Breaking Down The Data
As with most topics in epidemiology, interpreting the numbers is complex. The data should be sound before any comparisons can be made. For example, health organizations are collecting data on COVID-19 differently. Should they look at only confirmed cases? Or also probable cases? How do they account for undertesting, especially in the first few months of the pandemic? Or delays in reporting?
Additionally, there are differences in how the numbers are reported. For example, this dashboard reports data collected from various state and county health departments, whereas the CDC uses a different process to confirm deaths before reporting.
But there are other ways to evaluate the numbers. In the spring of this year, this paper found that weekly death counts of COVID-19 were much higher on average 20 times higher than weekly deaths from the last several seasons of the flu at its peak.
Fortunately, weekly deaths from COVID have decreased in recent months. As you can see here, recent weekly deaths in the U.S. are not as high as they were in the spring, which is obviously good news. The decrease in the number of deaths is likely due to better protection of people over 65 years old, earlier diagnosis, and better treatment.
Understanding The Case Fatality Crude Mortality And The Infection Fatality Rate
Case fatality rate
In the media, it is often the case fatality rate that is talked about when the risk of death from COVID-19 is discussed.1
This measure is sometimes also called case fatality risk or case fatality ratio. It is often abbreviated as CFR.
The CFR is not the same as the risk of death for an infected person even though, unfortunately, journalists sometimes suggest that it is. It is relevant and important, but far from the whole story.
The CFR is easy to calculate. You take the number of people who have died from the disease, and you divide it by the total number of people diagnosed with the disease. So if 10 people have died, and 100 people have been diagnosed with the disease, the CFR is , or 10%.
But its important to note that it is the ratio between the number of confirmed deaths from the disease and the number of confirmed cases, not total cases. That means that it is not the same as and, in fast-moving situations like COVID-19, probably not even very close to the true risk for an infected person.
Another important metric, which should not be confused with the CFR, is the crude mortality rate.
Crude mortality rate
The crude mortality rate is another very simple measure which, like the CFR, gives something that might sound like the answer to the question if someone is infected, how likely are they to die?.
But, just as with CFR, it is actually very different.
Infection fatality rate
Coronavirus Vs Flu Deaths
The first thing to know is that deaths due to COVID-19 and the flu are not counted in the same way. This means comparing the numbers isnt as straightforward as we would like.
Each death due to influenza in the U.S. does not have to be reported, so there is never a direct count. Each flu season, the CDC estimates deaths from the flu based on in-hospital deaths and death certificate data. They continue to update the data on their website as they collect it. Therefore, numbers from the last two flu seasons are not considered final just yet.
Conversely, each death due to COVID-19 is being recorded. The numbers you see and hear about are not estimates. So you can see how comparing mortality rates between the two isnt exact at this point.
That said, heres a quick look at the number of cases and deaths for the last two flu seasons and COVID-19 to date:
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How Many Children Have Died From Covid
Among the 3.4 million COVID-19 deaths1 reported in the MPIDR COVerAGE database, 0.4 per cent occur in children and adolescents under 20 years of age. Of the over 12,000 deaths reported in those under 20 years of age, 58 per cent occurred among adolescents ages 1019, and 42 per cent among children ages 09.
Data correct as of December 2021. For more information, including age and sex disaggregated data, visit our interactive dashboard.
1based off 65 per cent of the total global deaths reported by JHU.
The available evidence indicates the direct impact of COVID-19 on child, adolescent and youth mortality to be limited. However, there is concern that the indirect effects of the pandemic on mortality in these age groups stemming from strained health systems, household income loss, and disruptions to care-seeking and preventative interventions like vaccination may be more substantial.
The UN Inter-agency Group for Child Mortality Estimation, led by UNICEF, will continue to assess the impact of COVID-19 on child and adolescent mortality in 2020 and beyond as more data become available. Timely, high-quality, and disaggregated data will be critical to achieving this goal. While UNICEF and its partners continue to monitor and report on this pandemics impact on children, please find below additional resources on COVID-19 and mortality. This list is to be updated as new resources become available.
The Challenges Of Data Gaps
Significant data gaps exist in the African, Eastern Mediterranean, South-East Asian, and Western Pacific regions for which just over 360 000 total COVID-19 deaths were reported in 2020. Only 16 of the 106 Member States in these regions have sufficient data to make empirical calculations.
Without timely, reliable and actionable data we cannot accurately measure progress towards the health-related SDGs or WHOs Triple Billion targets. Moreover, we cannot accurately measure the impact of the COVID-19 pandemic to better inform public policy and prepare for future health emergencies. According to WHO’s World Health Statistics 2020 report, for almost one-fifth of countries over half of the SDG indicators lack recent, primary data. The availability of data also varies widely by income group and by indicator.
WHO is actively engaging with Member States to strengthen health information systems, particularly civil registration and vital statistics , and improve data availability and quality. This includes targeted interventions to address the weakest areas identified by the SCORE global report, 2020, which showed for example that only 27% of countries have sustainable capacity to survey public health threats.
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Calculating Cfr During An Ongoing Epidemic
CFR calculated using the above formula during ongoing epidemics provides a conditional, estimate ofCFR and is influenced by lags in report dates for cases and deaths . This leads to a wide variation in CFR estimates over the courseof an epidemic, which tends toward a stable, final estimate of CFR as active cases are resolved.
One simple solution to mitigating the bias due to delays to case resolution during an ongoing outbreak is to restrict the analysis to resolved cases:
However, this method does not eliminate all biases related to delayed reporting. For example, differences in the time it takes for cases to resolve can bias this estimate. If people sick with the disease typically die quicker than they recover, CFR maybe overestimated. If the reverse is true, it may be underestimated. Therefore, more sophisticated approaches that make use of statistical techniques to predict future outcomes among active cases based on the probabilities of past outcomes may be applied,including modified Kaplan-Meier survival analysis . Two important drawbacks to such approaches are first, that they tend to require individual-level data that areless accessible in real-time than aggregate case and death counts and second, that they are less simple to do, generally requiring the application of advanced statistical methods.
Taking risk groups into account
Potential bias in detection of cases and deaths
These biases may vary over the course of an outbreak:
The Suggestion That A Person Can’t Make Any Reasonable Guesses About His Own Likelihood Of Survival Is Misleading
Robby Soave|8.9.2021 12:22 PM
A viral Instagram post claimed that COVID-19 is 99 percent survivable for most age groupsthe elderly being an important exception. The post cited projections from the Centers for Disease Control and Prevention , but was flagged as misinformation by the social media site and rated “false” by the Poynter Institute’s PolitiFact.
That’s a curious verdict, since the underlying claim is likely true. While estimates of COVID-19’s infection fatality rate range from study to study, the expert consensus does indeed place the death rate at below 1 percent for most age groups.
PolitiFact is correct that the CDC’s September 2020 modeling projections should not be used to calculate the IFR. The post also erred in comparing the vaccine efficacy rate of 94 percent to the COVID-19 survivability rate. This is an apples and oranges comparison it does not mean that the average person’s natural immune response is better at fighting the disease than the vaccines. At present, the overwhelming majority of hospitalized COVID-19 patients are unvaccinated. Since the beginning of the year, 98 percent of COVID-19 deaths in Virginia were among the unvaccinated. The vaccines are not in competition with the body’s natural immune systemthey render COVID-19 even more mild, and even more survivable.
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Australian Data Answers Key Questions About Covid
The risk of death after the diagnosis of a COVID-19 infection during Victorias 2020 outbreaks was 4 percent overall but was estimated to be 10 times higher among the elderly, a study from the University of Sydneys NHMRC Clinical trials Centre has found.
The data analytics study, published in BMC Medical Research Methodology, is a comprehensive assessment of COVID-19 mortality prior to the introduction of vaccines in the state of Victoria, Australia, focusing particularly on the impact of age.
The findings demonstrate how modelling and data analytics can help answer key questions on COVID-19 infection in an Australian context. This can help guide global surveillance and the development of strategies to forecast and control the pandemic.
Professor Ian Marschner from the Faculty of Medicine and Health and NHMRC Clinical Trials Centre says the results, particularly the high mortality among the elderly, emphasise the importance of Australias vaccination program.
Data from Victoria were used as the Victorian health department publishes comprehensive data on age, and the Victorian outbreak comprised the majority of Australian cases in 2020.
Although it is well known that older age is a key risk factor for COVID-19 death, there are many related questions for which we have not had good answers, he said.
Why Do Death Rates Differ Between Countries
According to research by Imperial College, it’s because different countries are better or worse at spotting the milder, harder to count cases.
Countries use different tests for the virus, have different testing capacity and different rules for who gets tested. All of these factors change over time.
The UK government plans to increase testing to 10,000 a day initially, with a goal of reaching 25,000 a day within four weeks. It currently restricts testing mainly to people in hospitals.
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Modelling Needs To Be Continually Updated
Professor Marschner says the findings provide key information to help understand the natural progression of COVID-19 infection, and for calibrating mathematical models to the Australian context.
Modelling assumptions need to be continually updated on the basis of new data. The analysis of Australian data presented here estimates a longer delay to death than has previously been assumed for the Australian context, he says.
The study also underlines the need for age-specific analysis.
Models of COVID-19 spread in Australia have previously assumed the age-distribution of cases remains stable over time, whereas in the Victorian data there was strong evidence that it evolved over time, with the first wave having 2.7 percent of cases in people older than 80 years compared to 9.5 percent in the second wave.
These changes in the age distribution affect the overall mortality risk and make age-specific mortality analysis essential.
Overall, the study highlights the importance of close collaboration between data scientists, statisticians and mathematical modellers in developing quantitative tools to inform pandemic control strategies, says Professor Marschner.
Disclaimer: Professor Ian Marschner declares no competing interests.
The Death Rate In Confirmed Cases Is Not The Overall Death Rate
Most cases of most viruses go uncounted because people tend not to visit the doctor with mild symptoms.
On 17 March, the chief scientific adviser for the UK, Sir Patrick Vallance, estimated there were about 55,000 cases in the UK, when the confirmed case count was just under 2,000.
Dividing deaths by 2,000 will give you a much higher death rate than dividing by 55,000.
That’s one of the biggest reasons why the death rates among confirmed cases are a bad estimate of the true death rates: overestimating the severity by missing cases.
But you can also get it wrong in the other direction: underestimating the death rate by not taking into account those people currently infected who may eventually die.
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Mortality Risk Of Covid
We are grateful to everyone whose editorial review and expert feedback on this work helps us to continuously improve our work on the pandemic. Thank you. Here you find the acknowledgements.
Our interactive data visualizations which show the case fatality rate in each country, is updated daily.
The text below is updated periodically. In the last update we replaced some of the earlier content on mortality risks by age and preexisting health conditions before vaccines were available.
How You Might Feel While Recovering
Not everyone who catches SARS-CoV-2 will notice symptoms. If you do get them, they may show up 2 to 14 days after your infection. And those symptoms can vary from one person to the next.
One of the most common signs is a fever, which for most adults is 100.4 F or higher. It means your body is trying to fight off an invader.
Some people who had COVID-19 said they had trouble taking deep breaths and felt like they had a tight band wrapped around their chest. Others have likened the illness to a bad cold. Still others said it was the sickest theyve ever felt.
Loss of smell and taste have been reported in many cases. Some patients have skin rashes and darkened toes, called COVID toes.
You might feel short of breath, as if youd just run to grab a ringing phone. If so, call your doctor to ask about what you should do.
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Safe And Happy Holidays
The United States recently surpassed 50 million COVID-19 cases and 800,000 deaths since the start of the pandemic. This week also marks the first anniversary of the first COVID-19 vaccination in the United States. In recent weeks, COVID-19 cases and hospitalizations have increased, with many parts of the country experiencing substantial or high levels of community transmission. These increases and the recent emergence of the Omicron variant highlight the importance of prevention strategies to help people stay safe and reduce the spread of the virus that causes COVID-19.
Although we are still learning about Omicron, weve been fighting COVID-19 since last year and have the tools to end the pandemic. The United States saw the highest peak in COVID-19 cases in January 2021, following the 2020 holiday season. But this year, we have the most important protection of all: vaccination. As people start to travel and gather this year, COVID-19 vaccination, along with other important prevention strategies, continues to be our best defense against severe disease.
Study Design And Participants
This was a retrospective cohort study of adults aged 18 years and above admitted to the COVID-19 isolation unit between 29th March and 31st July 2020. We enrolled eligible patients that were hospitalized with confirmed COVID-19 via a positive SARS-CoV-2 RT-PCR and had a final outcome . The criteria for discharge was maintenance of oxygen saturation at rest or above 94% on room air, respiratory rate less than 24 breaths/min and absence of fevers over a 24-hour period.
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How Effective Is The Pfizer Vaccine
The reported effectiveness of the Pfizer vaccine is also potentially subject to change.
The Pfizer vaccine is currently reported to be at least 90% effective in preventing Covid-19 infection, meaning that people in the trial who had been given the vaccine were 90% less likely to get Covid-19 than those who didnt get the vaccine. The trial isnt yet complete, however, so this could change as the study goes on and more participants catch Covid-19.
But this is talking about how many people get infected, not how many people die. Comparing this to the fatality rate for the disease is comparing two entirely different things.
Its not yet clear whether any vaccine, in addition to reducing the chance of infection, would also reduce the chance of severe symptoms or death among those who do get infected.
Correction 19 November 2020
Correction: This article initially used figures for the number of people who died where Covid-19 was mentioned on the death certificate in any capacity, when we meant to use the figure for the number of people who died where Covid-19 was noted as the underlying cause of death.
Correction 31 March 2021
We corrected errors in the description of the recovery rate set out in the social media posts.