However, the demographics of confirmed cases are changing over time, with more young people being infected in the later stages than in the early stages of the outbreak. Specifically, patient-level studies have shown that older patients, men, and patients with underlying diseases have a greater risk of death and require respiratory assistance in the intensive care unit (ICU) 2, 3, 4, 5, 6, 7.
Previous studies have not yet reached a conclusion regarding this issue because they focused only on the individual scale or the national scale and ignored the cross-scale correlation. We attempt to propose a reliable understanding of this observation. However, it is a great challenge to quantitatively interpret observational data presenting a high variation in mortality evolution across countries, which reaches two to three orders of magnitude for the difference in case fatality rate (deaths per confirmed case) and crude death rate (deaths per 100,000 population). Reliable death statistics and quantitative modelling are essential for understanding the pandemic 1. Therefore, lessons learned from the past waves, such as quantitative assessment of the severity of the epidemic and clarification of the determining medical and social factors, are urgently needed to help policymakers prevent more deaths in the next wave. Since COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11, 2020, approximately 5 million deaths have been reported across 184 countries or regions as of October 1, 2021.
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