we really have no idea what the cfr is like outside of the hospitals it is interesting to note that nigeria had a cfr of only the us has had people who have completed their run with ebola of whom only has died of the victims in europe only have died that is a significantly lower cfr than what we're seeing in the three hardest hit countries so it may be that the cfr in those countries is already taking into account the fact that many of the patients are not getting adequate medical care how many of the patients in that data set went untreated in medical facilities