1.    Putting SARS-CoV2 and COVID-19 in Perspective – the reality of COVID-19 morbidity and recovery

Summary:
Putting COVID-19 in context of:
– other diseases, and
– not taking into consideration inflation of numbers due to misreporting based on ambiguous definitions by the WHO and CDC (see below), in addition to
– potential financial incentives for the reporting of COVID-19 deaths (Miller, 2020),

  • COVID-19-related deaths are not any more alarming than any other global disease,
  • COVID-19 has a low infection mortality rate and
  • The majority of those infected recover from it.

1.1 Defining COVID-19 deaths

  • Global statistics for comparison with COVID-19-related deaths. Unless indicated otherwise, data is for 2020.

1 https://www.worldometers.info/ (Percentage is calculated from # abortions in 2020/Current World Population)
2 https://www.who.int/health-topics/cardiovascular-diseases/#tab=tab_1
3 https://coronavirus.jhu.edu/  
4 https://www.ssa.gov/OACT/STATS/table4c6.html#ss; Troeger et al., 2019

  • COVID-19 is considered to have a LOW infection mortality rate (IFR) as indicated by the statistics below O’Driscoll et al. (2021) [Data is “age-specific COVID-19-associated death data from 45 countries and the results of 22 seroprevalence studies”]

    • COVID-19 Fatality rates by age:
      • 0-4 yrs old: 0.003%,
      • 5-9 yrs old: 0.001%,
      • 10-14 yrs old: 0.001%,
      • 15-19 yrs old: 0.003%,
      • 20-24 yrs old: 0.006%,
      • 25-29 yrs old: 0.013%,
      • 30-34 yrs old: 0.024%,
      • 35-39 yrs old: 0.040%,
      • 40-44 yrs old: 0.075%,
      • 45-49 yrs old: 0.121%,
      • 50-59 yrs old: 0.323%,
      • 60-64 yrs old: 0.456%,
      • 65-69 yrs old: 1.075%,
      • 70-74 yrs old: 1.674%,
      • 75-79 yrs old: 3.203%,
      • 80+ yrs old: 8.2%

    • Note: An 80 year old has a 6% chance of dying from anything within a year; An 85 year old has a 10% chance.
  • Other papers that reflect similar information include:
    • “Age-specific COVID-19 cases and deaths in Victoria, Australia, during 25 January through 10 December, 2020. Observed case fatality risk (CFR) is the ratio of deaths to cases.” (data in Table 1):

      • 0-9 yrs old: 0%; 10-19 yrs old: 0%; 20-29 yrs old: 0.02%; 30-39 yrs old: 0.06%; 40-49 yrs old: 0.04%; 50-59 yrs old: 0.63%; 60-69 yrs old: 2.16%; 70-79 yrs old: 14.41%; 80-89 yrs old: 31.90%; ≥90 yrs old: 40.03%. [NOTE: Data at the older ages needs to be interpreted with caution, given the possibility of other causes [e.g. the isolation, the loneliness, inappropriate treatments etc. as reported in numerous other papers, that may have severely impacted the outcome of survival in the elderly. Of course, the abstract results only focus on the older ages!] (Marschner, 2021)  

    • “Across all countries, the median IFR in community-dwelling elderly and elderly overall was 2.4% (range 0.3%-7.2%) and 5.5% (range 0.3%-12.1%). IFR was higher with larger proportions of people >85 years. Younger age strata had low IFR values (median 0.0027%, 0.014%, 0.031%, 0.082%, 0.27%, and 0.59%, at 0-19, 20-29, 30-39, 40-49, 50-59, and 60-69 years)…The IFR of COVID-19 in community-dwelling elderly people is lower than previously reported. Very low IFRs were confirmed in the youngest populations.” (Axfors and Ioannidis, 2021)

    • “…we estimate the overall IFR [Infection Fatality Rate] in a typical low-income country, with a population structure skewed towards younger individuals, to be 0.23% (0.14-0.42 95% prediction interval range). In contrast, in a typical high income country, with a greater concentration of elderly individuals, we estimate the overall IFR to be 1.15% (0.78-1.79 95% prediction interval range).” (Brazeau et al., 2020)

    • “This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.” (Fauci et al., 2020)

    • “Infection fatality rates ranged from 0.00% to 1.63%, corrected values from 0.00% to 1.54%. Across 51 locations, the median COVID-19 infection fatality rate was 0.27% (corrected 0.23%): the rate was 0.09% in locations with COVID-19 population mortality rates less than the global average (< 118 deaths/million), 0.20% in locations with 118–500 COVID-19 deaths/million people and 0.57% in locations with > 500 COVID-19 deaths/million people. In people younger than 70 years, infection fatality rates ranged from 0.00% to 0.31% with crude and corrected medians of 0.05%.” (Ioannidis, 2021)

  • Recovery rates have been reported as being between 97% and 99.75% (Nikhra, 2020)

  • Comorbidity with other diseases (e.g. obesity, heart failure, chronic kidney disease) is a significant contributor to death (Petrilli et al., 2020; Zhou et al., 2020) and makes up ~ 94% of reported deaths (“For 6% of the deaths, COVID-19 was the only cause mentioned”) (CDC, 2020a).

    • “Among 148,494 adults who received a COVID-19 diagnosis during an emergency department (ED) or inpatient visit at 238 U.S. hospitals during March-December 2020, 28.3% had overweight and 50.8% had obesity. Overweight and obesity were risk factors for invasive mechanical ventilation. Obesity was a risk factor for hospitalization and death, particularly among adults aged <65 years.” (Kompaniyets et al., 2021)

    • Reason for link between obesity being a comorbidity in COVID-19-related deaths: “Collectively, our findings indicate that adipose tissue supports SARS-CoV-2 infection and pathogenic inflammation and may explain the link between obesity and severe COVID-19” (Martínez-Colón et al., 2021)

  • Inflammation is a key issue in COVID-19: “Accumulating evidence suggests that severe COVID-19 is associated with an increased plasma level of inflammatory mediators including cytokines and chemokines such as interleukin (IL)-2, IL-6, IL-7, IL-10, tumor necrosis factor alpha (TNF-α), monocyte chemoattractant protein-1 (MCP1; also known as CCL2), macrophage inflammatory protein 1 alpha (MIP1α; also known as CCL3), C-reactive protein, ferritin, and D-dimers (Hojyo et al., 2020).” (Hoertel et al., 2021)

  • “Controlling the inflammatory response may be as important as targeting the virus. Therapies inhibiting viral infection and regulation of dysfunctional immune responses may synergize to block pathologies at multiple steps. At the same time, the association between immune dysfunction and outcome of disease severity in patients with COVID-19 should serve as a note of caution in vaccine development and evaluation.” (Tay et al., 2020)