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Assessing the Age Specificity of Infection Fatality Rates for COVID-19: Systematic Review, Meta-Analysis, and Public Policy Implications

31 Pages Posted: 15 Oct 2020

See all articles by Andrew Levin

Andrew Levin

Dartmouth College - Department of Economics

Gideon Meyerowitz-Katz

Independent

Nana Owusu-Boaitey

Independent

Kensington Cochran

Dartmouth College

Seamus Walsh

Dartmouth College

More...

Abstract

Objective: Determine age-specific infection fatality rates for COVID-19 to inform public health policies and communications that help protect vulnerable age groups.

Methods: Studies of COVID-19 prevalence were collected by conducting an online search of published articles, preprints, and government reports. A total of 89 studies were reviewed in depth and screened. Studies of 31 locations satisfied the inclusion criteria and were included in the meta-analysis. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities four weeks after the midpoint date of the study, reflecting typical lags in fatalities and reporting. Meta-regression procedures in Stata were used to analyze IFR by age.

Results: Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFRs are very low for children and younger adults but increase progressively to 0.4% at age 55, 1.3% at age 65, 4.5% at age 75, and 15% at age 85. We find that differences in the age structure of the population and the age-specific prevalence of COVID-19 explain 90% of the geographical variation in population IFR.

Discussion: These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza. Moreover, the overall IFR for COVID-19 should not be viewed as a fixed parameter but as intrinsically linked to the age-specific pattern of infections. Consequently, public health measures to mitigate infections in older adults could substantially decrease total deaths.

Funding Statement: No funding was received for conducting this study.

Declaration of Interests: The authors have no financial interests nor any other conflicts of interest related to this study.

Keywords: COVID-19, SARS-CoV-2, seroprevalence, Infection fatality rate, IFR, systematic review, meta-analysis, metaregression

Suggested Citation

Levin, Andrew and Meyerowitz-Katz, Gideon and Owusu-Boaitey, Nana and Cochran, Kensington and Walsh, Seamus, Assessing the Age Specificity of Infection Fatality Rates for COVID-19: Systematic Review, Meta-Analysis, and Public Policy Implications (August 28, 2020). Available at SSRN: https://ssrn.com/abstract=3684447 or http://dx.doi.org/10.2139/ssrn.3684447

Andrew Levin (Contact Author)

Dartmouth College - Department of Economics ( email )

Hanover, NH 03755
United States
603-646-8138 (Phone)

HOME PAGE: http://www.dartmouth.edu/~alevin

Gideon Meyerowitz-Katz

Independent ( email )

Nana Owusu-Boaitey

Independent ( email )

Kensington Cochran

Dartmouth College

Department of Sociology
Hanover, NH 03755
United States

Seamus Walsh

Dartmouth College

Department of Sociology
Hanover, NH 03755
United States

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