Issue link: https://www.ahpindiestylist.com/i/1250436
40 indie stylist Volume 1 Issue 1 It is thought that over time, more people will develop immunity to the virus, and with the help of a vaccine, it will be possible to reduce the risk it poses to levels similar to those of the common flu. However, we simply do not yet have enough information to judge this. According to the current understanding, COVID-19 causes a severe type of pneumonia in enough individuals to make the mortality rate around six to 10 times higher than that of the common seasonal flu. 10 It may be possible, in months and years to come, to reduce this rate or to access data that changes our understanding of the true mortality rate. However, as explained in a study looking at the mortality rate in Wuhan, China, any current estimates are based on uncertainties and what is known as "ascertainment bias," which is when a population sample does not fairly represent the target population (in this case, the total number of people affected). 11 There is a free basic course on the CDC website that explains the main ideas in epidemiology and how experts calculate things like the case- fatality ratio, and it is well worth spending a couple of hours on simply to understand the way these words and numbers are used. 12 As different countries are taking vastly different approaches to testing, we do not currently know the true number of infected people (cases) and therefore cannot accurately calculate the true fatality ratio. This ongoing report from CMMID Repository (caution advised: it is not yet peer reviewed) provides some interesting concerns regarding the reporting methods and mathematical models used to estimate the numbers we all hear in news reports, and demonstrates the degree of uncertainty currently surrounding the issue. 13 What we know beyond any doubt is that whatever the true case-fatality ratio (number of people who die out of all those infected), more people need critical care simultaneously than our health systems can handle, and that in and of itself will lead to more deaths. Front-line medical workers are also reporting a range of different symptoms in COVID-19 patients with more severe forms of the disease, and it is not yet clear who is more susceptible, but dangerous developments, from blood clots to massive inflammation, have been observed in young people as well as the elderly. 14 Until science can catch up and hopefully discover what causes these more severe reactions, it remains impossible to tell who will develop only mild symptoms and who may end up fighting for their life. This is the true source of the crisis regardless of whether or not it turns out to be more or less lethal than influenza once the current crisis has died down. TRUE OR FALSE? Only old people die of COVID-19, so young and healthy people don't need to worry This is the second major misconception that has contributed to the rapid spread of this virus, leading to difficult conversations that weigh economic factors against the cost of human life. The truth is we don't yet know precisely who is at most risk, beyond obviously vulnerable elders with multiple underlying conditions. Since COVID-19 reached Europe and the US, there have been reports of younger, healthy people dying and skewing the numbers somewhat, and these figures are also affected by the degree of testing being conducted. As at the end of March, according to CDC data, it appeared that more young adults were being hospitalized in the US compared with other countries (20–44 age range; 20 percent of hospitalizations; 12 percent of intensive care unit [ICU] admissions). Germany was another outlier with a median age of 50 years, while the death rate stands at 4.3 percent lower than countries such as Italy, Spain, the UK, and US, but higher than it was a few weeks ago. 15 At the time of writing (May 8, 2020), in the US it remained the case that hospitalization rates increase with age. 16 Germany took a different approach to testing and hospitalization compared to other countries, reflecting its advanced health-care infrastructure, which plays an important part in the overall outcome. At the time of writing, Germany is beginning to gradually repeal certain lockdown measures in stages, 17 although there seem to be early indications that the number of confirmed cases has begun to rise again since lockdown measures were relaxed. 18 When it comes to public health policy, the overall capabilities of any health service and its accessibility and capacity are key factors in calculating the virulence (how fast it spreads) or mortality rate (how many it