Coronavirus and Younger people

deirdre

Moderator
Staff member
Starting a thread specifically for how the virus (and hospital/medical resources) are being affected by younger people. The CDC released a report (data as of March 16). I added bold and color for highlight.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w
 

Mendel

Active Member
It's been well known that old ageis a big risk factor for Covid-19.
I have looked at the data included in the article, and I don't like it. Their table 2 has two percentages apiece, one is the fraction of total cases, and I've calculated the raw numbers from that. Two columns are off by 1 on the totals for that,and given the precision of the percentages, I guess that's acceptable. But I've also tried to work with the other numbers, which are supposed to be the percentage of known cases, from the raw numbers I obtained in the first step, and nothing works out.

But anyway, have some graphs based on these raw numbers:
CDC March 16.png
These graphs refelct the situation you'd see in the average hospital.
If you want to compare percentages, the risk for a specific age group, the graph changes, because we have fewer cases outside of 45-75. (And note that this risk is a low estimate, since it includes cases whose outcome may get worse!) It looks like this:
CDC March 16-relative.png
 

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Agent K

Active Member
The CDC hid this bar graph on their page about older adults to point out that older adults are a higher risk of death, but it also shows that younger adults take up hospital and ICU beds too. The younger ICU patients are much more likely to survive, and the oldest group had more deaths than ICU admissions.

https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications/older-adults.html


 

Agent K

Active Member
When comparing different epidemics, it's common to compare the death tolls, but epidemics that kill younger people have a bigger effect on the average life expectancy. "The 1918 (flu) pandemic actually caused the average life expectancy in the United States to drop by about 12 years for both men and women" because it tended to kill young adults. The 2009 H1N1 flu pandemic killed fewer Americans than the average seasonal flu, but 2-3 times more of them were under 65. That is, it killed about 12,500 Americans, and 87% of them, or 10900, were under 65, while the seasonal flu kills 30,000, but only 10-20%, or 4500, are under 65.

Here's the age breakdown of fatality rate for flu versus COVID-19 based on early data from China. Since we don't know the number of unreported COVID-19 cases, that graph may need to be scaled way down by some unknown factor.



Earlier this year, it was reported that "Life expectancy in the U.S. rose in 2018, the first such increase in four years"
https://abcnews.go.com/Health/us-life-expectancy-rose-2018-1st-time-years/story?id=68584064
Looking at that graph, the drop in drug overdoses is not that big, yet it drove the increase in life expectancy because overdose deaths occur at younger ages.
 

deirdre

Moderator
Staff member
Please finish reading my sentence.
your external quote is 100% about old people. This thread is about the effects of coronavirus, not drug use or flu or life expectancies, on young people medically and on the resources -those effects will have -on the medical structure as a whole.
 

Agent K

Active Member
Age breakdown of deaths in Italy from March 13. Two deaths in the 30-49 year-old group.

At the time, Maurizio Cecconi, head of anesthesiology & ICU at Humanitas Research Hospital in Lombardy, said the region has about 700-800 patients in ICU, most of them on ventilators. The median age of ICU patients was 65, which means that half were younger. He suggested that there were enough ICU beds for everyone.
Here's the Twitter thread about this:
Source: https://twitter.com/HelenBranswell/status/1238452389864263681


But on March 9, Politico reported that some hospitals were near saturation and had to prioritize younger patients over older ones.
https://www.politico.eu/article/coronavirus-italy-doctors-tough-calls-survival/
 

deirdre

Moderator
Staff member
This article which says it got it's data from official data from the Istituto Superiore di Sanita, published March 16 but the data footnote says March 13
https://www.bmj.com/content/bmj/368/bmj.m1065.full.pdf

I don't think the "significant percentage of patients are under 30" is referring to icu??? since there are only 10% age 50 and under in icu based on her numbers.
and so far I haven't found the original doc on the official site https://www.epicentro.iss.it/coronavirus/sars-cov-2-sorveglianza-dati
 

Mendel

Active Member
https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Steckbrief.html
Table 2: Demographic data and symptoms of Covid-19-patients from Germany (as of 03/18/2020) [I did not quote the symptoms]
Overview for the data from Germany
Demographics
Gender ratio56 % male
Median age47 years
Age distribution< 5 years: 0,8 %
5–14 years: 2,4 %
15–59 years: 80 %
≥ 60 years: 16,3 %
The median age is close to the median fo the whole population; our age distribution is 18% under 20 and 28% over 60, which means that so far, the virus has spread less to the "outside" ages.
 

DavidB66

Active Member
I previously raised a question as to why the COVID-19 death rate in Germany (deaths as a proportion of infections) is so low compared to that in other large European countries (France, Italy, Spain, UK). I wondered whether the German authorities are using a narrower definition of COVID-related deaths. The briefing note from the Robert Koch Institute (see Mendel's post above) doesn't entirely clear this up. There are versions of the note in both German and English. The Summary in the English version refers to 'deaths due to COVID-19', while further down (page 4) it uses the phrase 'COVID-19-related deaths'. In the Summary the German text refers to 'Todesfalle in Zusammenhang mit COVID-19-Erkrankungen'. The main text of the German version is longer and differently organised than the English version. Under the section 'Klinische Aspekte' it refers to 'Personen in Deutschland im Zusammenhang mit einer COVID-19-Erkrankung verstorben'. The English phrase 'due to' normally implies a definite causal connection, whereas 'COVID-related' is more ambiguous'. I think the German phrase 'in Zusammenhang mit' would usually be translated as 'in connection with', which again is somewhat ambiguous. The RKI's welcome page also links to 'Weitere Informationen' (in German only). I have looked at this, but my knowledge of German is not sufficient for a thorough read. I do not see anything, for example in the 'FAQ' section, directly relevant to the criteria for recording COVID-related deaths, but I may well have missed something.
 

Mendel

Active Member
I do not see anything, for example in the 'FAQ' section, directly relevant to the criteria for recording COVID-related deaths, but I may well have missed something.
This is the RKI FAQ (German): https://www.rki.de/SharedDocs/FAQ/NCOV2019/FAQ_Liste.html
The pertinent question is "Wie funktioniert der Meldeweg, was ist alles meldepflichtig und welche Informationen zu den Erkrankten werden ans RKI übermittelt?": How does the official reporting chain work, what must be reported, and what data about the patient is reported to the RKI?
The last paragraph reveals the information you seek:
The reported data contains all fatalities that are connected to a Covid-19-illness: both people who died of the disease directly ("died of"), as well as patients with existing conditions/illnesses and where the eventual cause of death is unclear ("died with"). Deceased, who had not been tested for Covid-19 while alive, can be tested posthumously.
This is essentially the same answer I gave you before: if you're infected and die in a house fire, you won't be counted, but in cases where it's unclear, your death is registered for the statistic. This judgment call is up to the physician who examines the body ("Leichenschau"), determines the cause of death and then reports it to the county health agency ("Gesundheitsamt"), who pass the data on to the RKI. The purpose of this (and the reason why the RKI exists) is to track epidemics, not to produce pleasant numbers.
 
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DavidB66

Active Member
This is the RKI FAQ (German): https://www.rki.de/SharedDocs/FAQ/NCOV2019/FAQ_Liste.html
The pertinent question is "Wie funktioniert der Meldeweg, was ist alles meldepflichtig und welche Informationen zu den Erkrankten werden ans RKI übermittelt?": How does reporting work, what must be reported, and what data about the patient is reported to the RKI?
The last paragraph reveals the information you seek:
The reported data contains all fatalities that are connected to a Covid-19-illness: both people who died of the disease directly ("died of"), as well as patients with existing conditions/illnesses and where the eventual cause of death is unclear ("died with"). Deceased, who had not been tested for Covid-19 while alive, can be tested posthumously.
This is essentially the same answer I gave you before: if you're infected and die in a house fire, you won't be counted, but in cases where it's unclear, your death is registered for the statistic. This judgment call is up to the physician who determines the cause of death and then reports it to the county health agency ("Gesundheitsamt"), who passes the data on to the RKI. The purpose of this (and the reason why the RKI exists) is to track epidemics, not to produce pleasant numbers.
Thanks. That's very helpful. I didn't know the word 'Meldeweg', so I didn't notice the relevance of that question.
 

Mendel

Active Member
The official German data provided by the RKI for the dashboard lists the cases by age group and sex, here's a timeline (using yesterday's data). Note that the last few days are typically incomplete, as some county health offices take a while to enter the paper forms online.
Cases by Age 03-28.png
Deaths by Age 03-28.png
Observations:
- fewer cases registered on Saturdays and Sundays
- every age group gets a fair share of COVID-19, but...
- at first, the old population wasn't infected as much, but that changed over time
- mostly old people die
- the young people need to better protect the old ones from getting infected

Please don't forget that all age groups, even those with no deaths, have very severe cases of pneumonia/ARDS.
 
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