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UpInArms

(51,284 posts) Mon Mar 30, 2020, 11:35 PM Mar 2020

Lancet: Likelihood of death due to coronavirus disease 2019

Original article title:

Likelihood of survival of coronavirus disease 2019

Estimates of case fatality ratios might vary slightly from country to country because of differences in prevention, control, and mitigation policies implemented, and because the case fatality ratio is substantially affected by the preparedness and availability of health care. Early studies5, 6 have shown that delaying the detection of infected cases not only increases the probability of spreading the virus to others (most likely family members, colleagues, and friends) but also makes the infection worse in some cases, thereby increasing the case fatality ratio.7

Comparisons of case fatality ratios for SARS, COVID-19, and seasonal influenza in different age groups are shown in the figure. Even though the fatality rate is low for younger people, it is very clear that any suggestion of COVID-19 being just like influenza is false: even for those aged 20–29 years, once infected with SARS-CoV-2, the mortality rate is 33 times higher than that from seasonal influenza. For people aged 60 years and older, the chance of survival following SARS-CoV-2 infection is approximately 95% in the absence of comorbid conditions. However, the chance of survival will be considerably decreased if the patient has underlying health conditions, and continues to decrease with age beyond 60 years.5, 6

Although China seems to be out of the woods now, many other countries are facing tremendous pressure from the COVID-19 pandemic. The strategies of early detection, early diagnosis, early isolation, and early treatment that were practised in China6 are likely to be not only useful in controlling the outbreak, but also contribute to decreasing the case fatality ratio of the disease.

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30257-7/fulltext

12 replies

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Lancet: Likelihood of death due to coronavirus disease 2019 (Original Post) UpInArms Mar 2020 OP

Those Numbers Are The Odds Of Death, Sir, Right? The Magistrate Mar 2020 #1

Yes, I thought so. Kind of scary otherwise. smirkymonkey Mar 2020 #3

Certainly Made Me Stir Up a Bleary Eye, Sir The Magistrate Mar 2020 #5

I did not write the headline ... UpInArms Mar 2020 #4

Your subject line is backwards jberryhill Mar 2020 #2

I changed the OP title UpInArms Mar 2020 #6

Thank You, Sir The Magistrate Mar 2020 #7

SAVE BETTY WHITE! pansypoo53219 Mar 2020 #8

Save RBG! Poiuyt Mar 2020 #9

Okay. So I'm 71 years old. PoindexterOglethorpe Mar 2020 #10

Covid stats (and SARS) are based on those who get the disease; flu stats on all people of that age muriel_volestrangler Mar 2020 #12

Note: the flu column is NOT a 'case fatality ratio', it's the death rate for the whole population muriel_volestrangler Mar 2020 #11

The Magistrate

(95,247 posts)

1. Those Numbers Are The Odds Of Death, Sir, Right?

Reply to UpInArms (Original post)

Mon Mar 30, 2020, 11:41 PM

Mar 2020

There ought to be a header on the columns saying so. People are going to have heart attacks before they can figure it out, looking at some of those numbers....

smirkymonkey

(63,221 posts)

3. Yes, I thought so. Kind of scary otherwise.

Reply to The Magistrate (Reply #1)

Mon Mar 30, 2020, 11:51 PM

Mar 2020

The Magistrate

(95,247 posts)

5. Certainly Made Me Stir Up a Bleary Eye, Sir

Reply to smirkymonkey (Reply #3)

Mon Mar 30, 2020, 11:54 PM

Mar 2020

UpInArms

(51,284 posts)

4. I did not write the headline ...

Reply to The Magistrate (Reply #1)

Mon Mar 30, 2020, 11:54 PM

Mar 2020

But I can change the OP title

jberryhill

(62,444 posts)

2. Your subject line is backwards

Reply to UpInArms (Original post)

Mon Mar 30, 2020, 11:47 PM

Mar 2020

Those are not the survival probabilities. They are the death probabilities.

UpInArms

(51,284 posts)

6. I changed the OP title

Reply to jberryhill (Reply #2)

Mon Mar 30, 2020, 11:56 PM

Mar 2020

The Magistrate

(95,247 posts)

7. Thank You, Sir

Reply to UpInArms (Reply #6)

Mon Mar 30, 2020, 11:58 PM

Mar 2020

Nobody really meant to jump on you.

The information is useful. Thank you for sharing it.

pansypoo53219

(20,978 posts)

8. SAVE BETTY WHITE!

Reply to UpInArms (Original post)

Tue Mar 31, 2020, 01:07 AM

Mar 2020

Poiuyt

(18,125 posts)

9. Save RBG!

Reply to pansypoo53219 (Reply #8)

Tue Mar 31, 2020, 01:36 AM

Mar 2020

PoindexterOglethorpe

(25,861 posts)

10. Okay. So I'm 71 years old.

Reply to UpInArms (Original post)

Tue Mar 31, 2020, 01:36 AM

Mar 2020

Do I have an 8.6% chance of surviving? Or an 8.6% chance of dying? There's a huge difference.

I suspect the correct answer is that I have an 8.6% chance of dying, although since I'm vastly healthier than almost anyone I know my age I'm guessing have have a minuscule chance of dying.

Oh, and are those percentages based on all people in that age range? Or only those who actually get the disease?

muriel_volestrangler

(101,321 posts)

12. Covid stats (and SARS) are based on those who get the disease; flu stats on all people of that age

Reply to PoindexterOglethorpe (Reply #10)

Tue Mar 31, 2020, 03:00 AM

Mar 2020

see reply #11. And yes, it's the percentages who die.

muriel_volestrangler

(101,321 posts)

11. Note: the flu column is NOT a 'case fatality ratio', it's the death rate for the whole population

Reply to UpInArms (Original post)

Tue Mar 31, 2020, 02:58 AM

Mar 2020

(of the USA) whether or not they caught the flu in a year.

Here's the Lancet article: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2820%2930257-7/fulltext

And footnote 9 says the flu statistics came from the USA, 2018-9 flu season: https://www.cdc.gov/flu/about/burden/2018-2019.html

That has, in Table 1, "Estimated influenza disease burden, by age group — United States, 2018-2019 influenza season", with, for instance, for the 65+ age group, 25,555 deaths from 3,073,227 symptomatic illnesses - a case fatality ratio of 0.83%. Table 2 has "Estimated rates of influenza-associated disease outcomes, per 100,000", and those are the figures the Lancet table uses - eg for 65+, the mortality rate is 48.7 per 100,000, which is the 0.0487% we see in the Lancet table.

So the Lancet are comparing what would happen if the entire population got Covid-19, with what happens with a population with widespread flu vaccination among the vulnerable groups. The Lancet also seems to be deriving the case fatality rate from the known deaths divided by those with reported symptoms. If there's no attempt to allow for much of the population not getting symptoms bad enough to report their illness and get on statistics (which is widely believed to be the case), then saying "everyone in the USA will get symptoms bad enough to be recorded" seems unrealistic.

I'm not convinced this is a meaningful comparison.

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