Increase in Deaths of Despair due to our COVID response is likely greater than lives we are saving with the response

The Well Being Trust and the Robert Graham Center have jointly released a report estimating the number of excess Deaths of Despair — defined as suicides and deaths due to drug and alcohol abuse — arising from the unemployment and social isolation arising from our COVID Response.  They really only focus on unemployment and do not consider the unprecedented social isolation, uncertainty, and disruption of routines that have been inflicted on all of us, because there is good data on the correlation of unemployment rate with deaths of despair, but the social isolation that has been inflicted on us is unprecedented. So their estimates are certainly underestimates, and possibly large underestimates.
Nonetheless, they estimate a range of 27,644 to 154,037, with a median of about 68,000 excess deaths of despair.   The median age of the deaths of despair is about 55, with a life expectancy of about 26 at that age.  So 68,000 persons x 26 years per person = 1,630,000 person-years of life expectancy lost.

                How does that compare to the lives saved by our COVID response? I estimate that the involuntary aspects of our COVID response (everything except quarantining the elderly and at risk and quarantining those infected or believed to be infected) will save only 668,000 person years of life, less than half of the increased deaths of despair.   This is based on an estimate that the involuntary aspects of the COVID response will save 138,000 lives, the same number of lives that will be lost by August 1 according to the University of Washington projections.

138,000 total persons

                88% age 70+ with a life expectancy of 3 years (44% 1-year and 44% 5 years)

                                                                                                                   = 364,000 person-years

                10% age 50-69, life expectancy of 15 years                              = 207,000 person-years

                2% under age 50, life expectance 35 years                                = 97,000 person-years

Total                                                                                                           = 668,000 person-years

Another way to look at it is the cost and benefit to the under-age-70 group, who is really the only group whose lives are being saved by the restrictions, because the over-age-70 and others at high risk are already motivated to quarantine themselves and wash their hands.  The overall case fatality rate (percent of those infected who die) is about 0.5% and about 90% of the dead are either over age 70 or 50-69 with serious underlying health issues that put them at significant risk of death without COVID and who would be motivated to quarantine themselves without the government ordering them to do so.  Among the under-age-70 population with no obvious health risks who would not quarantine themselves, the case fatality rate is about 0.05%.  Probably if we had done nothing, about 40% of the population would be infected with Sars-COV-2, and 0.05% of the under-age-70 who are infected would die (and about half of those dead being age 60-69), which would be 49,000 persons dead under age 70.  The overall person-years of life expectancy lost among the under-age-70 would be 950,000.

           Our restrictions are not saving all of those lives. In fact, according to many of the advocates for these restrictions, ultimately almost everyone will be infected anyway, so they are conceding that they are saving no lives at all.  But let’s say the involuntary restrictions ultimately prevent infection in 40% of the under-age-70 population.  Then it would save 950,000 person-years of life expectancy, again far less than the at least 1.63 million person-years of life lost due to excess deaths of despair.

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