Lower Coronavirus Fatality Rate Reported

Researchers at Oxford University updated their Global COVID-19 Case Fatality Rate (CFR) model and discovered some good news

Oxford reported the model indicates a worldwide CFR of 0.72%, as of April 9, 2020.

‘This data is the lowest end of the current CFR prediction interval and in line with several other estimates,’ wrote Jason Oke and Carl Heneghan.

‘The current COVID outbreak seems to be following previous pandemics: initial CFRs start high and trend downwards.’

‘For example, In Wuhan, the CFR has gone down from 17% in the initial phase to near 1% in the late stage.’

‘Evaluating CFR during a pandemic is, however, a very hazardous exercise, CFR rates are subject to selection bias, depending on who is tested for what reasons.’

‘Previous high-end CFR estimates should be treated with caution as the H1N1 (Swine Flu .02%) pandemic highlights that original estimates were off by a factor greater than 10.’

‘It is now essential to understand whether individuals are dying with or from the disease.’ 

‘Understanding this issue is critical.’ 

‘Cause of death information from death certificates is often inaccurate and incomplete, particularly for conditions such as pneumonia.’

‘Differences in how COVID-19 disease fatalities are attributed vary from dying with the disease (association), which is not the same as dying from the disease (causation).’

An example is a cardiovascular disease (CVD).

Most acute viral infections have 3 short-term effects on the CVD system, which can lead to miscoding, such as:

• the inflammatory response can increase the risk of an acute coronary syndrome; 
• depression of the myocardium can worsen heart failure, and,
• inflammation can unmask heart arrhythmias. 

While similar to coronaviruses, seasonal influenza infections can increase CVD fatalities significantly, and community-level rises in Influenza-like illness lead to rises in CVD mortality as well.

Disclaimer: This article has not been peer-reviewed; it should not replace individual clinical judgements and the sources cited should be checked. The views expressed in this commentary represent the views of the authors and not necessarily those of the host institution, the NHS, the NIHR, or the Department of Health and Social Care.

These CFRs are in the early stage of the SARS-CoV-2 pandemic and are subject to considerable uncertainties, which means the estimates are likely to change as more data emerges.

The researcher’s views are not a substitute for professional medical advice.

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