The document discusses estimates of the infection fatality rate (IFR) for COVID-19 reported by various organizations from March to October 2020. Initial IFR estimates from China in March were around 0.66%. Subsequent estimates from Europe and the US Centers for Disease Control and Prevention ranged from 0.12-1.08% and 0.003-5.4% depending on age. The World Health Organization estimated an overall IFR of 0.5-1% in August. A September study estimated a global IFR of 0.23% overall and 0.05% for people under 70 based on seroprevalence data. IFR estimates have decreased over time and vary between populations and locations.
The document discusses estimates of the infection fatality rate (IFR) for COVID-19 reported by various organizations from March to October 2020. Initial IFR estimates from China in March were around 0.66%. Subsequent estimates from Europe and the US Centers for Disease Control and Prevention ranged from 0.12-1.08% and 0.003-5.4% depending on age. The World Health Organization estimated an overall IFR of 0.5-1% in August. A September study estimated a global IFR of 0.23% overall and 0.05% for people under 70 based on seroprevalence data. IFR estimates have decreased over time and vary between populations and locations.
The document discusses estimates of the infection fatality rate (IFR) for COVID-19 reported by various organizations from March to October 2020. Initial IFR estimates from China in March were around 0.66%. Subsequent estimates from Europe and the US Centers for Disease Control and Prevention ranged from 0.12-1.08% and 0.003-5.4% depending on age. The World Health Organization estimated an overall IFR of 0.5-1% in August. A September study estimated a global IFR of 0.23% overall and 0.05% for people under 70 based on seroprevalence data. IFR estimates have decreased over time and vary between populations and locations.
The document discusses estimates of the infection fatality rate (IFR) for COVID-19 reported by various organizations from March to October 2020. Initial IFR estimates from China in March were around 0.66%. Subsequent estimates from Europe and the US Centers for Disease Control and Prevention ranged from 0.12-1.08% and 0.003-5.4% depending on age. The World Health Organization estimated an overall IFR of 0.5-1% in August. A September study estimated a global IFR of 0.23% overall and 0.05% for people under 70 based on seroprevalence data. IFR estimates have decreased over time and vary between populations and locations.
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Infection fatality rate (IFR)
The most important metric in assessing death rate is the infection fatality rate (IFR),[80][c] which is deaths attributed to disease divided by individuals infected (including all asymptomatic and undiagnosed) to-date.[82] In March, a peer-reviewed analysis of pre-serology data from mainland China yielded an overall IFR of 0.66% (with age-bracketed values ranging from 0.00161% for 0– 9 years to 0.595% for 50–59 years to 7.8% for > 80 years).[83] In April, an IFR range of 0.12–1.08% was derived from non-peer-reviewed serology surveys, with the upper bound characterized as much more credible and the range indicated as from 3 to 27 times deadlier than influenza (0.04%).[84] In July, the CDC adopted the IFR as a "more directly measurable parameter for disease severity for COVID-19" and computed an overall 'best estimate' for planning purposes for the U.S. of 0.65%.[85][86] In September, the CDC computed an age-bracketed ‘best estimate’ for the U.S. of 0.003% for 0–19 years; 0.02% for 20–49 years; 0.5% for 50–69 years; and 5.4% for 70+ years. [87] [d]
In August, the WHO reported serology testing for three locations in Europe (with some data through 2 June) that showed IFR overall estimates converging at approximately 0.5-1%. [81] A systematic review article in The BMJ advised that "caution is warranted … using serological tests for … epidemiological surveillance" and called for higher quality studies assessing accuracy with reference to a standard of "RT-PCR performed on at least two consecutive specimens, and, when feasible, includ[ing] viral cultures."[89][90] CEBM researchers have called for in-hospital 'case definition' to record "CT lung findings and associated blood tests"[91] and for the WHO to produce a "protocol to standardise the use and interpretation of PCR" with continuous re-calibration. [92] In September, a Bulletin of the World Health Organization article by John Ioannides estimated global IFR inferred from seroprevalence data at 0.23%[e] overall and 0.05% for people < 70 years, much lower than estimates made earlier in the pandemic. Ioannides criticized prior "average IFR … irresponsibly circulated widely in media and social media" as "probably extremely flawed as they depended on erroneous modeling assumptions, and/or focused only on selecting mostly studies from countries high death burden (that indeed have higher IFRs), and/or were done by inexperienced authors who used overtly wrong meta-analysis methods in a situation where there is extreme between-study heterogeneity.[93] As the data for his analysis was drawn "predominantly from hard-hit epicenters", Ioannides indicates that even lower "average values of 0.15–0.25% … and 0.03–0.04% for <70 years) as of October 2020 are plausible." [93][94] He also notes that in European countries with a large numbers of cases and deaths [95] and in the U.S., [96] "many, and in many cases most, deaths occurred in nursing homes”. [97] On 6 October, Dr. Mike Ryan, director of the WHO's Health Emergencies Programme announced "Our current best estimates tell us that about 10% of the global population may have been infected by this virus."[98] Also in October, the Centre for Evidence-Based Medicine (CEBM) reported a 'presumed estimate' of global IFR at between 0.10% to 0.35%, noting that this will vary between populations due to differences in demographics.[99] These researchers noted a decrease in IFR in England over time;[100][f] and, for the UK and Italy (the two Europeans nations worst hit by COVID-19), attribute the rise in daily cases, stability in daily deaths, and shift of cases to a younger population to waning viral circulation, misapplication of testing, and misinterpretation of test results rather than to prevention, treatment, or virus mutation. [101] Case fatality rate (CFR)
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