C-19 Infection Fatality Rate 0.02% to 0.40%
05-22-2020, 11:18 AM
#1
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C-19 Infection Fatality Rate 0.02% to 0.40%
Study pre-print puts Covid-19 Infection Fatality Rate at 0.02% to 0.40%.
https://www.medrxiv.org/content/10.1...253v1.full.pdf
https://www.medrxiv.org/content/10.1...253v1.full.pdf
Abstract
Objective To estimate the infection fatality rate of coronavirus disease 2019 (COVID-19) from data of seroprevalence studies. Methods Population studies with sample size of at least 500 and published as peer-reviewed papers or preprints as of May 12, 2020 were retrieved from PubMed, preprint servers, and communications with experts. Studies on blood donors were included, but studies on healthcare workers were excluded. The studies were assessed for design features and seroprevalence estimates. Infection fatality rate was estimated from each study dividing the number of COVID-19 deaths at a relevant time point by the number of estimated people infected in each relevant region. Correction was also attempted accounting for the types of antibodies assessed. Results Twelve studies were identified with usable data to enter into calculations. Seroprevalence estimates ranged from 0.113% to 25.9% and adjusted seroprevalence estimates ranged from 0.309% to 33%. Infection fatality rates ranged from 0.03% to 0.50% and corrected values ranged from 0.02% to 0.40%. Conclusions The infection fatality rate of COVID-19 can vary substantially across different locations and this may reflect differences in population age structure and case-mix of infected and deceased patients as well as multiple other factors. Estimates of infection fatality rates inferred from seroprevalence studies tend to be much lower than original speculations made in the early days of the pandemic.
05-22-2020, 11:34 AM
#2
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One would expect the estimated fatality rate to drop as they account for folks who were asymptomatic or had mild symptoms, didn't seek medical care or testing, and were therefore not accounted for early on. Only antibody testing (with known accuracy) can provide solid numbers, and you'll need a large, representative sample group.
But there's no clear consensus yet:
https://www.npr.org/sections/health-...are-optimistic
Also... there's frankly a big difference between 0.02% and 0.4%.
0.0002 risk of death is one in 5,000. Most folks might take a chance on that.
0.004 is one in 250. That strikes closer to home.
Of course those numbers are HIGHLY variable depending on your age and health. They really need to break it down by age group.
But there's no clear consensus yet:
https://www.npr.org/sections/health-...are-optimistic
Also... there's frankly a big difference between 0.02% and 0.4%.
0.0002 risk of death is one in 5,000. Most folks might take a chance on that.
0.004 is one in 250. That strikes closer to home.
Of course those numbers are HIGHLY variable depending on your age and health. They really need to break it down by age group.
05-22-2020, 11:56 AM
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Originally Posted by rickair7777
One would expect the estimated fatality rate to drop as they account for folks who were asymptomatic or had mild symptoms, didn't seek medical care or testing, and were therefore not accounted for early on. Only antibody testing (with known accuracy) can provide solid numbers, and you'll need a large, representative sample group.
But there's no clear consensus yet:
https://www.npr.org/sections/health-...are-optimistic
Also... there's frankly a big difference between 0.02% and 0.4%.
0.0002 risk of death is one in 5,000. Most folks might take a chance on that.
0.004 is one in 250. That strikes closer to home.
Of course those numbers are HIGHLY variable depending on your age and health. They really need to break it down by age group.
But there's no clear consensus yet:
https://www.npr.org/sections/health-...are-optimistic
Also... there's frankly a big difference between 0.02% and 0.4%.
0.0002 risk of death is one in 5,000. Most folks might take a chance on that.
0.004 is one in 250. That strikes closer to home.
Of course those numbers are HIGHLY variable depending on your age and health. They really need to break it down by age group.
You break it down by age group it gets sort of interesting. Outside of the very young, coronavirus is being blamed for (very roughly) 5% of all deaths. The huge difference in numbers per age seems to be a function of the underlying baseline death RATE itself. Older groups have such a high BASELINE death rate that a 5% Addition winds up being a HUGE number of people.
5% of the 40 and under group - at least until you get down in the under one year age group where prematurity, lethal, birth defects, and childhood cancers come in to play - simply isn’t that big a number because relatively few people in that group die of anything.
05-22-2020, 01:44 PM
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Originally Posted by rickair7777
One would expect the estimated fatality rate to drop as they account for folks who were asymptomatic or had mild symptoms, didn't seek medical care or testing, and were therefore not accounted for early on. Only antibody testing (with known accuracy) can provide solid numbers, and you'll need a large, representative sample group.
But there's no clear consensus yet:
https://www.npr.org/sections/health-...are-optimistic
Also... there's frankly a big difference between 0.02% and 0.4%.
0.0002 risk of death is one in 5,000. Most folks might take a chance on that.
0.004 is one in 250. That strikes closer to home.
Of course those numbers are HIGHLY variable depending on your age and health. They really need to break it down by age group.
But there's no clear consensus yet:
https://www.npr.org/sections/health-...are-optimistic
Also... there's frankly a big difference between 0.02% and 0.4%.
0.0002 risk of death is one in 5,000. Most folks might take a chance on that.
0.004 is one in 250. That strikes closer to home.
Of course those numbers are HIGHLY variable depending on your age and health. They really need to break it down by age group.
Hopefully you read the entire article (it's pretty short), but I get the sense that you didn't because the study utilizes the results of seroprevalence surveys (antibody testing), and speculates the reasons why the upper and lower bounds of their analysis is so wide. Overall they authors provide a good accounting of the shortcomings of their study. Your points regarding sample size (still quite small) and age distribution are well taken.
05-22-2020, 06:39 PM
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Originally Posted by Wang Wei
Hopefully you read the entire article (it's pretty short), but I get the sense that you didn't because the study utilizes the results of seroprevalence surveys (antibody testing), and speculates the reasons why the upper and lower bounds of their analysis is so wide. Overall they authors provide a good accounting of the shortcomings of their study. Your points regarding sample size (still quite small) and age distribution are well taken.
My takeaway is that the real tragedy is how we are utterly failing to protect the populations that are actually at risk, yet we are doing incredible damage to the populace as a whole.
05-23-2020, 08:24 AM
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Excerpts from the paper:
IFR - Infection Fatality Rate. The estimated percent chance of death if infected.
IFR - Infection Fatality Rate. The estimated percent chance of death if infected.
The three higher values (corrected IFR of 0.25-0.40) are in Gangelt, Geneva, and Wuhan. Gangelt represents a situation with a superspreader event (in a local carnival) and 7 deaths were recorded in the city, all of them in very elderly individuals (average age 81, sd 3.5). COVID-19 is known to have a very steep age gradient of death risk. It is expected therefore that in locations where the infection finds its way into killing predominantly elderly citizens, the overall, ageunadjusted IFR would be higher. However, IFR would still be very low in people less than 70 in these locations, e.g. in Gangelt IFR is 0.000 in non-elderly people. Similarly, in Switzerland, 69% of the deaths have occurred in people >80 years old and this explains the higher age-unadjusted IFR in Geneva, which was considered a paradise for spending one’s last years until the COVID-19 struck. Similar to Germany, very few deaths in Switzerland have been recorded in non-elderly people, e.g. only 2.5% have occurred in people <60 years old and the IFR in that age-group would be in the range of 0.01%. The majority of deaths in most of the hard hit European countries have happened in nursing homes and a large proportion of deaths also in the US also seem to follow this pattern. Moreover, a very large number of these nursing home deaths have no laboratory confirmation and thus they need to be seen with extra caution in terms of the causal impact of SARS-CoV-2.
Massive deaths of elderly individuals in nursing homes, nosocomial infections, and overwhelmed hospitals may also explain the very high fatality seen in specific locations in Northern Italy and in New York and New Jersey. A very unfortunate decision of the governors in New York and New Jersey was to have COVID-19 patients sent to nursing homes. Moreover, some hospitals in New York City hotspots reached maximum capacity and perhaps could not offer optimal care. With large proportions of medical and paramedical personnel infected, it is possible that nosocomial infections increased the death toll. Use of unnecessarily aggressive management (e.g. mechanical ventilation) may also have contributed to worse outcomes. Furthermore, New York City has an extremely busy, congested public transport system that may have exposed large segments of the population to high infectious load in close contact transmission and, thus, perhaps more severe disease.
05-23-2020, 09:19 AM
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The issue of mass transit use in the NYC Metropolitan area is a huge one. Before COVID, 40% of the total passenger miles travelled were on mass transit, mostly subway. The only other city in the US where mass transit acconts for as much as 10% of passenger miles is Chicago, and it is the barely 10%.
But another huge factor is simply population density. That’s been the main determinant of infection rate and severity of infection since Biblical times.
But another huge factor is simply population density. That’s been the main determinant of infection rate and severity of infection since Biblical times.
05-23-2020, 06:08 PM
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Originally Posted by Excargodog
The issue of mass transit use in the NYC Metropolitan area is a huge one. Before COVID, 40% of the total passenger miles travelled were on mass transit, mostly subway. The only other city in the US where mass transit acconts for as much as 10% of passenger miles is Chicago, and it is the barely 10%.
But another huge factor is simply population density. That’s been the main determinant of infection rate and severity of infection since Biblical times.
But another huge factor is simply population density. That’s been the main determinant of infection rate and severity of infection since Biblical times.
I'll completely admit my bias here as an airline employee, but I'm reluctant to blame mass transit as causing deaths. We don't seem to be seeing a lot of risk/death among airline employees or travelers, so even if it is spread that way it doesn't seen that consequential in terms of death.
At this point, my thoughts are that there's no practical way to stop the spread of the disease. However, we're extremely fortunate that it mostly impacts a specific segment of the population. We need to figure out how to protect them. Today, that means mostly protecting them from exposure, and it's clear that we're failing at that. There are some indications that we're getting better at treatment for those who become seriously ill. The vaccines are promising, and they may ultimately only be necessary for those who are at significant risk of severe illness and death from the disease.
05-23-2020, 06:46 PM
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Originally Posted by Anson Harris
Mass transit may be a factor in spread, but I think we would make bigger strides in reducing deaths if we could just figure out how to stop elderly people from getting infected and dying. Are elderly persons (esp those in care facilities) really using mass transit?
I'll completely admit my bias here as an airline employee, but I'm reluctant to blame mass transit as causing deaths. We don't seem to be seeing a lot of risk/death among airline employees or travelers, so even if it is spread that way it doesn't seen that consequential in terms of death.
At this point, my thoughts are that there's no practical way to stop the spread of the disease. However, we're extremely fortunate that it mostly impacts a specific segment of the population. We need to figure out how to protect them. Today, that means mostly protecting them from exposure, and it's clear that we're failing at that. There are some indications that we're getting better at treatment for those who become seriously ill. The vaccines are promising, and they may ultimately only be necessary for those who are at significant risk of severe illness and death from the disease.
I'll completely admit my bias here as an airline employee, but I'm reluctant to blame mass transit as causing deaths. We don't seem to be seeing a lot of risk/death among airline employees or travelers, so even if it is spread that way it doesn't seen that consequential in terms of death.
At this point, my thoughts are that there's no practical way to stop the spread of the disease. However, we're extremely fortunate that it mostly impacts a specific segment of the population. We need to figure out how to protect them. Today, that means mostly protecting them from exposure, and it's clear that we're failing at that. There are some indications that we're getting better at treatment for those who become seriously ill. The vaccines are promising, and they may ultimately only be necessary for those who are at significant risk of severe illness and death from the disease.
The subways at rush hour are a fantastic way to spread the virus. People packed in strap hanging and breathing on each other in those enclosed cars. If workers in care facilities took mass transit to work then spent significant time with patients that could have been a way it got to them. Visitors as well. The other way i was thinking it could spread in NYC was my apartments. If it can be transmitted easily from surfaces and everyone in the apartment building uses the same door handle to get in...
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