
When Covid-19 deaths are analysed by age, America is an outlier - mnm1
https://www.economist.com/graphic-detail/2020/06/24/when-covid-19-deaths-are-analysed-by-age-america-is-an-outlier
======
fallingfrog
Many young people in America have no health care, and delay going to the
doctor until they are on death’s doorstep. That might be part of it. Before I
got my first desk job at the age of 32, my reality was that going to a doctor
or dentist was as distant an idea as being an astronaut. I had never been, and
had no idea how one would even go about trying, and had no money to pay for
those kinds of services anyway. I’m sure that many people are stuck in that
position for far longer (or indefinitely). After I got that first job the
first thing I did was have 7 fillings and 2 root canals, saving several of my
teeth.

------
glofish
The graph on the left shows that America is doing much better than Europe as
far as case fatality rate goes, about half that of Britain/Spain or Italy.

Yet somehow that positive information is turned into a negative sentiment of
look how much worse the situation is, our people are younger.

Perhaps the explanation is that the two measures are fully correlated:

Patients in the US are younger, hence die less often.

~~~
Recurecur
The obvious interpretation of this is that in some places like Italy, the
older population received much more exposure than it did in the US. In Italy,
this was due to so many extended families living in the same home.

In fact, things would have skewed even younger in the US except for the
nursing home debacle in NY and NJ.

It's worth pointing out that there's quite a disconnect between the US media
coverage of the mortality rate here, versus the higher mortality rate in
Britain, France, and other EU countries. There is also a good chance that
COVID mortality in the US is being significantly overcounted.

Regardless, there's little choice at this point - we need to keep the economy
open as we wrestle with minimizing hospital visits and fatalities. Let's hope
improved treatments are developed at a high rate!

~~~
ChrisLomont
>There is also a good chance that COVID mortality in the US is being
significantly overcounted.

It seems experts (CDC among other) suggest the mortality is quite a bit
undercounted, since there are many deaths for which the person is not tested,
since we lacked the testing capabilities.

One interesting place to see it is expected death rates versus actual death
rates while COVID is here, and note there is no other known thing that spiked
at the same time to account for the excess deaths.

What science groups or medical groups are claiming it's overcounted?

For example,

[https://www.scientificamerican.com/article/how-
covid-19-deat...](https://www.scientificamerican.com/article/how-
covid-19-deaths-are-counted1/)

[https://www.npr.org/sections/goatsandsoda/2020/05/13/8548736...](https://www.npr.org/sections/goatsandsoda/2020/05/13/854873605/fauci-
says-u-s-death-toll-is-likely-higher-other-covid-stats-need-adjusting-too)

~~~
Junk_Collector
Is this really true though? Most states report separate numbers for cases and
confirmed cases as well as deaths and confirmed deaths. In Texas there is
something like a 3 order of magnitude difference between the number of
reported cases and the number of confirmed cases and you can see wild
discontinuities in the reporting data as they periodically change their
methodology and or criteria. New York, for instance, was reporting deaths were
Covid-19 might have contributed rather than confirmed deaths.

My biggest problem is that while it is trivial to find mountains of Covid
visualizations, raw data with clear explanations of it's criteria and
methodology is very hard to come by. I think it's quiet likely that some
locations are over reporting and others are under reporting.

~~~
ChrisLomont
>Is this really true though?

According to the research papers and professional groups I've looked as this
is true. If you want to discount experts that are well aware of the problems,
methodologies, etc., then I don't know how you'll reach any conclusion. Non-
experts are rarely more accurate than experts on complex issues.

As to methodology, CDC lists and recommends methodologies for all diseases,
and COVID deaths are counted by them using the same methodology that all
deaths are, whether cancer, heart attack, car wreck, etc. So there is nothing
special about how COVID deaths are counted from their recommendations.

Many states seems to have political pressure to downplay COVID, but I've not
seen credible complaints (or any complaints) by whistleblowers claiming
they're pressured to increase death counts.

And overall death counts versus expected death counts gives a picture of
likely COVID caused deaths that makes them far undercounted.

I expect scientists to arrive at pretty good counts eventually, then political
and nonsense spreaders to ignore anything that doesn't suit their narratives.

Here's [1] some CDC covid methodology info - if you google CDC COVID
methodology or CDC disease methodology you'll find plenty of methodology on
data collection.

[1] [https://www.cdc.gov/coronavirus/2019-ncov/covid-
data/covidvi...](https://www.cdc.gov/coronavirus/2019-ncov/covid-
data/covidview/purpose-methods.html)

~~~
Junk_Collector
I'm not trying to pick fights with experts or claim there there is some hidden
agenda to inflate death counts, I just want frank discussion of the data. Now,
from the CDC methodology you linked,

"For COVIDView, the percentage of total deaths occurring in a given week that
had pneumonia, influenza and/or COVID-19 (PIC) listed as a cause of death is
calculated. PIC deaths are identified based on ICD-10 multiple cause of death
codes J09-J18.9 or U07.1. PIC is being monitored in order to provide a more
accurate representation of COVID-19 related mortality than would monitoring
COVID-19 alone. Deaths due to COVID-19 may be classified as pneumonia deaths
or influenza deaths (deaths due to “flu” or “flu-like illness”) in the absence
of positive SARS-CoV-2 test results. The combined PIC categorization also
prevents double counting of deaths"

The death rate from Covid-19 includes deaths from other causes that have
similar symptoms. The reasons for this are good, it's very difficult to
identify between these diseases and lumping them together probably gives a
more accurate result than relying on confirmed cases. There's no malice here,
it's just a very difficult problem to work on, but it's also a methodology
that should be likely to give a high side estimate. Then from there, they
calculate excess deaths [1], which I was able to find through your link (thank
you). Outside of New York/New Jersey and Massachusetts, I don't find a high
disparity in the excess death ratio that supports the idea that there is
significant under reporting of deaths.

You can find cause of death vs year on their charts at [2] and most of the
excess deaths are from cardiac arrest or dementia. Now, that could be caused
by Covid, except if we go to New York where Covid has been by far the worst in
the US, you see a huge jump in respiratory deaths directly lining up with the
peaks in the reported Covid cases. So are more people having heart attacks? Is
Covid causing heart attacks? Are people unwilling to get treated at hospitals
for heart attacks because they are afraid of Covid? These are unanswered
questions and it could go any which way from what I understand. The data
appears to be out, and I think it will be out for a while which is why I don't
feel comfortable pushing the idea that we are under-reporting deaths or over-
reporting deaths because I think that we don't actually know.

[1]
[https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm](https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm)
[2]
[https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm...](https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm#dashboard)

~~~
ChrisLomont
>but it's also a methodology that should be likely to give a high side
estimate

It's the same methodology they use for all diseases. If it's too high an
estimate, they'd pretty quickly find it since it would overcount enough
reasons fro death that totals would not match measured death totals.

In my original post I linked evidence and the expert reasons why counting is
likely low.

>Outside of New York/New Jersey and Massachusetts, I don't find a high
disparity in the excess death ratio that supports the idea that there is
significant under reporting of deaths.

The CDC link had many states with many thousands of excess deaths. And
remember CDC death count lags actual death counts by a few weeks, so the
118k-154k (95%-ile) they list is to be compared to COVID as of a few weeks
ago, which was under 110K two weeks ago. So taking the median gives around
136K actual deaths (prob not all COVID, but majority so) vs 110K reported -
approx 20% undercounted.

>So are more people having heart attacks? Is Covid causing heart attacks?

Both of those are likely true [1]. Research since then is looking like COVID
is killing asymptomatic people via attacking the heart.

>I don't feel comfortable pushing the idea that we are under-reporting deaths
or over-reporting deaths because I think that we don't actually know

I've found significant decent groups and projects claiming undercounting, many
with decent empirical evidence. I've not found the opposite, despite looking.
I posted a few to get you started - discount as you wish.

[1]
[https://www.sciencedaily.com/releases/2020/03/200327113743.h...](https://www.sciencedaily.com/releases/2020/03/200327113743.htm)

------
jml7c5
Be careful reading this graph. The x-axis is "share of total deaths, %", but
these are _relative_ measures, not absolute ones. One way for the US to match
the other countries would be to intentionally kill a bunch of old people.

A better graph would be "infection fatality rate, %", grouped by age, and
compared across countries.

------
didibus
Is this article like under 100 words? Or is the rest paywalled and why I only
see the first two paragraphs?

~~~
nkurz
It's short, but not that short. Pasted:

IT IS NOW well-known that, although covid-19 can strike even the very young,
older folk face the greatest risk. In hard-hit rich countries, about 60% of
all deaths from the disease are among people aged 80 and over. America,
however, is an exception. Data released on June 16th by the Centres for
Disease Control (CDC) show that the country’s death toll skews significantly
younger. There, people in their 80s account for less than half of all covid-19
deaths; people in their 40s, 50s and 60s, meanwhile, account for a
significantly larger share of those who die. The median covid-19 sufferer in
America is a 48-year-old; in Italy it is a 63-year-old.

Why is America such an outlier? Part of the explanation surely lies in the
fact that America has a younger population than Europe does. America’s median
age is just 38; Italy’s is 45. Another reason, perhaps, is that middle-aged
Americans may be less healthy than their European peers, eg, because they tend
to be more obese.

Whatever the cause, the relative youthfulness of America’s covid-19 victims
means that the coronavirus is robbing Americans of more years of precious
life. A recent study by a group of Scottish researchers estimated the number
of years of life lost to covid-19 by age, taking account of the victims’
underlying health conditions. It found that in Italy, people who died in their
50s, 60s, and 70s typically lost 30, 21, and 12 years, respectively. Those in
their 80s lost five years, on average.

Applying these estimates to the victims of America’s outbreak, a back-of-the-
envelope calculation suggests that covid-19 has so far shortened the lives of
its American victims by 11 years, on average, compared with about nine years
in the hardest-hit European countries. America may not yet have reached the
same rate of covid-19 deaths as the likes of Britain, Spain and Italy. But the
contagion in America is far from contained. Anthony Fauci, one of the experts
in charge of America’s response, has warned of a “disturbing surge” in new
infections in parts of the country. And when the age profile is factored in,
there is even more reason for Americans to be disturbed.

------
redis_mlc
This video from UCSF explains the correlation of corn syrup, obesity and
diabetes, which also explains the corona mortality age distribution in the US:

Sugar: The Bitter Truth (2009)

[https://www.youtube.com/watch?v=dBnniua6-oM](https://www.youtube.com/watch?v=dBnniua6-oM)

It's a 90 minute video, so to summarize:

\- US decreased fat in processed food, but compensated with HFCS (corn syrup)

\- HFCS contains fructose, which is poisonous in large quantities, which we
are now eating (almost half a pound per day per person)

\- the additional calories in processed food caused Americans to gain 25
pounds in 20 years

If you drink regular soda with HFCS, then you should switch to one can of cane
sugar soda (from Mexico), or one diet can per day. Look at labels and avoid
HFCS whenever possible.

You can do a quick reality check on the above by comparing group photos from
the 1960s and today - nobody was fat back then, except for Mama Cass.

~~~
lookdangerous
Is corn syrup (instead of HF corn syrup) ok to consume, or is it too pretty
darn bad fer ya?

~~~
redis_mlc
The reporting says it's the fructose amount that's highest in importance,
since the liver warehouses it, and that seems to cause metabolic diseases,
followed lower in priority with large sucrose/glucose amounts.

So fructose in a single fruit with natural fibers is ok, but half a kilo per
week or more of raw fructose is toxic.

This is a more watchable video with industry slides admitting there's a
problem (similar to cigarette industry):

The Secrets of Sugar - the fifth estate (2014) (42 minutes)

[https://www.youtube.com/watch?v=K3ksKkCOgTw](https://www.youtube.com/watch?v=K3ksKkCOgTw)

I really encourage people to learn about this topic since it directly affects
quality of life. If you get free soda at work, skip the HFCS containers.

