Can judgments according to case fatality rate be correct all the time during epidemics? Some lessons from Coronavirus 2019-nCoV case fatality rate index in Iran
Abstract Background: Coronavirus 2019-nCoV was first identified in China in 2019. One of the most important indices noticed by experts, policymakers and managers which is daily evaluated in epidemics and a lot of judgments are made based on it, is case fatality rate (CFR) index of the disease. CFR can change during epidemics. This study aims to calculate CFR index for nCov-2019 in Iran and answer the following question: Is it right to base judgment on CFR all the time during epidemics and is it right to judge based on that since the outbreak of an epidemic?Methods: This research is a descriptive study. Its required data was obtained from the website of The Ministry of Health and Medical Education of Iran from February 20th 2020 until March 14th 2020. CFR index was calculated when the death toll of a disease is divided by the total number of people infected by that disease. Excel 2013 software was used to a1nalyze the data.Results: According to the findings of this study, In Iran, until March 14th 2020, 11364 people have been infected by Coronavirus 2019-nCoV and 514 people died of it. CFR index had a descending trend and it was 100%, 18.6%, 8.8%, 3.1%, 3.3%, 4.5% on the first, fifth, tenth, fifteenth, twentieth and twenty fifth day, respectively. Conclusion: In emerging epidemics, an index must not be based to judge a health system’s performance until that epidemics condition has not been clarified. It would be suggested that in the outbreak of an epidemic, specifically emerging diseases, CFR must not be the base of judgment. Making judgments, specifically, in the outbreak of emerging epidemics based on fatality rate can lead to an information bias.