Population-level COVID-19 mortality risk for non-elderly individuals overall and for non-elderly individuals without underlying diseases in pandemic epicenters

John P. A. Ioannidis; Cathrine Axfors; Despina G. Contopoulos-Ioannidis

The magnitude of COVID-19 death risks is difficult to grasp, especially when population-level risks are small. Therefore, we converted the absolute risks of COVID-19 death into equivalents of death risk by a well-known, almost ubiquitous activity, 4 driving/travelling by motor vehicle. We used estimates from the International Transport Forum Road Safety Annual Report 2018 (ref. 5) for the number of road deaths per billion vehicle miles for each European country. For Spain, Italy, and Portugal there were only data available for number of road fatalities per 100,000 inhabitants. Since these tend to correlate reasonably well with road deaths per billion vehicle miles in Europe, we used for Italy and Portugal the same road deaths per billion kilometers as Belgium, since they have the same road deaths per 100,000 inhabitants and we did the same for Germany and Spain. For USA locations, we used the state-specific data provided for 2018 by the Insurance Institute for Highway Safety. 6 For New York City, we used motor vehicle fatality data pertaining to New York State. We then divided the estimated miles travelled that correspond to the same death risk by the number of days that have passed since the first COVID-19 death was recorded in each location and until April 4, 2020. The result transforms the average risk of COVID-19 death during the period where COVID-19 deaths occur into an equivalent of miles travelled by car per day.