From a not-yet-peer-reviewed preprint (PDF) by Stanford’s John Ioannidis et al:
John P.A. Ioannidis, MD, DSc, Cathrine Axfors, MD, PhD, Despina G. Contopoulos-Ioannidis, MD
Individuals with age <65 account for 5%-9% of all COVID-19 deaths in the 8 European epicenters, and approach 30% in three US hotbed locations. People <65 years old had 34- to 73-fold lower risk than those ≥65 years old in the European countries and 13- to 15-fold lower risk in New York City, Louisiana and Michigan.
I highlighted New York City, where 30% of deaths have been under age 65. Keep in mind that New York City has a fairly wealthy and healthy population, with fewer really fat people than is average in the U.S. due to many people not having cars and thus having to walk a mile or two to and from public transportation every day. (Public transportation might well increase the odds that you will be infected while decreasing the odds that you will die from your infection.)
I’d also like to see the UK figures, which I suspect from some other numbers might lean more toward the US than toward Italy.
The absolute risk of COVID-19 death ranged from 1.7 per million for people <65 years old in Germany to 79 per million in New York City. The absolute risk of COVID-19 death for people ≥80 years old ranged from approximately 1 in 6,000 in Germany to 1 in 420 in Spain. The COVID-19 death risk in people <65 years old during the period of fatalities from the epidemic was equivalent to the death risk from driving between 9 miles per day (Germany) and 415 miles per day (New York City).
Is that driving 415 miles per day on the Interstates or driving 415 miles per day around New York City? The latter sounds nerve-wracking. (Answer: “For New York City, we used motor vehicle fatality data pertaining to New York State,” so some of those 415 miles per day are driving around NYC, but not all.)
Anyway, the more relevant question has not been what has been the average risk so far during the pandemic, but what is the current risk and what is the expected future risk.
People <65 years old and not having any underlying predisposing conditions accounted for only 0.3%, 0.7%, and 1.8% of all COVID-19 deaths in Netherlands, Italy, and New York City.
Let’s keep in mind that at least one of those predisposing conditions, hypertension (high blood pressure), is awfully common in the U.S. From the CDC:
Back to Ioannidis:
People <65 years old have very small risks of COVID-19 death even in the hotbeds of the pandemic and deaths for people <65 years without underlying predisposing conditions are remarkably uncommon. Strategies focusing specifically on protecting high-risk elderly individuals should be considered in managing the pandemic.
Something I’ve noticed is that downplayers like Ioannidis tend to go back and forth on the question of: Is your life worth living? To caricaturize their contrasting lines of thought:
A. If you have hypertension but not coronavirus, you are practically dead already, so who cares if coronavirus pushes you over the edge? Your life is barely worth living as it is!
B. If you have coronavirus but not hypertension, all that matters is that you not die of coronavirus. Nobody knows how bad this novel disease’s long term effects will be on your health and quality of life, but who cares? All that matters is you survive!
Both points of view are somewhat defensible, but it just should be pointed out that they are contradictory.
Another point is of course that most of his analyses assume a functioning, non-overwhelmed medical system. For example, I hope that PM Boris Johnson survives his hospital stay. The odds currently seem to be in his favor. But what would be the odds if he couldn’t get into a hospital because they were all full?
By the way, I presume 55-year-old Boris Johnson has some predisposing conditions, but he is the man who just four months ago finally resolved the seemingly endless Brexit crisis with his historic triumph in the General Election. Like Miss Jean Brodie, he is in his prime.
Nonetheless, it’s important to keep in mind that, as Ioannidis demonstrates, this new disease is demographically opposite from the Spanish Flu, which preyed hardest on young men.