European Case-Fatality Rates beyond lockdown and the UK’s outlier status

August 10, 2020

Jason Oke, Carl Heneghan


Analysing deaths since mid-July the UK is a clear outlier with a Case Fatality Rate(CFR) of 6.57. Every other European country has a CFR for this period less than three, and Spain is as low as 0.15.

Spain has reported over 60,000 cases, but only 94 deaths; Germany has 21,000 cases compared to the UK’s 26,500 cases but reports 93% fewer deaths (129 versus 1,744), and Russia has nearly ten times as many cases as the UK but only twice the deaths.

The difference in the UK is so stark that the primary explanation has to be in the current recording and reporting of deaths. We are expecting the UK numbers to be revised this week to bring them, somewhat, in line with the rest of Europe. The Telegraph, however,  is reporting that The official Covid-19 daily death toll may never be brought back. We’ll keep you posted.

Our methods

We downloaded COVID-19 data for European countries from the “Our World in Data” site  (https://github.com/owid/covid-19-data/raw/master/public/data/owid-covid-data.csv). We examined new cases for the period 1st July 2020 and new deaths 14th July 2020 to allow for the lag time between cases developing and death.

The case-fatality rate (CFR) was calculated as the sum of new deaths divided by the sum of new cases for each country; countries with fewer than three deaths were excluded.  The proportion of deaths to the total numbers of cases was meta-analysed using the R function metaprop, using fixed-effect inverse-variance weighting.

AUTHORS

Jason Oke is a Senior Statistician at the Nuffield Department of Primary Care Health Sciences and Module Coordinator for Statistical Computing with R and Stata (EBHC Med Stats), and Introduction to Statistics for Health Care Research (EBHC), as part of the Evidence-Based Health Care Programme.

Carl Heneghan is Professor of Evidence-Based Medicine and Director of Studies for the Evidence-Based Health Care Programmes (Full bio and disclosure statement here)

Disclaimer the article has not been peer-reviewed; it should not replace individual clinical judgement, and the sources cited should be checked. The views expressed in this commentary represent the views of the authors and not necessarily those of the host institution, the NHS, the NIHR, or the Department of Health and Social Care. The views are not a substitute