Excess Deaths (Updated)

It is difficult to comprehend how abject a failure the pandemic response in countries such as the US and the UK has been. Fortunately, The Economist has developed a model estimating excess deaths since the start of the pandemic. Unfortunately, it appears to be behind their paywall. So I have taken the liberty of screen-grabbing a few example graphs.

This graph compares the US and Australia. Had the US handled the pandemic as well as Australia (-17 vs. 250 per 100K), about 885,000 more Americans would be alive today. With a GDP per capita about $63.5K/year, this loses the economy about $56B/year.

This graph compares the UK and New Zealand. Had Boris Johnson handled the pandemic as well as Jacinda Arden (-49 vs. 170), about 149,000 more Britons would be alive today. With a GDP per capita about $42K/year, this loses the economy about $6.3B/year.

A graph is worth a thousand words. Below the fold, a little commentary.

The Economist argues that the true scale of the pandemic can only be determined from excess deaths:

Many people who die while infected with SARS-CoV-2 are never tested for it, and do not enter the official totals. Conversely, some people whose deaths have been attributed to covid-19 had other ailments that might have ended their lives on a similar timeframe anyway. And what about people who died of preventable causes during the pandemic, because hospitals full of covid-19 patients could not treat them? If such cases count, they must be offset by deaths that did not occur but would have in normal times, such as those caused by flu or air pollution.

Their machine-learning model:

estimates excess deaths for every country on every day since the pandemic began. It is based both on official excess-mortality data and on more than 100 other statistical indicators. Our final tallies use governments’ official excess-death numbers whenever and wherever they are available, and the model’s estimates in all other cases.

The model estimates that:

Although the official number of deaths caused by covid-19 is now 4.6m, our single best estimate is that the actual toll is 15.3m people. We find that there is a 95% chance that the true value lies between 9.4m and 18.2m additional deaths.

Excess deaths in the US and the UK are far from the worst, but my point is that countries at a similar level of development have done far better, and so have much less well-resourced countries. Had the US done as well as the model's estimate for China (38 vs. 250) about 702,000 more Americans would be alive today.

Update 9^th Oct 2021:

Paul Campos crunches some of the numbers for US excess deaths and ask this fascinating question: Why did excess mortality in the USA in 2020 rise more among young adults than among the cohorts that accounted for almost all COVID deaths?

as age increased, excess mortality risk caused by COVID increased as well, to the point where among people 75 and older almost all excess mortality risk was attributable directly to COVID. By contrast, among young adults, excess mortality attributable to COVID decreased as cohort age decreased, to the point where among the youngest adults very little excess mortality could be attributed to it. Yet excess mortality rates increased more among young adults than they did among older adults. (As a percentage increase against baseline mortality risk of course. Overall mortality rates are naturally much higher among elderly cohorts).

Here is Campos' data in table form, with "Deaths" numbers per 100,000.

Age	2019	2020	COVID	COVID %	Other %
	Deaths	Deaths	Deaths	of excess	of excess
25-34	128.1	157.9	5.5	19	81
35-44	199.2	246.2	15.8	34	66
45-54	392.4	467.8	44.2	42	58
55-64	883.3	1028.5	105	72	28
65-74	1765	2069	249	82	18
75-84	4308	4980	636	94	6
85+	13,229	15,007	1798	100	0

Something other than COVID-19 accounts for 4 out of 5 excess deaths in the 25-34 cohort. This proportion falls with age until at 85+ COVID-19 accounts for all the excess deaths. Campos writes:

The big question is: why did mortality rates rise so sharply among young adults in the USA in 2020, given that COVID, or at least COVID directly, seems to account for so little of that rise? (The indirect effects of the pandemic are a different story of course).

Answering that will require digging more into the precise causes of excess mortality among young people in the USA last year. Back of the enveloping suggests that the rise in the homicide rate accounts for maybe 15% to 20% of the increase in mortality risk among people under 45. Drug overdose rates also shot up among young adults, so that accounts for part of the rise as well. (Whether either of these causes of death is related in some way to the pandemic is yet another tangled epidemiological puzzle to solve).

In any case the social effects of the pandemic would seem to go far beyond its direct effects on population mortality, and most especially among the non-elderly.