Epidemiological Philosophy of Pandemics

Objectives

Current estimates of the total number of cases of COVID-19 are largely based on previously-determined case fatality rates (CFRs). In this study, we aim to find an association between the Covid-19 number of cases / million inhabitants (M) and mortality rate (MR), and the association of Covid MR −19 and CFR. The background theory in this study is based on two factors: (1) There is no evidence that the CFR is fixed throughout time or place during an epidemic and (2) there is evidence that an increased viral load (density of infection) leads to more fatalities.

Study Design

We chose 31 countries with testing coverage levels of > 400,0000 tests /M and populations greater than 1 million inhabitants.

Methods

We used ANOVA regression analyses to test the associations.

Results

There was a very highly significant correlation between MR and the total number of cases/ million population inhabitants(M) (P-value 0.0000).

The CRF changed with a change in the MR. A very high positive influence of the COVID-19 MR on the CFR (P-value = 0.0002).

Conclusions

Increased number of cases per million inhabitants is associated with increased MR. Increased MR is associated with increased CFR. This finding might explain variable mortality rates that happened during this pandemic and possibly previous pandemics. This evidence will give us an idea of the behavior of epidemics in general.