Estimating the case fatality ratio for COVID-19 using a time-shifted distribution analysis

Estimating the case fatality ratio (CFR) for COVID-19 is an important aspect of public health. However, calculating CFR accurately is problematic early in a novel disease outbreak, due to uncertainties regarding the time course of disease and difficulties in diagnosis and reporting of cases. In this...

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Bibliographic Details
Published in:Epidemiology & Infection 2021-07, Vol.149, p.e197-e197, Article e197
Main Authors: Thomas, B S, Marks, N A
Format: Article
Language:English
Subjects:
Asymptomatic
Coronaviruses
COVID-19
COVID-19 - mortality
Delay time
Disease Outbreaks - statistics & numerical data
Epidemics
Estimates
Estimation
Fatalities
Humans
Mathematical analysis
Mortality
Original Paper
Outbreaks
Parameters
Pathogens
Public health
Public Health - methods
Regression analysis
SARS-CoV-2 - physiology
Serology
Severe acute respiratory syndrome coronavirus 2
Statistical methods
Viral diseases
Virulence
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Summary:Estimating the case fatality ratio (CFR) for COVID-19 is an important aspect of public health. However, calculating CFR accurately is problematic early in a novel disease outbreak, due to uncertainties regarding the time course of disease and difficulties in diagnosis and reporting of cases. In this work, we present a simple method for calculating the CFR using only public case and death data over time by exploiting the correspondence between the time distributions of cases and deaths. The time-shifted distribution (TSD) analysis generates two parameters of interest: the delay time between reporting of cases and deaths and the CFR. These parameters converge reliably over time once the exponential growth phase has finished. Analysis is performed for early COVID-19 outbreaks in many countries, and we discuss corrections to CFR values using excess-death and seroprevalence data to estimate the infection fatality ratio (IFR). While CFR values range from 0.2% to 20% in different countries, estimates for IFR are mostly around 0.5-0.8% for countries that experienced moderate outbreaks and 1-3% for severe outbreaks. The simplicity and transparency of TSD analysis enhance its usefulness in characterizing a new disease as well as the state of the health and reporting systems.
ISSN:0950-2688
1469-4409
DOI:10.1017/S0950268821001436