The Centers for Disease Control and Prevention’s most recent weekly provisional mortality update has caused a stir. It says:
For 6% of deaths [involving COVID-19], COVID-19 was the only cause mentioned. For deaths with conditions or causes in addition to COVID-19, on average, there were 2.6 additional conditions or causes per death.
Does this mean that only 6% of those who have died with COVID-19 had no preexisting medical conditions?
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No. In fact, the Centers for Disease Control and Prevention didn’t differentiate between medical conditions a patient may have had before contracting COVID-19, and conditions that actually resulted fromthe virus.
But the update does reinforce what we know about the disease: Severe illness and death is very strongly correlated with age and chronic conditions. The update shows us yet again why our COVID-19 strategy needs to be smartly targeted to protect the most vulnerable.
The Centers for Disease Control and Prevention update looked at “conditions contributing to deaths involving coronavirus.” These contributing conditions include many that are complications of COVID-19.
For instance, the Centers for Disease Control and Prevention’s table classifies pneumonia and respiratory distress as contributing conditions. These conditions are common complications in severe respiratory diseases, and these commonly lead to respiratory failure.
Respiratory failure is when the body is no longer able to properly oxygenate the blood without assisted breathing, and is generally when physicians will put their patients on ventilators. It’s understandable then that the table lists more than 57,000 deaths associated with respiratory failure.
That number, though significant, doesn’t tell the entire story. The table also shows the occurrence of these conditions in different age groups, and in every listed condition, the number increases dramatically either at the 55 and over or the 65 and over age group.
For instance, the incidence in respiratory failure more than doubles from 3,153 in the 45 to 54 age group to 7,632 in the 55 to 65 age group. This nearly doubles again in the next age group (66 to 74), with 13,264 incidences. Of all COVID-19 deaths that were reported with respiratory failure, 78% of them were 65 or older. Over 90% were over 55.
This trend is consistent in every acute condition listed on this table and reinforces what we know about the disease—that this virus is particularly deadly to the elderly and those with preexisting conditions.
The Centers for Disease Control and Prevention also lists many chronic conditions that are known to be risk factors for severe outcomes in COVID-19.
After respiratory failure, the condition with the next highest incidence is “hypertensive diseases,” which is a group of diagnoses made up of several chronic high blood pressure diseases. Advanced COVID-19 often involves the heart, and thus those who already had chronic heart conditions were at increased risk of serious outcomes and mortality due to COVID-19.
The condition with the next highest incidences, unsurprisingly, is another chronic disease well known for making disease outcomes worse: diabetes.
Again, this reinforces what we have learned since the beginning of the pandemic: that there are certain risk factors that increase a person’s risk of mortality. It adds to the overwhelming volume of evidence that those over 65 are at particular risk, which only increases over 85.
We continue to learn more about this virus, and the Centers for Disease Control and Prevention should continue providing such updates and must improve its information collection.
But more important than the information itself is what we do with it. Policymakers largely have—rightly—given up broad and untargeted lockdown measures. We know exactly who this virus attacks the most, and our public health measures should be aimed at protecting them.
