Analysis of fatality impact and seroprevalence surveys in a community sustaining a SARS-CoV-2 superspreading event

Abstract

There is an ongoing debate on the COVID-19 infection fatality rate (IFR) and the impact of COVID-19 on overall population mortality. Here, we addressed these issues in a community in Germany with a major superspreader event analyzing deaths over time and auditing death certificates in the community.18 deaths that occurred within the first six months of the pandemic had a positive test for SARS-CoV-2. Six out of 18 deaths had non-COVID-19 related causes of death (COD). Individuals with COVID-19 COD typically died of respiratory failure (75%) and tended to have fewer reported comorbidities (p = 0.029). Duration between first confirmed infection and death was negatively associated with COVID-19 being COD (p = 0.04). Repeated seroprevalence essays in a cross-sectional epidemiological study showed modest increases in seroprevalence over time, and substantial seroreversion (30%). IFR estimates accordingly varied depending on COVID-19 death attribution. Careful ascertainment of COVID-19 deaths is important in understanding the impact of the pandemic.

Flaws and uncertainties in pandemic global excess death calculations

“…With age‐adjustment using the methodology described in, 4 excess deaths estimates for Germany and Netherlands are less than half of the Economist's (and lower than recorded COVID‐19 deaths), while for Sweden it is estimated there were fewer deaths in 2020–2022 versus 2017–2019 (‘death deficit’). In western European countries, COVID‐19 deaths were typically over‐counted 43–45,61 . Moreover, Sweden did have many deaths in nursing homes in early 2020, but life expectancy in Swedish nursing home residents is very short; therefore, these COVID‐19 deaths would not contribute excess deaths when 3 years (2020–2022) are considered 62 .…”

“…In western European countries, COVID-19 deaths were typically over-counted. [43][44][45]61 Moreover, Sweden did have many deaths in nursing homes in early 2020, but life expectancy in Swedish nursing home residents is very short; therefore, these COVID-19 deaths would not contribute excess deaths when 3 years (2020-2022) are considered. 62 Conversely, United States excess death estimates are consistently the highest with the two methodologies, and outnumber recorded COVID-19 deaths.…”