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Assessment of Epidemiological Determinants of COVID-19 Pandemic Related to Social and Economic Factors Globally

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Assessment of Epidemiological Determinants of COVID-19 Pandemic Related to Social and Economic Factors Globally Journal of Risk and Financial Management Article Assessment of Epidemiological Determinants of COVID-19 Pandemic Related to Social and Economic Factors Globally Mohammad Mahmudul Hassan 1,* , Md. Abul Kalam 2 , Shahanaj Shano 3, Md. Raihan Khan Nayem 1 , Md. Kaisar Rahman 1,4 , Shahneaz Ali Khan 1 and Ariful Islam 4,5 1 Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Chattogram 4225, Bangladesh; [email protected] (M.R.K.N.); [email protected] (M.K.R.); [email protected] (S.A.K.) 2 Helen Keller International, Dhaka 1212, Bangladesh; [email protected] 3 Institute of Epidemiology, Disease Control and Research, Dhaka 1212, Bangladesh; [email protected] 4 EcoHealth Alliance, New York, NY 10001, USA; [email protected] 5 Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin University, Geelong, VIC 3216, Australia * Correspondence: [email protected] Received: 24 July 2020; Accepted: 28 August 2020; Published: 1 September 2020 Abstract: The COVID-19 pandemic has manifested more than a health crisis and has severely impacted on social, economic, and development crises in the world. The relationship of COVID-19 with countries’ economic and other demographic statuses is an important criterion with which to assess the impact of this current outbreak. Based on available data from the online platform, we tested the hypotheses of a country’s economic status, population density, the median age of the population, and urbanization pattern influence on the test, attack, case fatality, and recovery rates of COVID-19. We performed correlation and multivariate multinomial regression analysis with relative risk ratio (RRR) to test the hypotheses. The correlation analysis showed that population density and test rate had a significantly negative association (r = 0.2384, p = 0.00). In contrast, the median age − had a significant positive correlation with recovery rate (r = 0.4654, p = 0.00) and case fatality rate (r = 0.2847, p = 0.00). The urban population rate had a positive significant correlation with recovery rate (r = 0.1610, p = 0.04). Lower-middle-income countries had a negative significant correlation with case fatality rate (r= 0.3310, p = 0.04). The multivariate multinomial logistic regression analysis − revealed that low-income countries are more likely to have an increased risk of case fatality rate (RRR = 0.986, 95% Confidence Interval; CI = 0.97 1.00, p < 0.05) and recovery rate (RRR = 0.967, − 95% CI = 0.95–0.98, p = 0.00). The lower-income countries are more likely to have a higher risk in case of attack rate (RRR = 0.981, 95% CI = 0.97–0.99, p = 0.00) and recovery rate (RRR = 0.971, 95% CI = 0.96–0.98, p = 0.00). Similarly, upper middle-income countries are more likely to have higher risk in case of attack rate (RRR = 0.988, 95% CI = 0.98–1.0, p = 0.01) and recovery rate (RRR = 0.978, 95% CI = 0.97–0.99, p = 0.00). The low- and lower-middle-income countries should invest more in health care services and implement adequate COVID-19 preventive measures to reduce the risk burden. We recommend a participatory, whole-of-government and whole-of-society approach for responding to the socio-economic challenges of COVID-19 and ensuring more resilient and robust health systems to safeguard against preventable deaths and poverty by improving public health outcomes. Keywords: COVID-19; epidemiological determinants; population density; social and economic status J. Risk Financial Manag. 2020, 13, 194; doi:10.3390/jrfm13090194 www.mdpi.com/journal/jrfm J. Risk Financial Manag. 2020, 13, 194 2 of 14 1. Introduction Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), or COVID-19, has affected the advancement of humans’ usual lifestyles, and now the whole world is fighting against an invisible enemy. In December 2019, a virus emerged in Wuhan, Hubei province, China, diffusing to more than 215 countries and regions with immense power of human-to-human transmission (She et al. 2020). Initially, the Chinese CDC (Center for Disease Control) isolated this novel virus belonging to the coronavirus family from a patient’s lower respiratory tract, and then the World Health Organization (WHO) identified this virus as COVID-19 on 11 February 2020 (Surveillances 2020). Globally, as of 11:04 am CEST, 16 July 2020, there have been 13,338,364 confirmed cases of COVID-19, including 579,319 deaths officially reported by the WHO (WHO 2020). Still, the virus spillover point remains a mystery, as some studies have shown that it may originate from a seafood wholesale market (a local seafood and live animal market with different species including wildlife being sold) of Wuhan, China, and that the reservoir sources might be bats (Qiu 2020), which utilized an intermediate host, probably pangolins. Atypical pneumonia, fever, coughing, muscle soreness, and fatigue, were seen in critical cases and intensive care was often needed, as breathing difficulty was an expected outcome (Singhal 2020). Due to the lunar year celebration in China, the massive movement of people from and between the Asian region and other parts of the world increased the geographical spreading of this contagion immediately at the point of the outbreak (Boulos and Geraghty 2020). Higher mortality was seen in patients with comorbidities like cancer, diabetes, and high blood pressure, making the condition more critical (Zaki et al. 2020; Zhu et al. 2020). Rapidly, the disease has spread throughout the world, and now it has become a global pandemic with ongoing devastating effects continuing (Zheng 2020). Travel from the affected areas is one of the main causes of the spread of this disease between countries throughout the world (Gössling et al. 2020). The major social consequences of the pandemic are documented as prejudice and anxiety, which are sensitive to the current pandemic situation, and increased psychological distancing from the nations most affected (Karwowski et al. 2020; Sorokowski et al. 2020). Though the size and persistence of the economic impact is unanswerable, the global spread of COVID-19 has the potential to derail the world economy (Baldwin and Mauro 2020). There are potential direct consequences of COVID-19 on mental stress and indirect effects associated with psychiatric complications (Temsah et al. 2020; Vindegaard and Benros 2020). However, there are limited research results on the global risk factors of COVID-19 transmission and patterns of spread (Wu et al. 2020; Bogoch et al. 2020; Chinazzi et al. 2020; Haider et al. 2020). Many countries of the globe are severely affected by COVID-19 with a higher number of cases and mortality, including the USA, Brazil, Russia, European countries (Spain, Italy, France, Germany, UK, etc.), Iran, and India. Overcrowded areas like schools, markets, public transport, and workplaces are the high-risk zones for transmission as it is a highly contagious infection (Rabi et al. 2020). Countries with high economic status, or modern cities, have chosen better workplaces for the people—aiming for more income, better quality of life, and better facilities. An urban area with high population density may be responsible for an epidemic situation. The pandemic situation of COVID-19 is aggravated by urbanization, as people fail to maintain social distance and so spread contamination. An urban area with high population density might be a risky place as more people come into contact with infected persons and increase the chance of contamination (Lindahl and Grace 2015). Moreover, critical care capacity is a problem in comparatively low- and lower-middle-income countries (Phua et al. 2020), and only a few hospitals have isolation capacity, which can provide intensive care with respiratory support. South Asia has an estimated 0.7–2.8 critical care beds per 100,000 population (Phua et al. 2020) and the number of beds is scarce in the lower- and middle-income countries compared to the more developed countries in the world. Furthermore, asymptomatic and early-stage infected persons can spread COVID-19 in the densely populated community. Older people are more prone to the disease and have a higher fatality rate than younger people, due to their clinical and immune responses (Nikolich-Zugich et al. 2020). The governments of different countries have implemented several steps to reduce the possibility of spreading the ongoing pandemic coronavirus. Social distancing, J. Risk Financial Manag. 2020, 13, 194 3 of 14 the lockdown of affected areas, restriction of public transport, working from home, and restriction of international flights were the crucial steps to prevent coronavirus spread. Indeed, as the extensive spread of the COVID-19 virus around the globe has reached several million confirmed cases to date; the gradual concern will be not only our health but also our livelihoods. The demographic determinants in the population are the key to determine the contact patterns. Eventually, the pandemic will spread around the world, according to its nature, with implications for effective control measures in the foreseeable future from a government perspective (Ridenhour et al. 2018). Population density and the median age of individual populations are the most critical issues to be assessed to measure pandemics and their spread. The lower the population’s median age in a community, the lower the disease incidence, even when pre-existing immunity levels in young individuals are low (Laskowski et al. 2011). Overall, the evolving nature of the pathogen, disease biology, and the demographic characteristics of the population are significant in identifying the type and intensity of public health intervention measures required for disease control (Choi 2012). Furthermore, the differential prevalence of predisposed health conditions and other types of health disparities increases uncertainty about how a novel virus would impact different countries with distinct mobility patterns, social interactions, and health characteristics.
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