Adjusting COVID-19 reports for countries' age disparities: a comparative framework for reporting performances

Objectives: The COVID-19 outbreak has impacted distinct health care systems differently. While the rate of disease for COVID-19 is highly age-variant, there is no unified and age/gender-inclusive reporting taking place. This renders the comparison of individual countries based on their corresponding metrics, such as CFR difficult. In this paper, we examine cross-country differences, in terms of the age distribution of symptomatic cases, hospitalizations, intensive care unit (ICU) cases, and fatalities. In addition, we propose a new quality measure (called dissonance ratio) to facilitate comparison of countries’ performance in testing and reporting COVID-19 cases (i.e., their reporting quality). Methods: By combining population pyramids with estimated COVID-19 age dependent conditional probabilities, we bridge country-level incidence data gathered from different countries and attribute the variability in data to country demographics. Results: We show that age-adjustment can account for as much as a 22-fold difference in the expected number of fatalities across different countries. We provide case, hospitalization, ICU, and fatality breakdown estimates for a comprehensive list of countries. Also, a comparison is conducted between countries in terms of their performance in reporting COVID-19 cases and fatalities. Conclusions: Our research sheds light on the importance of and propose a methodology to use countries’ population pyramids for obtaining accurate estimates of the healthcare system requirements based on the experience of other, already affected, countries at the time of pandemics.