COVID-19 and potential global mortality - Revisited

1. Introduction

On the 13th April 2020, Adhanom Tedros, Director General of the World Health Organization (WHO) stated:

This is a new virus, and the first pandemic caused by a coronavirus. We're all learning all the time and adjusting our strategy, based on the latest available evidence. We can only say what we know, and we can only act on what we know [1].

In a previous paper [2], this author attempted to assess potential COVID-19 continent-based mortality based on initial WHO data from China which estimated that 14% of infected cases are severe and require hospitalisation, 5% of infected cases are very severe and require intensive care admission, mostly for ventilation, and 4% of infected die [3].

However, it is becoming increasingly clear that a significant proportion of circulating COVID positive patients are asymptomatic, with potential for transmission of disease [4]. This may be circa 80–90% of COVID in community [4].

2. Methods

For this reason, the table in the initial paper showing continent and global estimates [2] has been recalculated with a correction factor, an estimated 10% symptomatic proportion of infected individuals.

3. Results

Updated results are shown in Table 1 . Mortality figures globally may be around the 50 million level.

Table 1.

Potential infections and deaths from COVID-19 using available data and current observations [3,4], along with an estimated 10% symptomatic cases.

	Continent	Population	Symptomatic %	Infection %	Number	Mortality %	Number
1	India	1,339,000,000	10	80	107,120,000	10	10,712,000
1	China	1,386,000,000	10	10	13,860,000	4	554,400
1	Rest	1,856,757,408	10	80	148,540,593	10	14,854,059
2	Africa	1,216,130,000	10	80	97,290,400	10	9,729,040
3	Europe	738,849,000	10	60	44,330,940	4	1,773,238
4	USA	327,096,265	10	60	19,625,776	10	1,962,578
4	Canada	37,064,562	10	60	2,223,874	10	222,387
4	Mexico	126,190,788	10	80	10,095,263	10	1,009,526
4	Rest	88,672,385	10	60	5,320,343	10	532,034
5	South America	422,535,000	10	60	25,352,100	10	2,535,210
6	Oceania	38,304,000	10	60	2,298,240	4	91,930
	World	7,576,600,514			476,057,528		43,976,402

It must be reiterated that these are best guesses and estimates that preclude the discovery of effective treatment and/or vaccination.

4. Discussion

Clearly, this pandemic has the potential to be as severe in terms of mortality as the influenza pandemic of 1918 which killed more than 50 million people and caused more than 500 million infections worldwide [5]. The conclusions of the previous paper stand [2]. Sudden surges of cases risk healthcare services being plunged into chaos and this may happen if the public do not do their part [6]. Infection cannot occur in the absence of contact. The only way to mitigate these numbers is to apply social distancing and take the precautions outlined by public health such as hand washing with soap, masks and so on.