Why The Death Rate From Coronavirus Is Plunging In China

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When it comes to the spiraling global coronavirus outbreak, scientists are still trying to pin down the answer to a basic question: How deadly is this virus?

Estimates have varied widely. For instance, at a Feb. 24 news conference in Beijing, a top Chinese health official, Liang Wannian, said the fatality rate for COVID-19 was quite high:

“Between 3 to 4% of patients have died,” said Liang.

Then he added a twist: Outside of Wuhan — the city at the epicenter of the outbreak, the death rate in China has been much lower: about 0.7 percent. That’s fewer than 1 fatality per 100 cases.


Similarly, a study released by China’s Center for Disease Control last month, found that if you factor out all the data from Hubei province, where Wuhan is located, the fatality rate in the rest of China drops to 0.4 percent.

Why such a big difference between Hubei and the rest of China?

At a news conference the next day, Dr. Bruce Aylward — who’d just concluded a fact-finding mission to China for the World Health Organization — pointed to three likely factors.

First, said Aylward, is that Wuhan suffered from being the first place where the new coronavirus surfaced. “Wuhan started fast and, and early. People didn’t know what we were dealing with. We were learning how to treat this.”

The more patients medical staff saw, the more they could start identifying what kind of supportive care made a difference. So by the time patients started showing up in hospitals in other provinces, doctors and nurses there had a lot more information about what it takes to keep patients alive.

Hospitals in the rest of world will likely also benefit from that knowledge.

The second reason for the higher death rate in Hubei “was just the sheer scale of the numbers,” said Aylward.

Hospitals in Wuhan were flooded with thousands of sick people. That stressed their capacity to provide the kind of round-the-clock intensive care needed for a patient with a critical case of COVID-19.

Elsewhere in China the caseload was much lower.

The implication for other countries: It’s worth trying to at least slow the pace of an outbreak with measures to keep the number of patients from overwhelming local hospitals.

The final factor, says Aylward, “At the beginning of this outbreak remember, people were finding severe disease. And that’s why the alarm bells went off.”

Those early severe cases made COVID-19 look like a much bigger killer. It was only after officials in China stepped up surveillance that they started uncovering many more mild cases (people with symptoms such as fever and dry cough but limited or no pneumonia).

All of this may also help explain why over time the death rate for COVID-19 has steadily dropped.

According to the China CDC study, among patients whose symptoms started between Jan. 1 and Jan. 10 the death rate was 15.6 percent. But it was just 0.8 percent among those who didn’t get sick until Feb. 1 to Feb. 11.

That pattern of progressively dropping death rates is one we’re likely to see in other countries.

In other words, there’s a good chance the fatality rate in nations with good health systems will end up being a lot lower than what was first seen in China.

Still, it’s worth noting that even after China got the death rate down to 0.7 percent, or even 0.4 percent, that’s still about four to seven times greater than the death rate for seasonal flu. (The rate for the flu is about 0.1 percent – or 1 in 1,000 patients.)

Also, the China CDC study shows that for coronavirus patients aged 70 to 79 the death rate more than triples. For those older than 80 it’s more than six times as high.

Anna Yeung-Cheung, a microbiologist at Manhattanville College in New York, says she also worries about health workers.

Yeung-Cheng, who is originally from Hong Kong, notes that many doctors there died during the SARS coronavirus outbreak of 2002-2003. And hundreds of Chinese health workers have been sickened in the COVID-19 outbreak — possibly, at least in part, because they were working so hard, she says.

Sure, says Yeung-Ching, “They’re young. But we need to take into account the stress that they are undergoing. This is stress to their body.”

Copyright 2020 NPR. To see more, visit https://www.npr.org.


Polls have closed in Virginia, Vermont and North Carolina in the last hour. And as we get ready to segue out of ALL THINGS CONSIDERED and into Special Coverage of Super Tuesday, I want to welcome my friend and co-host for the next couple of hours, the host of Weekend Edition Sunday, Lulu Garcia-Navarro.

Good to have you here on a weeknight.


Hey – a big night, too.

SHAPIRO: Big night already, even with just less than one hour of returns in. NPR’s Domenico Montanaro is here in the studio to walk us through what we know so far.

Hi, Domenico.


SHAPIRO: So what results have we seen so far tonight?

MONTANARO: So far tonight, Joe Biden has won two states with Virginia and North Carolina. Polls closed in North Carolina just about 20 minutes ago or so – 7:30. And Bernie Sanders won his home state of Vermont, which was, of course, expected. The – I think it’s surprising to see that Virginia and North Carolina went as quickly as they did for Joe Biden, almost right at poll close time. And I think that that does indicate that there is something of a Biden surge that’s happening.

SHAPIRO: Based on his victory in South Carolina on Saturday and his endorsements in the last couple days by Pete Buttigieg, Amy Klobuchar, Beto O’Rourke.

MONTANARO: Yeah. It does appear that there’s a degree of coalescing that’s happening from people who were voting, let’s say, for Buttigieg or Klobuchar, people whose minds hadn’t been quite made up yet. Almost half of voters in Virginia said that they had made up their minds just in the last few days. So clearly, South Carolina played a significant role in the votes for a lot of folks.

SHAPIRO: It’s such a turnaround when you look at the arc of this campaign, where Biden was first in national poll numbers for so many months, and then he performed really poorly in New Hampshire, in Iowa, in Nevada. And suddenly, he looks to be having a good night so far.

MONTANARO: And I think part of the problem for Joe Biden overall was that he wasn’t impressing people either on the debate stage or in person, frankly. I mean, when I saw him in Iowa, he was – his appearances were lackluster. They were kind of meandering. Voters were going to those events and then telling us afterward, well, I don’t know. I wanted to vote for him, but I wasn’t quite sure what to make of what we saw. I think almost as important as his South Carolina win in that margin was his victory speech afterward, which a lot of Democrats were talking about as the clearest and best speech they’d heard him give.

GARCIA-NAVARRO: And is that what you think convinced voters at the end that he is a viable candidate that can beat President Trump? – which is what most Democrats say that they want, ultimately.

MONTANARO: I think that they wanted to be – they were concerned with Joe Biden as a candidate and didn’t know if he was past his prime and whether or not he could actually stand up to Donald Trump and see him on a debate stage next to him. I think that’s something that’s been in the back of the minds of a lot of Democratic voters for the last year. So far, given what he did in South Carolina and given that speech afterward and his campaigning the last few days and so much of the people who’ve come out in support of him, it looks like, at least very early on tonight, that a lot of those moderate voters are coalescing around Joe Biden.

GARCIA-NAVARRO: Let’s bring in somebody else now. NPR’s Susan Davis is with the Bloomberg campaign in West Palm Beach, Fla.

And Sue, Bloomberg spent so heavily in Virginia and North Carolina. How big a blow is this for him?

SUSAN DAVIS, BYLINE: It’s a big blow. I don’t think it comes as a surprise. You could sort of feel the energy deflating from the campaign after Biden’s performance in South Carolina. You know, Bloomberg got into this race at a moment where the field seemed really unsettled and thought he could have a path to sort of own that moderate lane. And it didn’t really come to pass. When you consider, you know, he has spent over $500 million just on ads…

GARCIA-NAVARRO: An astonishing amount – astonishing amount of money.

DAVIS: An unprecedented – it blows every record out of the water. And he has spent probably another hundred million just on additional campaign infrastructure. His campaign manager spoke to reporters tonight here in West Palm Beach and – really sort of setting expectations in a tone that suggested he might not belong in this race. He contradicted Bloomberg, who earlier today told reporters he was in it to win it, would take it to the convention. Kevin Sheekey told reporters today he did not think there would be a contested convention and said they would assess the state of the campaign after all of the Super Tuesday results were in. He was asked specifically, would he drop out tonight? And Sheekey said, quote, “absolutely not.”

GARCIA-NAVARRO: I mean, when you look at this, there was this big question as to whether spending money was going to end up actually resulting in votes. And the polls were uncertain on this. I mean, we saw Bloomberg polling very well at certain times and in places where he spent a lot of money. What do you think this tells us about what the Democratic electorate wants and how they can be influenced or not by campaign ads?

DAVIS: You know, you can’t – you just can’t buy enthusiasm. There’s no amount of ad spending that can do that for a candidate. But one thing that voters did tell me and Kevin Sheekey committed to tonight was, one, they like that Bloomberg has committed to saying he’s going to continue to invest resources even if he doesn’t win the nomination. And Kevin Sheekey doubled down on that tonight, saying that they expected the nominee to be Michael Bloomberg or Joe Biden and that if Joe Biden is the nominee, Mike Bloomberg is going to do whatever it takes to get him elected, pointing to the 2018 midterms in which Mike Bloomberg invested in 24 House seats – Republican-held House seats. Twenty-one of them flipped to Democrats, helped to win the Democratic majority.

So Mike Bloomberg and his money – you know, they’re not going to get him the nomination – or most likely not going to get him the nomination. But he still wants to be a player in 2020, and his – that money could still be a big factor for whoever the nominee is.

SHAPIRO: Let’s bring in NPR’s Scott Detrow, who is with the Sanders campaign in Essex Junction, Vt.

Scott, Sanders won his home state tonight, as expected. Overall, what’s the mood there?

SCOTT DETROW, BYLINE: Well, a band just started playing, which helps with the mood, no matter what the occasion.

SHAPIRO: Did it need help?

DETROW: It did, actually, a little bit. The mood hasn’t quite turned down. But certainly, early network calls and Associated Press calls for Virginia and North Carolina really started with a punch to a crowd that, for the last few weeks, has been seeing their guy, Bernie Sanders, as the front-runner in the race. And even with all of the momentum that Joe Biden accumulated over the last few days – particularly that dramatic rally last night with Amy Klobuchar, with Beto O’Rourke and another appearance with Pete Buttigieg – Bernie Sanders had a lot of advantages going into today. And his campaign all along has centered their strategy for the Democratic nomination around March 3. That’s not to say the whole night is lost. There’s a lot to come later on in the night.

SHAPIRO: Oh, sure.

DETROW: And there are a lot of states that close later on where Bernie Sanders could do very well, including, most importantly, California, which we’re not going to know until the very late hours, early morning tomorrow, probably.

SHAPIRO: And Texas, as well.

DETROW: And Texas, as well. And that’s a state that I think really could tell you whether Sanders or Joe Biden has really seized the momentum in this primary. I will say, though – last point – Bernie Sanders did spend a lot of time campaigning in Virginia and North Carolina. So for Joe Biden, who was left for dead before Saturday, to win those states minutes after the polls are closed – or projected, at least – really says something about how quickly things have changed.

GARCIA-NAVARRO: Domenico, just in the little time we have left, a bunch more polls are going to close. What should we be watching for?

MONTANARO: Well, you’re going to have at the 8 o’clock hour Alabama, Maine, Massachusetts, Oklahoma and Tennessee. Tennessee has been a state that Joe Biden has spent the most money in. Now, he’s not – doesn’t have Bloomberg money.

SHAPIRO: Affected by the tornadoes today.

MONTANARO: That’s true. And they’ve extended the hours in at least one county till 10 p.m. So you know, we’re going to see where the vote winds up coming out of there. But Alabama, Tennessee – significant African American populations. Massachusetts – going to be really interesting to see what happens because it is Elizabeth Warren’s home state. We haven’t talked much about her, but she wants to feel – she feels like she can have the opportunity to, you know, at least have some significant role at the convention, potentially, if not win the election in pledge majority.

SHAPIRO: That’s NPR’s Domenico Montanaro here in the studio. We’ve also been speaking with Sue Davis and Scott Detrow, just some of the NPR reporters spending this evening with presidential campaigns all over the country. Much more to come as we go into NPR’s Special Coverage of Super Tuesday. Stay with us. Transcript provided by NPR, Copyright NPR.