By: John C. Lesher
The New York Times ran an edition recently in which the standard front page was replaced by the names of approximately 1,000 Americans who died from the Coronavirus. Names, ages and brief biographical notes were given. The deceased were listed in order by date of death, although the actual date and location of death for each decedent were not given. The data were culled from obituaries found in roughly 300 newspapers and other media sources published throughout the United States.
The method of listing was similar to the presentation of names on the Vietnam War Memorial in Washington, D.C., and, like a visitor to that Memorial, a reader is tempted to search the list to see if, sadly, some familiar name appears. I did the search and found no familiar name, but noticed something that caused me to take a much closer look at the thousand profiles.
The proportion of senior citizens listed was shocking. Throughout the lockdown associated with the pandemic we have heard that nursing homes were centers of severe infections and their senior residents were particularly vulnerable to the virus. The data in the Times indicate the brutal reality of that claim and possibly indicate that, if anything, its effect on seniors has been under-reported.
I looked at each entry and recorded it by age group: under 30; 30-39; 40-49; 50-59; 60-69 and 70 and over. I cannot speak as a skilled statistician and assert with confidence that the thousand names presented (my count was 1,011) represent a truly random and statistically valid national sample of the victims of the virus. All I know is that the numbers published are as follows (age group followed by the number of deaths in that group out of the 1,011 deaths presented by the Times):
Under 30—11—one of these was a 5 year old; the next youngest was 22.
30-39—13
40-49—40
50-59—68
60-69—161
70 and over—718
Depending on how you identify a senior citizen, the percentage of senior deaths varies: 71% if only those 70 or over are considered, but the percentage rises to 87% if your definition starts at age 60. I am forced to repeat that I have no way of knowing if this thousand person sample is representative of mortality for the entire nation caused by the Coronavirus. That said, a thousand case sample is usually of sufficient size to give a clear indication of a valid trend line.
Assuming the validity of the sample, the data have a mix of good and bad news that we should study closely. I have said in prior blogs that I supported the decisions by elected officials in the 50 states to lock down our citizenry and, as a consequence, our economy. Simply put, our officials lacked concrete data and prior experience with a biological enemy and they decided to err on the side of caution. But now is now and we are beginning to see how this pathogen works its way through our society. We have an evolving “book” on this virus and should evaluate whether or not various impositions on social and business activities have been effective, or, much worse, have they been harmful—a cure worse than the disease. If the virus resurges in the fall or winter as some predict, will we apply the same prophylaxis? What have we learned?
The primary and glaring conclusion from the age-group breakout is that seniors need highly concentrated attention. It is a clear warning that anyone in a certain age group (your author is 76) is intensely vulnerable to the most damaging aspects of this virus. However, the 87% mortality number shown above for those over 60 couldn’t possibly have come solely from nursing homes and other residences of seniors. I assume that the senior mortality shown came from nursing homes, Veterans hospitals and extended care facilities, but also included those seniors enjoying various independent living arrangements. I will leave it to experts to suggest methodologies by which we can protect all seniors, not just the institutionalized; suffice it to say that the Times’ data are a strong indicator that our aged populous needs a special and immediate focus from health providers.
What about other age groups? For example, has closing our schools helped? We are intensely protective of our children, but the data raise the possibility that our youth are in far less danger than previously supposed. Several nations (e.g., Denmark) have re-opened schools with strictures such as social distancing in place. All persons under 30—not just children—represent only 1% of the mortality shown in the Times compilation. The 1% statistic drops to 1/10 of 1% when those 21 and under are considered.
Another query is whether we needed to shut down every business deemed “non-essential.”We’ll never know the answers until a survey of the entire mortality data set is subject to a rigorous statistical manipulation. That data set is available. We need our skilled mathematicians to review it and advise our elected officials as to the true risks to every segment of our population.
We must keep in mind that there are tolerances in life that we accept as necessary. The 35,000 killed annually in motor vehicle accidents, and the 2,000,000 injured, is a prime example. I believe if the full data analysis suggested by this blog is performed, we will be able to judge with a reasonable level of accuracy the risks of any particular activity to any segment of our population. We then can target our remedies onto specific areas of concern and avoid a repeat of the one-size-fits-all lockdown of an entire society.