08 May COVID-19: Estimating The Infection Fatality Rate Among Symptomatic US Patients
MedicalResearch.com Interview with:
Anirban Basu, Ph.D.
Stergachis Family Endowed Director and Professor
The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute
University of Washington, Seattle
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The infection fatality ratio (IFR) of Covid19 infections is a key parameter to model the future burden of this pandemic. Case fatality rates at any point in time provide a biased estimate of IFR because of the undercounting in both the reported number of covid deaths (numerator) and the reported number of Covid19 cases (denominator). Instead, this study looked at the temporality or time trend of the CFRs within specific counties in the US (where data were deemed to be mature) to understand the underlying IFRs that these trends allude to. It estimates county-specific IFR to range from 0.5% to 3.6%, with a population average for the US at 1.3% (95% CCI: 0.6% – 2.1%).
MedicalResearch.com: What should readers take away from your report?
Response: Covid19 infection is deadlier than flu. We can put a rest to that debate. If 20% of the US population is infected by the end of the year ( and 20% is an extremely conservative number), the current trends in social distancing and healthcare supply continue, and we eliminate the 20% of infections that would recover asymptomatically, then we are looking at an expected number of deaths of about 350K to 1.2M deaths! This is a staggering number, which can only be brought down with sound public health measures.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Understanding age-distribution of infection fatality ratios and combining these estimates with the age-distribution of the spread of the infections can help us get a more accurate picture of the death numbers. A pivotal step to fight against this virus would be to identify communities and neighborhoods where the virus is clustering. Sero-testing with smart sampling designs, pooled serum diagnostics, and contract tracer analysis can help identify these neighborhoods so that we can target our limited public health resources efficiently.
MedicalResearch.com: Is there anything else you would like to add?
Response: The infection fatality ratio estimate is itself dynamic in nature. The overall estimate can both increase or decrease in the future, depending on the the demographics where the infections will be spreading. It is possible, as the infection spreads to more rural counties of the country, the overall IFR will increase due to the lack of access to necessary health care delivery.
Disclosure: Nothing to disclose. I have worked as a consultant for various biomedical industry and health insurance companies. No funds were received for this analysis.
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