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Expected Deaths and COVID
@misterbitcoin posted a link to the CDC website to point out that the Wuhan Virus is waning. The most interesting number to me is “percent of expected deaths.” What does that mean? Let’s go to the CDC definition:
Percent of expected deaths is the number of deaths for all causes for this week in 2020 compared to the average number across the same week in 2017–2019. Previous analyses of 2015–2016 provisional data completeness have found that completeness is lower in the first few weeks following the date of death (<25%), and then increases over time such that data are generally at least 75% complete within 8 weeks of when the death occurred (8).
So the data are incomplete, but the percent of expected deaths shows how many deaths from all causes occurred in 2020 compared to other years. If the number is 100, there is basically no change. Over 100% means that there were “excessive” deaths. Under 100% means that fewer people died than expected.
Most of the states are around 100. This means that for those states, the Wuhan Virus has not resulted in an increase of the death rate. For instance, the “virus-ravaged” states of Georgia, Florida, and Texas are at 98, 99, and 99 percent respectively. This is also a running total, so the recent spike in those states may be bringing the death rate up now, but that means the overall rate was lower before.
This means the Wuhan Virus has killed a lot of people, but they would have likely died anyway. The overall death rate for the entire country is 104%, meaning that about 4% more people have died than would have otherwise.
There are also several outliers, and the biggest is: Guess where? The New York state overall death rate is 26% higher than average. But this excludes New York City, whose death rate is 103% higher than normal. That’s right, during the period of the pandemic, more than twice as many people died in the Big Apple compared to the same period in 2017-19. I didn’t do a deep data dive, but I’ll bet that, if you exclude New York, the pandemic resulted in fewer overall deaths in the US.
This actuarial way of looking at it may seem insensitive, but life insurance companies make a lot of money by figuring this stuff out. It looks like they’ll make a bundle this year.
Published in Healthcare
New York City’s response to the virus was so bad, it skewed the numbers for the entire country.
I know I’m congenitally inclined to despise the place, but really.
I think using different ways of looking at the data available is helpful. We get to look from multiple perspectives. In a way, we still don’t have a lot of answers, but the different approaches might keep some people honest. Or not.
The “New York metropolitan area” includes significant portions of New Jersey and Connecticut. ‘Basically commuting distance from NYC.
And it doesn’t include the rest of New York State (which is large).
So state-based statistics are going to be misleading here.
As I said, New York State and New York City are separate. The state with the highest death rate after New York is New Jersey, with 42% excess deaths. (My brother lives in New Jersey, by the way. He’ll be 60 this year. He’s not particularly concerned.)
Other states in the NYC Metro Area: Connecticut is only 89%, Massachusetts is 123% and Rhode Island is 106%.
I wonder what Connecticut and Rhode Island did right?
My guess is that a lot of the difference between states is going to be demographic, but the large outliers in excessive deaths are going to be because of government actions.
I think there are many other possible explanations. I think confining people (political) definitely made people become sicker from it. However, it’s also possible that there were several strains in play (medical). We got better at treating the disease the longer it was in the U.S. hospitals (medical).
Weather has a lot to do with how deadly the virus is among people who test positive for it. As late winter and early spring passed, the temperature and humidity changed (medical), and there was more disinfecting UV sunlight around. So people got a light exposure (medical) to the fomites and other infected people rather than the heavier exposure that came about because people were inside so much.
When my kids were little and there wasn’t the chicken pox vaccine, it was the conventional wisdom that the first kid in a family to come down with the virus had a much tougher time with it than the other kids in the household. That was absolutely what happened with my kids. I remember one kid got it very lightly, and the other was covered with the chicken pox. My point is that the order matters in the way viruses infect people and make them sick. That’s why, I think, as you move in concentric circles farther away from the covid-19 epicenters, the impact of the virus becomes weaker.
There are many other factors too. The SARS 2003 outbreak stopped making people sick so we stopped studying it, but I’m convinced it continued to circulate. The human immune system came to recognize it and repel it. That’s why there’s this almost Passover effect that we are seeing with young people not becoming sick from their exposure to this “new” virus. It also explains how in a very hard hit area north of Boston, we had only a 10 to 13 percent rate of infection. If you have innate immunity, you don’t produce measurable antibodies so we don’t know yet how to determine that number.
We can be pretty sure that this virus is simply going to disappear 18 months from when it first appeared because the first SARS in 2003 disappeared after 18 months. The virus gets weaker. We don’t know why. The Spanish flu did the same thing–it just disappeared after about 18 months.
I hope we are amassing and storing enough information right now that we can figure out how these viruses come and go even after this one stops making people sick. :-) We know a lot about viruses as individual organisms, but we don’t know enough yet about how they spread within populations to prevent them from doing so.
We have to gain this knowledge if we are to get back to international travel.
Actually, we do know why. There’s even a name for it: Attenuation.
It takes about 4 weeks for the cdc death numbers to be almost ‘complete’
June 13 is almost complete.
June 20 and later, death data are still coming in.
I think cdc updates the table twice a day
I think the virus will dissipate by July 31, the same day pandemic relief ends (unless Congress extends it)
This pandemic has largely been a nursing home and/or northeast phenomenon
The weather was very similar in Wuhan, Lombardy, New York, and Boston when the virus was peaking in all four places: gray, cold, dreary, 40 to 52 degrees. :-)
what temps do respiratory viruses thrive? between 37 f and 63 f
What comparisons are there between nursing home deaths in NYC and nursing home deaths in low death states?
https://nypost.com/2020/06/27/almost-half-of-us-covid-19-deaths-are-linked-to-nursing-homes/
https://www.nytimes.com/interactive/2020/us/coronavirus-nursing-homes.html?action=click&module=Spotlight&pgtype=Homepage
According to NY Times, nursing home deaths account for 20% of covid deaths in NY which seems low to me.
The 2006 CDC guide to flu-like epidemics says it takes 8 months to pass through the USA. That feels about right.
Let it be so! :-) I hope that’s right. Fantastic.
It appears that it is going on hot and heavy in Arizona, Texas and Florida right now.
Only if we let it. All the precautions we are taking are extending the risks, not reducing them.
Cases in Mexico are increasing near the border counties
Which is why it’s also going hot and heavy in California. For some reason that one is left out.
Cases and hospitalizations are increasing but it’s not hot and heavy
Most of the reason that cases are increasing is that there is more testing and it’s more accurate. “Hospitalizations” are increasing because everyone being admitted is being tested. Example: I had a patient in the ER who had appendicitis. Everyone going to surgery was tested and he was positive for the Wuhan Virus. SARS does not cause appendicitis.
excellent point: patients with covid vs patients suffering from covid
Weekly deaths involving covid are trending down!
Also of interest, deaths involving covid, pneumonia and influenza are also showing the same trend. I look at this column because the 3 illnesses are similar and sometimes miscategorized.