Every day we hear the news about the number of cases of people dying from Coronavirus.
When elderly people die they often die with a complex presentation. There are of course some cases of simple causes - electrocution due to faulty wiring, aeroplane crash and so on. But in many cases the cause of death is a secondary infection. As an example, many cancer patients die from pneumonia, although one could argue quite reasonably that the cause of death is cancer.
So, there is a difference between people dying "from" a condition and people dying "with" a condition.
How does this link back to Covid-19?
How many deaths in England and Wales are from people dying "with" Covid-19 and how many are "from" Covid-19?
The difference in deaths, broken down by age cohort, broken down by "with" and "from" is the key metric.
So far I have been unable to find any source of this data.
Why is this important? Let's look at a thought experiment. A patient with terminal lung cancer and an estimated life expectancy of one month develops Covid-19 and dies. Should that death be attributed to Cancer or Covid-19?
If this death is attributed to Covid-19 then this may lead politicians to invest more money in treatment of Covid-19, at the expense of Cancer treatment. Is that equitable, sensible and efficient?
What we really need is a table with data rather like the below:
Why? So we can take the fear out of the headline numbers and start to look at the real impact of Covid-19 on our populations.
If we look at the mortality from and with Covid-19 we also have to look at the change in mortality brought about by social distancing. One would assume that the number of drink driving deaths would fall - since pubs are closed.
There was an epidemiological study after the 1990-1991 Persian Gulf War that showed that US military deaths were reduced versus a non-war situation, since troops in Saudi Arabia were not able to drink and engage in normal activities. Could it be that Covid-19 results in a lower overall mortality/morbidity figure for polities such as Australia and the UK that have brought in strict social distancing?
See also:
Policy frameworks for pandemics - part 4 - incidence of costs versus incidence of benefits...
The regular reader may note that this really is rather off-topic. And from the perspective of a blog that has traditionally looked at topics such as Fixed Income Trading: New venues ( How many Fixed Income trading venues are there? ) , Product Management and Fintech and What's the difference between an EMS and an OMS? this may seem a little unusual. However, your author was trained as an Economist and took a keen interest in Health Economics and the interface between rationality, efficiency and morality. As such, with the usual topics somewhat becalmed I decided to repurpose this blog for an intellectual diversion. I can assure the reader that normal service will be resumed sooner or later...
These numbers are shocking and every death is a tragedy. How can we look at this with more structure?
How do we evaluate costs? Specifically, the costs of the loss of a human life? Or of a marked degradation in the quality of a human life?
These two factors are generally termed
(a) Mortality
(b) Morbidity
Increases in death - mortality - are generally easy to measure - is someone alive or dead?
If we look at the derived data from
We can see that on any day in 2018 in England and Wales we see approximately 734 males deaths and 749 female deaths. Look at the table below, for females aged 3034 we see 2.4 deaths per day in 2018 in England and Wales.
Sum of NDTHS | Sex | 365 | |||
Age | 1 | 2 | Grand Total | Male | Female |
Neonates | 1040 | 811 | 1851 | 2.84932 | 2.22192 |
<1 | 400 | 320 | 720 | 1.09589 | 0.87671 |
01-04 | 215 | 164 | 379 | 0.58904 | 0.44932 |
05-09 | 137 | 133 | 270 | 0.37534 | 0.36438 |
10-14 | 194 | 116 | 310 | 0.53151 | 0.31781 |
15-19 | 561 | 270 | 831 | 1.53699 | 0.73973 |
20-24 | 981 | 378 | 1359 | 2.68767 | 1.03562 |
25-29 | 1242 | 581 | 1823 | 3.40274 | 1.59178 |
30-34 | 1658 | 876 | 2534 | 4.54247 | 2.4 |
35-39 | 2260 | 1347 | 3607 | 6.19178 | 3.69041 |
40-44 | 3185 | 1835 | 5020 | 8.72603 | 5.0274 |
45-49 | 5251 | 3454 | 8705 | 14.3863 | 9.46301 |
50-54 | 7870 | 5094 | 12964 | 21.5616 | 13.9562 |
55-59 | 10755 | 7425 | 18180 | 29.4658 | 20.3425 |
60-64 | 14355 | 9950 | 24305 | 39.3288 | 27.2603 |
65-69 | 21232 | 14616 | 35848 | 58.1699 | 40.0438 |
70-74 | 31296 | 22884 | 54180 | 85.7425 | 62.6959 |
75-79 | 36041 | 29195 | 65236 | 98.7425 | 79.9863 |
80-84 | 44735 | 41951 | 86686 | 122.562 | 114.934 |
85+ | 84552 | 132229 | 216781 | 231.649 | 362.271 |
Grand Total | 267960 | 273629 | 541589 | 734.137 | 749.668 |
So, there is a difference between people dying "from" a condition and people dying "with" a condition.
How does this link back to Covid-19?
How many deaths in England and Wales are from people dying "with" Covid-19 and how many are "from" Covid-19?
The difference in deaths, broken down by age cohort, broken down by "with" and "from" is the key metric.
So far I have been unable to find any source of this data.
Why is this important? Let's look at a thought experiment. A patient with terminal lung cancer and an estimated life expectancy of one month develops Covid-19 and dies. Should that death be attributed to Cancer or Covid-19?
If this death is attributed to Covid-19 then this may lead politicians to invest more money in treatment of Covid-19, at the expense of Cancer treatment. Is that equitable, sensible and efficient?
What we really need is a table with data rather like the below:
Sum of NDTHS | Sex | 365 | Estimated for 2020 | ||||||
Age | 1 | 2 | Grand Total | Male | Female | Male | Female | Delta(m) | Delta(f) |
Neonates | 1040 | 811 | 1851 | 2.84932 | 2.22192 | ||||
<1 | 400 | 320 | 720 | 1.09589 | 0.87671 | ||||
01-04 | 215 | 164 | 379 | 0.58904 | 0.44932 | ||||
05-09 | 137 | 133 | 270 | 0.37534 | 0.36438 | ||||
10-14 | 194 | 116 | 310 | 0.53151 | 0.31781 | ||||
15-19 | 561 | 270 | 831 | 1.53699 | 0.73973 | ||||
20-24 | 981 | 378 | 1359 | 2.68767 | 1.03562 | ||||
25-29 | 1242 | 581 | 1823 | 3.40274 | 1.59178 | ||||
30-34 | 1658 | 876 | 2534 | 4.54247 | 2.4 | ||||
35-39 | 2260 | 1347 | 3607 | 6.19178 | 3.69041 | ||||
40-44 | 3185 | 1835 | 5020 | 8.72603 | 5.0274 | ||||
45-49 | 5251 | 3454 | 8705 | 14.3863 | 9.46301 | ||||
50-54 | 7870 | 5094 | 12964 | 21.5616 | 13.9562 | ||||
55-59 | 10755 | 7425 | 18180 | 29.4658 | 20.3425 | ||||
60-64 | 14355 | 9950 | 24305 | 39.3288 | 27.2603 | ||||
65-69 | 21232 | 14616 | 35848 | 58.1699 | 40.0438 | ||||
70-74 | 31296 | 22884 | 54180 | 85.7425 | 62.6959 | ||||
75-79 | 36041 | 29195 | 65236 | 98.7425 | 79.9863 | ||||
80-84 | 44735 | 41951 | 86686 | 122.562 | 114.934 | ||||
85+ | 84552 | 132229 | 216781 | 231.649 | 362.271 | ||||
Grand Total | 267960 | 273629 | 541589 | 734.137 | 749.668 |
Why? So we can take the fear out of the headline numbers and start to look at the real impact of Covid-19 on our populations.
If we look at the mortality from and with Covid-19 we also have to look at the change in mortality brought about by social distancing. One would assume that the number of drink driving deaths would fall - since pubs are closed.
There was an epidemiological study after the 1990-1991 Persian Gulf War that showed that US military deaths were reduced versus a non-war situation, since troops in Saudi Arabia were not able to drink and engage in normal activities. Could it be that Covid-19 results in a lower overall mortality/morbidity figure for polities such as Australia and the UK that have brought in strict social distancing?
See also:
Policy frameworks for pandemics - part 4 - incidence of costs versus incidence of benefits...
The regular reader may note that this really is rather off-topic. And from the perspective of a blog that has traditionally looked at topics such as Fixed Income Trading: New venues ( How many Fixed Income trading venues are there? ) , Product Management and Fintech and What's the difference between an EMS and an OMS? this may seem a little unusual. However, your author was trained as an Economist and took a keen interest in Health Economics and the interface between rationality, efficiency and morality. As such, with the usual topics somewhat becalmed I decided to repurpose this blog for an intellectual diversion. I can assure the reader that normal service will be resumed sooner or later...
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