Coronavirus disease 2019 (Covid-19), declared a pandemic by the World Health Organization (WHO) on 11 March 2020, has now spread across 175 countries with approximately 480,000 total confirmed cases worldwide, according to data from John Hopkins University. Being able to quantify the proportion of a population with chronic underlying disease helps nations to plan for the number of people who may require hospitalisation if they contract severe Covid-19.

A March 2020 risk assessment by the European Centre for Disease Prevention and Control (ECDC) reports that 80% of cases experience a mild form of the disease (ie, cough and fever), 14% develop more severe disease (lower respiratory tract infection), and 6% experience critical illness (respiratory and multi-organ failure). Severe and critical forms of this disease are more common in the elderly and those with chronic underlying health conditions. The WHO listed the chronic underlying health problems that put people at greater risk of Covid-19 to include cardiovascular disease, diabetes, chronic respiratory disease, and cancer.

GlobalData epidemiologists have analyzed the proportion of men and women of all ages across the nine major markets (9MM: US, France, Germany, Italy, Spain, UK, Japan, China, and South Korea) who have underlying health conditions, specifically cardiovascular disease, respiratory disease, cancer, diabetes, and selected rare diseases (Figure 1). GlobalData epidemiologists estimated that 15% of men and women of all ages across the 9MM had one or more underlying health condition in 2019. The country in the 9MM with the highest proportion of individuals was shown to be the US, where GlobalData epidemiologists reported 30% of men and women had one or more underlying health condition in 2019. All populations across the 9MM have been shown to have high proportions of people with underlying health problems, and therefore high proportions of people at risk from severe or critical Covid-19. This highlights the need to prevent the spread of this disease, to protect these risk groups and depressurise health systems.

Italy failed to protect its at-risk population quickly enough, with the number of critically ill patients now exceeding the number of intensive care unit (ICU) beds; the country has now reported more than 6,000 deaths from Covid-19. In Italy, 23% of the population was over 65 years of age in 2019, higher than most other markets. With health comorbidities increasing with age, the Italian health system has been unable to cope with the number of severe cases of Covid-19. Other countries must use the proportion of people at risk of developing severe Covid-19 to prepare their healthcare systems to cope with these numbers. Additionally, slowing the spread of Covid-19 across countries allows healthcare systems more time to prepare. In the UK, all risk groups received a letter advising them to stay home for at least 12 weeks. Slowing the number of risk group individuals infected with Covid-19 prevents deaths that are avoidable with a fully functioning healthcare system.