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How lethal is COVID-19? Here's what a public health pro says is known and unknown

Untested asymptomatic cases make getting exact measurements difficult

MACON, Ga. — Georgia's current mortality rate and case fatality rate for COVID-19 vastly outpace the same figures for the common flu, according to a Georgia State University School of Public Health professor and publicly accessible data from the Georgia Department of Public Health (DPH).

However, those figures may be inflated due to a current inability to accurately track asymptomatic cases in people who do not get tested.

Understanding those figures, though, first requires understanding the difference between the two measurements.

"One of them is a measure of what's happened to the disease within the population and the other one is a measure of what percentage of those individuals that have already gotten the disease have died," said Georgia State University School of Public Health professor Colin Smith.

Smith is a former Georgia Public Health Association president and a clinical assistant professor at Georgia State.

According to him and Michael Hokanson, the spokesperson for the North Central Health District, mortality rate measures how many people have died across an entire population. The figure is calculated by dividing the number of confirmed deaths by the total population and then multiplying the result by 100,000 to get a "per 100,000 residents" figure.

The Georgia Department of Public Health confirms 2,745 COVID-19-related deaths as of June 25.

Out of Georgia's more than 10 million residents, the COVID-19 mortality rate for known infections is about 25 deaths per 100,000 people.

Smith notes that's more than 20 times higher than the same figure for the common flu.

"The 5-year aggregate for influenza for Georgia from 2014 to 2018 is 1.1 or 1.10 roughly, per 100,000 population," said the professor.

Case fatality rate measures how deadly a disease is among those who catch it. The figure is calculated by dividing the number of confirmed deaths by the total number of confirmed cases.

The DPH has confirmed more than 71,000 cases of COVID-19 and 2,745 virus-related deaths as of June 25, which puts the statewide case fatality rate of known infections at about 3.86%.

Smith notes that's also well above the case fatality rate for the flu.

"Flu has a case fatality rate of 0.1," he said.

However, Smith notes those calculations do not take into account asymptomatic cases that have not been confirmed with a test.

If they were to be included, he says, those figures would likely decrease.

However, it's currently impossible to say for sure how big the decrease would be because nobody is certain how many untested asymptomatic cases exist.

Given current information, though, Hokanson says the virus needs to be taken seriously.

"Now is not the time to forget about this -- it was never the time to forget about this before, but with the cases going up, this is something people need to still be thinking about," said the public health spokesperson.

He stressed that people should still be following social distancing guidelines and wearing cloth face masks in public.

Hokanson added that the recent increase in new daily confirmed cases is not simply a result of increased statewide testing capacity. 

"It's not the only factor in these new numbers," said Hokanson. "We know when restrictions lifted, with people just getting tired of being cooped up, people are going to parties they're going to celebrations. We know that school systems are doing activities and those are opportunities for the illness to spread."

Hokanson also said that the North Central Health District's COVID-19 case fatality rate is higher than the statewide figure (around 6% versus the statewide roughly 3.8%). He said that's partly because most of the NCHD's deaths came from long-term care facility outbreaks.

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