How deadly is COVID-19? It’s difficult to say with certainty, because there’s so much we don’t know. We don’t know how many people had the virus or have it now, how many people had mild symptoms or none at all, how many people got sick but didn’t show up at hospitals.
Death certificates tell us with certainty that someone has died, but they often don’t provide certainty about the cause of death.
It is extremely rare for people who are otherwise healthy to die of COVID-19. Most of the people who die with COVID-19 — 98 percent in one study — have at least two other major life-threatening conditions, such as diabetes and heart disease. Surprisingly little data have been collected to sort out these multiple causes.
As an insurance executive and a professional consumer of statistics, I focus on excess deaths — the number of deaths in a given period above those in a typical year. Data about deaths is reliable; COVID-19 data isn’t.
In addition, many die during an epidemic because other conditions like heart problems, strokes and severe depression go untreated. Those deaths don’t show up in COVID-19 statistics at all.
We know that metropolitan New York has been a hot spot during the COVID-19 epidemic, with a higher death rate than the rest of the US. The actual disparity is absolutely shocking. As a proportion of population, the number of excess deaths in New York City during the epidemic has been 16 times as high as in the rest of America.
A study released May 15 by the city’s Department of Health provides the data but has attracted remarkably little notice. It shows that 32,000 people died in New York City between March 11 and May 2 — a period that captures the epidemic’s peak and most of its toll. In typical times, there are some 8,000 New York City deaths between those dates. That means there were 24,000 excess deaths, of which only 14,000 were confirmed as COVID-19.
In the entire country during the same period, there were 82,000 excess deaths, according to data from the Centers for Disease Control and Prevention. New York City, with 2.5 percent of the US population, had 29.2 percent of the country’s excess deaths.
Why has New York been hit so hard? A familiar explanation is blunders by the Trump administration, of which there have been many. But if you exclude New Jersey and New York state, US deaths were only about 10 percent above normal — compared with 5 percent for Germany, 25 percent for France and 40 percent for Italy.
Another explanation is that New York is unique in America in its population density and reliance on public transportation. True, but Hong Kong — almost as dense and adjacent to mainland China, where the virus originated — has reported only four COVID-19 fatalities in a population of 7.5 million.
A more credible explanation is the incompetence of our state and local governments. Mayor Bill de Blasio, Gov. Andrew Cuomo and the city Health Department were reportedly at loggerheads as the crisis unfolded.
Their shutdown orders came too late, after a few critical weeks when the disease was being transmitted exponentially. Compounding the error, the New York State Department of Health ordered the transfer of some 4,300 COVID-19 patients from hospitals to nursing homes. This exposed the oldest, frailest and most vulnerable to the virus.
You may wonder what these excess-death numbers mean for your chances of living through this epidemic. Everyone has a nonzero chance of dying in 2020. The younger and healthier you are, the better your chances. For an average 90-year-old, the extra risk of being in New York City was around one in six, the odds of rolling a particular number on a single die.
For a 70-year-old, being in New York City during the epidemic increased your chance of dying in 2020 by around one chance in 30, slightly more than the odds of rolling snake eyes.
Here’s the good news: If you’re an average American living outside New York City, the epidemic was a period with barely noticeable increased risk. Your chance of being an extra fatality was about one in 5,000, somewhat higher than your chance of dying in an auto accident in a year.
And if you were under 50 with no serious health conditions, your risk was in the ballpark of one in 50,000, similar to your risk of dying in a fire. In New York, those odds were approximately one in 300 and 1 in 3,000, respectively.
“Nothing in life is to be feared, it is only to be understood,” Marie Curie observed. “Now is the time to understand more, so that we may fear less.” COVID-19 is a complex and fearsome challenge, but a little arithmetic can offer a lot of understanding.
Robert Rosenkranz is chairman of Delphi Capital Management and founder of the Intelligence Squared US Debate Series. From The Wall Street Journal.
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