What happens to people if they are infected with the coronavirus?

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Indian doctor walks past patients waiting to get examined for coronavirus symptoms at a free screening camp at a government run hospital in New Delhi, India. Photo: AP

As we understand right now, COVID-19 starts in the upper respiratory system. For an average of five days after infection, patients have no symptoms, but scientists believe they can spread the disease at this stage. Symptoms usually start fairly mild—commonly a fever, dry cough, and fatigue. And again, in this stage many people continue to go about their lives, visiting friends and family—and spreading the disease. (Many infected people may have no symptoms, but can still spread the disease to others.)

After this, particularly if the person’s immune system is not strong, the infection moves into the lungs and potentially causes pneumonia. If the pneumonia becomes severe, people will need assistance breathing—oxygen, ventilators, and other medical interventions.1 If they don’t get this help, they may die, and a significant number of people who reach this stage die even with proper medical help.

The World Health Organization (WHO) estimates that around 80 percent of confirmed cases—those who test positive for the virus—experience “mild to moderate” symptoms, lasting a week or more, that can range from symptoms similar to influenza to a pneumonia that is not bad enough to require hospitalization. They then recover, though some may experience long-term respiratory problems. The other 20 percent will have a more severe pneumonia marked by difficulty breathing that requires hospitalization. Of those hospitalized, as many as one in four may require intensive care unit (ICU) treatment, often needing ventilators—complex machines that force air into the lungs of people who cannot breathe effectively on their own.2

So it is currently estimated that up to 20 percent of confirmed cases require life-saving care that only hospitals can provide.

In terms of fatalities or deaths from COVID-19, it varies by the age of the person who gets it. The older you are, the more dangerous it is. It is estimated that around one person out of 100 in their 50s, and about 18 out of 100 people over 80, will die from it.3

The estimated death rates for different age groups are based on the data from the first outbreak in China, but it is not clear if data from outbreaks in other countries breaks down in exactly the same way. But we can say that older people are the most at risk, but that for all adults this can be a very dangerous diseases⏤the U.S. Centers for Disease Control and Prevention (CDC) reported on March 18 that nearly 40 percent of the people hospitalized with COVID-19 were between 20 and 54 years old.

Along with age, a major factor in mortality is the health of the patient. People with conditions like diabetes, heart disease, or serious lung disease or whose immune systems are compromised (like people with HIV/AIDS or people taking drugs that suppress their immune systems as part of cancer treatments) are more likely to die than people in their age group who do not have these conditions.

Another big factor influencing death rates is not the health of the individual, but the functioning of the society as a whole. If everybody who is seriously ill with COVID-19 receives the needed medical interventions, death rates drop dramatically. For instance, in the early stages of the epidemic in China, the city of Wuhan was hit hard and suddenly, hospitals were overwhelmed, physicians did not know how to treat it, and the death rate was 5.8 per hundred people. But its spread in other parts of China was much slower, health care systems were not overwhelmed, and the death rate plummeted to about nine per thousand infected people.4

Because of all these variables, combined with the fact that—because of insufficient testing—we don’t know how many people have the disease to begin with, it is hard to state with any certainty what the death rate has been, or what it will be. Estimates run as high as 3.4 percent and as low as 0.2 percent. But as a rough guide, most experts are currently using a figure of 1 percent—one death per a hundred people infected.

Indian doctor walks past patients waiting to get examined for coronavirus symptoms at a free screening camp at a government run hospital in New Delhi, India. Photo: AP

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