# Communicating the Risk of Death from Novel Coronavirus Disease (COVID-19)

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## Abstract

**:**

## 1. Introduction

## 2. Graduating from Simple Division

## 3. Infection Fatality Risk (IFR): All Infected Individuals as the Denominator

## 4. Additional Calibrations of the Ascertainment Rate

## 5. Heterogeneous risk of Death

_{i}be the risk of death of an individual i, and write the logit model in the form

## 6. Conclusions

## Author Contributions

## Funding

## Conflicts of Interest

## References

- European Centre for Disease Prevention and Control. “Situation Update—Worldwide”. 2020. Available online: https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases (accessed on 13 February 2020).
- Kelly, H.; Cowling, B.J. Case fatality: Rate, ratio, or risk? Epidemiology
**2013**, 24, 622–623. [Google Scholar] [CrossRef] [PubMed][Green Version] - Ghani, A.C.; Donnelly, C.A.; Cox, D.R.; Griffin, J.T.; Fraser, C.; Lam, T.H.; Ho, L.M.; Chan, W.S.; Anderson, R.M.; Hedley, A.J.; et al. Methods for estimating the case fatality ratio for a novel, emerging infectious disease. Am. J. Epidemiol.
**2005**, 162, 479–486. [Google Scholar] [CrossRef] [PubMed] - Nishiura, H.; Klinkenberg, D.; Roberts, M.; Heesterbeek, J.A. Early epidemiological assessment of the virulence of emerging infectious diseases: A case study of an influenza pandemic. PLoS ONE
**2009**, 4, e6852. [Google Scholar] [CrossRef] [PubMed][Green Version] - Jung, S.M.; Akhmetzhanov, A.R.; Hayashi, K.; Linton, N.M.; Yang, Y.; Yuan, B.; Kobayashi, T.; Kinoshita, R.; Nishiura, H. Real time estimation of the risk of death from novel coronavirus (2019-nCoV) infection: Inference using exported cases. J. Clin. Med.
**2020**, 9, 523. [Google Scholar] - Dorigatti, I.; Okell, L.; Cori, A.; Imai, N.; Baguelin, M.; Bhatia, S.; Boonyasiri, A.; Cucunubá, Z.; Cuomo-Dannenburg, G.; FitzJohn, R.; et al. Report 4: Severity of 2019-Novel Coronavirus (nCoV). Available online: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-2019-nCoV-severity-10-02-2020.pdf (accessed on 13 February 2020).
- Althaus, C. Estimating case Fatality Ratio of COVID-19 from Observed Cases outside China. Available online: https://github.com/calthaus/ncov-cfr (accessed on 16 February 2020).
- Nishiura, H.; Kobayashi, T.; Yang, Y.; Hayashi, K.; Miyama, T.; Kinoshita, R.; Linton, N.M.; Jung, S.M.; Yuan, B.; Suzuki, A.; et al. The rate of underascertainment of novel coronavirus (2019-nCoV) infection: Estimation using Japanese passengers data on evacuation flights. J. Clin. Med.
**2020**, 9, 419. [Google Scholar] [CrossRef] [PubMed][Green Version] - Wong, J.Y.; Wu, P.; Nishiura, H.; Goldstein, E.; Lau, E.H.; Yang, L.; Chuang, S.K.; Tsang, T.; Peiris, J.S.; Wu, J.T.; et al. Infection fatality risk of the pandemic A (H1N1) 2009 virus in Hong Kong. Am. J. Epidemiol.
**2013**, 177, 834–840. [Google Scholar] [CrossRef] [PubMed][Green Version] - Li, Q.; Guan, X.; Wu, P.; Wang, X.; Zhou, L.; Tong, Y.; Ren, R.; Leung, K.S.M.; Lau, E.H.Y.; Wong, J.Y.; et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N. Engl. J. Med.
**2020**. [Google Scholar] [CrossRef] [PubMed] - Read, J.M.; Bridgen, J.R.E.; Cummings, D.A.T.; Ho, A.; Jewell, C.P. Novel coronavirus 2019-nCoV: Early estimation of epidemiological parameters and epidemic predictions. MedRxiv
**2020**. [Google Scholar] [CrossRef][Green Version] - Poon, L.L.; Chan, K.H.; Wong, O.K.; Yam, W.C.; Yuen, K.Y.; Guan, Y.; Lo, Y.M.; Peiris, J.S. Early diagnosis of SARS coronavirus infection by real time RT-PCR. J. Clin. Virol.
**2003**, 28, 233–238. [Google Scholar] [CrossRef] [PubMed] - de Sousa, R.; Reusken, C.; Koopmans, M. MERS coronavirus: Data gaps for laboratory preparedness. J. Clin. Virol.
**2014**, 59, 4–11. [Google Scholar] [CrossRef] [PubMed] - Nishiura, H. Case fatality ratio of pandemic influenza. Lancet Infect. Dis.
**2010**, 10, 443–444. [Google Scholar] [CrossRef] - Donnelly, C.A.; Ghani, A.C.; Leung, G.M.; Hedley, A.J.; Fraser, C.; Riley, S.; Abu-Raddad, L.J.; Ho, L.M.; Thach, T.Q.; Chau, P.; et al. Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. Lancet
**2003**, 361, 1761–1766. [Google Scholar] [CrossRef][Green Version] - Mizumoto, K.; Endo, A.; Chowell, G.; Miyamatsu, Y.; Saitoh, M.; Nishiura, H. Real-time characterization of risks of death associated with the Middle East respiratory syndrome (MERS) in the Republic of Korea, 2015. BMC Med.
**2015**, 13, 228. [Google Scholar] [CrossRef] [PubMed][Green Version] - Yang, Y.; Lu, Q.; Liu, M.; Wang, Y.; Zhang, A.; Jalali, N.; Dean, N.; Longini, I.; Halloran, M.E.; Xu, B.; et al. Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China. MedRxiv
**2020**. [Google Scholar] [CrossRef][Green Version] - Linton, N.M.; Kobayashi, T.; Yang, Y.; Hayashi, K.; Akhmetzhanov, A.R.; Jung, S. ; Epidemiological characteristics of novel coronavirus infection: A statistical analysis of publicly available case data. J. Clin. Med.
**2020**, 9, 538. [Google Scholar]

**Table 1.**Confirmed case fatality risk (cCFR) with and without adjustment of the time from illness onset to death.

Locations | Unadjusted cCFR as of 14 February 2020 [1] | Adjusted cCFR [6] | 95% Confidence Intervals of cCFR [6] |
---|---|---|---|

Hubei | 2.5% | 18% | 11–81% |

Outside mainland China | 0.4% | 1–5% | 1–85% |

**Table 2.**Ascertainment rate and infection fatality risk estimates estimated from Japanese evacuees from Wuhan City, China.

Sensitivity | Virus Detection Window (Days) | |||||
---|---|---|---|---|---|---|

1 Day | 3 Days | 5 Days | ||||

q (%) | IFR (%) | q (%) | IFR (%) | q (%) | IFR (%) | |

30% | 0.2 (0.2, 0.3) | 0.02 (0.02, 0.02) | 0.7 (0.6, 0.8) | 0.06 (0.05, 0.07) | 1.1 (0.9, 1.4) | 0.10 (0.08, 0.12) |

50% | 0.4 (0.3, 0.5) | 0.03 (0.03, 0.04) | 1.1 (0.9, 1.5) | 0.10 (0.08, 0.13) | 1.9 (1.5, 2.5) | 0.16 (0.13, 0.22) |

80% | 0.6 (0.4, 0.9) | 0.05 (0.04, 0.08) | 1.8 (1.3, 2.6) | 0.16 (0.12, 0.23) | 3.1 (2.2, 4.4) | 0.27 (0.19, 0.38) |

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## Share and Cite

**MDPI and ACS Style**

Kobayashi, T.; Jung, S.-m.; Linton, N.M.; Kinoshita, R.; Hayashi, K.; Miyama, T.; Anzai, A.; Yang, Y.; Yuan, B.; Akhmetzhanov, A.R.; Suzuki, A.; Nishiura, H. Communicating the Risk of Death from Novel Coronavirus Disease (COVID-19). *J. Clin. Med.* **2020**, *9*, 580.
https://doi.org/10.3390/jcm9020580

**AMA Style**

Kobayashi T, Jung S-m, Linton NM, Kinoshita R, Hayashi K, Miyama T, Anzai A, Yang Y, Yuan B, Akhmetzhanov AR, Suzuki A, Nishiura H. Communicating the Risk of Death from Novel Coronavirus Disease (COVID-19). *Journal of Clinical Medicine*. 2020; 9(2):580.
https://doi.org/10.3390/jcm9020580

**Chicago/Turabian Style**

Kobayashi, Tetsuro, Sung-mok Jung, Natalie M. Linton, Ryo Kinoshita, Katsuma Hayashi, Takeshi Miyama, Asami Anzai, Yichi Yang, Baoyin Yuan, Andrei R. Akhmetzhanov, Ayako Suzuki, and Hiroshi Nishiura. 2020. "Communicating the Risk of Death from Novel Coronavirus Disease (COVID-19)" *Journal of Clinical Medicine* 9, no. 2: 580.
https://doi.org/10.3390/jcm9020580