On a purely statistical basis, I should be dead by now. It’s something I try to keep in mind while reporting on the SARS-CoV-2 pandemic.
Average life expectancy at my birth in 1952 was 68.52 years, and I have now passed that number. Luckily, it is a mean within a range, and I am happy to be in the cohort pushing the mean up instead of dragging it down.
Nature wants to kill us all, because death and birth are the essentials of the natural system. Nature might even have tried to kill us with a SARS-CoV virus more than a century ago, but more on that later.
First a little more about how lucky I am to be here.
As a child, I survived a bout with pneumonia, a respiratory infection that left my mother, a registered nurse, fearing I might die. I remember her telling me I had a temperature of 106 degrees when she found me scratching at the walls in the bedroom.
Then very young, I do still remember the giant spiders I was trying to get off that wall. Those fever-induced hallucinations are among my earliest memories.
Penicillin, still something of a miracle drug in the 1950s, and sulfapyridine, the drug used to treat British Prime Minister Winston Churchill in 1942, probably saved my life, the penicillin being worthy of more credit than the sulfapyridine which was later judged to be minimally effective.
I could make the flat out claim they did save my life, but will not do so because there is no way to prove this, and I rather detest the claims people make to this or that “saved my life” with more conjecture than evidence to back the claim.
That said, I do hope those big, round, “sulfa pills” that looked more like something meant for a horse than a child did play some role in my survival because they were a bitch to choke down. Old Dr. Cook prescribed them along with the injections of penicillin apparently still worried that a drug just coming into widespread use to treat infections might not be as effective as believed.
Whatever cured me, my mother gave thanks to modern medicine, something I would do more than once in the decades to follow. There was a neurosurgeon who miraculously repaired a ruptured disc in the 1980s and gave me back the ability to walk, run and resume the active lifestyle I’ve always enjoyed.
Fate basically blessed me to be born in a time when, thanks almost solely to modern medicine, the annual projections for human life expectancy just kept going up and up and up. Sadly, some family members who came before were not so lucky.
The advances in the treatment of cancer came too late for father, who was just weeks past his 46th birthday when he died in 1974.
My mother would beat the average for her generation and make it to 70 only to succumb to the baggage of a childhood infection. Apparent heart damage linked to an old bout with rheumatic fever born of a scarlet fever infection, a still common childhood disease in this country in the early 20th century, weakened that organ and one night in her sleep it just quit beating.
Scarlet fever is considered of little threat to anyone today. “Antibiotics get you well fast,” according to the Centers for Disease Control, and thus the disease seldom progresses to rheumatic fever.
Everyone reading this can consider themselves blessed to live in this era, pandemic or no pandemic.
Average life expectancy in the U.S. passed 70 in 1962 and hit 75 in 1989. By 2011, kids now entering middle school were looking at, on average, a whole decade of life beyond what had been predicted for those born when I was in 1952.
And those kids still are looking at long lives because Covid-19 – unlike many other infectious diseases that have plagued the world over time – is a disease of the old not the young, unlike pneumonia and various diarrhea diseases that still wreak havoc among the young, especially in poor countries.
The United Nations Children’s Fund says these diseases still kill about 2 million children under the age of five each year. They are the big reason the average life expectancy in more than a dozen African countries is age 60 or lower, and why life expectancy in the majority of them is 65 or lower.
Studies are still ongoing to determine exactly what the pandemic had done to life expectancy in this country, but the best estimate at the moment appears to be that it has been reduced by 1.8 years. This would mean those living in the U.S. are expected to live only a dozen years longer than those born into most African nations.
PBS reported this drop to 77 years of expected life as “the greatest change in the American lifespan since World War II,” but failed to note that the number still tops life expectancy at birth in 1945 by a 12 years.
And how much any of this matters is debatable against the backdrop of the meaning of life: Is it really only about quantity or does quality matter?
75 is enough
In 2018, only a year before the pandemic began, Dr. Ezekiel Emanuel, chair of the department of medical ethics and health policy at the University of Pennsylvania and a globally recognized bioethicist, was arguing quality was of such value that age 75 was a good cut-off point to put an end to major, life-saving, medical interventions.
“Right after I published that article in The Atlantic (in 2014 headlined ‘Why I Hope to Die at 75’), “there was a big advertising campaign by AARP (American Association of Retired People) about how the beat goes on forever and so can my life. Then they show these very vigorous people, not very old, hiking in what looks like Montana. Around the same time, The New York Times wrote a big article on people in their 80s doing things like driving motorcycles and snorkeling. Those people exist, those activities exist, but they don’t show you the flip side.
“In these ads, you didn’t have the full picture of just how many people are in nursing homes, people who were just sitting around in vegetative states or people who are unable to leave their houses. So, you get a much-distorted view of what it’s like to age.”
A lot of those people who were in nursing homes or unable to leave their houses are now dead, and Emanuel would likely get crucified if he were today to repeat his assertion that the quality of life matters more than the length of life no matter how strong his case.
Emanuel was 57 years old when he wrote the Atlantic article, and he admitted his “preference drives my daughters crazy. It drives my brothers crazy. My loving friends think I am crazy. They think that I can’t mean what I say; that I haven’t thought clearly about this, because there is so much in the world to see and do. To convince me of my errors, they enumerate the myriad people I know who are over 75 and doing quite well.”
He even accepted that he might be among the lucky few over “75 and doing quite well,” noting specifically that “as far as my physician and I know, (I am) very healthy, with no chronic illness. I just climbed Kilimanjaro with two of my nephews. So I am not talking about bargaining with God to live to 75 because I have a terminal illness. Nor am I talking about waking up one morning 18 years from now and ending my life through euthanasia or suicide. Since the 1990s, I have actively opposed legalizing euthanasia and physician-assisted suicide.”
He went on, however, to make a very long and thorough defense of his view of quality over quantity that is probably best summed by what he said in the Forbes interview three years later:
“I would say if you look at the world’s literature on creativity and productivity and generating and thinking new thoughts, it’s very hard to find anyone after 75 who has done anything positive. I can think of four people in all of history where we see good evidence of their creativity, productivity and generation of thought post-75. You have Michelangelo, Benjamin Franklin, Goethe, and Verdi. What ends up happening in life is that you switch from being engaged with life to being much more passive.”
In short, the quality of life tends to go off the cliff somewhere at or beyond 75. Any of us could be outliers in this normal progression from birth until the last great adventure into the unknown. At the age of 91, Indiana cyclist Carl Grove in 2019 set an over-90 age record by pedaling 21.44 miles in an hour.
That’s an average speed of over 21 mph. I have some cycling friends a lot younger than 91 who would be hard-pressed to do a steady 20 mph for half as long.
Unfortunately, most of us won’t be outliers. We’re far more likely to hang on until, as Emmanuel put it, we are “no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.”
Every life matters…
And yet, we now find our society responding to a disease that preys primarily on the old by imposing restrictions on the young in the belief that “if we save even one life,” it is a good thing.
As of today, according to the latest CDC figures, 74.4 percent of those dead of or with Covid-19 – the disease caused by the SARS-CoV-2 virus – in the last two years were aged 65 or over. Fewer than 51,000 people under the age of 50 have died in this time. This is about the same number of deaths that would be expected due to suicide among under 50s in a two-year period.
Prior to their deaths, most of the Covid dead were also suffering from what we have come to call co-morbidities, but used to be called simply “chronic diseases:”
“….Conditions that last one year or more and require ongoing medical attention or limit activities of daily living or both,” is how the CDC defined them. “Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States. They are also leading drivers of the nation’s $3.8 trillion in annual health care costs.”
Some of these diseases strike people because they are simply unlucky. One of my best friends, a woman others might have considered a “health nut,” died of breast cancer in her 40s. Bad things sometimes happen to good people.
But a lot of those dying of Covid-19 in the Western world have been medically compromised by lifestyle choices long known to shorten lifespans. Researchers more than two decades ago linked obesity to 280,000 to 325,000 deaths per year in the U.S.
Their peer-reviewed study published in the Journal of the American Medical Association (JAMA) in 1998 called obesity “a major health problem in the United States.” Nobody seemed to pay much attention. In the years that followed, the percentage of Americans who are obese just kept going up.
According to the CDC, the 22.3 percent of Americans who were obese in the period from 1988 to 1994 had nearly doubled to 39.8 percent by 2015-16. The pandemic has since taken a heavy toll on these people.
Obesity was identified as “a risk factor for both hospitalization and death, exhibiting a dose-response relationship with increasing body-mass index category,” the CDC was reporting as early as December 2020.
It was especially dangerous among the minority of younger people dying from Covid-19 – that 25 percent of people under age 65. Obesity was found to double their chances of death.
The story was and is much the same for deaths associated with what might be called lack of general physical fitness, which has been in decline in the U.S. for decades. Daniel Lieberman, an evolutionary biologist at Harvard, notes that we ignore at our own expense the reality humans evolved as an animal constantly on the move.
Exercise stresses the body, requiring it to spend significant resources on repair after each session to patch tears in muscle fibers, remedy cartilage damage and heal microfractures, he told The Harvard Gazette. As a result, the body’s natural antioxidants and anti-inflammatories are activated, blood flow increases, and the body undertakes cellular and DNA repairs shown to lower the risk of diabetes, obesity, cancer, osteoporosis, Alzheimer’s, and depression.
And now, it has been shown to lower the risk of Covid-19.
The research on this subject in the time of Covid is not couched in terms of how much greater the chances of severe disease for those who are out of shape, but instead in terms of how much better off the physically fit. But this is nothing but the opposite end of the same stick.
When Canadian researchers examined the fitness relationship to Covid-19 last year, they found that when cardiorespiratory fitness “was categorized as high, moderate, and low, compared to individuals with low fitness, those with moderate fitness had a 57 percent lower risk and those with high fitness had a 63 percent lower risk of dying from Covid-19.
Their peer-reviewed results were published at PLOS-One. That 63 percent reduction in risk – which fell in a range that could go as high as 85 percent – might help explain why the professional athletes who have caught Covid-19 seem to have had minimal issues.
Consider hard-luck cyclists Fernando Gaviria, who Cycling News today reported “will not ride the UAE Tour after testing positive for Covid-19 for a third time in two years. The Colombian sprinter won two stages at the recent Tour of Oman and was due to travel to the UAE for Sunday’s first stage but discovered he was positive in a pre-race protocol PCR test.”
The good news there is that despite twice fighting off Covid-19 infections, Gavira shows no signs of any long-term respiratory effects. Nobody wins world tour bike races if their respiratory fitness is in any way compromised.
Nobody can outrun death, as Lieberman notes, but studies of the world’s last active hunter-gatherers, who are constantly on the move, shows that their “healthspan” – the number of healthy years of life – nearly matches their lifespan.
The value of exercise is further backed up by a long-running study of 21,000 Harvard graduates that has found that moderate to vigorous exercise – that which burns 2,000 or more calories per week – done on a regular basis lowers death rates 21 percent for those ages age 25 to 49, 36 percent for those 50 to 59, and 50 percent for those 70 to 84.
- And those percentages were arrived at pre-Covid. Given the protective value of overall good health in the face of the pandemic, the percentages are surely even higher today.
Much of this readily available data on who dies of Covid-19 and why has been largely ignored by the medical community and a mainstream media tied to the if-it-saves-even-one-life dogma.
Thus the fixation on how Covid-19 can kill anyone, or as the Washington Post headlined back 2020 “Hundreds of young Americans have now been killed by the coronavirus, data shows. “
Yes, Covid-19 can kill anyone, and hundreds of young Americans did die. But they were among tens of thousands of young Americans who die in this country every year. The CDC reports about 16,000 Americans under the age of 24 dead in accidents, the leading cause of death for young people, in 2018.
Nearly 7,000 more under age 24 committed suicide, and more than 5,000 died in homicides, the third leading cause of death for those age 15 to 24. Young, black men have been dying in homicides at a staggering rate, primarily in America’s inner-cities for years, and society as a whole doesn’t seem to care enough to do much about it.
The CDC data now shows 6,503 people under the age of 29 dead from Covid-19 since the pandemic began in 2020. That two-year death toll is less than the number of Americans under 24 who died in homicides over the course of those two years, and significantly less than the number of those who committed suicide in 2018 alone.
And today there are growing concerns about what the lockdown approach to the pandemic has been doing to the mental health of people young and old. Suicides among black residents of Maryland are reported to have gone up 94 percent.
Why wouldn’t it be? Government policy has made the pandemic about as stressful as possible for everyone, which was the biggest concern of Dr. Tom Inglesby, the director of the John Hopkins Center for Health Security, and colleagues who authored a 2006 paper on pandemic preparedness published in the journal Biosecurity and Bioterrorism: Biodefense strategy.
The study was aimed at preparations for what might be done to help handle a new influenza pandemic on the order of the Spanish flu, which remains a global disaster far worse than Covid-19, but the recommendations apply equally to any pandemic caused by a respiratory virus such as SARS-CoV-2.
The study is an interesting read now given its recommendations on the useful and the useless. The study highlighted the value of and need for vaccines to try to minimize the death toll, and underlined the effectiveness of isolating the sick to slow the spread of the disease.
It also tossed cold water on a lot of other activities that have been taken since the SARS-CoV-2 pandemic began in early 2019:
- Lockdowns? “There are no historical observations or scientific studies that support the quarantine by confinement of groups of possibly infected people for extended periods….”
- Travel restrictions? “…Closing airports and screening travelers at borders have historically been ineffective.”
- Prohibiting social gatherings? “There are…no certain indications that these actions have had any definitive effect on the severity of an epidemic.”
- Social distancing? Likely helpful but hard to do in many situations, most especially the workplace.
- Masks? “In Asia, during the SARS (SARS-CoV-1) many people in the affected communities wore surgical masks when in public. But studies have shown that the ordinary surgical mask does little to prevent inhalation of small droplets….The pores in the mask become blocked by moisture from breathing, and the air stream simply diverts around the mask.”
- Personal protective equipment (PPE)? “There are few data available to support the efficacy of N96 or surgical masks outside a healthcare setting. N95 masks need to be fit-tested to be efficacious and are uncomfortable to wear for more than an hour or two.
- School closures? “The impact of school closings on illness rates has been mixed,” and there are serious social consequences at multiple levels.
None of the research done since the latest pandemic began has done much to alter those conclusions. Of the two random controlled trials (RCTs) conducted to study masks, one could find no benefit and the other reported a small benefit.
Pandemic models on the other hand have made claims to success from all sorts of normalcy destroying, so-called non-pharmaceutical inventions (NPIs) from masking to school closings while pretty much just proving that if a modeler makes the right assumptions and does enough math it is possible to prove pigs can fly.
Meanwhile, the modelers and their acolytes have basically managed to do a masterful job of undermining what the 2006 study, at its very end, identified as “An overriding principle:
“Experience has shown that communities faced with epidemics or other adverse events respond best and with the least anxiety when the normal social functioning of the community is least disrupted. Strong political and public health leadership to provide reassurance and to ensure that needed medical care services are provided are critical elements. If either is seen to be less than optimal, a manageable epidemic could move toward catastrophe.”
In many places in the U.S. and the Western world, the response of government entities has been to maximize – not minimize – anxiety. Canada is now apparently so close to civil war that Prime Minister Justin Trudeau has decided it necessary to declare martial law and label those opposed to government policies “terrorists.”
Well, obviously because “if it saves even one life,” this must be done.
Maybe the time has come for everyone to accept that life is a death sentence. We are all destined to die.
We can take risks that increase the odds we die sooner rather than later. We can embrace lifestyles that maximize our chances of living longer rather than shorter. But we’re all gonna die, and there’s nothing at all we can do about that twist of fate called “bad luck.”
And yet there are those who appear to want to embrace the hysteria and oppose any sort of return to normal.
“There Is Nothing Normal about One Million People Dead from COVID,” Scientific American of all magazines headlined at the start of the month. “Mass media and policy makers are pushing for a return to pre-COVID times while trying to normalize a staggering death toll.”
Beneath the headline, a card-carrying member of the mainstream media – Steven W. Thrasher, a professor at the Medill School of Journalism and the Institute of Sexual and Gender Minority Health and Wellbeing at Northwestern University, a former staff writer at the Village Voice and “writer-at-large” (whatever that is) for The Guardian – proclaimed that “sometime in the next few weeks, the official death toll for the two-year COVID pandemic in the U.S. will reach one million….This is an unfathomable number of people dead, yet, mass media are downplaying it.”
No, it’s not.
In the first place, mass media in the U.S. can hardly be accused of “downplaying” anything related to Covid-19, but more importantly, Thrasher’s conclusion as to what is fathomable and what isn’t ignores the reality of death in this country.
Millions of people die every year. The total in 2018, the year before the pandemic began, was over 2.8 million. Double that to get a two-year figure for comparison sake, and the number comes to near 5.7 million.
So Covid-19 was involved in one in about six deaths in the years that followed, but how many people actually died from Covid-19, and how many died from their pre-existing illnesses compounded by Covid-19 is far from sorted out of as this time and will likely be a subject for studies for years and years to come.
Consider the numbers reported earlier here on obesity. If one takes the upper range of estimated annual deaths due to obesity – 350,000 – and doubles that to get a two-year aggregate, there are 700,000 people dead of obesity, which makes the Covid number a whole lot more fathomable.
Or consider heart disease deaths, many of which are preventable by lifestyle changes, or cancer deaths. There were more than 655,000 of the former and just shy of 600,000 of the latter in 2018, according to the CDC.
Thus the two-year equivalents would come to roughly 1.3 million and 1.2 million. Take this and consider that large numbers of people with obesity, heart disease and cancer have died of or with Covid-19 since the pandemic began and the number of dead in the pandemic looks even more fathomable.