Quarantine Day 31: What Would Actuaries Say?

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There’s an old joke that engineers are accountants who lack social skills, but where then, does that leave actuaries who are somewhere between smart-witted accountants and savoir faire engineers? Actuarial Science deals with evaluating risks and maintaining the economic stability of insurance or financial organizations. Actuaries use mathematics, statistics, and probability to anticipate future events and take preventive measures. While the work actuaries do is often considered cold and abject, it is nonetheless necessary for making informed decisions.

The United States has approximately 328.2M citizens with an average lifespan of 79 years (76 years for men and 81 years for women). According to IndexMundi, and the CDC, approximately 2,863,859 Americans die each year from something. Of the top ten causes, only two are non-health related; accidents and suicides. Approximately 180,000 Americans die each year from accidents and about 50,000 die from suicide, which means approximately 2.63M Americans die each year from some health related calamity. So far is year, 813,946 Americans had died from something other than COVID, which puts us on track to have 2,829,431 deaths in America due to something other than COVID by the end of the year.

We all watched in horror as New York struggled with COVID and images of coffins being stacked in mass graves will burn into our collective conscious for a very long time. It’s especially acute for me because when I was involved in pandemic planning, that’s the problem we couldn’t solve. We figured out how to get food delivered to Manhattan when New Jersey truckers were sick, we figured out how to get life saving medications dispersed adequately, but we never found a successful solution for dealing with dead bodies in a way that was respectful and honored diverse religious practices.

To narrow and contrast, New York averages 165,817 deaths per year and thus far has had 46,843 nonCOVID related deaths in 2020. This means the Empire state is on track to have 163k deaths do to something other than COVID by the end of the year. But not every state will have it as bad as New York. In New Mexico for example, people mostly live in individual homes and don’t rely on public transportation. On average, New Mexico has 18,388 deaths per year. So far there have been 5,226 nonCOVID deaths this year in New Mexico and the state is on track to have 18,167 nonCOVID deaths by the end of the year.

In order to assess how far out of norm 2020 becomes when the impact of COVID is factored in, we have to determine how to account for the COVID deaths; that’s where things get complicated. First, the CDC has a history of over counting influenza deaths and this year there’s a financial incentive because hospitals get paid for each COIVD death but receive nothing for flu deaths. A further complication is that the CDC estimates 78% of all COVID patients requiring ICU treatment have underlying medical conditions. While this does not suggest that 78% of COVID deaths would have been from something else, it is logical to assume some would have.

A Huffington Post article citing CDC data puts the average annual number of flu deaths in the U. S. at 36,000. But that’s just an average, in 2017, 61,000 Americans died from the flu. The annual number of deaths due to flu in New York is 4,517 and in New Mexico is 365. In order to assess the impact of COVID, we first have account for the number of Americans who were going to die from flu. 

If the COVID pandemic behaves as past pandemics then the number of deaths that occurred on the way up to the apex would be somewhat mirrored on the way down. Assuming government statements that the apex was reached on April 14th are correct, this puts the total U.S. COVID death count for 2020 around 50,000. For New York the total COVID death count in 2020 would be around 20,000 and in New Mexico, 72. Keep in mind that while end of year death counts won’t be in dispute, the number attributed to COVID will be due to over counting. Since hospitals are financially incentivized to label deaths as COVID, we will not get a reasonable differential between the number of Americans who died from flu or other illnesses versus those that died from COVID.

The recent SARS and MERS pandemics were contained to a single wave but the more deadly Spanish Flu came in three waves with the second being the most deadly. That means even after we get this current crisis behind us, we could be in a far worse situation by September. But let’s suppose for now that the COVID pandemic is a single wave and that it behaves in a bell shaped manner. Then the U. S. is on track to have 2,840,731 deaths in 2020 from something, including COVID. Similarly, New York will have 178,318 deaths and New Mexico will have 17,874. These numbers were reached using the following formula,

Annual # of deaths – annual # of flu deaths + # of COVID deaths

U. S.: 2,829,431 – 36,000 + 47,300 = 2,840,731

New York: 162,835 – 4,517 + 20,000 = 178,318

New Mexico: 18,167 – 365 + 72 = 17,874

If these conditions hold, the total number of American deaths due to something in 2020, including COVID, would be 0.4% higher than expected for a normal year.

Summary: I believe we are in the midst of a serious crisis and mitigation measures were both necessary and effective. However, without a rational analysis of facts to put things in perspective, without an objective assessment of data, we can’t make informed decisions regarding how far to allow governmental overreach and when/how we restart our lives and our economy. In the midst of this COVID pandemic, the U. S. is currently on track to have 2,840,731 people die from something, including COVID, which would be 0.4% higher than normal. If this pandemic behaves in a bell shaped manner, approximately 50,000 American deaths will be attributed to COIVD but this number represents financially incentivized over-counting. If America ends the year with these projections, one has to wonder if a hundred years from now when actuaries study historical data, 2020 stands out as exceptional?

Note: The U. S. rate of population growth is 0.5%. The 2019 population of the U. S. was 328.2M. There were 3.788M births and 2.863M deaths last year for a birth-death increase of 924k (0.28%). However, the US population grew 1.64M (0.50%) with the rest being from migration. 

Aside: Really, 50,000 Americans commit suicide each year! Where are these people, you never hear about them? I guess the opioid pushers from the American Medical Association are right when they warn side effects may include “thoughts of suicide.”