The straw that broke the camel’s back

Perhaps we need to embrace a different method to handle the coronavirus outbreak to better use the resources at hand.

Medical workers in protective suits treat patients suffering with coronavirus disease (COVID-19) in Rome, Italy (photo credit: GUGLIELMO MANGIAPANE / REUTERS)
Medical workers in protective suits treat patients suffering with coronavirus disease (COVID-19) in Rome, Italy
The mortality-rate data from the Italian National Institute of Health has to be alarming, and many governments are reacting to it by imposing drastic measures tantamount to a severe or complete curfew, which has grounded their economies to a virtual standstill.
Based on the emerging Italian data, is this the proper response?
Clearly, the data show that the older population is at a disproportionately higher risk (60 and above) than the younger population. However, the data also suggests that 99% of the fatalities have also had prior illnesses. Or otherwise stated, the virus is the straw that broke the camel’s back. Therefore, it begs the question: “is it the age alone that is the risk factor, or is it the acquisition of other illnesses with age that makes the elderly more susceptible to the deadly impact of the coronavirus?”
Furthermore, a closer evaluation of the data reveals that being infected by the virus is not an automatic death sentence. Of 7,121 cases reported for the 70-79 age bracket, 1,080 died. That’s a 15.3% mortality rate. However, considering that about 74% of those had suffered from two or more underlying illnesses, the mortality rate for healthy people or those with no more than one illness drops to 4%. While that is not great, it does give hope to 96 out of a 100 people and reason to keep vigil on social distancing, personal sanitation and other precautions.
It’s important to note for context that, according to a 2017 US Centers for Disease Control and Prevention study, “Between 291,000 and 646,000 people worldwide die from seasonal influenza-related respiratory illnesses each year, higher than a previous estimate of 250,000 to 500,000 and based on a robust, multinational survey.”
If indeed it is the underlying medical conditions that caused the deaths, when exacerbated by the onset of COVID-19, then a better screening approach may focus the response to the statistically vulnerable population, thus utilizing strained resources better and allowing the less vulnerable to return to work, school and life.
Especially in countries where healthcare is universal (such as France, Italy and Israel for example) and where medical histories of the population are readily at hand, it should be a fairly simple task (legality and privacy laws notwithstanding) to develop a profile of individuals at risk and come up with a proactive protection strategy. Perhaps something akin to the terror-threat matrix in the US, which is color-based. For example:
·       Green - People under 50 with no prior conditions could go back to work and school and maintain normal sanitary precautions.
·       Orange - People 50-75 with no prior conditions could go back to normal activity after screening (and found negative) for COVID-19, maintain normal sanitary precautions but keep guard against contact with potential virus carriers.
·       Red - People over 75 or people of any age with prior conditions should remain sequestered and maintain high vigilance against contagion until they can be immunized when immunization or effective medical treatment becomes available.
Therefore, it is the opinion of this writer that should a statistical analysis, done by the proper authorities, validate the hypothesis that COVID-19-related deaths are more attributable to the prior illnesses than the virus itself, then perhaps resources could be allocated better to protect the truly vulnerable and allow those at significantly lesser risk to return to work and allow the world economy to recover faster.

Tags italy data