U -to-hospitalization ratio is used to assess the proportion of 
patients requiring ICU admission in relation to the total number of hospitalizations. The death -to-hospitalization ratio 
is used to assess the proportion of death s in relation to hospitalized patients.  
 
These indicators are subject to the same limitations mentioned above and their calculations are limited to the 
countries reporting all relevant data elements (hospitalizations , ICU admissions and deaths) in a given reporting 
period . It should be noted that there may be differences in reporting among countries. For instance, in some 
countries, hospitalization data may include ICU admissions, whereas in others, ICU admissions may be reported 
separately. Furthermore, it is important to  consider that some death s might have occurred outside of hospital 
facilities.  
 
Overall, the ICU -to-hospitalization ratio has been decreasing since the peak in July 2021 when the ratio was 0.2 6, 
dropping below 0.15 since the beginning of 2022, and around 0.05 since the start of 2023  (Figure 8) . The trend has 
been stable  in recent wee ks. This suggests that a decreasing proportion of new hospitalizations require intensive 
care.  
 
Similarly, the death -to-hospitalization ratio has been showing a general decline since July 2021. Since January 2023, 
it has remained under 0.15 , varying  between 0.06 to 0.14. This is an encouraging trend indicating a lower mortality 
risk among hospitalized individuals.  
 
Please n ote that the causes for these decreases cannot be directly interpreted from these data, but likely include a 
combination of increases in infection -derived or vaccine -derived immunity, improvements in early diagnosis and 
clinical care, reduced strain on hea lth systems, and other factors. It is not possible to infer a decreased intrinsic 
virulence amongst newer SARS -CoV-2 variants