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How Serious Is the COVID-19 Pandemic?

How Serious Is the COVID-19 Pandemic and How Long Will It Have to Be Mitigated?

These are the questions addressed in a new study by Imperial College London, conducted in collaboration with the WHO and other institutions. The authors stress that the results of their models are not forecasts, but indicate the magnitude of the problem and important influencing factors. The effects will depend, above all, on action in the coming weeks and months (p. 3):

  • Without mitigation measures, about 40 million deaths would be expected worldwide this year (confidence interval 35-42 million; p. 7). Most victims would be in Asia and Europe, and comparatively few in sub-Saharan Africa (p. 11). In Germany, there would be between 722,000 and 927,000 deaths (Appendix). Although low-income countries have poorer health care and larger households, this is outweighed by the positive effect of their lower proportion of older people, lowering the expected numbers of cases requiring treatment, as well as deaths (p. 8).
  • If the number of contact persons per day is halved, the number of deaths will also be halved, to about 20 million (in Germany 230,000 to 479,000; appendix). This represents only a small degree of social distancing (a complete shutdown corresponds to a reduction by 87% [1]). In this scenario, too, the health care systems would be overburdened; in high-income countries by a factor of 7, in poor countries by a factor of 25. In the latter, the provision of intensive care is 85% lower than in rich countries (p. 5, [2]). As soon as health systems are overwhelmed, the mortality rate increases because not all serious cases can be treated. Substantially higher figures than in the model calculation would therefore be expected (p. 2, 9). These differences between poor and rich countries are likely underestimated in the model calculations, probably in both directions (pp. 8, 15).
  • If the number of daily contacts is reduced to a quarter, and testing and quarantine of confirmed cases is expanded, further deaths can be avoided (p. 7). Starting at 1.6 deaths per 100,000 inhabitants (123,000 deaths worldwide, 1300 in Germany [2]), the number of deaths can be reduced to about 10.5 million worldwide (including 149,000 in Germany) (Appendix, [2]). The peak load of hospitals and their intensive care departments would also far exceed their capacities in this scenario (p. 12; Appendix). At current growth rates, the above-mentioned level of 1.6 deaths per 100,000 inhabitants is expected to appear in 1-2 weeks [3].
  • If this had been started at 0.2 deaths per 100,000 inhabitants (15,400 deaths worldwide, 168 in Germany [2]), the number of global deaths could have been limited to 1.9 million (of which about 23,000 in Germany) (Appendix, [2]). Only in this scenario would the capacities of the hospitals have been sufficient (p. 12; Appendix). Unfortunately, however, we already have over 30,000 deaths worldwide and over 400 in Germany [3]. Therefore, it would be more likely that 4 million deaths can be expected [2].

The model calculations show how crucial it is to act quickly and consistently.

The measures for mitigation would have to be maintained until a treatment or vaccine is available. Depending on the development of the epidemic, the measures can be relaxed and reintroduced [4]. In doing so, it must be taken into account that the effects of measures are only reflected in the case numbers after the incubation period has expired. In the best case, a treatment could be tested and approved in a few weeks or months (e.g. remdesivir, lopinavir/ritonavir or [hydroxy]chloroquine, drugs originally developed for Ebola, HIV or malaria) [5]. The level of effectiveness of the drugs as well as their actual availability to those affected will be decisive.

In Wuhan, a complete shutdown lasting two months (with the closure of almost all businesses and the entire transport system) was apparently successful [6]. For comparison: in Germany, a partial shutdown currently applies for one month.

Another difference in Germany (and Europe) is that protective masks are hardly used (and hardly recommended), although they interrupt the chain of infection in 70-95% of cases and are recommended internationally [7].

The death toll calculated by Imperial College is close to that of the 1918-20 influenza pandemic ("Spanish flu"), for which estimates range from 17 to 100 million deaths [8]. Similarly, the much slower pandemic of HIV/AIDS had claimed 32 million lives by the end of 2018 [9].

The scenarios of Imperial College are also of a similar order of magnitude to other calculations on the consequences of the COVID-19 pandemic, such as for Great Britain and the USA (p. 7). For Germany, other estimates range from about 278,000 to over a million deaths. Prof. Christian Drosten (Charité) estimated 278,000 deaths in Germany in case of no mitigation measures [10]. Worldwide, this would correspond to about 25 million deaths, but due to the poorer health care for the majority of mankind, this would be a too simple and understated extrapolation [2]. A confidential strategy paper of the German government mentions a figure of more than one million deaths in Germany in the worst case [11], which would mean a correspondingly higher number globally.

The OECD projects the world economy to shrink by 2.4% in 2020 due to the pandemic [12].

Given our current understanding, the COVID-19 pandemic is the biggest global challenge since World War II. The overburdening of health systems and the economic impacts also means that other global challenges such as hunger, newborn and maternal mortality, financial stability and poverty, and other infectious diseases (viral hepatitis, pneumonia, tuberculosis, HIV/AIDS and malaria) are expected to aggravate. The consequences of the pandemic can be absolutely devastating in health, social and economic terms, particularly in less developed countries.

 


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Sources:
 

All numbers, for which no [digit in squared brackets] is given, are taken from the following study (summary or specified page number):

  • Patrick G. T. Walker, Charles Whittaker, Azra C. Ghani et al.: The Global Impact of COVID-19 and Strategies for Mitigation and Suppression. (COVID-19 Report 12) WHO Collaborating Centre for Infectious Disease Modelling, MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London. 26 March 2020 [version 2: 29 March 2020].
  • Appendix (spreadsheet).

 

Annotations and Further Sources:

  1. A reduction from an average of 15 to 2 contact persons per day is assumed (at least in industrialized countries).
  2. Own calculation from the values by the study.
  3. https://coronavirus.jhu.edu/map.html
  4. https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
  5. https://www.vfa.de/de/arzneimittel-forschung/woran-wir-forschen/therapeutische-medikamente-gegen-die-coronavirusinfektion-covid-19
    https://www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments
  6. https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-Exiting-Social-Distancing-24-03-2020.pdf
  7. https://www.aerzteblatt.de/nachrichten/105751/Grippe-Chirurgische-Maske-schuetzt-genauso-gut-wie-teure-N95-Atemschutzmaske
    "As evidence suggests COVID-19 could be transmitted before symptom onset, community transmission might be reduced if everyone, including people who have been infected but are asymptomatic and contagious, wear face masks." "Perhaps it would also be rational to recommend that people in quarantine wear face masks if they need to leave home for any reason, to prevent potential asymptomatic or presymptomatic transmission. In addition, vulnerable populations, such as older adults and those with underlying medical conditions, should wear face masks if available." https://www.thelancet.com/action/showPdf?pii=S2213-2600%2820%2930134-X
  8. https://academic.oup.com/aje/article/187/12/2561/5092383
    http://www.millenniumassessment.org/documents/document.356.aspx.pdf (p. 89)
    https://wwwnc.cdc.gov/eid/article/12/1/05-0979_article
    https://muse.jhu.edu/article/4826
    http://www.euro.who.int/en/health-topics/communicable-diseases/influenza/pandemic-influenza/past-pandemics
    https://www.ncbi.nlm.nih.gov/books/NBK513241/
  9. https://www.unaids.org/en/resources/fact-sheet
  10. https://www.heise.de/newsticker/meldung/Zahlen-bitte-3-4-Coronavirus-Fallsterblichkeit-False-Number-4679338.html?seite=all
  11. https://www.spiegel.de/politik/deutschland/corona-in-deutschland-vertrauliche-regierungsstudie-beschreibt-verschiedene-szenarien-a-1cafaac1-3932-434d-b4de-2f63bce0315d
  12. https://issuu.com/oecd.publishing/docs/oecd-interim-economic-outlook-coronavirus-impact-m/4

 

Suggested Citation:
Global2030: How Serious Is the COVID-19 Pandemic and How Long Will It Have to Be Mitigated? Berlin, Global Challenges Initiative e. V., 29 March 2020. (www.global2030.net/news/1585515968-covid19.html).

Last modified: 2020-03-29 (Links updated again: 2020-04-04)
Address of this page (URI, URL): http://www.global2030.net/news/1585515968-covid19.html