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Do not fill this in! === Deaths === {{Main|COVID-19 pandemic deaths|COVID-19 pandemic death rates by country}} {{Further|List of deaths due to COVID-19}} [[File:COVID19 deceased in Hackensack NJ April 27.jpg|thumb|The deceased in a refrigerated "mobile morgue" outside a hospital in [[Hackensack, New Jersey]], US, in April 2020]] [[File:Covid-19 São Paulo - Cemiterios.jpg|thumb|Gravediggers bury the body of a man suspected of having died of COVID-19 in the cemetery of Vila Alpina, east side of [[São Paulo]], in April 2020.]] [[File:Global excess and reported COVID-19 deaths and death rates per 100,000 population.webp|thumb|Global excess and reported COVID-19 deaths and deaths per 100,000 according to the WHO study<ref name="10.1038/s41586-022-05522-2"/>]] As of {{Cases in the COVID-19 pandemic|date|editlink=|ref=no}}, more than {{Cases in the COVID-19 pandemic|dround|editlink=|ref=yes}} deaths had been attributed to COVID-19. The first confirmed death was in Wuhan on 9 January 2020.<ref name="AutoDW-25" /> These numbers vary by region and over time, influenced by testing volume, healthcare system quality, treatment options, government response,<ref>Multiple sources: * {{#invoke:cite magazine||title=The Best Global Responses to the COVID-19 Pandemic|url=https://time.com/5851633/best-global-responses-covid-19/|magazine=Time|access-date=18 August 2020}} * {{#invoke:cite web||date=11 May 2020|title=Portugal and Spain: same peninsula, very different coronavirus impact|url=https://english.elpais.com/spanish_news/2020-05-11/portugal-and-spain-same-peninsula-very-different-coronavirus-impact.html|access-date=25 May 2020|website=El País|vauthors=Barrio PL, del Javier M}} * {{#invoke:cite news||date=5 April 2020|title=Fewer deaths in Veneto offer clues for fight against virus|website=Financial Times|url=https://www.ft.com/content/9c75d47f-49ee-4613-add1-a692b97d95d3|access-date=25 May 2020|vauthors=Johnson M}}</ref> time since the initial outbreak, and population characteristics, such as age, sex, and overall health.<ref name="worldindata">{{#invoke:cite journal||vauthors=Ritchie H, Roser M|date=25 March 2020|title=What do we know about the risk of dying from COVID-19?|url=https://ourworldindata.org/covid-mortality-risk|journal=[[Our World in Data]]|access-date=28 March 2020|veditors=Chivers T}}</ref> Multiple measures are used to quantify mortality.<ref name="wBm2a">{{#invoke:cite web||date=18 February 2019|title=Principles of Epidemiology {{!}} Lesson 3 – Section 3|url=https://www.cdc.gov/csels/dsepd/ss1978/lesson3/section3.html|access-date=28 March 2020|website=US [[Centers for Disease Control and Prevention]] (CDC)}}</ref> Official death counts typically include people who died after testing positive. Such counts exclude deaths without a test.<ref name="20200331reuters">{{#invoke:cite news||date=31 March 2020|title=Italy's coronavirus deaths could be underestimated in data: Official|work=Reuters|url=https://www.reuters.com/article/us-health-coronavirus-italy-data/italys-coronavirus-deaths-could-be-underestimated-in-data-official-idUSKBN21I250}}</ref> Conversely, deaths of people who died from underlying conditions following a positive test may be included.<ref name="stuff120443722">{{#invoke:cite web || title=Coronavirus: Is Covid-19 really the cause of all the fatalities in Italy?|url=https://www.stuff.co.nz/national/health/coronavirus/120443722/coronavirus-is-covid19-really-the-cause-of-all-the-fatalities-in-italy|access-date=16 April 2020|website=Stuff|date=20 March 2020}}</ref> Countries such as Belgium include deaths from suspected cases, including those without a test, thereby increasing counts.<ref name="npr841005901">{{#invoke:cite news|| vauthors = Schultz T |date=22 April 2020|title=Why Belgium's Death Rate Is So High: It Counts Lots Of Suspected COVID-19 Cases|newspaper=NPR|url=https://www.npr.org/sections/coronavirus-live-updates/2020/04/22/841005901/why-belgiums-death-rate-is-so-high-it-counts-lots-of-suspected-covid-19-cases|access-date=25 April 2020}}</ref> Official death counts have been claimed to underreport the actual death toll, because [[Mortality displacement|excess mortality]] (the number of deaths in a period compared to a long-term average) data show an increase in deaths that is not explained by COVID-19 deaths alone.<ref name=":7">{{#invoke:cite news||title=Tracking covid-19 excess deaths across countries|newspaper=The Economist|url=https://www.economist.com/graphic-detail/coronavirus-excess-deaths-tracker|access-date=6 November 2022}}</ref> Using such data, estimates of the true number of deaths from COVID-19 worldwide have included a range from 18.2 to 33.5 million (≈27.4 million) by 18 November 2023 by ''[[The Economist]]'',<ref name=Economist2023 /><ref name=":7" /> as well as over 18.5 million by 1 April 2023 by the [[Institute for Health Metrics and Evaluation]]<ref name="COVID-19 Projections">{{#invoke:cite web || title=COVID-19 Projections|url=https://covid19.healthdata.org/|access-date=20 January 2022|website=Institute for Health Metrics and Evaluation}}</ref> and ≈18.2 million (earlier) deaths between 1 January 2020, and 31 December 2021, by a comprehensive international study.<ref name="10.1016/S0140-6736(21)02796-3">{{#invoke:cite journal || title = Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21 | journal = Lancet | volume = 399 | issue = 10334 | pages = 1513–1536 | date = April 2022 | pmid = 35279232 | pmc = 8912932 | doi = 10.1016/S0140-6736(21)02796-3 | last1 = Wang | first1 = Haidong | last2 = Paulson | first2 = Katherine R. | last3 = Pease | first3 = Spencer A. | last4 = Watson | first4 = Stefanie | last5 = Comfort | first5 = Haley | last6 = Zheng | first6 = Peng | last7 = Aravkin | first7 = Aleksandr Y. | last8 = Bisignano | first8 = Catherine | last9 = Barber | first9 = Ryan M. | last10 = Alam | first10 = Tahiya | last11 = Fuller | first11 = John E. | last12 = May | first12 = Erin A. | last13 = Jones | first13 = Darwin Phan | last14 = Frisch | first14 = Meghan E. | last15 = Abbafati | first15 = Cristiana | last16 = Adolph | first16 = Christopher | last17 = Allorant | first17 = Adrien | last18 = Amlag | first18 = Joanne O. | last19 = Bang-Jensen | first19 = Bree | last20 = Bertolacci | first20 = Gregory J. | last21 = Bloom | first21 = Sabina S. | last22 = Carter | first22 = Austin | last23 = Castro | first23 = Emma | last24 = Chakrabarti | first24 = Suman | last25 = Chattopadhyay | first25 = Jhilik | last26 = Cogen | first26 = Rebecca M. | last27 = Collins | first27 = James K. | last28 = Cooperrider | first28 = Kimberly | last29 = Dai | first29 = Xiaochen | last30 = Dangel | first30 = William James }}<br />News article about the study: {{#invoke:cite journal || vauthors = Adam D | title = COVID's true death toll: much higher than official records | journal = Nature | volume = 603 | issue = 7902 | page = 562 | date = March 2022 | pmid = 35277684 | doi = 10.1038/d41586-022-00708-0 | s2cid = 247407282 | bibcode = 2022Natur.603..562A }}</ref> Such deaths include deaths due to healthcare capacity constraints and priorities, as well as reluctance to seek care (to avoid possible infection).<ref name="20200429reason">{{#invoke:cite web || date=29 April 2020|title=What 'Excess Deaths' Do and Don't Tell Us About COVID-19|url=https://reason.com/2020/04/29/what-excess-deaths-do-and-dont-tell-us-about-covid-19/|access-date=4 May 2020|website=Reason}}</ref> Further research may help distinguish the proportions directly caused by COVID-19 from those caused by indirect consequences of the pandemic.<ref name="10.1016/S0140-6736(21)02796-3"/><!--as well as from potential likely coincidental concurrent increases or issues with the expected deaths modelling/data.--> In May 2022, the WHO estimated the number of excess deaths by the end of 2021 to be 14.9 million compared to 5.4 million reported COVID-19 deaths, with the majority of the unreported 9.5 million deaths believed to be direct deaths due the virus, rather than indirect deaths. Some deaths were because [[Impact of the COVID-19 pandemic on other health issues|people with other conditions could not access medical services]].<ref>{{#invoke:cite news ||url=https://www.bbc.co.uk/news/health-61327778 |title=Covid: World's true pandemic death toll nearly 15 million, says WHO|first1= Naomi |last1=Grimley|first2= Jack |last2=Cornish|first3= Nassos |last3=Stylianou|work=BBC News |date=5 May 2022}}</ref><ref>{{#invoke:cite news ||title=Nearly 15 million deaths directly or indirectly linked to COVID-19 {{!}} UN News |url=https://news.un.org/en/story/2022/05/1117582 |access-date=4 February 2023 |work=news.un.org |date=5 May 2022 }}</ref> A December 2022 [[WHO]] study estimated excess deaths from the pandemic during 2020 and 2021, again concluding ≈14.8 million excess early deaths occurred, reaffirming and detailing their prior calculations from May as well as updating them, addressing criticisms. These numbers do not include measures like [[years of potential life lost]] and may make the pandemic 2021's [[List of causes of death by rate|leading cause of death]].<ref>{{#invoke:cite news ||title=Nearly 15 million excess deaths occurred globally in 2020 and 2021 |url=https://www.newscientist.com/article/2351763-nearly-15-million-excess-deaths-occurred-globally-in-2020-and-2021/ |access-date=17 January 2023 |work=New Scientist}}</ref><ref>{{#invoke:cite web ||title=Globale Übersterblichkeit durch COVID-19 |url=https://www.sciencemediacenter.de/alle-angebote/research-in-context/details/news/globale-uebersterblichkeit-durch-covid-19/ |website=www.sciencemediacenter.de |access-date=17 January 2023 }}</ref><ref name="10.1038/s41586-022-05522-2">{{#invoke:cite journal ||last1=Msemburi |first1=William |last2=Karlinsky |first2=Ariel |last3=Knutson |first3=Victoria |last4=Aleshin-Guendel |first4=Serge |last5=Chatterji |first5=Somnath |last6=Wakefield |first6=Jon |title=The WHO estimates of excess mortality associated with the COVID-19 pandemic |journal=Nature |date=January 2023 |volume=613 |issue=7942 |pages=130–137 |doi=10.1038/s41586-022-05522-2 |pmid=36517599 |pmc=9812776 |bibcode=2023Natur.613..130M |issn=1476-4687|doi-access=free}}</ref> The time between symptom onset and death ranges from{{nbsp}}6 to 41 days, typically about 14 days.<ref name="pathogenesis" /> Mortality rates increase as a function of age. People at the greatest mortality risk are the elderly and those with underlying conditions.<ref>{{#invoke:cite journal || vauthors = Yanez ND, Weiss NS, Romand JA, Treggiari MM | title = COVID-19 mortality risk for older men and women | journal = BMC Public Health | volume = 20 | issue = 1 | page = 1742 | date = November 2020 | pmid = 33213391 | pmc = 7675386 | doi = 10.1186/s12889-020-09826-8 |doi-access=free}}</ref><ref name="6XONR">{{#invoke:cite web || date=15 March 2021|title=People with Certain Medical Conditions|url=https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html|access-date=19 March 2021|website=Centers for Disease Control and Prevention}}</ref> <br> <gallery mode="packed" widths="360px" heights="160"> File:Covid-19 daily deaths in top 5 countries and the world.png|Semi-log plot of weekly deaths due to COVID-19 in the world and top six current countries (mean with cases) File:Mapping estimated P-scores (excess deaths relative to expected deaths).webp|alt=Excess deaths relative to expected deaths (the patterns indicate the quality of the all-cause mortality data that were available for each respective country)|Excess deaths relative to expected deaths (The patterns indicate the quality of the all-cause mortality data that were available for each respective country.)<ref name="10.1038/s41586-022-05522-2"/> File:COVID-19 pandemic excess deaths - global and WHO region P-scores (excess deaths relative to expected deaths).webp|Excess deaths relative to expected deaths (global and WHO region)<ref name="10.1038/s41586-022-05522-2"/> File:The 25 countries with the highest total estimated COVID-19 pandemic excess deaths between January 2020 and December 2021.webp|The 25 countries with the highest total estimated COVID-19 pandemic excess deaths between January 2020 and December 2021<ref name="10.1038/s41586-022-05522-2"/> File:The 25 countries with the highest mean P-scores (excess deaths relative to expected deaths).webp|The 25 countries with the highest mean P-scores (excess deaths relative to expected deaths)<ref name="10.1038/s41586-022-05522-2"/> </gallery> ==== Infection fatality ratio (IFR) ==== {{See also|List of human disease case fatality rates}} {| class="wikitable floatright" |+ class="nowrap" | IFR estimate per <br />age group<ref name="EJE_levinetal" /> |- ! Age group !! IFR |- | 0–34 || 0.004% |- | 35–44 || 0.068% |- | 45–54 || 0.23% |- | 55–64 || 0.75% |- | 65–74 || 2.5% |- | 75–84 || 8.5% |- | 85 + || 28.3% |} The [[Infection fatality rate|infection fatality ratio]] (IFR) is the cumulative number of deaths attributed to the disease divided by the cumulative number of infected individuals (including asymptomatic and undiagnosed infections and excluding vaccinated infected individuals).<ref name="fjMw6">{{#invoke:cite web || vauthors = Tate N |title=What Changing Death Rates Tell Us About COVID-19|url=https://www.webmd.com/lung/news/20200901/what-changing-death-rates-tell-us-about-covid|access-date=19 September 2020|website=WebMD}}</ref><ref name="WHOest">{{#invoke:cite web || date=4 August 2020|title=Estimating mortality from COVID-19|url=https://www.who.int/news-room/commentaries/detail/estimating-mortality-from-covid-19|access-date=21 September 2020|publisher=World Health Organization}}</ref><ref name="ovoEx">{{#invoke:cite web ||date=11 February 2020|title=Coronavirus Disease 2019 (COVID-19)|url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html|access-date=19 September 2020|website=Centers for Disease Control and Prevention}}</ref> It is expressed in percentage points.<ref>Multiple sources: * {{#invoke:cite journal || vauthors = Mallapaty S | title = How deadly is the coronavirus? Scientists are close to an answer | journal = Nature | volume = 582 | issue = 7813 | pages = 467–468 | date = June 2020 | pmid = 32546810 | doi = 10.1038/d41586-020-01738-2 | s2cid = 219726496 | doi-access = free | bibcode = 2020Natur.582..467M }} * {{#invoke:cite journal || vauthors = Alwan NA, Burgess RA, Ashworth S, Beale R, Bhadelia N, Bogaert D, Dowd J, Eckerle I, Goldman LR, Greenhalgh T, Gurdasani D, Hamdy A, Hanage WP, Hodcroft EB, Hyde Z, Kellam P, Kelly-Irving M, Krammer F, Lipsitch M, McNally A, McKee M, Nouri A, Pimenta D, Priesemann V, Rutter H, Silver J, Sridhar D, Swanton C, Walensky RP, Yamey G, Ziauddeen H | title = Scientific consensus on the COVID-19 pandemic: we need to act now | journal = Lancet | volume = 396 | issue = 10260 | pages = e71–e72 | date = October 2020 | pmid = 33069277 | pmc = 7557300 | doi = 10.1016/S0140-6736(20)32153-X }} * {{#invoke:cite journal || vauthors = Meyerowitz-Katz G, Merone L | title = A systematic review and meta-analysis of published research data on COVID-19 infection fatality rates | journal = International Journal of Infectious Diseases | volume = 101 | pages = 138–148 | date = December 2020 | pmid = 33007452 | pmc = 7524446 | doi = 10.1016/j.ijid.2020.09.1464 }}</ref> Other studies refer to this metric as the ''infection fatality risk''.<ref>{{#invoke:cite journal || vauthors = Yang W, Kandula S, Huynh M, Greene SK, Van Wye G, Li W, Chan HT, McGibbon E, Yeung A, Olson D, Fine A, Shaman J | title = Estimating the infection-fatality risk of SARS-CoV-2 in New York City during the spring 2020 pandemic wave: a model-based analysis | journal = The Lancet. Infectious Diseases | volume = 21 | issue = 2 | pages = 203–212 | date = February 2021 | pmid = 33091374 | pmc = 7572090 | doi = 10.1016/S1473-3099(20)30769-6 }}</ref><ref>{{#invoke:cite journal || vauthors = Pastor-Barriuso R, Pérez-Gómez B, Hernán MA, Pérez-Olmeda M, Yotti R, Oteo-Iglesias J, Sanmartín JL, León-Gómez I, Fernández-García A, Fernández-Navarro P, Cruz I, Martín M, Delgado-Sanz C, Fernández de Larrea N, León Paniagua J, Muñoz-Montalvo JF, Blanco F, Larrauri A, Pollán M | title = Infection fatality risk for SARS-CoV-2 in community dwelling population of Spain: nationwide seroepidemiological study | journal = BMJ | volume = 371 | pages = m4509 | date = November 2020 | pmid = 33246972 | pmc = 7690290 | doi = 10.1136/bmj.m4509 }}</ref> In November 2020, a review article in [[Nature (journal)|''Nature'']] reported estimates of population-weighted IFRs for various countries, excluding deaths in elderly care facilities, and found a median range of 0.24% to 1.49%.<ref>{{#invoke:cite journal || vauthors = O'Driscoll M, Ribeiro Dos Santos G, Wang L, Cummings DA, Azman AS, Paireau J, Fontanet A, Cauchemez S, Salje H | title = Age-specific mortality and immunity patterns of SARS-CoV-2 | journal = Nature | volume = 590 | issue = 7844 | pages = 140–145 | date = February 2021 | pmid = 33137809 | doi = 10.1038/s41586-020-2918-0 | bibcode = 2021Natur.590..140O | s2cid = 226244375 | doi-access = free }}</ref> IFRs rise as a function of age (from 0.002% at age 10 and 0.01% at age 25, to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85). These rates vary by a factor of ≈10,000 across the age groups.<ref name="EJE_levinetal" /> For comparison, the IFR for middle-aged adults is two orders of magnitude higher than the annualised risk of a fatal automobile accident and much higher than the risk of dying from [[seasonal influenza]].<ref name="EJE_levinetal" /> In December 2020, a systematic review and meta-analysis estimated that population-weighted IFR was 0.5% to 1% in some countries (France, Netherlands, New Zealand, and Portugal), 1% to 2% in other countries (Australia, England, Lithuania, and Spain), and about 2.5% in Italy. This study reported that most of the differences reflected corresponding differences in the population's age structure and the age-specific pattern of infections.<ref name="EJE_levinetal">{{#invoke:cite journal || vauthors = Levin AT, Hanage WP, Owusu-Boaitey N, Cochran KB, Walsh SP, Meyerowitz-Katz G | title = Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications | journal = European Journal of Epidemiology | volume = 35 | issue = 12 | pages = 1123–1138 | date = December 2020 | pmid = 33289900 | pmc = 7721859 | doi = 10.1007/s10654-020-00698-1 | doi-access = free }}</ref> There have also been reviews that have compared the fatality rate of this pandemic with prior pandemics, such as MERS-CoV.<ref>{{#invoke:cite journal ||last1=Pitlik |first1=SD |title=COVID-19 Compared to Other Pandemic Diseases. |journal=Rambam Maimonides Medical Journal |date=31 July 2020 |volume=11 |issue=3 |pages=e0027 |doi=10.5041/RMMJ.10418 |pmid=32792043 |pmc=7426550 }}</ref> For comparison the infection mortality rate of seasonal flu in the United States is 0.1%, which is 13 times lower than COVID-19.<ref>{{#invoke:cite book ||last1=Spence |first1=Nicholas D. |last2=Sekercioglu |first2=Fatih |title=Indigenous Health and Well-Being in the COVID-19 Pandemic |date=31 August 2022 |publisher=Taylor & Francis |isbn=978-1-000-64420-3 |url=https://books.google.com/books?id=CA5_EAAAQBAJ&dq=infection+fatality+ratio++influenza++is+0.1%25+united+states&pg=PT125 |access-date=12 May 2023 }}</ref> ==== Case fatality ratio (CFR) ==== Another metric in assessing death rate is the [[case fatality rate|case fatality ratio]] (CFR),{{efn|Some refer to "fatality rate"; however, "fatality ratio" is more accurate as this is not per unit time.<ref name="WHOest" />}} which is the ratio of deaths to diagnoses. This metric can be misleading because of the delay between symptom onset and death and because testing focuses on symptomatic individuals.<ref name="Hauser 2020">{{#invoke:cite journal||vauthors=Hauser A, Counotte MJ, Margossian CC, Konstantinoudis G, Low N, Althaus CL, Riou J|date=July 2020|title=Estimation of SARS-CoV-2 mortality during the early stages of an epidemic: A modeling study in Hubei, China, and six regions in Europe|journal=PLOS Medicine|volume=17|issue=7|pages=e1003189|doi=10.1371/journal.pmed.1003189|pmc=7386608|pmid=32722715|doi-access=free}}</ref> Based on [[Johns Hopkins University]] statistics, the global CFR is {{replace|{{Cases in the COVID-19 pandemic|ratio|editlink=|ref=no}}|%| percent}} ({{Cases in the COVID-19 pandemic|deaths|editlink=|ref=no}} deaths for {{Cases in the COVID-19 pandemic|confirmed|editlink=|ref=no}} cases) as of {{Cases in the COVID-19 pandemic|date|editlink=|ref=no}}.{{Cases in the COVID-19 pandemic|ref=yes}} The number varies by region and has generally declined over time.<ref name="b0L7I">{{#invoke:cite journal||vauthors=Lazzerini M, Putoto G|date=May 2020|title=COVID-19 in Italy: momentous decisions and many uncertainties|journal=The Lancet. Global Health|volume=8|issue=5|pages=e641–e642|doi=10.1016/S2214-109X(20)30110-8|pmc=7104294|pmid=32199072}}</ref> Summary: Please note that all contributions to Christianpedia may be edited, altered, or removed by other contributors. If you do not want your writing to be edited mercilessly, then do not submit it here. You are also promising us that you wrote this yourself, or copied it from a public domain or similar free resource (see Christianpedia:Copyrights for details). Do not submit copyrighted work without permission! Cancel Editing help (opens in new window) Discuss this page