On coronavirus and what actually kills Americans

Today I’d like to explore some statistics around potential COVID-19 fatalities and the various ways that Americans typically die. This can help us understand exactly how afraid we should be of this novel virus at every age.

As anyone who reads my posts knows, I’m pretty obsessed with quantifying risk. Spending the last 20+ years of my professional career knee-deep in data as a market researcher, entrepreneur, and investor made me this way and gave me the necessary statistical skills.

What prompted this post was a simple personal question: How worried should I be about COVID-19 compared to all the other ways I might die this year?

The CDC provides a treasure trove of US fatality statistics via their publicly accessible WISQARS system, so I started by pulling a report with data around US fatalities to better understand how Americans typically die in a year and analyzed it.

Here is what I discovered about US fatalities by age range:

The first implication is that being old is really dangerous and being young is really safe. In fact, there were so few deaths in the CDC’s child, teenager, and early 20’s age categories that I had to clump them all together into “<24 years” just to make them visible on this chart.

As you’ll see above, the vast majority of the fatalities happen over the age of 55, and the most of those fatalities are caused by just two things: heart disease and malignant neoplasms (i.e., cancer)

With older folks so dominating this chart, I had to force stack the bars to 100% to make the fatality causes for the younger age cohorts legible:

Now we can see that when younger people die, there are three dominant causes: unintentional injury, suicide, and to a lesser extent, homicide. While young people very rarely die, when they do, it’s often gruesomely.

Now for the question of the day: How will COVID-19 fit into this picture?

We don’t yet know how many COVID-19 fatalities there will be this year, but we do have a good understand of how these fatalities will be distributed by age group as I discussed in my post On coronavirus vs the seasonal flu. So, if we’re willing to make an assumption around total COVID-19 fatalities, we can approximate how these charts might look at the end of 2020.

I think the result will be surprising to most people.

Let’s assume that COVID-19 tragically claims 200,000 American lives this year, which is worse than the current 147,000 estimate by the IMHE, the forecasting model relied upon by the White House. If that’s the case, here’s how US fatalities by age range might look in 2020:

COVID-19 only becomes visibly noticeable in the 65+ age category, and even then, it remains dwarfed by both heart disease and cancer, but still kills more than Alzheimer’s or cerebrovascular (i.e., stroke)

One caveat is that I had to group all 65+ years COVID-19 fatalities into a single group to match with the WISQARS data, but the virus is actually far more fatal to an 85 year-old than a 65 year-old. Also bear in mind that the temporal distribution of COVID-19 deaths is much different — they come on strongly and pass quickly in one or two waves, whereas the non-infectious disease causes are spread more evenly throughout the year.

If I again force stack the bars to 100% to make the fatality causes for the younger age cohorts legible, it becomes clear that COVID-19 is virtually a non-issue for the under 65 folks compared to other causes (again, assuming its final death toll is 200,000 American lives this year):

Personally I fall into the 35–44 year age group, and for my cohort, heart disease and cancer are far more dangerous in this scenario, each at about 8x the fatality risk of COVID-19. Suicide has 5.7x the fatality risk, homicide 2.5x the fatality risk, diabetes 1.7x the fatality risk, and influenza/pneumonia 0.7x the fatality risk. But what I really need to worry about are cars, drugs, and ladders… unintentional injury has 17x the fatality risk for my cohort.

All of the diseases above are at least moderately preventable with sufficient focus. Heart disease and many forms of cancer risk are heavily impacted by diet, stress, exercise, drinking and smoking behavior. Suicide and drug overdose (a common cause of unintentional injury) are symptoms of poor mental health, homicide risk is influenced by socioeconomics, and diabetes by obesity.

To see how worried you should be about COVID-19 compared to other death causes for your age group, just look above at the size of the bright yellow bar compared to the others for your cohort.

It’s important to keep vigilant and protect yourself and your loved ones from fatal threats, but you can only do so if you focus on the right ones. Stay healthy and well.

Techie and investor. Founder at Rebel Fund and previously Pioneer Fund. Chairman of Infosurv/Intengo and CrowdMed (YC W13). Former Bain consultant. Data nerd.

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