Commentary / Coronavirus

Estimating the Risk of Death from COVID-19 vs. Influenza or Pneumonia by Age

maskAs Americans struggle to understand the risks of COVID-19 relative to other infectious diseases, a common benchmark is influenza, commonly known as the flu. So what is the relative risk of dying from COVID-19 vs. the flu? The answer: it depends on your age, and also your assumptions about how deadly COVID-19 will turn out to be.

However, based on mid-range assumptions, it appears that those under 25 have a significantly lower risk of dying from COVID-19 vs. the flu, while those over 35 are at significantly greater risk. Those over 75, in particular, are at the greatest risk of dying from COVID-19.

The risk of dying from COVID-19 is impossible to answer definitively at this time, because we do not yet know how widely the novel coronavirus will spread, and exactly how lethal infection from SARS-CoV-2 is. Many patients recover from the infection without showing any symptoms.

What we do know is that death from COVID-19 disproportionately affects the elderly.

Based on data from the Centers for Disease Control and Prevention, as of May 13, those older than 85 are 314 times more likely to die of COVID-19 than those aged 25–34; those under 15, by contrast, are 43 times less likely to die of the disease than those aged 25–34.









Assessing the relative risk of death from COVID-19 and influenza involves a fair amount of educated guesswork, because we do not know how lethal COVID-19 will ultimately be.

As of May 18, one widely-cited but often-criticized epidemiological model, that of the Institute for Health Metrics and Evaluation at the University of Washington, estimates that the U.S. will experience 147,040 deaths from COVID-19 by August 4, with a 95% confidence interval of 113,182 to 226,971.

For the purposes of this exercise, we assumed that the U.S. COVID-19 death toll ultimately reaches 150,000.

The second challenge we have is that the lethality of influenza varies from year to year, depending on the exact strain of influenza and many other variables, such as the weather. In addition, some people die of pneumonia that is presumed to be caused by influenza, while in other cases, pneumonia is not associated with influenza.

For this analysis, we averaged the death tolls from influenza and pneumonia from 2007 to 2017 from the CDC’s National Center for Health Statistics. On average, in those 11 years, 172 people per million U.S. residents died of influenza or pneumonia, or roughly 60,000 per year.

Based on that analysis, what is striking is that those under the age of 25 are at significantly lower risk of death from COVID-19 than of the flu. Under our assumptions, for example, school-aged children between 5 and 14 have a 1 in 200,000 chance of dying of influenza, but a 1 in 2.5 million chance of dying of COVID-19.

For toddlers, the relative risk is even more pronounced. We estimate that Americans between ages 1–4 are 27 times more likely to die of influenza than of COVID-19.

It is clear from these analyses that death from COVID-19 is low for those under 55, and especially those under 25. By contrast, it is relatively high for those over 75. This evidence should lead us to consider ways to reopen pre-K and K-12 schools and also postsecondary institutions like colleges. It should also lead us to do everything we can to protect the elderly, especially those in nursing homes.

Those between 55 and 75 years of age are somewhere in between. In aggregate, those in this age range are roughly 4 times as likely to die of COVID-19 than influenza.

However, the absolute risk of death from COVID-19 scales up in this bracket by age. At a death toll of 150,000, about 1 in 2,300 individuals aged 55–64 will die of COVID-19; among those aged 65–74, about one in 1,000 will.

According to our projections, if 150,000 Americans in total die of COVID-19, approximately 2,700 35–44-year olds would be in that category. For context, in 2016, 2,851 individuals in that age range died of liver disease; 3,369 died of homicide; 7,030 died in suicides; 10,477 died of heart disease; 10,903 died of malignant cancers; and 20,975 died of unintentional injuries such as car accidents.

As noted above, assessing the relative risk of dying from COVID-19 vs. other diseases requires us to estimate the ultimate death toll from COVID-19, and one should adjust the relative risk numbers calculated above for alternate scenarios. For example, if 300,000 Americans die of COVID-19 in 2020, instead of 150,000, one would need to divide the relative risk numbers listed above by 2.

Having said that, there is growing evidence that complete economic lockdowns cause more harm than good, and that it is possible to prudently reopen the economy today. Reopening is especially important to lower-income Americans, whose economic prospects have been most durably and significantly harmed by shelter-in-place orders.

As we reopen the economy, we should pay special attention to those older than 50 with risk factors such as cardiovascular disease, high blood pressure, diabetes, obesity, kidney failure, and immunodeficiency. These individuals should take special care to engage in frequent hand-washing and physical distancing. But our caution should include an understanding that while the risks of COVID-19 are serious, they appear to be in the range of other lethal diseases that are all too common in the United States and other industrialized countries.


Reprinted with Permission from - Free Opp by - Avik Roy

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John D Blake
2 years ago

I would like to know what those #’s look like over the last 30 days. I believe our understanding and treatment options are much better now than early on. I would hope that the death rates for each group has significantly decreased.

2 years ago

We really don’t know the correct death rate because the states receive more money for COVID19 deaths …. a friend’s mother died of cancer and when they got the death certificate, it said COVID 19. You see the states get extra money for the covie deaths….so there have really been very little flu deaths this year….how Is this possible? Follow the money….same goes for hospitals…no matter what you are admitted for if it has to do with respiratory problems, you are a COVID 19 admission because the hospital gets $13,000 each and if you have to go on a ventilator, they get a cool $39,000 each. The numbers are scewed and so many lies and misinformation has made this the unknown virus. The fake news is still reporting gloom,doom, panic and fear….they have yet to report that the CDC just admitted that it is very hard to get the virus from touching surfaces….have you heard this? If you watch the fake news, you probably are unaware of it. Some states are using this for facist regimes to control the people. I have had to be quiet because my husband is a county judge and he has to do what the state says…..however, I told him I will NOT go through this absurdity again regardless of his status….I will be rebelling on the streets and encouraging others to do the same. Do you realize for the last two months, the government has controlled every aspect of your life, have decided who is essential and who is not, told you where you can go, what you can do? We still live in America and the Constitution is still the law of the land and it supercedes the emergency health conditions….I am tired of having my freedoms trampled on and will no longer put up with it.

Peter K
2 years ago
Reply to  wandamurline

Do you know why the government is paying 13K for a Covid19 death? A death is a death so why should a specific reason “pay”? It makes no sense to me and my feeble 76 y/o mind!

2 years ago

This data has been available for a while now in the medical community at large and to anyone even remotely interested in real data on Covid-19. However, the mainstream media and Democrat Governors holding their states’ citizens hostage have ZERO interest in it. It simply goes against the narrative the media is trying to sell the public on a daily basis and the Democrats simply want to prolong the “crisis” as long as possible. This data accurately quantifies the risk factor by age regarding the Covid-19 virus and completely blows up the narrative that exposure to Covid-19 means certain death. In reality, those under 60 years of age have a slightly better than 99.97 percent change of full survival with no complications from Covid-19 per the most recent data available. Obviously, the older and weaker your immune system gets, compounded by any existing pre-conditions you may also have as you age, the greater any virus, bacteria or any illness is to your health and your ability to survive it. Nothing earth shattering or ground breaking there. It’s called basic biology, that is applicable to all living things. Again, the bottom line is this accurate data is a far cry from the daily fear-mongering and emotional heart string pulling that is heard non-stop from both the media and the Democrats.

Peter K
2 years ago
Reply to  PaulE

PaulE, Excellent piece. Now, begs the question, “how do we disseminate it?”

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