It's not just the elderly and it's not just about the health care system - to me, it's much more about preventing 1MM or more additional US deaths over the next 6-18 months, assuming we open things up and allow the US to move towards herd immunity, which is what some seem to want.
There are 83MM people in the US aged 45-64 and the total death rate for these people from COVID in NYC is 1540 per 1MM, which translates to 127K deaths of people in the US between 45 and 64, assuming the NYC death rates are similar for what the US's will be, which should eventually be the case, even if it's not now, as there should be no reason NYC people would be more likely to die from the virus than anyone else, unless there's some demographic or health care system reason, which could be factors, but are likely minor ones. But NYC only has about 20-25% infected so far (20% as of 4/30, but the first two results were closer to 25%, so since more people have been infected since the antibody study, let's take the 25% number infected right now in NYC. So one needs to multiply that 25% infected by 2.4X to get the total number of deaths for 60% being infected or very close to herd immunity. That would up the number to 305K dead between 45-64.
There are 30MM people in the US 65-74 and the NYC death rates for them is 5020 per 1MM, which translates to 150K deaths of people in the US between 65 and 74, assuming the NYC death rates are similar for what the US's will be. But NYC only has about 25% infected so far, so one needs to multiply that number by 2.4X to get the total number of deaths for 60% being infected or very close to herd immunity. That would up the number to 360K dead between 65-74.
There are 19MM people in the US over 75 and the NYC death rates for them is 12,620 per 1MM, which translates to 240K deaths of people in the US for people 75 and over, assuming the NYC death rates are similar for what the US's will be. But NYC only has about 25% infected so far, so one needs to multiply that number by 2.4X to get the total number of deaths for 60% being infected or very close to herd immunity. That would up the number to 576K dead over 75.
And finally, there are 109MM people in the US 19-44 and the NYC death rates for them is 168 per 1MM, which translates to "only" 18K deaths of people in the US between 19 and 44, assuming the NYC death rates are similar for what the US's will be. But NYC only has about 25% infected so far, so one needs to multiply that number by 2.4X to get the total number of deaths for 60% being infected or very close to herd immunity. That would up the number to 43K dead between 19-44. In a typical flu season, about 3400 people from 18-49 (didn't have 19-44) die from the flu and that number would obviously be less (3000?) for 18-44.
That's about 1.28MM total US dead, which is a fair amount greater than the 950K total dead the Wharton model had last week, if we stopped all interventions/social distancing and went to herd immunity over the next 6 to maybe 18 months (because the rate of spread will be much slower in low population density areas). The calcs above assume no interventions and no treatment/cure/vaccine and 60% of the US becoming infected at herd immunity and dying at rates we see in NYC now. The calcs also assume the NYC ~25% infected number, from antibody testing is correct. There could obviously be errors in all of those assumptions, but even if the deaths were simply just the 950K deaths in the Wharton model that's still an insane level of deaths over the next 18 months or so.
Also, here's a reality check on the numbers above. NYC right now, has 19,700 deaths in 25% of its population of 8.5MM (2.12MM infected) so the infection fatality number right now is 0.93%. If that overall 0.93% number held for the 60% of 330MM that would eventually become infected, that would be 1.84MM US deaths. Even if we went with NY State numbers of 26K deaths in 15% of the population with antibodies out of 20MM, that's an IFR of 0.86%, which would translate to 1.70MM US deaths. We better hope there are a lot more people with antibodies in NYC/NY or that there is something unusual about NYC/NY death rates or that we have a real treatment (plasma/engineered antibodies?) soon or that transmission rates end up being slower than expected in less densely populated areas with less interventions, giving more time for a cure/vaccine. Also, keep in mind that true infection rates in the rest of the US are likely only around 3-5%, given the much slower outbreaks in much less densely populated areas - this is where a Federal antibody testing program would be nice.
These kinds of potential deaths are why we need to get transmission rates down to much lower levels, such that death rates will stay at low levels, especially until we have a treatment/cure/vaccine. And the only way to do that is aggressive testing, tracing, and isolating to quickly detect and snuff out flare-ups, along with wearing masks in public and at least moderate social distancing to prevent the flare-ups in the first place and minimize them when they occur. This is the direction the NE Region (NY, NJ, CT, RI, MA, PA, DE) are heading as well as CA, WA, and OR, which combined are about 1/3 of the US population (106MM) but not the direction much of the rest of the country is headed.
US Population By Age (2018)
Sometimes I wonder if I'm missing something really important, but nothing obvious comes to mind. Hey
@SkilletHead2 - being a numbers/math guy, who hasn't been immersed in this, as far as I can tell - can you check me here? Thanks.
