Who’s Really At Risk of Dying From Covid-19

[gwraigty]

I'm still for reopening the economy but I don't think we can afford to under estimate the danger. We need to be ready to accept and respond to a new wave or we could see states or cities opening up and then slamming back down. That could be more devastating for the economy that a slow reopening.

I've read a couple of articles that say we might have to face a new reality of repeated lockdowns. I don't see how that would be sustainable, either short-term or long-term. The consequences would be widespread and dire.

 

[Midpack]

I've read a couple of articles that say we might have to face a new reality of repeated lockdowns. I don't see how that would be sustainable, either short-term or long-term. The consequences would be widespread and dire.

+1. I’m probably wrong and I’ll get flamed by some but... It may be the right thing to do, but I think it will be much harder to lockdown a second or third time. Governments, businesses and individuals are now really feeling the economic damage and realize 80-90% of us are at low risk. Health care resources could more easily keep up if the vulnerable were semi locked down or otherwise protected. [I’d be happy to make accommodations for the vulnerable in exchange for reopening the economy]. The vulnerable are going to have to take much greater precautions voluntarily or otherwise, or face a triage situation. More and more people now realize the economic damage could cost lives too, it’s not one or the other - health v economy.

 

[devans0]

I do not trust published stats to be accurate. The surge in total deaths and barriers in testing suggests that the stats are under counted and this would be primarily in younger victims.

The places that are at greatest risk are places with close contacts between people. Prisons, detention centers, care facilities, cruise ships, and factories are being hit hard.

We have a several family members with high risk of complications. We are fortunate that we can isolate, so we are isolating.

 

[sengsational]

CDC stats seem to clearly show those with underlying health issues (heart disease, cancer, respiratory issues, diabetes, compromised immune systems, etc.) are the ones most at risk. The same people who are usually less able to fight off many serious illnesses. The elderly are at risk only because they typically have a higher incidence of underlying health issues and weaker immune systems. Not to be cavalier about it, but those of our generation in good health are much lower risk as well, not every 65+ yo is at high risk. And there’s a small group of healthy people with a genetic predisposition to suffer or die from Covid-19.

Age often correlates to endothelial related diseases, which is why earlier the news was that it's harder on the oldest people. But more specifically, it's harder on those that are subject to runaway inflammation. NYC reported (saw on MedCram) that the hospital admissions had a much higher rate of hypertension and obesity than the general population. And COPD turned out NOT to be a risk factor!

 

[donheff]

+1. I’m probably wrong and I’ll get flamed but... It may be the right thing to do, but I think it will be much harder to lockdown a second or third time. Governments, businesses and individuals are now really feeling the economic damage and realize 80-90% of us are at low risk. Health care resources could more easily keep up if the vulnerable were semi locked down. The vulnerable are going to have to take much greater precautions voluntarily or otherwise, or face a triage situation. Most people realize the economic damage could cost lives too, it’s not one or the other - health v economy.

+1 I hope schools don't shut down every time a kid gets infected or we will have backdoor shutdowns screwing up millions of lives. We initiated this shutdown to ease the transition for the medical community. Now we need to prepare to deal with the long term more along the lines of a bad flu season (albeit with far more deaths in nursing homes and among challenged populations). At 71, I'm in a challenged population.

 

[audreyh1]

IHME's model has been reasonably good for deaths; and way, way off for resource use.

Predicts a total of 72k deaths by Aug 1st with only ~300 most likely total deaths between June 1 and Aug 1. Yes, there is a range to 114k deaths.
Hope it is right, but appears to me to be very optimistic.

Hmm - considering we are above 67K deaths already today, I predict they are going to be way off again. 72K deaths sound like end of this week to me.

I'm just very glad we didn't experience the Italy or Spain situation, which is precisely what we were trying to avoid. But some areas did come close. Albany GA for one. NYC.

 

[NameRedacted]

Not sure if this is the right thread to post this but here is an article that I found interesting that I think explains why Covid-19 patients that are intubated have such a low survival rate:


https://www.theguardian.com/world/2...s-grapple-with-covid-19s-mysterious-mechanism


Here are a couple of excerpts that made an impression on me:



"What is particularly baffling is patients are presenting with poor oxygenation but little lung damage. This type of presentation is more typical of patients suffering from altitude sickness than a viral infection, Gattignoni says. As a result, patients who are very sick may not feel like they’re really struggling to breathe – even as they’re being critically deprived of oxygen."


and


"
The problem is, mechanical ventilation in intensive care replaces the strength of the respiratory muscles. If patients are struggling to breathe but their lung structure is OK, this ventilation does little to help and in fact may prove harmful, Gattinoni said, because mechanical ventilation is invasive.
He said while only a small number of patients are severe enough to require ventilation, a significant proportion of those on ventilators die, continuing to show low blood oxygen levels despite mechanical assistance."

 

[rjk514]

Well said...we were in Florida at the start of this mess and your comment about spring breakers is spot on...they could of cared less...

 

[Music Lover]

Hmm - considering we are above 67K deaths already today, I predict they are going to be way off again. 72K deaths sound like end of this week to me.

I'm just very glad we didn't experience the Italy or Spain situation, which is precisely what we were trying to avoid. But some areas did come close. Albany GA for one. NYC.

CDC just revised the fatality count to 37,308:

https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

 

[Aerides]

CDC just revised the fatality count to 37,308:

https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

No, this is not a revision, it's a different data point as spelled out on the CDC page. And these numbers stop at 4/25:

Why these numbers are different
Provisional death counts may not match counts from other sources, such as media reports or numbers from county health departments. Our counts often track 1–2 weeks behind other data for a number of reasons: Death certificates take time to be completed. There are many steps involved in completing and submitting a death certificate. Waiting for test results can create additional delays. States report at different rates. Currently, 63% of all U.S. deaths are reported within 10 days of the date of death, but there is significant variation among jurisdictions. It takes extra time to code COVID-19 deaths. While 80% of deaths are electronically processed and coded by NCHS within minutes, most deaths from COVID-19 must be coded manually, which takes an average of 7 days. Other reporting systems use different definitions or methods for counting deaths.

 

[gwraigty]

+1. I’m probably wrong and I’ll get flamed by some but... It may be the right thing to do, but I think it will be much harder to lockdown a second or third time. Governments, businesses and individuals are now really feeling the economic damage and realize 80-90% of us are at low risk. Health care resources could more easily keep up if the vulnerable were semi locked down or otherwise protected. [I’d be happy to make accommodations for the vulnerable in exchange for reopening the economy]. The vulnerable are going to have to take much greater precautions voluntarily or otherwise, or face a triage situation. More and more people now realize the economic damage could cost lives too, it’s not one or the other - health v economy.

+1

At the risk of getting flamed myself, I wonder how many people who advocate keeping the economy locked down realize that the economic fallout could eventually impact areas that have usually been considered "untouchable". There's a whole lot of money that's not being paid into Social Security and Medicare right now.

I think some people (hopefully no one here on this forum ) really don't understand where their money comes from. For example, a local manufacturing company had shut down for awhile, then got permission to reopen in late April on a limited basis. A stay at home mom of 2 kids with auto immune disorders was hysterical about it because her husband works there. She wanted him to quit his job rather than go back to work. The logical progression of that would bring on more problems than they already have.

 

[ivinsfan]

There seems to be some official confusion RE, flu deaths, COVID deaths...with flu deaths ranging from 24-62K. That's a pretty big range. So are some flu deaths COVID, or vice versa.

Unfortunately political ends dictate that some groups will want to code them as flu and some will want to code them as COVID for their own political agenda.

As yes, as a county we have officially reached a new low..

 

[gwraigty]

+1 I hope schools don't shut down every time a kid gets infected or we will have backdoor shutdowns screwing up millions of lives. We initiated this shutdown to ease the transition for the medical community. Now we need to prepare to deal with the long term more along the lines of a bad flu season (albeit with far more deaths in nursing homes and among challenged populations). At 71, I'm in a challenged population.

+1

My friends works in a local school district in food service. They prepare 26,000 meals a week in take home meals for the kids. She told me that the district is scrambling trying to figure out how they could possibly reopen in the fall. (Our governor is leaving it up to each school district to try and figure it out. ) They've discussed having kids go every other day and allowing only 6 kids on a school bus to allow for 6 ft. between them...nothing that is workable at all. No matter what, some kids will get infected. Then what?

Right now, with businesses in Ohio, there's nothing in the order that requires the whole business to shut down because of infected employees. There's a lot of concern because DeWine won't reopen day cares so that working parents of young children can go back to work when their employer requires it. He's aware of the problem, but his "solution" is for the employers to try and accommodate their employees in these types of matters.

I could easily sit back and say, who cares, I have no school age kids anymore, I don't have to work, this doesn't affect me...but that's not true in the long run. Just like how COVID-19 has the potential to affect us all health wise, too many people not working because of multiple obstacles thrown into their path is going to affect us all economically.

 

[Aerides]

I think that as things start to open up, the decisions will come down to the business owners. Even in states with low/no restrictions, a business that isn't safe to their staff or customers is not going to stay open. Just as many businesses made those decisions in advance of the official government directives.

So, even with zero orders, we won't be 100% open, because a lot of this stuff will be decided on a case by case basis by those who open and lock the actual shop doors each day.

 

[Nemo2]

At 71, I'm in a challenged population.

I'm now closer to 78 than I was to 77......and, having had sepsis, I find myself in a possibly/probably immunocompromised group, (even though it's been a year, and I work out, not obese or diabetic, etc).....what to do?

As John Prine put it:

"That's the way that the world goes 'round
You're up one day, the next you're down
It's half an inch of water, and you think you're gonna drown."

None of us are getting out of this alive.

 

[gwraigty]

I think that as things start to open up, the decisions will come down to the business owners. Even in states with low/no restrictions, a business that isn't safe to their staff or customers is not going to stay open. Just as many businesses made those decisions in advance of the official government directives.

So, even with zero orders, we won't be 100% open, because a lot of this stuff will be decided on a case by case basis by those who open and lock the actual shop doors each day.

I agree it's not going to be 100%, due to many variables. A lot of the talk here is about retail-type businesses. There are still supply chain issues across a wide spectrum, not just in our food supply.

 

[Dtail]

No, this is not a revision, it's a different data point as spelled out on the CDC page. And these numbers stop at 4/25:

Why these numbers are different
Provisional death counts may not match counts from other sources, such as media reports or numbers from county health departments. Our counts often track 1–2 weeks behind other data for a number of reasons: Death certificates take time to be completed. There are many steps involved in completing and submitting a death certificate. Waiting for test results can create additional delays. States report at different rates. Currently, 63% of all U.S. deaths are reported within 10 days of the date of death, but there is significant variation among jurisdictions. It takes extra time to code COVID-19 deaths. While 80% of deaths are electronically processed and coded by NCHS within minutes, most deaths from COVID-19 must be coded manually, which takes an average of 7 days. Other reporting systems use different definitions or methods for counting deaths.

Kind of meaningless vs. the other tracking sources.
The one time the CDC has something to say...........

 

[Chuckanut]

This is from a Letter to the Editor in the May 2, WSJ:

Emphasis added by me.

Are we seniors as a group to remain at home indefinitely? No church attendance, no restaurants, no weddings, no other family or social gatherings? I am 78 years old and consider myself to be in reasonably good health. I have worked hard at maintaining that level, working out at the gym and playing tennis several days every week. Confinement isn’t the lifestyle I had in mind. Along with the other important virus studies the medical community is now undertaking, an attempt needs to be made to identify levels of vulnerability for seniors. Age and the broad definition of “underlying medical conditions” don’t go far enough.

As I have said, I would be willing to spend another month locked away at home if it means those a less risk can get back to work and restore our economic health. It's a small price to pay and a Win/Win, IMHO.

But we also need more granular analysis of whose at risk and why. I realize that as an older person my immune system is not as robust as it was in my 30's or even 50's. But, how does that fact merge with my overall level of health? I don't want to be treated as a very healthy 20 year old or as a feeble 85 year old.

I would think there have been enough cases of this disease that some estimates of overall vulnerability can be made, not just lumping all people of the same age into one group. That may be better than nothing, but we should be able to do much better.

Maybe if we had better information, some of the people marching about demanding the opening of this place, that place and the other place might be more restrained. And the economy will rebound faster.

I don't know. We don't know. That's the point.

 

[Tekward]

One group at risk (nice picture):


https://www.imperial.ac.uk/news/197216/being-male-overweight-lead-more-serious/


"The researchers have found that after adjusting for other medical problems such as lung, heart and kidney disease that are already known to cause poor outcomes, being male or obese (with a BMI over 30) is a significant factor associated with death in UK hospitals."

 

[REWahoo]

"The researchers have found that after adjusting for other medical problems such as lung, heart and kidney disease that are already known to cause poor outcomes, being male or obese (with a BMI over 30) is a significant factor associated with death in UK hospitals."

Thankfully the only factor listed above likely to result in a poor outcome for me is being male. Since I've probably missed the window of opportunity for gender reassignment, the only recourse I see left is to stay out of UK hospitals.

 

[Dtail]

One group at risk (nice picture):


https://www.imperial.ac.uk/news/197216/being-male-overweight-lead-more-serious/


"The researchers have found that after adjusting for other medical problems such as lung, heart and kidney disease that are already known to cause poor outcomes, being male or obese (with a BMI over 30) is a significant factor associated with death in UK hospitals."

Well at least he is exercising.

 

[mpeirce]

Counterintuitive, but apparently it helps if you are a smoker.

https://www.economist.com/science-a...ly-than-non-smokers-to-fall-ill-with-covid-19

 

[braumeister]

Counterintuitive, but apparently it helps if you are a smoker.

https://www.economist.com/science-a...ly-than-non-smokers-to-fall-ill-with-covid-19

Well, sure! They have that nice protective layer of "tar" coating their lungs!

That article is behind a paywall, so I'm not sure what it really says.
But I remember reading a month or so ago that smokers around Wuhan were much more likely to be fatalities than nonsmokers. So I doubt if there is much of a real correlation.

 

[MichaelB]

Here’s a quote from the article.

Nicotine is not thought to attack sars-cov-2 directly. It may, however, play an indirect role that involves a cell-membrane protein called ace2, to which the virus attaches itself in order to gain access to a cell. Some researchers suspect that nicotine binds to ace2 as well, and that this makes it harder for the virus to do so alongside it. Nicotine may also soothe inflammation caused by the infection, a hypothesis supported by its use to treat inflamed bowels.

It may help, but I’ll not take up smoking as a precautionary measure.

 

[Gumby]

I really enjoyed smoking, and probably would again. But after 36 years, I'm just not going back to it.