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The Health is real wealth proved during the Covid-19 epidemic: How our lives have been stolen by COVID-19?

How do you calculate the cost of an epidemic? COVID-19 has killed an estimated 15 million people since its release in late 2019, but its health impact is far-reaching. For hundreds of millions of people worldwide, the SARS-CoV-2 coronavirus has brought a host of problems, ranging from serious illnesses to chronic symptoms known as long-term COVID.Determining the size of that health burden is a challenge, but it is important – governments use such statistics to plan how to use the health care budget. So researchers are beginning to integrate all the health effects and are trying to find lessons in any patterns. They hope, for example, to see how different people are affected and to provide evidence about the effects of vaccines and the new strains of the virus.

Even without an epidemic, there is no easy way to calculate all the consequences of a variety of health conditions: good data can be difficult to obtain and decisions on how to balance loads depend on nature. “There are many types of social choices where there is no solid science,” said Theo Vos, a epidemiologist at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle, a research center that aims to categorize global health burden. “How do you appreciate a year of asthma, a year without legs, a year of depression?”

Those figures become increasingly difficult when scientists face new viruses and viruses.Research teams are exploring multiple ways to calculate COVID-19 load, and many are beginning to report their results. Preliminary data suggest that impact is significant and varies from country to country. One study found that COVID-19 was most prevalent in 16 European countries, but that the effects in different countries vary due to factors ranging from the age of the population to political responses to the epidemic.With the epidemic sweeping through many parts of the world, it is too early to count the number. But some researchers think it has been helpful to change the way they calculate the health effects of diseases. “The epidemic has strengthened cooperation in the field of disease burden,” said Sara Monteiro Pires, a epidemiologist at the Technical University of Denmark. Researchers are now adapting the methods they use to measure disease burden, and they are adapting models and data from each location. They hope that this will make the results more accurate.

COVID-19 in adults

The UK National Health Service lists twelve symptoms of COVID-19 in adults, from odor loss to high fever. Even people who are mild-tempered and have symptoms from home may notice chronic health effects, such as fatigue or shortness of breath. If symptoms persist for more than a few months, people can be diagnosed with a disease commonly known as long-term COVID.To quantify how the disease affects the entire population, scientists have compiled data on individual experiences. This includes the number of people infected with the virus, the number of symptoms, the duration of the disease, how many need to be treated in hospital or died, and the age of the patients, among other things. Then use them to find out how many years you have lost as a result of the disease and how many years you have lived with symptoms of disability.

Researchers can use the average life expectancy in the world to determine how many years it has lost due to premature death. Loss due to disability is difficult to calculate, however. To quantify those, researchers used data on the number of people affected by a particular illness, the length of time they had and the number of illnesses known as weight gain. IHME’s Global Burden of Disease Group maintains a standard list of disability weight; The latest version available, published in 2019, offers a soft ear weighing 0.013 and multiple sclerosis 0.719 (weight 0 is perfect health; 1 weight is death).

Currently, there is no standardized weight loss for COVID-19. Instead, researchers use the weight of disability associated with other infectious diseases and similar health conditions.Addition of years of life lost as a result of illness, disability or premature death provides a measure of unit load known as disability-adjusted life years, or DALYs. It is the cornerstone of research on the burden of disease.Data entering DALY comes from a variety of sources. Most are usually collected by national health authorities. In COVID-19, some data was collected through targeted monitoring efforts such as REACT study (Real-time Assessment of Community Transmission), a large sample activity that began in 2020 and documented how SARS-CoV-2 is progressing in England. and what symptoms people experience.

Max Taquet, a medical researcher and engineer at the University of Oxford, UK, who uses data from medical records to understand the neurological and psychological effects of COVID-19, says that estimating COVID’s long-term health effects is difficult and alarming. “Most of us are amazed at the level of the problem,” he said, “but we do see the post-infection syndrome and other viral infections.” With COVID-19, scientists monitor the results in real time. “It’s good that we’re finally paying attention.”There is no guarantee that these data sources will always exist, however. The UK government announced in March that it would suspend funding for certain REACT research branches and another monitoring effort.

Study of 16 European countries

Premature health effects lost to COVID-19 are intrusive. “Overall, the impact of COVID-19 has been extremely high worldwide,” said Gianfranco Politano, a biologist at the Polytechnic University of Turin in Italy, who participated in blood tests. a study of 16 European countries.

A European study suggests that Slovakia may have had less responsibility than other countries because the government took immediate action to close the door and people obeyed.

Each country analysis also reveals significant differences in the health burden of COVID-19. A study from Malta shows that between March 2020 and March 2021, COVID-19 became the fourth leading cause of disability, accounted for after heart disease, lower back pain and diabetes5. In India, it is very low on the list: it uses 2019 data as a guideline, it could account for 3% of total health burden – it puts it out of the top 10 and rated it as low burden for ischemic heart disease, malnutrition and chronic respiratory diseases6. The authors agree, however, that COVID-19 cases may be reported less frequently in India, which could affect the quality of DALYs.

Each project receives its own data in a different way, which may add to the DALY rating variance. The research team that evaluated DALYs in 16 European countries, for example, used aggregated data from the European Center for Disease Prevention and Control (ECDC), the World Health Organization (WHO) and the World Bank Group; many national studies used highly detailed data for a particular country. As a result, DALY estimates for the same country vary in different hands

There are still no global health statistics from COVID-19, but IHME has been releasing catalogs for some diseases since the 1990’s. In early 2020, when it became clear that the epidemic was raging, the institute had a machine to help us understand the broader health outcomes of SARS-CoV-2 and began working to add COVID-19 to the catalog. About 100 employees were diverted from the effort. Their data is currently under consideration.

Unlike many other statistics, the data cover long-term COVID load estimates. Vos presented the unpublished data to US authorities to help them determine how persistent symptoms might affect people’s ability to function. The findings suggest that by 2020 and 2021, an estimated 4.6 million people in the United States had symptoms lasting at least three months. More than 85% of these cases come as a result of COVID-19 which did not require hospital treatment.”It’s a big problem, these are very disabled people,” Vos said.

Data & IHME team

One major problem for researchers trying to quantify the burden of COVID-19 is data coverage. Some countries, such as those in the Pacific Islands, record so few events that the data is not statistically accurate. And many sub-Saharan African countries, among other regions, do not have the capacity to track deaths due to COVID due to inadequate enrollment systems. The IHME team does this by using data from neighboring countries to make specific country-specific estimates. But in the end, accurate calculations will require the collection of more detailed data. “” She and her colleague Anna Vassall recently predicted that about 30% of COVID-19’s health burden could be paralysis7, not death.The second blind spot for data is the long COVID. To date, only a few research groups other than IHME have included such data in their estimates. Some think that without a good knowledge of long-term COVID, calculating the burden of this disease prematurely.

Other national ratings – such as those of Scotland2, Malta5 and Ireland8 – include limited COVID data in their analysis, but acknowledge uncertainty. Grant Wyper, a public health officer in Public Health Scotland, helped compile the estimates and said the long-term COVID data was limited and that the condition was often interpreted in a variety of ways – compiling details of just one person. symptom, such loss and sense of smell, and those from people who had several symptoms, which can have a very negative impact on the quality of life.

Because little was known when modeling the first disease, Wyper and his team used the weight of normal disability in the health outcomes seen after infection. They are now working to improve the long-term disability of COVID in order to make it more accurate, he says.But the estimates are based on the assumption that people who do not have symptoms during the critical phase do not develop long COVID. Taquet says it is not yet clear if that is the case. “There is no reason to believe that a person who has no symptoms at the time of infection will not continue to have long-term COVID symptoms over time,” he adds. His team found that two out of five people with chronic COVID symptoms 3-6 months after infection did not report symptoms for the first 3 months.

Other groups that may be negatively affected are COVID-19. Briggs and Vassall emphasize that data should be collected in a sensitive way, and categorized by age, socioeconomic group and ethnic group. “As we move into the epidemic, we have to be more concerned about equality,” he said. On the other hand, the European Burden of Disease Network hopes to look at how social inequality affects the future health burden.

Measuring DALY takes time – usually the analysis is done only once a year. This means that some important questions about the burden of COVID-19 – such as how vaccines affect disease levels and severity – will not be answered temporarily. The fact that COVID-19 is only a few years old means that scientists do not have enough information to make accurate predictions, says Maria Gianino, an economist at the University of Turin, who has worked in research in 16 European countries. Despite the challenges, Monteiro Pires thinks the future of disease burden studies is bright. A lot of support comes their way, he said. “It is widely acknowledged that this is an important public health tool”.

Source Journal Reference:Holly Else, The pandemic’s true health cost: how much of our lives has COVID stolen?, Nature 605, 410-413 (2022) doi: https://doi.org/10.1038/d41586-022-01341-7

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