How do you estimate the low end of a death rate?

If 50% of the United States population were infected and the mortality rate was 1%, the expected number of deaths would be around 1,700,000. Is this a realistic number?

The worst area for the coronavirus to date has been Hubei Province, China. The statistics associated with the January and February 2020 fatalities show the following break-down by age

0-9 years less than 0.01%
10-19 years 0.02%
20-29 years 0.08%
30-39 years 0.18 %
40-49 years 0.40%
50-59 years 1.3%
60-69 years 4.6%
70-79 years 9.8%
80-89 years 18%

The most recent review of Hubei Province fatalities indicates that the mortality rate is 1.4%, lower than original estimates of 2-3%. Part of their assumptions was that a larger number of people were infected than previously known, probably as high as 70,000.

The overall fatalities numbers from Hubei, Province are not that far off those being reported in general worldwide. Some populations are better – Hong Kong, Taiwan, and South Korea. Some are worse. The Chinese did not know how the virus spread or how to test people for it. This resulted in higher than normal deaths that could have been prevented if testing and treatment started earlier. The imposed quarantine saved thousands of lives.

We should base our ‘best case’ scenario numbers on what didn’t happen in China. Testing is identifying people with the disease so that they can be isolated. Age, sex, and pre-existing conditions reflect an accurate guess at the true mortality rate of the coronavirus.

Wikipedia breaks down the United States demographics slightly differently than WHO did for the Chinese fatalities. In the US, the age demographics are,

0-14 years 18.62%
15-24 years 13.12%
25-54 years 39.29%
55-64 years 12.94%
65 years and older 16.03%

How can the data obtain to date forecast our future infections and deaths from the coronavirus?
The New York Times published a sliding scale estimator or deaths based on the percent infected and a predicted death rate. For example, in the United States, if 50% were infected and 1.5% died, the total fatalities would be around 2.5 million. Is a 50% infection rate accurate? Is a 1.5% death rate realistic?

At a 25% infection rate and a 0.7% death rate from coronavirus, the number of fatalities would be around 630,000. The lowest death total estimate that I’ve seen is 480,000 based on a University of Nebraska public health researcher. Are these guesses (25% and 0.7%) the low end of possibility?

How does the coronavirus compare with other health issues? People with pre-existing conditions, such as cancer, heart disease, dementia, COPD, stroke, diabetes, pneumonia, liver disease, and obesity are going to be at higher risk when exposed to the coronavirus.

Heart disease is the leading cause of death in the United States. Over 650,000 people die annually. Cancer is the number two cause of death with numbers approaching 600,000. How many people, older than you, know people with one or more of the pre-existing conditions listed above?

If the disease is not contained the fatality rate will exceed one million, without a doubt. With containment, the number of deaths could be as low as 200,000. These numbers are from epidemiologists at the CDC. It also assumes the coronavirus runs its course within one year.

It is estimated that 20% of the Hubei Province were infected. Throw those numbers into the NY Times calculator and the deaths amount to under 350,000. To put it into a more easily understood statistic, how many people can die based on their age?

In my best-case scenario (low-end estimate of 20% infected and 0.5% death rate), the following numbers are possible. Ages 10-19 years will see a little over 500 death – well below the expected deaths from cancer, suicide, car crashes, and guns.

Ages 20-29 years, the expected number of deaths from the coronavirus would be 1600, still less than the numbers for suicide, car crashes, guns, and drug overdoses. From 30-39 years, the coronavirus deaths would add up to 2000 – again well below the deaths attributed to car crashes, cancer, guns, and drug overdoses. Please note that the other categories for deaths are the top five for each age group.

Ages 40-49 years, the coronavirus deaths would be a bit over 5000. Cancer, heart disease, drug overdoses, and liver disease far exceed coronavirus deaths. Ages 50-59 years, the deaths from coronavirus would be estimated to be 22,000. This puts the coronavirus death count at #3 in this age group. Cancer and heart disease are higher. Drug overdose and liver disease are lower.

Ages 60-69 years, coronavirus deaths maintain a solid #3 position with nearly 70,000 deaths. Cancer and heart disease are much higher. Diabetes, Emphysema, and COPD are lower. Ages 70-79 see the deaths tallied at a bit over 100,000. Coronavirus is still a solid third in the top five deaths. Cancer and heart disease still occupy the number one and two positions for this age group. Emphysema and dementia-related deaths come in less than half the rate for the coronavirus.

The 80-89 age group sees an estimated 136,000 deaths – number 4 overall for their age group. Heart disease, dementia-related, and cancer have higher numbers. Stroke deaths are a little over half the coronavirus deaths in 5th positions for the over 80 crowd.

Are my numbers too low? I don’t think so. It seems that every day a new quarantine rule goes into effect. People are aware of the disease to spread from people without symptoms. For the past two weeks, I have been monitoring the regular meetings I attend on a weekly basis. Everyone present was asymptomatic – without symptoms.

Does that make me feel better? No, I placed myself under a modified house arrest to protect me from catching the disease and infecting someone who has serious health issues. I don’t have any fear that I can survive the coronavirus, even in my near-mid-70s. However, I don’t want to spread the disease inadvertently thinking that everything is copacetic.

Yes, our infected numbers will go up. Mostly from more testing. Yes, there will be more deaths than a typical flu season – usually around 50,000 deaths. If the United States approach to reduce social distances among the population, increase the testing and accuracy of the testing, and earlier treatment of those with pre-existing conditions, then I think this will allow major lessons learned for the next unknown killer disease.

Live Longer & Enjoy Life! – Red O’Laughlin

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