The Corner

Health Care

U.S. COVID-19 Fatality Rate Steady: About 1 Percent

A medical worker exits a tent erected to test for the coronavirus at the Brooklyn Hospital Center in Brooklyn, N.Y., March 19, 2020. (Andrew Kelly/Reuters)

Like many Americans, I’ve been tracking statistical reports about the coronavirus pandemic. In particular, I’ve been closely following Worldometer, which seems reliable, covers the globe, and gets updated frequently. It has been frustrating, though, to try to find good breakouts on fatality rate numbers.

I do not mean to suggest that this information is not out there. It just does not get the same attention as the total number of cases and the total number of deaths.

Reporting those two stats in isolation makes them seem especially alarming. If, hypothetically, on Day One there were 100 cases, and on Day 5 there were 1,000 cases, that would be a very troubling rate of increase, though it could be mitigated by a number of factors. (For example, if testing has improved in the interim, the surge in reported cases could reflect better information about the overall phenomenon, rather than just a rapid spread of the disease.) Similarly, if there were ten deaths on Day 5 after only one on Day One, that jump would seem frightening . . . but it would be a proportional increase in fatalities given the tenfold jump in reported cases — assuming the fatality rate has been reliably established.

As John McCormack noted last weekend, the omnipresent Dr. Anthony Fauci, longtime director of the National Institute of Allergies and Infectious Diseases, has testified that COVID-19 could be ten times more lethal than influenza. The latter has about a 0.1 percent fatality rate, so that suggests that the COVID-19 rate is about 1 percent. Yet, Dr. Fauci has written (in the New England Journal of Medicine), that “the case fatality rate may be considerably less than 1%,” if we assume that “the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases.”

That seems like a sensible assumption. After all, testing has skewed toward people who feel sick enough to report. We must also recognize, as Victor Davis Hanson has pointed out, that there are bound to be country-to-country variations (some of them stark) in fatality rates for the same disease due to differences in local conditions and populations. (Victor observes that the fatality rate for flu and related pneumonia is 16 times higher in Saudi Arabia than it is in Finland.)

The Worldometer charts do not break out fatality rate, so I ran some computations myself, using Worldometer’s underlying statistics. Those statistics are constantly updated. When I checked this morning, the U.S. fatality rate appeared to be about 1.5 percent (217 deaths out of 14,366 reported cases).

Our fatality rate is thus significantly lower than the global rate of 4.1 percent (10,080 out of 248,098). The U.S. number is comparable to South Korea’s 1.2 percent (100 deaths out of 8,652 cases). It is markedly better than Italy’s staggering 8.3 percent fatality rate (3,405 out of 41,035), the U.K.’s 4.4 percent (144 out of 3,269), and France’s 3.4 percent (372 out of 10,995). By contrast, we seem to be doing worse than Germany, which had lost 44 people out of 16,626 reported cases (a 0.3 percent fatality rate). I do not put much stock in the numbers out of China and Iran, whose regimes are not trustworthy. China is almost certainly lowballing at 4 percent (3,248 deaths out of 80,967 reported cases); Iran’s eye-popping 17.7 percent fatality rate (3,248 out of 18,407) is so astronomical, even compared to Italy, that I’m skeptical (though Iran is a troubled enough country that it could be reasonably accurate).

What I was most struck by was how consistent the U.S. fatality rate stayed during the most recent ten-day period.

Even as the number of newly reported cases spiked, from 290 on March 10 to 4,530 on March 19, the fatality rate hovered at slightly over 1 percent: The March 10 rate was 1.3 percent (4 deaths), and March 19 it was 1.2 percent (57 deaths). Obviously, it’s important to note that the daily deaths are not necessarily attributable to that day’s newly reported infection cases (in fact, they’re usually not).

There were some quirks over the ten days. The rate went as high as 2.6 percent on March 11 (307 new cases, eight deaths) and as low as 0.8  percent on March 12 (396 new cases, three deaths). But on the whole, and with the caveat that a ten-day stretch is too small a data set from which to draw confident conclusions, the daily rate roughly tracks the 1.5 percent fatality rate we have for total U.S. cases.

Clearly, we have to do what we can to minimize the incidence of COVID-19 infections: hygiene, social distancing, and heightened protections for especially vulnerable groups (the elderly and people with underlying medical problems). Nevertheless, there remains, as Dr. Fauci suggests, a good chance that the fatality rate could drop under 1 percent, once (a) testing is widely available and (b) more people with no symptoms or very mild cases inflate the “reported cases” category.

Again, spikes in reported cases are disturbing, and the death count is heartbreaking. Let’s keep our eye, though, on the fatality rate.

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