With the rise of the Delta variant, the renewed hysteria in the media, and the troubling push for internal passports on my mind, I thought it would be interesting to take a look at the numbers available for COVID mortality within the context of the numbers available for general mortality.  For this exercise I looked only at the numbers for the USA, using data published by the CDC.  Full mortality reports seem to be published about 1-2 years after the year for which the data is gathered, but partial/preliminary reports with headline numbers are available for more recent data, including data encompassing the COVID pandemic.  Therefor I used numbers from the National Vital Statistics Reports on leading causes of death for 2019 (source), from the data-briefs tables for 2018/2019 mortality (source), and from the COVID-19 provisional counts tables (source) in my analysis.  I also feel I should caveat everything I’m about to write by reminding the reader that I am not a health expert or a statistician, and that this is (as the title states) merely a back of the napkin analysis of the data.

The first place to start when looking at the data is the CDC’s own table for COVID deaths for 2020 (I excluded 2021 data so that I could do year over year analysis, and also because 2021 is ongoing and even the data for the year so far is incomplete as there are always reporting and tabulation lags).

Of note, the CDC includes not only COVID numbers but also pneumonia and influenza numbers in their COVID data sets.  The apparent reason for this is that not only was 2020 a year clouded by a novel coronavirus pandemic, but it was also a year of anomalously high respiratory infections in general.  These two things are in some way related, which is why the CDC chose to present the information together (for context, the CDC usually groups pneumonia and influenza together when tabulating cause of death).  The table is a little bit confusing, as it appears the columns for COVID and pneumonia both include cases of death caused by a conjunction of these two conditions, which is also presented in its own column.  Separating the headline numbers out, it appears that in 2020 there were about 206 thousand deaths attributed to COVID alone, about 180 thousand deaths attributed to COVID plus pneumonia, about 170 thousand deaths attributed to pneumonia alone, and about nine thousand deaths attributed to influenza.

For context, I decided to look at how the pneumonia+influenza numbers for 2020 compared to the pneumonia+influenza numbers for 2019.  To do so I subtracted the reported COVID deaths from the reported Pneumonia, Influenza, or COVID deaths category to get numbers for pneumonia and influenza alone and compared the numbers reported for the pneumonia+influenza category from 2019 in the table below.  Note that for certain age groups in 2019 (marked by asterisks) I had to estimate, as the data sources I used only provided categorical numbers for the top ten causes of death in 2019.

It appears that in addition to the COVID pandemic, 2020 saw a more than three-fold increase in pneumonia and influenza deaths as well.  While it is possible that some of these cases represent under-reported or misclassified COVID deaths, the entire health industry in the US seems to have been very diligent at trying to track and report COVID, so it seems unlikely to me that COVID deaths would be under-reported to the magnitude required to explain this entirely.  It is also possible that some people survived COVID in a weakened state that left them susceptible to subsequent respiratory infection.  Yet another possibility is that there was some under-reported shadow pandemic spreading simultaneously with COVID, accounting for nearly a fourth of the additional deaths caused by respiratory infections in 2020.  In any case, I think that this massive increase in non-COVID respiratory infections calls into question the efficacy of the measures taken (especially masking and social distancing) to prevent the spread of respiratory infection.

Of special note in consideration of the fact that the school year will be starting soon, in 2020 even with the COVID pandemic in full swing influenza and pneumonia were still collectively a greater threat to the under 25 crowd than was COVID-19.  This should come as no surprise to anyone who has been following the developing story of COVID, but it is still worth noting to put the disease into perspective.  The reverse is true for the older crowd (again, no surprise), with COVID contributing to over twice as many deaths as pneumonia+influenza in the over 55 crowd, who were already suffering three times as many deaths from pneumonia+influenza as in 2019.

Taking a step back and looking at the year over year total death numbers, it is clear that 2020 was a year of anomalously high death.

Comparing the change in death numbers from 2019-2020 to the change in death numbers from 2018-2019, it is clear that the pandemic and related events took a significant toll on the population.  Every age group from age 15 on up saw a spike in deaths of around 20%, although the under 15 group seems to have been largely unaffected.  However, as we know that COVID hits the old far harder than the young, I decided to try to break out the numbers further to see where the change in death is occurring.  To that end, I took the total change in deaths for each category and subtracted out the COVID deaths and the change in deaths attributed to pneumonia+influenza (calculated earlier) to arrive at numbers representing the change in deaths year over year attributable to causes other than the increase in respiratory mortality.

In general it appears that the increase in deaths from non-respiratory causes is similar to a normal year-over-year change.  But there is an exception: the age groups 15-44 have an anomalously high death spike that is not attributable to the pandemic and other respiratory disease increases that befell the nation in 2020.  This is concerning, and when the CDC publishes their cause of death numbers for 2020 it will be interesting to see where these increases in deaths came from.  As we will look at later in this article, deaths due to human action (accidents, suicides, homicides) are typically some of the leading causes of death in these age categories, so it is not outside the realm of possibility that the reaction to the pandemic (both social and political) is responsible for an increase in deaths in these age categories.  It is known that the lock-downs have had a deleterious affect on mental health, which would be a likely contributor to an increase in deaths due to human action.  Until we see the final numbers this is just speculation, but it is surely an area of concern that needs to be studied and addressed so that it can be taken into consideration when determining the best course of action to face future pandemics.

In addition, it is worth considering whether the scale of the reaction was warranted with respect to the scale of the disease.  COVID was a real danger to many people, but when put in context with overall mortality it does not seem to have been quite the cataclysm that it is often portrayed as.

COVID accounted for no more than 13% of all deaths for any age group, a significant number but still short of being a top concern for any except the elderly and infirm.  For the younger crowd, who fortunately suffer lower levels of death in general than their elders, COVID represented an even smaller portion of this already smaller number of deaths, to the point where I don’t think it can hardly be said to be a danger worth altering their lives to avoid.  To get greater context on this, I decided to compare the 2020 COVID death numbers for each age category with the numbers for the top 5 causes of death from 2019, graphed below.











As we can see, COVID doesn’t challenge the top 5 for any age group from birth up to age 35.  After then it becomes a greater threat, surpassing deaths due to human action for those over 55.  Even so, for no group does it threaten to take the number one spot.  It will be interesting to see if these numbers line up the same when the CDC publishes their all-cause cause of death numbers for 2020, and it is possible that COVID will prove a greater threat for the elderly than these graphs predict, due to the fact that COVID deaths are frequently accompanied by many comorbidities that may have caused death in the absence of COVID, thereby shifting numbers from one cause of death column to another.  The fact that non-respiratory deaths for the very elderly were lower in 2020 than in 2019 seems to indicate that to some extent COVID was a harvesting event that culled people who would have died due to other causes.  Overall, this comparison indicates that while the disease is a danger worth taking precautions against, it is not especially exceptional in the pantheon of threats to human life.

In sum, a brief look at the data indicates that COVID was a danger that caused great harm to certain groups (especially the elderly) and was due proper consideration but was not the existential threat it has frequently been presented as and probably did not warrant the unprecedented steps taken to prevent its spread.  Indeed, there is a probability that the lock-downs themselves caused more harm to the younger age groups than the disease itself did, something that should be given due consideration in the future.  Hopefully when passions subside and more data comes in this whole episode can be judged in a more measured way, so that in the future we can avoid the mistakes of the past.