{"id":3956,"date":"2020-05-08T08:54:12","date_gmt":"2020-05-08T13:54:12","guid":{"rendered":"http:\/\/blueberrytown.com\/?p=3956"},"modified":"2020-05-08T09:22:06","modified_gmt":"2020-05-08T14:22:06","slug":"covid-19-and-incremental-risk-in-american-life","status":"publish","type":"post","link":"https:\/\/blueberrytown.com\/index.php\/2020\/05\/08\/covid-19-and-incremental-risk-in-american-life\/","title":{"rendered":"Covid-19 and incremental risk in American life"},"content":{"rendered":"\n

A few minutes ago the US Department of Labor announced<\/a> the unsurprising news that payrolls had dropped by more than 20 million people in April, and the headline unemployment rate had risen to a catastrophic 14.7%, which is probably a few points lower than the reality because of quirks in the reporting. “We meant to do that,” insofar as these declines were the result of some combination of voluntary decisions to social distance and government policies, in each case to limit the casualties from Covid-19. In other words, we have chosen<\/em> to take on massively more economic risk in order to reduce the mortality and morbidity risk from Covid-19.<\/p>\n\n\n\n

News such as this and what we know<\/em> from speaking with friends and neighbors naturally invites many questions. Among them: Do the government policies and individual practices to flatten the curve work<\/em>? If so, in what respect do they work? And, finally, are they worth it?<\/p>\n\n\n\n

As we wrote almost a month ago<\/a>, it will be a long time before we are actually able to know which policies worked, and at what cost. Here are the criteria we proposed:<\/p>\n\n\n\n

Ultimately, we will know three things in each applicable jurisdiction (itself a hot topic, of which a bit more below): (1) excess deaths<\/strong> (whether from the virus or the stress of the economy and confinement or from local collapse of the healthcare system) over the baseline experience, (2) excess morbidity and mental health problems<\/strong>, and (3) the decline in the jurisdiction\u2019s GDP per capita<\/strong> against the baseline. Those three things in a given country or state will be the indicators of success or failure.<\/p><\/blockquote>\n\n\n\n

No matter the claims you read from competing media, politicians, and “experts,” we do not believe that we will be able to determine which policies most efficiently worked against these three values for quite some time.<\/p>\n\n\n\n

There is, however, another way to think about the risk Covid-19 has added to American life: How does it compare to health risks within recent memory?<\/p>\n\n\n\n

Through today<\/a>, about 77,000 people have died of Covid-19 in the United States. Yes, the number might be somewhat higher or lower depending on how you count, but at that number we have lost roughly 23 people per 100,000 of population. Even if the total deaths this year quadruple in an awful second wave, we will have lost around 100 people per 100,000. (Neither of these figures are age-adjusted, which puts more weight on deaths of younger people and less on deaths of older people deaths, as most comparable data are.)<\/p>\n\n\n\n

That still seems like a lot of dead people, and by recent standards it is. There is much tragedy in 77,000 incremental dead people, and vastly more in four times that number.<\/p>\n\n\n\n

But how does the risk of Covid-19 compare to other risks with which we are familiar, and which we readily accept, or accepted?<\/p>\n\n\n\n

See, for instance, this graph<\/a> of age-adjusted mortality from cardiovascular disease in the United States. In 1960 we lost 559 people per 100,000 to cardiovascular disease, and as recently as 1990 we lost 322 people per 100,000. In 2017, that number was 165 per 100,000. In other words, if there had been no improvement in the treatment and prevention of cardiovascular disease since only 1990, in 2017 we would have lost an additional 157 people per 100,000, or more than 500,000 people. <\/p>\n\n\n\n

Were you anxious about your risk of dying in 1990? If not, perhaps you shouldn’t be too afraid of Covid-19 this year.<\/p>\n\n\n\n

Suppose we say that the deaths from Covid-19 this year will in fact quadruple, to about 100 per 100,000. Without adjusting for age, that probably overstates the Covid-19 death rate compared to cardiovascular disease. Even that many deaths from Covid-19 would be the equivalent of giving up the improvement in death rates from cardiovascular disease since only 2004.<\/em> For one year!<\/p>\n\n\n\n

Were you anxious about your risk of dying in 2004? Not particularly? Not enough to lose weight and strap on running shoes? With that framing, is the crushing poverty, which is increasingly looking long-term, from continued mandatory distancing too high a price for such a small relative benefit? If the numbers were presented this way, we believe that most Americans would say “no,” perhaps except for one thing.<\/p>\n\n\n\n

One American does not kill another American by transmitting cardiovascular disease. But Americans do kill each other by transmitting Covid-19. We are obviously willing to risk killing strangers in the abstract, which we prove every time we drive too fast because we left the house too late. But nobody wants to kill their own mother or grandmother<\/a>. The pain in that possibility is too great.<\/p>\n\n\n\n

So, are we paying such an enormous price to avoid Covid-19 deaths, however few they are now likely to be compared to other health risks in recent memory, because we are personally afraid of the disease, or because we do not want to live with the guilt of killing a loved one?<\/p>\n\n\n\n

Or, maybe, we humans just do a very poor job of thinking about risk. Never has that failing been more expensive.<\/p>\n","protected":false},"excerpt":{"rendered":"

A few minutes ago the US Department of Labor announced the unsurprising news that payrolls had dropped by more than 20 million people in April, and the headline unemployment rate had risen to a catastrophic 14.7%, which is probably a few points lower than the reality because of quirks in the reporting. “We meant to do that,” insofar as these declines were the result of some combination of voluntary decisions to social distance and government policies, in each case to limit the casualties from Covid-19. In other words, we have chosen to take on massively more economic risk in order to reduce the mortality and morbidity risk from Covid-19. News such as this and what we know from speaking with friends and neighbors naturally invites many questions. Among them: Do the government policies and individual practices to flatten the curve work? If so, in what respect do they work? And, finally, are they worth it? As we wrote almost a month ago, it will be a long time before we are actually able to know which policies worked, and at what cost. Here are the criteria we proposed: Ultimately, we will know three things in each applicable jurisdiction (itself a […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[183],"tags":[],"class_list":["post-3956","post","type-post","status-publish","format-standard","hentry","category-coronavirus"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7t3qc-11O","jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/blueberrytown.com\/index.php\/wp-json\/wp\/v2\/posts\/3956","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blueberrytown.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blueberrytown.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blueberrytown.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blueberrytown.com\/index.php\/wp-json\/wp\/v2\/comments?post=3956"}],"version-history":[{"count":8,"href":"https:\/\/blueberrytown.com\/index.php\/wp-json\/wp\/v2\/posts\/3956\/revisions"}],"predecessor-version":[{"id":3964,"href":"https:\/\/blueberrytown.com\/index.php\/wp-json\/wp\/v2\/posts\/3956\/revisions\/3964"}],"wp:attachment":[{"href":"https:\/\/blueberrytown.com\/index.php\/wp-json\/wp\/v2\/media?parent=3956"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blueberrytown.com\/index.php\/wp-json\/wp\/v2\/categories?post=3956"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blueberrytown.com\/index.php\/wp-json\/wp\/v2\/tags?post=3956"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}