Putting COVID-19 deaths in context

OPINION

BY LEN CABRERA

Since April 17, we’ve been calculating the COVID-19 case fatality rate (CFR) by age to demonstrate that this virus is primarily dangerous to older people and that the vast majority of Floridians do not need to worry about dying from COVID-19. Here’s the latest version of that graph, using the August 14 version of the Florida Department of Health (FDOH) case line data. (We cut off the data at August 8 to somewhat match the CDC data that will be discussed shortly. Lately, the FDOH site has been buggy, so the data can also be downloaded here.)

We get strong objections from people who say any reassuring information could cause people to let their guard down. They say that older people are at great risk because that graph says 1 in 5 cases (20%) of people over 85 will die. That ignores the original argument: young, healthy people are not in danger. (“You want to kill grandma” is a common refrain to silence any opposition to the coronavirus overreaction.)

It is somewhat misleading to say that 20% of the elderly will die because that ignores the chances of catching COVID-19. There is a good case study on the Diamond Princess cruise ship, where people were confined in close proximity, and only 17% of the people on the ship tested positive. Therefore the probability of dying from COVID-19 is the product of the probability of catching COVID-19 and the probability of dying from COVID-19 (the CFR, preferably specific to your age group and health status). That makes the probability of catching AND dying from COVID-19 for the 85+ population 0.17(0.20) = 3.4%. That still sounds bad, but the average probability of passing in the next 12 months for men between 85 and 100 years of age is 21.8%, according to the Social Security Administration’s Actuarial Life Table.

Rather than looking at theoretical probabilities, now we can put COVID-19 deaths in context with other causes of death because the CDC finally released data on COVID-19 and total deaths by age. (This was originally released on August 5 and updated on August 12.) The FDOH does not publish data for other causes of death immediately, as it does COVID-19. Here is  the CDC data for Florida and the U.S. as a whole:

The CDC data is based on a review of death certificates and can be delayed up to 8 weeks, so the data does not match up perfectly with the FDOH case line data. The CDC data goes through August 8; the FDOH August 14 data file (restricted to August 8) has about 2,200 more deaths listed, but the distribution of deaths by age is almost identical to the CDC data.

The CDC data can be combined with U.S. Census data on population to show the disproportionate impact of COVID-19 on the older population. For U.S. population data, we’re using the Census population clock for August 8 with the distribution percentages on this Census table. For Florida, we’re using the population and distribution from the Florida Demographic Estimating Conference.

Individuals over 85 comprise only 2.8% of Florida’s population and make up 32.7% of COVID-19 deaths. Individuals over 75 comprise 9.5% of Florida’s population and make up 61.6% of COVID-19 deaths. Compare that to the population under 55, which makes up 65.3% of Florida’s population and only 7.2% of COVID-19 deaths. This table shows the percentage of the population and COVID-19 deaths for various age groups in Florida and the U.S.:

The following graphs show the distribution of population and COVID-19 deaths by age group.

The graphs above highlight the facet that COVID-19 predominantly targets older people—the point at which a person’s risk for dying of COVID-19 is the same as their prevalence in the population is around 65 years of age. The relative risk of dying drops off quickly below 65 and rises quickly above 65.

In fact, life expectancy in Florida is 79.7 (76.9 for males, 82.6 for females). The median age for COVID-19 deaths in Florida is 79 (77 for males, 81 for females; these figures are from the FDOH case line data). 73% of all COVID deaths in Florida are over age 70.

The CDC data also allows us to put COVID-19 deaths into context with all other deaths. In Florida, less than 6% of 2020 deaths through August 8 were caused by COVID-19. For people under 35, that figure drops just below 1% (45 out of 4,672). Above 65, it’s 6.2%; above 75 it’s 6.2%; above 85 it’s 6.0%. The graph below shows Florida COVID-19 deaths as a percentage of total deaths by age group.

Obviously, people in their 80s are more likely to die than younger people, but it is notable that for every age group, people in Florida are roughly 15 times more likely to die of something besides COVID. That means we’re obsessively focusing on a tiny percentage of people who die while dismissing every side effect of the policies that have been enacted to mitigate COVID-19.

The CDC just announced that symptoms of anxiety disorder have tripled since last year. In June, 11% of adults surveyed had contemplated suicide in the past 30 days, nearly double the number from 2019. For the 18-24 age group, 25% reported having these thoughts. There are indications that we will lose far more young people to suicide than to COVID-19 this year.

Trauma experienced by the weak and vulnerable population who have been isolated by draconian social distancing rules has been lost in the panic over COVID-19. Nearly 4,300 people over the age of 75 died from COVID-19 in Florida (87,000 in the U.S.), but consider the 64,000 others in Florida (815,000 in the U.S.) who died from other causes this year. Many were forced to face their final days in the hospital alone, without the comfort of friends or family, for fear of asymptomatic spread of COVID-19.

Some precautions are, of course, necessary to protect the vulnerable from infection, but they should be taken by (and around) the vulnerable population. Instead, governments and other institutions have over-reacted, treating everyone as if they are infected with Ebola. Whether that was caused by or is the cause of the mass public panic and misperception of COVID-19 is debatable, but understanding what the data tells us about risk by age group is the first step toward overcoming the fear.

A survey of 1,000 adults in 6 different countries (6,000 total) was released in mid-July. Although a majority of them favored government policies they believed would keep them safe, all responses on policy preferences should be immediately discounted because the average guess of respondents on the percentage of each country’s population that had died from COVID-19 was well over 100 times the actual percentage (see page 24). The average for U.S. respondents was 9%, 225 times higher than the actual number. That 9% death rate would be nearly 30 million deaths–and that was the average, meaning some people thought it was higher. That explains why some people are begging national and local governments to be even more tyrannical.

The actual percentage of the U.S. population that has died from COVID-19, based on the CDC data, is 0.045%: 149,192 deaths compared to a population of 330,085,565 (on August 8). That percentage is even lower in Florida (0.033%) because Governor DeSantis didn’t order nursing homes to take COVID-19-positive residents back like some incompetent governors did, effectively allowing the virus to spread among the most vulnerable population. (It’s so bad that New York is hiding the number of deaths in nursing homes.)

Below is a graph showing the percentage of the Florida population that has died from COVID-19 by age group.

It’s hard to believe with all the panic, but well over 99% of every age group has survived the COVID-19 pandemic so far. With the daily announcements of hundreds of COVID-19 deaths raising the specter of bodies piled in the streets, most people would probably be shocked to learn that only 0.38% of the 85+ population has died from/with COVID-19. (6.4% of the 85+ population has died so far this year.) 

Turning to even younger groups and the issue of reopening schools, it’s evident from the chart above that students are at very low risk of dying from COVID-19. To put students and their parents at ease: the chances of dying for someone in the 5-14 age group is roughly 1 in a million (using the FDOH data). For the 15-24 age group, it’s 9 in a million: 0.0009%. Those numbers include the at-risk population. Those who are not obese or diabetic (or have other health issues) have even less to fear.

In March, it was feared that nobody had any immunity to COVID-19, so everyone would get it. People jumped to worst-case scenarios based on WHO reports of 3.8% CFR in China (5.8% in Wuhan). On March 3, the WHO Director-General said, “Globally, about 3.4% of reported COVID-19 cases have died.” It’s time for people to come to grips with the reality that COVID-19 is not nearly as deadly as originally feared, especially for healthy people under 65. The CFR for those under 65 in Florida is only 0.36%. That’s case fatality rate; the infection fatality rate is much smaller, possible even 1/10th. For comparison, the average infection fatality rate for seasonal flu is 0.14% for all ages. (It ranged from 0.1% to 0.18% for 2010-2018.)

This news should be reason to celebrate and remove restrictions, not to continue to use case numbers to keep everyone locked down. The original plan was to “flatten the curve” to protect our hospital capacity, and that has been done. According to the CDC, the percentage of emergency department visits for COVID-19-like illness for the week ending August 8 was only 2.6%. In fact, it was never over 7%.

The models predicting that millions would die were wrong, but instead of celebrating the real data, our media has continued to keep us fearful that the stacks of bodies are just around the corner… “wait two more weeks.” Let’s stop the panic, end the lockdowns, send kids back to school, and return to normal life. We can protect the vulnerable, but we must also focus on all the people who have been harmed while we cowered in our homes, afraid of a virus with a survival rate over 99.7% for people under 65.