The death rate of an emerging disease always looks bad in the early stages of an outbreak, but it often drops once better data become available. The coronavirus death rate hasn't dropped.
The Harvard historian Jill Lepore recounted recently in The New Yorker magazine that when democracies sink into crisis, the question “where are we going?” leaps to everyone’s mind, as if we were waiting for a weather forecast to tell us how healthy our democracy was going to be tomorrow. Quoting Italian philosopher Benedetto Croce, Lepore writes that “political problems are not external forces beyond our control; they are forces within our control.
Case fatality rate and infection fatality rate By Jan. 31, China had reported a total of 11,821 cases of COVID-19 and 259 deaths; that’s about a 2% case fatality rate. Two weeks later, the tally had risen to more than 50,000 cases and 1,524 deaths, corresponding to about 3% case fatality . For an easily transmissible disease, a 2% or 3% fatality rate is extremely dangerous.
First, some definitions from Steven Riley at Imperial College. The infection fatality rate gives the probability of dying for an infected person. The case fatality rate gives the probability of dying for an infected person who is sick enough to report to a hospital or clinic. CFR is larger than IFR, because individuals who report to hospitals are typically more severely ill.
The IFR is much more difficult to estimate than the CFR. The reason is that it is hard to count people who are mildly ill or who show no symptoms at all. If you are able to count and test everybody — for example, on a cruise ship, or in a small community — then you may be able to paint a picture of what fraction of infections are asymptomatic, mild, symptomatic and severe.
On balance, it is reasonable to guess that COVID-19 will infect as many Americans over the next year as influenza does in a typical winter — somewhere between 25 million and 115 million. Maybe a bit more if the virus turns out to be more contagious than we thought. Maybe a bit less if we put restrictions in place that minimize our travel and our social and professional contacts.
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