Why Epidemiologists Still Don't Know the Death Rate for COVID-19

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Why Epidemiologists Still Don't Know the Death Rate for COVID-19
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Coroners in some parts of the country are overwhelmed. Funeral homes in coronavirus hot spots can barely keep up. Newspaper obituary pages in hard-hit areas go on and on. COVID-19 is on track to kill far more people in the United States this year than the seasonal flu.But determining just how deadly

Coroners in some parts of the country are overwhelmed. Funeral homes in coronavirus hot spots can barely keep up. Newspaper obituary pages in hard-hit areas go on and on. COVID-19 is on track to kill far more people in the United States this year than the seasonal flu.

In Italy, the death rate stands at about 13%, and in the United States, around 4.3%, according to the latest figures on known cases and deaths. Even in South Korea, where widespread testing helped contain the outbreak, 2% of people who tested positive for the virus have died, recent data shows. Story continuesOn top of that, deaths lag infections. The thousands of people with COVID-19 who died this week in the United States were most likely infected as far back as a month ago. So as the number of new cases reported begins to fall in hard-hit places like New York City, the death rate will almost certainly rise.

Epidemiologists call it “severity bias.” It is why the fatality rate in Wuhan, China, where the outbreak began, was reported to be between 2% and 3.4% before it was revised to 1.4%, and it may yet be lower. Facing a shortage of tests to confirm who has the disease and who does not, and fearing a shortage of ICU beds, hospitals in some areas of the United States have declined to test or admit people whose oxygen saturation is above 90%.

A clue comes from Iceland, which has tested 6% of its population, perhaps the highest proportion of any country. Of those who tested positive, 43% had no symptoms at the time, though it is likely that many developed them later. But the public should not take a false comfort in death-rate statistics that might suddenly seem lower, epidemiologists warn.

The disparity between New York, with 55 deaths per 100,000 people, and California, with two, for instance, has been widely attributed to the imposition of earlier stay-at-home orders in California, which already had a work-at-home culture prepared to embrace the restrictions.

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