The covid-19 population fatality rate over the 16 week (112 day) peak of the epidemic in England and Wales was equivalent to those over 55 experiencing around 5 weeks extra mortality risk above “normal,” and steadily less for younger age groups, reducing to just two extra days for schoolchildren. We would normally expect around 26 617 deaths in this age group over this period, and so covid-19 represented a 28% increased risk. Sir David Spiegelhalter has been Winton Professor of the Public Understanding of Risk at the University of Cambridge since October 2007. Ng J, Bakrania K, Falkous C, Russell R. Covid-19 mortality rates by age and gender: why is the disease killing more men than women?RGA 2020 Jul 10. Spiegelhalter is an ISI highly cited researcher. Oslo, January 2018. The risks of catching and dying from the virus vary 10 000-fold depending on age, as shown in the linear graph, and it is challenging to communicate such a massive range. What is the best way to communicate risk in medicine and the broader public sphere? In the same period this age group experienced 138 deaths from other causes. However, there are serious problems in the application of science to policy — from energy to health and environment to education. Importantly, all the risks quoted are the average (mean) risks for people of the relevant age but are not the risks of the average person. Of course, while death is the most serious and easily recorded outcome, information is growing on the number of people experiencing prolonged symptoms of covid-19. Office for National Statistics. The 2018 CSaP Annual Conference will be held at the Royal Society on 28 June. Communicating evidence in legal cases. Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare. He has worked on clinical trials and drug safety and consulted and taught in a number of pharmaceutical companies, and also collaborates on developing methods for health technology assessment applicable to organisations such as NICE. At the other extreme, 2% (1 in 49) of all those aged over 90 in England and Wales were registered as dying with covid-19 in these 16 weeks; this represents around 4300 times the risk of catching and dying from covid-19 compared with 15-24 year olds. 2020 [cited 2020 May 30]. The website UnderstandingUncertainty.org features a wide range of resources, and he works closely with the Millennium Mathematics Project in trying to bring risk and uncertainty into education. YOUR risk of dying from coronavirus is the "roughly the same as your annual risk", a top expert says. Contributors and sources: DS is a statistician who conducted all the analyses, wrote the code to produce the graphics, and wrote the paper. Explaining risk in this way could help people understand and manage their response, says David Spiegelhalter. technical support for your product directly (links go to external sites): Thank you for your interest in spreading the word about The BMJ. The covid-19 death rates create a remarkably straight line on a logarithmic scale (top), indicating an exponential increase of risk with age. In March 2020 I compared these estimates with the annual actuarial risks shown in figure 1 and found the agreement was reasonable,8 with the covid-19 risk estimates following a similar pattern to the background risk (fig 2, top). So living through this 112 day period of the epidemic is as if these people have on average been exposed to an extra 36 days’ risk (32% of 112). Birrell P, Blake J, van Leeuwen E, de Angelis D, Biostatistics Unit MRC, COVID-19 Working Group. There may also have been some selection of frail elderly people, bringing their deaths forward and leaving a temporarily more resilient cohort. Calls for the closer integration of science in political decision-making have been commonplace for decades. The David and Claudia Harding Foundation provide funding for the Winton Centre for Risk and Evidence Communication. This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. Some of the lack of understanding, Spiegelhalter believes, is down to bad communication, something of he admits he's been guilty of himself. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. We have also launched fully accredited online courses in risk communication. Sir David Spiegelhalter joins us to discuss all things risk-related and his work as the Winton Professor of Public Understanding of Risk at Cambridge University. COVID-19: nowcast and forecast. So for the large majority of healthy people, their risks of either dying from covid-19, or dying of something else, are much lower than those quoted here. If you are unable to import citations, please contact As covid-19 turns from a societal threat into a matter of risk management, it is vital that the associated risks are understood and clearly communicated.1 But these risks vary hugely between people, and so finding appropriate analogues is a challenge. Accumulating data on deaths from covid-19 show an association with age that closely matches the “normal” risk we all face. Office for National Statistics. "For example, about six months ago I said that your risk of dying from COVID-19 is the same as your risk of dying this year." Deaths registered in 16 weeks between 7 March and 26 June 2020 in England and Wales: 49 607 deaths with covid-19 on death certificate. In the 16 weeks (112 days) between 7 March and 26 June 2020, 218 354 deaths were registered in England and Wales, compared with an average of 159 595 for this period over the past five years. This amounts to around two days’ extra risk of dying during the 112 days of the epidemic. Deaths involving COVID-19, England and Wales: deaths occurring in June 2020. But if you were frail and had a 60% risk of dying next year, then with infection this would rise to 2×0.6–0.62=0.84, so altogether you would have an 84% chance of dying. Explaining risk in this way could help people understand and manage their response, says David Spiegelhalter As covid-19 turns from a societal threat into a matter of risk management, it is vital that the associated risks are understood and clearly communicated. This is equivalent to around 31 days’ extra risk of dying during 112 days of the epidemic. The second row of table 2 shows that three deaths from covid-19 have been recorded among over 7 million schoolchildren aged 5 to 14 (around 1 in 2.4 million), an extremely low risk that represents only 2% of the average normal risk faced by this group. This requires a cross-disciplinary approach, as well as strong two-way communications between academics and those working in the policy front-line. It should always be remembered that these are risks to the individual: there is still a responsibility to consider the potential risks an individual may cause to others. Office for National Statistics. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. For low p, this will be very close to 2p, and so it is generally fine to say that covid-19 would roughly double the risk of dying. He divides his work between the Statistical Laboratory and the Medical Research Council Biostatistics Unit. For David's tips to policy makers on interpreting scientific claims, see his paper published in Nature in November 2013 here. This steeper gradient suggests that the additional risk from being infected is rather more than the normal annual risk for those over 55, and rather less than the annual risk for those under 55. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Other countries show a similar gradient.4, Estimated effects of sex and age on population fatality rates for covid-19 based on 49 607 deaths registered in England and Wales between 7 March and 26 June 2020*. The “normal” risk (dashed lines) is the actuarial annual mortality, scaled by a factor 16/52 to reflect the risk over 16 weeks. In contrast to the population fatality rate, we might expect the infection fatality rate—that is, the risk of death if infected—to remain fairly stable over time. These are observed historical rates in the population and cannot be quoted as the future risks of getting covid-19 and dying. Table 1 shows the death rate during this 16 week period was around 12-13% higher for each year older, corresponding to doubling for every five to six additional years of age, and this relation is consistent from childhood to old age. This near linearity on a logarithmic scale corresponds to an exponential increase—from age 35, the annual hazard increases at an average 9.7% a year for men and 10.4% a year for women. This mounting problem presents a whole new challenge for surveillance, risk assessment, and risk communication. It is difficult to communicate the huge range of individual mortality risks from covid-19 experienced by people of different ages. This can be directly obtained from death registrations in which covid-19 is mentioned on the death certificate in England and Wales.2 It will include those dying both from and with the virus, while underestimating the true number of deaths linked to covid-19 because of underdiagnosis in people who did not display classic symptoms, were not tested, and so did not have covid-19 mentioned on the death certificate.