Missouri COVID update: Case-fatality rate trending up

JEFFERSON CITY, Mo. – The COVID case-fatality rate in Missouri has gone up nearly half a percent in the last four months.

According to the Missouri Department of Health and Senior Services, the state has recorded 489,374 cumulative cases of SARS-CoV-2—an increase of 407 positive cases (PCR testing only)—and 8,498 total deaths as of Wednesday, March 31, an increase of 3 over yesterday. That’s a case-fatality rate of 1.74%.

The case-fatality rate has gone up for since last December.

Please keep in mind that not all cases and deaths recorded occurred in the last 24 hours.

The Bureau of Vital Records at DHSS performs a weekly linkage between deaths to the state and death certificates to improve quality and ensure all decedents that died of COVID-19 are reflected in the systems. As a result, the state’s death toll will see a sharp increase from time-to-time. Again, that does not mean a large number of deaths happened in one day; instead, it is a single-day reported increase.

At the state level, DHSS is not tracking probable or pending COVID deaths. Those numbers are not added to the state’s death count until confirmed in the disease surveillance system either by the county or through analysis of death certificates.

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The 10 days with the most reported cases occurred between Nov. 7, 2020 and Jan. 8, 2021.

The 7-day rolling average for cases in Missouri sits at 351; yesterday, it was 349.

Approximately 46.8% of all reported cases are for individuals 39 years of age and younger. The state has further broken down the age groups into smaller units. The 18 to 24 age group has 61,429 recorded cases, while 25 to 29-year-olds have 41,068 cases.

Missouri has administered 4,883,456 PCR tests for COVID-19 over the entirety of the pandemic and as of March 30, 83% of those tests have come back negative. People who have received multiple PCR tests are not counted twice, according to the state health department.

According to the state health department’s COVID-19 Dashboard, “A PCR test looks for the viral RNA in the nose, throat, or other areas in the respiratory tract to determine if there is an active infection with SARS-CoV-2, the virus that causes COVID-19. A positive PCR test means that the person has an active COVID-19 infection.”

The Missouri COVID Dashboard no longer includes the deduplicated method of testing when compiling the 7-day moving average of positive tests. The state is now only using the non-deduplicated method, which is the CDC’s preferred method. That number is calculated using the number of tests taken over the period since many people take multiple tests. Under this way of tabulating things, Missouri has a 4.2% positivity rate as of March 28. Health officials exclude the most recent three days to ensure data accuracy when calculating the moving average.

As of March 28, Missouri is reporting 784 COVID hospitalizations and a rolling 7-day average of 816. The remaining inpatient hospital bed capacity sits at 26% statewide. The state’s public health care metrics lag behind by three days due to reporting delays, especially on weekends. Keep in mind that the state counts all beds available and not just beds that are staffed by medical personnel.

Across the state, 148 COVID patients are in ICU beds, leaving the state’s remaining intensive care capacity at 27%.

The 7-day rolling average for hospitalizations was over 1,000 from Sept. 16, 2020, to March 5, 2021. It was over 2,000 from Nov. 9, 2020, to Jan. 27, 2021.

Approximately 49.0% of all recorded deaths in the state are for patients 80 years of age and older.

If you have additional questions about the coronavirus, the Missouri Department of Health and Senior Services is available at 877-435-8411.

As of March 31, the CDC identified 30,213,759 cases of COVID-19 and 548,162 deaths across all 50 states and 9 U.S.-affiliated districts, jurisdictions, and affiliated territories, for a national case-fatality rate of 1.81%.

How do COVID deaths compare to other illnesses, like the flu or even the H1N1 pandemics of 1918 and 2009? It’s a common question.

According to the Centers for Disease Control and Prevention (CDC), preliminary data on the 2018-2019 influenza season in the United States shows an estimated 35,520,883 cases and 34,157 deaths; that would mean a case-fatality rate of 0.09 percent. Case-fatality rates on previous seasons are as follows: 0.136 percent (2017-2018), 0.131 percent (2016-2017), 0.096 percent (2015-2016), and 0.17 percent (2014-2015).

The 1918 H1N1 epidemic, commonly referred to as the “Spanish Flu,” is estimated to have infected 29.4 million Americans and claimed 675,000 lives as a result; a case-fatality rate of 2.3 percent. The Spanish Flu claimed greater numbers of young people than typically expected from other influenzas.

Beginning in January 2009, another H1N1 virus—known as the “swine flu”—spread around the globe and was first detected in the US in April of that year. The CDC identified an estimated 60.8 million cases and 12,469 deaths; a 0.021 percent case-fatality rate.

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