COVID-19 Mortality Rate: A Grim Update

Medical staff care for patients infected with the Coronavirus in regional hospitals, Paris, France. April 1, 2020. (Thomas Samson/Reuters)

Yesterday, in explaining the decision to extend the heavy restrictions on communal and economic life, President Trump and his coronavirus task force related that we are in for a very rough next three weeks (up from what the president had just recently estimated would be two weeks). The bleak message was that things are going to get worse, much worse, before they get better.

Those of us who have been closely watching the fatality rate (see here and here) can see that we are already onto the getting-worse phase. Dramatically so.

According to the Worldometer statistics (which are consistent with those compiled by Johns Hopkins University), the U.S. mortality rate has surged to 2.16 percent (4,099 deaths out of 189,711 reported cases as of this morning). Last week, it was about 1.5 percent. The U.S. rate is still less than half of the global rate of 5 percent (44,214 deaths out of 885,301 reported cases), which itself is probably a gross understatement (unless you believe the rosy reports from China — see Jim Geraghty’s nonpareil reporting on that, here and here, as well as our Zachary Evans’s report this morning). Nevertheless, the uptick is alarming.

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Remember, Dr. Anthony Fauci has been saying the mortality rate would probably be about 1 percent, and perhaps significantly below that. Nevertheless, he concedes that current modeling projects that between 100,000 and 200,000 (or more) Americans infected with the coronavirus will perish. To revisit an oft-touted comparison, the death rate for influenza, from which tens of thousands of Americans die each year, is just 0.1 percent. (After initially analogizing COVID-19 to the flu, over which we do not shut down the country, the president rejected the analogy at yesterday’s briefing.)

I’ve been continuing to keep tabs on a daily mortality rate, based on each day’s reported deaths and new cases. To repeat, this is a rough and imperfect computation, since the newly reported deaths overwhelmingly do not arise out of the day’s newly reported cases. It is, however, a useful indication of how things are trending. Right now, it is frightening. Just ten days ago, the daily rate was hovering over 1 percent. Yesterday, it was 3.29 percent as deaths hit a record daily high of 912 (well over 300 more than on any previous day), as new cases swelled to 24,742. The numbers have been getting worse all week, with just one day (March 29) slightly under 2 percent, and most others well over it (2.70 and 2.75 percent on, respectively, March 28 and 30).

It is said that we should expect the numbers to rise because much more testing is being done. I confess to being confused by this. Obviously, additional testing would explain the spike in the number of reported cases. But the rate is the rate. One would think it would stay fairly constant regardless of the number of cases (notwithstanding the wide disparities between rates when we compare countries). In fact, if we assume the mortality rate should be around 1 percent, then one would expect that more reported cases would drive the mortality rate down. To the contrary, it is surging.

Perhaps this is a function of the weeks-long incubation and progression of COVID-19 infections. We are now seeing deaths that stem from infections that happened before drastic social-distancing restrictions, business shutdowns, and quarantines were put in place. One hopes that we will soon see the mortality rate come down as a lagging result of these measures, along with widespread additional testing. Still, we’re now told there are going to be millions of cases, so the difference between a rate of over 2 percent versus a rate of around 1 percent would be catastrophic.

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