Informed decision against COVID-19

The whole world is fighting against the new corona virus: COVID-19. The medical experts are also new on full understanding the characteristic of this virus. The virus related data are flooding in. The preliminary statistical analysis and inferences are emerging.

People are panicking along with the Governments are in dilemma to make evidence based policy making. The major problem of this disease is unavailability of confirmed cure though large numbers of corona patients are already cured. Till this writing (22 March 2020) as of WHO  situation report, nearly 300k persons are infected and nearly 5% of infected persons died.

Governments all over the world including Nepal are making decisions on Ad-hoc basis. Lots of noises distributed without any facts and evidences. All over the world governments are announcing lock down without knowing, how long they could have to do the same. The announced lock down period also varies. Some governments have announced for a week, some two weeks and …The announcement do not have any supported facts. It is sure the long term impact of COVID – 19 will be very costly for every nation.

According to www.worldmeters.info, 100k cases are closed. From the closed cased, the outcomes reflects 87% patients were recovered and 13% were dead. Here it is noteworthy; every infected persons do not died. The same website has mentioned, as of currently infected persons in treatment, 95% are in mild condition and 5% are in critical condition. This evidence reflects even someone test positive, it does not means he/she certainly goes in critical conditions and died ultimately.

The biggest learning is from China. According to www.cdc.gov , the website of centers for disease control and prevention of US, in its The Morbidity and Mortality weekly report published on 20 March 2020 mentions the data from China suggest (COVID-19) deaths have occurred among adults aged ≥60 years and among persons with serious underlying health conditions. Only one death occurred in age <= 19 years. In US no ICU admissions or deaths were reported among persons aged ≤19 years.

As of 4,226 cases reported in US on 16 March, age of 2,449 patients known. Among the age known patients, the age disaggregation shows 9% were from age group ≥85 years, 36% were aged 65–84 years, 17% were aged 55–64 years, 18% were 45–54 years, and 20% were aged 20–44 years. Less than 1% of hospitalizations were among persons aged ≤19 years.

Further, the Chinese Scientists have published the preliminary study report on COVID 19 cases on 2143 children in Journal of pediatrics. They have concluded Children at all ages were sensitive to COVID-19, and there was no significant gender difference. Clinical manifestations of children’s COVID-19 cases were less severe than those of adults’ patients.

After China, Italy has been epicenter for pandemic effect of corona virus. Till this writing, 59k cases recorded and among this 12k cases has been closed. The outcome of closed cases is 56% recovered and 46% death. On comparing the closed cases of Italy with China, the horrible picture is reflected in Italy. In china only 5% death occurred in closed cases. The in depth study of age statistics in the Italy cases still to be published. However, Italy is the second nation with highest population with age greater than 65. According to the news published in www.telegraph.co.uk, the death is hard hit on old age people. The median age of Italy patients is 67 years while for China it is 46 years. This fact reflects why death toll in Italy is high in comparison to China. Also, it is obvious older the age, it is equally likely to be coupled with other diseases. It is expected the mortality rate could be low in Italy if death number separated that caused solely from corona virus.

Luckily, Nepal remaining safe on spreading new Corona virus. Recently prevention measures have been adopt that is praiseworthy. It is equally necessary to question mark, is control and prevention measure going on any analyzing of evidences? Many state and non-state organizations have expended the resources for prevention and control. Such as isolation wards prepared, training delivered, awareness messages disseminated and others etc. etc. This stimulated another question, is resources expended on worthwhile stuffs?

The learning of other countries as of evidences discussed above reflects the corona virus hard hit the old age citizens. The corona virus alone do not kill the patients, when coupled with other disease accelerate the death rate. Naturally old age citizens need care more than normal aged patients. Treatment for corona virus alone may not suffice for curing the patients coupled with other diseases. Likewise, the generations of evidences if epidemic out broke is equally important. The availability of solid facts help health care experts and policy makers for inform decision with evidence. The informed decision making do not put decision maker in dilemma.  Has Nepal prepared from this perspective?

Nepal has opportunity to prepare against COVID-19 based on the evidences with intelligent analyzing of facts and figures from other nations. This ensure the efficient and effective mobilization of scare resources.