Saturday, April 18, 2020

Deaths per million of the elderly as the best, unused criterion

Good coronavirus stats are hard to find. As a measure of societal impact, deaths per million people is probably the best, at least somewhat closer to reality than diagnosed cases per million. It does have the problem of people dying undiagnosed and of different areas using different methodologies for counting a death. I expect retrospectives in the future will just use what's often done during epidemics, comparing the year-on-year death rate before and during the epidemic. For now, deaths per million with somewhat varying methodologies is the best for overall impact - but not for measuring how well the country has handled the disease.

The overall impact depends on demographics, which is beyond immediate control of society. If you want to consider how good a job they've done given their demographics, then you need to adjust. Elderly people age 65+ are 15% of the US population and 23% of Italy's population. I've been arguing that deaths per million of the elderly are the best way to compare countries' effectiveness of their interventions, but you can't find that stat anywhere.

So here's my tentative effort. In the US, about 80% of the deaths are from people age 65+. In Italy, about 85% of fatalities were 70+. I couldn't find the figures that included those age 65-69. Current total deaths in the US and Italy are 37,000 and 22,700 respectively, and populations are 320 million and 60 million.

Math time: 48 million elderly in the US, 14 million in Italy. So that's 30 thousand elderly deaths in the US, 19 thousand in Italy. The American death rate for elderly currently is 625 per million, and Italy is 1,350 per million.

Very rough and ready stats that I'm sure could be improved. Making it worse but easier to figure out is to simply assume 80% of deaths anywhere are among the elderly. Spain has 20 thousand deaths, 46 million people, 17% elderly. That's 2000 deaths per million. France is 1500 per million. Germany is 200 deaths per million.

The US has done better than I expected. We'll see how this plays out over time.


Victor Venema said...

Yes, looking at raw numbers America does not do so badly now. What makes it look bad is what comes out of the White House and how much better it should have been able to do.

Italy and Spain were in an economic slump since the 2008 Bush deregulation crash. A normal American may have hard times since as well, but the average American did well. There is no good reason why America did not at least respond as well as Germany and Germany also did not respond forcefully enough in retrospect.

Looking at the future, I fear that the epidemic will stay virulent in America for a lot longer than elsewhere and will thus do a lot more economic damage. With many states thinking they do not need a lockdown and people from such states spreading viruses all over America. With Trump calling on his supporters not to take the situation seriously and even threatening with violence, I do not see the situation getting better soon.

While in Germany the number of new cases is a third below the peak, we will mostly stay at home for at least another two weeks to get to a situation where tracing and tracking of infected people becomes an efficient way of reducing infections, which allows for much less restrictions on contacts long term while staying equally safe.

john aussie said...

Some of the states in Australia have been closed to others.

Regardless once a person crosses a border they have to go into isolation.
Only essential business is open.
I think the New Zealand action of total shutdown is proving effective.
Also the emphatic statement by their leader is a guide to how to talk to people.
Of course the German leader is also one to admire.
It is just dismaying to see how the USA is failing its people.
Their leader is a study in how not to lead in times of need.

john Aussie

Victor Venema said...

"The US has done better than I expected. We'll see how this plays out over time."

"Yes, looking at raw numbers America does not do so badly now"

Maybe we are too friendly, only because America is not leading the ranking for the worst current situation. That is a really low bar. From one of the richest high-tech countries and self-proclaimed leader of the world one may expect a competition for the best response in the world.

thefordprefect said...

deaths per million not good - if Andorra 77,000 pop got a case or 2 it would put it at the top of the heap. perhaps death per [pop per unit area] ?

thefordprefect said...

actually there have been at least 35 dead in Andorra so even not using your oldies formula that's 454 per million!

Brian Schmidt said...

Ford - yes, in small populations, deaths per million will vary wildly. The stat will only be useful where you have hundreds of deaths or more.

Victor - yes, the US could've competed for best in class, and we'll end up in the middle of the pack instead. Our US-government-level medical establishment messed up for reasons only partly related to Trump, and Trump himself is a disaster. Our strong federal system partly made up for it - e.g., I'll guess that California has better stats than Germany. OTOH, our strong federal system will let bad-behaving states mess everything up as we move towards recovery, especially given we have an idiot as president who under normal conditions would pressure the states to be reasonable.

Our very old constitution isn't as democratic as younger political systems, and the problem shows.

Victor Venema said...

I do not believe the constitution is the problem in this case. Any other president, even George W. Bush, would have had at least ten times less casualties.

If there is a problem with the constitution then that it did not foresee the corporate takeover of American politics, leading to the election of a lazy ignorant conman enriching himself and his class as president.

EliRabett said...

In a sense it's the British problem, because many of the limits on the branches of government were unwritten, and being unwritten when a party and president who decided that there were no limits broke the unwritten rules there was nothing to stop them.

Brian said...

Victor - it's a constitutional problem because of our Electoral College established in the 1787 version of our constitution - if we were democratic then the vote winner would've taken office and Hillary would've limited the number of deaths, or maybe even left enough experts in Beijing to persuade the Chinese to act faster. When people discuss the policy outcome failures of American democracy, in significant part that's because our system is undemocratic.

Eli - yes I agree in part, but it's impossible to write down everything. We lawyers try to do that, but you really need some level of trust and ethics to make political systems work.