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new case fatality and infection fatality rate estimates for China - Printable Version

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new case fatality and infection fatality rate estimates for China - oldalum - 04-01-2020

from a study in Lancet: case fatality rate of 1.38% (1.23 to 1.53%) and infection fatality rate of 0.66% (0.39-1.33%). I did not study the methodology, but seems like it includes a lot of guesstimates.


RE: new case fatality and infection fatality rate estimates for China - BostonCard - 04-01-2020

Link to the article: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext

Quote:Using data on 24 deaths that occurred in mainland China and 165 recoveries outside of China, we estimated the mean duration from onset of symptoms to death to be 17·8 days (95% credible interval [CrI] 16·9–19·2) and to hospital discharge to be 24·7 days (22·9–28·1). In all laboratory confirmed and clinically diagnosed cases from mainland China (n=70 117), we estimated a crude case fatality ratio (adjusted for censoring) of 3·67% (95% CrI 3·56–3·80). However, after further adjusting for demography and under-ascertainment, we obtained a best estimate of the case fatality ratio in China of 1·38% (1·23–1·53), with substantially higher ratios in older age groups (0·32% [0·27–0·38] in those aged <60 years vs 6·4% [5·7–7·2] in those aged ≥60 years), up to 13·4% (11·2–15·9) in those aged 80 years or older. Estimates of case fatality ratio from international cases stratified by age were consistent with those from China (parametric estimate 1·4% [0·4–3·5] in those aged <60 years [n=360] and 4·5% [1·8–11·1] in those aged ≥60 years [n=151]). Our estimated overall infection fatality ratio for China was 0·66% (0·39–1·33), with an increasing profile with age. Similarly, estimates of the proportion of infected individuals likely to be hospitalised increased with age up to a maximum of 18·4% (11·0–7·6) in those aged 80 years or older.

They are not guesstimates, but basically try to reconstruct a number based on incomplete data sets (and one major assumption, that the attack rate is not age related).  But basically, they take data sets that have more complete ascertainment (the Diamond Princess and foreigners repatriated from Wuhan) and apply them to Wuhan to reconstruct what would have happened there with a more complete dataset.

Quote:However, it should be noted that this correction is applicable under the assumption of a uniform infection attack rate (ie, exposure) across the population. We also assumed perfect case ascertainment outside of Wuhan in the age group with the most cases relative to their population size (50–59-year-olds); however, if many cases were missed, the case fatality ratio and infection fatality ratio estimates might be lower. In the absence of random population surveys of infection prevalence, our adjustment from case fatality ratio to infection fatality ratio relied on repatriation flight data, which was not age specific. The reported proportion of infected individuals who were asymptomatic on the Diamond Princess did not vary considerably by age, supporting this approach, but future larger representative population prevalence surveys and seroprevalence surveys will inform such estimates further.

BC