Mortality Rate for COVID-19 May Be Closer to Influenza

Mortality Rate for COVID-19 May Be Closer to Influenza

At a press briefing on Mar. 3, 2020, the director general of the World Health Organization (WHO), Dr. Tedros Ghebreyesus, said, “Globally, about 3.4 percent of reported COVID-19 cases have died.” On Mar. 13, The New York Times reported that modeling experts from the Centers for Disease Control and Prevention (CDC) were estimating that if no actions are taken to stop the spread of coronavirus in the U.S., worst-case scenario, “between 160 million and 214 million people in the U.S. could be infected over the course of the epidemic” and “as many as 200,000 to 1.7 million people could die.”1 2 3 4 5

The 3.4 percent mortality rate for COVID-19 and the worst-case scenario predictions by the CDC are in marked contrast to earlier estimates that had placed the mortality rate at around 2.3 percent,6 a figure that was reached by dividing the number of deaths by the number of confirmed cases of the disease (rather than the number of actual cases of COVID-19, which is unknown).7

Other infectious disease experts disagree with the WHO’s often quoted 3.4 percent mortality rate, maintaining that it is much lower. Instead of COVID-19 being more 30 times deadly than the annual influenza virus, which has an estimated mortality rate of 0.1 percent, U.S. health officials such as Anthony Fauci, MD of the National Institutes of Health (NIH) believe the mortality rate is closer to one percent, or about 10 times more fatal than seasonal influenza.8

The WHO figure does not take into account asymptomatic COVID-19 cases or cases in which symptoms are minimal, said Dr. Fauci.9 In other words, there are many mild cases of COVID-19 that are not being diagnosed, reported and counted because many of those people are not going to the hospital and are not being tested, diagnosed and reported. So it is difficult to come up with a reasonable estimate for just how lethal COVID-19 really is compared to other infections.5

A one percent mortality rate for an infectious disease is still high. However, even that estimate is based on extremely limited data, given that very few people in the U.S.—and in many other countries—have been tested for COVID-19. There also have been problems with the accuracy of lab tests for the virus. “We’re very concerned about false positives, just as damning as false negatives” said Bruce Carlson of medical diagnostic market research firm Kalorama Information in New York.10 11 12 13 14 15

Chief medical officer and epidemiologist Professor Chris Whitty thinks the mortality rate for COVID-19 may end up being less than one percent.5 “I am reasonably confident one percent is the upper rate of mortality,” Prof. Whitty said.16

Prof. Whitty’s prediction is consistent with current estimated mortality rates for COVID-19 in countries like South Korea and Germany. In South Korea, the rate has been pegged at 0.6 percent. In Germany, the rate is 0.2 percent, which is particularly interesting since that country has the highest median age in all of Europe and, thus, potentially could be the most vulnerable to the severest impact of the disease.17 18 19

Germany’s rate of 0.2 percent is consistent with the COVID-19 mortality rate around the world, excluding China. Microbiologist Lothar Wieler, PhD, president of the Robert Koch Institute (RKI) in Germany, believes that, ultimately, the rate in China will settle at about 0.2 percent as well. A study released by China’s Center for Disease Control in February estimated the mortality rate of the disease in China, excluding Hubei province, where the city of Wuhan is located, had already dropped to 0.4 percent.18 20

In Wuhan, reportedly the epicenter of the COVID-19 outbreak, the mortality rate of the disease is now down to 1.4 percent based on a recent estimate by infectious disease researchers Joseph Wu, PhD and Kathy Leung, PhD of the University of Hong Kong. However, that estimate may be high, according to epidemiologist Jeffrey Shaman, PhD of the Mailman School of Public Health at Columbia University.21

“I think there are many more than the [approximately] 70,000″ confirmed cases of COVID-19 in Hubei, said Dr. Shaman. If so, the higher number of cases would skew the mortality rate for the disease downward.21

Like other infectious disease experts, Dr. Wieler believes the impact of COVID-19 may ultimately prove to be similar to that of a severe outbreak of influenza.18


References:

1 Fink S. The worst-case estimate for U.S. coronavirus deaths. The New York Times Mar. 13, 2020.
2 Bacon J. Coronavirus 20 times more lethal than the flu? Death toll passes 2,000. USA Today Feb. 18, 2020.
3 Ducharme J, Wolfson E. The WHO Estimated COVID-19 Mortality at 3.4%. That Doesn’t Tell the Whole Story TIME Mar. 9, 2020.
4 Lovelace B, Higgins-Dunn N. WHO says coronavirus death rate is 3.4% globally, higher than previously thought. CNBC Mar. 4, 2020.
5 Devlin H, Boseley S. Coronavirus facts: is there a cure and what is the mortality rate of the virus? The Guardian Mar. 15, 2020.
6 Soucheray S. Study of 72,000 COVID-19 patients finds 2.3% death rate. CIDRAP News Feb. 24, 2020.
7 O’Donnell T. Coronavirus is 10 times more lethal than the seasonal flu, Trump’s task force immunologist says. The Week Mar. 11, 2020.
8 Fauci A, Lane HC, Redfield RR. Covid-19 – Navigating the Uncharted. NEJM Feb. 28, 2020.
9 McCormack J. Coronavirus vs. the Flu: The Difference Between a 1% and 0.1% Fatality Rate Is Huge. National Review Mar. 14, 2020.
10 Kisken T. Officials: Coronavirus tests create uncertainty about child’s positive COVID-19 status. Ventura County Star Mar. 14, 2020.
11 Letzter R. American stuck in Egypt for false-positive coronavirus test describes his struggle in military hospital. Live Science Mar. 12, 2020.
12 Lichtenstein K. Are Coronavirus Tests Accurate? MedicineNet Health News Feb. 18, 2020.
13 Molteni M, Rogers A. Everything You Need to Know About Coronavirus Testing. WIRED Mar. 16, 2020.
14 Petersen M. Lack of accurate coronavirus tests sets back effort to limit infections. Los Angeles Times Feb. 28, 2020.
15 Simpson C. Public warned not to use coronavirus rapid testing kits. The Telegraph Mar. 15, 2020.
16 Mullen G. Coronavirus mortality rate is ‘70% HIGHER than first feared’ – as bug declared a pandemic. The Sun Mar. 12, 2020.
17 Kiersz A. Coronavirus death rates in South Korea reinforce a frightening pattern of how the disease affects older people. Business Insider Mar. 11, 2020.
18 DW Akademie. Coronavirus: Germany hopes to contain COVID-19.
19 Sepkowitz K. Why South Korea has so few coronavirus deaths while Italy has so many. CNN Mar. 17, 2020.
20 Aizenman N. Why The Death Rate From Coronavirus Is Plunging In China. NPR Mar. 3, 2020.
21 Begley S. Lower death rate estimates for coronavirus, especially for non-elderly, provide glimmer of hope. STAT Mar. 16, 2020.

7 Responses to "Mortality Rate for COVID-19 May Be Closer to Influenza"

  1. Redpill   March 19, 2020 at 12:18 am

    FYI:
    https://swprs.org/a-swiss-doctor-on-covid-19/

    -Swiss Propaganda Research

    A Swiss Doctor on Covid-19
    Published: March 14, 2020; upd. March 19, 2020; Languages: EN, DE

    A Swiss medical doctor provided the following information on the current situation in order to enable our readers to make a realistic risk assessment.

    According to the latest data of the Italian National Health Institute ISS, the average age of the positively-tested deceased in Italy is currently about 81 years. 10% of the deceased are over 90 years old. 90% of the deceased are over 70 years old.

    80% of the deceased had suffered from two or more chronic diseases. 50% of the deceased had suffered from three or more chronic diseases. The chronic diseases include in particular cardiovascular problems, diabetes, respiratory problems and cancer.

    Less than 1% of the deceased were healthy persons, i.e. persons without pre-existing chronic diseases. Only about 30% of the deceased are women.
    The Italian Institute of Health moreover distinguishes between those who died from the coronavirus and those who died with the coronavirus. In many cases it is not yet clear whether the persons died from the virus or from their pre-existing chronic diseases or from a combination of both.

    The two Italians deceased under 40 years of age (both 39 years old) were a cancer patient and a diabetes patient with additional complications. In these cases, too, the exact cause of death was not yet clear (i.e. if from the virus or from their pre-existing diseases).

    The partial overloading of the hospitals is due to the general rush of patients and the increased number of patients requiring special or intensive care. In particular, the aim is to stabilize respiratory function and, in severe cases, to provide anti-viral therapies.

    (Update: The Italian National Institute of Health published a statistical report on test-positive patients and deceased, confirming the above data.)

    The doctor also points out the following aspects:
    Northern Italy has one of the oldest populations and the worst air quality in Europe, which has already led to an increased number of respiratory diseases and deaths in the past and is likely an additional risk factor in the current epidemic.

    South Korea, for instance, has experienced a much milder course than Italy and has already passed the peak of the epidemic. In South Korea, only about 70 deaths with a positive test result have been reported so far. As in Italy, those affected were mostly high-risk patients.

    The approximately twelve test-positive Swiss deaths so far were also high-risk patients with chronic diseases, an average age of 80 years and a maximum age of 90 years, whose exact cause of death, i.e. from the virus or from their pre-existing diseases, is not yet known.

    Furthermore, according to a first Chinese study, the internationally used virus test kits may give a false positive result in some cases. In these cases, the persons may not have contracted the new coronavirus, but presumably one of the many existing human coronaviruses that are part of the annual (and currently ongoing) cold and flu epidemics. (1)

    Thus the most important indicator for judging the danger of the disease is not the frequently reported number of positively-tested persons and deaths, but the number of persons actually and unexpectedly developing or dying from pneumonia (so-called excess mortality).

    According to all current data, for the healthy general population of school and working age, a mild to moderate course of the Covid-19 disease can be expected. Senior citizens and persons with existing chronic diseases should be protected. The medical capacities should be optimally prepared.

    Medical literature
    (1) Zhuang et al., Potential false-positive rate among the ‚asymptomatic infected individuals‘ in close contacts of COVID-19 patients, Chinese Medical Association Publishing House, March 2020.
    (2) Grasselli et al., Critical Care Utilization for the COVID-19 Outbreak in Lombardy, JAMA, March 2020.
    (3) WHO, Report of the WHO-China Joint Mission on Coronavirus Disease 2019, February 2020.

    Reference values
    Important reference values include the number of annual flu deaths, which is up to 8,000 in Italy and up to 60,000 in the US; normal overall mortality, which in Italy is up to 2,000 people per day; and the average number of pneumonia cases per year, which in Italy is over 120,000.

    Current all-cause mortality in Europe and in Italy is still normal or even below-average. Any excess mortality due to Covid-19 should become visible in the European monitoring charts.

    Updates
    March 16, 2020
    A German lung specialist confirmed that the virus test has not yet been clinically validated, i.e. it may indeed respond positive to other, more common coronaviruses, too.

    March 17, 2020
    According to press reports, some Swiss emergency units are already overloaded simply because of the large number of people who want to be tested. This points to an additional psychological and logistical component of the current situation.
    The mortality profile remains puzzling from a virological point of view because, in contrast to influenza viruses, children are spared and men are affected about twice as often as women. On the other hand, this profile corresponds to natural mortality, which is close to zero for children and almost twice as high for 75-year-old men as for women of the same age.

    The younger test-positive deceased almost always had severe pre-existing conditions. For example, a 21-year-old Spanish soccer coach had died test-positive. However, the doctors diagnosed an unrecognized leukemia, whose typical complications include severe pneumonia.

    The decisive factor in assessing the danger of the disease is therefore not the number of test-positive persons and deceased, which is often mentioned in the media, but the number of people actually and unexpectedly developing or dying from pneumonia (so-called excess mortality). So far, this value is still very low in most countries.

    According to official figures, there are currently about 1850 test-positive patients in intensive care in Italy, most of them in northern Italy. There is no official data on the age and disease profile of these patients. The occupancy rate of the North Italian ICUs in the winter months is typically already 85 to 90%. Some or many of these existing patients could also be test-positive by now. However, the number of additional unexpected pneumonia cases is not yet known.
    March 17, 2020 (II)

    In a study on 3000 persons, the Italian immunology professor Sergio Romagnani of the University of Florence comes to the conclusion that 50 to 75% of the test-positive persons of all age groups remain completely free of symptoms – significantly more than previously assumed.

    A hospital doctor in the Spanish city of Malaga writes on Twitter that people are currently more likely to die from panic and systemic collapse than from the virus. The hospital is being overrun by people with colds, flu and possibly Covid19 and doctors have lost control.

    March 18, 2020
    A new epidemiological study (preprint) concludes that the mortality of Covid19 even in the Chinese city of Wuhan was only 0.04% to 0.12% and thus rather lower than that of seasonal flu, which has a mortality rate of about 0.1%. As a reason for the apparently highly overestimated mortality of Covid19, the researchers suspect that only a small number of cases were originally recorded in Wuhan, as the disease was probably asymptomatic or mild in many people.
    Chinese researchers argue that extreme winter smog in the city of Wuhan may have played a causal role in the outbreak of pneumonia. In the summer of 2019, public protests were already taking place in Wuhan because of the poor air quality.

    New satellite images show how Northern Italy has the highest levels of air pollution in Europe, and how this air pollution has been greatly reduced by the quarantine.

    A manufacturer of the Covid19 test kit states that it should only be used for research purposes and not for diagnostic applications, as it has not yet been clinically validated.

    Stanford professor John P.A. Ioannidis asks: „A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data.“

    March 19, 2020
    The Italian National Health Institute ISS has published a new report on test-positive deaths:
    The median age is 80.5 years (79.5 for men, 83.7 for women).
    10% of the deceased was over 90 years old; 90% of the deceased was over 70 years old.

    0.8% of the deceased had no pre-existing chronic illnesses.
    Approximately 75% of the deceased had two or more pre-existing conditions, 50% had three more pre-existing conditions, particularly heart disease, diabetes and cancer.

    17 of the deceased were under 50 years of age. Of these, five were between 31 and 39 years old, all of them with serious or very serious pre-existing conditions.
    The National Health Institute hasn’t yet determined what the patients examined ultimately died of and refers to them as Covid19-positive deaths in general.

    Reply
  2. Suzanne   March 21, 2020 at 10:08 am

    We learned in nutrition school that the flu totals given by NIH and CDC are much lower than they say. They add a zero to the real totals! Imagine them doing this? I certainly can!

    Reply
  3. INGRID C DURDEN   March 21, 2020 at 11:00 am

    Redpill, thank you for this article. I think this whole thing is a panic attack. Yes there are people dying, but as you state, most of the people who died are already sick and most are also old.
    The lower numbers for Germany may also be due to the quick action. When I called my senior friend 2 weeks ago, the retirement community where she lives was already on lock down for a week or more. I wonder if every flu season a lot of people might not contract the illness if they stayed home. I remember the time when I was a kid and most all mothers were stay at home moms, taking care of the household and the children. No one ever went on holiday, we just enjoyed the vacation at home and may be a trip to the seaside or the hills. A picnic in the woods. Nostalgia ? probably a solution for the unhappy situation now !

    Reply
  4. PKP   March 21, 2020 at 6:42 pm

    This doesn’t explain Italy. Why are their hospitals overrun? If the death rate is like the flu, this would happen every year in Italy. It doesn’t. Is there an something I’m missing?

    Reply
    • Jan   March 24, 2020 at 4:33 pm

      Yes – missing the ‘lack-of-common-sense’ gene these anti-vaxxers seem to have!

      Reply
  5. Jo   March 21, 2020 at 11:52 pm

    China said found at least two strains.
    WHY Italy double death rate, compared to nearly all at 4%? (I mean, after a few weeks, not the first couple deaths.)
    But then also, WHY South Korea sustains a one-quarter death rate?!

    Why did Fauci pay $19Million to Greffex, LAST SEPTEMBER, for coronavirus vaccine to be made from military-only adenovirus vaccine? (When CAN that SOB rot in jail?)

    Japanese FAVIPIRIVR (a flu drug) works.
    China cured people with intravenous Vitamin C.

    SARS-CoV-2 (called CoVID-19) is a MERS-modified SARS? Didn’t SARS suddenly disappear, in 2004 after a two year 9% death rate? I’m not sure about those. What do you know?.

    Reply
  6. A. Hamberg   March 25, 2020 at 4:12 pm

    The death rate varies proportionately to the level of care available to treat the seriously ill. Yes, age, pre-existing conditions etc all play a role but the bottom line is that in the greater populations without access to ventilators etc to treat serious/critical cases the rate is higher. Italy has a world-class health care system but not unlimited numbers of ventilators or drugs or personal protection gear. Once the system is over capacity, deaths increase – this is true everywhere.

    Reply

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