Lifestyle acquired immunity, decentralized intelligent infrastructures and revised healthcare expenditures may limit pandemic catastrophe: a lesson from COVID-19

Abstract

Human race has often faced pandemic with substantial number of fatalities. As COVID-19 pandemic reached and endured in every corner on earth, countries with moderate to strong healthcare support and expenditure seemed to struggle in containing disease transmission and casualties. COVID-19 affected countries have variability in demographic, socioeconomic and life style health indicators. At this context it is important to find out at what extent these parametric variations are actually modulating disease outcomes. To answer this, we have selected demographic, socioeconomic and health indicators e.g. population density, percentage of urban population, median age, health expenditure per capita, obesity, diabetes prevalence, alcohol intake, tobacco use, case fatality of non communicable diseases (NCDs) as independent variables. Countries were grouped according to these variables and influence on dependent variables e.g. COVID-19 test positive, case fatality and case recovery rates were statistically analyzed. The results suggest that countries with variable median age has significantly different outcome on test positive rate (P<0.01). Both median age (P=0.0397) and health expenditure per capita (P=0.0041) has positive relation with case recovery. Increasing number of test per 100K population showed positive and negative relation with number of positives per 100K population (P=0.0001) and percentage of test positives (P<0.0001) respectively. Alcohol intake per capita in liter (P=0.0046), diabetes prevalence (P=0.0389) and NCDs mortalities (P=0.0477) also showed statistical relation with case fatality rate. Further analysis revealed that countries with high healthcare expenditure along with high median age and increased urban population showed more case fatality but also had better recovery rate. Investment in health sector alone is insufficient in controlling pandemic severity. Intelligent and sustainable healthcare both in urban and rural settings and healthy lifestyle acquired immunity may reduce disease transmission and comorbidity induced fatalities respectively.

COVID-19 trend in Bangladesh: deviation from epidemiological model and critical analysis of the possible factors

“…In addition, sufficient testing is required to properly declare COVID-19 related deaths and recovery. In our previous report (May 26, 2020), analyzing 91 countries’ number of tests performed per 100 K population data we found positive as well as negative correlation with positive cases and test positive (%) respectively with statistical significance [12]. Countries where limited numbers of tests were performed test positive (%) was comparatively higher.…”

“…In our previous report we also found that countries with high median age showed strong association with COVID-19 case fatality rate [12]. This was mainly due to prevalence of non communicable diseases as contributing factor for comorbidity and reduced immunity of elderly people.…”

“…The copyright holder for this preprint this version posted June 23, 2020. ; https://doi.org/10.1101/2020.05.31.20118745 doi: medRxiv preprint 8 as negative correlation with positive cases and test positive (%) respectively with statistical significance [12]. Countries where limited numbers of tests were performed test positive (%) was comparatively higher.…”

Which are factors determining a low COVID-19 mortality in society? High health expenditure and lower exposure of population to air pollution as critical factors for an effective strategy to cope with future pandemics similar to COVID-19

“…Ahmed et al (2020) focus on different demographic, socioeconomic, and lifestyle health factors in countries to explain the variety of COVID-19 effects in society. This study by Ahmed et al (2020) suggests that health expenditure per capita has a positive relation with case recovery; in particular, countries having high healthcare investments associated with high average age and proportion of urban population have high number of case fatality; as a consequence, investment in health sector is one of the factors that plays a vital role to control the spread of COVID-19 pandemic. Barrera-Algarín et al (2020) state that in Europe lower investment in health per capita is associated with high numbers of COVID-19 deaths per million inhabitants; in general, a high negative impact of COVID-19 in terms of mortality is due to low expenditure in public health associated with high socioeconomic inequality.…”

“…Kapitsinis (2020) investigates the diffusion of the novel coronavirus in nine European countries and pinpoints that health investments play a vital role to alleviate mortality rate of COVID-19. Ahmed et al (2020) focus on different demographic, socioeconomic, and lifestyle health factors in countries to explain the variety of COVID-19 effects in society. This study by Ahmed et al (2020) suggests that health expenditure per capita has a positive relation with case recovery; in particular, countries having high healthcare investments associated with high average age and proportion of urban population have high number of case fatality; as a consequence, investment in health sector is one of the factors that plays a vital role to control the spread of COVID-19 pandemic.…”