Downplayed by the media, two very different COVID-19 outcomes for the old and young
When it comes to the risk of dying from COVID-19, two words tell the story: old age. Wisconsinites 80 years and older with the virus are 5,354 times more likely to die than teens who are infected, according to state and federal statistics. This reality has rarely been emphasized in media coverage of the pandemic over the past year.
There is still much to learn about the role of many other factors — underlying health conditions, disabilities, institutional settings, racial and socioeconomic situations — but they are all dwarfed by the age of the victims.
As of March 20, there were 6,576 deaths from COVID-19 in Wisconsin, according to data from the state Department of Health Services (DHS). Nearly eight in 10 were people 70 and older. More than half were at least 80, and more than a fifth were 90 and older.
Conversely, just 8%, or 542 people, 60 and younger died from COVID-19. That age group accounts for more than three-quarters of the state population. Only three people age 10 to 19 died from the virus, and no victims were younger than 10.
The statistics for young and old are consistent nationally and globally. As of March 17, COVID-19 had killed about 306,000 Americans 65 and older and 183 children under 18.
In all, there have been more than 500,000 excess deaths in the pandemic year, or about 20% more deaths in the United States than expected for a normal year, according to a study by Rick Leavitt for the Society of Actuaries.
The study estimates that 84% of those deaths were due to COVID-19, 90% of them people 65 and older. Among victims between 15 and 34, however, only 21% were linked primarily to COVID-19, competing with murder, suicide, drug overdose and a variety of socioeconomic factors. Among the very young, the study says, fewer people died during the pandemic than statistically expected.
DHS is beginning to get a clearer picture of where these elderly victims lived. Nearly half of them, 3,162 people, lived in long-term care facilities, such as nursing homes and assisted living centers, according to the agency’s data. That number could go higher because DHS still hasn’t accounted for the living situations for more than a quarter of all deaths.
DHS is also not sure exactly how many in the group housing population are not elderly but are disabled, in homeless shelters or in prison.
Those with intellectual disabilities and developmental disorders have three times the mortality risk of all other groups, Lisa Pugh told the Badger Institute. Pugh, executive director of the advocacy group The Arc Wisconsin, had called for people with disabilities to be prioritized for vaccinations along with the elderly. (On March 22, Wisconsinites with certain medical conditions — intellectual disabilities among them — became eligible for the vaccine.)
“These are clearly some of the most vulnerable people in our state,” Pugh says. “And it’s not just the elderly and frail elderly in nursing homes. Those who were at high risk but living on their own … face similar risks of exposure with multiple care providers and sometimes the inability to comply with social distancing and mask-wearing.”
Of the COVID-19 deaths in Wisconsin, 4,011, or 61%, had an additional underlying health condition, according to data obtained in an open records request of DHS by the Badger Institute. For another 2,424, or 37%, an additional condition could not be determined. Just 101 victims had no other conditions, the records show.
Some epidemiologists have argued the overall death rate from COVID-19 is too high because underlying health conditions would have killed the individuals anyway. Critics have countered that people can live with a serious underlying condition for years. The argument is likely to go unsettled.
The growing body of data also calls into question the media reporting, particularly in the early months of the pandemic, that blacks and other ethnic minorities were proportionally harder hit.
Blacks accounted for 7.3% of COVID-19 deaths in Wisconsin but make up only 6.4% of the population, according to DHS. Whites represented 82.9% of the deaths and make up 80.9% of the population. Put another way, there were 126.9 deaths per 100,000 in the black population, compared with 113.7 deaths per 100,000 in the white population.
However, Hispanics make up 7.1% of the population but only 5.8% of the deaths (91.3 per 100,000). Asians make up 3% of the population but only 1.9% of the deaths (69.1 per 100,000).
In addition, despite all the early cues that old age should have been the predominant concern, medical experts and political leaders hammered away through the summer about the risks to the young. This was, in part, a misreading of comparative risks hidden in mortality data. And again, a failure to take age into account when analyzing it.
In November, CNN ran a shocking story that COVID-19 had killed 10 times the number of people who die in car crashes in an average year. Jennifer Beam Dowd, an associate professor of demography and population health at the University of Oxford, did a comparison and found that a person younger than 35 in the U.S. was 3.75 times more likely to die from a car crash than from COVID-19, while a person 85 or older was 1,489 times more likely to die from COVID-19.
Politicians and the media also scolded the public for equating COVID-19 with the flu. Although they are not perfect (COVID-19 mortality counts are from confirmed cases, while influenza are from population and reporting estimates), both numbers hew to our theory of age.
Avik Roy, president of the Foundation for Research on Equal Opportunity, has been making comparisons using Centers for Disease Control and Prevention reports since the pandemic began. Children younger than 15 are nearly eight times more likely to die from the flu than COVID-19, the foundation reported. It is nearly the opposite for the elderly.
“Those over 75, in particular, are at the greatest risk of dying from COVID-19,” Roy wrote.
The widespread administration of vaccines, not only for the elderly, has meant a dramatic drop in death counts in most states.
There have been plenty of think pieces musing on what we have or should have learned from this pandemic. Clearly, it was difficult in the thick of it to think coolly while trying to assemble a complete picture.
But one thing was apparent from the start: The very old, particularly those in nursing homes, should have always been the highest priority. The public would have been better served by a media presenting an accurate, rather than a sensational, assessment. It might have led to more reasoned discourse and less fear and panic.
Richard Moore is the investigative reporter for the Lakeland Times in Minocqua. Permission to reprint is granted as long as the author and Badger Institute are properly cited.