All about risk
Description:
Reviewing the recent Society of Actuaries report on preliminary mortality results in U.S. population, with a focus on increased mortality from non-COVID causes. U.S. Population Mortality
Observations, Preview of 2020 Experience Society of Actuaries research:
https://www.soa.org/resources/research-reports/2021/us-population-observations-preview/
Author(s): Mary Pat Campbell
Publication Date: 21 May 2021
Publication Site: Meep’s Math Matters on YouTube
Report Link: https://www.soa.org/globalassets/assets/files/resources/research-report/2021/us-population-observations-preview.pdf
Link: https://www.soa.org/resources/research-reports/2021/us-population-observations-preview/
Graphic:
Excerpt:
The overall age-adjusted mortality rate for 2020 was 828.7 deaths per 100,000 of population. This rate was 15.9% greater than the 2019 overall age-adjusted mortality rate. This high level of mortality has not been experienced in the U.S. since 2003.
If deaths coded as COVID (COVID deaths)3 were excluded, the overall age-adjusted 2020 mortality rate would have been 737.2 per 100,000 or 3.1% higher than the 2019 rate. This increase excluding COVID deaths is also noteworthy because it reverses the two previous calendar years of decreasing mortality; however, some or all of this may be due to the misclassification of CODs as discussed in Section 6.
2020 mortality rates increased in both sexes, with the male rates increasing more than the female rates. The differences in the increases between males and females were about 3% when all causes of death (CODs) are included and about 1% when COVID deaths are excluded.
The slope of the 2020 COVID mortality curve by age group is not as steep as the slope of the non-COVID deaths, indicating that COVID impacts younger ages more evenly across age groups that all other non-COVID CODs combined.
In the review of the 2020 mortality rates by age group, it is interesting to see that the highest percentage increases were in the younger adult ages, not at the very old ages. When COVID deaths were removed, ages 15-44 saw the largest increases in mortality rates.
Author(s): Cynthia MacDonald, FSA, MAAA
Publication Date: 20 May 2021
Publication Site: Society of Actuaries
Link: https://marypatcampbell.substack.com/p/mortality-nuggets-global-excess-deaths
Video:
Excerpt:
In particular, it is pretty clear to me that specifically in the U.S., the non-COVID excess mortality has been very high. I do not think that’s under-counted COVID deaths. I think it’s due to other causes. We’ve already seen that car accident deaths were up, even though total miles driven was down by a lot.
So yay for their statistics in grabbing the excess deaths, but boo for assuming all those excess deaths were COVID.
Now, results of COVID and COVID policies, sure, I’d go with that. But do you want to start digging into the stats of suicides, drug overdoses, “accidental” deaths, and more? How about deaths of neglect? I bet that is involved in a bunch of non-COVID elderly deaths.
Author(s): Mary Pat Campbell
Publication Date: 18 May 2021
Publication Site: STUMP at substack
Link: https://www.theguardian.com/commentisfree/2021/may/04/why-do-americans-die-earlier-than-europeans
Excerpt:
A 30-year-old American is three times more likely to die at that age than his or her European peers. In fact, Americans do worse at just about every age. To make matters more grim, the American disadvantage is growing over time.
In 2017, for example, higher American mortality translated into roughly 401,000 excess deaths – deaths that would not have occurred if the US had Europe’s lower age-specific death rates. Pre-pandemic, that 401,000 is about 12% of all American deaths. The percentage is even higher below age 85, where one in four Americans die simply because they do not live in Europe.
…..
There have been many efforts to account for the US mortality disadvantage. There is no single answer, but three factors stand out. First, death rates from drug overdose are much higher in the US than in Europe and have risen sharply in the 21st century. Second is the rapid rise in the proportion of American adults who are obese. In 2016, 40% of American adults were obese, a larger proportion than in Europe. Higher levels of obesity in the US may account for 55% of its shortfall in life expectancy relative to other rich countries. Third, the US stands out among wealthy countries for not offering universal healthcare insurance. One analysis suggests that the absence of universal healthcare resulted in 45,000 excess deaths at ages 18-64 in 2005. That number represents about a quarter of excess deaths in that age range.
…..
Above age 65, healthcare insurance coverage is nearly universal via Medicare. An international review of medical practice by the National Academy of Sciences suggested that the US does comparatively well in identifying and treating cardiovascular diseases and many cancers. But the prevalence of these diseases, the principal killers in wealthy countries, is unusually high in the US. Heart disease, a type of cardiovascular disease and America’s number one cause of death for decades, is strongly linked to lifestyle factors such as obesity. Although the connection between obesity and health risks is well known, consumer preferences for unhealthy food are strong. Not just because humans are biologically vulnerable to sweets and fats, but because major food producers and distributors are incentivized to turn this weakness into profit.
Author(s): Samuel Preston, Yana Vierboom
Publication Date: 4 May 2021
Publication Site: The Guardian UK
Link: https://www.medrxiv.org/content/10.1101/2021.03.02.21252772v4
Graphic:
Abstract:
Variations in the age patterns and magnitudes of excess deaths, as well as differences in population sizes and age structures make cross-national comparisons of the cumulative mortality impacts of the COVID-19 pandemic challenging. Life expectancy is a widely-used indicator that provides a clear and cross-nationally comparable picture of the population-level impacts of the pandemic on mortality. Life tables by sex were calculated for 29 countries, including most European countries, Chile and the USA for 2015-2020. Life expectancy at birth and at age 60 for 2020 were contextualised against recent trends between 2015-19. Using decomposition techniques we examined which specific age groups contributed to reductions in life expectancy in 2020 and to what extent reductions were attributable to official COVID-19 deaths. Life expectancy at birth declined from 2019 to 2020 in 27 out of 29 countries. Males in the USA and Bulgaria experienced the largest losses in life expectancy at birth during 2020 (2.1 and 1.6 years respectively), but reductions of more than an entire year were documented in eleven countries for males, and eight among females. Reductions were mostly attributable to increased mortality above age 60 and to official COVID-19 deaths. The COVID-19 pandemic triggered significant mortality increases in 2020 of a magnitude not witnessed since WW-II in Western Europe or the breakup of the Soviet Union in Eastern Europe. Females from 15 countries and males from 10 ended up with lower life expectancy at birth in 2020 than in 2015.
Author(s): José Manuel Aburto, Jonas Schöley, Ilya Kashnitsky, Luyin Zhang, Charles Rahal, Trifon I. Missov Melinda C. Mills, Jennifer B. Dowd, Ridhi Kashyap
Publication Date: 6 April 2021
Publication Site: medRxiv
Graphic:
Methodology: https://www.economist.com/graphic-detail/2021/05/13/how-we-estimated-the-true-death-toll-of-the-pandemic
Publication Date: 15 May 2021
Publication Site: The Economist
Link: https://www.nationalreview.com/2021/05/rebekah-jones-the-covid-whistleblower-who-wasnt/
Excerpt:
There is an extremely good reason that nobody in the Florida Department of Health has sided with Jones. It’s the same reason that there has been no devastating New York Times exposé about Florida’s “real” numbers. That reason? There is simply no story here. By all accounts, Rebekah Jones is a talented developer of GIS dashboards. But that’s all she is. She’s not a data scientist. She’s not an epidemiologist. She’s not a doctor. She didn’t “build” the “data system,” as she now claims, nor is she a “data manager.” Her role at the FDOH was to serve as one of the people who export other people’s work—from sets over which she had no control—and to present it nicely on the state’s dashboard. To understand just how far removed Jones really is from the actual data, consider that even now—even as she rakes in cash from the gullible to support her own independent dashboard—she is using precisely the same FDOH data used by everyone else in the world. Yes, you read that right: Jones’s “rebel” dashboard is hooked up directly to the same FDOH that she pretends daily is engaged in a conspiracy. As Jones herself confirmed on Twitter: “I use DOH’s data. If you access the data from both sources, you’ll see that it is identical.” She just displays them differently.
Or, to put it more bluntly, she displays them badly. When you get past all of the nonsense, what Jones is ultimately saying is that the State of Florida—and, by extension, the Centers for Disease Control and Prevention—has not processed its data in the same way that she would if she were in charge. But, frankly, why would it? Again, Jones isn’t an epidemiologist, and her objections, while compelling to the sort of low-information political obsessive she is so good at attracting, betray a considerable ignorance of the material issues. In order to increase the numbers in Florida’s case count, Jones counts positive antibody tests as cases. But that’s unsound, given that (a) those positives include people who have already had COVID-19 or who have had the vaccine, and (b) Jones is unable to avoid double-counting people who have taken both an antibody test and a COVID test that came back positive, because the state correctly refuses to publish the names of the people who have taken those tests. Likewise, Jones claims that Florida is hiding deaths because it does not include nonresidents in its headline numbers. But Florida does report nonresident deaths; it just reports them separately, as every state does, and as the CDC’s guidelines demand. Jones’s most recent claim is that Florida’s “excess death” number is suspicious. But that, too, has been rigorously debunked by pretty much everyone who understands what “excess deaths” means in an epidemiological context—including by the CDC; by Daniel Weinberger, an epidemiologist at the Yale School of Public Health; by Lauren Rossen, a statistician at the CDC’s National Center for Health Statistics; and, most notably, by Jason Salemi, an epidemiologist at the University of South Florida, who, having gone to the trouble of making a video explaining calmly why the talking point was false, was then bullied off Twitter by Jones and her followers.
Author(s): Charles C. W. Cooke
Publication Date: 13 May 2021
Publication Site: National Review
Link: https://voxeu.org/article/social-and-economic-costs-covid-19
Graphic:
Excerpt:
First, we compute the differences between the output paths for 2020–2030 projected before and after the pandemic (the shaded area in Figure 1) and estimate its present value discounting at a 0% real interest rate (a reasonably conservative assumption in a context where real rates are negative for most developed countries). This yields a total loss of about half of global GDP.
Next, there is the question of the fiscal stimulus (equivalent to 15% of GDP, according to the IMF fiscal monitor) without which the output loss in 2020 would have been much steeper. How much of the economic impact of the fiscal unwinding is properly accounted for in the revised growth projections (Beck et al. 2021), particularly given that a big part of the stimulus (6% of the 15%) was below the line (loans, equity stakes, guarantees) with a cost that is contingent on the speed and composition of economic recovery in each country? There is no simple answer here. Moreover, we are ignoring potential bouts of financial stress or debt restructurings in heavily indebted countries (Persaud 2021), as well as the second wave of stimulus already in line for 2021 in many advanced economies. All things considered, adding the full 15% of GDP as an indicative measure of the cost of fiscal support does not look unreasonable.
Third, there is the value of the excess deaths due to Covid-19. There is, of course, no uncontroversial way to put a value on human life. For the sake of argument, we follow a recent estimation for the US by Cutler and Summers (2020) that uses the ‘statistical lives’ value to place it between $10 million and $7 million per life. If we take the considerably more conservative $5 million per life, acknowledging that the statistical value may vary across countries, the cost related to the global cumulative deaths registered so far amounts to 16.9% of global GDP.
Author(s): Eduardo Levy Yeyati, Federico Filippini
Publication Date:
Publication Site: Vox EU
Link: https://wwwnc.cdc.gov/eid/article/12/1/05-0979_article
Graphic:
Abstract:
The “Spanish” influenza pandemic of 1918–1919, which caused ≈50 million deaths worldwide, remains an ominous warning to public health. Many questions about its origins, its unusual epidemiologic features, and the basis of its pathogenicity remain unanswered. The public health implications of the pandemic therefore remain in doubt even as we now grapple with the feared emergence of a pandemic caused by H5N1 or other virus. However, new information about the 1918 virus is emerging, for example, sequencing of the entire genome from archival autopsy tissues. But, the viral genome alone is unlikely to provide answers to some critical questions. Understanding the 1918 pandemic and its implications for future pandemics requires careful experimentation and in-depth historical analysis.
Author(s): Jeffery K. Taubenberger, David M. Morens
Publication Date: January 2006
Publication Site: CDC
Link: https://pubmed.ncbi.nlm.nih.gov/19788357/
Abstract:
The high case-fatality rate–especially among young adults–during the 1918-1919 influenza pandemic is incompletely understood. Although late deaths showed bacterial pneumonia, early deaths exhibited extremely “wet,” sometimes hemorrhagic lungs. The hypothesis presented herein is that aspirin contributed to the incidence and severity of viral pathology, bacterial infection, and death, because physicians of the day were unaware that the regimens (8.0-31.2 g per day) produce levels associated with hyperventilation and pulmonary edema in 33% and 3% of recipients, respectively. Recently, pulmonary edema was found at autopsy in 46% of 26 salicylate-intoxicated adults. Experimentally, salicylates increase lung fluid and protein levels and impair mucociliary clearance. In 1918, the US Surgeon General, the US Navy, and the Journal of the American Medical Association recommended use of aspirin just before the October death spike. If these recommendations were followed, and if pulmonary edema occurred in 3% of persons, a significant proportion of the deaths may be attributable to aspirin.
Author(s): Karen M Starko
Publication Date: 1 November 2009
Publication Site: Clinical Infectious Diseases
Link: https://www.nber.org/papers/w28550
Graphic:
Abstract:
We estimate the long-term effects of experiencing high levels of job demands on the mortality and aging of CEOs. The estimation exploits variation in takeover protection and industry crises. First, using hand-collected data on the dates of birth and death for 1,605 CEOs of large, publicly-listed U.S. firms, we estimate the resulting changes in mortality. The hazard estimates indicate that CEOs’ lifespan increases by two years when insulated from market discipline via anti-takeover laws, and decreases by 1.5 years in response to an industry-wide downturn. Second, we apply neural-network based machine-learning techniques to assess visible signs of aging in pictures of CEOs. We estimate that exposure to a distress shock during the Great Recession increases CEOs’ apparent age by one year over the next decade. Our findings imply significant health costs of managerial stress, also relative to known health risks.
Author(s): Mark Borgschulte, Marius Guenzel, Canyao Liu, Ulrike Malmendier
Publication Date: March 2021
Publication Site: NBER
Video:
Description:
Looking at U.S. mortality stats as of April 23, 2021 –and thinking what full year 2021 deaths may look like. Plus discussing co-morbidities and correlations.
Author(s): Mary Pat Campbell
Publication Date: 23 April 2021
Publication Site: Meep’s Math Matters at YouTube