March 26, 2020

COVID-19: ECDC notes 30% hospitalisation rate among diagnosed cases in EU/EEA countries with available data

The European Centre for Disease Prevention and Control (ECDC) published the seventh update to its Rapid Risk Assessment on COVID-19 on 25 March.



According to ECDC, as of 25 March, 204,930 cases and 11,810 deaths have been reported in the EU/EEA and the UK. ECDC noted that the number of reported COVID-19 cases is rapidly increasing in all EU/EEA countries and the UK, and the notification rate is increasing at a similar trajectory as was observed in Hubei province in late January/early February and in Italy in late February/early March.

The report noted that in EU/EEA countries with available data, 30% of diagnosed COVID-19 cases were hospitalised and 4% had severe illness. Among hospitalised cases, severe illness was reported in 15% of cases, and death occurred in 12% of these cases, with higher case–fatality rates in older adults. Hospitalisation rates were higher for those aged 60 years and above.

With regard to crude case-fatality, ECDC noted that estimates for Germany, Italy and Spain showed that both the risk and absolute numbers of deaths rapidly increased with age for those aged 60 years and above in each country.

In the present situation where COVID-19 is rapidly spreading in Europe, the current assessment is as follows, according to ECDC:

  • The risk of severe disease associated with COVID-19 for people in the EU/EEA and the UK is currently considered moderate for the general population and very high for older adults and individuals with chronic underlying conditions.
  • The risk of occurrence of widespread national community transmission of COVID-19 in the EU/EEA and the UK in the coming weeks is moderate if effective mitigation measures are in place and very high if insufficient mitigation measures are in place.
  • The risk of healthcare system capacity being exceeded in the EU/EEA and the UK in the coming weeks is considered high.

The agency advised further that measures taken at this stage should ultimately aim at protecting the most vulnerable population groups from severe illness and fatal outcome by reducing transmission in the general population and enabling the reinforcement of healthcare systems.

Given the current epidemiology and risk assessment, and the expected developments in the next days to few weeks, ECDC has outlined the following public health measures to be applied in EU/EEA countries to reduce further spread and mitigate the impact of the pandemic:

  • Community measures and social distancing should be implemented proactively and with active community engagement in order to reduce the impact of the epidemic and to delay its peak, allowing healthcare systems to prepare and cope with an increased influx of patients.
  • Measures in healthcare facilities are an immediate priority in order to:
    • slow the demand for specialised healthcare, such as ICU beds;
    • safeguard risk groups
    • protect healthcare workers that provide care
    • minimise the export of cases to other healthcare facilities and the community.
  • Testing and surveillance strategies should rapidly detect cases and elucidate transmission patterns.

“A strategic approach based on early and rigorous application of these measures will help reduce the burden and pressure on the healthcare system, and in particular on hospitals, and will allow more time for the testing of therapeutics and vaccine development”, ECDC added.