Lifespan jumps up for most
Only time will tell how history assesses the pandemic that terrified Americans in the early 21st century, but a few things are already becoming clear.
For many of those incarcerated while the SARS-CoV-2 virus was at its peak, prison was a death sentence. And for the rest of the country, at the population level at least, the pandemic was nowhere near as bad as first feared.
As the year draws to a close, we should all still living give thanks for the latter.
From then on, it increased steadily until hitting age 78.8 in 2010 after which it pretty much flat-lined with the age bouncing between 78.8 and 79 until it finally jumped up to 79.1 in 2019 only to come crashing down with the arrival of the pandemic.
Our World in Data, which uses World Health Organization data, and the U.S. Center for Disease Control (CDC) show slightly different decreases in life expectancy during the pandemic – 1.9 years, according to the former, and 2.4 years, according to the latter – but either way the drop was a quarter to a less than a third that of the Spanish flu by direct measure.
In relative terms, however, the difference is stark. The Spanish flu reduced the American lifespan by more than 14 percent, the SARS-CoV-2 pandemic, using the CDC’s estimate, by about 3 percent.
And all early reports have the trend tracking quickly upward again now.
“U.S. life expectancy at birth for 2022, based on near-final data, was 77.5 years,
an increase of 1.1 years from 2021,” the CDC reported last month. “This increase does not fully offset the loss of 2.4 years of life expectancy between 2019 and 2021 that resulted mostly from increases in excess deaths due to the COVID-19 pandemic.”
But the new number does put the population back near the 77.6 level the CDC was bragging about as “an all-time high” in 2005.
That warning can now be viewed as a forecast of the crisis that was to come when a previously unknown, airborne virus emerged from China in 2019. The chronic diseases already stalking Americans in 2005 would prove especially deadly with the arrival of SARS-CoV-2 caused Covid-19.
Deadly burdens
Another study published in the journal PloS One in 2021 reported the pandemic virus put people with chronic kidney diseases (CKD) at extreme risk as well.
Blood pressure regulation problems – both low and high – are strongly associated with Parkinson’s and high blood pressure (hypertension) along with age was one of the biggest comorbidities cited as increasing the risk of death from Covid-19.
“In the United States…49.7 percent of COVID-19–hospitalized patients had hypertension. It was reported that a twofold to threefold higher prevalence of hypertension was a risk for progression to critical illness or even death in the population.”
Huge numbers of Americans, especially older Americans, were then suffering from and still suffer from high blood pressure. The CDC has estimated it affects 50 percent of the male population and 44 percent of the female population with black males at even greater risk and” with only one in five aware they have a problem.
Hypertension is especially prevalent in the Deep South with the CDC reporting “Mississippi, Louisiana, Arkansas, Oklahoma, Texas, Kentucky, Tennessee, Alabama, Georgia, South Carolina and North Carolina” among the states with the highest prevalence.
Mississippi’s per capita mortality for Covid-19 in 2020 trailed only that of New Jersey and New York – the original epicenters for Covid-19 deaths – plus South Dakota at the start of the pandemic, but by 2021 – despite the annual death rate increasing from 123.5 per 100,00 to 146.3 per 100,000 in Mississippi – it had slipped to fifth on the mortality list as the disease ravaged the South.
Oklahoma, according to CDC data, had the highest death rate in 2021 at 158.8 per 100,000 with Alabama, Texas, West Virginia and Mississippi close behind. West Virginia is the only of those states the CDC failed to point out specifically as suffering a high burden of hypertension in 2021, but a 2018 study published in the Journal of Clinical Hypertension ranked the state the worst in the nation for hypertension among men.
But the data on hypertension might offer a different explanation for why the death rate was so high in some conservative states. Wyoming was, along with West Virginia, identified by NPR as one of those hard-hit, Trump-supporting states.
According to the Wyoming Department of Health, 30 percent of Wyoming residents have been told by a doctor that they have high blood pressure, and according to the CDC, “about one in five adults with high blood pressure is unaware of it and would not report having it.”
A rural Western state with a tiny population, Wyoming is well known to be facing a shortage of healthcare providers. It would not be surprising if the rate of hypertension in the state is near or above 50 percent given unreported cases, and hypertension continues to be linked to increased Covid-19 deaths even after vaccination.
A fundamental health issue
Reporting in the journal Hypertension last year, doctors from the well-known Cedars-Sinia Medical Center wrote that “our findings reveal a persistent and marked association between hypertension and risk for severe Covid-19 illness, even among a fully vaccinated patient population. The Omicron variant of SARS-CoV-2 has led to overall less severe Covid-19 illness in most affected individuals when compared with prior variants, with morbidity and mortality even further reduced by receiving three doses of vaccine.
“(But) our findings were consistent with prior studies demonstrating greater hospitalization risk with advanced age and time since the last vaccine dose. Even when controlling for these and other clinical variables, the risk of hospitalization related to breakthrough Omicron infection was more than doubled by the presence of hypertension.”
Hypertension is itself strongly linked to the American Slothdemic that nobody really wants to take seriously in a country where “comfort” is largely defined by never breaking a sweat.
Nonpharmacological practices morphed into non-pharmacological interventions (NPIs) after the pandemic began although exercise was rarely mentioned as one of the most important of these.
Chief among the NPIs pushed by the federal government were social distancing, which clearly works to protect people from any aerially transmitted virus because you can’t get infected unless you get near someone who has exhaled the virus into the air; hand washing, which proved to be only minimally important this case; and masking, the effectiveness of which is still being debated.
America’s prisons, where people are closely monitored and controlled, could be considered a laboratory for examining how well masking worked. The federal Bureau of Prisons in late November ordered that “both inmates and visitors must wear appropriate face coverings (e.g. no bandanas) at all times and will perform hand hygiene just before and after the visit. Tables, chairs and other high-touch surfaces will be disinfected between visitation groups; all areas, to include lobbies, will be cleaned following the completion of visiting each day.
“In addition to screening and testing inmates, temperature checks and COVID-19 screening is being conducted for staff, contractors, and other visitors to our correctional institutions, with those who register a temperature of 100.4° Fahrenheit or higher denied access to the building.”
A study published in Science Advances at the start of this month only underlined the early findings. It reported that prison “mortality increased by 77 percent in 2020 relative to 2019, corresponding to 3.4 times the mortality increase in the general population, and that mortality in prisons increased across all age groups. Covid-19 was the primary driver for increases in mortality due to natural causes.”
The 2021 study noted that the “higher age- and sex-adjusted mortality from Covid-19 in Bureau of Prisons likely reflects the high rates of underlying health conditions, especially at younger ages, which increase the risk of severe illness from Covid-19.”
High rates of underlying health conditions were and remain a Covid-19 problem outside as well as inside American prisons. This has led all sorts of nongovernmental organizations (NGOs) to lobby Americans to change their lifestyles.
Unfortunately, Americans appear to be largely ignoring the message and becoming ever more sedentary instead of getting off their asses and moving. The latest report from the CDC says 120 million – or 48.1 percent of the nation’s population, up from the 46 percent in 2018 – now suffer from high blood pressure.
“In 2021, hypertension was a primary or contributing cause of 691,095 deaths in the United States,” that report adds. That’s almost twice the number of deaths in which Covid-19 was implicated in the same year.
The government’s response to the pandemic, however, was not to bluntly tell Americans to improve their fitness or risk death; it was to order them to get vaccinated. The vaccination effort has now been declared a big success, but only time will tell if that is proven true.
As with the many influenza viruses that have emerged over the decades, SARS-CoV-2 proved resistant to the vaccines. Because of this, the vaccines never stopped the spread of the virus as U.S. Covid-czar Anthony Fauci promised and how much they served to reduce the death rate at the population level is destined to be debated in the future.
On an individual level, they surely saved some people, but at the population level, it is harder to tell. Many of those most vulnerable to SARS-CoV-2 died early in the pandemic; the emergence and eventual dominance of the Omicron variants made the disease itself less deadly, and the vaccines, ironically, proved most effective in the physically fit and the young, who were already at low risk of death from SARS-CoV-2.
Though “vaccine efficacy or effectiveness estimates against severe disease remained greater than 70 percent over time,” according to a system review reported last year, the real-world significance of this varied greatly by age.
Even among those 30 to 39 with a median IFR of 0.011 percent, a 70 percent improvement would boost their chances of surviving Covid-10 to 99.9 percent, which is a pretty small improvement compared to the 99.8 percent chance without the vaccine.
And these IFR rates are calculated for age groups as a whole.
The odds of survival only increase for fit people in all age groups because exercise is essentially a vaccination against all diseases. Among those under age 50 in the U.S., almost all who died were unfit and already burdened by one or more comorbidities, many times severe ones.
When it came to this pandemic, the real take-home message for the nation should have been and should be that it pays to stay fit. But most Americans are unlikely to want to hear this because exercise requires effort, and the U.S. has largely become a technocracy wherein life is to be made constantly better, and all problems solved, with new technology.
Thus machines have come to dictate socio-political policy though the takeover is seldom noticed.
On the political right in the country, there is little to no support for altering the human environment to encourage people to walk or bicycle more to improve health as part of everyday transportation for fear of offending the motorhead crowd even if getting Americans fitter and, as a result, thinner would save the country an estimated $173 billion per year, according to the CDC.
On the political left meanwhile, there is little or no support for telling people to take charge of their health because the political base there has been built on the idea of caring for the unwashed masses rather than encouraging them to help care for themselves.
Were the late President John F. Kennedy – he of the inaugural speech telling Americans to “ask not what your country can for you; ask what you can do for your country” – to return tomorrow, he would be shocked to see what has become of these now unUnited States since his assassination. He would also be likely to be immediately ostracized by new the Democratic party for ignoring the needs of the downtrodden and underprivileged by suggesting everyone should be a party to efforts to make the country a better place for all.
Kennedy, it should be noted, was the last president to seriously take on the issue of the nation’s rapidly declining fitness after the end of World War II.
“Kennedy’s success was not just a matter of bureaucratic changes. Unlike his predecessor, Kennedy addressed the issue of physical fitness frequently in his public pronouncements and assigned new projects to the council. Perhaps his most famous intervention in the area of fitness was the fifty-mile hike.
“The real impact of the fifty-mile hike was with the public at large. Many Americans took the hike as a challenge from their president. The Kennedy council capitalized on this enthusiasm with a national publicity campaign on physical fitness. The campaign was organized, extensive, media-savvy, and above all, countrywide.”
Baby boomers from the 1960s who are still around today will likely remember this because the 50-mile hike was for a brief time the talk of the nation. In the book “Mrs. Kennedy and Me,” retired Secret Service agent Clint Hill writes fondly about Jackie Kennedy and the president roping him into doing the 50 miles to provide security for Prince “Stash” Radziwill, Mrs. Kennedy’s brother-in-law, and the President’s good friend Chuck Spaulding, an investment banker and JFK’s former Yale roommate.
It took them 20 hours to cover 50 miles with the President and First Lady several times visiting to check on their progress.
“Somewhere around the 45-mile point, President and Mrs. Kennedy returned again to encourage us. Finally, at about eight o’clock on the evening of February 23, we reached the fifty-mile point, and I breathed a sigh of relief. The adrenaline that had been flowing for the past twenty hours now stopped and I could feel the effects. Aches and pains in my back and legs, blisters on my feet. But, by God, we had finished.”
For one short time in U.S. history, walking those 50 miles as a show of fitness actually became a fad in the country, and today many Americans are challenged to walk 50 yards across a parking lot from their car to the grocery store.
During the pandemic, sadly, too many of them paid the ultimate price for the resultant loss of fitness.
Categories: Commentary
If one wants to increase the odds for a longer life then, Hong Kong or Switzerland, among 45 other countries, might be better choices The ‘average life expectancy’ in the US doesn’t reflect the average between sexes, the difference almost 5 yrs between the sexes. That doesn’t leave much time between a late retirement date and an average mortality date; so it would be better to get that fishing trip in sooner , than later. Based on personal (unscientific) observation, other than luck of the draw, overuse of alcohol will tend to shorten length of life and inattention to one’s physical well being will do the same. IMO, the trajectories for both willl start getting set in mid 40’s. Unless ‘fitness’ is appraoched methodically and strategically,, it may not happen accidently. The result is that people ‘settle’ into their ways and refuse or neglect to adapt , and thus shorten their lives or dimiish their quality of life uneccesarily. It’s as much a mental process as a physical process.