Issue Briefs
How We Should Think About the Odds of Dying From Covid-19
By Lucian Pugliaresi
May 03, 2020.
As government officials consider relaxing the lockdown of the national economy, there remains concern among many in the population that the risks of dying from Covid-19 are too high and that government decisions authorizing a return to work are premature. Putting aside the trauma and associated pain and suffering from contracting the virus, the central concern is whether people would likely lose their lives by returning to work, going to a restaurant, or even visiting the hair salon or gym. At the same time, the economic costs of the lockdown are imposing catastrophic and long-term damage to the national economy.
Situation not sustainable
The current situation, as Governor Cuomo has pointed out, is “not sustainable.” We cannot eliminate all deaths from this disease, but as we try to restore economic growth, it is time to evaluate what strategies, at the margin, are likely to provide the biggest payoffs in reducing individual risk. Of course, collective behavior (increasing or decreasing the rate of transmission of the virus) can also alter the number of fatalities. This is the primary reason that public-health policy has focused on enforcing social isolation. But extreme social isolation is costly.
Restarting the economy while lowering infection risk
CDC collects an enormous amount of data and will continue to be in a central position to publish and inform the public on the risk of dying from Covid-19. Most of us recognize that we cannot fully eliminate the risk of becoming infected, but what strategies are likely to have the highest yield in lowering our risk of infection, and who among us is most at risk? Individual risk of death will shift down as we learn more about the disease and become better informed on what measures are most effective for reducing transmission and what therapies work best for the infected.
How risky is it to go back to work?
There is a lot of discussion about the case fatality rate, i.e., what the chances are of dying if we become infected. But since we have little good data on the probability of becoming infected, we are not in a position to make an informed judgment on joint risk, which is the chance of getting infected and dying.
We do, however, have a fairly accurate estimate of deaths from Covid-19. Data on deaths in Italy and New York confirm that for the population under 50 years of age, the risk of death is close to zero and rises after that through all older age cohorts. I am well aware of heart-wrenching stories of younger men and women dying from
Covid-19; but so far, they account for a very small number of those who die from the disease.
Here is what we know from death data from New York and Italy: 70%–80% of Covid-19 deaths occur among those over 70. We also know that the risk of death rises with so-called comorbidities—diabetes, obesity, high blood pressure, impaired immunity, and so on. Two other groups are especially vulnerable: health-care providers (which should now be given a separate status category under occupational health risk); and those living in nursing homes. For New York and New Jersey, 20%–40% of the deaths are occurring in nursing homes.
How can CDC help us understand the death risk from Covid-19?
* The 2017 crude death rate, according to CDC, for the entire U.S. population (325 million) was 8.65 per thousand (yielding a probability of dying in any one year of 0.87%). This is calculated from a total of 2,813,000 deaths from all causes. Most epidemiological models are now showing 60,000–70,000 deaths for Covid-19 by August. Even if total Covid-19 deaths were to rise to 120,000 for the entire year, the crude death rate for the entire population would rise to only 0.9%.
* Taking U.S. resident population data and the actual death rate for older cohorts, the pre-Covid-19 crude death rates calculate out as follows for older males (men face a substantially higher risk than women): (i) 65–74 years: 17 per thousand, which yields an annual probability of death of 1.7%; (ii) 75–84 years: 42 per thousand, which yields an annual probability of death of 4.2%; (iii) 85+ years: 150 per thousand, which yields an annual probability of death of 15%.
This article was originally published on Real Clear Markets; full article here
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Lucian Pugliaresi is president of the Energy Policy Research Foundation, Inc. (EPRINC) in Washington, DC. He served on the National Security Council staff during the Reagan administration. |