This is an opinion piece from infectious disease specialist from MSKCC but I think highlights some good points on the demographics between Italy and SK. I didn't realize it's mostly the younger getting it in SK...only around 20% of cases is in the above 60 population. I do think testing helps find them and then separate them from the older more vulnerable quicker. Wonder what might be the demographics in Germany, they seem to have an even lower mortality rate.
Some excerpts from the article:
So why does Korea, the poster child of testing, have so few deaths while Italy and its late-to-the-table testing program have so many? Is it only because more testing brings mild cases into the "infected" group, diluting the statistical impact of the handful of the very ill?
Doubtful. For now, it is because of vast differences in the affected patients. Soon and increasingly,
it also will be due to overwhelmed hospitals and doctors and nurses.
Which is probably bad news for those hoping that the United States, which is currently way, way behind in testing for coronavirus, can somehow test itself out of the mess.
Plenty has already been written about how the population of Italy differs from much of the world. According to
a UN report in 2015, 28.6% of the Italian population was 60 years old or older (second in the world after Japan at 33%). This compares to South Korea, where 18.5% of the population is at least 60 years of age, ranking 53rd globally.
The impact of this disparity is
quickly shown in the analysis of coronavirus deaths in each county. In Italy, 90% of the more than 1,000 deaths occur in those 70 or older.
By contrast, the outbreak in South Korea has occurred among
much younger people. There, only 20% of cases have been diagnosed in those 60 years old and up. The largest affected group is those in their 20s, who account for almost 30% of all cases.
Then there is gender. The gender split in COVID-19 cases worldwide is about 50-50, but there are gender differences in survival.
According to data from the original outbreak in China, the overall death rate is 4.7% in men versus 2.8% in women -- a whopping difference. Which is good news for
South Korea, where 62% of cases occur among women.
Smoking is another factor clearly associated with poor survival.
Smoking rates are about the same between the two countries: 24% for Italians and 27% for South Koreans. But gender differences among smokers are widely different: In Italy, 28% of men versus 20% of women smoke, while in Korea, it is about 50% of men and less than 5% of women.
In other words, South Korea has an outbreak among youngish, non-smoking women, whereas Italy's disease is occurring among the old and the very old, many of whom are smokers. (We do not know the male-female breakdown of Italy's cases).
These basic demographic distinctions explain the difference in death rates between these two hard-hit countries -- as well as helping to explain why Seattle, with its nursing home outbreak, accounts for such a large proportion of US coronavirus deaths.
To understand exactly what is happening, we need daily case updates to include information about age and sex.
The blundering lack of an effective testing program in the US is an unconscionable failure and has led (and will lead) to more transmission of COVID-19.
But it is important to recognize that survival with the infection is a completely other matter, one that will require very different investments, training, and expertise.
https://www.cnn.com/2020/03/16/opin...oronavirus-survivability-sepkowitz/index.html
