Sajjad Baber

Craniomaxillofacial research center, Department of Oral and Maxillofacial Surgery, School of Dentistry, Resident, International Campus, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran

*Corresponding author: Sajjad Baber, Craniomaxillofacial research center, Department of Oral and Maxillofacial Surgery, School of Dentistry, Resident, International Campus, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran

Abstract
Background: Corona virus disease was first reported in Wuhan City, Hubei province, China. Soon the corona virus disease has spread to many countries. World health organization has described the situation as Pandemic. By 12 March 2020, corona virus disease has affected 125 countries around the world. Corona virus was first confirmed in Iran on 19 February 2020.

Objective: The aim of writing this small article is to determine the mortality rate of corona virus disease in different cities of Iran. This article will give readers an idea of different ways to control spread of corona virus disease in Iran.

Methods: Author has collected the data of daily confirmed cases from different diagnostic centers and hospitals across the country from 19 February 2020 to 1 April 2020.

Results: Mortality rate of corona virus disease is roughly 4 %.

Conclusion: Mortality rate could rise if COVID 19 infection is not controlled.

Keywords: COVID 19, mortality, Iran, pandemic

Iran represents a country of about 83 million people. Initial findings suggest that a merchant may bring the virus from Wuhan to Qom. It is important to mention that both cases could have been sick weeks ago and infecting others for weeks [7].

More infectious cases had been reported in major cities after Qom. After that, the Iranian government had begun taking practical measures. Subways, cars and BRT buses were disinfected. Schools, universities and cultural centers were closed. The Iranian health ministry had politely advised locals to carefully avoid crowdy areas and not shake hands. Citizens were also advised to limit the extensive use of bank notes. A lot of inmates in various prisons were released on a temporary basis. Short working hours were allowed in workplaces and public offices [7,8].

Signs and symptoms of corona virus disease 19 [COVID 19]: It usually starts with mild fever, cough, profound fatigue, and mild pain in the body. A headache with or without moderate diarrhea or abdominal pain begins slowly. This can typically lead to respiratory distress in severe cases [9].

Epidemiology and quarantine
Corona virus disease-19 [COVID- 19] infection typically spreads at a very fast pace and recently described as ‘Pandemic’ by world health organization. Quarantine is necessary for suspected patients. Quarantine is the reasonable restriction of movement of already infected or about to infect local people.

Methods to reduce spread of infection
Remember an important proverb ‘Prevention is better than cure’.

1. Proper washing of hands with soap and water/hand sanitizer.
2. Maintaining clean and hygienic workplaces.
3. Handshake and kiss should be forbidden.
4. No excursions in Nowruz should be permitted.
5. No in restaurant food.
6. Meat well prepared.
7. Adequate use of herbs and in particular fruits, to improve immunity.
8. Periodic exercise.
9. Avoid touching nose, mouth, and eyes. Remember T sign of face.
10. Quarantine areas where contamination is high.
11. Educate through electronic media.
12. No unprotective interaction with wildlife.
13. No close contact with individuals having cold or flu like symptoms.
14. Infected persons should stay at home.
15. Complete isolation of COVID 19 patients.
16. Infected individuals should wear face masks to keep the infection away from other people. [3,10-12].

Materials and methods
Data collection: There are numerous ways to collect the data of COVID 19 patients.

1. Household transmission data: We can ask the family members via telephone about symptoms of COVID 19. This method is unreliable. The family members can be false negative due to absence of symptoms or false positive like misdiagnosing with seasonal flu.
2. Questionnaire via mobile application software: These surveys are cost wise cheap and fast but again this method is not reliable.
3. Data collected from ministry of health: This ministry usually collects data from hospitals and laboratories electronically.

According to author, the standard method is hospital based or a laboratory-based data.

Not a single method can tell us the pinpoint accuracy of mortality rate of COVID- 19. Some patients might be in the incubation period. Ordinary villagers might consider this as an ordinary pneumonia due to lack of education and old customs and traditions. COVID-19 cases may be missed due to lack of diagnostic kits. Rapid testing Polymerase chain reaction [RT PCT] was used to confirm COVID - 19 in suspected cases.

Author has obtained data of daily series of confirmed cases from different diagnostic centers and hospitals across the country from 19 February 2020 to 1 April 2020.Iranian ministry of health and medical education confirmed 47593 cases and 3036 deaths and 3871 critical cases till 1 April in Iran.

It is important to mention that no disparity of number of cases was found between the Iranian ministry of health and medical education and different diagnostic centers and hospitals.

Results
There are 47,593 cases reported so far in Iran with 3,036 deaths and about 3,871 in intensive care unit till 1 April 2020. Author believes that mortality rate of COVID -19 is roughly 4 % mostly elderly people i.e. approx. 88 % and young people with existing systemic diseases and poor immune system (10 %). Around 2 % of child deaths between age 12 to 14 years have been reported. It is important to mention that about 15,473 people have been recovered from infection. Detailed numbers of COVID 19 infections from 1 March to 1 April 2020 is summarized in the form of Tables 1-3.

Table 1: Detailed numbers of COVID 19 infections of month March from 1 to 12

The infection has spread in all the31 provinces with Tehran, Mazandaran and Qom province are mostly affected as shown in the graph.

Graph 1: mortality rate of various age groups till 1 April 2020

Graph 1 shows the mortality rate of various age groups till 1 April 2020. According to this graph, a total number of 3,036 persons died. There are   approximately 2,671 deaths of Old people,304 deaths of young individuals and 61 deaths of Children which consists of 88 %,10 % and 2 % respectively. Based on the research, I can assume that the average mortality rate in Iran would be around 4 % to 5 % but it could rise if COVID 19 infection is not effectively controlled. The mortality rate was initially estimated to 2 % by World health organization. On 3 March 2020, mortality rate was increased to 3.4 %. It can increase to furthermore depending on the spread of infections in different countries.

Graph 2: This graph shows us COVID 19 data collection of total count of patients from 1 March to 12 March 2020. According to this graph there are approximately10,075 of the total figures of infected patients in which 1075 infections are detected in the past 24 hours. Total number of deceased individuals up to 12 March 2020 are 429 while the number of deceased individuals in past 24 hours are 75. It is important to mention that about 3276 people have been recovered from infection while from 1st to 5th March no recovered persons are noted.

Graph 3: This graph shows the COVID 19 data collected in different Provinces of Iran from 4 March to 12 March 2020.From 4^th march, the number of infected cases in Tehran, Mazandaran, Qom, Isfahan and Gilan province was 253,9,101,0 and 35 respectively which has increased in 9 days to 2673,997,846,792 and 613 respectively. The number of infected cases has increased in all five provinces particularly in the province of Tehran.

Some local and independent media outlets and local officials have tried to create panic by giving false information without providing substantial evidence. May be some of the cases have not been properly screened due to apparent lack of testing kits.

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