“We are all experiencing the same storm but we are all in different boats. Some folks are in yachts and other folks are in little dinghies with holes on the bottom trying to survive.”

-Brittany Packnett Cunningham

According to the Johns Hopkins University Coronavirus Resource Center one of the most important pieces of data that can be used to analyze the devastation of Covid-19 are mortality rates. However, due to varying ways of tracking the disease in different countries there are major discrepancies in this essential piece of research. It is alarming that the same virus, which according to experts in the field hasn’t mutated much as it has spread, can lead to such varying mortality rates in different countries. Johns Hopkins identifies 4 reasons why there are such stark differences in mortality rates:

1) The difference in the number of people tested. With more testing milder symptoms or asymptomatic cases can be identified

2) Demographics: older populations as well as populations living below the poverty level in their country

3) Characteristics of the healthcare system: If these systems are strained and have smaller amount of staff and resources

4) Other factors, many of which remain unknown

Primarily, if some countries are only testing patients ill enough to go to the hospital and do not test less ill or asymptomatic cases, the death rate can appear higher than in other countries where testing is widespread. Widespread testing for COVID-19 is not just important to get accurate data but also to contain the disease. Places where testing had been rolled out universally soon after the first cases were reported, such as Iceland and the Village of Vo in northern Italy, were able to get a quicker and more thorough understanding of how the disease was moving through the population, the number of asymptomatic cases, and the number of people who did not have active infections but appeared to have been exposed as a result of antibody tests. Observing this movement of the virus is the understanding we need to combat it effectively.

The world continues to respond to the pandemic respiratory disease COVID-19. As the number of cases grows around the globe, both through increased detection and viral spread, it is essential to develop strategies to protect persons who are most vulnerable to have severe illness from SARS-CoV-19 infection. The World Health Organization (WHO) has stated that most who are infected will be asymptomatic, have only mild symptoms, or recover spontaneously without special treatment.

The Centers for Disease Control and Prevention (CDC), WHO has issued specific guidance for persons at greater risk for serious morbidity and mortality from COVID-19. It states that "older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness" with COVID-19. These include persons older than age 65 years, persons who live in nursing homes or long-term care facilities, and persons with high-risk conditions such as heart disease, diabetes, lung disease, cancer, and hypertension. Recent evidence suggests that infants and young children may also be at high risk. Individuals who are immunocompromised (i.e., persons undergoing cancer treatment or bone marrow/organ transplantation, persons with immune deficiencies or poorly controlled HIV or AIDS, or persons who take medications that weaken the immune system) are at risk as well.

The WHO, CDC, and other organizations have also issued guidelines for special populations such as persons in nursing homes, migrant camps, or prisons.

The CDC has suggested strategies to help homeless service providers plan, prepare, and respond to COVID-19. These include establishing ongoing communication with local public health departments and government emergency planning groups; identifying healthcare facilities that will provide for the homeless; encouraging everyday preventive actions; providing COVID-19 prevention supplies; planning for staff and volunteer absences; reporting cases of suspected COVID-19 to the local health department; transporting persons with severe illness to medical facilities; designating space to accommodate and isolate clients with mild respiratory symptoms; planning for higher shelter usage during an outbreak; minimizing the number of staff members who interact face to face with clients with respiratory symptoms; keeping beds/mats ≥ 6 feet apart in general sleeping areas; and providing a surgical mask to any client with respiratory symptoms.

The CDC and WHO recommend social distancing, staying at home as much as possible, frequent handwashing, cleaning and disinfecting the home, having essential supplies on hand, and avoiding crowds and travel. People who develop cough and fever should call their doctor, and people with difficulty breathing, chest pain, cyanosis, or altered mental state should seek immediate medical attention.