COVID-19 Megathread 6: Return of the Omicron

[jimrtex]

Re: School Reopenings

https://www.latimes.com/california/story/2021-03-22/less-than-30-of-students-ready-to-return-to-lausd-campuses-survey-shows
LA Times: Less than a third of students ready to return to LAUSD campuses

Parents of fewer than 1 in 3 students said they are ready to send their children back to Los Angeles school district campuses, a reluctance fueled by lingering health concerns as well as confusion and dissatisfaction with the in-person academic program being offered.

To build up family trust, L.A. Unified School District officials have been holding online “town halls,” while principals are meeting with parents. And on Monday, Supt. Austin Beutner announced that, starting April 5, adult family members will be offered vaccines at Lincoln High School on the Eastside and Washington Preparatory High School in South Los Angeles.

Beutner also set the week of April 12 for elementary school reopenings, starting with 60 campuses, with hundreds of others to follow the next week.

The low projected numbers of those returning are based on the results of a district survey — which has been extended beyond the original March 19 deadline. As of Monday afternoon, about 62% of families had responded. Families who don’t respond will have their children assigned to remain in distance learning for the rest of the academic year.

Of those families who submitted a survey, fewer than half opted for a return to campus. When those who are returning are juxtaposed against the total enrollment of 465,000 students in kindergarten through 12th grade, the numbers are stark: 33% of elementary school students would return, 21% of middle schoolers would and 14% of high schoolers would.

Parents in the more affluent Westside L.A. are about twice as likely to return their children to an elementary school campus as those in low-income MacArthur Park, South Los Angeles, Panorama City or Koreatown. The COVID-19 death rate is almost five times as high in MacArthur Park as in West L.A., while the vaccination rate is half as much, according to data provided by L.A. Unified.

[...]

So you'll have a "lost generation" of poor, mostly non-white kids who were already in a disadvantageous position against their white wealthy libs counter-parts, but whose parents are choosing not to send them to school over public health concerns.

But these draconian requirements were necessary, r-r-r-ight? Well...perhaps according to those poor, mostly non-white parents.

What were they being offered for "in school".

In some cases, it meant being divided into two groups who would attend class for two-to-three hours in the morning or afternoon with no lunch (that time would be for sanitizing everything). This would be four days a week, with the remainder of time being filled with homework.

[jimrtex]

May 15, 2021 Vaccination Update

Percentage of population fully vaccinated according to CDC

National Average: 36.7%

Image Link

CT: 47.6%
DE: 38.8%
DC: 38.2%
FL: 35.4%
HI: 43.1%
IN: 32.1%
LA: 29.5%
MD: 41.9%
MA: 46.0%
MS: 25.2%
NH: 35.4%
NJ: 43.8%
PR: 31.0%
RI: 45.5%
VT: 46.1%
WV: 32.8%

Some states are too small or oddly shaped to have numbers fit properly on them, so they're listed above


One thing that really strikes me is the difference between New Hampshire, with a percentage of fully vaccinated people at 35.4% (below the national average), and every other New England state, which are all above 45.0% and rank together as being the top 5 in the nation. Why is this? "Live free or die" taken too literally?

What is really bizarre is that NH is also reporting 99.9% for those over 65.

[jimrtex]

US life expectancy falls by more than a year due to Covid-19 pandemic, CDC study says

Life expectancy in the United States fell by a year and a half in 2020 primarily due to increases in death due to the Covid-19 pandemic, according to early data released by the US Centers for Disease Control and Prevention.

"U.S. life expectancy at birth for 2020, based on nearly final data, was 77.3 years, the lowest it has been since 2003," researchers at the CDC's National Center for Health Statistics wrote in a new report published on Wednesday.

US life expectancy declined from 78.8 years in 2019 to 77.3 years in 2020, the researchers reported, and Covid-19 deaths contributed to 73.8% of that decline.

The report was based on provisional data from death and birth records for the year 2020, processed by the National Center for Health Statistics. Since the study relied on recorded deaths and births, some deaths or births that had not yet been counted or recorded were not included in the early data.

https://www.cnn.com/2021/07/21/health/life-expectancy-covid-19-pandemic-cdc-study-wellness/index.html

I feel like this was reported a few months ago, but this is apparently a new study.

I still don’t understand how the death of 0.2% of the population, most of whom were old, could result in a 2% decrease in life expectancy among the entire population.   

Let's look at life expectancy for older persons. At age 65, life expectancy is 19.5 years. This is the mean. If there is a group of 100 65-year-olds, they will have a collective life expectancy of 19.5 x 100 = 1950 years.

Some will die at 65 some will die at 85, and a few might die at 105 (we probably need more than 100 in our study. Perhaps 10,000 or 100,000 subjects).

Deaths will steadily increase as the age-specific death rate increases.

For 55-64 it is 1.0%
For 65-74 it is 2.0%
For 75-84 it is 4.6%
For 85+ it is 13.1%

If is (mumble, mumble, turns envelope over ...) likely to around 1.5% at age 65 and perhaps 3.0% at 75.

But at some point even though the share of persons who will die at a particular age is increasing, fewer persons will die because there are fewer people left out of our original cohort. The distribution will have a long tail towards the 65 YO side and a sharp decline on the older side. If 10% or more of people are dying, there is a sharp decline. The median and mode will be older than the mean.

So let's look at those 100 65-YO who were expected to live 1950 more person-years. We expected about 1.5 to die in the first year, So we might have 98.5 living another year, and the others living an average of 0.5 years, for a total of 99.25 years.

(1950 - 99.25)/98.5 = 18.79 life expectation for remainder.

But what if 2% died in that first year.

98 survived and would have an expected life expectancy of 18.79.

If we take in our future life expectancy plus the years lived at 65 we get.

98 x (18.79 + 1) + 2 x 0.5 = 1940

Our original estimate was high.

But what will happen for our now 66 YO in 2021?

Life expectancy is projecting the past forward. It is getting pretty dicey if we try to figure out whether there will be cures for cancer, dementia, heart attacks, stroke, and hip fractures.

So what do we expect for 2021 and 2022? Will they be like 2020? Do we try to blend 2016 to 2020. Or do we toss 2020 as an anomaly.

If we repeat the experience of 2020 going forward over and over, there will be lots of premature deaths due to COVID.

Note that to some extent, life expectancy is just an alternate measure of infant mortality. If a baby gets to their 1st birthday they are pretty good until around 20, when they start doing stupid things, and perhaps 40 when some bodies start wearing out.

[jimrtex]

It sounds to me like they just made this life expectancy calculation based on the 2020 data and nothing else.  In other words, they are assuming that 2020 represents the new normal going forward, and that covid will be the 3rd leading cause of death in the US for the foreseeable future.  Which is just unbelievably stupid.

Hmm?

Life expectancy is just an average. Weighted maybe, but an average. If a bunch of people die unexpectedly, however that happens, life expectancy goes down because of it, even if we know that won't repeat.

Right, but certainly not enough people died of covid just in 2020 to reduce overall life expectancy by 2%.   Less than 0.2% of Americans died, and they probably lost on average something like 10 years of life, since most were over 65 already.   Given this, the actually loss of life expectancy due to covid should be closer to 0.02%, not 2%.  It might be more like 2% if you assume 500k people are going to die of covid every year going forward.

If hundreds of thousands of people die who otherwise would not, then such reduces life expectancy. So far we are counting almost entirely direct kills of COVID-19 and perhaps some side kills (like suicides and drug overdoses due to economic and social distress).

The full effect of COVID-19 upon subsequent morbidity of survivors is not yet known. We know that certain conditions such as diabetes and cirrhosis shorten the life expectancy of anyone who has them. Likewise, anyone who has had any heart attack, stroke, or cancer is prone to more of the same.

People may not survive unscathed.

You are right that if hundreds of thousands of people die who otherwise would not, this reduces life expectancy.  But it cannot possibly reduce life expectancy by this much.  It’s off by several orders of magnitude.  

In order to reduce life expectancy by 2%, a virus would have to kill AT LEAST 2% of the entire US population.  And in reality, it would need to kill a lot more than 2% of the entire population, because it is mostly killing old people.   Given the age profile of covid deaths, it would need to kill more like 20% of the entire population.  But it didn’t kill 20%, or 2%; it killed 0.2%

I don’t care how many secondary effects you care to count; it still doesn’t get anywhere close to this estimate.  Has anyone defending this actually tried to think through the numbers they are implying?

Around 3 million Americans die annually or about 1% of the population.

What would be the effect if that were reduced to 0% so that nobody died - ever.

What would be life expectancy? Methuselah would be a youngin.

Going from 0% to 1% reduces life expectancy from 969+ years to 80 years. Why do you think that going from 1% to 1.2% would only reduce life expectancy by 0.2%?

[jimrtex]

It sounds to me like they just made this life expectancy calculation based on the 2020 data and nothing else.  In other words, they are assuming that 2020 represents the new normal going forward, and that covid will be the 3rd leading cause of death in the US for the foreseeable future.  Which is just unbelievably stupid.

Life expectancy is calculated as the average length of life for a hypothetical cohort of people assumed to be exposed, from birth through death, to the mortality rates observed for one particular period of time (in this case the year 2020.)  Higher total mortality rates will always decrease life expectancy when it is calculated this way. A population that has more total death has lower life expectancy.         

Remember that life expectancy is a function of observed deaths, not the survivorship or age of the living (i.e., we can safely assume that everyone will die at some point, lol.) 

Even if we assume COVID didn't change mortality rates for the cohort of people younger than age 80, it would still lower overall life expectancy because more 85 or 90-year olds would be dying.  The change in mortality would mean we'd expect fewer 30-year olds to live to age 90 (and all subsequent ages, too) which decreases the total population life expectancy.  This should seem intuitive once you remember life expectancy is an average.  If we engaged in gerocide Children of Men-style and murdered everyone on their 90th birthday life expectancy would go down because we'd be "moving up" all deaths that would have happened at age 91, 92, 93, etc. 

If covid only changes the mortality rate for people over 80, it should only have any effect on the life expectancy of 30-year olds if covid is still a raging pandemic 50 years from now.  And that appears to be what this study is assuming.  

If you think this is a reasonable assumption, then I suppose the “everyone needs to wear masks everywhere forever” policy is right on the mark.

You say life expectancy is an average, and obviously this is true.  But the big question is “an average of what?”.   To answer this, we need to ask what range of data represents the best reflection of what we think the future will look like.  Is 2020 the best reflection of the future, or will some wider lens give us a more reasonable estimate?  I would suggest that 2020 is -not- a representative year, and we’ll get a much better prediction by, for instance, averaging the last several years.

The report we were given is somewhat like saying “Life expectancy in New York City fell 40 years on September 11, 2001”.  And indeed, if you assume, based on data from that day, that 3000 NYC residents will die every day in terrorist attacks going forward, this might be a reasonable claim.  But the assumption is obviously ridiculous, and makes the conclusion worthless from a practical standpoint.

"We've always done it this way. These tables have been calculated back to 1900. It provides a way to see long term trends changes in mortality."

If you were you an actuary for an insurance company would you use this data to calculate more generous annuity and pension payments?

"Are you kidding? It would bankrupt the company! We are Public Health Scientists! Besides we said the results are provisional."

Anyhow these appendixes illustrate the calculation.

https://www.cdc.gov/nchs/data/vsrr/vsrr015-tables-508.pdf

If you look at Table 1:

Column 1, q is the probability of dying in a given interval. It might be easier to understand by throwing away the last few digits and converting to a percentage,

For example for 55-60 0.041406 means 4.14% of 55 YO will die before 60.

Column 3, d, number dying in interval is calculated by multiplying column 2, l (number living at start of interval) by q.

Column 2, l, is then updated by subtracting the number dying in the interval from the number living at the start of the interval. Thus this column shows the number left from our original 100,000 persons.

Column 4, L, person-years lived in interval is roughly calculated by multiplying the number living at the beginning of the interval by the years in the interval (usually five) There is a slight downward adjustment for those who die during the interval. Probably a bit over 2.5 years.

Column 5, T, person-years remaining, is calculated by summing column 4 from bottom to top.

Column 6, e, life expectancy, is calculated by dividing column 5 T, by column 2, l, number living.

You can reduce e, by increasing q just a tad, particularly at older ages. But as you note, this implies that the persons in the cohort will experience the same deaths from Covid, year after year.

Table 15 shows the change in life expectancy.

[jimrtex]

It sounds to me like they just made this life expectancy calculation based on the 2020 data and nothing else.  In other words, they are assuming that 2020 represents the new normal going forward, and that covid will be the 3rd leading cause of death in the US for the foreseeable future.  Which is just unbelievably stupid.

Life expectancy is calculated as the average length of life for a hypothetical cohort of people assumed to be exposed, from birth through death, to the mortality rates observed for one particular period of time (in this case the year 2020.)  Higher total mortality rates will always decrease life expectancy when it is calculated this way. A population that has more total death has lower life expectancy.         

Remember that life expectancy is a function of observed deaths, not the survivorship or age of the living (i.e., we can safely assume that everyone will die at some point, lol.) 

Even if we assume COVID didn't change mortality rates for the cohort of people younger than age 80, it would still lower overall life expectancy because more 85 or 90-year olds would be dying.  The change in mortality would mean we'd expect fewer 30-year olds to live to age 90 (and all subsequent ages, too) which decreases the total population life expectancy.  This should seem intuitive once you remember life expectancy is an average.  If we engaged in gerocide Children of Men-style and murdered everyone on their 90th birthday life expectancy would go down because we'd be "moving up" all deaths that would have happened at age 91, 92, 93, etc. 

If covid only changes the mortality rate for people over 80, it should only have any effect on the life expectancy of 30-year olds if covid is still a raging pandemic 50 years from now.  And that appears to be what this study is assuming. 

If you think this is a reasonable assumption, then I suppose the “everyone needs to wear masks everywhere forever” policy is right on the mark.

You say life expectancy is an average, and obviously this is true.  But the big question is “an average of what?”.   To answer this, we need to ask what range of data represents the best reflection of what we think the future will look like.  Is 2020 the best reflection of the future, or will some wider lens give us a more reasonable estimate?  I would suggest that 2020 is -not- a representative year, and we’ll get a much better prediction by, for instance, averaging the last several years.

The report we were given is somewhat like saying “Life expectancy in New York City fell 40 years on September 11, 2001”.  And indeed, if you assume, based on data from that day, that 3000 NYC residents will die every day in terrorist attacks going forward, this might be a reasonable claim.  But the assumption is obviously ridiculous, and makes the conclusion worthless from a practical standpoint.

Lol, this study is not "assuming"...this is how life expectancy is calculated as a basic statistical measure

You seem to think life expectancy is a prediction about the future.  In reality, it is a measure of the present, based on the current total mortality curve for the entire population.

Surely you understand why we cannot predict when people will die 30 or 40 years from now?  lol 

"life expectancy" is a projection (an estimate for the future based on the current or the past). The calculation is based on the assumption that the age-specific death rate for 2020 will continue indefinitely (for the next 80+ years for newborns).

You are correct, that "life expectancy" does not measure expectations about life.

[jimrtex]

Here's the CDC report:

https://www.cdc.gov/nchs/data/vsrr/VSRR015-508.pdf

Nothing jumps out at me as an error. It seems that's just how it's calculated. I don't think there's an issue with reporting it. You've given the caveats. Covid deaths will likely decline so life expectancy will likely go back up.

This is unrelated to covid, but I never realized that Hispanics have a significantly higher life expectancy than white people across the board.  Prior to 2020, Hispanics lived an average of 3 years longer than whites, which is a pretty huge difference when you think about it.  I wonder why that is.

How Does Cause of Death Contribute to the Hispanic Mortality Advantage in the United States?

Click on Full Text PDF in upper right corner which provides a breakdown based on cause of death.

But the abstract pretty much matches your question: (i.e. an uneducated guess would be that Hispanics would have life expectancy similar to blacks)

These are quite surprising. For example age-specific death rates for age 25-44.

Age-specific death rates (PDF)

[jimrtex]

Interesting the teen who is vaccinated thinks parents should be able to veto the decision, and the one who isn't thinks they shouldn't be able to

They are both adults.

The issue in Tennessee was likely HPV vaccination which were being promoted to teenagers in high schools.

[jimrtex]

https://twitter.com/seldo/status/1424746056890281984?s=20

A professional data analyst would not infer motive based on this data.