COVID dead have median life expectancy had they not contracted COVID of less than 1 year, average of about 4 years

How much remaining life span do the people dying of COVID have?  To know how much good our COVID restrictions have accomplished, we would like to know not only how many COVID deaths the restrictions have prevented but also how much longer the COVID dead would have lived if they had not contracted COVID.

I have said in conversations with people about COVID that we are all going to die someday, and often people get offended when I say that.  But I do not mean to be offensive and I am not being flippant.  We really are all going to die someday, and someday is probably sooner than we like to think.  Most great religions and spiritual traditions teach that an awareness of our mortality and the fact we will die is one of the most important, if not the most important, lesson we need to learn to live an ethical and happy and grateful life.  The Buddhists have a tradition of meditating on your own mortality and imagining yourself as a rotting corpse.  Jesus said, “Leave the dead to bury the dead.”

So again, how long would the people dying of COVID have lived if they had not contracted COVID, and when we prevent a COVID death, how many years of life is that saving?  The information in the top three rows of this table is relevant to that calculation and the bottom three rows present our conclusions.

The COVID dead are not only old and sick relative to the population as a whole, they are actually somewhat older and sicker than people who die as a whole.  For the overall dead, 99% do not have a pre-existing serious health condition.  For the overall dead in the U.S., only 80% are age 60 and up, whereas 92% of the COVID dead are.

From their age alone, a paper in the Proceedings of the National Academy of Sciences (USA) calculated the COVID dead have 11.7 years of life expectancy remaining at the time of their deaths, on average (reference 1). But that did not consider their health, and it is clear that people dying of COVID are in much worse health than average for their age.  For one thing 99% of them have a serious pre-existing condition. Secondly, the fact that they died of COVID shows they were in worse health than average for their age, since at every age the large majority of infected people survive COVID, and it stands to reason that those who survive COVID were in better health on average, and therefore had a longer actual life expectancy, than those of the same age who die from it.  Even in the age 85+ group in the U.S., we at COVID Sanity calculate that the COVID infection fatality rate (IFR) is 9%.  No one would dispute that the 91% of age 85+ who survive COVID were in better health (on average, although not in every case) prior to COVID infection, and therefore had a longer actual life expectancy, than the 9% who die of it.  Likewise for every other age group.

In Minnesota, 70% of the COVID dead lived in a long-term care facility.  A study in Sweden found that the median life expectancy of the long-term care COVID dead is 5 to 9 months (reference 2). The median length of stay in a nursing home in the U.S. is 5 months until death and the average is 13.4 months (reference 3). If the average stay from entry is 13.4 months, the average for a current resident should be about half that or 7 months.  It should be noted that the term “long term care facility” is broader than nursing homes; it includes assisted living facilities and hospices as well. The assisted living residents would have a longer life expectancy than nursing home residents, and hospice patients would have a shorter life expectancy.  But still, it appears that the long-term care residents dying of COVID have a median life expectancy of certainly less than a year and probably about 7 months.  The average or mean is longer than the median, but the average is also almost certainly less than a year.  (To refresh your memory, “median” is the value where 50% of the numbers are higher and 50% are lower, whereas the average is the sum of all individual values divided by the number of individual values.  In this series—1, 2, 3, 4, and 20—the median is 3 but the average is 6.)

The median person dying of COVID in Minnesota is an 84-year-old male living in a long-term care facility with serious preexisting conditions who is sicker than the average 84-year-old man living in a long-term care facility (again, because those who die of COVID are sicker than those of the same age who survive it).  So that person has a life expectancy of less than a year in reality, considering his health, whereas the average 84-year old has a life expectancy of 6 years.  The actual life expectancy considering his health, therefore, is less than 20% of his age-based life expectancy.

The PNAS article calculates the average age-based life expectancy of the COVID dead as 11.7 years.  But their actual life expectancy considering their health is certainly much less than that.  It is not possible to precisely calculate that, but when 50% of the COVID dead had a life expectancy of less than a year and the median person dying of COVID had a life expectancy considering his health status that is less than 20% of that considering only his age, the average we estimate is about 4 years or one-third of their age-based life expectancy.

References.

  1. Goldstein JR, Lee RD. Demographic perspectives on the mortality of COVID-19 and other epidemics. Proc. Natl. Acad. Sci USA September 8, 2020 117 (36) 22035-22041; first published August 20, 2020; https://doi.org/10.1073/pnas.2006392117
  2. Stern C and Klein DB. Society. 2020 Jul 19 : 1–12. https://doi.org/10.1007/s12115-020-00508-0 [Epub ahead of print] PMID: 32836557.
  3. Kelly, A. et al. (2010) Length of Stay for Older Adults Residing in Nursing Homes at the End of Life. J. Am. Geriatrics Soc. 58:1701-1706. https://doi.org/10.1111/j.1532-5415.2010.03005.x