Covid: old people are dying still

Using historical records from Canada and the U.S., researchers demonstrated that more 28 year old people died during the 1918 Spanish Flu pandemic that anyone else. Why? They argue that this increased mortality resulted from an early life exposure to influenza during the previous Russian flu pandemic of 1889–90.

Now, during covid, it is old people who are dying and yet their voice is not being heard. Graeme Walker reports.

We now have access to most of the data re covid and covid-related deaths in Australia (from the Dept of Health website). Clearly none of these numbers and data are perfect, but it’s what we have. 

1. In the heady days of removing restrictions etc I am still worried about older people. I was wondering, what is the actual chance of dying from covid across age groups?. And one wants to know about Australia. 

In the attached table I provide just a summary of my calculations, listing the important conclusion, an individuals’ likelihood of death from coronavirus infection.  I have calculated this as deaths per 1000 +ve cases.

Age rangeDeaths per 1000 +ve cases (pre Dec 2021)Deaths per 1000 +ve cases (Up to today)
under 9<1<1
10-19<1<1
20-29<1<1
30-391<1
40-493<1
50-59151
60-69301
70-7910018
80-8924068
90+28075

You can read from the table, things have improved from pre-december 2021 data to the inclusion of the very latest data. For example you can see that in the initial waves a 90 year old would have nearly 30% chances of dying if infected, in the latest wave it’s more like 8%. or less. 

The improvement could be due to vaccination, and/or a less virulent strain (omricon), and/or a kind of “field effect” where the waves of infection are moving through a previously infected population.  Arguing against this field effect hypothesis:  in the spanish flu, the second wave in the US was worse than the first ….. so a second wave can be worse in some circumstances. 

Of note, deaths are one thing but we do not know how many Australians have ongoing post-viral syndrome. 

In all, I think good news, and kind of better than I expected, but there are still older people in hospital who are dying from covid.

Caveat: of course some infected people don’t get tested, but the important conclusions are related to older people, who you would think are more likely to be symptomatic and get tested than younger people, hence any erroneous conclusions due to lack of testing  would most likely result in overestimating the death rate in young people, which is practically zero anyway (see table). 

2.  There have been over 5,500 deaths to date (but it would have been a lot more without lockdowns, vaccines etc). With regard to cause of death related to covid there is now up-to-date data on this from the Australian Bureau of Statistics. Note we are only discussing here where the underlying cause of death is judged medically to be covid initiating a train of morbid events leading to death (WHO definition).

 As expected the ABS data shows that the majority of people dying from covid had comorbidities. I also note from the Australian Institute of Health and Welfare general population statistics that about 80% of Australians over 65 have one or more chronic health conditions, and this general skewing to older ages is, on a whole population basis, apparently much stronger than for other factors such as sex, socioeconomic status etc (see attached graphs).

With mostly older people badly affected by covid one can ask are they dying due to their comorbidities and not from covid? The most common comorbidities in covid deaths were chronic cardiac problems (arrhythmia, cardiomyopathy, etc) (36%), Dementia (31%), and Diabetes (20%) (ABS).  It is possible that  people could have died from these conditions and not covid, whilst still being coronavirus-positive. But of all Australian covid-related death certificates,the doctors had noted that  69% had pneumonia, 13% had respiratory failure, and 4% respiratory distress syndrome. So in 86% of cases death was probably driven by these respiratory problems, the remaining 14% judged to be other manifestations of coronavirus infection, mainly renal and cardiac problems, and/or sepsis.  The comorbidities could be causally related to death, or “silent” bystanders carried by older people anyway, one cannot be totally sure, but most covid deaths have acute respiratory problems listed on the death certificates. Make of it what you will. 

One has to consider the consequences of passing coronavirus on to older individuals. Correct me if I’m wrong but it seems that in these times of emphasis on inclusion we hardly ever hear in the media anything of the views of the elderly about covid policies, when they are overwhelmingly the group at risk of dying from it.

For biological reasons older people are most affected – summarised in the references below.

Graeme Walker
14 March 2022

Mueller AL, McNamara MS, Sinclair DA. Why does COVID-19 disproportionately affect older people?. Aging (Albany NY). 2020;12(10):9959-9981. doi:10.18632/aging.103344

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