Is COVID-19 more deadly than we thought?


Among the key questions shaping the debate around restrictive health measures to combat COVID-19 is the danger of the new coronavirus. Is it more like a bad strain of the flu, or is it more deadly?

Health experts say it is too early in the pandemic for a definitive answer because the basic information for making this calculation – how many people have contracted COVID-19 and how many have died – is not fully known due to the test limits.

But on March 3, before the rapid spread of cases led to closings in the United States, the director general of the World Health Organization reported that “worldwide, approximately 3.4% of COVID- 19 reported died ”and“ by comparison, seasonal flu in general kills well under 1% of those infected. “

Today, according to the global number of WHO cases and deaths, the COVID-19 death rate worldwide is double what it announced in March – 7%. Other organizations that track the numbers, such as Johns Hopkins University, show a similar overall death rate. At the regional level, the figures vary more. WHO and Johns Hopkins figures for the United States indicate a rate of approximately 6%, while WHO figures for Europe indicate a rate of 9%.

“COVID19 is a pretty serious illness,” said Dr. Heng Duong of the Santa Clara Valley Medical Center, who lowered similar death rates at the Santa Clara County Supervisory Board this week. “It is true that most people are fine. But when people get sick, they get really sick. “

In comparison, SARS – severe acute respiratory syndrome – caused by a cousin of the new coronavirus killed 774 – 10% – of the 8,098 people it infected during a 2003 epidemic, according to the Centers for Disease Control and Prevention of United States. But the virus has not proven to be as contagious, so it has not spread far.

The 1918-19 influenza pandemic, one of the most severe in history, which killed an estimated 50 million people worldwide and 675,000 in the United States, would generally have a fatality rate of more than 2, 5%.

Duong and other experts said that the true case fatality rate for COVID-19 could be much lower since there are likely to be a large number of people who have been infected with mild symptoms and have not been confirmed by tests, which have been primarily focused on those seeking hospital treatment or in high-risk environments.

But Duong added that “even if the fatality rate is closer to 1%, it is actually very high,” noting that the fatality rate for seasonal flu is around one-tenth of it.

In the United States, 80% of deaths from COVID-19 have been recorded among those 65 and older, according to the CDC.

What does all this mean for us? Dr. Robert Siegel, professor of microbiology and immunology at Stanford University, said that the relative danger of the disease was part of a bitter struggle between advocates and critics of public health bans to verify the spread of the virus. But the rate of specific cases ultimately doesn’t matter – the public health response will be the same.

“There is a political component to how these things are estimated,” said Siegel. “The fact is, we know it is a serious illness. We already know that it’s more serious than the flu. If you get the disease and the case fatality rate is 1% or the case fatality rate is 5%, I think you treat them the same way. It would be an alarming rate – you would not be playing Russian roulette with these odds. If it’s 1 in a million, it’s something else. “

The debate arises amid recent reports recognizing a wider range of symptoms and complications in many cases of COVID-19 – from “COVID toe” skin damage and loss of smell to kidney, heart and neurological damage , blood clots and strokes. Duong noted that the flu can also cause some of these symptoms, although the frequency was higher with COVID-19. Yet he said that about eight in ten people infected with the disease are able to cope at home.


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