The Impact of Age

Last week, Florida released a comprehensive report that summarizes many key Covid-19 statistics – including the number of hospitalizations.[i]  Since the beginning of the pandemic, state hospitalization figures have been difficult to locate – some do not release the numbers.  

Let’s take a look at some of the key findings from Florida.    

Florida data

Columns represents the distribution of covid cases, hospitalizations, and deaths across specific age categories – reminder, percentages run vertically and add up to hundred.  For example, out of the total number of confirmed cases, 14% were 15-25 years old.   

First consider column 1.  Over a majority of Florida covid cases involved people younger than 45.  This confirms recent reports that the virus increasingly afflicts younger people.     

Second, column 2, hospitalizations are much more likely among older age groups.  Nearly 70% of hospitalizations include people 55 years of age or older. 

Finally, almost two-thirds of Florida’s covid deaths are among people 75 years of age or older.   

After testing positive

What is the likelihood of hospitalization?  Overall, 12.3% of covid cases sought hospital treatment (13,775/111,724).  The figure below displays hospitalization rate by age brackets.

Just less than half of 85 plus age group that tested positive required hospital treatment.  And less than 2% of the 15-24 year old group. 

Hospitalized mortality rate

Among those hospitalized, what is the mortality rate?  Overall, nearly a quarter of covid hospital patients died (3,327/13,775 = 24.1%).

More than any other calculation, the hospitalized mortality rate illustrates the close connection between age and the coronavirus.   Approximately 61% of the 85 plus age patients died.  That percentage, however, drops sharply with the age brackets, halting at 1.4% for patients 15 to 24 years old.          

Case mortality rate

What are the chances of death after testing positive?  The news media continually up-date the number of cases and deaths, so this calculation receives significant attention.  See previous posts (part 1 & 2) for a discussion of data problems and politicization of this measure.     

In total, approximately 3% of Florida’s covid cases ended in death. (3,327/111,724). 

While age differences are still important, the case mortality rate offers less variance across age than either hospital mortality or hospital rate.  In other words, the divisions between the young and old are not as large.    

Take Away

Four months into the pandemic, Florida’s data offer a familiar picture of an older generations’ struggle with the disease.  Yet the data also uncover a large percentage of cases among younger age groups.  Because young adults are less likely to require hospital treatment – and a comparably small fraction die from the disease, they do not seem to generate the same collective anxiety and urgency.  

For example, compare today to late March and early April.  At that time, deep uncertainty forced lawmakers’ hand.  The stated objectives included flattening the curve, saving lives, and buying time for hospitals to prepare for thousands of cases.       

Now, amid state record numbers for confirmed cases, economic and social activities approach pre-pandemic levels.  Because young adult infections appear to be causing the increases, full steam ahead.   Maybe.

Over the next few weeks, states may reconsider their policies in light of several facts.   First, there are many unknowns about this disease.  The Florida data tell us only what transpired the past few months.  They cannot predict the future. 

As noted, the hospitalization rate for young adults is comparatively small.  Nevertheless, recent reports from Texas suggest that a larger proportion of hospital patients are young people.  And they are sicker than expected.  Previously, about 1 in 5 people in ICU beds were under 50.  Today, Houston Methodist CEO Dr. Marc Boom reported it is almost 1 in 3.      

Second, with increasing number of young and middle age adults infected, transmission to the elderly population looms larger.  The initial lockdowns tried to avoid this very possibility.    

Finally, the pandemic is political.  With a surge in the number of cases, expect Democrats to overact and Republicans to underreact.  They will surely point fingers.  And with elections a few months away, the appeal of partisan explanations will be stronger than ever. 

Resist it.     

After all, elections are about accountability.  Step outside the partisan box and impartially evaluate local, state and federal officials’ handling of the pandemic.  Collectively, if this happens – people use performance based voting instead surrendering to partisan feelings, politicians may not be so quick next time to politicize public health.    

[i] A published twitter feed by Avik Roy inspired today’s post.  

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