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      Geographical Distribution of COVID-19 Cases and Deaths Worldwide

      editorial
      1 , 2 , *
      Journal of Research in Health Sciences
      Hamadan University of Medical Sciences

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          Abstract

          COVID-19, the disease caused by the new coronavirus, is a highly contiguous infection that spread immediately across the world since its beginning in Wuhan, China on Dec 31, 2019 1 . By Aug 23, 2020, over 23.5 million people were infected and more than 800,000 people died from the disease 2 . Besides several well-known and much deadlier diseases worldwide 3 , COVID-19 is an emerging infectious disease that has caused huge health and economic disaster worldwide. COVID-19 disease involved almost all countries around the world. Like any other disease, genetic variations in population across different areas of the world may affect the COVID-19 related morbidity and mortality. Moreover, the disease surveillance system and completeness and timeliness of cases and/or deaths reports can cause differences in disease mortality and morbidity rates in different parts of the world. However, the geographical variation in COVID-19 cases and deaths is very wide following a mysterious pattern. As shown in Figure 1, while the prevalence of this disease is very high in the western hemisphere, the prevalence of the disease is not very high in the eastern hemisphere irrespective of the economic levels of the countries. A majority of countries with a prevalence of more than 10,000 cases per million are located in the Americas, while a small number of countries in the eastern hemisphere have such a high prevalence. The variation in the COVID-19 mortality rate is much wider than the disease prevalence in the western and eastern hemispheres. The vast of the countries with death rates of more than 200 death per million are located in the western hemisphere including the Americas and Western European countries while such a high mortality rate has rarely occurred in the countries of the eastern hemisphere (Figure 2). The geographical distribution of this disease does not seem to be related to the economic level of countries. If this was the case, it would be expected that the prevalence of disease and death rates due to COVID-19 would follow the pattern of the economic level of countries. Accordingly, the prevalence of the disease and mortality rates would be lower in high-income countries than in low-income countries. However, the geographical distribution of the disease does not indicate such a thing. Something that draws attention at first glance is that the geographical distribution of the disease varies widely in the west and east of the planet. It follows a kind of eastern and western distribution. Therefore, this variation seems to be beyond the economic level of countries. Figure 1 The geographical distribution of the COVID-19 cases per million worldwide Figure 2 The geographical distribution of the COVID-19 deaths per million worldwide Another issue that seems very strange about the geographical distribution of COVID-19 coronavirus is that the prevalence and death rate of the disease is very low at the origin of this disease. COVID-19 coronavirus was first detected in China and spread from there to other parts of the world. However, this country, which is the origin of the disease and the most populous country in the world, has been much less affected by the disease than many other countries. This mysterious geographical distribution in COVID-19 cases and deaths is a question that should be answered. Besides the mysterious geographical distribution of COVID-19, many other aspects of this disease are still unknown and many unanswered questions remained. Where did COVID-19 coronavirus come from? Is the virus the result of human manipulation in a top-secret military lab or a natural mutation? Why this disease has had little effect on the country of origin as well as the countries of the eastern hemisphere, but it severely affected the Americas and Western Europe? Why does it spare some and kill others? Has the virus mutated during the pandemic period or may it mutate in the future and make the vaccine ineffective? We still have a long way to go to fully understand the disease and learn more about its mysterious characteristics.

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          Neglected Major Causes of Death Much Deadlier Than COVID-19

          COVID-19, the disease caused by the new coronavirus, was first detected as pneumonia of unknown cause in Wuhan, China on December 31, 2019 1 . In a very short time, the outbreak was declared a public health emergency worldwide by the World Health Organization on January 30, 2020 and then characterized as a pandemic on March 11. By May 15, 2020, over 4.5 million people worldwide were infected by the new coronavirus and 304,127 people died from the disease 2 . Although COVID-19 is a highly contagious and dangerous infectious disease, several deadlier diseases are killing thousands of people worldwide every day, but unfortunately, many people do not pay attention to them. Now the critical question is why people do not pay attention to these major causes of death as much as they do to COVID-19. It may be shocking to many people if they hear that more than 49,041 people died due to cardiovascular diseases, 26,301 people due to cancer, 20,822 people due to hypertension, and 19,178 people from air pollution within the past 24 hours worldwide. It may be unbelievable for many people if they find out that the same number of death from the same diseases have been occurring for several years and will occur in the following days, weeks, months, and years! Probably, a majority of people may not believe these figures. Unfortunately, not only these figures are true but also the situation is much more devastating than this. According to the report of the World Health Organization in 2018 3 and other sources 4,5 , apparently, millions of people died of 19 major causes of death worldwide (Table 1). Table 1 Major causes of death worldwide based on the World Health Organization report 3 and other sources 4,5 Causes Year Death Cardiovascular diseases 2018 17,900,000 Cancer 2018 9,600,000 Hypertension 2018 7,500,000 Air pollution 2018 7,000,000 Chronic obstructive respiratory diseases 2018 3,170,000 Alcohol 2018 3,000,000 Pneumonia 2019 2,560,000 Diabetes 2018 1,600,000 Tuberculosis 2018 1,500,000 Road traffic accidents 2018 1,350,000 Hepatitis B and C 2018 1,340,000 Tobacco 2018 1,200,000 Suicide 2018 800,000 HIV/AIDS 2018 770,000 Influenza 2018 650,000 Diarrhea 2018 525,000 Homicides 2018 470,000 Malaria 2018 405,000 The depth of the tragedy is shown in Figure 1. This figure shows the most common causes of death worldwide. The rank of COVID-19 is 13th among 20 major causes of death. That means, based on current evidence, a diverse group of diseases and health-related conditions kill much many more people every day than COVID-19 does worldwide. Of course, changing upward or downward in the rank of COVID-19 over time is possible depending on whether the disease progresses or regresses. Furthermore, the incidence rate and death rate of COVID-19 are affected by the validity and availability of diagnostic tests. Accordingly, many expert believe that more people have died from coronavirus than reported. Figure 1 The death rate of 20 leading causes of death worldwide based on the World Health Organization report in 2018 3 and other sources 4,5 [To obtain death rate per month, the annual deaths due to COVID-19 were divided by 4 and that of other diseases were divided by 12.] Now we return to the critical question: "why do people not pay attention to these major causes of death as much as they do to COVID-19?" COVID-19 is new pneumonia associated with huge health and economic crises. We are now in the middle of crises and Covid-19 is still the hot topic of worldwide news during the past four months. An international campaign has been launched to curb the disease. Unfortunately, despite the efforts made so far, COVID-19 seems to be around for a long time. In that case, people will never tolerate the restrictions adopted to reduce the spread of the disease for a long time. As a result, the recommended preventive measures, such as stay-at-home, physical distancing, and lockdown restrictions, will be eased gradually and life will inevitably return to normal while the disease still kills many people every day. We will forget the catastrophic consequences of this horrible pandemic very soon as we did heretofore other much deadlier diseases. The reality is that we are human. This is the inherent characteristic of human that get used to any situation and phenomenon that takes for a long time particularly when there is no easy solution for it. The transmission of COVID-19 is faster than many contagious diseases we have ever known. This issue caused great panic among people worldwide. Paying special attention to the disease and taking preventive measures to curb and control the disease is a health priority. This paper does not intend to underestimate the importance of COVID-19, rather it reminds the importance of other dangerous but neglected causes of death that kill thousands of people worldwide every day. Unfortunately, people hear little about the importance and catastrophic consequences of these common causes of death in the media. Therefore, they do not pay enough attention to them while a majority of the deaths due to the aforementioned diseases will be prevented by changing lifestyles and improving health services. COVID-19 reminded us how vulnerable we are and how forgetful and unaware of major causes of death we are!
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            Author and article information

            Journal
            J Res Health Sci
            J Res Health Sci
            J Res Health Sci
            J Res Health Sci
            JRHS
            Journal of Research in Health Sciences
            Hamadan University of Medical Sciences
            2228-7795
            2228-7809
            Summer 2020
            30 September 2020
            : 20
            : 3
            : e00483
            Affiliations
            1Research Center for Health Sciences, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
            2Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
            Author notes
            [* ]Correspondence: Jalal Poorolajal (MD, MPH, PhD) Tel:+98 81 38380090; E-mail: poorolajal@ 123456umsha.ac.ir
            Article
            10.34172/jrhs.2020.24
            7585770
            33169715
            b5aeb68b-0acb-4dde-a0d3-6dce65913dd6
            © 2020 The Author(s); Published by Hamadan University of Medical Sciences.

            This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

            History
            : 01 September 2020
            : 27 September 2020
            : 28 September 2020
            Page count
            Figures: 2, References: 3
            Categories
            Editorial

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