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COVID-19 Global Mortality: Comparing Actual and Modelled Patterns in Space and Time Using an Infection Fatality Rate (IFR) Model

16 Pages Posted: 14 Dec 2020

See all articles by John Church

John Church

Independent Researcher

Raj Bhopal

Usher Institute, University of Edinburgh



Background: International variations in COVID-19 mortality are stark and incompletely explained by age. We examined the global impact on COVID-19 mortality, including the proportion hypothetically infected, using an infection fatality rate (IFR) model.

Methods: The age stratified IFR model was based on the distribution in UK and Diamond Princess cruise ship mortality data. We applied this model to more than 60 countries, comprising 86% of global population, using their age structure (from Population Pyramid) to estimate their expected average IFR. We used this IFR and reported mortality from Worldometer to estimate the hypothetical proportions of the population infected. We plotted the observed mortality monthly since March, examining countries by region of the world. We compared the hypothetical proportions infected with national sero-prevalence data.

Results: Internationally, the average IFRs ranged from <0.1% to over 1%. National mortality was often different from that predicted by the IFR, and by November there were dramatic differences across and within regions. There were variations by individual country and region in the hypothesised proportion of the population infected, ranging from <2% to >40%, to generate the reported mortality. These hypothesised proportions were mostly higher than reported sero-prevalence.

Interpretation: The model and graphic output help describe the pandemic and generate hypotheses for the observed differences. Mortality variations remaining unexplained by age could reflect differences in the: accuracy of data, proportion of the population infected, efficacy of public health interventions or pre-existing population resistance or vulnerability to infection.  

Funding: There was no external funding.

Declaration of Interests: None.

Ethics Approval Statement: No approvals were sought as all data were in the public domain.

Suggested Citation

Church, John and Bhopal, Raj, COVID-19 Global Mortality: Comparing Actual and Modelled Patterns in Space and Time Using an Infection Fatality Rate (IFR) Model. Available at SSRN: or

John Church

Independent Researcher ( email )

Raj Bhopal (Contact Author)

Usher Institute, University of Edinburgh ( email )

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