4 ms·

Based on these data, can we now calculate the expected impact on life-years instead of just "deaths?" An 80 year old dying isn't a tragedy in the way a 30 year

Based on these data, can we now calculate the expected impact on life-years instead of just "deaths?" An 80 year old dying isn't a tragedy in the way a 30 year old is.

SpicyLemonZest 6y ago
We still don't have enough data to get a good estimate of that, because we don't have good data on the number of people infected by the virus. Even the best surveillance testing regimes are known to miss a bunch of cases.
vharuck 6y ago
I'd say we'd need at least two years until that. The first to make a life table [0] and determine increased risk for each age in years. Then we could assume each person's added risk at successive ages is similar to people of that age this year. The second (and further) years would support or disprove that assumption. My guess is disprove.
toss1 6y ago
If you want to go down that path, you must also include long-term impairment of life function E.g., a pitcher for the Boston Red Sox is out for the season due to a heart condition brought on by COVID-19, prognosis unknown. [1] You don't get any healthier than a professional athlete for a top major sport, and although this guy likely will not die, he is off the field in in danger of losing his career. And yes, I know several 80, and even 100-year olds that are a lot more sharp and physically active than many 40 year olds. Age is not the mere number you think it is. Genetics and decades of healthy/unhealthy choices create massive variations in healthspan and lifespan - you simply do not know that your "typical" 80-year-old has a near expiration date - (s)he could have decades of healthy, happy life ahead. [1] https://www.si.com/mlb/2020/08/01/eduardo-rodriguez-red-sox-out-for-season-covid-19-heart-issue https://www.si.com/mlb/2020/08/01/eduardo-rodriguez-red-sox-...
- samatman 6y ago
  You were on a roll in the first half, but you didn't stick the landing. Sure, plenty of hale and healthy 80 year olds. Also, a majority of 80 year old Covid patients survive. Are they likely to be the same cohort? That's what I would bet on. QALY stands for Quality-Adjusted Life Years. That includes long-term impairment of life function, in the definition. And you're spot-on, we don't even have preliminary data on that, yet. If it were a really big and obvious effect, like 20% of all patients suffer a 20% downward adjustment that will never get better, I wager we'd have a preprint to that effect. It's a terrible thing for those affected, of course it is. But how many? How badly? We just don't know yet.
  - toss1 6y ago
    Indeed, we have no strong data on that, because it literally can not yet exist, and will not for many years But the initial reports of both serious effects to blood, circulatory, lung, organ, and peripheral & central nervous system are real cause for concern, as are teh sufficient numbers of extended illnesses, enough that it already has a name - "Covid long haulers", and support forums.
    - samatman 6y ago
      Yes, but at the risk of repeating myself, if this crossed a certain murky threshold, we would have more than reports and support fora, we would have preprints and preliminary numbers. From my own small sample of people I personally know, I can tell you about twenty reports of complete recovery, and one long hauler. Is that typical? We agree that it will be years before we know with any certainty. I'm pointing out the dog that isn't barking. Also worth pointing out: a family friend in her 80s never recovered from a bout of pneumonia, suffering a reduced quality of life until her death about a year later. Severe illnesses do this sometimes, that's known. Is Covid more likely to? Not known.
      - toss1 6y ago
        I understand. Have you been actively searching for preprints of long-term conditions (I haven't, only noticing what I come across in definitely non-exhaustive just-trying-to-keep-up-with-it-all reading)? If so, do you have any good recommendations for where to look?
chimprich 6y ago
Not quite sure if this is what you're asking, but one study calculated years of life lost per virus death at 13 years for women and 11 for men: https://wellcomeopenresearch.org/articles/5-75 https://wellcomeopenresearch.org/articles/5-75
- dr_dshiv 6y ago
  That's fascinating. Because poverty lowers life span by ~ 10 years [1]. And covid economics are expected to push over 100 million children into poverty [2]. So that's a billion life years lost from economic costs versus the 10 million life years lost if 1 million die from covid. [1] https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30327-9/fulltext https://www.thelancet.com/journals/langlo/article/PIIS2214-1... [2] https://data.unicef.org/topic/child-poverty/covid-19/#:~:text=The%20global%20socioeconomic%20crisis%20caused,as%20of%2029%20June%202020 https://data.unicef.org/topic/child-poverty/covid-19/#:~:tex....
  - dr_dshiv 6y ago
    More here: https://elibrary.worldbank.org/doi/abs/10.1596/1813-9450-9277 https://elibrary.worldbank.org/doi/abs/10.1596/1813-9450-927...

Based on these data, can we now calculate the expected impact on life-years instead of just "deaths?" An 80 year old dying isn't a tragedy in the way a 30 year old is.

SpicyLemonZest 6y ago

We still don't have enough data to get a good estimate of that, because we don't have good data on the number of people infected by the virus. Even the best surveillance testing regimes are known to miss a bunch of cases.

vharuck 6y ago

I'd say we'd need at least two years until that. The first to make a life table [0] and determine increased risk for each age in years. Then we could assume each person's added risk at successive ages is similar to people of that age this year. The second (and further) years would support or disprove that assumption. My guess is disprove.

toss1 6y ago

If you want to go down that path, you must also include long-term impairment of life function E.g., a pitcher for the Boston Red Sox is out for the season due to a heart condition brought on by COVID-19, prognosis unknown. [1] You don't get any healthier than a professional athlete for a top major sport, and although this guy likely will not die, he is off the field in in danger of losing his career. And yes, I know several 80, and even 100-year olds that are a lot more sharp and physically active than many 40 year olds. Age is not the mere number you think it is. Genetics and decades of healthy/unhealthy choices create massive variations in healthspan and lifespan - you simply do not know that your "typical" 80-year-old has a near expiration date - (s)he could have decades of healthy, happy life ahead. [1] https://www.si.com/mlb/2020/08/01/eduardo-rodriguez-red-sox-out-for-season-covid-19-heart-issue https://www.si.com/mlb/2020/08/01/eduardo-rodriguez-red-sox-...

samatman 6y ago
You were on a roll in the first half, but you didn't stick the landing. Sure, plenty of hale and healthy 80 year olds. Also, a majority of 80 year old Covid patients survive. Are they likely to be the same cohort? That's what I would bet on. QALY stands for Quality-Adjusted Life Years. That includes long-term impairment of life function, in the definition. And you're spot-on, we don't even have preliminary data on that, yet. If it were a really big and obvious effect, like 20% of all patients suffer a 20% downward adjustment that will never get better, I wager we'd have a preprint to that effect. It's a terrible thing for those affected, of course it is. But how many? How badly? We just don't know yet.
- toss1 6y ago
  Indeed, we have no strong data on that, because it literally can not yet exist, and will not for many years But the initial reports of both serious effects to blood, circulatory, lung, organ, and peripheral & central nervous system are real cause for concern, as are teh sufficient numbers of extended illnesses, enough that it already has a name - "Covid long haulers", and support forums.
  - samatman 6y ago
    Yes, but at the risk of repeating myself, if this crossed a certain murky threshold, we would have more than reports and support fora, we would have preprints and preliminary numbers. From my own small sample of people I personally know, I can tell you about twenty reports of complete recovery, and one long hauler. Is that typical? We agree that it will be years before we know with any certainty. I'm pointing out the dog that isn't barking. Also worth pointing out: a family friend in her 80s never recovered from a bout of pneumonia, suffering a reduced quality of life until her death about a year later. Severe illnesses do this sometimes, that's known. Is Covid more likely to? Not known.
    - toss1 6y ago
      I understand. Have you been actively searching for preprints of long-term conditions (I haven't, only noticing what I come across in definitely non-exhaustive just-trying-to-keep-up-with-it-all reading)? If so, do you have any good recommendations for where to look?

chimprich 6y ago

Not quite sure if this is what you're asking, but one study calculated years of life lost per virus death at 13 years for women and 11 for men: https://wellcomeopenresearch.org/articles/5-75 https://wellcomeopenresearch.org/articles/5-75

dr_dshiv 6y ago
That's fascinating. Because poverty lowers life span by ~ 10 years [1]. And covid economics are expected to push over 100 million children into poverty [2]. So that's a billion life years lost from economic costs versus the 10 million life years lost if 1 million die from covid. [1] https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30327-9/fulltext https://www.thelancet.com/journals/langlo/article/PIIS2214-1... [2] https://data.unicef.org/topic/child-poverty/covid-19/#:~:text=The%20global%20socioeconomic%20crisis%20caused,as%20of%2029%20June%202020 https://data.unicef.org/topic/child-poverty/covid-19/#:~:tex....
- dr_dshiv 6y ago
  More here: https://elibrary.worldbank.org/doi/abs/10.1596/1813-9450-9277 https://elibrary.worldbank.org/doi/abs/10.1596/1813-9450-927...