Demographic science aids in understanding the spread and fatality rates of COVID-19

Jennifer Beam Dowd*, Liliana Andriano, David M Brazel, Valentina Rotondi, Per Block, Xuejie Ding, Yan Liu, Melinda C Mills*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

576 Citations (Scopus)


Governments around the world must rapidly mobilize and make difficult policy decisions to mitigate the coronavirus disease 2019 (COVID-19) pandemic. Because deaths have been concentrated at older ages, we highlight the important role of demography, particularly, how the age structure of a population may help explain differences in fatality rates across countries and how transmission unfolds. We examine the role of age structure in deaths thus far in Italy and South Korea and illustrate how the pandemic could unfold in populations with similar population sizes but different age structures, showing a dramatically higher burden of mortality in countries with older versus younger populations. This powerful interaction of demography and current age-specific mortality for COVID-19 suggests that social distancing and other policies to slow transmission should consider the age composition of local and national contexts as well as intergenerational interactions. We also call for countries to provide case and fatality data disaggregated by age and sex to improve real-time targeted forecasting of hospitalization and critical care needs.

Original languageEnglish
Pages (from-to)9696-9698
Number of pages3
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number18
Publication statusPublished - 5-May-2020
Externally publishedYes


  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections/epidemiology
  • Humans
  • Italy
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral/epidemiology
  • Republic of Korea
  • SARS-CoV-2
  • Sex Factors


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