Here's a gruesome thought that probably entered everyone's head over the past year: "If I actually catch this virus, what are my chances of dying?"
As it turns out, this is a much more difficult question to answer than tends to be presumed. Many media outlets and even some experts throughout the year made a habit of presenting the "case fatality rate" as an accurate representation of an individuals risk of mortality. Judging by how CFR is calculated, this is clearly a mistake.
It would be naïve to think we have tested and identified every single person with COVID-19. CFR has its uses, but not for this purpose.
For our purposes, we are far more interested in the IFR. Simply replace our denominator from "C19 Cases" to "C19 Infections". We can find this number via serological antibody studies (NOT rt-PCR tests).
Based on data coming out of China early in the year, agencies like the WHO made their original IFR estimates for COVID-19 which ranged from 3.4% to 7%. Naturally, the media took off with these numbers, stoking worldwide fear.
By late May, the CDC had revised the number down to 0.26%. For whatever reason, media recoiled from the good news. For example, the following article rates the claim as "partly false" because the numbers were "subject to change". What a way to miss the point. Of course the numbers are subject to change. Its no revelation that imprecise estimates might eventually be tuned up a bit. The relevant takeaway is that the new estimates were dramatically lower than the original projections.
This shouldn't have been surprising to those paying attention to the wealth of evidence supporting this radically lower IFR coming out in April/May.
Today, the WHO estimates an overall IFR of 0.23%.
Even the closest original estimates were nearly 15x higher! (3.4 / 0.23)
The paper further estimates a 0.05% IFR for people under 70.
The CDC has further stratified the numbers based on age.
Thus our survival rates by age are:
0-19 years: 99.997%
20-49 years: 99.98%
50-69 years: 99.5%
70+ years: 94.6%
Here's a paper from August addressing the clear problems and dangers of IFR overestimation and fear-based public health campaigns.
At this point, I think it's appropriate to acknowledge that in this post we are talking about human lives. While it is easy to reduce people to numbers, there is no statistic in the world that can dismiss the experiences and hardships of individuals, nor are they meant to. Many people have indeed lost loved ones to COVID-19. We must treat that fact with sincerity and respect.
We cannot however let this cloud our judgement. In the age of information, context and a wider perspective are absolutely critical if we hope to understand any issue. The best method such information can be communicated is via statistics. By presenting objective facts and data about COVID-19, we are by no means diminishing the real human impact of this virus, nor are we insinuating that some lives are somehow less valuable than others. To the contrary, we are doing our best to gain life-saving knowledge which can guide our efforts in minimizing deaths. Lets continue.
Given the CDC's estimates, this should come as no surprise: for most countries, the median age of COVID-19 deaths is over 80 (78 for US).
Nursing home and Assisted Living facilities account for 42% of all COVID-19 deaths.
Only about 6% of all deaths involving COVID-19 had no serious preconditions.
On average, those who have died with COVID-19 had 2.6 additional conditions contributing to mortality.
Thus we have confirmed the two facts that everyone has probably already heard.
1. The risk of mortality is far greater for the elderly.
2. The risk of mortality is far greater for those with comorbidities (who tend to be the elderly).
There is no better argument for an age stratified approach to COVID-19 public health measures than these two facts, as visualized below.
This implies that our blunt approach has been wrong from the start. Target measures will always be more effective than thoughtless, destructive measures aimed in no particular direction. Why waste time, money, and resources to destroy countless lives/livelihoods all in an attempt to (ineffectively) "protect" millions of people who are not at risk via all-encompassing lockdowns.
Clearly, our efforts need to be refocused on those who are at risk.
Side note: This is the crux of the "herd immunity" argument. By encouraging those who are not at risk to continue interacting with the world, healthy people easily build lasting immunity to the virus. A more immune society helps nip outbreaks by preventing real spread, thus saving lives. This is why, counterintuitively, all-encompassing lockdowns can increase the risk of the most vulnerable.
It's quite unfortunate how many public health officials and governors have preferred to implement destructive, sweeping blunt force measures (like lockdowns), rather than protections with a little specificity. An age based approach is just so obvious at this point, to say nothing of more locality based approaches. (The benefits of decentralization!)
A look at the raw numbers can help us put COVID-19's impact on each age group into context.
By charting all cause monthly deaths per million, we find the impact of COVID-19 is directly comparable to the 1958 (H2N2) influenza virus and the 1968 (H3N2) influenza virus. Both were medium influenza pandemics. No lockdowns, no masks, no new normal, no national freakout. Subtracting lockdown deaths puts COVID-19's impact even lower.
Expanding further provides even more context.
We have upended society and destroyed millions of lives for a not-so-novel coronavirus. World leader are behaving in ways that are undeniably irrational and contradictory to the evidence - if they're basing their decisions of the data that is. Reject the lockdowns, reject the mask, reject the new normal. We are being played as fools.
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