The Washington PostDemocracy Dies in Darkness

The hidden cost of the coronavirus death toll to younger Americans

In this Aug. 31 photo, a covid-19 patient tended to in the intensive care unit at St. Luke's Boise Medical Center in Idaho. (Kyle Green/AP)

Since the coronavirus emerged last year, there’s been a repeated line of argument aimed at minimizing it that can be summarized succinctly: Most people who contract it live.

That, happily, is true. The majority of people who contract the virus live, particularly younger people. Ironically, that may also have helped increase the virus’s death toll: a deadlier virus might have led to fewer people who went on to help spread it.

But the argument suffers from two flaws, one obvious and one not. The obvious one is that 675,000 dead Americans, more than 1-in-500 alive last year, is a brutal toll for the country to have paid. The 1 or 2 percent who do die of the virus add up to a lot when indifference to the virus is used as an excuse not to try to contain it.

The less obvious point is that, while it is true that covid-19 disproportionately kills older Americans, it has also killed a lot of younger ones. And while all of those deaths are tragic, the tragedy is different when a 40-year-old dies than when someone in her 90s does. This was another weird argument that has cropped up: a lot of those who died were going to die soon anyway, as though that makes it all right. But a lot of those who died also might have expected to have had years or decades of life in front of them — a future that vanished when they succumbed to covid.

There have been efforts to measure that loss of prospective life, including a new study from a group of researchers from the University of Illinois at Urbana-Champaign and the University of Southern California. They looked at pandemic-related deaths — both directly from the virus and excess deaths probably related to the pandemic — from March of 2020 to March of this year. They estimate that the pandemic cost Americans a cumulative 10.68 million years of life over that period. Adjusted to the estimated individual risk of those who died, as the researchers prefer to consider the value, the number drops, but only slightly.

The pandemic cost Americans over nine million years of life.

This calculation is useful not only for measuring that death toll as a figure other than just a tally of bodies but also because it allows us to better consider where the toll of the pandemic has been paid. For example. we can consider the total number of deaths and the total number of years of life lost as rectangles, the total area of which serves as the death toll (about 740,000) or the cumulative number of years of life lost (that 9 million figure). Here’s how those rectangles are broken up by age groups and by groups divvied up in race, age and gender.

The best place to start is with those lighter-colored squares in the bottom set of rectangles. In the rectangle at left, the number of deaths, the light-colored, under-65 pool makes up a small part of the total rectangle. But when considering years of life lost, it makes up more than half of the total. You can see in the top two rectangles how the under-55 deaths make up a corner of the total in the first rectangle and then about a third of the total in terms of years lost.

This makes sense, obviously: younger people will have lost more years of life. But the point is that waving away deaths as unusual or weighted toward older Americans downplays how much potential is lost among the other deaths.

You’ve likely also noticed the broad disparities by race and gender in the distribution of deaths and years-of-life lost. We can visualize that discrepancy by looking at the number of deaths and years-of-life-lost relative to the population of each group. The researchers also considered quality-adjusted life-years, a measure that takes into account the projected quality of life of those who died. The relationships are generally, but not always, similar to the years-of-life-lost metric.

We can see that the largest orange circle is for those 85 and up; that group saw the most deaths per 10,000. The group also had the highest total population-adjusted loss of years of life. But it was those 75 to 84 who saw the biggest relative loss of quality-adjusted life-years.

On the right, the stark differences in race and gender are apparent. No group lost more years of life relative to population than Hispanic men aged 65 and over, though Black men in that age group weren’t far behind. For every 10,000 Hispanic men in that age group, the researchers estimated that about 2,000 years of life were lost.

We can visualize this another way, comparing deaths (left to right) with years of life lost (bottom to top). When looking at age, we see the age groups curve up and to the right: fewer years of life lost as age groups increase.

Again, though, overlapping race and gender makes a big difference. Black and Hispanic men under the age of 65 actually saw more loss of years of life than White women aged 65 and over, a sign of the disparity in the effects of the disease. That’s reinforced in the older age group, too, clearly: Black and Hispanic men there saw far more loss of years of life than Whites.

Most people who contract the virus do live. Younger people are less likely to die than older people. But a huge part of what America has lost in this pandemic is the future lives of those who succumbed to the virus, a loss that skews back to the lower end of the age spectrum and affects non-White Americans more dramatically.

In other words, it is not something to be readily dismissed.

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