In the midst of pandemic caused by severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2), now popularly referred to as coronavirus disease 2019 (COVID-19), many strategies have been adopted by governments as to how to fight this illness that has affected many lives. Non-pharmaceutical interventions (NPIs) are being implemented to eradicate the disease but these have just delayed and moderated the spread of the virus since vaccines and antiviral drugs have yet to be discovered [
1]. A variety of regulations has been designed, among which include restriction of non-essential travel, imposition of social distancing, declaration of lockdowns on big cities and banning mass gatherings, all supposedly to prevent the spread of the novel corona virus [
2].
The COVID-19 disease was first identified in Wuhan, China, in early December 2019 with the early cases reported in the city resulting in its spread worldwide that brought negatively significant changes to the normal lives of people in different countries of the world. Different laboratories and research institutions correspondingly responded and are in a race to discover solutions or a vaccine for the cure of this virus. As a result, there are more than 50 COVID-19 vaccine candidates under clinical trials [
3].
As of 12 December 2020, there were already 71,437,016 cases recorded worldwide that resulted to 1,601,163 casualties [
4]. There were 49,636,518 people who had already recovered from the disease not because of vaccines developed but only with the use of treatment for the symptoms of the patients. At this time of crisis, where vaccines were limited and most of them are in clinical trials, early prevention for such diseases is better than cure. Many states already conducted mass testing to determine the presence of viruses in different areas. But there are some arguments that mass testing is not necessary for their country. In South Korea, exploratory data analysis was used in assessing how effective mass testing is. According to the result, they noticed that 33 days after the first infection in the country, a significant increase in the number of tests resulted from a significant increase in the identified number of infected cases. This result allows the government to take early actions to focus more efforts in containing the breakout that will eventually happen [
5]. According to Facundo, P. and Shi L., testing is a very close substitute for quarantine and can substantially reduce the need for indiscriminate quarantines [
6]. With this, some rich countries have already administered mass testing like Germany, which carried out at least 500,000 tests a week as soon as the virus entered its territory [
7]. However, some policy makers also says that infection rate does not justify mass testing there is no need for mass testing for COVID-19 in Taiwan as the rate of infection so far has been quite low [
8]. Though in different countries have different scenarios, where number of cases and death rates varies, it is important to know what the different factors which may affect these numbers are.
Many researches have been published regarding the behavior, effects on humans, development of vaccines and etc., but not much research in assessing the number of deaths and cases of the said virus. This paper aims to provide an answer to the question: should a country provide mass testing? Is it necessary in our fight against COVID-19? Basically, this study investigates the factors affecting the number of deaths and cases of COVID-19 a year since the 1st outbreak occurred in Wuhan, the capital of the province of Hubei, China.
Literature Review
A pandemic includes diseases of very different etiologies that exhibit a variety of epidemiologic features as applied to important global events spanning many centuries [
9]. In the past few years, many diseases have appeared and threatened all the people worldwide. Before the appearance of this severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), some countries had already suffered from severe acute respiratory syndrome coronavirus (SARS-CoV) which is an infectious disease that caught global attention in the 21st century [
10] and Middle East respiratory syndrome coronavirus (MERS-CoV). Asia and other parts of the world were affected by SARS-CoV in 2003 while MERS-CoV had a first outbreak in Saudi Arabia (2012 and 2018) and larger outbreaks occurred in South Korea in 2015 [
11].
To avoid the wide spread of those diseases, equipment and new tools were developed to detect people who are showing symptoms either SARS or MERS. In 2003, there was no vaccine developed yet for SARS, but it was recommended by the World Health Organization (WHO) [
12] that containment measures are based on: surveillance network including early warning system; isolation of suspected or probable cases, voluntary or mandatory quarantine of suspected contacts for 10 days and exit screening for outgoing passengers from areas with recent local transmission by asking questions and temperature measurement. Infrared (IR) cameras were also used to detect subjects with fever, the basic symptom of SARS and avian influenza. However, the accuracy of this system can be affected by human, environmental, and equipment variables. It might also be inconvenient that the thermal imager measures the skin temperature and not the core body temperature [
13].
South Korea suffered from the MERS outbreak in 2015. According to Kim K.H., main contributors to the outbreak were late diagnosis, quarantine failure of ‘super spreaders’, familial care-giving and visiting non-disclosure by patients, and poor communication by the South Korean government, inadequate hospital infection management, and ‘doctor shopping’ [
14]. The outbreak was entirely nosocomial, and was largely attributable to infection management and policy failures, rather than biomedical factors. Using multivariate regression analyses, risk factors such as black race is a risk factor for worse COVID-19 outcome independent of comorbidities, poverty, access to health care, and other mitigating factors. However, factors affecting case load include lower daily temperatures but do not affect deaths [
15].
From the previous studies, many factors can be linked in the deaths and cases of COVID-19. In view of the environment, important factors affecting the mortality of the disease can be temperature variation and humidity [
16]. However, there is no evidence supporting the assertion that case counts of COVID-19 could decline when the weather becomes warmer [
17]. It was also found that there is a significant relationship between air pollution and COVID-19 infection after controlling for confounding factors [
18]. In China, airflow direction of and air condition was consistent with droplets of the virus which cause more transmissions in restaurants [
19]. In view of sociodemographic factors, number of cases, sex ratio, disposable income and the average age are significant determinants of the death rates in the German states [
20]. COVID-19 deaths are mainly observed among elderly males aged over 65, and smoking patients might face a greater risk of developing into the critical or mortal condition and the comorbidities such as hypertension, diabetes, cardiovascular disease, obesity, population density and respiratory diseases could also greatly affect the prognosis of the COVID-19 [
21,
22,
23,
24,
25,
26,
27,
28]. In contrast, some researchers found that population density is not an important factor affecting COVID-19 cases or deaths [
29,
30].
Rate of infection and the fast transmission of the disease is one of the alarming issues of the pandemic. In Thailand, the number of tourists and their activities were found to be significant factors on the number of infected patients from COVID-19 [
31]. In Italy, a tighter lockdown, mobility decreased enough to bring down transmission promptly below the level needed to sustain the epidemic [
32]. However, new measures of social isolation are being implemented again as Italy experiences a second wave due to the easing preventive measures [
33].
According to the Centers for Disease Control and Prevention (CDC) COVID-19 Response, geographic differences in reported case fatality ratios might also reflect differences in testing practices; jurisdictions with relatively high proportions of deaths might be those where testing has been more limited and restricted to the most severely ill [
34].
As of today, determination of COVID-19 is now faster with the aid of a more robust quarantine strategy due to the lessons learned from SARS in 2003 [
35]. However, scalable, rapid and affordable COVID-19 diagnostics could help to limit the spread of SARS-CoV-2, consequently saving lives [
36].