Coronavirus: What are the chances of dying and who is most at risk?

Coronavirus: What are the chances of dying and who is most at risk?
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The illness caused by the new coronavirus , COVID-19, continues to spread across borders, but the risk of contracting it isn’t the same for everyone.

It depends on a range of factors — age, travel history, access to and quality of health care — but scientists are still working to determine exactly how deadly it is.

Here’s a look at what we know so far.

It’s hard to say at this point.

In Wuhan, China — where the virus first exploded — about two to four per cent of patients have died, according to the World Health Organization (WHO). Throughout the rest of China, the death rate is much lower, at around 0.7 per cent.

Coronavirus outbreak: WHO says ‘too early’ to call COVID-19 a pandemic

Coronavirus outbreak: WHO says ‘too early’ to call COVID-19 a pandemic

Dr. Bruce Aylward, the Canadian doctor who led a WHO team to China to look into the epidemic, said the reason for the discrepancy between Wuhan and the rest of China is partly because of how early and fast the disease hit the city. In the beginning, “people didn’t know what we were dealing with,” he said, adding doctors were just learning how to treat it.

Now, with more accurate testing, milder cases are being diagnosed and isolated.

There are different factors to consider when identifying fatality rates, said Dr. Isaac Bogoch, an infectious disease specialist based out of Toronto General Hospital. He said it comes down to three things: each country knowing exactly how many people have the infection, good structures to report and confirm illnesses, and, simply, time.

“You can’t just take this as a snapshot in time just yet,”  he said. “There could be people who are critically ill, but they’re counted as alive when, in fact, they’re very likely to succumb to the illness in the coming week or weeks ahead.”

He pointed to South Korea as an example of where improved testing has so far provided a clearer picture of fatalities.

“If you look at South Korea, they have thousands of cases there, but their rate is roughly 0.5 per cent. What they’ve done is offer very, very broad screening tests, picking up a large number of people who have very mild symptoms,” he said.

“To really understand a case fatality rate, you have to know how many people have the infection. That is the denominator. We don’t know what the denominator is in many places, including South Korea, but I think South Korea has done a much better job in finding out what the denominator is by widening their screening.”

Determining an overall death rate is challenging, according to researchers at Imperial College London in the U.K., because of the differences in how countries spot milder cases. The discrepancies in tracking cases make underreporting easy, which can skew a death rate.

This figure illustrates how surveillance of coronavirus is typically biased toward detecting severe cases, particularly at the start of an epidemic when the means of diagnosing is limited.

(Imperial College London)

While deaths are reported and tallied quickly, the researchers say there is less information on those who have recovered.

But more mild cases being identified doesn’t make any mortality rate insignificant, Aylward told reporters at a routine WHO press conference earlier this month.

“The same number of people that were dying still die,” he said.

Until recently, most people diagnosed with COVID-19 outside of China had recently travelled there. Now there are significant clusters of the virus in Iran, Italy, South Korea and Japan.

The death toll is also climbing outside China. As of March 2, Japan had reported six deaths, Italy 34 and Iran 54. The United States had two.
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