As Virus Deaths Grow, Two Rich Nations Keep Fatality Below 0.1%

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As the global death toll from the coronavirus pandemic exceeds 250,000, two tiny nations stand out with the lowest fatality rates among countries who are experiencing major outbreaks.

In Qatar and Singapore, the death toll is less than 0.1% of reported infections. In Singapore, where total cases have surged to one of the highest in Asia as it grapples with outbreaks in foreign-worker dormitories, a102-year-old woman recovered from the virus and was discharged from hospital over the weekend.

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Patient demographics and the ability of the health-care system to cope are key to keeping the survival rate high in this pandemic, health experts say. While some countries with small outbreaks like Vietnam have not suffered a single death, those dealing with major spread -- defined as more than 10,000 cases -- often start to see their health-care infrastructure come under pressure.

Among economies with major outbreaks, Qatar’s case fatality ratio is the lowest at 0.07% -- 12 deaths out of more than 16,000 cases. Singapore’s ratio is 0.093% of more than 19,000 infections. Both countries have also kept mortality from the virus low as a proportion of their populations: less than 0.5 per 100,000 people.

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The two nations are also among some of the wealthiest in the world, which means they can better afford the test kits and hospital beds they need. Just behind Qatar and Singapore in survival rates are Belarus, Saudi Arabia and United Arab Emirates.

These rates are calculated from official numbers self-reported by nations. Belarus has come undercriticism for allegedly under-reporting its data.

Low case fatality ratios boil down to three things: testing, age of the population and intensive care unit capacity, said Raina MacIntyre, professor of global biosecurity at the University of New South Wales.

“Countries that test more and detect more mild cases will have an apparently lower case fatality rate,” she said. Older populations and countries that exceed their intensive care unit and ventilator capacity will also have higher death rates, she said.

While Singapore has an aging population and a higher median age than Qatar, the majority of its infections are among low-wage foreign workers, who are typically young and undergo health checks before they are allowed into the country to work.

Similarly, many of the cases in the Middle East are within the younger, migrant workforce. The majority of the population in U.A.E. and Qatar are younger expatriates, who also go through health checks before entering the country, and are required to leave once their employment is over.

— With assistance by Claudia Maedler, Donna Abu-Nasr, Simone Foxman, Philip Heijmans, and Nayla Razzouk

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