The epidemic disease COVID-19 belongs to family of coronavirus; out of six CoVs two viruses are more pathogenic and raised its impact on population include SARS (Severe Acute Respiratory Syndrome) in 2003, where the fatality rate is 10%; while MERS (Middle East Respiratory Syndrome) killed 34% of people [15]. But, current novel coronavirus COVID-19 widen very province of China as well as 27 other countries and region with more than 70,000 cases with 2-3% mortality as of Feb 18, 2020 [1, 16]. However, the number of COVID-19 cases and its fatality rate increasing by passing every day, on 6th April the fatality rates is 5.51% out of 1.3 million and by 26th April 2020 reaches 6.95% fatality out of 2.96 million COVID-19 cases in worldwide.
In Wuhan, China lockdown strategy implemented for more than two months and succeeded to control COVID-19 transmission. Hence, present all countries following lockdown strategy since last one month to break the transmission chain of COVID-19. Lockdown makes peoples to go for self isolation at home, which facilitate to maintain social distance in public. The present study was observed that the impact of lockdown might reduce the addition of new cases but failed to register zero new cases, because lack of awareness in public about seriousness of pandemic disease and failure to maintain social distance.
Morbidity rate of COVID-19: The prevalence of COVID-19 is increasing rapidly in all over the world. In earlier WHO reported that COVID-19 was transmitted to 25 countries in worldwide, but present it has spreads to 213 countries [1, 11]. The present online data confirms that increased ratio of COVID-19 cases in worldwide as well as country wise from 18th Feb to 26th April 2020 in a period of 20 days. On 18th Feb 2020, the number of COVID-19 cases confirmed as 71,447 in worldwide and it reaches 1.3 million (increased 18.7 times) by 6th April 2020 in 47 days and later the number is achieved 2.96 million (increased 2.21fold) by 26th April 2020 in just 20 days. The most affected countries and its percentage of cases include United States shows 32.61% cases followed by 7.65% in Spain, 6.68% in Italy, 5.48% in France, 5.33% in Germany and 5.16% in United Kingdom and remaining countries have shown <5% cases figure 1. Increased percentage of cases in country wise have been observed between a time periods of 18th Feb to 26th April 2020. In United States as of 18th Feb 2020 only 15 cases are reported and it reaches 368,196 by 6th April (27.5% in worldwide) and further achieved 0.96 million (32.61%) by 26th April 2020 in just 20 days. Whereas in Spain 0.23 million cases are reported by 26th April from 2 cases as of 18th Feb 2020. Few other countries has shown more than 0.1 million include Italy, France, Germany, United Kingdom and Turkey. However, many countries declared lockdown in mid of March 2020 and continuing, but registering new COVID-19 cases are not closed.
In India 3 COVID-19 cases are reported as of 18th Feb 2020 and it reaches 4281 by 6th April (in 47 days), further it achieved 26,917 (increased 6.29 fold) by 26th April 2020 in 20 days. As we know lockdown was started on 22nd March in India and continues, but COVID-19 cases number increased from 3 to 1427 folds by 6th April in 47 days and then reaches to 6.29 fold, where as in worldwide reaches 0.35% to 0.91% out of 2.96 million by 26th April 2020. Recent times of India news reported that COVID-19 growth has fall down to 8% from 22% due to lockdown, otherwise the number might be crossed 2 lakh by 23rd March. It also stated that based on present status the number might be increased to 2.5 lakh by the end of May 2020 [17]. This data has confirms that lockdown has impact on epidemic disease, but it fails to register zero cases due to lack of maintaining social distance and negligence in public. We have to understand that without social distance lockdown cannot show full impact on epidemic disease. Another major issue is asymptomatic carriers of COVID-19, where more than 69% of cases are registered as asymptomatic and they are more dangerous than symptomatic carriers. If precise preventive precautions are not taking possibilities are there to increase addition of new COVID-19 cases in coming days. Lockdown must be continuing with strict rules until register zero new cases to avoid significant circumstances in future.
Fatality rate of COVID-19: Present data had shown that number of deaths related to COVID-19 is higher than other coronavirus family (SARS, MERS) outbreaks of 21st century. In worldwide 205,892 peoples are lost their live with COVID-19 by 26th April 2020, majority of fatality rate was identified in the following countries include United States 27% (54856), Italy 13% (26644), Spain 11% (23190), France 11% (22856), United Kingdom 10% (20732), and remaining countries have seen <10% of fatality rate Figure 3. On 18th Feb 2020, 2.48% (1775) death was reported from 71447 COVID-19 cases and it reaches 5.51% by 6th April 2020 in 47 days from 1.3 million and further it went to 6.95% in 20 days out of 2.96 million cases by 26th April 2020. The increased rate fatality with COVID-19 in individual countries from 7th April to 26th April 2020 include Belgium 7.84 - 15.38%, United Kingdom 10.41 - 13.56%, France 9.02 – 14.09%, Italy 12.47 - 13.48%, Netherlands 9.93 - 11.82% and Spain 9.67 - 10.23% whereas other countries have <10% shown in table 4. Severe acute respiratory distress syndrome is the major reason to cause death of patients with COVID-19. The fatality rate is high in COVID-19 patients with co-morbidity like cardiovascular disease, hypertension and diabetes, and old age is another factor [14].
Recovery Percentage of COVID-19: Pandemic disease COVID-19 spreads very fast throughout the world at a same time the recovery percentage also satisfactory. As of 6th April 2020, the recovery percentage of COVID-19 was 20.63% and it has reached 29.20% (in 20 days) by 26th April 2020 in worldwide. In country wise the recovery percentage of COVID-19 cases are shown in table 5, where >50% recovery cases are seen in China 94.50% followed by Iran 76.99%, Switzerland 75.01%, Germany 70.99%, and Spain (51.95%), Brazil 51.53%, rest of the countries has <50% recovery. In many countries recovery percentage of cases were increased, except Netherlands 0.31% and United Kingdom 0.51% where it shows too low. The reason might be due to age factor and treatment variation.
Since, there was no specific treatment to cure pandemic disease, the only way to prevent transmission of disease are lockdown and maintaining social distance. Almost all countries done lockdown for a month, but the impact was less due to misuse of lockdown, lack of social distance and zero knowledge of COVID-19/ignoring seriousness of pandemic disease. Even though in 20 days of lockdown period, the number of cases was reached more than double in worldwide. In this situation, if withdraw lockdown we cannot imagine the figure of COVID-19 cases in coming days. However, it’s better to extend lockdown until register zero new cases at least for a week, otherwise morbidity and fatality will be uncountable since this pandemic disease also spreading asymptomatically.