Coronavirus

What 'Excess Deaths' Do and Don't Tell Us About COVID-19

While official death tolls clearly underestimate the epidemic's impact, total mortality numbers can be misleading.

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New York Times analysis of mortality data from seven states concludes that the "coronavirus death toll" is "far higher than reported." During the five weeks from March 8 through April 11, the Times found, there were nearly 50 percent more deaths in those states than the average for the same period in the last five years. Comparing those excess deaths to the number of COVID-19 deaths reported in each state, the analysis finds a total difference of 9,000, which is about 50 percent higher than the official tallies suggest.

Like an earlier Times analysis of excess deaths in 11 countries, these calculations call attention to fatalities associated with the COVID-19 epidemic that do not show up in the provisional numbers reported to the U.S. Centers for Disease Control and Prevention (CDC). Those omitted fatalities include not just overlooked deaths caused by COVID-19 (e.g., those involving people who died at home and were never tested) but also deaths from other causes that might have been prevented in the absence of the epidemic.

The latter category could include people who did not get adequate treatment because hospitals were flooded by COVID-19 cases, people who avoided hospitals because they were afraid of catching the disease, and people who died because of lockdown-related bans on "elective" surgeries. As former Nebraska Sen. Bob Kerrey noted in a recent Wall Street Journal op-ed piece, those prohibited surgeries have included potentially lifesaving procedures such as diagnostic biopsies and treatments for cancer and heart disease.

Looking at excess deaths therefore helps illuminate the full impact of the epidemic, which goes beyond deaths directly caused by COVID-19. It also includes deaths due to strained health care systems in places such as New York and New Jersey, deaths caused by fear of the disease (which may have led people to eschew medical care), and even deaths caused by policies aimed at curtailing the epidemic.

At the same time, equating excess deaths with the "coronavirus death toll" is potentially misleading. While COVID-19 deaths that have been overlooked obviously are relevant in figuring out what percentage of people infected by the virus will be killed by it, deaths that were not actually caused by COVID-19 are not. Four months into this pandemic, the infection fatality rate (IFR) remains unclear. It hinges not just on the true number of deaths (the point emphasized by the Times) but also on the true number of infections, which is bound to be far higher than the number of confirmed cases because testing in the United States so far has been skewed toward people with severe symptoms, who are not representative of people who have been infected.

The ratio of total infections to confirmed cases is a matter of much controversy. Antibody studies in the United States have generated estimates ranging from around 10 times more total infections than confirmed cases in New York to something like 70 times more in Santa Clara County, California (a result that critics of that study view as impossibly high). Furthermore, it seems likely that the ratio and the IFR vary from one part of the country to another, depending on local conditions such as age demographics, the prevalence of preexisting medical conditions, testing rates, and the quality and capacity of the health care system.

Still, it seems clear that when it comes to crude case fatality rates (reported deaths as a percentage of confirmed cases), the error in the denominator is much bigger than the error in the numerator. Even if we (inaccurately) attribute all the excess deaths counted by the Times to COVID-19, a death toll that is off by 50 percent affects the IFR calculation much less than a case tally that is off by a factor of 10 (as suggested by antibody tests in New York).

Another question raised by the Times analysis is the extent to which its findings for these seven states (Colorado, Illinois, Maryland, Massachusetts, Michigan, New Jersey, and New York) reflect the situation in other states or the country as a whole. The CDC keeps a weekly tally that compares "deaths from all causes" to expected deaths based on data for the same week in 2017 through 2019. Perhaps coincidentally, all of the states that the Times chose for its analysis had excess deaths in the week ending yesterday. Most states did not.

According to the CDC, for example, California, Florida, Georgia, Ohio, Pennsylvania, Texas, Virginia, and Washington all had fewer deaths in the week ending on April 28 than would be expected based on the 2017–19 average. The same was true, on average, for the United States, which had 6 percent fewer deaths than expected. In the weeks ending on March 28, April 4, and April 11, by contrast, the country as a whole did have excess deaths, ranging from 2 percent to 15 above the 2017–19 average. But those percentages are far lower than what the Times found in the seven states it considered.

Maybe those snapshots are misleading, and maybe the states that are not seeing excess deaths right now will in the future, depending on the stage of their epidemics and the impact of loosening lockdown restrictions. But it sure looks like the Times picked states that would generate impressive excess-death counts—in particular, New York and New Jersey, which together account for more than 70 percent of the gap between official COVID-19 death tolls and excess deaths described by the Times.

The newspaper's interpretation of these data is questionable in another way. "These increases belie arguments that the virus is only killing people who would have died anyway from other causes," it says. That formulation is a straw man, since it is obviously not true that everyone who is killed by COVID-19 "would have died anyway" (except in the long term). But since COVID-19 deaths are concentrated among people who are elderly and/or have serious preexisting medical conditions, the extent to which the epidemic will increase excess deaths this year remains unclear.

That point has been raised by experts such as British epidemiologist Neil Ferguson, whom no one would accuse of trying to minimize the threat posed by COVID-19. "By the end of the year, what proportion of those people who've died from COVID-19 [in the U.K.] would have died anyhow?" Ferguson asked during parliamentary testimony last month. "It might be as much as half to two-thirds of the deaths we're seeing from COVID-19, because it's affecting people who are either at the end of their lives or in poor health conditions. So I think these considerations are very valid."

Since the Times analysis covers just five weeks, it does not address that issue. And even if Ferguson's estimate is wrong, the distribution of deaths matters. Although some people think broaching the subject is unseemly, inhumane, or uncivilized, the number of life-years lost to COVID-19 is clearly relevant in assessing the costs and benefits of policies aimed at containing it.

NEXT: Coronavirus Closures Make It Hard for Truckers To Get a Meal, Yet Some States Still Refuse To Let Food Trucks Operate at Rest Stops

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  1. Many commenters here, myself included, have long insisted that, at some point, you run out of half-dead 85 year olds.

    1. Indeed, that’s why they need to ramp up the “excess deaths” talk. Otherwise the pandemic peters out and they can’t politicize it anymore!

      We should all be clamoring for mandatory testing of every dead body. Force them not to attribute the ones that test negative to the virus.

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    2. Yeah, and how do we kick the half-dead 85 year old GOP and Democrat hacks off the ticket and replace them with reputable immunologists who can properly micromanage every aspect of the pandemic?

      1. Let’s make sure that we get Donald Trump and Mike Pence out of office in November, since they helped make an already-horrible situation (i. e. the Covid-19 pandemic) a hell of a lot worse than it could’ve and should’ve been.

        1. They had to show that they “care” more for you than the dems do. It’s the greatest orgasm of “I care more for you” that this seventy-three year old has EVER seen. The Democrats had to get all pious because they want to hurt the otherwise bustling Trump economy, and the Republicans have to show that they “care” more for you than the dems. It’s obscene.

          People who are at risk (the old and infirm) should sequester themselves and avoid the infection. The rest of us should go on living.

        2. How exactly did they do that?

  2. The interesting question to me is the difference between states whose economy was impacted by COVID-19 and states whose economy was impacted by lock-downs . . . and, no, the lock-downs are not an inevitable result of COVID-19. We know that because some states instituted lock-downs in response to COVID-19 where others did not.

    “The coronavirus pandemic is hitting state labor markets to very different degrees, with some seeing as many as one in five workers file for unemployment benefits and others far fewer.

    The variation appears to partly reflect when officials mandated business closures to stem the spread of the virus during the four weeks through April 11, as well as the state economies’ dependence on the industries most affected.

    . . . .

    Rates of illness, however, don’t appear to be a factor. South Dakota, the state with the smallest share of the labor force filing claims, at 4.9%, had about double the rate of reported cases of Covid-19 per 1,000 residents through April 11 as Hawaii, where the highest share of workers sought assistance, according to a Wall Street Journal analysis of Labor Department claims figures and Johns Hopkins University data on the disease.

    https://www.wsj.com/articles/coronavirus-sends-one-fifth-of-workers-to-unemployment-line-in-some-states-11587461401?

    It’s easy to be distracted by statistics like the mortality rate, and it can be hard to tell the difference between focusing on one thing to the exclusion of other considerations and becoming irrationally obsessed.

    Regardless of whether the mortality rates are misleading, the statistics suggesting that lock-downs are making the economic devastation worse than it would be otherwise aren’t misleading at all, and focusing on the mortality rates of a virus that may not be controllable–even with social distancing–to the exclusion of focusing on the willful and voluntary destruction of our economy by governors and the people who support them is irrational.

    1. I remain skeptical that the economy can be reopened without increasing the risk of infection and death to average people.

      I remain in outright denial that the economy can be locked down for the amount of time necessary to immunize 330 million people.

      I therefore conclude that the economy will need to be reopened at some point despite it increasing the risk of infection and death to average people.

      Somebody please show me where I’m wrong.

      1. //I remain skeptical that the economy can be reopened without increasing the risk of infection and death to average people. //

        Risk of infection to the average person? Sure. Risk of death to the average person? No. The people dying from this virus are not your average person.

        For the overwhelming majority of Americans the only risk from reopening the economy is either (1) a bad cold (2) a mild cold or (3) no symptoms at all.

        1. My thinking on this is specific to what Germany is experiencing right now.

          Germany was extremely aggressive in tracking individuals who were infected and quarantining them–along with the people with whom they had contact. They’re held up as a model of what President Trump should have done, and people were suggesting that the reason they could start opening their economy up was because they were so aggressive with their quarantines, testing, and lock-downs.

          . . . not so fast.

          “Germany’s coronavirus reproduction rate has increased to 0.9 according to the country’s centre for disease and control, the Robert Koch Institute, meaning every 10 people with the virus infect an average of nine others.

          That’s up from a reproduction rate of 0.7 a week ago, according to the Institute’s Vice President Lars Schaade.

          German Chancellor Angela Merkel has previously warned that if the number — also known as the R0 value — rises above 1, the country’s health system would eventually be overwhelmed.

          Yesterday she expressed concern that some German states were moving to ease coronavirus restrictions too soon, saying it could undermine the results that have been achieved.”

          —-CNN

          https://edition.cnn.com/world/live-news/coronavirus-pandemic-04-24-20-intl/h_1b76ae623f01f30c03601354511236c9

          That R0 number is the number of people who are infected on average by every infected person. If it goes up above one, the rate of infections becomes geometric rather than linear. That R0 number, from the data, appears to be a function of how harsh the lock-down orders are and how thoroughly they’re enforced. In other words, when they eased the lock-down restrictions a tiny little bit, the infection rate started spiking back up again.

          This is why I remain skeptical that the economy can be opened up again without increasing the risk of infection. As far as the virus only being deadly to those with underlying medical conditions, the average person over 75 probably has an underlying medical condition. I don’t want to play semantics, here, but the average person’s chances of dying from COVID-19 go up if they’re infected. So, yeah, their chances of dying from COVID-19 go up with the rate of infection.

          Meanwhile, Germany’s lockdown has been more severe than ours, and if opening the economy back up necessarily means increasing the rate of infection, then they may have paid a terrible economic price for little or no benefit. If the infection rate only stays low so long as the economy is shut down, and the infection rate accelerates once the economy is opened back up again, then what good was shutting the economy down so harshly? What was the benefit relative to the cost?

          1. Please do remember we live in a federalist society. 40% of deaths are from the North East. About 20% inside to explosions in nursing care units. Stop asking for a one size fits all plan from the feds. North Dakota didnt shut down, they are doing just fine. Arizona is at 280 deaths, big whoop. But oh wait, over a million without a job now.

            Stop saying this is a federal government issue.

            1. Stop saying this is a federal government issue.

              I see the part where I said it was a mistake for states to implement lock-downs.

              Where did I say this was a federal government issue?

              1. When you said to look at germany and how they implemented a single strategy.

                1. The facts are what they are.

                  The Germans did what they did regardless of whether you approve.

                  How do I compare what they did relative to what we did without making reference to what the Germans did?

                  The fact is that plenty of people (on the left here and in Europe) are holding Germany up as a shining example of what the US and the rest of the world should have done.

                  “Germany appears to have avoided the worst of a pandemic that has devastated its neighbors and reminded those old enough of a world war that shook the continent.

                  Europe’s richest and most populous country — with a trained scientist at the helm, a generally rule-following public and an enviable health care system — is becoming a case study in how to deal with a public health crisis.

                  Its approach to the coronavirus outbreak that has killed at least 224,000 people worldwide is not as daring as Sweden’s “herd immunity” strategy, but it is far more systematic than the disarray unfolding in the United States.

                  . . .

                  As the virus has swept the globe, Germany’s built-in advantages came quickly into play: extensive testing capabilities, a well-funded public health care system, universal health insurance coverage and a high per-capita number of critical care beds. The country’s fairly comprehensive shutdown of public life also came relatively early, in mid-March.

                  Other factors are less tangible but equally crucial: a high level of public confidence in the state and its leaders, cooperation across the political spectrum, and a system of government, crafted after World War II, in which federal, state and local officials share carefully calibrated authority.”

                  https://www.msn.com/en-us/news/world/germany-avoids-the-worst-of-coronavirus-crisis-e2-80-94-but-how/ar-BB13om9l

                  Because I disagree with their strategy (and showed why it appears to have been a futile and unnecessarily expensive effort) and believer we shouldn’t have a national strategy is no reason to pretend that Germany didn’t have a strategy or that their strategy wasn’t different from ours.

                  If you don’t have a better response to the accusation that Germany’s strategy was different and better than ours because the lockdowns were harsher, sooner, and broader in scope–better than to object that shouldn’t be a national strategy (when I never said there should be)–then maybe you should try harder.

                  You appear to be pretending that something didn’t happen in order to object to something that I never said.

          2. //In other words, when they eased the lock-down restrictions a tiny little bit, the infection rate started spiking back up again. //

            That is to be expected.

            //I don’t want to play semantics, here, but the average person’s chances of dying from COVID-19 go up if they’re infected. So, yeah, their chances of dying from COVID-19 go up with the rate of infection. //

            Their risk of dying with COVID-19 goes up, but not from COVID-19. Again, it depends on how we define average and how we ascertain causality, which is very difficult in a medical context. Anyway, this point doesn’t really matter all that much. Even assuming the risk does of death does go up, it is statistically negligible. For the overwhelming majority of people, the can effectively ignore the increased risk of death, if any.

            //If the infection rate only stays low so long as the economy is shut down, and the infection rate accelerates once the economy is opened back up again, then what good was shutting the economy down so harshly? //

            There was no point. We cannot prove that the lockdowns had any effect on the rate of infections (it seems “logical” but that doesn’t mean it is true), let alone that the lockdowns “flattened the curve.”

            The one things has remained true throughout is that, for all practical purposes, it is impossible to hide from a contagious virus that infects the respiratory tract. It is not worth the cost, and we shouldn’t worry about it.

            1. We can compare countries like South Korea and Sweden that didn’t shut down schools and/or businesses or issue stay-at-home orders to those that did those things. It doesn’t look like they’re doing any worse than the countries that are cutting their own economic throats.

          3. Ken, Even Germany has only done about 2 million tests, which is roughly 2.5% of their population. So their denominator will also be much larger and their increase to 0.9% IFR should also decrease once they do enough Ab tests to accurately assess what % of their society was actually infected even if they had few symptoms.

            1. I believe their R0 number is about new infections exclusively. R0 isn’t about the number of infected vs. the number of uninfected. It’s about the rate of new infections. The R0 goes up when people’s susceptibility increases for various reasons–and people coming into contact with each other makes the number of people one person infects rise. I think that’s all there is to it.

              You can’t open the economy up–not even a little bit more–without increasing the number of new infections or the rate that the virus spreads. No, that doesn’t mean we (or the Germans) shouldn’t keep the economy closed down. It means that keeping the economy closed down was a futile exercise if the intent was to stop the virus from spreading–because the economy can only stay closed for so long without doing tremendous economic damage. We’re still not looking at getting everyone immunized until 2021. Keeping the economy closed that long simply isn’t possible.

              So if you eventually need to open up the economy anyway–in spite of that increasing the rate of infection–then how much unnecessary damage are we doing to the economy now by keeping it closed under the false hope that shutting the economy down for long enough will make the virus stop spreading? As soon as we open the economy again, the virus will start spreading again.

              Holding our breath until we turn blue is not the solution to COVID-19 for the same reason that shutting the economy down until COVID-19 stops spreading isn’t the solution–we can’t survive long enough to stop the spread of the virus that way.

      2. Ken… take the last 20 years if the peanut crisis that increased allergy counts to actually cause even more deaths. Then apply it to this.

        Humans have always dealt with pandemics. We are not fragile people. There are only a few serious pandemics in history. The harm of each has decreased due to scientific knowledge. But we have also increased the harm from allergies and such by over reacting and not letting our evolved immune system work correctly. Ie the peanut allergy explosion.

        So the question is when do we actually assume a pandemic is severe enough to justify abnormal controls, especially negative ones.

        Hint, it isnt when the majority of harm is directed at 70+ elderly with comorbidities.

        1. So the question is when do we actually assume a pandemic is severe enough to justify abnormal controls, especially negative ones.

          It’s called a finite game. If we have 700,000 people who need vaccination and it will take 4 weeks to get them vaccinated, quarantining 700,000 people for 4 weeks until they all get vaccinated makes some sense. Players are clear, objectives are achievable, rules are predictable.

          When we have no idea how many people need vaccinated, how long to make a vaccine, nor how long it will take to vaccinate them all, quarantines are just a stab in the dark (as the data is beginning to reveal). It’s an infinite game where the goal is simply to perpetuate the game.

          It converts a closed-ended problem, where people have questions, others have answers and anybody can simply convey questions to answers, into an open one. Where nobody has all the answers but people who have questions are dependent on the people who have what few answers there are.

        2. Jesse, you and I have disagreed about this epidemic in the past—around mid-late March—though I’m on your side now. Been there since the 1st week of April.

          Does your opinion about how the country should have handled this situation, change if the CFR was the 3% or so people were originally fearing? And not the .1-.3 it looks like this thing actually is?

          All that said, this crisis ceased being about public health and a virus a long time ago.

          1. I’ve always stated that even of the pandemic ended up killing even 1% of the population that it would cause less harm long term than forced quarantine. I base this on a few factors: a) humanity isnt fragile, b) unemployment is generally at 4% so anything less than that should technically not cause a detriment to the economy outside of healthcare costs, and c) (the evil part of you’re a bleeding heart) not every life is worth saving no matter the cost. And we all agree on this as we dont have no cost end of life treatments. I dont think it is worth enslaving 5 people to pay for the care of a single other person.

            But I also look at history of these types of things, and again, the death percentage outside of a handful of pandemics has been relatively minor. We have 2.8 million deaths a year in america alone. 100k is statistical noise. The death rate of the 70+ population is 13%, the same as covid, the and populations are not independent.

            I’ve never thought this was a big deal. And I say that as someone who has lost multiple family members in the last year. Death happens. Humanity does a shit job of dealing it.

            1. I just lost my mother-in-law to Covid-19, stemming from one of those nursing home outbreaks here in the People’s Republic of NJ. I found out that it is a very bad way to go, Jesse. Gasping for air in a manner almost exactly like a fish out of water. It is pretty fucking awful.

              You’re right that our culture here does a terrible job dealing with death.

              I’ll be glad when we open up America, again.

              1. So is cancer. So are a lot of ways. My grandfather was having his lungs drained every few weeks the last year of his life. He was happy when my mother finally accepted he was dying and stopped taking him to the hospital. They treated him for comfort and he died quietly, but happy, a few weeks later.

                As for covid, 80% of the patients that ended up on respirators. That is not a good way to go. The treatment ended up being more painful than covid by itself. Pneumonia is a big killer of the elderly so this isnt the first type of disease like this. It is in fact very common.

                Sorry to hear about your mother in law, but would she have been better served treating the pain and anxiety?

                1. Ended up on respirators died*

                2. It was pretty quick, Jesse. And she was ready to go (in her late 90’s), still quite lucid. She must’ve had it a week or so before she tested positive. Very slight fever. No cough. Positive for KungFlu on a Friday and by Sunday afternoon, she was gone. That last day was truly fucking awful. The oxygen mask was no help. I said the Viddui prayer for her.

                  She was a truly a good woman, and a wonderful MIL.

                  Baruch Dayan Ha’Emet, Mi Suegra

            2. Ok, so you’re starting logic is that 3 million deaths is an acceptable outcome? 100k deaths is “statistical noise”? I fear you are allowing yourself to fall into a trap of callousness because you are conflating the severity-of-the-virus issue with the issue of infringement on freedom. Much of Reason’s work on this, along with the reader reactions, seems to be succumbing to that same conflation of the matters at hand. You can believe that government-ordered “stay-at-home” actions are a terrible idea, and still respect how dangerous the virus appears to be. And you don’t have to choose between belief in freedom and belief in the virus’ being a severe pathogen. The true libertarian approach with some intellectual soundness would be to have the utmost compassion while maintaining that our society can self-institute isolation measures without being ordered to by the government. Of course, if you create a false choice between “maintaining liberty” and “believing in the virus’ severity” — you come the wrong end no matter what you choose.

        3. Who are you arguing with?

          This is like the second time where your response seems to be to some other post.

          I remain skeptical that the economy can be reopened without increasing the risk of infection and death to average people.

          I remain in outright denial that the economy can be locked down for the amount of time necessary to immunize 330 million people.

          I therefore conclude that the economy will need to be reopened at some point despite it increasing the risk of infection and death to average people.”

          —-Ken Shultz

          Is it the bolded part that’s the issue?

          Because I acknowledge that opening the economy will let the virus spread at an increased rate does not mean that I oppose opening the economy.

          People who ignore facts because they don’t like some of the implications are intellectually dishonest or intellectual weaklings. Opposing the lockdowns does not require us to behave as intellectually dishonest weaklings. Even if lifting the lockdowns does increase the rate of infection, we should lift them anyway.

          Incidentally, I support gun rights regardless of whether they increase the murder rate, I support the Fourth Amendment regardless of whether it means more terrorist attacks, and I support the First Amendment regardless of whether it means more fake news or political ads placed by Russians. I also support capitalism even if it means there will be cycles of high unemployment.

          Few positions come without any downsides, and smart, intellectually honest people acknowledge the downsides and defend the correct positions anyway. That’s what we’re talking about when we talk about rationality and persuasion.

      3. I remain in outright denial that the economy can be locked down for the amount of time necessary to immunize 330 million people.

        I therefore conclude that the economy will need to be reopened at some point despite it increasing the risk of infection and death to average people.

        If the amount of time it took to immunize 330 Million people was 2 weeks, we might be able to keep the economy locked down. If it was 2 months, likely not. If it was 2 yrs. almost certainly not. Considering no one has a guess (and plenty of TOP MEN are certain this will be endemic) and it’s almost certainly towards the latter end of the spectrum, (continued) quarantine is almost certainly stupid.

        Quarantine only makes sense if you can A) conclusively identify everyone infected and B) vaccinate or otherwise immunize the uninfected. Otherwise, you’re just deluding yourself about the logistics and management of healthcare over which you have no actual control (and very little clue).

        1. Exactly.

          My understanding is that we shouldn’t expect a working vaccine until August. From there, it may take six months to get everyone vaccinated who wants to get vaccinated.

          So, we’re looking at keeping the economy locked down until 2021, at the very least?!

          That’s absurdly impractical. We might have a revolution before the government kept the economy locked down for that long.

          In the cost/benefit analysis, they’re putting their thumb on the benefit side of the scale by pretending that we’re going to stop the virus from spreading by keeping the economy shut down, but that’s not a realistically achievable goal.

          After we decided to hold our breath until we turn blue, the way to win is to stop holding our breath.

      4. You’re not wrong. The only question is what sort of ‘informed consent’ that will be based on.

        On some BS notion (based entirely on denial of reality) that this is simply ‘a cold’ or ‘the flu’?

        On some BS notion that the only changes to the economy occurred because of the lockdowns rather than the virus itself and hence getting rid of the lockdown will on its own propel the markets/employment back to where it was when we were denying the existence of the virus in Feb. Sweden is the model for ‘no lockdown’ – but the fact is that they are shedding jobs at the fastest rate in a decade, unemployment is now 10%+, their central bank has lowered interest rates to zero, GDP is projected to fall by 10% this year, and they have been doing a ton of Keynesian stimulus as we have.

        There’s a ton of options/alternatives that could be done in a country where basing stuff on knowledge (informed consent) is at least a possibility. But that isn’t the US. This disease has become politicized here – and in the US DeRp never involves knowledge. So there is no possible good option here. Only positioning for elections.

        1. Still hoping we get to that 2 million deaths it seems. Ever think it is you being irrational?

        2. Giving the states the leeway to make tough choices on their own–so that we’re not doing the same thing nationwide–is probably a good policy, even if I think they should reopen their economies up immediately.

          I’m not sure the pressure to reopen the economy will be a Republican vs. Democrat thing. If construction workers can’t work, I’m not sure it matters whether they’re registered Democrats, they’ll be in favor of reopening the economy.

          If the reopening the economy vs. shutting it down becomes a Republican vs. Democrat issue, I might expect to see the issue driving party identification rather than the other way around.

          Construction workers don’t care whether they’re registered Democrats or Republicans so much as they care whether the government allows their construction sites to open again, so I’m not sure partisanship is likely to be the driving force on this.

      5. “I therefore conclude that the economy will need to be reopened at some point despite it increasing the risk of infection and death to average people.”

        It won’t increase the risk of infection or death unless hospitals become overwhelmed and people that could be saved will not be. Everyone who would get the disease without the lockdown will still get it… just later. That’s what flattening the curve means! Making the pandemic last longer so that the load on the hospitals at any one time is reduced.

        COVID is a very contagious disease, and other than the large and growing population of people who have already had it, we are immunologically naive. If the disease is extant in the population, given enough time, everyone is going to get it. Social distancing and quarantining only reduce the odds of getting it. As long as the odds are not zero, over time, the odds of continuing to dodge it become more and more slim. The only thing that would block that is herd immunity, which we are deliberately inhibiting with the measures that are in place. Nothing else is going to put a final stop to this pandemic, whether that immunity comes from natural means (having had the virus and gotten over it) or unnatural ones (from a needle).

        The goal of all of the measures was to prevent hospitals from being overwhelmed. They’re not overwhelmed now, and in the vast majority of them in the US, they never were. Continuing to delay the one thing that will finally end this (herd immunity) helps no one and saves no one. We don’t need to lock down the 99+% who are not going to die from the disease to keep them from dying. With only a small number of exceptions that will always exist in a given sample, we know exactly which people are likely to die from COVID. If we concentrate our efforts on quarantining them, while letting (not requiring) the younger, healthier people take the hit and get it over with, herd immunity will form, and that will allow the vulnerable to come out of hiding.

        If quarantining were as effective as some people think, the vulnerable would never be able to come out, because we’d be more or less permanently delaying the one thing that can make it safe for them permanently. I’d say that it’s not the moral duty of the healthy to avoid getting the disease at all costs in order to protect the octogenarians, as we’ve been told, because that protection only lasts while we continue to hide away and not live our lives– which we can’t do for very long.

        If there is a duty the healthy have to the old and to the immunologically compromised, I’d say it would be for those of us who are able to take the hit go do that, so we can get our immunity and get one step closer to actually ending this thing. Herd immunity will end the pandemic… quarantining never will. Quarantining, by design, just drags it out for a longer period of time. Quarantining until a vaccine (that may never come) is created is a fool’s endeavor when we have the means to accomplish the same thing without one, and without all of the massive collateral damage that may be worse than the disease itself (if you count the loss of liberty, it is certainly worse).

        We’re not talking about smallpox or ebola here… most people, especially the younger ones, have mild or no symptoms at all. This is particularly true of school-age kids, who are being denied an education now for fear of a disease that poses very little threat to them.

      6. No, things probably can’t be opened up without an increase in infections. It needs to happen anyway (as you say). I think all we are doing is putting off the inevitable and making everything worse in the long run because of the restrictions.

    2. Check this piece I wrote comparing locked-down Kentucky with voluntary-measures Arkansas: https://link.medium.com/iI7PBBjpS5

      1. Fantastic!

        Thanks for the link.

        Everyone should read.

      2. Very nice. People are apparently terrible at weighing the thing they fear might happen against the known consequences of the deliberate actions we are seeing. I hope this kind of article helps somewhat.

    3. I suspect we’ll see similar normalized death rates and infection rates all over–barring outliers like new york city where you pretty much have to use public transport to get to places in a reasonable amount of time. It won’t matter if there was a quarantine or not or the relative amount of quarantine. It will be rural vs city and public transport vs not. Not red state vs blue state. Wait and see.

    4. Keep in mind South Dakota makes and sells things people need. Hawaii sells tourism. So of course their work dried up faster.

  3. What the analysis did not do… look at monthly variances, look at yearly effects. 80-90% in a recent british study have severe comorbidities. Covid may be the straw but can we stop pretending this is a culling of healthy individuals?

  4. “how did he die?”
    “he jumped off a building and landed on some carona virus”
    “damn, another carona death”

    1. The trick to any reporting is noticing when they start adding the word related to a stat.

      1. Exactly. Nearly anything can be corona-related if you squint hard enough.

    2. I posed this yesterday, but I think it is worth reposting:

      “The man died as a result of a drug overdose while infected with COVID-19, a significant contributing condition, according to county spokeswoman Ashley Bautista. He is the youngest victim to die from the virus yet in the county. The other death recorded Thursday was a 99-year-old man.”

      https://www.vcstar.com/story/news/local/2020/04/23/coronavirus-covid-19-california-update-ventura-county/3015868001/

  5. Math from the NYT? Nothing to read here.

    1. That’s is perhaps the best summary.

    2. The essential math is simple as can be, Longtobefree. It’s a simple stat that everyone agrees on. The monthly death rate in New York City, the epicenter of the infection, doubled compared to even a terrible flu season. Go ahead and argue why… but the basic number of dead bodies piling up is not what’s up for debate.

  6. Those omitted fatalities include…deaths from other causes that might have been prevented in the absence of the epidemic…and people who died because of lockdown-related bans on “elective” surgeries…those prohibited surgeries have included potentially lifesaving procedures such as diagnostic biopsies and treatments for cancer and heart disease.

    In other words, fatalities not caused by the virus but the gross overreaction. It takes an especially mendacious person to argue these additional deaths are “far higher than expected” and justify the response rather than the complete opposite.

    1. Absolutely correct! I accidentally flagged this comment for review…I meant to signal my approval but didn’t realize what the flag stood for.

    2. The MSM refuses to even acknowledge this consideration.

      1. It’s actually horrifying when you realize that there’s a significant percentage of these excess deaths that have been caused by a panicked overreaction created by the media.

        1. RIGHT? It’s crazy that we can get article after article and news segment after news segment about all these people dying at home, but NOBODY in the media stops to think — Hey wait, are we literally scaring people to death? Nah, it’s surely the covid!

    3. Yup. That’s all too true, swillfredo pareto. It’s too bad that some people get screwed by being deprived of necessary surgeries that are elective by losing their lives unnecessarily. What a bunch of s**tstains.

  7. Perhaps coincidentally, all of the states that the Times chose for its analysis had excess deaths in the week ending yesterday.

    How could that possibly be a coincidence?

    1. The chosen states were Colorado, Illinois, Maryland, Massachusetts, Michigan, New Jersey, and New York. Even if they did not cherry-pick these for the numbers they wanted, it’s not at all a random sample. All include large cities. Four of 7 are on the East Coast. Six are east of the Mississippi, and all are east of the Continental Divide. Michigan has 50% of its population in one extended metropolis (Detroit to Ann Arbor and Flint), and I suspect all the others are at least as dominated by their big cities – and every one of those big cities is run by Democrats. IIRC, all of these states generally produce Democratic majorities in statewide elections, provided the Dem candidates aren’t as objectionable as Hillary.

      In other words, the NYT has demonstrated that the conditions they favor kill people when the system is stressed.

  8. The rules for recording coronavirus deaths in the UK mean that if a person arrives at hospital with a gunshot wound to the head, is kept alive long enough to contract coronavirus, then dies – it was a coronavirus death.
    Not sure any physicians would actually go along with this, but the administrators surely will.

    1. “He wouldn’t have died of pneumonia if I hadn’t shot him.” — Arsenic and Old Lace

      My friend’s exterminator in Pennsylvania had a friend who was recorded as one of the county’s 2 Covid-19 deaths. He was 81 with multiple problems but didn’t have any respiratory symptoms, but he fell down the stairs and broke his neck, and his corpse had SARS-Cov2 RNA.

      1. The real question to ask is why would they even test the corpse of a man with a broken neck? The CoD is already known.

        1. To the contrary – we need to test every such corpse.

          Otherwise, the alarmists will count every such death as a COVID-19 “excess death”. At least if the corpse is tested, there’s a good chance it will test negative.

          It would be great if they could declare that even if the corpse tests positive, it’s still not a COVID-19 death because of the broken neck, but that’s asking too much of people with agendas. But if they’re required to test and the test is negative, they won’t be able to count it.

        2. The sneeze was violent and made him trip.

  9. Both the Times and this article completely ignore the fact that lockdown-related unemployment can easily be predicted to kill tens of thousands of people. Temporary unemployment increases the risk of having a heart attack or stroke by 78%.
    The stress-related disease death toll resulting from the USA’s 22 million unemployed alone can be reasonably predicted to be over 60,000. https://link.medium.com/iI7PBBjpS5
    Add in deaths from suicides, neglected medical conditions, and the horrific toll of starvation sure to follow on in the developing world, and it’s clear that we’re cutting our own throats.

    1. Those bodies don’t count, Petie Cue. haven’t you been listening to all the panic-mongers? Only deaths ‘with’ covid-19 count, and trying to figure out other consequences is wasting time you should be using to *PANIC*.

      (But seriously, I’ve been saying this for weeks. The above, while sarcastic, is actually representative of the *panic* mindset).

  10. Jacob,

    Since flu deaths peak in say November to January and this virus is hitting us in Feb. to April, it would also be of great interest to look at various 5 week stretches of peak deaths from throughout the year or at least from a similar time during both a normal and an extreme flu season (such as 2017-18).

    1. YEah it would be nice to see a flu vs covid dashboard

    2. Flu deaths generally have 2 peaks in a season. And one of those is march. But would be interesting to ask those doctors if people are testing for the flu or assuming covid with the march deaths.

  11. Oh, it’s the New York Times. We can safely ignore it as Fake Stats. 🙂

    1. They will search and search until they find models and questionable experts to support their preformed ideas of how to make this as big of a tragedy as they possibly can.

  12. “I just want to be clear in terms of the definition of people dying of COVID. The case definition is very simplistic. It means at the time of death it was a COVID positive diagnosis. So, that means that if you were in hospice and had already been given a few weeks to live, and then you also were found to have COVID, that would be counted as a COVID death. It means that if technically even if you died of a clear alternate cause but you had COVID at the same time it’s still listed as a COVID death. Everyone who is listed as a COVID death—that doesn’t mean it was the cause of the death, but they had COVID at the time of the death.”

    Dr. Ngozi Ezike of the Illinois Dept. of Public Health, admitting that COVID deaths are being grossly overcounted.

    https://www.facebook.com/annie.vereen/videos/3179971522027747/?t=0

    1. There was a recent story in USA Today, i think, about someone who died of a drug overdose, but was counted as a covid-19 death because they also had covid-19. USA Today wasn’t being critical of this counting – they were actively promoting it.

      1. Another very anecdotal piece of evidence. 1 instance in a population of 335 million counts for nil.

        1. I’m not making a statistical claim, I’m making a methodological claim. The death count is untrustworthy because they’re counting people who patently didn’t die of covid-19 as covid-19 deaths. That’s flagrant, and before you even get to the fact that no one is doing the work to ascertain whether covid-19 was responsible for death in the less obvious cases.

          I don’t know how many badly counted covid deaths there are, because the necessary information to know that isn’t available anywhere. And that should increase your skepticism about how lethal covid-19 is, not lessen it.

        2. The population is 50kish. Not 330 million.

    2. That can’t possibly account for everything though. You’ll need more examples to explain the high numbers of deaths than 85 years old in hospice as that is a very small part of the populace. Big claims require big data and big facts, not extrapolating one very small specific case to the entire population you’re studying.

      1. Okay. The NYC data dump had comments in the github meta data showing they were counting deaths as covid related even without tests, merely if they shared symptoms of covid. The flu generally has a second bump in march and early april. But flu deaths are oddly absent this year in that time period.

    3. Birx said the same during one of the Trump briefings. A death with the virus present is counted as being the result of the virus. If you got a random test and found out you were one of the asymptomatic people with the disease, and you were so distracted by the news that you got hit by a bus, that would be a COVID death. It’s clear that COVID deaths are being overcounted, yet the media keep the “fear, fear, fear” drumbeat going. When the death toll was low but the reported case mortality rate was high, we were hearing about the case mortality rate. As testing ramped up and case mortality plummeted, we heard of the growing number of cases (which is expected when you start looking for something you hadn’t looked for before). When the number of absolute deaths began to sound scarier than the confirmed cases, that became the daily tally. Every bit of news is meant to scare, not inform.

      Consider that bit we keep getting about “there’s no evidence that getting over COVID means you’re immune.” There’s no evidence that it doesn’t, either, so why are they only stating the one that makes it sound like it’s hopeless? Most people are not critical thinkers, and they do not know that lack of evidence is not evidence of lack. Given the lack of direct evidence in either direction, it is quite reasonable to assume COVID just like every other viral (non-immunological) disease.

      There would be no point trying to develop or waiting for a vaccine if it was not like all of the other viral diseases. The entire goal of vaccination is to simulate an infection with the pathogen in question to get the body to create antibodies to fight that disease. If actually getting infected with the disease fails to produce antibodies that protect against the disease, there’s not much point in trying to simulate an infection to create those very same antibodies.

  13. It is vital that deaths from the virus be counted separately from deaths among people who do not have the virus.

    Policy makers should immediately require that anyone who is found dead be tested, regardless of cause of death. The alternative is to allow the defenders of draconian policies to inflate the IFR of COVID-19 with deaths that aren’t caused by the virus and use that inflation to justify more draconian policies.

    Furthermore, as policy makers might be called to account for their bad policies, we must not allow deaths that are caused by bad policies to be blamed on the virus. If there’s a spike in non-COVID deaths that is much larger in some areas than in others, policy should be properly scrutinized.

  14. The only conclusion I have is that this is evidence that the Chinese dictatorship of the proletariat is cooking the books.

  15. Let’s say that the excess deaths were caused by something other than COVID (stress, heart attack, suicides, etc.) That’s still be on the government with dithered and dicked around while this disease was brewing in the background. That would still be the responsibility of a government pandering in conspiracy theories and denial, right? I mean, provided, of course, that government was run by a Democrat. It seems like with Dear Leader in charge there’s always some good excuse around for 14-16% unemployment and multi-trillion dollar deficits.

    1. You mean like when Pelosi said “come to Chinatown”?

    2. You are really trying too hard to prove yourself ignorant.

    3. You’re complaining that Trump and the GOP were complicit in a socialist response to the virus? You do know that the Chinese, who screwed the pooch worse than any other country, are Communists, right?

      I would have preferred if the government continued to not do anything, but the chicken littles continue to rule the day, aided and abetted by a media whose job lately has been to scare, not inform. The mostly illegal actions taken by the various state governments are worse than the disease itself. People will weigh the information and act out of self-preservation if they perceive an actual threat. Most of the businesses that are closed down (in full or in part) now were already like that before my state had any lockdown order at all, and the same number of people were wearing masks and what-not as they are now. The state governments that more closely resemble that of the People’s Republic of China are worse, of course. Just get the government out of my $&%#$* life!

  16. “While official death tolls clearly underestimate the epidemic’s impact”

    No, that’s not at all clear. While there are some deaths going uncounted that should be, there are also other deaths that are being counted that shouldn’t.

    We will likely never know for sure if covid19 deaths on net are being over or under counted.

    1. You don’t think that increased numbers of deaths from suicides, homicides, drug overdoses, cancers, heart attacks and strokes that also come about as a result of longterm lockdowns and social distancing due to the Covid-19 virus should be counted? That’s pretty fucked up thinking, if I may say so.

      1. They should be counted but they are not deaths due to a virus about as lethal as the fucking flu.

        Seriously are you on drugs?

      2. increased numbers of deaths from suicides, homicides, drug overdoses, cancers, heart attacks and strokes that also come about as a result of longterm lockdowns and social distancing due to panicked government officials.

        FTFY

      3. “You don’t think that increased numbers of deaths from suicides, homicides, drug overdoses, cancers, heart attacks and strokes that also come about as a result of longterm lockdowns and social distancing due to the Covid-19 virus should be counted? ”

        Not when those very deaths are being used as justification for extending those same policies that killed them!

        Imagine that car airbags, meant to save lives in car accidents, actually killed a lot of people who would otherwise have lived. The death rate from car accidents (which is when airbags deploy) would rise, and then that increase in traffic deaths could be used to broaden the airbag mandate! Do you not see the problem there?

  17. This surmisal would require that the previous weeks’ deaths be somewhat low(er); but I wonder if the agencies that were “counting” deaths in those states were bogged down with meetings and coronavirus stats and then they finally caught up and posted some of the previous weeks’ deaths in a short amount of time?

  18. No one is bothered by “elective” surgeries including stuff like biopsies and heart surgery?

    I thought the term meant stuff like nose jobs or liposuction. Or, at most, something like knee replacement that could be put off for a few months at the cost of a longer time spent limping.

    By the definition given in this article, it sounds like most surgeries short of removing a bullet or maybe a c-section for a breach baby is now considered elective. That’s insane.

  19. The times was fawning over Ohio’s governor last night, touting all the great stuff he’s done with his restrictions, despite the hundreds of thousands he’s forced out of work.

    The most interesting stat, in my opinion, was that Ohio ranks smack dab in the middle (lower half, actually- 26th) in cases per 100,000. If he made all the right moves and pressed all the right buttons, shouldn’t Ohio be leading the way?

    As someone mentioned earlier, we’ve slit our economic throat with these restrictions and yet we’re no better or worse off than the others with respect to the virus.

  20. Choose one of the following: Return to life as we knew it, pre COVID. or invoke new rules to avoid catching a deadly disease which will kill us. For the “return…” option, shout at the top of your lungs, “COVID-19 does not kill healthy people < 60 years old"

  21. Cherry picking and twisting data to fit preconceived conclusions?

    That’s the typical NY Times in action!

    Why does anybody treat the NY Times as a legitimate news source?

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    Oh look. The overall US death rate actually declined in April. It turns out you can only manufacture “excess deaths” if you cherrypick 11 countries and 7 states which had greater deaths but exclude all the ones that had less. Voila! By the power of statistics COVID-19 is transformed from a typical seasonal disease into a nightmarish black death.

    Every single journalist peddling this misinformation (dare I say “bald faced lies”) should seriously reconsider their life choices.

    1. “Every single journalist peddling this misinformation (dare I say “bald faced lies”) should seriously reconsider their life choices.”

      They’re living their lives exactly as they intended. They’re Making a Difference.

    2. Bud, you are looking at this in a somewhat skewed way. There were twice, perhaps triple, as many deaths in March and April in New York City as there are in a normal flu-ridden month. So that’s not even up for debate here — not even in this article. Twice as many dead bodies, total, nevermind what caused it. What you are arguing here that the overall death rate across the entire U.S. may have decreased slightly…… How are you even trying to compare a minor percentage fluctuation to a DOUBLING (100 percent increase) of the death rate in a population group?

      1. That’s exactly the comparison that should be made to tell whether policies were effective. It seems clear that NYC’s lockdown killed many people who weren’t infected with COVID-19. It’s impossible to tell how effective that lockdown was at stopping transmission of the virus, but it was certainly less effective than other areas that did not leave mass transit open and the majority of their population packed into subways and buses whenever they went out. Not that it would have been possible for NYC to do otherwise – most of their residents can’t afford any other transportation after paying NYC’s high rents, and I doubt the city’s road system could handle even the essential trips all switching to cars and taxis.

        The problem is, conditions in NYC can’t be compared to most of the country. I think the story is similar in each of the metropolitan areas driving these statistics in the NYT’s cherry-picked states. So we can’t say how much worse NYC’s policies are than the states with a decrease in mortality.

  25. If your worried whether you will catch the virus or not let me set your mind at ease, you will (if you haven’t already). Any chance of knocking this out went away the minute those people got on planes to destinations around the world. This is not an influenza virus and is not just going to go away with the seasons, it may get knocked back as people get out in the sunshine instead of hunkering down together inside as we do when it is cold. This virus being from the same family as the common cold will be with us forever now, and like the cold it will more likely than not mutate too fast for an effective vaccine to ever be made. The only hope for the elderly and infirm at this point would be if it mutates into a less virulent form (much like syphilis did, when it first hit Europe it would kill in less than a month, now people can live into old age with it). All we did with this lockdown is stretch if out a bit, when we do get out it will be there waiting on us.

  26. We need to compare with basic statistics related to previous years. Some people died from COVID 19 but have long term illness and this COVID 19 speed up the process…
    Not easy to have clear view of this covid 19 consequences.

    https://www.marbre-import.fr/

  27. What you really need to do is talk to actuaries. We won’t know for a year or two if we really got excess deaths or if near-term deaths were merely pushed up a few months.

    We know NYC metro had more weekly deaths than “normal” for March-April the last few weeks. But we won’t know if six months from now NYC metro had fewer deaths than normal for July-August until we actually live through July-August.

    Similarly, areas experiencing fewer weekly deaths than normal in March-April may experience more weekly deaths than normal n August-September. If so, it may just be a mere delay of expected death by a few months, but risks being dramatized as a “second wave” of C19.

    To really gauge how deadly C19 is, we won’t know for about two years when we have enough non-seasonal data.

    Six weeks of data is more accurate (for predictive purposes) than two weeks of data. Twelve weeks is even better. But if you try to make long-term changes to the environment based on short-term data your comparative conclusions two years down the road will be comparing apples to oranges.

    Actuaries deal with this all the time. The predictions of extremely-specialized professionals (like Fauci, et al) were necessary for short-term decision-making; as time marches on we need to use the data analysis of actuaries who know how to deal with broader sets of data as the basis for broad, long-term policy decisions.

  28. One other consideration: what is the typical lag time for reporting deaths? Are deaths reported to the CDC in “real-time”? Doubtful. Are they reported more quickly now than they have in the past few years that the NYT is using to set a baseline?

    As Sullum notes, we will not be able to really determine the full-impact of the pandemic on mortality rates until we have many, many more months of data. A longer “run-out” period will not only provide a clearer picture of number of deaths attributed to the virus that would have happen anyway, but also allow for statistical noise due to changes in reporting lag over the years.

  29. Jacob Sollum hit a homerun. A fair honest, in depth analysis of the New York Times article. As we all know, you can make numbers say damn near anything. Journalist like Mr. Sollum are essential workers. Citizens rely on the free press – the NY Times is not a part of that free press. The NY Times is fake news.

    1. “You can make numbers say damn near anything.”

      Sure, if there are variables involved. There are not many variables to sort through when the overall death rate of a massive city doubles or triples, however. The death rate in New York, doubled, possibly tripled since the virus arrived. That’s the flat fact of it. Twice as many dead bodies — 5,000 more deaths in one month than average even during flu season. How you can rationalize that away, I don’t know.

  30. It seems it would be more helpful to compare current death rates with the range over the last 5 years, or better, more rather than the average.
    Funny, every weather temperature report includes todays forcasted high and low temps, the average high, the average low, and the record highs and lows. Shouldn’t be any different in this situation.

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  32. Pompeii bailout: $5 trillion only a pittance.

    Joking aside,

    Federal government needed only one thing: assured access control.

    Then the states should be like, “We got this now.”

    Dependency on federal government could soon destroy rather than ruin the America that as been known during our lifetimes. Congress be love me, “Well, no one’s ever seen the end to the growth of national debt, but there’s no time like the present.”

    However, inspired by the free market, I can predict to the contrary that the new federal government can hope to attract many new, different types of surgeons to the necessary task.

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