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Ebola Summary of Cases, Deaths, Discharges, and CFR (8,756 cases and 4,579 deaths as of ~10/8/14)

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  • Ebola Summary of Cases, Deaths, Discharges, and CFR (8,756 cases and 4,579 deaths as of ~10/8/14)

    Using the most recent situation reports from the Ministries of Health in Guinea, Liberia, and Sierra Leone, I put the following table together. It appears that the overall CFR is going to be closer to 70%, which is higher than what is being reported. The discrepancy is due to the fact that they are dividing the number of deaths by the total number of cases; however, some of those cases are still in treatment. I divided the number of deaths by the sum of total deaths plus total recovered cases.

    Click image for larger version

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    "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

  • #2
    Re: Summary of Cases, Deaths, Discharges, and CFR

    Thanks for putting that together.

    Although it's refreshing to see the media finally moving away from the "90 percent fatal" line which used to feature in many reports (often leaving out the "up to"), they now seem to have moved to an equally inaccurate measure just by looking at total cases and total deaths.

    The problem is compounded by the WHO publicly stating that 47% survive - http://www.who.int/csr/disease/ebola/en/ - which doesn't seem to be backed up by the recovery numbers.

    I'm not so sure the numbers will catch up, though. The Sierra Leone figures have had a big gap between total cases and recoveries + deaths for months. A lot of cases are not being recorded as either deaths or recoveries, and I don't think that's just because a lot of them are new.

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    • #3
      Re: Summary of Cases, Deaths, Discharges, and CFR

      Where are you getting or how are you computing the number of recovered cases?

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      • #4
        Re: Summary of Cases, Deaths, Discharges, and CFR

        In the MoH Situation Reports, I have found either the actual number discharged/recovered, or they show the number still in treatment/current admissions. These are usually buried in one of the tables in the report.

        Originally posted by Sharky View Post
        Where are you getting or how are you computing the number of recovered cases?
        "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

        Comment


        • #5
          Re: Summary of Cases, Deaths, Discharges, and CFR

          Here are screen shots of the data I used to determine the number of recovered cases so I could calculate a CFR.

          Sierra Lione simply reports the number of cases discharged:
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          Liberia reports the total number currently in treatment:
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          Guinea also reports the total number currently in treatment:
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          By knowing the number in treatment, the total number of cases, and the number of deaths, I can determine the number discharged/recovered.
          "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

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          • #6
            Re: Summary of Cases, Deaths, Discharges, and CFR

            Opinion

            Sierra Leone News: Ebola what is the true Case Fatality Rate CFR?
            ...
            In its web page of August 15, (http://www.msf.org/article/internati...sly-inadequate ), the organization breaks its statistics down by country. Finally here we get information that is almost complete.

            For Sierra Leone:
            204 confirmed cases
            52 recovered
            50 patients in center.

            Therefore, assuming the patients who have not recovered and are not still in the center have all died (the only other option is that they left the hospital alive without being certified as recovered, which is unlikely) and discarding the 50 patients in the center whose eventual outcomes are not known, we have 102 deaths from 154 confirmed Ebola patients all of whose outcomes are known:

            Sierra Leone MSF CFR = (102/154)*100 = 66.2%

            For Guinea Conakry:
            80 confirmed cases ***inconsistent with MSF August 8
            50 recovered ***inconsistent with MSF August 8
            4 patients in treatment center
            Guinea Conakry MSF CFR = (26/76)*100 =34.2%

            For Guinea Guekedou:
            197 confirmed cases
            45 recovered
            11 in treatment center

            Guinea Guekedou MSF CFR = (141/186)*100 = 75.8%
            From the above we see that the Sierra Leone MSF CFR is not very different from the Guinea Guekedou MSF CFR. These numbers are also not very different from the maximum CFR given above from the Sierra Leone Ministry of Health figures, which also included patients not hospitalized.

            We are told specifically that all the MSF cases were admitted at MSF facilities. The Guinea Conakry figure is much lower, but is based on a smaller sample and there are also inconsistencies with earlier figures.

            The Sierra Leone Ministry of Health and Sanitation gives figures (http://health.gov.sl/wp-content/uplo...ort_Vol-92.pdf ) for Ebola patients at the two Ebola facilities in Sierra Leone, at Kenema and Kailahun. The Kenema facility is run by Ministry of Health staff separately from the MSF Kailahun Case Management center, so it would be interesting to compare CFRs for these two different facilities.

            For the Kenema facility:
            Cumulative admission 390 (Note: the data does not indicate whether these were all lab confirmed with Ebola)
            Cumulative discharged 175
            Currently admitted 65
            Cumulative deaths 162

            The discharged, currently admitted and deaths exceed the admissions, which indicates a discrepancy in the data, albeit relatively small. Using the data as given, for this set of patients:

            Kenema Ebola Center CFR = (162/325)*100 = 49.8%
            For the Kailahun MSF facility, using the Ministry of Health data
            Cumulative admissions 294
            Cumulative discharged 69
            Currently admitted Not indicated
            Cumulative deaths 180

            Assuming all admissions are accounted for, as they should be in a well run facility we can conclude that currently admitted are 294-69-180 = 45. This is close to the figure given by MSF itself above (50), although the dates are different. For this set of patients:

            Kailahun MSF CFR = (180/249)*100 =72.3%
            This is fairly close to the 66% figure obtained above using data from the organization’s web page of August 15.

            Conclusions: Using all the available data from the two Ebola facilities in Sierra Leone we get CFRs that range between 50% and 72%. This is considerably higher than the 37.7% CFR that our Ministry of Health is reporting. The method used by MOH is mathematically incorrect and leads to an underestimation of CFR.

            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela

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            • #7
              Re: Summary of Cases, Deaths, Discharges, and CFR

              There is also this excerpt from MSF report yesterday:

              "MSF?s care centers in Liberia and Sierra Leone are overcrowded with suspected Ebola patients. People continue to become ill and are dying in their villages and communities. In Sierra Leone, highly infectious bodies are rotting in the streets."


              With intensive care units full and medical supplies running out, eastern Aleppo’s seven remaining hospitals cannot cope for much longer, says surgeon Dr. Abu Huthaifa.
              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela

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              • #8
                Re: Summary of Cases, Deaths, Discharges, and CFR

                SITREP 109 for Liberia is now available on ReliefWeb.

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                • #9
                  Re: Summary of Cases, Deaths, Discharges, and CFR

                  Thanks, franzpick.

                  Here is a link to the pdf file:

                  http://novel-infectious-diseases.blogspot.com/

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                  • #10
                    Re: Summary of Cases, Deaths, Discharges, and CFR

                    Thanks Al - I shouldn't post from my non-pdf, unresponsive tablet but wanted everyone to know of the first new data that's come out in 4 days. Shortly I expect to post a simple database showing a 4 week summary as well as most recent new case/death numbers and trend changes for each of the 20 most active towns, areas and counties in the 4 or maybe 5 afflicted countries, to provide an estimate of the more timely figures that WHO used to publish but has, for unknown reasons, chosen to no longer make public.

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                    • #11
                      Re: Ebola Summary of Cases, Deaths, Discharges, and CFR

                      The last summary case update by the World Health Organization was on August 28, 2014. (link) WHO understands its critical role as the official international source for novel disease information. I think WHO cannot reconcile widely conflicting reports about infected cases and deaths from West Africa. At times, WHO does seem to delay public reporting of outbreak numbers until it is satisfied that the numbers are relatively accurate. I am not sure that WHO is keeping the numbers secret, it is just that they may not have a better grasp of the situation than the flublogia disease trackers following the local media and health ministry reports.
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                      http://novel-infectious-diseases.blogspot.com/

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                      • #12
                        Re: Ebola Summary of Cases, Deaths, Discharges, and CFR

                        I updated the table with the latest information from Liberia, Sierra Leone, and Nigeria. The total number of deaths is in line with what was reportedly released by the WHO today, although I can't find a WHO document with the updated numbers.

                        Click image for larger version

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                        Sierra Leonne has been providing daily updates on their facebook page here: https://www.facebook.com/pages/Minis...81064805403702
                        "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

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                        • #13
                          Re: Ebola Summary of Cases, Deaths, Discharges, and CFR

                          Building on the numbers above to get a better idea about CFR using conventional confidence intervals:

                          Sierra Leone: 62% (95% CI 58 to 74%)
                          Guinea Guekedou MS: 76% (69 to 82)
                          Kenema Ebola Center: 50% (44 to 55)
                          Kailahun MSF CFR: 72 % (66 to 78)

                          Overall 50% (47 to 53).

                          However, I suspect that may be biased, as patients who are able to make it to a centre are likely in less dire shape than those that aren't...

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                          • #14
                            Re: Ebola Summary of Cases, Deaths, Discharges, and CFR

                            This is updated with the most recent numbers. I'm not clear as to the number of discharged cases in Nigeria - alert?

                            Also, I think we all understand that the number of cases listed as still in treatment in Sierra Leone cannot be accurate. However, to calculate the CFR only the total number of deaths is divided by the total of deaths and recovered cases, both of which are listed by the Sierra Leone Ministry of Health and Sanitation.

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                            "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

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                            • #15
                              Re: Ebola Summary of Cases, Deaths, Discharges, and CFR

                              I've updated the table below with the most current data provided at the following links:

                              Sierra Leone - https://www.facebook.com/pages/Minis...81064805403702

                              Liberia - http://www.mohsw.gov.lr/content_disp...=press_release

                              Guinea - http://reliefweb.int/sites/reliefweb...EMBRE_2014.pdf

                              WHO - http://www.who.int/csr/disease/ebola...on-reports/en/

                              Note that something is wrong with the most recent Liberia numbers. They decreased total deaths by 70 between their situation reports 116 and 118. I doubt the overall CFR has decreased by more than 10% in the past couple of weeks.

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                              "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

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