The COVID Strategy America Hasn’t Really Tried

“ Compared with someone in their 20s, a person over 65 years old is not slightly more likely to die of COVID but at least 65 times more likely to die of COVID. Over age 75, they become 140 times more likely to die. Over age 85, they are 340 times more likely to die. No other basic fact of life matters as dramatically as age for COVID. Other common factors associated with risk—race, diabetes, cancer, immunosuppression—make the disease deadlier by a factor of “only” two to four.”

See the chart in the article:  Rates of COVID-19 Deaths by Vaccination Status and Age Group, per 100k ( Nov 28-Dec 4 2021)

https://www.theatlantic.com/health/archive/2022/02/vaccinate-old/622080/

You are looking at age specific death rates in the Atlantic article you cite, which do not provide the probability of dying. For the latter, you need to modify the age specific death rate, which is usually done by creating a  “life table” or its equivalent. For details, I point you to chapter 7 in Methods of Demographic Analysis, 2nd Edition, by F. Yusuf, J. Martins, and D. A. Swanson (2014). Springer. (https://link.springer.com/book/10.1007/978-94-007-6784-3 ).

The way I read the chart I mentioned, was that during the week in late November last year ( possibly representative), boosted people over 65 died at a rate of less than one per 100k.
Unvaccinated people in the same age range died at 45 per 100k.
The other possible ways to die are still there, but the article is, among other things, indicating that age is much more important than diabetes,asthma etc in predicting who will die from Covid.  It’s also emphasizing the large difference in death rates between boosted and unvaccinated for those over 65.

Yes, it is common in publich health to look at age-specific death rates and to construct various ratios to get an idea of relative mortality. However, measures strictly based on the age-specific death rate, do not provide the “conditional probability of dying,” where the condition is that one has reached a given age, (age x) and the probability is aimed at dying before you reach the next checkpoint (i.e., x + k).  The Kaiser-Permanente study on the mortality effects of smoking are similar in that they do not provide the (conditional) probability of dying. 

Friedman G., I. Tekawa, M. Sadler, and S. Sidney (1997). Smoking and mortality: The Kaiser Permanente Experience. pp. 477–499 in D. Shopl and D. Burns, L. Garfinkel, J. Samet (eds). Changes in Cigarette-Related Disease Risks and Their Implication for Prevention and Control. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Cancer Institute.

In order to get the (conditional) probability of dying, the age-specific death rates needed to be modified. See 

D. A. Swanson, S. Chow, and T. Bryan (2020) “Constructing Life Tables from the Kaiser Permanente Smoking Study and Applying the Results to the Population of the United States.” (2020)  pp.115-152 in B. Jivetti and M. N. Hoque (eds.). Population Change and Public Policy. Springer B.V. Press. Dordrecht, Heidelberg, London, and New York. 

To the extent that I understand what you’re saying ( my problem, not yours), it sounds like at 73 I can start bar-hopping—covid or no covid, vaccinated or not.  😊   On the other hand, since I don’t smoke, only drink occasionally, eat healthy, exercise, keep up on all medical tests and vaccinations, I may fall outside those averages.

Very few people fit the averages. Variance is a fact of living and that includes variance in age at death ( https://populationreview.com/taylors-law-and-the-relationship-between-life-expectancy-at-birth-and-variance-in-age-at-death-in-a-period-life-table/ )

As I wrote in the article, “This means that just like a vaccinated person, an un-vaccinated person is  more likely to die from something other than COVID-19 after age 78. However, if you are un-vaccinated, the question here is why keep COVID-19 on the list of potential causes of death?”  Your choice. 

See you at Tony’s in Custer next Friday? Maybe Loretta Lynn will show up for chicken and jo-jos and a couple of Rainiers.

Sorry to belabor this but I really want to understand.  With the indoor mask mandates going away, I want to assess the risks of some socializing.     So as you pass 70, (and speaking primarily of those vaccinated/boosted)  because there is a greater and greater liklihood of other things affecting you physically in very bad ways, the relative risk of that resulting from Covid goes down.  Or stated differently, there becomes less reason to totally isolate.  Even if all you do after 70 is pickup groceries at curbside, you’re still driving and you’re still old.
Now, you can make those other things more significant by smoking, drinking to excess, eating to excess, driving like a maniac, but all other things being equal, you have less reason to just stay home all of the time in an attempt to insulate yourself from Covid?

At the other end of things, the vaccinated/boosted 25-year-old is much less likely to die from those other old-age risks, so Covid stands out more.

Because of relatives next door at great risk from Covid, I’ve been trying to live more or less as if I had a cabin on top of Mt Baker.  Now I want to take “calculated risks” to live a bit more normally, and protect the relative by not visiting them in person unless I’m able to quarantine first.

With the omicron variant, BA.2 poised to make the rounds, (https://www.al.com/news/2022/02/ba2-omicron-variant-2-new-covid-symptoms-reported.html ), I prefer to keep it from becoming one of the many other causes of death looming for somebody my age, so I am maintaining the same protocols (mask wearing, avoiding crowds, etc.) that I have been using for two years in an effort to reduce the risk of getting it and passing it on. When a clear picture emerges of its transmissability and effects I will revist this choice.

Sounds reasonable.  I think it depends on whether you’re enjoying life now—e.g. do you have a Covid pod (social circle of people living nearly identically).  If not, I think the calculus is different.