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
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.