SARS-CoV-2 CDC Fatality Rate Update

The CDC has newly released estimates on fatality, hospitalization, and other biologic characteristics of SARS-CoV2.  [https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html] The most interesting and potentially reassuring take away is that the CDC’s best estimate now lowers the fatality rate significantly. Below is a table from the CDC listing five scenarios of best, worst and current estimates.

The CDC is estimating an overall fatality rate around 0.4%. This is much lower than the up to 13% death rate coming out of Italy.  Before going deeper in the numbers, I want to take take a moment to say that while we speak of death rates, and reassurance, each of these statistics is based on people who died, people who had friends and family that love them.  My heart goes out to the victims, their friends and family.

While the overall death rate is being projected at 0.4%, it is important to note that this is composed of very different rates across age. For those under 50 years of age the average death rate is extremely low, estimated to be 0.05%. For those 50-64 years of age the fatality rate is now thought to be 0.2%, and for those over 65 years the case fatality rate is estimated to be 1.3%. For reference, 0.2% is the fatality rate of measles in the US, one of the vaccines many Americans refuse.
​[https://www.cdc.gov/vaccines/pubs/pinkbook/meas.html]

To put this further  into perspective, I thought it may be useful to look at a person's chance of death of any cause in a given year.  This data comes from our government and is called a life table.  [https://www.ssa.gov/oact/STATS/table4c6.html]. 

After the age of 22, the chance of death from any cause in these age groups appears to remain higher than the SARS-CoV-2 estimated fatality rate. For example a 50 year old has a 0.4% chance of dying of any cause and a 0.2% chance of dying of COVID-19. A 70 year old has a 1.88% chance of dying of any cause and a 1.3% chance of dying of COVID-19.

Does this mean we can be completely free of masks and begin holding large events? Sadly, though the fatality rate is low, I don’t think the data otherwise supports that.  The hospitalization/ICU rate is what I think should drive many decisions.

The CDC estimates hospitalization rate by age from 1.7% to 7.4% with an overall hospitalization rate of 3.4% and of those between 21%- 29% will need to go to the ICU. To illustrate why this is problematic, first consider the US population of 330M, if hospitalization occurs regularly until herd immunity at an estimate of 66%, it means over 5M Americans would need to be hospitalized and over 2M would need ICU care.

With only about 63,000 ICU beds [Total less neonatal, pediatric and cardiac ICUs] https://www.aha.org/statistics/fast-facts-us-hospitals in the US and potentially over 15M ICU days needed if the disease ran its course unchecked until we reached herd immunity, excess deaths from SARS-CoV2, stroke, heart attack and other causes would likely occur as care could be unavailable. ICU availability is still our biggest weakness as our ICU’s could be over-run as we saw in Italy.

​While I do not think we should be hosting large events, I do not think we should necessarily live in a bubble.  I like the Michael Olsterholm approach of attempting to thread the rope through the needle. Slow openings to allow a slower course hopefully preventing excess deaths.

I have spent a great deal of time suggesting that we need to be aware of misinformation.  Please check references.  Social media is not a great platform for an accurate information.  Some news outlets may also not be portraying accurate information in order to grab viewers.  I find often that news outlets either don't have enough science writers or they attempt to get better viewership by sensationalizing the headline. For great information on SARS-CoV-2. Please consider looking to:


CDC: https://www.cdc.gov/coronavirus/2019-ncov/index.html
CIDRAP/ Olsterholm Report: https://www.cidrap.umn.edu/covid-19
Hospital and university news updates such as:  
​https://www.hsph.harvard.edu/coronavirus/covid-19-news-and-resources/

I hope this is helpful to you!!

~Amy 

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