Richard A. Epstein, law professor whose projections that the COVID-19 epidemic would first only kill 500 Americans and then he updated his projection and threw a junior assistant under the bus by projecting a death toll of 5,000 Americans , and serious policy influencer in the conservative movement has come up with a new justification to have societal wide re-openings far sooner than the public health experts want. He writes that most of the people who are dying of COVID are not really dying of COVID:
How should physicians report and health departments record deaths in individuals with comorbidities like asthma, cancer, heart disease, diabetes, and the like? Treating everyone who dies with the coronavirus as if they died from the coronavirus necessarily overstates the number of cases by some uncertain amount. But the evidence is overwhelming that the virus by itself kills few individuals. The CDC reported that “approximately 90% of hospitalized patients identified through COVID-NET had one or more underlying conditions heavily concentrated in people over 70 years of age (where the comorbidities are more severe).”
The upshot is that no matter how one counts these cases, it makes no sense to shutter large number of businesses.
That is both morally atrocious and also wrong on so many levels. Comorbidities (diseases/chronic conditions that people have) don’t work like that with mortality. Very few conditions have short term prognosis leading to death. The common and treatable comorbidities of America are long term, chronic, underlying conditions.
My mother is 67 years old. I’ve mentioned before she is a medical zebra full of weird 1 in a million conditions. She also has a few of the fairly typical comorbidities of old age — her blood pressure is a bit high, as well as her blood sugar and she could afford to lose a few pounds. In a non-COVID world, there is a pretty damn good chance that she’ll see at least a few of her grandchildren graduate high school (the oldest is a 6th grader). Her friends with good blood pressure, no diabetes and a BMI in the low twenties have a decent chance of outlasting her. And this is still the case that is likely to occur for, as of last Sunday’s Anderson Family Zoom Call, both of my parents are physically isolating at their house and show no symptoms.
Absent COVID, my mother is likely to live most of a decade.
Conditional on my mother becoming infected without good therapeutics being available, her life expectency is less than a counterfactual version of herself that is in perfect health. But if she was to die three weeks after being infected by COVID, it would be COVID that killed her and took a decade of life that she otherwise would have been statistically likely to have occurred even with her comorbidities. Comorbidities can increase the odds of death conditional on a COVID infection, but the “but for” cause of death is COVID.