Tuesday, March 24, 2020

Unanswered Coronavirus Question

The coronavirus may be a substitution of one cause of death of older, severely ill people for another cause on a death certificate. Stopping the virus might not decrease the mortality rate of the most likely affected individuals.

So far, most of the people dying from the coronavirus are older, have multiple serious health problems and more likely male. On average, an 85 year old male has almost a 10 percent one year mortality rate, a 10 percent chance of dying in one year when not adjusted for the health of the individual, A 90 year old male has a 16 percent chance of dying in one year. Individuals who have multiple serious health problems have much higher mortality rates than the above average actuarial numbers.

The important unanswered question about the coronavirus is whether or not the virus is increasing the mortality rate of severely ill older people? Whether the virus is causing excess deaths in epidemiology terms? If someone is so ill that they would have likely died from heart failure, flu, pneumonia or some other non Covid-19 cause in the next few weeks, dying from the coronavirus and listing it as the cause of death is misleading. It gives the public the false impression that but for the coronavirus the individual would have an extended life and not have died from other causes around the same time.

If stopping the virus does not increase the expected life of infected ill individuals, is it worth shutting down the economy?

Addendum
As more insurance companies modify their existing health insurance policy coverage to fully pay for coronavirus outpatient and in-hospital testing and treatment, doctors will have incentives to list more coronavirus diagnosis as the primary cause of death on medical records and death certificates in place of other causes. The number of deaths due to coronavirus will certainly be inflated by some amount and we should expect to see a sharp increase in proportional deaths around the time of expanded health care insurance coverage.

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