WHO statement – “Older people are at highest risk from COVID-19”: Should the hypothesis be corroborated or rejected?

Abstract

Coronavirus COVID 19 has become a threat to mankind affecting millions of people worldwide. United States, Italy and Spain has the highest number of Coronavirus cases as of April 30, 2020. According to World Health Organization (WHO) statement – “Older people are at highest risk from COVID-19”. However, in contrast to the statement, some new studies and findings have come to light. And this has created confusion in our mind as to whether the hypothesis should be corroborated or rejected.

Dear Editor,

Coronavirus COVID 19 has become a threat to mankind affecting millions of people worldwide [1], [2]. United States, Italy and Spain has the highest number of Coronavirus cases as of April 30, 2020 [3], [4], [5]. According to World Health Organization (WHO) [6] statement – “Older people are at highest risk from COVID-19”. However, in contrast to the statement, some new studies and findings have come to light. And this has created confusion in our mind as to whether the hypothesis should be corroborated or rejected.

A well-known literature published by Chinese Center for Disease Control and Prevention [7], found that older people are found to be at highest risk from COVID-19. The facts and figures of COVID 19 fatality rate by age in mainland China can be found online [8]. In mainland china, 80 percent of all deaths occurred among people aged 60 and above as of February 11, 2020 [9]. Wu Z and McGoogan [10] also reported that old age, cardiovascular disease, diabetes, chronic respiratory disease, hypertension, and cancer were all associated with an increased risk of death in mainland china.

The same pattern in also observed in Italy [11] where more than 60 per cent of total population is over 40 years of age. According to the reports, Italy has the world’s highest number of deaths [12] and it is believed that the higher percentage of older person may have contributed to more infections and deaths in Italy with regards to the novel coronavirus. In Italy, approximately 85 percent were patients aged 70 years and older [13].

In United Kingdom, “25% of people in the United Kingdom are designated as high risk including all adults aged over 70 and those with underlying health conditions such as respiratory and cardiovascular disease, and cancer” (doi.org/https://doi.org//10.1136/bmj.m1198). In New York city, as of April 14, 2020; older person with previous underlying illnesses like Diabetes, Lung Disease, Cancer, Immunodeficiency, Heart Disease, Hypertension, Asthma, Kidney Disease, and GI/Liver Disease are more vulnerable to COVID 19 compared with no underlying illness [14].

Japan has the world‘s oldest population with 28.4 percentage of old people. According to 2014 estimates, 33.0% of the Japanese population is above the age of 60, 25.9% are aged 65 or above, and 12.5% are aged 75 or above. However, the number of COVID 19 cases in older people is less compared to younger people [15].

On the contradictory, in India, an age-wise analysis of 1809 coronavirus patients show that most of the infected person belong to the age group of 21–40 (42%), 83% of India's coronavirus patients are below the age of 50 [16]. This result shows that in India younger generation are at higher risk of contracting the disease. Facts and figures are published in the India Today newspaper dated April 4, 2020 [17].

Some of the list of countries with highest number of older people (65 + years and above) with COVID 19 most vulnerable age group is represented in Table 1 . Out of 29 countries, only 10 countries are having more risk in older people. This finding made us ponder upon the statement “Older people are at highest risk from COVID-19, to either corroborate or reject the hypothesis.

Table 1.

COVID-19 Vulnerability age group in countries with larger percentage of older people.

Rank	Country	65+ (%)	Most vulnerable group (Yrs.) #
1	Japan	28.2	20–59
2	Italy	22.8	>50
3	Finland	21.9	20–59
6	Germany	21.4	20–49
9	France	20.3	45–64
10	Latvia	20.3	20–49
12	Sweden*	19.9	70–90
14	Estonia	19.8	30–54
15	Denmark	19.6	50–59
16	Czech Republic*	19.6	>75
17	Slovenia	19.6	45–54
18	Hungary*	19.3	66–88
20	Spain*	19.1	70–79
21	Netherlands*	18.9	>75
22	Austria	18.8	45–54
23	Belgium*	18.7	80–89
25	Switzerland*	18.3	>80
26	Romania	18.2	40–49
28	Poland*	17.5	75–77
30	Norway	17.2	50–59
31	Canada	17.2	50–59
32	Ukraine*	16.5	60–69
33	Hong Kong	16.4	21–30
36	United States*	16	>75
37	Australia	15.8	20–29
38	New Zealand	15.3	20–29
41	South Korea	15.1	20–29
44	Russian Federation	14.6	18–45
48	Iceland	14.2	50–59

Source of data: ^# Statista Research Department; *COVID 19 more vulnerable in older people.

To conclude, COVID 19 can affect all age group irrespective of whether the individual is young or old. Therefore, the statement by World Health Organization, “Older people are at highest risk from COVID-19” is still conflicting. Therefore, in depth research is required before making such claims as this may piles up the mental pressure to individuals. There have been cases whether people believed to be suffering from COVID 19 committing suicide in India [18], [19], [20], Bangladesh [21], frontline medical doctor from New York [22], and German finance minister; Thomas Schafer [23]. As of now, it would be more apt to state that “People with chronic health conditions are at highest risk from COVID 19” as strong immunity is the key weapon to fight against Covid-19.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.