Studies on COVID-19 Lethality


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20 May 2020 – Facts on Covid-19


1) Covid-19 infection fatality rates (IFR) based on antibody studies

Population-based antibody seroprevalence studies.

Country Published Population IFR (%) Source
Germany May 4 Heinsberg Cluster <0.36¹ Study
Iran May 1 Guilan province <0.12 Study
USA April 30 Santa Clara County 0.17 Study
Denmark April 28 Blood donors (<70y) 0.08 Study
USA April 24 Miami-Dade County 0.18² Report
USA April 21 Los Angeles County <0.20 Study

1) The adjusted IFR is 0.278% (see page 9 of study); 2) Based on 300 deaths.

2) Covid-19 infection fatality rates based on controlled PCR studies

Controlled PCR studies in population subgroups.

Country Date Population IFR (%) Source
USA May 10 MLB employees 0.00 Report
France May 10 Aircraft carrier 0.00 Report
USA May 10 Aircraft carrier 0.09 Report
USA May 1 Tennessee prison 0.00 Report
Italy¹ April 28 Health workers 0.30 Study
USA April 17 Boston homeless 0.00 Report
USA April 17 Boston blood donors 0.00 Report
Greece April 16 Repatriations 0.00 Study
USA April 13 NYC pregnant women 0.00 Study
1) Deaths in Italian health care workers by age group (ISS, April 28, 2020)

3) Covid-19 infection fatality rates based on models

Covid-19 IFR based on epidemiological models or predictions. These values are often higher than the actual values based on serological antibody studies (see above).

Country Published Population IFR (%) Source
France May 13 France 0.70 Study
Switzerland May 11 Switzerland 0.40 Study
UK May 7 UK 0.08¹ Study
France May 7 France 0.80² Study
Global May 5 Global 0.17 Study
India May 3 India 0.41 Study
April 20 Lombardia
New York City
China March 30 Mainland China 0.66 Study
Ship April 17 Diamond Princess 0.13³ Study
China March 13 Wuhan city 0.12 Study
China March 9 Mainland China 0.50 Study

1) Based on 29% prevalence and 50,000 deaths; 2) The IFR is 0.50 excluding nursing homes; 3) Age-adjusted IFR based on US population.

French model: IFR (x100) per age group (Study)

4) Additional antibody and PCR studies

These studies typically determine the actual prevalence of recent or current Covid-19 infections in a population. In most cases, they find that Covid-19 is much more widespread than previously assumed, with most people showing no or only mild symptoms.

Country Published Population Prev. Factor Source
USA May 15 Boston 12.5% 8x Report
Czech Rep. May 15 South Bohemia 5% 10x Report
Spain May 13 Spain
10x Study
UK May 8 UK 29% 200x Study
Switzerland May 6 Geneva 9.7% 10x Study
Global May 5 < 65 years old Study
Japan May 5 Kobe City 2.7% 396x Study
USA May 2 New York State
New York City
Spain May 2 Health workers 11.2% Study
Netherlands April 29 Blood donors 2.7% Study
France April 23 Northern France 3% Study
USA April 19 Chelsea MA 32% 16x Report
Iceland April 14 Iceland (PCR) 0.8% Study

5) Median age of Covid-19 deaths per country

Half of all deaths were below, half were above the median age.

Country Median age
Austria 80+ years EMS
England 80+ years NHS
France 84 years SPF
Germany 82 years RKI
Italy 81 years ISS
Spain ~82 years MDS
Sweden 86 years FOHM
Switzerland 84 years BAG
USA ~80 years CDC
Example: Death rate by age group in Massachusetts (Source)

7) Hospitalization rate

Initial estimates based on Chinese data assumed a very high 20% hospitalization rate, which led to the strategy of ‘flattening the curve’ to avoid overburdening hospitals. However, population-based antibody studies (see above) have since shown that actual hospitalization rates are close to 1%, which is within the range of hospitalization rates for influenza (1 to 2%).

The US CDC found that Covid-19 hospitalization rates for people aged 65 and over are “within ranges of influenza hospitalization rates”, with rates slightly higher for people aged 18 to 64 and “much lower” (compared to influenza) for people under 18.

In local hotspots like New York City, the overall hospitalization rate based on antibody studies is about 2.5% (19.9% or 1.7 million people with antibodies and 43,000 hospitalizations by May 2), which is somewhat above a severe wave of influenza.

The much lower than expected hospitalization rate may explain why most Covid-19 ‘field hospitals’ even in hard-hit countries like the US, the UK and China remained largely empty.

8) Percentage of Covid-19 deaths in care homes per country

In many countries, deaths in care homes account for 30 to 60% of all additional deaths.

Source: Mortality associated with COVID-19 outbreaks in care homes (LTC Covid, May 3, 2020)

9) Development of the epidemic

Even in countries without a lockdown, the epidemic reached its peak within a few weeks of the outbreak. However, many media showed cumulative deaths per day of report (left) instead of daily deaths per day of death (right), falsely implying an ever escalating situation.

Cumulative deaths per day of report vs. daily deaths per day of death. (OWD/FOHM; April 24)

See also

Main article: Facts on Covid-19

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