Abstract

BackgroundEarly severity estimates of coronavirus disease 2019 (COVID-19) are critically needed to assess the potential impact of the ongoing pandemic in different demographic groups. Here we estimate the real-time delay-adjusted case fatality rate across nine age groups by gender in Chile, the country with the highest testing rate for COVID-19 in Latin America.MethodsWe used a publicly available real-time daily series of age-stratified COVID-19 cases and deaths reported by the Ministry of Health in Chile from the beginning of the epidemic in March through August 31, 2020. We used a robust likelihood function and a delay distribution to estimate real-time delay-adjusted case-fatality risk and estimate model parameters using a Monte Carlo Markov Chain in a Bayesian framework.ResultsAs of August 31, 2020, our estimates of the time-delay adjusted case fatality rate (CFR) for men and women are 4.16% [95% Credible Interval (CrI): 4.09–4.24%] and 3.26% (95% CrI: 3.19–3.34%), respectively, while the overall estimate is 3.72% (95% CrI: 3.67–3.78%). Seniors aged 80 years and over have an adjusted CFR of 56.82% (95% CrI: 55.25–58.34%) for men and 41.10% (95% CrI: 40.02–42.26%) for women. Results showed a peak in estimated CFR during the June peak of the epidemic. The peak possibly reflects insufficient laboratory capacity, as illustrated by high test positivity rates (33% positive 7-day average nationally in June), which may have resulted in lower reporting rates.ConclusionsSeverity estimates from COVID-19 in Chile suggest that male seniors, especially among those aged ≥ 70 years, are being disproportionately affected by the pandemic, a finding consistent with other regions. The ongoing pandemic is imposing a high death toll in South America, and Chile has one of the highest reported mortality rates globally thus far. These real-time estimates may help inform public health officials' decisions in the region and underscore the need to implement more effective measures to ameliorate fatality.

Highlights

  • Severity estimates of coronavirus disease 2019 (COVID-19) are critically needed to assess the potential impact of the ongoing pandemic in different demographic groups

  • In addition to alreadystrained healthcare systems, other factors have affected the dynamics of the pandemic in the region, including migration, sociopolitical crises, struggling economies, other infectious disease outbreaks, poor leadership, and challenges tied to the implementation of social distancing, hygiene, and lockdown strategies, due to inadequate water and sanitation infrastructure and precarious living conditions [6, 8,9,10,11,12,13,14,15]

  • We found a similar pattern for women, except that most deaths were reported among women aged 80 years and older (44.4%)

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Summary

Introduction

Severity estimates of coronavirus disease 2019 (COVID-19) are critically needed to assess the potential impact of the ongoing pandemic in different demographic groups. We estimate the real-time delayadjusted case fatality rate across nine age groups by gender in Chile, the country with the highest testing rate for COVID-19 in Latin America. The coronavirus disease 2019 (COVID-19) pandemic has strained or overwhelmed health systems across the world [1, 2], with about 25.5 million COVID-19 cases and 850. Models estimated that a surge in the number of ill patients could overwhelm treatment capacity by June unless aggressive control measures were implemented [19]. Control measures prevented the epidemic’s growth in some regions, during the first months of the epidemic [20,21,22]

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