How COVID-19 Demographics Can Inform Public Policy

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by James A. Bacon

The COVID-19 virus, we have been told repeatedly strikes all ages. That statement is true, but also misleading. If one crunches the numbers from the Virginia Department of Health COVID-19 dashboard, there is no avoiding the conclusion that COVID-19 is a serious disease primarily for the middle-aged and elderly, and it kills mainly the elderly.

In the chart above, the blue bar breaks down each age bracket by the percentage it comprises of Virginia’s 8.5 million inhabitants. The green bar breaks down the percentage of confirmed COVID-19 patients in each age bracket. The yellow bar shows the percentage of hospitalizations in each bracket, and the orange bar the percentage of deaths.

A tiny percentage of Virginians under 20 years old have tested positive for COVID-19. If they do get it, their symptoms are rarely serious, and they are hardly ever hospitalized. Not one Virginian under the age of 20 has died from the virus.

The odds of contracting a case serious enough to be hospitalized increase with age. Very few people under 30 are hospitalized, but after 30, the odds don’t vary dramatically between age groups. Deaths are rare among Virginians under 50, and not likely for anyone under 60. But patients over 80 are extremely vulnerable, accounting for more than half of all COVID-19 deaths in the state.

None of this is especially revelatory. The data shown here tell us what we already know. But this presentation helps clarify thinking on some key public policy issues.

School reopening. Should Virginia schools re-open next fall? It depends upon whose perspective we take. From the perspective of K-12 students themselves, the risks are close to non-existent. A small number will contract the disease, but almost none will get sick enough to require hospitalization. Barring a fluke case, none will die.

From the perspective of teachers and parents, who fall into older age brackets, the perspective is different. Because so few young people get the disease, very few are carriers. Accordingly, the risk of contracting a disease from a school kid is far lower than, say, hanging out at a crowded bar or living in a nursing home. But that doesn’t mean the risks are trivial. Perhaps any back-to-school movement needs to be accompanied by strict enforcement of sanitary measures, such as frequent use of hand sanitizer, and/or the enforcement of social distancing for older teachers and staff.

Long-term care facilities. At the other end of the age spectrum, the numbers remind us we need to focus preventive efforts on the elderly age groups most likely to contract the disease, to be hospitalized for it, and to die from it. In particular, we should to pay attention to nursing homes and assisted care facilities where the elderly are likely to come into contact with a large number of people. Not only are they more likely to catch the virus in such settings, they are far more likely to die from it.

According to VDA data, 2,902 confirmed COVID-19 cases, or about 14% of all identified cases in Virginia, have occurred in long-term care facilities. Likewise, about 15% of all cases leading to death have come from long-term care facilities. The enclosed nature of these facilities and the difficulty in maintaining social distancing for a population that requires such intensive personal care puts nursing home populations at special risk. Unlike schools, we can’t shut them down. There is nowhere else for the residents to go. But stricter measures that would not be tolerated in other settings, along with more extensive testing and contact tracing, may continue to be advisable for nursing homes.

Workplaces. Virginia workplaces are dominated by the four age groups between 20 and 59, with a smattering of over-60 Virginians. Policies should be crafted for the unique demographics of those age groups. Given their demographics, the risk of contracting and spreading the disease is greater in workplaces than in schools, although a relatively small percentage of the working-age population will end up hospitalized, and a very small number will end up dying. Conditions will vary widely, however. Some businesses employ mostly young people, others employ more middle-aged people. Some businesses require close personal contact, others don’t. Some businesses can mix telework with in-office work, others cannot. A blanket, top-down policy decided by the Governor for the entire state does not make sense. Businesses should be trusted to do what’s best in their situation, and the state should step in when hot spots develop.

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38 responses to “How COVID-19 Demographics Can Inform Public Policy

  1. You forgot gerrymandering.

  2. re: ” School reopening. Should Virginia schools re-open next fall? It depends upon whose perspective we take. From the perspective of K-12 students themselves, the risks are close to non-existent. A small number will contract the disease, but almost none will get sick enough to require hospitalization. Barring a fluke case, none will die.”

    This is a bit misleading.

    read this:

    ” Children ‘do transmit COVID-19’ to adults, says researcher whose report was ‘misunderstood’ as evidence that kids cannot spread coronavirus”

    Some news outlets reported that children cannot transmit COVID-19, based on a recently published review of 78 previous COVID-19 studies.
    One of the researchers issued a statement clarifying that children “almost certainly do transmit COVID-19.”
    The World Health Organization has also cautioned against claims that children cannot transmit COVID-19, reminding the public that there is a lot scientists still don’t know about the disease.”

    The problem is that kids can carry the virus from home to school.

    Consider a child that is dressed by a parent who is infected.

    Or the childs book case and books in a home with someone who is infected.

    Some schools have stopped distributing food via school buses because the school bus drivers were being infected.

    The folks that say that because kids don’t get infected, therefore we can open schools are not paying close enough attention to the potential.

    This is yet another one of those things where the facts are disputed and some want to re-open schools while others do not.

    All we need is for one school to re-open and several of the teachers to get infected and this line of thinking is going to quickly go away.

    The quandary is – if we do not know conclusively right now – what to do?

    some are willing to roll the dice, others, not.

    • If the conclusion is to not open schools, that’s fine, but understand the other part of that must be holding everybody back a full year, and pushing the whole production process off. What is being done in most homes now is basically worthless, and will remain worthless if repeated in the fall.

      • Steve – no matter what happens, it’s NOT going to be the way it was.

        That’s just the reality and yes it may well mean that kids lose some time on their achievement timetables.

        But we cannot just open up schools because parents are having a tough time with their kids.

        And I’m not sure I buy the “worthless” as we have a LOT of kids that do get home-schooled with distance learning and it seems to be successful in a lot of cases.

        We have to re-think how k-12 is going to work. Check in with Mr. Whitehead here in the blog… he says he has 27 years of teaching and I think his views and insights are worth listening to.

      • We would also need to furlough all teachers, school administrators, school custodians, etc for that year. Holding back students for a year will result in more students attending schools once they reopen since a new class of kindergartners will arrive while no high school seniors graduate. That will raise costs when schools reopen. Given the coming state and local government financial crunch we just won’t have the funds to pay people not to work.

        My opinion is that this lockdown will end quickly once state and local government employees start getting furloughed and laid off.

        • And the reopening will end faster than it starts if they then die.

          The counseling costs for little Tommy will be enormous if he loses 3 teachers in a row.

  3. re: ” My opinion is that this lockdown will end quickly once state and local government employees start getting furloughed and laid off.”

    If local govt does not have the revenues to pay them.. what else would you expect?

    what will change that?

    And if we lay off a bunch of school and govt employees – doesn’t that take the economy to even more disastrous levels?

    Teachers and govt folks – buy homes, cars, services, etc.. just like anyone else in the economy who works and has a salary.

    • You are agreeing with me. This lockdown will have economic consequences that our political leaders seem unable to grasp. Right now the federal government is printing magic money which is no more than a palliative for the underlying economic contagion. The work-from-home white collar people and the government employees don’t feel the pain because they still have their usual paychecks coming in. The furloughed blue collar folks are anxious but the assistance checks are being cashed. Some people are earning two to three times more in unemployment benefits than they were making at work (See link below). Things don’t seem that bad. Why rush a reopening?

      Why? Because it’s going to hit the fan when the money runs out. You’ll yearn for the days when trying to find enough N95 masks was the biggest problem facing society. How long can the federal government keep paying $600 / week (or, $15 per hour) on top of state unemployment benefits in a country with a 30% unemployment rate?

      Peaceful American society is living on borrowed time right now. Something has to change and change soon.

      https://www.forbes.com/sites/ryanguina/2020/05/06/5-reasons-you-should-go-back-to-work-even-if-you-make-more-from-unemployment-benefits/#65d3dbd12fc3

      • no. I do NOT agree with this: ” This lockdown will have economic consequences that our political leaders seem unable to grasp.”

        This is loony. How many politicians are you talking about? All of them?

        It’s as if you think you know better than them. You got an opinion. I’ll give you that but I would no more trust your view than the man in the moon compared to the Governors.

        re: ” The work-from-home white collar people and the government employees don’t feel the pain because they still have their usual paychecks coming in”

        You are right – but it’s WAY MORE than just govt workers. There still is a significant private sector economy that is still up and running. There is also a significant part that is not but you cannot fix it with the govt “opening up”. People are not going to go to businesses where they feel there is a danger of infection – no matter what govt says but you insist on making govt the boogeyman which is just … not smart.

        Yeah… is there chaos in the distribution of money and unemployment…yep… that happens… it’s part of the nature of
        the beast.

        How long can unemployment go on? I have similar fears but the watchword is “don’t be stupid”. Now, more than every, we need to think about what we need to do and the simple reality is you cannot “WILL” the economy back – it’s seriously damaged but you can’t just say it’s time to “undo” it.

        I went to the Doctor this morning. It’s totally different than it was before. It’s not govt regs… it’s the Doctor’s practice that wants to stay open and not have it’s employees infected and have to shut down the office.

        You can want to blame that on someone but geeze… who can you REALLY legitimately blame that on?

        It’s like I said. Conservatives are mad as hell and they got to have their boggeyman and others to blame for it… it can’t just be a disaster…someone has to pay… that’s the basic thinking …and it’s just never going to get us towards something better …

        we HAVE TO DEAL with the issue.. and stop trying to blame…or worse make it partisan blame.. enough with you guys!

        • Conservative — money can be saved at the cost of a few lives.
          Liberal — lives can be saved at the cost of a few dollars.

          Hmm, supply side, demand side?

  4. Reopen… the data shows it may solve that whole pension and social security problem….
    And you’re right “things will never be the same…” the new norm may be less people live long enough to suffer in nursing homes laying in beds oblivious to the world around them while some fat cat medical investor rapes Medicaid… I’m cool with that.
    Another plus… the virus may be the “term limit” for outdated lawmakers on both sides.

    • sort of another version of this:

    • NorrhsideDude says:

      “Another plus… the virus may be the “term limit” for outdated lawmakers on both sides.”

      Better yet let’s herd all of Virginia’s so called Lawmakers into a Virginia state supervised nursing home, lock ’em in naked, and watch ’em drop on Video Cam.

      Long overdue Virginia Justice at last.

  5. I think we’re trying make decisions on data that’s still incomplete. It’s hard to believe no children have been hospitalized in Virginia with COVID – there have been some and some very young!
    We’re anxious to move on but we don’t know enough to make those decisions. The problem is that people’s lives are at stake but folks are pushing too hard to do things too fast.

    • The data is still out on kids and especially so whether they can bring COVID19 from home to school or vice versa…

      The virus can stay live on some surfaces including people who are immune but have come in contact with others with the virus.

      It would be like taking an item of clothing from an infect person and passing that clothing around others uninfected.

      One kid on a standard occupied school bus could spread the virus to other kids – none of them to be affected but then who they come in contact with at school after they get off the bus.

      The point here is that we do not know for sure yet – but we have folks that say “open up the schools”… damn the torpedos, etc…

      big talk. dumb talk. asshat talk.

  6. “Science” says shelter at home and stay safe. Don’t be anti-science. The science is clear. Protect yourself. Stay at home!

    But what if I told you that 66% of the new COVID19 hospitalizations in New York were people who are staying at home and sheltering in place? Well, if you’re Governor Cuomo you’d say that statistic is “shocking”. Not “wrong”, not “overstated”, not a “partisan ploy” but “shocking”.

    Guess what ….

    https://www.cnbc.com/2020/05/06/ny-gov-cuomo-says-its-shocking-most-new-coronavirus-hospitalizations-are-people-staying-home.html

    • Nope. That’s misrepresenting what science is and what science is saying.

      Science is saying that the virus is highly contagious and the more we mix together the more it will spread. That’s a scientific fact for most of us.

      What happens in response to that is the issue. How to do it.

      And the problem is not what people are SUPPOSED to do but what they ACTUALLY DO and that’s a big problem in places where the population is dense and people live in apartments or worse in prisons or nursing homes.

      Basically – you folks are in the school of – ” we can’t stop this so we need to stop trying and just let the disease run through us and some of us will die in the process.

      correct?

  7. “…we can’t stop this so we need to stop trying and just let the disease run through us and some of us will die in the process.” No statement has more scientific basis than that. Historical, as well. Until there is a vaccine, that is simply what will happen – rapidly or slowly. Totally unstoppable. Rapidly or slowly? You vote for slowly (because it hurts Trump, mainly.) Granted, a full and total shutdown would make it even slower. But China still has new cases and deaths.

    • re: ” You vote for slowly (because it hurts Trump, mainl”

      more really foolish blather.

      I no more care what hurts Trump that (I hope) you care what hurts Northam but it could be that you are actually projecting here!

      If we had to depend on Trump alone to get a vaccine, good luck on that. Thank goodness we have others but the possibility that we don’t get
      a vaccine soon or at all exists also.

      But I also think you have missed an important possibility with regard to whether we do things sooner or later and that is, even without a vaccine, we may find effective treatments that save people from death. That’s likely to not happen right away but waiting is not without merit.

      This goes back to science. Science is what can help us go forward.

      If we turn away from science, and let the anti-science folks take over, we’re in big trouble because then, idiocy like “it’s only the old who will die” will take over …

      This has to be one of the worst things that has ever happened to us but it’s no excuse to be stupid about it. Now is the time to NOT be stupid.

    • Finally. Exactly right. Nobody ever said that a partial lockdown would stop the spread of the disease. Nobody. The goal was to “flatten the curve”. However, the area under the curve was the same size whether it was flattened or peaked (give or take eventually getting a vaccine). That’s what “science” said.

      As the majority of people being admitted into New York hospitals for COVID19 are discovering – staying home has not made them stay safe – no matter what the pop singers, actors and professional athletes on TV told them. Staying at home under New York’s tight definition of a lockdown reduces your odds of getting COVID19 over any given period of time. But time marches on and the odds eventually catch up with you even if you are locked down under the New York definition of being locked down. Again – the goal has always been to flatten the curve, not reduce the area under the curve.

      Let’s say you’re 70 and want to minimize your chances of dying of COVID19. You have to avoid the disease long enough for a vaccine or herd immunity. And remember, the regular flu vaccine reduces your chances of getting the flu by 60% not 100%. Herd immunity isn’t an exact “science” (most “science” isn’t exact). I’ve seen estimates from 62% to 82% of the population having contracted the disease as the baseline for herd immunity. However, “science” is unclear as to whether contracting COVID19 makes you immune and, if so, for how long. And “science” can’t predict whether the virus will mutate and erase herd immunity. So much for getting a cookbook for behavior from the available “science”.

      Even if you do believe there will be a foolproof vaccine or lasting herd immunity you have to avoid the dread disease long enough to get there. That requires a lockdown that’s a lot more locked down than what is being achieved through government regulation in New York. No going outside. Never. Not once. Not ever. Nobody allowed in your house who has been outside. When things are delivered you must wait for some time after the delivery person leaves before opening the door. How long? “Science” doesn’t know. Let’s say 3 hours. Then, wearing gloves and an N95 or better face mask, you must move the delivered goods to an airtight area for decontamination. How long will the decontamination take? “Science” doesn’t know. Let’s say five days. While still wearing the gloves, hold your breath, remove the N95 mask and all clothing and put them into the airtight decontamination chamber. Carefully remove the gloves making sure you don’t touch you own skin after doing so. Run naked to the shower. First scrub your hands with soap and hot water then use you hands to scrub the rest of your body with soap and hot water. Put on fresh gloves and a fresh mask and spray the shower with disinfectant.

      The lockdown we are in does not keep people from dying. It spreads the dying out over a longer period of time than would otherwise be the case as the good shelter-in-place people from New York are discovering. People who say loosening the lockdown means “people will die” should really say “people will die sooner”.

      • “Let’s say you’re 70 and want to minimize your chances of dying of COVID19. You have to avoid the disease long enough for a vaccine or herd immunity.”

        If you can dodge a wrench, you can dodge a small spikey ball.

      • DJ – how many people in NYC have NOT got COVID19?

        And your idea of “never” is just not the reality.

        People go to the grocery store. They go walking… They go to the drug store… etc…

        The social distancing rules are indeed science-based but as you say, science does not have all the exact answers but to presume they have none is again the all or nothing approach that is wrong.

        The social distancing is for the MOST RISKY BEHAVIORs and fully acknowledges that other behaviors are also with risk but far less.

        It’s not all or nothing.

        If you space out the infections over time – more and more will be learned about the virus – about things we may be able to do and the potential of treatments that can save lives even if infected.

        It’s not all or nothing. It’s a conundrum and the watch word is don’t be stupid. The answers are not simple – they’re more complicated but we have to work our way through them.

        The frustrated lemming critters are a danger not only to themselves but the rest of us – that they would have us jump with them.

        No can do. This is like dealing with a bunch of adolescents.

      • I agree with you Steve –

        Though it is worse. Don Rippert takes the time, effort and brainpower to share some informed and useful observations in a highly literate way on an important topic and this pair rush to the scene and urinate all over his comments, making sure it’s unpleasant for other intelligent people, save nitwits, to be anywhere in the neighborhood, much less participate in furthering the conversation. It’s killing the quality of blog. Yet Bacon allows it.

    • “You vote for slowly (because it hurts Trump, mainly.)[sic]”

      Like hell! What will hurt Trump is when it goes viral, so to speak, and kills a lot of people quickly.

      This may come as a shock to Conservatives, but most people value living more than money.

      • Good Lord Nancy, NOW you’ve DONE IT! money is more important than living… yepper…

      • Spoken like a person who is not missing a pay check right now. Easy for you, bub. You guys should form a company, Snarks Unlimited.

        • well.. when I see the actual service workers in the streets demanding we “open up”, vice the gun toting tea party/Trumpster critters I might reconsider.

          Like the meatpackers… whose standing up for the workers protective gear and health care and who is demanding immunity for the “investors” who are “hurting”.

          money or your life? hmm… if he have money then yes.. it’s okay to use those workers lives… to save your own investments, right?

        • I thought the “cap” for the stimulus was way too high.

          I would have been more than happy if mine went directly to workers, and it may anyhow… indirectly.

          But the whole stimulus thing is a clusterf___ The money should be going directly to the workers, not investors or businesses and it should continue not be one-shot.

          We need a modern-day CCC program. Let those that cannot return to their original work become contact tracers or work in food banks or get an infrastructure program going , etc.

          the way it is configured right now is just wrong.

  8. To protect the planet, at age 30 everyone must undergo the rite of Carrousel.

  9. We should be amazed and humbled at what a big-hearted country we are. Roughly 30 million people and growing have peacefully sacrificed their life savings, their comforts and lifestyles, and amazingly their children’s futures so that 1 million don’t die this year. 30 million for one million. Or at least those were the worse case numbers a month ago. As noted above a very small percentage are likely to die, possibly no greater per cent of infected than the worst flu when all the numbers are in.

    Hopefully, we will as a nation come to a reasonable balance between the cost of limiting deaths and the deaths those costs prevent. Hopefully, America will come to grips with the fact that death can not be prevented for anyone and the costs to society to keep some alive is a terrible and should be unconscionable burden on those beginning life.

    The country has made a grand sacrifice. Treatment plans are improving daily. Health facilities are not overwhelmed. Protective gear is now available. It’s now time for those who might get it to make a sacrifice and let the bulk of the country get their lives back, safe practices notwithstanding.

  10. Keep the schools closed because the teachers might get sick from the kids, but keep those Walmarts open so everyone of all ages can keep mixing and mingling. Sounds like a well thought out plan with absolutely consistent application across the board! Never thought I would see a time when ABC stores were more essential than schools and all the Walmarts were germ free!

    • Grocery stores are one a week or once every two weeks… Ditto ABC.

      School is every day with lots of kids from lots of different homes to lots of contacts at school.

      It’s the science thats driving the restrictions, not arbitrary govt.

      Schools that were using school buses to deliver food to families have had bus drivers get sick with the virus.

  11. “Never thought I would see a time when ABC stores were more essential than schools and all the Walmarts were germ free!”

    Likely ABC stores make more money direct to Virginia state government, and ABC stores keep the people dumb, drunk and happy, in hard times, a perfect solution for government to do what it wants in bad times, a central driver in Russian political control by despots.

  12. Comment posted on behalf of Matt Hurt:

    Thought you might be interested to see how similar the curves of COVID 19 deaths by age group were to general death rates by age group. 2007 was the most recent data I could find.

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