Official data from around the globe shows that the number of Covid-19 cases worldwide has crossed the 211 million mark.
But recent studies have indicated that we may have already seen one billion infections.
One study suggests that two-thirds of India’s population – more than 800 million people – have developed antibodies against Covid-19, indicating that the number of people who had contracted the disease is far in excess of the official statistics.
Separately, a South African disease expert has said that as many as four in five people in South Africa – a nation of more than 59 million – may have contracted the virus.
Notably, at the start of the pandemic, some experts had predicted that we would see as much as two-thirds of the global population getting infected over the course of the pandemic – about 5.2 billion people.
Professor John Middleton, president of The Association of Schools of Public Health in the European Region, found the scenario of two-thirds of the global population infected by the coronavirus plausible.
“It’s not an illusion, it’s not a fake pandemic. It’s very real and people need to take it seriously,” he said.
“Perpetual Covid-19 is what I see at the moment. And governments that don’t suppress and respond to the virus vigorously, I’m afraid, will perpetuate the virus for everybody.”
Another alarming estimate by the World Health Organisation at the start of the pandemic suggested that the mortality rate – the percentage of fatalities occurring out of the total cases reported – would be around 2 per cent.
Based on the official figure of about 4.4 million deaths, it would imply that we are currently seeing a mortality rate of 2.09 per cent, which is in line with the prediction.
However, if one factors in the estimated excess deaths in India and the 103 countries that figure in new studies, as well as the higher number of coronavirus cases estimated by the studies, the actual mortality rate in the pandemic so far becomes far more difficult to determine.
Pertinently, excess mortality may be due to many factors, such as deaths from various illnesses caused by a medical system collapse during the pandemic, and those from other causes such as wars and natural disasters.
However, for most countries, the numbers of these additional deaths are small in comparison with those succumbing to Covid-19. Thus, excess mortality can be used as a proxy for pandemic mortality, according to peer-reviewed research.
Determining the actual number of cases, however, is problematic.
Professor Leo Yee Sin, executive director of Singapore’s National Centre for Infectious Diseases, pointed out that death as the most severe outcome is just the tip of the iceberg when it comes to calculating the true number of Covid-19 cases.
“Determining the base can be tricky, as asymptomatic and mild cases are not apparent,” she said.
Professor Sanjay Rampal, head of the department of social and preventive medicine at the University of Malaya’s Faculty of Medicine and a member of the Asia-Pacific Academic Consortium for Public Health, concurred. He said: “Based on current testing strategies, true asymptomatic cases are more likely to be missed, compared with the more severe cases.”
Given the high transmissibility of the virus and the slow roll-out of vaccination at the global level, it is likely that Covid-19 infections would continue to occur for some time to come, he added.
“However, the morbidity of the disease is expected to be drastically decreased in vaccinated populations,” he said.
Arvind Jayaram
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