Mortality Rate Lower Than Past Coronavirus Outbreaks, Higher Than Seasonal Flu

Patrick Goodenough | March 5, 2020 | 3:48am EST
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A health official in northern Italy, one of the regions of the world worst affected by the outbreak. (Photo by Stefano Guidi/Getty Images)
A health official in northern Italy, one of the regions of the world worst affected by the outbreak. (Photo by Stefano Guidi/Getty Images)

(Note: Many experts question the validity of the 3.4 percent COVID-19 mortality rate, since that is based on known and confirmed cases only, and doesn’t take into account many cases not known or not reported. Tom Wingfield, senior clinical lecturer and honorary consultant physician at the Liverpool School of Tropical Medicine, says, “the calculation relies on numbers of cases and deaths reported to organizations such as WHO.  Modelling studies have suggested that there are likely to be a significant proportion of cases and, to a lesser extent, deaths that go unreported.”)

( – The Wuhan coronavirus sweeping the globe currently has a mortality rate higher than that of seasonal influenza – although many, many more people die of flu – but lower than that of two previous coronavirus outbreaks since the turn of the century.

Of the 93,090 confirmed COVID-19 cases reported by the World Health Organization (WHO) as of Wednesday, 3,198 have resulted in death, providing a lethality rate right now of 3.4 percent.

(Graph: / Data: WHO)
(Graph: / Data: WHO)

In contrast, the mortality rate for severe acute respiratory syndrome coronavirus (SARS) in 2002-2003 was ten percent, and the rate for the Middle East respiratory syndrome coronavirus (MERS) in 2013 was 37 percent.

In total, 770 deaths from SARS, and 858 deaths from MERS were reported during those earlier outbreaks.

The estimated mortality rate for seasonal flu is around 0.1 percent. Although that is significantly lower than for the three coronaviruses (SARS, MERS and the virus that causes COVID-19), as millions of people get flu each year, the death toll is far higher – between 290,000 and 650,000 deaths globally each year.

Of the 3,198 COVID-19 deaths reported by the WHO as of Wednesday, 2, 984 occurred in China, where the outbreak emerged in the city of Wuhan late last year, and 215 in ten other countries.

They are: Italy (80 deaths as per WHO), Iran (77), South Korea (32), Japan (6), the United States (6), France (4), Taiwan (1), Australia (1), the Philippines (1), and Thailand (1). The remaining six fatal cases originated on the Diamond Princess cruise ship berthed in Japan.

Caution: The above figures are from the WHO and are updated once daily. The Centers for Disease Control and Prevention (CDC) on Wednesday was reporting nine deaths in the United States, and Vice President Mike Pence spoke of a tenth on Wednesday afternoon.

Real-time data compiled by the Center for Systems Science and Engineering at Johns Hopkins University, whose sources include the WHO, CDC, and equivalent bodies in China and Europe, also give higher numbers than the WHO’s daily update. Even so, the JHU numbers at the time of writing – 95,416 cases, 3,285 deaths – still equate to a 3.4 percent mortality rate.

Although the bulk of cases and deaths are in China, the pattern of spread has shifted noticeably.  For the past eight consecutive days, more new cases have been reported outside China than inside China. And the gap is widening: On Wednesday, China reported only 120 new cases while 2,103 new cases were reported in other countries.

(Graph: WHO)
(Graph: WHO)

Now, for the past two days, more deaths also have been reported outside of China than inside: 31 in China compared to 38 outside of China on Tuesday, and 38 in China compared to 48 elsewhere on Wednesday.

Speaking in Geneva this week, WHO Secretary-General Tedros Adhanom Ghebreyesus explained that while COVID-19 and flu both cause respiratory disease and spread the same way, via small droplets of fluid from the nose and mouth of a carrier, there are also important differences between the two.

From data available so far, COVID-19 does not transmit as efficiently as influenza. With flu, people who are infected but not yet sick are major drivers of transmission, he said, whereas for COVID-19, evidence from China suggests that only one percent of infected people do not have symptoms, and in most cases symptoms developed within two days.

However, COVID-19 causes more severe disease than seasonal flu, Tedros said.

“While many people globally have built up immunity to seasonal flu strains, COVID-19 is a new virus to which no one has immunity. That means more people are susceptible to infection, and some will suffer severe disease.”

“We have vaccines and therapeutics for seasonal flu, but at the moment there is no vaccine and no specific treatment for COVID-19,” he said. “However, clinical trials of therapeutics are now being done, and more than 20 vaccines are in development.”

Finally, Tedros said, containment was impossible for seasonal flu, because the number of infections are just too great.

“But it is possible for COVID-19. We don’t do contact tracing for seasonal flu – but countries should do it for COVID-19, because it will prevent infections and save lives. Containment is possible.”



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