Do you believe this number?

Do you believe this number at face value and without question? “40% of the USA’s coronavirus deaths could have been prevented.”

I hope not. Even if you think you likely will agree with the headline that is all over my news feed today, this statement should give you pause. At very least, I would ask you to stop and think for just a moment. What does that number mean? How was it calculated? Should I care? Is this a call to any action?

Especially, please ask when you read such articles, where can I find more information? If you read nothing else from my blog, read the source and understand it if you are curious, I think it has some very interesting food for thought. You have to register on the site, but the article is free.

I first want to critique some of the news coverage. I was specifically disappointed in USA Today which only named the Lancet Commission report on “Public Policy and Health in the Trump Era.” I thought Newsweek was better because the article actually quoted directly the relevant section of the report. I was most pleased with ABC’s write up because they provided a link to the report and the title of the article was less sensationalizing. 

Let me just go through how I engaged with this material this evening. As I first read the news article these are the things that smell funny to me. 

  1. I was on alert that 40% is a round number not given with any uncertainty. 
  2. ‘Could have been prevented.’ I was very unsatisfied that this term was not well defined in several articles. How do they know these deaths were preventable? That doesn’t make sense. 
  3. I was also alerted because the date range over which this data was collected was not specifically mentioned. 

So, I wanted to look at the report more closely. 

The main downside is that the report is a 49 page document. While I genuinely think it has some valuable insight, this is a lot for someone to sit down and read. But, even if all you did was look at the first 2 out of 11 charts in this report and understand what they indicate, I think you would have a better understanding of the 40% number and what it really means. You might come to the same conclusion that I did: that the importance of this report is not just a critique of recent policies but rather that there are deep and ever worsening health issues for Americans as compared to the rest of the world.

The first figure shows life expectancy in the US compared to other G7 countries (Japan, Italy, France, Canada, UK, and Germany) and spoilers, it isn’t great. Starting in the mid 80’s the life expectancy has been shorter in the US than all of these other developed countries and has remained at the bottom of this list and since then, the gap has only widened. 

The second and similar figure shows the number of deaths above the average of the six other G7 countries. This plot shows that since 2014 there has been a yearly excess of 400,000 deaths in this country every year if you compare US health statistics to other parts of the world. It also shows that this is simply the state of things at the end of a 40 year cultural inheritance of poorer health. 

So after reading this far I began to understand that the “40% preventable COVID deaths” is a number which compares our loss of life to other countries and implies a claim of causation that had we enacted better policies similar to those enacted by other countries more lives would have been saved. 

This claim is suspect at best. Only by actually stopping and thinking for just a moment and reading this report one can question this conclusion. Consider the alternative, that the US was as healthy as the rest of the world prior to the pandemic but had a 40% higher death rate during the time of the pandemic. In that case, we could justifiably blame recent policy, dismissal and inaction for those deaths. But somehow we have to reconcile that health in the US has been on the decline for a long time and talk about how to change it. There are some recommendations in this report. 

The point is, one could dismiss this 40% number as politically prejudicial, one could overlook this number with a grim acceptance that this number aligns with your expectations for the policies of the former president, or one can realize that we have a problem in the culture of american health and healthcare and consider what can be done.

Please be well and stay safe,