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Estimating the infection and case fatality ratio for COVID-19 using age-adjusted data from the outbreak on the Diamond Princess cruise ship
Adam J Kucharski
CMMID nCov working group
Stefan Flasche
Rosalind M Eggo
Timothy W Russell
Sam Abbott
Christopher I Jarvis
Kevin van-Zandvoort
Joel Hellewell
Ruwan Ratnayake
Novel Coronavirus
Acceso Abierto
Adjusting for delay from confirmation-to-death, we estimated case and infection fatality ratios (CFR, IFR) for COVID-19 on the Diamond Princess ship as 2.3% (0.75%-5.3%) and 1.2% (0.38-2.7%). Comparing deaths onboard with expected deaths based on naive CFR estimates using China data, we estimate IFR and CFR in China to be 0.5% (95% CI: 0.2-1.2%) and 1.1% (95% CI: 0.3-2.4%) respectively. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement TWR, JH SA, SF and AJK are supported by the Wellcome Trust (grant numbers: 206250/Z/17/Z, 210758/Z/18/Z, 210758/Z/18/Z, 210758/Z/18/Z, 208812/Z/17/Z, 206250/Z/17/Z). CIJ is supported by Global Challenges Research Fund (GCRF) project ‘RECAP’ managed through RCUK and ESRC (ES/P010873/1). KvZ is supported by Elrha’s Research for Health in Humanitarian Crises (R2HC) Programme, which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. The R2HC programme is funded by the UK Government (DFID), the Wellcome Trust, and the UK National Institute for Health Research (NIHR). RR is supported by Canadian Institutes of Health Research (Award no. DFS-164266). RME is supported by HDR UK (grant: MR/S003975/1) CMMID nCoV working group funding statements: Thibaut Jombart (RCUK/ESRC (grant: ES/P010873/1); UK PH RST; NIHR HPRU Modelling Methodology), Amy Gimma (GCRF (ES/P010873/1)), Nikos I Bosse (no funding statement to declare), Alicia Rosello (NIHR (grant: PR-OD-1017-20002)), Mark Jit (Gates (INV-003174), NIHR (16/137/109)), James D Munday (Wellcome Trust (grant: 210758/Z/18/Z)), Billy J Quilty (NIHR (16/137/109)), Petra Klepac (Gates (INV-003174)), Hamish Gibbs (NIHR (ITCRZ 03010)), Yang Liu (Gates (INV-003174), NIHR (16/137/109)), Sebasitan Funk (Wellcome Trust (grant: 210758/Z/18/Z)), Samuel Clifford (Wellcome Trust (grant: 208812/Z/17/Z)), Fiona Sun (NIHR EPIC grant (16/137/109)), Kiesha Prem (Gates (INV-003174)), Charlie Diamond (NIHR (16/137/109)), Nicholas Davies (NIHR (HPRU-2012-10096)), Carl A B Pearson ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All of the data and the code required to reproduce the figures and results of this study can be found at the public github repository: <>
Cold Spring Harbor Laboratory Press
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