ICU.
For those over 70, according to the USA statistics about 10% of reported cases have died. About 30% of identified cases have been hospitalised and about 6% have gone into ICU.
The likely outcome will vary for each nation depending on the success in caring for sick patients and the age distribution of the population. However, for the purpose of this analysis, an average fatality rate for infected persons has been estimated to be 1%.
For more detail, go to https://www.vox.com/2020/3/23/21190033/coronavirus-covid-19-deaths-by-age, which presents an interesting analysis.
Reported Cases
In all the nations where fatalities from coronavirus are significantly more than 1% of reported cases we have good reason to believe that the reported cases are significantly understated.
This particularly applies to Italy and Spain. It is apparent in these nations that community transmission has meant that testing could not possibly keep up with the rate of infection, thus leaving vast numbers of people untested. Also, the kind of contact tracing that has been so effective in Singapore and elsewhere would now be relatively ineffective. Thus it is not appropriate to treat the Italian and Spanish coronavirus experience as a guide to the future trajectory of those nations still striving to make contact tracing work.
It is also the case that symptom-led counting of reported cases will significantly understate the numbers of people who have met (and defeated) the coronavirus. It will miss those who have no symptoms (those who are asymptomatic).
Here are the details of reported cases of coronavirus in those nations most hard hit by the virus, with a simple estimate of unreported cases:
- China: reported 81,591 + 32,000 asymptomatic = 113,591.
- Italy: reported 69,176 + estimated unreported = 682,000.
- USA: reported 52,145 + estimated unreported = 68,500.
- Spain: reported 39,676 + estimated unreported = 280,800.
- Germany: reported 32,781 (deaths 157).
- Iran: reported 24,811 + estimated unreported = 193,400.
- France: reported 22,616 + estimated unreported = 110,000.
- Switzerland: reported 9,877 + estimated unreported = 12,200.
- South Korea: reported 9,037 + estimated unreported = 12,000.
- United Kingdom: reported 8,164 + estimated unreported = 42,200.
- Netherlands: reported 5,580 + estimated unreported = 27,600.
- Belgium: reported 4,269 + estimated unreported = 12,200.
- Australia: reported 2,144 (deaths 8).
- Indonesia: reported 686 + estimated unreported = 5,500.
In most cases, the reported cases will reflect those who report themselves to be tested because they show symptoms of the disease. If we use the China data as a rough guide (in the absence of an actual study), we could say that about one third of all cases will be asymptomatic. Taking that into account, we could say that a real issue with undiagnosed cases of coronavirus currently applies in Italy, Spain, France, United Kingdom, Netherlands, Belgium, Iran and Indonesia. However, it is not necessary to resolve that issue: it is more important for all nations to address the fundamental problem. That is to stop the spread of the disease within their own borders.
Herd Immunity
From past pandemics, it has been estimated that 60% of a population has to be exposed to a virus before community immunity can be achieved.
None of the nations listed above have come even close to that number. The social consequences of allowing 60% of the population to be infected will be dire. It will be like a plague in the Middle Ages. It is unlikely that letting the disease run its course will be an acceptable approach to ending the coronavirus pandemic.
Social Isolation
Infection with coronavirus is passed from one person to another. A number of nations are attempting to enforce social isolation by introducing laws that make it more difficult for all people to mix with each other. These laws are now being introduced in the United Kingdom, United States, Australia, New Zealand, India and in many other places.
Such laws are probably necessary in order to create a new social environment in which those who are infected with the virus isolate themselves from others, with the intention of these laws being that infected persons cannot pass on the disease. Yet it is a first step, not a long term solution. This is because one can expect that the social consequences of this kind of widespread shutdown of normal societal relations and economic activity will be intolerable quite quickly, with the cure being considered to be worse that the disease.
Along with such (temporary) laws, Australian governments require everyone who has the disease to self-isolate (if not in hospital). This also applies to everyone who has had contact with that person (while infected). All such people are monitored by a health workers (over the phone – perhaps by skype) every day until the monitoring period ends. One assumes that other nations are taking similar steps.
Draconian policies like these are required in every nation that wishes to prevent the spread of this disease within their borders. People who come from nations that do not implement policies like these are likely to find it difficult to travel to countries that do implement such draconian policies.