How dangerous is COVID-19 in the grand scheme of things?

Just how dangerous is COVID-19? The worst crisis since World War II, is what experts said at the start of the pandemic, a statement backed up by the stringent pandemic lockdowns thrown up by governments worldwide.

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Today, almost four months later, as India heads towards Unlock 1.0, there has been a change in the official messaging which has deflated the fearsome reputation of the Sars-CoV-2 virus somewhat to that of an overwrought rogue flu not yet tamed by a vaccine.

Understandably, this has left some people perplexed.

“I think it is ironic that we had such severe lockdowns when the number of cases was low at the beginning, and now when the number of cases is sky-rocketing, lockdown relaxations are being lifted,” said a recovered COVID-19 patient that DH recently spoke to.

It is a statement mirrored by members of the press corps and citizens reeling under the impact of the “quarantine fatigue''. But is this downgrading of the dangers of COVID-19 warranted?

Absolutely, say members of the State COVID Task Force. Dr M K Sudarshan, head of the COVID-19 Analysis Committee said amounts of data which have been generated on disease recovery rates and demographic incidence rates over the last few months has revealed the chinks in the virus’ armour.

“The data shows that this is a disease which can be managed. The only concern is safeguarding senior citizens and especially people with comorbidities,” he added.

When placing COVID-19 on a scale with other major pathogens, its reputation certainly pales. The existing data appears to indicate that the dangers of the disease is being played up at the cost of more serious illnesses such tuberculosis, malaria, meningitis and even dengue.

However, while the Sars-CoV-2 virus may not necessarily be the “ender of worlds” that it was made out to be at the start of the pandemic, it is nevertheless a dangerous killer that cannot be underestimated. This is borne out by the fact the 382,867 (3.82 lakh) deaths which have been racked up so far worldwide (as of June 5, 2020), according to the World Health Organization (WHO).

But this figure too can be misleading as a majority of the deaths happened in the United States, where comorbidity is a factor.

One way to tell

Ideally, according to the experts, we should be looking at the effective reproduction number of the virus to gauge the spread of the disease in a particular region or state. This “effective reproduction number” (commonly known as R0) is calculated using the number of contacts multiplied by the probability of transmission per contact. Probability is calculated using mathematical methodologies.

This has direct implications on deaths. If there are more patients than intensive care beds, the death rates can spike. According to an April 20 report by the Centre for Disease Dynamics, Economics and Policy (CDDEP), the state government had a total of 3,486 ICU beds, including for non-COVID-care. The number for COVID-care has hovered around 700 to 800.

In a real-time R0 graph created by Parijat Khan, a Hyderabad-based developer, whose work is based on Department of Health and Family Welfare data and has been cited by experts, Karnataka’s R0 has been veering from a low of 1.1 to a high of 2.02 since May 4. As of Thursday, June 4, it was 1.52, meaning that every person infected with the novel coronavirus is spreading it to an average of one other person, with 0.52 added chance of infecting a second individual.

“If you see the figures for Karnataka, you will notice that whenever the R0 value has become 1 or less, the growth rate has started to flatten and whenever the R0 is more than 1, there is a spike in the growth. So, in short, there is a correlation, but it is a short-term correlation since R0 heavily depends on the correctness of the data and measures taken to contain the pandemic,” Khan said.

What does all this mean? For starters, it shows that the virus is still spreading. And because the pandemic is still an on-going feature of daily life, it is not yet possible to pin down the Sars-CoV-2 virus into a category of pathogen based on virulence. Scientists claim that the virus has already mutated into 10 different clades (strains), with more mutations expected. Even establishing the death rate of the disease has been difficult so far because of the unknown true number of cases. Epidemiologists still do not know what percentage infected by the virus will perish.

Taken together, what all of this indicates is that we are not yet in the clear.