Analysis | How many coronavirus deaths each day are acceptable? - The Washington Post

The Centers for Disease Control and Prevention estimates that 24,000 to 62,000 people died during the flu season that began in October 2019 and ran into April of last year. It was an unusual season, overlapping with the beginning of the coronavirus pandemic. That total, though, means that somewhere between 129 and 333 people died each day as the flu spread around the country.

This is a risk that we accept. There exist vaccines to prevent the flu, but outreach to encourage vaccination is generally fairly modest. Older Americans are likely to hear from their physicians that it’s a good idea, but many Americans simply just go through the flu season and emerge on the other side either having avoided infection entirely or after recuperating from an illness.

At the heart of the current debate over the coronavirus pandemic is a related question: At what point do we decide that the number of people dying of the virus or being hobbled by its occasional long-term effects is acceptable?

It’s a grim question, certainly, the sort of thing that we generally outsource to insurers and actuaries. But it’s also a question that we need to answer. There’s no real chance that the coronavirus will be entirely eliminated, meaning it’s likely to become endemic. So at what point do we scale back our focus on it?

Conservative commentator Ben Shapiro raised that question Tuesday morning.

That average of coronavirus deaths presented by Shapiro is a bit higher than The Washington Post has it; our data indicates an average of 268 deaths per day as of Monday. That’s about in the middle of the range of the estimates from the last flu season — but this, like Shapiro’s examples, is an apples-to-oranges comparison.

After all, the average number of coronavirus deaths is derived from reported fatalities. The flu-season estimate is just that, an estimate based on public health observations. The actual number of recorded flu deaths is far lower, with about 8,300 flu deaths tallied by the CDC during the October-to-April season, or about 45 deaths per day. That’s one-sixth of the current total for coronavirus.

It’s also important to note that deaths from the coronavirus aren’t really comparable to deaths from heart disease, cancer or stroke for the simple reason that they are, in fact, largely preventable. Were there a vaccine that could prevent cancer and the country still felt comfortable with 1,600 daily deaths, then Shapiro’s point would be much sharper. To shrug at more than 300 preventable deaths because of 430 less-preventable ones is misleading.

Shapiro does then advocate vaccinations, it’s important to note. But he later comes back to the central question.

It’s much easier for a random right-wing pundit to suggest that we should just let hundreds of people die a day than it is for an elected official. Especially because another of Shapiro’s points — that the vaccine has blunted the death toll as case totals rise — is not as certain as he presents it.

We explored this last week, looking at the link between new cases and deaths in the United States over the pre-vaccination period of the pandemic. With cases continuing to rise, it’s worth revisiting.

This is what the pandemic looks like at this point, according to The Post’s aggregated data. Cases have begun rising again quickly, in part because of the rampant spread of the virus’s delta variant. As cases rose, so did hospitalizations. The question that follows is whether deaths will as well.

You can see an uptick in the average number of deaths each day over the past two weeks or so, but it’s not clear whether that’s an anomaly or not. If most of the new cases are among the unvaccinated, as the government argues, we would expect hospitalizations and deaths to follow the same established pattern. If a substantial portion are among the vaccinated, we would expect a relatively lower level of hospitalizations and deaths.

There’s been a fairly robust relationship between new cases, hospitalizations and deaths. The two-week change in new cases leads the two-week change in hospitalizations by about a week, and the two-week change in deaths by about three weeks.

That pattern appears to be holding so far, even as the number of cases is spiking faster than at any point in the past 10 months.

The United Kingdom is further along in its delta-related surge and hasn’t seen a similar surge in deaths, as Shapiro points out. But it’s also the case that a greater percentage of Britons are fully vaccinated than are Americans in most age groups.

Here, too, there are a lot of compounding factors, such as that Britain is more reliant on less-effective vaccines, moderating the lessons we might learn. It’s also the case that the United States has five times Britain’s population, so its 96 deaths per day are the equivalent of about 500 here — though that’s still a much better ratio of deaths to cases. Will the United States similarly see a tamped-down death toll? Or will our sheer numbers of unvaccinated people mean we’re destined to see a wildfire of infections rip through our millions of unvaccinated adults, including millions of seniors?

That, again is the question. How many deaths are acceptable? But it’s more complicated than that, of course. How much lost productivity from illness? When should the United States stop pushing people to be vaccinated, to get a booster shot or to take precautions against the virus’s spread? At what point do elected leaders (outside of South Dakota) follow Shapiro’s lead and declare that it’s every person for himself?

Those accountable to voters seem to believe we’re not there yet.

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Analysis | How many coronavirus deaths each day are acceptable? - The Washington Post
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