Numbers and Context

A disclaimer from the start. None of this is meant to minimize what has happened as a result of the ongoing plague. Death of someone close to you is always painful. But we also have to accept that death is part of the world.

Another caveat – I don’t read or follow any of the major news networks. My impression of them is what I get from various headlines that I come across. It is possible this is information is being presented but I have my doubts.

Numbers by themselves aren’t very useful. We have become fixated on the total number of new cases and total number of deaths. And when they cross certain thresholds, the media is quick to point this out. It makes for a very scary situation when you see raw numbers but that’s not the whole story.

The CDC has finally started posting more informative tables and you can find similar information on state websites. The more I see of this, the more I’m convinced that any place that is still clinging to the one size fits all approach of hiding in place isn’t doing this for true scientific reasons.

I can understand the reasons for this back in March. We didn’t know a lot. We had a new scary virus that was wreaking havoc on places. We didn’t know about mortality rate. We didn’t know how fast it would spread. We didn’t know about vulnerability in certain groups. The models were predicting the collapse of the health care system and death everywhere.

But lets put some of the numbers into context. Right now, the CDC has only accounted for 33,500 of the COVID 19 deaths. They warn on their website that this is because there is a lag between the death and when the death certificate is processed.

But over the period where we had 33,513 deaths due to this new virus, we had 47,295 deaths due to Pneumonia. Of the 33,513 virus deaths, there were 14,910 where both the virus and pneumonia were listed. Which brings up the problem of knowing who died from the virus and who died with the virus. Again, not to minimize, but how many of these deaths were already at risk of dying from other causes.

And, it comes back to my point about putting these into context. If we tracked pneumonia the way we tracked this virus, it would look just as scary or perhaps even more scary. Yes, slightly different circumstances but the stuff that causes pneumonia is probably out there along with this new virus. We live with that risk pretty much every day.

The other thing CDC does is break this down by age. This virus disproportionately kills the elderly. In the current table, 58% of the deaths are in people 75 and older and that group only makes up about 7% of the general population. Drop down to 65 and older and that group is 80% of the deaths while only being 16% of the population. Drop down to 55 and older and you’ve now accounted for 92% of the deaths in a group that makes up only 30% of the population. Since I’m in that last group, I don’t like adding it to the total.

If you look at the younger age groups, they currently have 9 deaths in kids under 14. That contrasts to 104 deaths from pneumonia and 81 deaths from influenza. The influenza deaths do include cases that list either the virus or pneumonia and they don’t break it down any finer. Looking back, I think there is a legitimate question as to whether we really needed to shut down all the schools. We don’t do it for the flue and, in the younger age groups, flu is more deadly than this virus. Not true in the older groups.

What seems clear from this data is that the goal going forward should be to find ways to protect and shelter the elderly. And that clearly we haven’t been doing a great job of that. I looked into a couple of states. In Pennsylvania, 65% of the deaths were in nursing homes. In New Jersey, 48% were in long term care facilities. The first outbreak was in a nursing home in Washington. New York apparently allowed people who tested positive to be admitted to nursing homes.

But I also think that any of these open up orders should address the risk. I read the one from Colorado and it did. It listed high risk categories and said those folks should remain at home. I don’t think that is consistent from state to state though. And I’d like to know if they are going to focus testing and resources on nursing home personnel. A one size fits all opening is just as bad as a one size fits all closing.

And it is true that you can’t force people to follow orders. We are seeing lots of evidence of that. But it would be nice to get the information out there and let people understand the risk. Holding a giant gathering with the grandparents probably isn’t a good idea right now. But keeping young and healthy people locked in their houses doesn’t seem to make a lot of sense either.

OK, that’s enough with the numbers for now.