Here we go again: Putting COVID numbers in context

A disclaimer: COVID-19 is serious. If you don’t take it seriously by following the rather simple alleviation tactics you have available to you (vaccination, mask-wearing, washing hands, etc.), it can kill you.

There is a difference, however, between it can kill you and it will kill you, and this is a distinction that is seldom clear from the media’s coverage of the pandemic. As I’ve discussed before, numbers are offered out of context and percentages – especially increases in cases, hospitalizations, or deaths – are presented in a hyperbolic manner that make things seem much worse than they really are:

“Alaska and Arkansas more than doubled cases in the last week.” Okay, is that from 50 cases to 100 cases, or is it from 1000 to 2000 cases? Context matters.

“In Missouri, hospitalizations jumped by nearly 30% over the weekend.” Considering the covidestim.org map I included yesterday, this isn’t surprising, and a surge in hospitalizations is what we want to avoid so we don’t overwhelm our facilities and, more importantly, our healthcare workers. But is this from 100 to 130 people hospitalized, or from 1000 to 1300? Again, context matters.

The data aren’t wrong, but the context isn’t there, so they’re less useful than they could be at best, and counter-productive to an informed discussion at worst.

I went to an in-person conference last week in Bellaire, Michigan, which is near Traverse City. Definitely “northern Michigan.” Before I left, I saw a story online that said that COVID-19 cases in “northern Michigan” had risen 50% in the previous week. Which sounds pretty alarming. But there was no definition of what “northern Michigan” meant. (Believe me, there’s no agreement between the various parts of this Great Lakes State on what it means!) Was that “north of Lansing,” or “north of Mount Pleasant,” or “north of Grayling,” or even just the Upper Peninsula? Didn’t say. And, like the examples above, was the 50% rise from 100 to 150 cases (drilling down, that’s what it was) or possibly from 2 cases to 3 (also a 50% increase). So maybe it was concerning… or maybe it wasn’t.

There’s been a lot of concern about children and COVID-19, which is understandable. Nobody likes to see a child suffer or possibly die from an illness, and until very recently vaccines weren’t available for anyone under the age of 18. We continue to recommend that everyone wear a mask indoors, as a precautionary measure. The precautions are more obvious if someone isn’t vaccinated; the mask may help prevent transmission to that person (as well as help prevent them from spreading the virus if they already have it). Unfortunately, the unvaccinated are the least likely to follow those guidelines.

Mask-wearing may help fully-vaccinated people from contracting a “breakthrough” case of COVID, but more often the reasoning is to keep them from spreading the virus unknowingly to unvaccinated people, including children and teenagers.

We rarely distinguish between the likelihood of a particular individual getting COVID, becoming seriously ill, and dying, though. It’s an across-the-board recommendation that treats every American as having an equal chance of death in the face of COVID-19, which isn’t true.

A second disclaimer: This isn’t breaking news; I’m not presenting some discovery that I came up with on my own. (In fact, I’ve already looked at this back in May.) The data have been available for months, but the conclusions, while not terribly complex, don’t fit neatly in a headline or the lead paragraph of a news story.

COVID-related death rates by age group in the United States

Daily death rate, 2 October 2021, per 100,000 people in the United States, by age group.
Graph: Tom Kephart. Source: Our World in Data.

Fully-vaccinated individuals

On 2 October, the number of deaths from COVID-19 per 100,000 fully-vaccinated people in the U.S. aged 12-17 was 0.03, which was 0.3% of all COVID-related deaths of fully-vaccinated people on that date. A fully-vaccinated American teenager had a 1 in approximately 3.3 million chance of dying of COVID on that date.

Also on 2 October, the number of deaths from COVID-19 per 100,000 fully-vaccinated people in the U.S. aged 65-79 was 1.57, which was 18.2% of all COVID-related deaths of fully-vaccinated people on that date. A fully-vaccinated American senior citizen in that age range had a 1 in approximately 63,000 chance of dying of COVID on that date.

Finally, on 2 October, the number of deaths from COVID-19 per 100,000 fully-vaccinated people in the U.S. aged 80 and older was 6.51, which was 75.6% of all COVID-related deaths of fully-vaccinated people on that date. Our oldest fully-vaccinated citizens had a 1 in about 15,300 chance of dying of COVID on that date.

Put another way, those 65 and over fully-vaccinated Americans were over 15 times more likely to die of COVID on October 2 than people in the other four age cohorts combined, and 269 times more likely to die than a fully-vaccinated teenager.

Unvaccinated individuals

On 2 October, the number of deaths from COVID-19 per 100,000 unvaccinated people in the U.S. aged 12-17 was 0.05, which was 0.1% of all COVID-related deaths of unvaccinated people on that date. An unvaccinated American teenager had a 1 in approximately 2 million chance of dying of COVID on that date.

Also on 2 October, the number of deaths from COVID-19 per 100,000 unvaccinated people in the U.S. aged 65-79 was 31.87, which was 39.6% of all COVID-related deaths of unvaccinated people on that date. An unvaccinated American senior citizen in that age range had a 1 in approximately 3100 chance of dying of COVID on that date.

Finally, on 2 October, the number of deaths from COVID-19 per 100,000 unvaccinated people in the U.S. aged 80 and older was 38.28, which was 47.6% of all COVID-related deaths of unvaccinated people on that date. Our oldest unvaccinated citizens had a 1 in about 2600 chance of dying of COVID on that date.

Put another way, those 65 and over unvaccinated Americans were nearly seven times more likely to die of COVID on October 2 than people in the other four age cohorts combined, and over 1400 times more likely to die than an unvaccinated teenager.

Variations between vaccines

There continues to be a lot of discussion about which vaccine is “better.” Looking at the daily death rate data from 10 April to 2 October 2021, there’s not a lot of difference between the three main vaccines available in the U.S. The death rate for those who received the Johnson & Johnson single shot was 0.91 per 100K in April and remained steady at 0.88 in October; Pfizer’s April rate was 0.28 and rose to 0.60 in October (a 119% relative increase); and Moderna’s April rate was 0.15 and rose to 0.46 in October (a 202% relative increase). Those increases for Pfizer and Moderna seem notable as they could indicate the slow wearing-off of immunity, yet they remain very low at less than one death per 100,000 among those who received that vaccine.

Among all age groups, from 10 April to 2 October 2021, unvaccinated people died from COVID at a rate of 3.89 per 100K in April and 7.29 per 100K in October (an 87% relative increase).

So which vaccine a person received has little significance, but being vaccinated versus unvaccinated certainly does.

Risk of dying from COVID versus driving a car

While the data sets don’t align perfectly, a male drivers aged 15-24 had a death rate of 19.0 per 100,000 in 2019; female drivers of the same age cohort had a death rate of 8.2 per 100,000. Both rates are significantly higher than the death rates from COVID for the 12-17 and 18-29 cohorts, approaching the rate of unvaccinated 50-64 year olds.

Conclusion

Let’s repeat this so there’s no misunderstanding of what I’m trying to do here: COVID-19 is serious. If you don’t take it seriously by following the rather simple alleviation tactics you have available to you (vaccination, mask-wearing, washing hands, etc.), it can kill you.

But we’re doing ourselves a disservice by reducing the statistics to the most alarming, and often misleading, components. The SARS-CoV-2 virus is particularly deadly to older people, including those 65 to 79 but especially those 80 and older. Overall health of older and elderly people is certainly a factor, as are possible underlying health issues (many of which are exacerbated by age as well). Vaccinating children is as important to keep them from spreading COVID to their grandparents and great-grandparents as it is protecting them from dying. We’ve been concerned about the health of our children while the focus really needs to be on our oldest community members.

We’re getting bogged down in the various numbers and seem to have lost track of what they mean or whether the really mean anything. In addition to the physical, economic, and mental realities of pandemic fatigue, we also seem to be losing the ability to muster much of a response to the changing data on numbers of cases, how full ERs and ICU wards are, or how many people are dying from a virus that probably won’t be eradicated but certainly could have been much more controlled at this point. Everyone has their own data point they’re watching – and some of them don’t make any sense or have been chosen to fit a specific narrative.

The endless focus on COVID also distracts us from other concerns, some of which are deadly (including other illnesses such as influenza) and some of which aren’t (our widening political gulf between right and left and its implications for the future of our nation). There are new vaccines on the horizon and antiviral pills even closer to being available. An honest discussion of where we are – as opposed to overheated, sensationalistic media and water cooler talk – is critical if we have any hope of resolving the problems that we’re facing.