On July 27, 2020, the number of confirmed cases was 16,523,815
 worldwide, with 655,112 deaths resulting in a crude fatality rate of 4.0%..

Case Fatality Rate of COVID-19

The sum of all stages of the product of the probability of dying from the disease at a given stage and the probability of surviving to that stage. The case fatality risk proportion of COVID-19 is less often used than case fatality rate and is still being determined with ongoing research.

Case Fatality Risk Proportion of COVID-19

Fatality of COVID-19 by Continent

When identifying COVID-19 associated deaths, it's important to understand what methods are being used to compile the fatality statistics. It is possible to underestimate the severity of the pandemic if deaths aren't appropriately accounted for.
- Confirmed COVID-19 associated death
- Probable COVID-19 associated death
- Excess death

Types of COVID-19 Associated Deaths

African American/black individuals had a much higher mortality rate (73 COVID-19 cases per 100 000 individuals) compared to Latino individuals (36 COVID-19 cases per 100000 individuals) and White individuals (22 COVID-19 cases per 100000 individuals).

COVID-19 Mortality Differences by Race, United States

As of May 7, 2020 in New York City, NY,  there was greater age-adjusted COVID-19 mortality rates of Latino individuals (187 per 100 000) and African American individuals (184 per 100 000), than of White (93 per 100 000) individuals. 

COVID-19 Mortality Differences by Race, NYC, United States

Studies of COVID-19 Patient Mortality Categorized by Geographic Region 

IFR stands for infection mortality rate and it represents the proportion of infected people who will die (including those who don't get tested/don't show symptoms). It is one of the most important statistics when studying disease. The current best estimate of COVID-19 is 0.5-1%.

IFR of COVID-19

- Breastfeeding Medicine
- Bulletin Of Mathematical Biology
- Intensive Care Medicine 
- Journal of Risk Research
- Journal of the American Medical Association (JAMA)
- MedRxIV
- New journal
- Resuscitation
- Social Science Research Network (SSRN)
- The Lancet
- The New England Journal of Medicine

COVID-19 Fatality References by Journal/Source

Due to differences in testing and case definitions, as well as how new COVID-19 is, the fatality of the virus is not well-defined yet.

University of Michigan - Ann Arbor

- Case Demographics of Patients
- Categorized by Geographic Location
- Communicable Period
- Control Strategies
- Disparate COVID-19 Outcomes
- Fatality
- Interventions
- Patient Comorbidities
- Patient Laboratory Results
- Psychological effects
- Recovery & Rehabilitation
- Re-opening of Childcare/ Educational Environments
- Secondary Infections
- Signs
- Symptomology
- Time from Onset to Reporting
- Telehealth (telemedicine)
- Transmission
- Risk Factors
- COVID-19 Vaccination Uptake

Focuses of Epidemiological studies on COVID-19

World Health Organization

Norman E. Fenton, Martin Neil, Magda Osman & Scott McLachlan
Journal of Risk Research, DOI: 10.1080/13669877.2020.1756381
Received: April 7, 2020
Accepted April 10, 2020
Published online: April 24, 2020
https://www.tandfonline.com/doi/full/10.1080/13669877.2020.1756381


COVID-19 infection and death rates: the need to incorporate causal explanations for the data and avoid bias in testing

Fatality of COVID-19

Countries have implemented multiple control strategies for reducing the spread of COVID-19, such as closing schools and businesses to enforce social distancing.

Struggle pertaining to controlling the virus:
The epidemiology of the respiratory virus changes rapidly. Reponses have to be nimble. Given that everyone is susceptible to for which we lack effective biologic interventions, the response has required large-scale behavior change, including social distancing and public masking.

Control Strategies for COVID-19

- Age
- Education
- Employment
- Ethnicity
- Gender
- Income
- Marital status
- Race





Case Demographics of Patients with COVID-19

- Asia
- Africa 
- North America
- South America
- Europe
- Australia & Oceania 

Epidemiological studies on COVID-19 Categorized by Continents

The progression of COVID-19 varies greatly by individual and demographic, as do many of the factors related to the disease. Studies have been analyzing the disease progression timeline, or the time frames before patients feel symptoms, are admitted to the hospital, are admitted to the ICU, are put on a mechanical ventilator, experience acute respiratory distress syndrome, etc. Not every COVID-19 case will reach each of these events.

COVID-19 Clinical Disease Progression Timeline

- 0-19 (n=123): 0%
- 20-44 (n=705): 0.1–0.2%
- 45-54 (n=429): 0.5–0.8%
- 55-64 (n=429): 1.4–2.6%
- 65-74 (n=409): 2.7–4.9%
- 75-84 (n=210): 4.3–10.5%
- greater than or equal to 85 (n=144): 10.4–27.3%
- Total (n=2,449): 1.8–3.4%

Case-Fatality Among COVID-19 Patients in the United States by Age

Following a primary infection of SARS-CoV-2, some patients acquire a secondary infection of SARS-CoV-2, or a co-infection with a different bacteria or virus

Secondary/Co-Infections of COVID-19

COVID-19 patients have gone through laboratory testing to determine the impact and extent of SARS-CoV-2 on the body.

COVID-19 Laboratory Results

The spread of the SARS-CoV-2 virus has produced or highlighted disparate outcomes of different types between population groups all over the world. Health disparities can highlight inequitable access, treatment, etc. within a country or state and often indicate the need for public health intervention.

Disparate COVID-19 Outcomes

Due to the varying experiences for those with COVID-19, recovery and rehabilitation look different for many individuals. As a baseline, "for persons recovered from COVID-19 illness, CDC recommends that isolation be maintained for at least 10 days after illness onset and at least 3 days (72 hours) after recovery. Illness onset is defined as the date symptoms begin. Recovery is defined as resolution of fever without the use of fever-reducing medications with progressive improvement or resolution of other symptoms. Ideally, isolation should be maintained for this full period to the extent that it is practicable under rapidly changing circumstances."

COVID-19 Recovery & Rehabilitation

- Resuscitation
- Convalescent Plasma (CP) Transfusion

COVID-19 Patient Interventions

The seroprevalence of COVID-19 is the measurement of the level of the pathogen in a population. There have been difficulties with estimating the seroprevalence in large populations because of the unknown qualities of COVID-19, expense in widespread population collection, asymptomatic infection, etc.

Seroprevalence of SARS-CoV-2 (COVID-19) 

A communicable period is defined as the interval from the first day of positive ribonucleic acid test to the first day of continuous negative test. For COVID-19, the communicable period has been established as two days before onset of symptoms until three days of symptom relief and no fever. 

Communicable Period of COVID-19

- Fever (when high temperature is measured)
- Laboratory confirmation of illness via viral testing
- Radiological lung abnormalities such as ground-glass chest and stripe shadowing


Clinical Characteristics of Asymptomatic COVID-19 Patients

Telehealth are health-related services and information through electronic communication technologies to help patients with or people influenced by COVID-19. It allows long-distance patient and clinician care, education, and monitoring. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. 

Telehealth (telemedicine) and COVID-19

Presence and severity of symptoms of COVID-19 depend largely on individual characteristics. COVID-19 produces both symptomatic and asymptomatic infection.

Symptomology of COVID-19 

The psychological effect COVID-19 is having on the populations affected by the pandemic

Psychological Effects of COVID-19 Pandemic

COVID-19 comorbidities are high risk conditions that put patients at greater risk for infection and negative outcomes. Some COVID-19 comorbidities have been found to be: 
- Cancer 
- Cardiovascular Disease
- Diabetes
- Digestive Diseases
- HIV
- Hypertension
- Immunological Disease
- Liver Injury
- Obesity
- Renal disease
- Respiratory System Disease

COVID-19 Patient Comorbidities

- Schools (K-12)

- Universities/Colleges

- Summer Camps

- Daycares

- Nurseries

Re-opening Childcare/ Educational Environments

COVID-19 is spread through person-to-person transmission. The virus spreads mainly through close personal contact (such as when people are within 6 feet of one another) and through the respiratory droplets of someone infected with COVID-19.  Aerosol transmission is also likely, but the relative contribution of these smaller respiratory particles is not completely understood. While less common, spreading can also occur when people touch contaminated objects or surfaces and then their faces, eyes, or mouth. 

Transmission of COVID-19

- smoking
- high BMI
- old age
- congregate housing
- environmental conditions
- Immune system conditions

Risk Factors For COVID-19

We can explore factors that affect the uptake of established adult vaccinations to inform efforts of COVID-19 vaccine acceptance. 

- Social Factors 
- Knowledge, Attitudes, and Beliefs
- Racial Factors
- Age

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