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Among working-age adults, COVID has increased the crude death rate from 0.43% to 0.47%

Here is Chris Hayes today on Twitter:

I tweeted back that the level of COVID deaths wasn't actually that high, and naturally I've been dragged all over Twitter as a result. Maybe I deserved it. But I still think there's something not quite right about this.

The CDC's preliminary mortality report for 2020 is here. When you separate out the numbers for working-age adults, here's what you get: COVID has increased the crude death rate from 0.43% of the population to 0.47%. If this happened in the absence of COVID it would barely even be noticeable.

As before, I want to emphasize that I'm not saying that the deaths of the elderly don't matter. Or that COVID-19 is no big deal. Or that long COVID isn't scary. Or that we couldn't have done better.

All I'm saying is that the lived experience of most people simply doesn't match the constant rhetoric of "staggeringly" high levels of death. Does this matter? I think it does, though I admit I'm not quite sure how. But it's something to think about if you're trying to figure out why so many people have come to accept the COVID death rate as normal and tolerable.

118 thoughts on “Among working-age adults, COVID has increased the crude death rate from 0.43% to 0.47%

  1. Altoid

    Personally, I think Kevin was hearing Hayes being Hayes in his mind's ear as he read that tweet and got annoyed. Sometimes Hayes does that to me, and then this was Hayes responding to Nate Silver! The self-assurance overload beggars the imagination.

    Differential incidence is a thing we haven't mentioned yet. The country today isn't NYC in the spring of 2020, and that's kind of our image of the covid disaster. But it's been running in waves over different parts of the country at different times, and affecting different classes in our population. Least affected of all, I'd bet, would be well-educated, white-collar or retired, Democratic-leaning segments like most readers here and certainly like Kevin himself, as well as me.

    Right now, it seems like the worst affected areas are small cities and small-town, semi-rural areas that also strongly lean MAGA, like southwestern Michigan. Not many of us posting here live in these places, I'd bet, and in raw numbers there aren't a whole lot of people there, by definition. In three weeks the incidence will move somewhere different, but probably a similar socio-political profile.

    Unless omicron really turns out to be significantly less lethal than delta, that pattern will likely mean a fairly steady background level of covid deaths near what it is are now that will continue for a long time and that will be felt as rolling waves mostly in the small cities and small-town, semi-rural areas that lean MAGA. Hospitals there, because they're small relative to population, will cyclically overload with covid patients. That will continue until a more benign variant emerges, or more of these people get vaxxed, or there aren't enough of them to maintain transmission.

    "Working-age adults" is the wrong metric, imo, when you're looking for economic and population effects. Try something more like wage workers, as opposed to salaried. Or look at specific industries, or in regions with lighter population densities. You need aggregates, but you also need finer measures. My bet, for what it's worth, is that ultimately this will turn out to be yet another staggering blow to the rural economy and to the already-declining small towns hit by opioids and suicides.

    1. MontyTheClipArtMongoose

      Loq Qabin Republiqan Nate "Priors Checker" Silver is a pedantic, Peter Principle blowhard, but even he didn't go so far as Chris Hayes as to be 110% certain joebiden raped Tara Reade as violently as Ted Bundy or Willie Horton would have.

    2. royko

      Hey, I live in SW Michigan, so I can weigh in. We're currently in a surge (as you've seen) right now, although I think our peak at this time last year was higher. November-January last year was our worst portion of the pandemic.

      What's it like? There's a fair amount of Covid going around right now, enough that most everyone knows someone who got in within the last month, but not so much that everyone has it. Hospitals are strained but hanging in there. Schools with masking policies are doing OK with more generous quarantine rules, a few schools without masking policies have had to close for short periods. Honestly, copycat Oxford threats are causing more disruption in schools lately. More people are wearing masks in stores than earlier in the year, but it's still well below 50%. But if you weren't paying attention to the numbers, you probably wouldn't realize just from living here how much Covid there is right now. (And I think you could say the same for last winter.)

      I think our numbers for the entirety of the pandemic are fairly close to average for the country. In the first year, March to March, we lost almost as many people as we do in a year for cancer, locally as well as nationally. This year (March to March) might be a little less, but not much. So it's like 2 years of having a double cancer death rate. As a result, some of us have personally known people that died, but most haven't, or it hasn't been anyone especially close to them. The really hardcore MAGAs still think it's all some kind of political hoax (and are quite vocal at local meetings), much of the population just doesn't see it as a big deal. It's kind of sad. The minority concerned about the pandemic are vaxxed and are getting their kids vaxxed and are masking where appropriate. People who don't just aren't doing much of anything. I think our local vax rate is a bit over 50% for the total population.

      What is a high level of death? That's really relative. I suppose the Covid death rate is low enough that a lot of people are unaffected and thus see it as a low death rate, if that's one metric. If it were 10x as bad, everyone would know someone who died and would be pretty freaked out. How much it personally affects individuals seems to be a bigger factor than raw numbers.

      What is the appropriate level of response to basically two years of (almost) a new cancer-level disease? Or 20 years of flu in 2 years, if you prefer to think in those terms? I feel like if in March 2020 they'd known a million people were going to die in two years, that would have been considered a pretty big deal. But stretched out, people got used to the idea pretty quickly. (MAGAs think all the numbers are faked anyway.)

      Personally, I think it's tragic, and wish we'd done more. But in SW Michigan, I'm in the minority.

      1. Justin

        I also live in SW Michigan and agree with your assessment. It’s kind of funny that the Pfizer plant here makes all their vaccine for US and still so many skip it. Last year at this time they were heroes and now… meh. ????

      2. Altoid

        Thanks for the profile. I'm in a part of central PA where things are basically similar, except this area's been declining economically for the past 40-50 years. Rust belt.

        I think maybe we're not taking enough account of the socio-cultural incidence of covid in areas like this. A lot of people around here seem to be fatalistic in one way or another about getting acutely sick, chronically sick, or dying. Some of that is based in religion but by no means all-- it's just that so little of what affects them is subject to anything they can do, that covid is just one more thing. Very much class-based, so the brunt is borne not only by older people (much less now with more stringent vaxxing in long-term care, etc) but by hourly wage workers.

        I was going to say this is kind of a MAGA ethos-- just stop being a p**y and do what you have to do-- but the noisiest and most visible MAGA folks around here tend to run small businesses or medical practices. So maybe it's more that the owners say it and their employees live it, or something like that.

        Hospitals are where the real crunch is being felt, and that doesn't look like it's going to change anytime soon. Everything else can be absorbed as background noise or check-out line chatter, but I'm not sure about the hospital situation. The long ER wait times and deferred non-covid procedures and staffing shrinkage are real and have already become demoralizing enough to draw the local newspaper's attention.

    3. Spadesofgrey

      Nope, worst effected are ghettos. Nope to your entire post. It's dialectical. New York suburbs were hit harder than Many rural Ohio counties. You need a nostril rip.

  2. cephalopod

    Most people just aren't that concerned about increased deaths among the elderly, and that is what differentiates this from other events with high numbers of deaths.

    Just look at nursing homes. Somewhere above 10% of nursing home residents have died of covid and I dont know a single person who preemptively removed a family member from a nursing home.

    That is what has surprised me the most. With so many Americans working from home during the pandemic, I thought that at least 20% of nursing home residents would be removed and brought into family-members' homes. But that didnt happen.

    So, yeah, I'm not the least bit surprised that a lot of people aren't that worked up about a disease they have associated with high risk for the elderly. The risks to younger people are small enough that most people can't really do the math, and things like "long covid" are so imprecisely defined that they are easy for people to dismiss.

  3. skeptonomist

    The death rate is low among young people - under 65 - but very high among the old. Should covid be ignored by younger people just because it death from it is a low probability for them personally? There has been no need for panic, at least after the death rate was found not to be extremely high, but defeating the pandemic requires people to be aware and to take the requisite measures to stop the spread, not just to reduce the danger to themselves. The spread should be stopped because of that high death rate among the old, but also because the longer it goes on and the more widespread it is, the greater the danger of more deadly variants arising. At this point the main thing that people should be doing is getting vaccinated, but saying that there is not much danger to individuals is not encouraging this. If it takes people being scared to force them to get vaccinated, then they should be scared.

    It would also be a good idea to have more stringent methods to contain pandemics, such as testing and isolation. These things work - other countries did them. We are not likely to adopt such methods, but minimizing the danger of this particular pandemic makes it even harder to do any useful things, even to organize to get vaccines produced and distributed in case of future pandemics.

    1. Vog46

      "It would also be a good idea to have more stringent methods to contain pandemics, such as testing and isolation. These things work - other countries did them. We are not likely to adopt such methods........"

      That says it all skept.
      we will NOT do whats needed if it impedes in any way shape or form on our "perceived" freedoms.

  4. ruralhobo

    If people can get used to ecosystem destruction, a bleak future for their kids, a frontal and concerted attack on democracy and ever more intrusive surveillance, I suppose they can get used to a slightly higher death rate.

    Perhaps we should wonder not why the people remain calm but why governments don't. If they don't even panic over climate change, why panic about anything at all?

  5. Bluto_Blutarski

    Another way of looking at those numbers is that there's a 10% increase in the number of deaths among working age adults. So about one in 10 working-age deaths are due to Covid.

  6. Vog46

    I am going to voice my opinion on this KD post, hopefully from a different perspective.

    KD seems to want to use "language" to try to inject some "sanity" in the affects of COVID but keep in mind his unique situation. He IS suffering from (at present) and incurable disease - so he (And Marian) have had to face his inevitable demise already. So he is biased by this fact. He is, barring a jolting scientific discovery going to die and probably earlier than he normally would have. The outpouring of concern from those of us who post here, and at MJ, along with family friends are NORMAL reactions to the situation he is in health wise.

    But his situation jaundices his view of death as a whole because he's learned, personally, to have to accept it. For all our technical prowess and scientific advancements - we cannot cure what he has. This has GOT to have an affect on people. It would affect me.

    Keep this in mind as you read his covid posts. Minimizing death rates, or counts is an outgrowth of the struggles HE faces personally.

  7. Krowe

    It looks to me like working age people have about a 10% greater chance of dying during the pandemic than they did before (0.43% x 1.1 = 0.47%). Even though mortality is still low for these age cohorts, I think that's still a big deal.

  8. bokun59elboku

    Pretty much this thinking confirms how little Americans care about old people. This is probably why old people vote in such high numbers. They know the youngs would ice floe them in a nanosecond and so they need to protect themselves by controlling politics.

  9. Vog46

    Interesting news out of Israel.
    In the bronchial tract Omicron reproduces 70 TIMES faster than Delta, but in the lungs it has less affect. This is both re-assuring and dangerous. COVID spreads by exhalation be it by speaking coughing etc.........
    We could have Omicron and be imposing one heluva viral load on those around us before we even have an inkling that WE have Omicron.
    Now, that doesn't mean we shut down the economy.
    I think we have to realize that much like the earlier waves we need to be extra cautious but we also need to accept the fact that Omicron is spreading so fast and mixing with DELTA that we need to be prepared for the next wave which may have increased transmission, AND severe symptoms.
    Because of this we need to start thinking that if we had our vaccines over 5 months ago we need to get a booster OR be counted as unvaccinated - period.
    If I use that as a standard, my home state of NC isn't fairing that well. And this is exactly what Faucci is alluding to.
    We need to step up, or be ready for what's next because Omicron showed that COVID is not over

    1. rational thought

      Vog,

      One comment here that I think you will agree with .

      I think you have posted worrying about omicron being so different as to effectively be a different virus. And thus getting natural immunity from getting omicron will do less to protect you from delta and vice versa. Allowing both strains to circulate simultaneously and maybe even get infected with both at same time . Which would be bad news.

      I think that worry is somewhat overblown as so far it does seem that both vaccines and delta natural immunity still gives some protection against omicron , just reduced. And the data from London do show delta going down significantly as omicron has become dominant ( yes already in London!) Which suggests it is pushing out delta somewhat, but not as fast as delta did to others .

      But this study you cited showing such a dramatic differences in how it multiplies much faster in bronchius and less in lungs, sure looks like it operates in a totally different way than prior versions, not just in a different magnitude.

  10. rharrisonauthor

    The death rate of those infected appears to be in the range of 1-2%. About 1/6 of the US population has been infected (officially - it could be more). 1/6 of 2% is 0.33% and 1/6 of 1% is 0.16%. So we wouldn't expect a large tick in overall death rates.

    A shift of 0.04% suggests we have errors in the rates, but not orders of magnitude errors.

    1. Vog46

      That would be great if both post infection and vaccination immunity was permanent - but its not.
      Omicron has rendered previous immunity almost irrelevant
      Take away anyone who has =been vaccinated in the last 4 months or so (or boostered) then recalculate based upon the rest of the population being exposed to Omicron and what comes next
      We are so used to thinking one and done that it has hindered out approach to dealing with a living thing that changes

  11. skeptonomist

    Rather than just considering identified covid deaths it may be more relevant to consider excess death rates

    https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386938

    as some covid deaths are missed and care for other conditions has been reduced. For the US the excess is 19% (although there may be other measures than the link). The spread internationally may be even greater than for cases or covid deaths. Should we not have some concern for what happens in other countries? Do we not have some responsibility to provide vaccines to them? The chance of new mutations, which could be more harmful, is proportional to total world-wide infections, not just those in the US. We are certainly not going to be isolated from any new strains.

  12. memyselfandi

    "COVID has increased the crude death rate from 0.43% of the population to 0.47%. If this happened in the absence of COVID it would barely even be noticeable." A 10% increase in the likelihood of death is not! barely noticeable. You'll definitely notice the increase in your life insurance premium.

  13. pack43cress

    People need to stop mis-using the statistics. The statistics are useful *in a context*. Stats about COVID are not the same as stats about cancer, stats about heart attacks, stats about fatal automobile accidents. Why? Because COVID is an infectious disease, and all of the others are not.
    When dealing with an infectious disease, the total raw number of bad outcomes is something that can be minimized by minimizing the number of cases that occur. The statistics about mortality have only one use: comparing the lethality of this disease to the lethality of other infectious disease in history. And what is the value of that comparison? Only to try to get people to understand the population risk, as opposed to any individual’s risk.
    Anyone who uses the statistics to “decide” their own behaviors based on shallow notions of individual risk is doing completely the wrong thing. Why? Because individual risk is not relevant to optimizing the population’s outcomes. The thing that IS relevant is population health outcomes if population behaviors.
    A case mortality rate of 1% would mean 1 death if only 100 people caught the disease. If 100 million people catch the disease it means a million deaths. Don’t talk to me about percentage of population deaths as a rationale for not participating in the mitigation measures. The more people who get it, the more prevalent it will be, the more unnecessary death will occur.
    If you roll a 10-sided die once, there’s a 10% chance you will roll a “1”. If you roll it 100 times, you’re almost guaranteed to roll a “1”. People behaving as if their individual risk being 0.01% means they don’t have to worry about getting infected with COVID are actually causing deaths of other human beings by COVID.
    In insurance, if the statistical reality is that on 1 in 5000 insureds are going to have an accident that totals their car in a given calendar year, the insurance business does not assume that there will be zero totaled car claims. In fact, they assume that there will be lots of extremely unlikely events that result in a totaled car claim. So they just need to have enough insureds so that the business model works.
    With an new infectious viral disease, where it mutates a lot, and there is no guarantee that it won’t mutate into something more sinister in health outcomes, the only sane response is to have complete population dedication to reducing transmission. Period. The deaths and long-term health problems will continue until the human race gets the transmission rate down, way down.

  14. lawnorder

    That same CDC report also expresses the same numbers in a different way. "The age-adjusted death rate increased by 15.9% in 2020". That puts a different light on things, doesn't it?

  15. spatrick

    "Most people just aren't that concerned about increased deaths among the elderly, and that is what differentiates this from other events with high numbers of deaths."

    Indeed, if the deaths were among children, young adults or middle aged, do you think the reaction would be the same?

    Unfortunately I'm afraid the public is so determined to get back to "normal", whatever the hell that was, which has been fed by politicians on both sides thinking we could somehow lick the pandemic (by various means) and the confusing, sometimes contradictory orders from health officials that is has left people "worn out". Unfortunately the truth is we're going to have to figure out ways to live the virus and its mutant strains (and I say this as someone whose been vaccinated and came down with it and whose wife almost died from it) until it can be controlled and contained. And I completely agree with Gov. Polis of Colorado. The vaccines are there, they're free, and if you don't get them, well, sorry, you're SOL.

  16. thebigtexan

    I wonder how many deaths Americans will accept from climate change. Is a million per year acceptable? My gut feeling is that it probably will be.

  17. Vog46

    This is way too preliminary - but worthy of keeping our eyes on:
    From Columbia University
    https://www.nydailynews.com/coronavirus/ny-covid-columbia-university-study-shows-omicron-resistant-to-vaccines-20211216-73x6jmf3xrblxmyjn3drtku52a-story.html

    A new Columbia University study says the omicron variant of COVID-19 is “markedly resistant” to existing vaccines, antibody treatments and even booster shots may provide********only modest protection********** against infection.

    The draft study was led by renowned researcher Dr. David Ho and early evidence suggests the lightning quick-spreading strain is likely to cause a massive wave of so-called breakthrough infections even among fully vaccinated people.

    “We found (omicron) to be markedly resistant to neutralization in individuals vaccinated with one of the four widely used COVID-19 vaccines, “ said the study. “Even serum from persons vaccinated and boosted with mRNA-based vaccines exhibited *******substantially diminished neutralizing activity******* against (omicron),” it added.

    The study is still in the so-called “pre-print” stage, meaning it has not been reviewed by other experts or edited by any scientific journal. It was released Wednesday by the Aaron Diamond AIDS Research Center, which is now focused on fighting COVID.

    The study says existing antibody therapies, like the monoclonal antibody cocktails that are credited with saving many lives during current and previous COVID waves, appear to be********mostly ineffective******* against omicron.

    It also noted that natural antibodies from previous infections ********are not effective******* in warding off omicron, meaning people who have had COVID-19 in the past are************ virtually unprotected from reinfection *********in the coming omicron wave.

    Translation: Americans should be very concerned about omicron as it starts to spread across the New York area and nationwide.

    The study still recommends getting vaccinated and obtaining booster shots to obtain even modest protection they offer against infection and especially against serious or life-threatening diseases.

    The unusually blunt study notes that omicron “struck fear” in even veteran researchers when it was first identified because of its high number of mutations, especially in the virus’s so-called spike proteins. Those are part of the virus that antibodies attack, so changes can make them less effective at preventing infection.

    “These extensive spike mutations raise the specter that current vaccines and therapeutic antibodies would be greatly compromised,” the study said. “This concern is amplified by the findings we now report.”

    There is no doubt that omicron spreads faster than previous variants. Caseloads are doubling every three days or so, mirroring jumps in Britain where it is already spreading fast.

    The study only involved a handful of patients and it made no effort to discover whether omicron might cause less or more severe illness.

    Early clinical reports from South Africa, where omicron was first identified and is spreading widely, offer hope that the variant hasn’t caused as many severe cases or deaths so far.

    But the study grimly warns that new vaccines and treatments will need to be developed quickly

    It seemed to contradict the hopeful claims by Dr. Anthony Fauci that existing vaccines and booster shots should be sufficient to get us through a new omicron wave.

    “The omicron variant has now put an exclamation mark on this point. It is not too far-fetched to think that this (COVID) is now only a mutation or two away from being********* pan-resistant to (all) current antibodies,”********* the study said.
    *********************************************************************

    This is a very small study
    But ask yourselves this
    When was the last time someone said things like:
    ........only modest protection.........
    ..........substantially diminished neutralizing activity........
    .........mostly ineffective...........
    .........are not effective*.........
    ..........virtually unprotected from reinfection..........

    When it came to vaccine, post infection or alternative treatment levels of protection???????

    I hope this study is wrong in all aspects.
    But its sounding more and more like there's no protection.
    Congratulations to those that have been hesitant. Perhaps if Dear Leader had exhorted his troops to be like him and get the vaccine we wouldn't be in this place right now

  18. Vog46

    Been hearing some disturbing reports out of the UK regarding the severity of Omicron.
    We currently have 3 groups of people
    Totally unvaccinated, never had covid - they are called Naive people
    Vaccinated or previously infected but now with waning immunity
    Fully vaccinated and recently received booster

    What the UK scientists are saying is this. Among the naive people with no previous contact with COVID, or vaccines or other types of treatments.- To THESE people Omicron is more deadly or at least as deadly as DELTA.
    The question remains is how many are naive here in the U.S.
    But this is the WAY to judge this variant for how serious is may be.
    The UK says its just as bad as DELTA
    Interesting given our penchant for statistics on this blog THIS is an interesting little factoid

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