Important aspects to consider about the coronavirus

Below are some aspects that should be taken into account in the definition of measures to deal with the crisis caused by the COVID-19 virus; and for the reflection of each one of the people, especially in the Latin American countries that we have the possibility of learning from other countries where the virus came before, with the hope that we make better decisions regarding our behavior, at a time when the Everyone's well-being depends on each of us.

1. The number of infected persons capable of transmitting the virus is much greater than the number of reported sick cases

This is so because there are many carriers of asymptomatic viruses. According to a study conducted by the team of Justin Lessler, from the Department of Epidemiology at the Johns Hopkins University Bloombergd School of Public Health, the average time from exposure to COVID-19 to the onset of symptoms (incubation period) is 5.1 days. That is, a person can be infected and have no symptoms for a period that according to the WHO can be between 2 and 14 days, and that on average is 5.1 days. Thus, there are a large number of asymptomatic carriers who, although not ill, can transmit the virus.

To obtain an approximate number of the total infected (sick + asymptomatic) we can do the following reasoning:

"If the incubation period is on average 5.1 days, it means that today's patients were infected on average 5.1 days ago. In the same way, today's infected will become ill on average within 5.1 days. ”

However, some carriers will not develop the disease. Given that there is no data on how much that proportion could be, since they will not go to the health system, to take them into account in this simulation, what will be done is calculate the number of people infected, not with the patients, who may be within 5.1 days, but within 6 days, which would be a little more. In this way, we would have an approximation to the total number of those infected at a given time (infected patients + infected patients who will be ill + infected patients without symptoms who will not become ill), according to the number of reported cases.

But how will we know how many reported cases there will be in 6 days? To know this number, we can follow the growth pattern of the number of those infected in other countries where the virus came earlier.

In France the period of doubling the number of cases of patients is 3 days, in Brazil and Italy this number is even less (54 hours and 43 minutes). It is worth clarifying that the shorter the doubling period, the faster the number of infected will grow. For this simulation we are going to take the 3 days of France.

With the above assumptions and based on the fact that in Colombia as of yesterday, March 22, 2020, there were already 235 cases, the simulation shown in the following table can be obtained:

Table 1. Simulation of the sick and infected in Colombia

According to the data in the table, while coronavirus patients already numbered 235 as of yesterday, in reality the number of those infected with the capacity to infect others was 940, four times the number of patients. This is very important, because one of the great mistakes made by European countries was to take measures based on the number of patients (cases of coronavirus reported), but the number of total infected with the capacity to infect others (infected sick + infected asymptomatic who will get sick + infected asymptomatic who will not get sick).

In addition, in a span of just two weeks the Colombian health system would collapse, which according to the Colombian Association of Scientific Societies (ACSC) barely has 5,300 Intensive Care Units. If we take into account that of the 5,300, only between 10% and 15% have adequate insulation so as not to infect other patients (approximately 750 beds), the situation becomes much more critical.

2. The death rate is much higher than is believed

According to what is said in the news, the death rate is approximately between 2% and 3%. Comparing the figures for Germany, France, Spain and Italy, we can see that this is indeed the case.

Table 2. COVID-19 mortality rate in four European countries

Built with data taken from

But there is a miscalculation there, because today's deceased are being related to today's cases, when in fact today's deceased developed the disease a few days ago. Therefore, the calculation should be made on the number of cases from those days ago, which will surely be fewer, which considerably increases the death rate.

For example. If in one country there are already 2,000 cases of coronavirus and 40 deaths due to this cause, the relationship between the deceased and the cases gives 2% mortality. But, assuming that on average a deceased by coronavirus takes a week from the development of the disease until it dies, the calculation should be made with the number of cases from a week ago. So, if a week ago there were 400 cases, the mortality rises to 10%, since of 400 cases 40 died.

There are no figures on how long ago on average a person who died of coronavirus became ill, but to give an idea of the true death rate of the virus, a simulation is done below, with 5, 6 and 7 days, where you can see that the mortality rate amounts to 8.4; 10.1 and 15.5 respectively. It is clear that it is not just any flu.

Table 3. COVID-19 Mortality Rate Simulations in Four European Countries

Built with data taken from

It should also be borne in mind that the mortality rate will increase when a country's health system collapses, since many patients will have a greater probability of dying due to not having the corresponding medical attention.

On the other hand, in countries such as Germany, France, Spain and Italy the proportion of older adults is on average 20.9%, while specifically in the Colombian case that proportion is 8.5%. Taking into account that approximately 80% of mortality occurs in this segment of the population, the mortality estimates for Colombia corrected for this factor would be 4.4% (Simulation 1), 5.66% (Simulation 2) and 8.14% (Simulation 3), as shown in the penultimate column of the following table.

Table 4. Adjustment of the mortality rate for Colombia, by the proportion factor of the population aged 65 or over.

An important conclusion that can be obtained by correcting mortality for the differences between the proportions of the population over 65 years of age, is that in Colombia, mortality is reduced to a little more than half of mortality in the four European countries (last column of the table). These calculations could well be extrapolated to Latin America, which has a proportion of adults over 65 (8.4%) very similar to that of Colombia (8.5%).

3. Final considerations

Colombian Culture: Colombians are used to being "fanned", cheating, not respecting the ranks, not respecting the rules if that does not entail iron vigilance, a conviction and a judicial / criminal system that enforces it. For this reason, it is very optimistic to expect that at least the majority of the population will respect quarantine; further exacerbating the crisis.

Corruption: Colombia, and in general Latin America, have a high degree of corruption, which delays decision-making and execution. In a crisis like this, where one day can represent thousands of lives, the delay in deciding where to build / equip new care centers is a serious problem; and the delay in its execution is even more serious.

Violence: Colombians are used to an amazing level of violence. Massacres, dismemberment, mass graves, false positives, assassination of social leaders, bombs, bomb necklaces, kidnappings, extortion, and the list is very long and includes many of the social actors as those responsible. People who were previously in guerrilla or paramilitary groups, accustomed to this type of situation, could now be just around the corner. Common crime is also very high. If, under “normal” conditions, a criminal can murder another person by stealing a cell phone, what can be expected at a time when food and basic necessities are scarce? This makes it easy to light the wick of widespread chaos once ICUs are not enough;and it will worsen if people are missing in the essential sectors (health, food, public safety, private security, etc.). On the other hand, there is intra-family violence, which can drive those who suffer it to not respect quarantine.

Economy: Considering that the Colombian economy has an informality of close to 50%, an extended quarantine for this sector will be impossible to sustain without direct government aid. But also in the formal sector, government help is needed, since it is difficult for MSMEs to have the necessary resources to continue maintaining their payroll if they do not obtain income.

4. Conclusions

The number of people capable of transmitting the virus is approximately four times the number of reported cases. If the curve of patients with coronavirus cannot be flattened, the health system in Colombia will collapse around April 5. If it cannot be flattened the curve of patients with coronavirus, on April 6 we would have approximately 7,520 cases and 30,080 infected. And in a little over a month and a half, most of the Colombian population will have been infected with the virus. The mortality of the virus is much higher than is believed; However. Latin America and the Caribbean have the mitigating factor of having a proportion of the elderly population that is considerably less than that of the European countries. However, mortality would be greater than 2 or 3%, which is disclosed in various sources.

5. Recommendations

That all households prepare for a period of quarantine longer than expected and comply with it rigorously, to avoid exposing themselves to the virus and reduce the slope of the contagion curve, thus avoiding the collapse of the health system. health.Increase the attention capacity (centers, beds and respirators) as soon as possible, for which various spaces such as hotels, convention centers, etc. can be used.Maximize the number of breathing equipment, orienting their production towards companies that are able to manufacture them. Provide financial aid from the government to the entire population, suspending the payment of public services, financial debts and taxes; and even, granting survival bonuses for the neediest.