By: Dr. Pashko R. Camaj, Doctor of Public Health Sciences*/
Often, we get the newsflash and headlines about the numbers of cases as it goes up in different parts of the country or within a region. The growing number of cases in part reflects the rapid spread of Covid-19 as many United States (U.S.) states and territories experience community spread. In addition, the number of Covid-19 cases being reported in the U.S. is rising due to increased laboratory testing and reporting across the country. Detailed and accurate data will help us better understand and track the size and scope of the outbreak and strengthen prevention and response efforts.However, using sheer number and not rates can give a false impression, and that is what many in the media (social or otherwise) too often do. So when we hear and read about the “numbers going up” it can be real, because of new infections, but in many cases, it’s a function of the numbers of tests going up, and with that, the number of positive case increase. To illustrate, if 50 out of 1000 peopletest positive for Covid-19, that is a 5 percent infection rate. That is the same rate that 100 out of 2,000 positive casesrepresent, even though the number doubled from 50 to 100.
Scientific evidence has shown that many Covid-19 infected people will never experience any symptoms or may experience very mild symptoms. So, as we test more people, we find more cases. Important, though they may be asymptomatic, they can spread the virus to others. Its dual nature, often benign, yet sometimes deadly, puts Covid-19 in a rare category among the common pathogens that afflict humanity. In a recent review published in the Annals of Internal Medicine, data from 16 sources around the world, have shown that at least 30 percent and possibly as high as 40-45 percent of people will not show symptoms of the disease.
Understanding and making sense of these numbers is essential as we battle, track and contain the virus.Concentrating testing efforts exclusively on those with symptoms, as has largely been done so far, is not a right approach-it is a mistake. Public health officials across the country, and across the globe,must cast the net far more widely to capture many that are infected with Covid-19, yet, asymptomatic.
More about the numbers: To date, there are about 7.5 million Covid-19 cases reported worldwide: with about 425,000 deaths and 4.5 million people that have recovered from the disease. The case fatality rate based on these numbers is about 5.6 percent, yet knowing that there could be many millions of people who had been infected but never tested, because they were asymptomatic or tests were not available, that case fatality rate is most likely significantly lower, some data suggest it to be closer to 1-2percent, which is still about 2-4 times higher than that of the seasonal flu!
Finally, proper interpretation of data and numbers, gives us the confidence we need to make the correct decisions. The knowledge that many people who become infected with the coronavirus will never experience any symptoms, yet can still make others sick, helps public officials make the right decisions and adjust tactics for tracking, controlling and defeating this virus. Science is all about clarifying things, making the invisible visible. Science has shown us that maintaining a good distance from others in public or wearing a mask or a facial cover, maintaining good hand hygieneremains essential in preventing new infections. Assumptions in general are not good, especially in science. But in this case,to protect others it is best to assume and behave as though you are infected -untilthe day comes, hopefully soon,when we can declare that the covid-19 pandemic has ended!
*Vice-President of Pan-Albanian Federation of America-VATRA