Article Information

Corresponding author: Sajjad Baber

Article Type : Research Article

Volume : 1

Issue : 2

Received Date : 14 Jun ,2020


Accepted Date : 26 Jun ,2020

Published Date : 03 Jul ,2020


DOI : https://doi.org/10.38207/jcmphr100227

Citation: Baber S (2020) Average Mortality Rate Of COVID-19 In Iran. J Comm Med Pub Health Rep 1(2): https://doi.org/10.38207/jcmphr100227

Copyright: © © Baber S 2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
  Average Mortality rate of Covid-19 in Iran

Sajjad Baber

Craniomaxillofacial research center, Department of Oral and Maxillofacial Surgery, School of Dentistry, Resident, International Campus, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran

*Corresponding author: Sajjad Baber, Craniomaxillofacial research center, Department of Oral and Maxillofacial Surgery, School of Dentistry, Resident, International Campus, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran

Abstract
Background:
Corona virus disease was first reported in Wuhan City, Hubei province, China. Soon the corona virus disease has spread to many countries. World health organization has described the situation as Pandemic. By 12 March 2020, corona virus disease has affected 125 countries around the world. Corona virus was first confirmed in Iran on 19 February 2020.

Objective: The aim of writing this small article is to determine the mortality rate of corona virus disease in different cities of Iran. This article will give readers an idea of different ways to control spread of corona virus disease in Iran.

Methods: Author has collected the data of daily confirmed cases from different diagnostic centers and hospitals across the country from 19 February 2020 to 1 April 2020.

Results: Mortality rate of corona virus disease is roughly 4 %.

Conclusion: Mortality rate could rise if COVID 19 infection is not controlled.

Keywords: COVID 19, mortality, Iran, pandemic

Introduction
A case of pneumonia with unknown pathogen was first reported on 8 December in Wuhan City, Hubei province, China. On December 31, China confirmed around 27 cases of pneumonia with unknown pathogen to World health organization. Chinese scientists discovered the pathogen on 7 January and named as novel corona virus, Corona virus disease [COVID-19] [1,2]. World health organization on 30 January declared a ‘public health emergency of international concern’. Soon the COVID-19 has spread to many countries. Honorable Director-General of WHO, Tedros Adhanom Ghebreyesus termed the situation as ‘Pandemic’ [3]. By 12 March 2020, COVID-19 has affected 125 countries around the world [3,4]. First two confirmed cases of Corona virus were emerged in Qom on 19 February 2020. Both cases were accurately detected before they died [5]. It was a shock to Iranian officials as none of them travelled abroad or out of Qom. It was extremely challenging for the Iranian administration to start testing of corona virus on suspected cases due to economic sanctions of the United States on direct access to test kits [6].

Iran represents a country of about 83 million people. Initial findings suggest that a merchant may bring the virus from Wuhan to Qom. It is important to mention that both cases could have been sick weeks ago and infecting others for weeks [7].

More infectious cases had been reported in major cities after Qom. After that, the Iranian government had begun taking practical measures. Subways, cars and BRT buses were disinfected. Schools, universities and cultural centers were closed. The Iranian health ministry had politely advised locals to carefully avoid crowdy areas and not shake hands. Citizens were also advised to limit the extensive use of bank notes. A lot of inmates in various prisons were released on a temporary basis. Short working hours were allowed in workplaces and public offices [7,8].

Signs and symptoms of corona virus disease 19 [COVID 19]: It usually starts with mild fever, cough, profound fatigue, and mild pain in the body. A headache with or without moderate diarrhea or abdominal pain begins slowly. This can typically lead to respiratory distress in severe cases [9].

Epidemiology and quarantine
Corona virus disease-19 [COVID- 19] infection typically spreads at a very fast pace and recently described as ‘Pandemic’ by world health organization. Quarantine is necessary for suspected patients. Quarantine is the reasonable restriction of movement of already infected or about to infect local people.

Suspected patients can quarantine in hospital. Mild cases with good immunity can self-quarantine at home.

Generally, the incubation period of corona virus is approximately 14 days. China reported a case of 27 days incubation period in world health organization. It can typically transmit through air via coughing or blood contamination and faeces of infected persons. Mortality rate is higher in old age and patients with systemic diseases [10,11].

There are several advantages of small cities.
First, it requires low cost and improved communication as compare to big cities. Second, due to low population, there is less consumption of masks, face shields and gowns. Third, low manpower or active personnel are required in smaller cities.

Methods to reduce spread of infection
Remember an important proverb ‘Prevention is better than cure’.

  1. Proper washing of hands with soap and water/hand sanitizer.
  2. Maintaining clean and hygienic workplaces.
  3. Handshake and kiss should be forbidden.
  4. No excursions in Nowruz should be permitted.
  5. No in restaurant food.
  6. Meat well prepared.
  7. Adequate use of herbs and in particular fruits, to improve immunity.
  8. Periodic exercise.
  9. Avoid touching nose, mouth, and eyes. Remember T sign of face.
  10. Quarantine areas where contamination is high.
  11. Educate through electronic media.
  12. No unprotective interaction with wildlife.
  13. No close contact with individuals having cold or flu like symptoms.
  14. Infected persons should stay at home.
  15. Complete isolation of COVID 19 patients.
  16. Infected individuals should wear face masks to keep the infection away from other people. [3,10-12].

Materials and methods
Data collection:
There are numerous ways to collect the data of COVID 19 patients.

  1. Household transmission data: We can ask the family members via telephone about symptoms of COVID 19. This method is unreliable. The family members can be false negative due to absence of symptoms or false positive like misdiagnosing with seasonal flu.
  2. Questionnaire via mobile application software: These surveys are cost wise cheap and fast but again this method is not reliable.
  3. Data collected from ministry of health: This ministry usually collects data from hospitals and laboratories electronically.

According to author, the standard method is hospital based or a laboratory-based data.

Not a single method can tell us the pinpoint accuracy of mortality rate of COVID- 19. Some patients might be in the incubation period. Ordinary villagers might consider this as an ordinary pneumonia due to lack of education and old customs and traditions. COVID-19 cases may be missed due to lack of diagnostic kits. Rapid testing Polymerase chain reaction [RT PCT] was used to confirm COVID - 19 in suspected cases.

Author has obtained data of daily series of confirmed cases from different diagnostic centers and hospitals across the country from 19 February 2020 to 1 April 2020.Iranian ministry of health and medical education confirmed 47593 cases and 3036 deaths and 3871 critical cases till 1 April in Iran.

It is important to mention that no disparity of number of cases was found between the Iranian ministry of health and medical education and different diagnostic centers and hospitals.

Results
There are 47,593 cases reported so far in Iran with 3,036 deaths and about 3,871 in intensive care unit till 1 April 2020. Author believes that mortality rate of COVID -19 is roughly 4 % mostly elderly people i.e. approx. 88 % and young people with existing systemic diseases and poor immune system (10 %). Around 2 % of child deaths between age 12 to 14 years have been reported. It is important to mention that about 15,473 people have been recovered from infection. Detailed numbers of COVID 19 infections from 1 March to 1 April 2020 is summarized in the form of Tables 1-3.

Table 1: Detailed numbers of COVID 19 infections of month March from 1 to 12

Day

1

2

3

4

5

6

7

8

9

10

11

12

Total number of infected persons

978

1501

2336

2922

3513

4747

5823

6566

7161

8042

9000

10075

Infected persons in past 24 hours

394

523

835

586

591

1234

1076

743

595

881

958

1075

Total number of deceased persons

54

66

77

92

107

124

145

194

237

291

354

429

Deceased persons in past 24 hours

11

12

11

15

15

17

21

49

43

51

63

75

Total number of recovered persons

0

0

0

0

0

913

1669

2134

2394

2731

2959

3276

Recovered persons in past 24 hours

0

0

0

0

0

913

753

465

260

337

228

317

TabDetailed numbers of COVID 19 infections of month March from 13th day to 24 day.

Day

13

14

15

16

17

18

19

20

21

22

23

24

Total number of infected persons

11364

12729

13938

14991

16169

17361

18407

19644

20610

21638

23049

24811

Infected persons in past 24 hours

1289

1365

1209

1053

1178

1192

1046

1237

966

1027

1411

1762

Total number of deceased persons

514

611

724

853

988

1135

1284

1433

1556

1685

1812

1934

Deceased persons in past 24 hours

85

97

113

129

125

147

149

149

123

129

127

122

Total number of recovered persons

3529

4339

4590

4996

5389

5710

5979

6745

7635

7913

8376

8913

Recovered persons in past 24 hours

253

810

251

406

393

321

269

766

890

278

463

537

Table 3: Detailed numbers of COVID 19 infections of March from 25th to April 1st in Iran.

Day

25

26

27

28

29

30

31

1

Total number of infected persons

27017

29406

32332

35408

38309

41495

44606

47593

Infected persons in past 24 hours

2206

2389

2926

3076

2901

3186

3111

2988

Total number of deceased persons

2077

2234

2378

2517

2640

2757

2898

3036

Deceased persons in past 24 hours

143

157

144

139

123

117

141

138

Total number of recovered persons

9625

10457

11133

11679

12391

13911

14656

15473

Recovered persons in past 24 hours

712

832

676

546

712

1520

745

817

Table 1, 2 and 3 are showing COVID 19 data collection of diverse number of patients from 1 March to 1 April 2020 in Iran. Iran registered its initial case on 19 February 2020. Table 1, 2 and 3 showed that the total number of cases infected on March 1 was 978 which increased to 24,811 on 24 March, a total of 34 days. From 25th march to 1st April 2020, the overall number of active infections were 47,593 a figure nearly double in one week.

The infection has spread in all the31 provinces with Tehran, Mazandaran and Qom province are mostly affected as shown in the graph.

Graph 1: mortality rate of various age groups till 1 April 2020

Graph 1 shows the mortality rate of various age groups till 1 April 2020. According to this graph, a total number of 3,036 persons died. There are   approximately 2,671 deaths of Old people,304 deaths of young individuals and 61 deaths of Children which consists of 88 %,10 % and 2 % respectively. Based on the research, I can assume that the average mortality rate in Iran would be around 4 % to 5 % but it could rise if COVID 19 infection is not effectively controlled. The mortality rate was initially estimated to 2 % by World health organization. On 3 March 2020, mortality rate was increased to 3.4 %. It can increase to furthermore depending on the spread of infections in different countries.

Graph 2: This graph shows us COVID 19 data collection of total count of patients from 1 March to 12 March 2020. According to this graph there are approximately10,075 of the total figures of infected patients in which 1075 infections are detected in the past 24 hours. Total number of deceased individuals up to 12 March 2020 are 429 while the number of deceased individuals in past 24 hours are 75. It is important to mention that about 3276 people have been recovered from infection while from 1st to 5th March no recovered persons are noted.

Graph 3: This graph shows the COVID 19 data collected in different Provinces of Iran from 4 March to 12 March 2020.From 4th march, the number of infected cases in Tehran, Mazandaran, Qom, Isfahan and Gilan province was 253,9,101,0 and 35 respectively which has increased in 9 days to 2673,997,846,792 and 613 respectively. The number of infected cases has increased in all five provinces particularly in the province of Tehran.

Discussion
It is a great challenge for Iran to typically control COVID 19. In the past, we have seen the impact of other epidemics such as severe acute respiratory syndrome [SARS] and Middle east respiratory syndrome [MERS] in some developed countries. Beyond Iran, COVID- 19 has been reported in 125 other countries such as China, Italy, South Korea, Spain, France, Germany, United States of America, Switzerland, Norway, and Japan etc. The outbreak raised several research questions such as its origin, pathogenesis, and treatment. There is currently no appropriate drug or effective vaccine. Chloroquine Sulphate and Anti-retroviral have been used on COVID- 19 patients on trial basis. Some countries such as China, the United States of America, UK, Israel, and Iran claim to have been or nearly effective in vaccine development. The vaccine is incredibly difficult for large populations to manufacture in a shorter time frame [13,14]. It is easier to quarantine small cities with small population than larger cities with large population. Improved manpower and numerous facilities are fundamental for managing outbreaks in bigger cities and provinces. This large and complex outbreak of COVID 19 revealed problems in Iran's health care system. Such specific problems are lack of preparedness in potential emergency, prevention and control of diseases, lack of availability of test kits for accurate diagnosis of COVID 19, adequate masks and protective equipment. One major problem is the United States sanctions on Iran which normally include lifesaving drugs and diagnostic equipment [13,15,16].

Some local and independent media outlets and local officials have tried to create panic by giving false information without providing substantial evidence. May be some of the cases have not been properly screened due to apparent lack of testing kits.

In my opinion, all the countries should help each other to contain COVID 19 outbreak. Information regarding COVID-19 should be shared on each platform.

In conclusion, to overcome such outbreak, Iran should improve its health systems. Extensive testing is the main key to stop covid 19 infection chain. United States should lift sanctions on humanitarian grounds so that Iran could be able to contain COVID 19.WHO and other international aid agencies should cooperate with Iran to control the spread of Corona virus infection. Media and newspaper should also pay a role to educate the public about this disease. All countries affected with this epidemic should share their experience. General public should cooperate with the government to contain the disease. In the author best knowledge, this is the first study to approximate the number of Corona virus cases in different cities and provinces of Iran. God bless us all!

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