I think it varies from country to country according to their living conditions, the ages in which they are found, health and immune conditions

I think it varies from country to country according to their living conditions, the ages in which they are found, health and immune conditions

DR RUAA --that indeed may be so but I encountered a figure that is even more startling--out of patients who test positive to SARS-CovII and are hospitalized , 80% recover with the treatment at hand and go home while the remaining 20 % are dispatched to their eternal homes. What a pity!!

Ijaz Durrani

The World Health Organization (WHO) today estimated the overall fatality rate for SARS (severe acute respiratory syndrome) patients at 14% to 15%, significantly higher than previous estimates. The agency estimated the rate for people older than 64 years to be more than 50%.

The revised WHO estimates, based on data from four countries, came on the heels of a Lancet article in which researchers studied case records from Hong Kong and calculated a case-fatality ratio as high as 55% for patients aged 60 and older.

In the early stages of the SARS epidemic, health officials estimated the mortality rate at less than 4%. More recently, officials have cited rates in the 6% to 7% range. Today's SARS figures from the WHO—6,903 cumulative cases and 495 deaths—point to a case-fatality ratio of 7.2%. But WHO officials note that this calculation underestimates the rate, since some currently ill patients will die of the disease.

Ijaz Durrani

Please note the following links"

https://www.who.int/csr/sars/en/WHOconsensus.pdf

https://www.ncbi.nlm.nih.gov/books/NBK45714/

Dear colleague, it depends on which statistical basis you refer. Normally you refer on persons who have been diagnosed with corona virus. But that number depends how dense the population has been investigted. It makes a difference when you have a population of 10 Mio. habitants and you make 20.000 checks instead if 40.000. In the case you have found 100 persons dying you get a relation of 1:200 or 1 : 400 death per diagnosed persons. Best greetings WD

Mortality depends on many factors. First of all, from the efficiency and workload of the healthcare system in a particular country, as well as from the immune status of the population. In addition, it is possible that there are already different strains.

It is difficult to have an accurate estimation of the fatality rate of the Covid-19 at this early stage of the pandemic. The mortality rate of such a pandemic is a function of many factors such as demographic characteristics, quality of life, medicare services among others. The current reported mortality rate is higher as it is based on the initial stage of the pandemic. we still do not have sufficient understanding of the virus and it affects accurate estimation. The estimation is still based on special population.

Have a look at this link.

https://www.thelancet.com/action/showPdf?pii=S1473-3099%2820%2930195-X

The current estimates of numbers of COVID-19 cases and deaths are very inaccurate. The sensitivity and specificity of the diagnostic tests for COVID-19 are not yet known in vivo. There are reports of very high sensitivity and specificity in vitro. However a number of confounding factors (e.g. the stage of illness and the way the swab was taken) mean that the false negative rate of these tests may be high in clinical practice.

Wenling Wang; Yanli Xu; Ruqin Gao; et al Detection of SARS-CoV-2 in Different Types of Clinical Specimens. Jama 2020 (in press).

The numbers of cases reported will also depend on strategies used for screening. Many countries are only screening symptomatic patients presenting to healthcare facilities. Others are attempting to screen a significant proportion of the population.

I believe the total number of cases of COVID-19 is significantly higher than that being reported. There are many confounding factors (both political and diagnostic) that make the initial number of deaths reported as being due to COVID-19 extremely difficult to interpret.

Another important factor to consider when trying to interpret variation in mortality rates between countries is differences in cultural interpretation of quality of life. This impacts the social and medical ethics and the delivery, limitation and withdrawal of life sustaining therapies.

In many Western cultures quality of life is valued far more than quantity of life. In those settings limitation and even withdrawal of life sustaining therapies resulting in cardiac arrest are a common mode of death.

In many Eastern cultures quantity of life is valued more than quality of life. In these settings treatment limitations and withdrawals of therapy are rare. Admission to intensive therapy units and prolonged organ support are common. Mode of death is often failure of resuscitation after cardiac arrest.

These differences are magnified when there are limited resources particularly in Western countries. The social and medical acceptance of treatment limitations is increased; this may significantly increase case fatality rates.

An unfortunate adverse effect of social distancing for the Covid-19 pandemic has arisen. There has been a dramatic fall in the number of blood donors in Saudi Arabia a result of social isolation during the Covid-19 Pandemic. Supplies of blood are being depleted. This is likely to be a global phenomenon

If insufficient blood of the correct type is available a woman may die as a result of not being transfused blood for severe acute bleeding following delivery of a child, for example. This will be most challenging for patients with rare blood group

Patients may die as a result of not being transfused blood severe acute bleeding due to stress ulceration, for example. If the patient has severe or critical Covid-19, the cause of death is actually the Covid-19 but it is likely to be coded as GI tract bleeding.

In summary once the dust has settled on this pandemic. I suspect that the actual mortality due to Covid-19 itself will be substantially lower than 2%. Other factors will mean that the actual number of deaths related to the pandemic will be much greater than 5%.

Estimates with wide ranges tend to reflect confirmed cases versus possible or probable cases based on estimates. Since there is currently no widespread testing in the US, people who present with symptoms of COVID-19 but who do not meet testing criteria may or may not make it into the statisitics. Some of the estimates versus confirmed cases come from clinicians describing higher rates of infection in their areas of practice than what is reflected in the data for their state or their city. In our institution cases are being reported separated out into confirmed cases versus unconfirmed, and a category for people tested but results not yet available. Those numbers don't capture the people at home who never call into the telehealth line, or whose family members might later say that a family member was sick with the "flu" and symptoms that were consistent with some or most associated with COVID-19.

Another source of estimation are the people with COVID-19 who die of cardiac or other complications, and the complication is what is listed as the cause of death in one country, state or institution and COVID-19 is listed as the cause of death in another country, state or institution.

I am going to comment with a heavy and intense amount of data, that not only was there a second wave, but more importantly, a third and fourth destructive and lethal wave did in fact occur.