Case-Fatality Rates for COVID-19: Are we Ignoring Something?

Abstract: The availability of accurate data is of vital importance in the COVID-19 pandemic which has presented itself as a formidable challenge. The objective of our paper was to identify the flaws in simple estimates of case-fatality rate (CFR), the epidemiological indicator currently in use, and compare it to another more effective indicator, the adjusted case-fatality rate (aCFR). aCFR is defined as the number of COVID-19-associated fatalities*100/ total cases that reached outcome, i.e. death or recovery, according to the methodology of Ghani and colleagues. The results showed varying CFRs and aCFRs for several countries, signifying the problem with using CFR. Belgium is a prime example of such a case as it had a CFR of 15.82% while an aCFR of 36.38% and the number of cases in Belgium is high enough to make the discrepancy in these results significant. The deaths caused by COVID-19 are being underrepresented by CFR. It can lead to misleading results, especially when comparing countries and regions on their mortalities. Keywords: COVID-19, COVID-19 pandemic, SARS-CoV-2, 2019-nCoV, Epidemiology, Epidemiologic measurements, Case-fatality rate.