Hacker News Reader

Comment by lkrubner | Hacker News Reader

Many people kept insisting "Not many young people are dying from Covid-19" a statement that over looked the fact that, under normal circumstances, not many young people die at all. But there was an article in the New York Times that offered these facts about people aged 20 to 40.

July, 2019: 11,000 dead

July, 2020: 16,000 dead

Both numbers are small in a country where 3 million people die each year, about 250,000 a month. But it's still a 45% increase, so that age group was the worst affected, in terms of the increase in death. The increase in the death rate of old people was not as dramatic, as older people make up the vast majority of all deaths, every year.

View on HN

If you look at expected years of life lost - and the average person is ~30 - you could multiply the numbers by ~47.

~47 x 5,000 = 235k years of life (extra).

In the US in 2020 the average age of death from Covid was ~77 [1]. People ~77 are expected to life ~10.2 years [2]. In 2020, there were ~350k Covid deaths [3]. But (very crudely) 3.5M years of life lost.

This small group of 11,000 people (3%) made up 7% of years of life lost.

By 2021, the average age of Covid death was ~67 - so the average person was losing ~17 years of life [1]. This is because that extra ~5,000 deaths has so much weight.

[1] https://www.google.com/amp/s/www.wvpublic.org/health-science...

[2] https://www.ssa.gov/oact/STATS/table4c6.html

[3] https://www.cdc.gov/mmwr/volumes/70/wr/mm7014e1.htm

This calculation is wrong. While the average 77 years old person will live 10.2 years, it’s not founded and unlikely the people dying from Covid at that age are distributed uniformly.

Most likely a 77 yo dying of Covid is in worse health and have more co morbidities than the average 77 yo.

This calculation is interesting and a good way to look at things, but it requires more nuance that is likely to reduce those numbers.

I'm not sure that calculation makes sense. If someone has already lived to 77 he probably has a much higher chance of living to 78 than the average person. And if someone has lived past 78 does that mean he's lost negative years of life?

Yep, 78 is life expectancy at birth. Your life expectancy goes up every day you are alive.

Well... every day bar one.

Thanks - added a reference to an actuary table.

From the article this discussion is about "Most of the claims for deaths being filed are not classified as COVID-19 deaths, Davison said."

I am confused why you are completely ignoring this statement and trying to claim the exact opposite.

Excess deaths by 45% would seem to indicate that the cause of death is simply incorrect. (Or it’s one of myriad tangentially related deaths: procedures not done, doctors not seen, hospital beds not available, on top of COVID related stressors exacerbating drug use and mental health problems.)

> July, 2019: 11,000 dead

> July, 2020: 16,000 dead

> But it's still a 45% increase, so that age group was the worst affected, in terms of the increase in death.

You can't draw that conclusion at all with, effectively, one data point while assuming the other is a baseline. You need to develop a proper statistical profile, determine the mean, variance/standard deviation, standard error and then try to understand the numbers to make inferences.

How many Covid-related? How many drug overdoses? How many suicides?

This seems like what-about-ism.

You could look these numbers up easily on the CDCs death data, and then you could formulate a coherent thought.

Instead, it seems like you're just trying to derail the conversation with as little effort as possible.

No, it’s not what-about-ism. It’s a suggestion that the two numbers being thrown around are accompanied by some bare minimum of detail to have a meaningful conversation.

OP made the link to Covid-19, which seems very plausible, but it’s not clear if they have facts to support this or it’s just a guess. Suicides and overdoses are two of the leading causes of death among young Americans. It’s irresponsible to discuss a 40% increase in deaths and imply this is all Covid-19 without any evidence.

Asking someone to look up some numbers for you to complete your random hypothesis isn't exactly constructive either way.

The random hypothesis was made by OP, who inferred that the 45% increase in deaths is due to Covid-19.

I would guess a lot of that 45% is due to Covid, but how much would be a guess, and I suspect OP is just guessing too.

Overdoses are historically one of the leading causes of death among people in this age range, and we’re also setting records for overdose deaths this year [0], but that gets no almost coverage compared to Covid. I think it’s reasonable to keep in mind that overdoses could also be contributing to that 45% uptick, unless we have evidence to the contrary.

[0] https://www.pbs.org/wgbh/frontline/article/opioid-crisis-202...

A really useful exercise you can do for yourself (I did it) is to download the CDC total US deaths data and plot each of the past 7 years as lines on an x axis that goes from week 1 to week 52 of the year. Keeping in mind that this graph does not take cause of death into account, you will note two striking features: 1) the death curves for the 5 years up to and including 2019 are extremely similar, with the exception that you can tell they are overall slightly elevated one winter by a particularly bad flu season (I think it was end of 2017 / beginning of 2018). And 2) 2020 and 2021 have very large Covid-surge-shaped excess death bumps that imply an incredibly strong correlation between Covid and the deviation in deaths from “normal” years. And if you find the delta between a “normal” year and the ones with the Covid-shaped bumps in it, it matches up extremely closely with the numbers CDC is also reporting as “Covid-related deaths.”

In order to say that a significant number of these are drug and suicide deaths, you’d also have to be positing a theory that drug and suicide deaths are also for some reason elevating themselves in precise timing with the Covid surges. I’m not going to claim this is impossible, but it does seem extremely far fetched to me, and I suspect seeing the data laid out like I describe would probably make you abandon your theory. (Edit: using ‘your theory’ colloquially here. I know you havent posited any specific theory here, but your line of reasoning and skepticism is clear)

Edit to add: I actually don’t doubt that excess drug and suicide deaths are partially responsible for general elevated death numbers. Lockdowns, isolation, job losses, etc are all certainly driving some of this. But these are slow and steady drivers, not ones that rise and fall precisely with the number of Covid cases, which takes me to the conclusion that they are in the noise compared to Covid itself. (And the CDC death categorizations happen to agree with that)

That’s a good suggestion. Here are the excess deaths for 25-44 year olds: https://imgur.com/a/b4Pobrh

There’s definitely a significant rise in excess deaths among 25-44 year olds coinciding with the Delta peak in August/September.

Something interesting though: In the Covid “valley” of June/July, when Covid-related deaths were at a record low nationally, 25-44 year olds still had a ~35% increase in excess deaths. I’d expect a drop in excess deaths close to prepandemic levels if they were being driven mainly by (short-term) Covid effects during that time. It seems like the baseline death rate increased independently of number of active Covid cases.

Covid deaths were accompanied by a steady increase in overdose deaths starting in early 2019 (https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm), rising from from 68k to 97k over the course of the pandemic.

I don’t have time at the moment to do the math, but I’d suspect most of the increase we’ve seen in the past year is due to Covid, but with the increase in overdoses and other causes contributing much than noise since 2019. This could explain the higher death rate that persisted throughout the summer.

It’s quite likely that the timing of 25-44 yo deaths from Covid has a much wider distribution than older age groups.

It seems reasonable to speculate that younger people are able survive longer with respiratory problems and probably have less co-morbidities.

Perhaps. But this means that when Covid deaths dropped to ~1,700/week nationally over the summer and 25-44 year olds still had ~800 excess deaths/week, almost half the people dying of Covid-19 in the US were young and nobody was talking about it. Seems unlikely.

Excess deaths includes deaths that were directly attributable due to other causes, but may still be indirectly caused by COVID. Suppose I were to break into a dialysis clinic and abscond with half the equipment. If this is an isolated incident, then patients can be sent to other clinics, or dialysis machines brought in. But suppose I were to break into every dialysis clinic and steal half the equipment. In that case, there's no surplus that can be shuffled around, and people would die. The direct cause of death would still be kidney failure, but I would have been the indirect cause.

In the same way, COVID puts pressure on the hospital system as a whole. Nurses who could have been monitoring a post-surgery recovery are instead monitoring ventilators in the COVID wing, or are quarantined after being exposed. The crash cart arrives a little bit slower to a heart attack, because the closest one was already in use. If the available nurses are on longer shifts, that contributes to sleep deprivation, making it easy to miss details that would otherwise have been caught.

This is true across all age groups. As of September, while COVID had 4.6 million direct fatalities, there had been 15 million excess deaths. Determining the final scope of COVID will be a matter of long research, and certainly isn't something that can be resolved in a short internet argument. Dismissing it as "Seems unlikely." when not even comparing between the same same type of measurement seems premature.

[0] https://www.wsws.org/en/articles/2021/09/06/econ-s06.html

>And 2) 2020 and 2021 have very large Covid-surge-shaped excess death bumps that imply an incredibly strong correlation between Covid and the deviation in deaths from “normal” years.

It would be more accurate to say "COVID-19 impacted years" than "incredibly strong correlation between Covid".

A lot of government and public policy changes were quickly made during these times. Are you willing to say with complete certainty that the lockdowns and associated increase in poor mental health had no impact?

We also had global supply chain crunches which affected food and medication availability (among other things). Are you willing to say that having certain brands of prevention / life saving drugs completely unavailable (forcing people to consult doctors for substitutes or go without) had no impact?

I think you’ll see that I very explicitly said I am not willing to definitively say those things, but that I am highly skeptical that those types of effects would be so responsive to the changes in number of Covid cases.

Does it in any way make sense to you that Covid cases falling by X% in a given week would directly cause an immediate corresponding drop in depression, drug overdose, or prescription drug supply chain issues? That would be absolutely incredible to me. It did however cause an immediate corresponding decline in excess deaths, regardless of assigning any cause. That tells me something.

> It did however cause an immediate corresponding decline in excess deaths, regardless of assigning any cause.

Did it, though? We see deaths increase in August/September during the Delta wave, but we don’t see them decline when Covid cases fell drastically earlier in the summer: https://imgur.com/a/b4Pobrh

That suggests 25-44 year olds may be experiencing an elevated death rate that persists even when Covid cases were low.

I’ll need to rerun my graphs. I haven’t done them since mid summer but at the time if you overlaid the Covid rise and fall on the excess deaths rise and fall it was uncanny how well they matched. The falling side of delta may have been different.

For anyone who wants to see this data without running the numbers themselves, the CDC has a dashboard showing total weekly deaths per week over the last several years, the trend line, and the obvious significant increases over the last couple years. They update it weekly, but it takes a couple weeks for the data to become accurate (the recent weeks have always been an undercount while reporting catches up).

For interpretation, the orange line is average expected deaths for that week, and you'd expect weekly deaths to cluster around that. Red is the "upper bound threshold", ie deaths over this are way out of the norm.

You can also switch the dashboard to "Excess deaths with and without COVID-19", which shows the same bar chart but with reported covid deaths stacked on top of non-covid reported deaths. It makes it clear that (1) excess deaths line up very well with reported deaths and (2) the US has done an overall good job of reporting covid deaths, outside of some probable undercounting at the very start.

https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

He's asking someone for numbers that prove their own hypothesis. Why is that making you sweat so much?

It's not just lazy, it's derailing.

What exactly am I derailing? An unsubstantiated claim made by OP that contradicts details provided in the parent article?

“Most of the claims for deaths being filed are not classified as COVID-19 deaths … there were far fewer deaths from COVID-19 in Indiana compared to a year ago – 195 verses 336 – but more deaths from other causes – 1,350 versus 1,319 … the moving average of daily deaths from COVID-19 is less than half of what it was a year ago”

“Lazy” is not reading the article. And if “derailing” an unfounded assumption to better understand these deaths is wrong, I don’t want to be right.

Covid is real, vaccines are good, etc, etc.

But why has everyone switched like thi? Freyr is correct. The OP put forward the proposition, it's up to them to provide data that makes the case.

The leading cause of death for young people is injuries (https://www.wthr.com/article/news/health/coronavirus/state-r...).

However, injuries are far more likely to be life threatening if health care resources are scarce, as they have become in Indiana.

This is precisely the challenge presented by a pandemic. That's precisely why the lethality of the pandemic virus is largely irrelevant. The threat from a pandemic is the overwhelming of health care resources.

So it's kind of splitting hairs to worry about whether the cause of death is COVID-19 or not. Either way, it's the pandemic. There's a literally historic shift in the death rate among the young that correlates very well with the the availability of care... and we have the people working in the hospitals saying that this is the underlying problem.

Maybe young people have had a 40% increase in deaths from injury, from suicides, from overdoses, or from tipping over vending machines. The specific COD isn't the problem.

My little brother died this year. He was electrocuted and his heart stopped immediately. You can keep someones brain alive with cpr for around thirty minutes but they didn't have any available first responders (they have defibs) because of covid calls. They showed up an hour later.

Does he count as a covid death.

If you say so, we also have estimate the threat of the disease by excess death.

The biggest portion of this growth is almost certainly being driven by opioid poisoning. This was growing quickly pre-pandemic, but has skyrocketed in the last two years.

"almost certainly"... So without evidence you conclude that young people are dying at a higher rate NOT because of the deadly global pandemic. QED.

Scott Alexander actually wrote about COVID related suicides and why they haven't risen nearly as much as one might have expected.

https://www.worksinprogress.co/issue/why-didnt-suicides-rise...

I looked up the information in a previous thread. For the United States, using the most conservative Covid numbers, they outweighs these by at least a factor of 5.

Edit: https://news.ycombinator.com/item?id=29706964

Do you have a link or source?

Overdose and suicide are two of the leading causes of death among young people. If Covid deaths were 5X higher, we’d see a much much larger overall increase than 40%.

Edit: Your numbers are for the total population, not young people. The death rates and leading causes of death are drastically different between young people and the general population.

Do you have a link or source to support your hypothesis? It should be trivial to provide it.

OP says deaths among people 20-40 are up 45%, and inferred that this is due to Covid. That’s the hypothesis being made here. And it contradicts what’s in the parent article, namely that many of these deaths are from causes other than Covid:

“The CDC weekly death counts, which reflect the information on death certificates and so have a lag of up to eight weeks or longer, show that for the week ending Nov. 6, there were far fewer deaths from COVID-19 in Indiana compared to a year ago – 195 verses 336 – but more deaths from other causes – 1,350 versus 1,319.”

I’m suggesting that other leading causes of death among people in this age range could possibly be up this year, and contributing to this uptick, perhaps by a significant amount.

For example, in SF, the number of people in this age range dying of overdoses far outnumbers the people in this age range dying of Covid. Nationally, we are setting record numbers of overdoses, driven mostly by fentanyl.

”In 2021, the Centers for Disease Control and Prevention estimated in November that more than 100,000 people died of drug overdoses in the first year of the COVID-19 pandemic, May 2020 to April 2021, with about three-quarters of those deaths involving opioids — a national record.” [0]

[0] https://www.pbs.org/wgbh/frontline/article/opioid-crisis-202...

[1] https://vtdigger.org/2022/01/02/opioid-overdose-deaths-poise...

[2] https://www.wfmj.com/story/45563074/mercer-county-sees-recor...

The article is talking about deaths by Nov 2020 compared to Nov 2021 when there was an accessible effective vaccine. Parent comment is talking about increase of deaths from 2019 to 2020. I don't see the applicability of that quote. (Maybe OP and you and me are all off topic, but here we are.)

[0] has no statistics on opioid deaths. [1] says that the deaths were going to be higher in Vermont, at (a projected) 200 deaths for the year vs 157 for the previous. That's maybe meaningful, but isn't limited to the age group the post parent was discussing. [2] Does not have year over year statistics to compare against. Just that it was the worst, and is drawing on a smaller sample size than [1].

If (and this kind of seems like a big if) Vermont is representative of the rest of the US, *and* the age group he was discussing then maybe you have one source that supports your claim that a large portion of the deaths are from additional opioid deaths.

On the other hand assuming the root of the increase of all cause mortality between 2019 and 2020 among adults is mostly uncorrelated with the pandemic is a tough thing to convince me of. Can you please provide a source showing the national increase of opioid overdoses and suicide between 2019 and 2020 among the 20-40 age group?

Note I agree entirely that there were more overdose deaths in the US in 2020 than 2019 (that's easy to source https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/...) what is hard is breaking it down into these smaller nuggets that we're discussing.

ETA: I couldn't find the original NY Times article grand-grand-grand... parent talked about that got us down this path, but this is pretty convincing that all cause mortality increased by at least 45% https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376843/

How many drug overdoses and suicides are directly related to covid and its impact on society, and by extension our failure to stop it before it became unstoppable?

> July, 2019: 11,000 dead > July, 2020: 16,000 dead

Where are you getting those numbers?

2019 - ages 25 - 44:

- represent ~320 deaths per 100k. [0]

- represent 85M pop. [1]

=> That's ~272k deaths per year in that age band.

You can check my math.

[0] (page 3) https://www.cdc.gov/nchs/data/databriefs/db395-H.pdf

[1] https://www.statista.com/statistics/241488/population-of-the...

Further, this chart shows covid deaths as a proportion of all cause mortality. [2]

For ages under 50, covid accounts for 1-5% of all deaths.

For ages over 50, covid accounts for 10-15% of all deaths.

[2] (caveat, this is a snapshot of Feb 17 2021 data) https://datavisualizations.heritage.org/public-health/covid-...

In no age band do we see a 45% increase in deaths due to covid.

Reply on news.ycombinator.com