Abstract
COVID-19 case fatalities surged during the month of March 2020 in Italy, reaching over 10,000 by 28 March 2020. This number exceeds the number of fatalities in China (3,301) recorded from January to March, even though the number of diagnosed cases was similar (85,000 Italy vs. 80,000 China). Case Fatality Rates (CFR) could be somewhat unreliable because the estimation of total case numbers is limited by several factors, including insufficient testing and limitations in test kits and materials, such as NP swabs and PPE for testers. Sero prevalence of SARS-CoV-2 antibodies may help in more accurate estimations of the total number of cases. Nevertheless, the disparity in the differences in the total number of fatalities between Italy and China suggests investigation into several factors, such as demographics, sociological interactions, availability of medical equipment (ICU beds and PPE), variants in immune proteins (e.g., HLA, IFNs), past immunity to related CoVs, and mutations in SARS-CoV-2, could impact survival of severe COVID-19 illness survival and the number of case fatalities.
Highlights
In five weeks, the number of COVID-19 deaths in Italy jumped from 21 to an astounding 3,200 by 20 March and increased to over 9,000 deaths by 28 March 2020 [1,2,3]
In terms of case fatality rates (CFR), Italy stands at a CFR of 10.6% and China has a CFR of 4% [4]
There could be limiting factors in testing itself; for example, the test kits may be limited as was the case in the United States for much of the early stages of the epidemic in the USA, or material needed to do testing, such as nasopharyngeal swabs (NP swabs), may be in short supply, which is true in Italy, Spain, the USA, Canada, and probably more countries
Summary
The number of COVID-19 deaths in Italy jumped from 21 to an astounding 3,200 by 20 March and increased to over 9,000 deaths by 28 March 2020 [1,2,3]. In terms of case fatality rates (CFR), Italy stands at a CFR of 10.6% and China has a CFR of 4% [4]. To put the situation into perspective and to accurately calculate the CFR, the total number of cases and infections has to be determined.
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