Two weeks ago, there were 189,452 confirmed cases of COVID-19 in the world with 7,505 deaths and a mortality rate of about 4 percent. By mid-day Tuesday were more than 800,000 cases and nearly 40,000 deaths with a worldwide mortality rate of about 4.9 percent.
The numbers are increasing daily and vary from nation to nation.
Two weeks ago, the United States was eighth in the world in the number of cases. Since then, we have passed both Italy and China with over 160,000 cases. Now, we are No. 1 in total cases, but we have a lower mortality rate (about 1.8 percent) than the rest of the world.
Italy has an incredibly high mortality rate of about 11 percent.
Several factors contribute to each nation’s mortality rate. Italy, for example, has the second-oldest population in the world and high numbers of their men smoke. Japan has the oldest population, but a much lower mortality rate than Italy. Japan has the benefit of being an island nation.
Some of the best COVID-19 testing is happening in Germany and South Korea. Both have mortality rates of less than one-half of one percent.
If the U.S. had better testing, we would have more identified cases and our mortality rate would be lower because we would be dividing the number of deaths by a larger denominator. Also, aggressive testing and the ability to separate infected people from non-infected people from the start of the epidemic seems to have made a difference in places like Germany and South Korea.
In the United States, the mortality rate for COVID-19 is currently 18 times higher than the average number of deaths during a typical flu season. Also, people with COVID-19 virus infect, on average, about 2 to 3 other people compared with the flu which infects, on average, 1.3 people. Not until each person with the virus is, on average, spreading their infection to less than 1 other person will the number of people infected with COVID-19 begin to decrease. Thus, the importance of continued social distancing and isolation of those infected.
Another variable that makes COVID-19 so much more infectious is incubation time. When a person is exposed to the flu, symptoms appear within one to four days. With COVID-19, symptoms may take 14 days or more to appear. Or they may never appear. A recent study on the Diamond Princess cruise ship by the CDC found Coronavirus RNA on some of the ship’s interior surfaces 17 days after all the passengers had left the ship and in rooms where the passengers did not show symptoms.
While we currently use the 14-day rule for isolation with COVID-19, Dr. David Ho of Columbia University, an expert on viral epidemics reported that virus shedding “could continue for days up to three weeks after a person recovers.” Thus, until we do a better job of testing and identifying who does and does not have the virus, we need to act like everyone we interact with could be infected.
Other variables in the mortality rate have to do with a nation’s health care system and the ability to cope with large numbers of sick people. Thirty years ago, America had about 6 hospital beds per 1,000 people. Today, the U.S. has 2.4 beds per 1,000 people. To put this in perspective, 27 other countries (for example, Germany, Austria, Belgium, Poland, Greece, Norway, Ireland, Turkey) have more hospital bed capacity than America. Japan, with the most, has almost 8 hospital beds per 1,000 people. This may contribute to their low mortality rate. Also, some nations have universal health care making it easier for people to seek testing and treatment.
Many U.S. hospitals reach capacity during the annual flu season with beds placed in hallways because of limited capacity. Add COVID-19 to the mix and American hospitals are being overwhelmed, especially in high-populated cities like New York City. Our limited bed capacity is another reason why we need to decrease the spread as quickly as possible. Again comparing this virus to the Flu, the CDC expects that up to 20 percent of people with COVID-19 may need to be hospitalized compared to about 2 percent with the Flu.
The virus "lives" because we serve as hosts. If we can stop the spread, we can stop the virus. We all need to play a role in that goal.
Tom Zirpoli is the program coordinator of the Human Services Management graduate program at McDaniel College. His column appears on Wednesday. Email him at email@example.com.