Death from Despair Part 5: Analysis by Race, by Race Crossed with Gender, by Race, Gender and Age (Analysis of American Indian/Alaskan Native and White Males by Age)

1. Analysis by Race

American Indians/Alaskan Natives consistently have the highest rate of death. That is followed closely by Whites. That the Total line closely follows the White line is unsurprising given that Whites form the largest racial group.  African Americans and Asians fall below the Total line. As we have seen earlier the line for African Americans has risen sharply in the last few years because of sharp increase in drug-related deaths. Asians may have the lowest death rate however, the death rate for Asians continues to rise, not at the accelerated rates of the three groups, but are rising nevertheless. 

Of concern, deaths from despair continue to rise for everyone no matter your racial group.

2. By Race and Gender

I further subdivided the data by gender. In the figure below, females are represented by squares and males by circles. 

Every group has shown an increase in deaths from despair, even female Asians who clearly show the lowest rate of increase. As a whole, females show a lower death rate than males. One notable exception is that male Asians have a lower death rate than American Indian/Alaskan Natives and female Whites.

What I find particularly striking about this graph are the lines for American Indian/Alaskan Native Males and White Males. Both lines follow a steeper trajectory with strikingly higher death rates than the other groups. What I find striking as well is that these two lines closely follow each other. And for those two reasons I decided to drill into the data from these two groups with Age as a factor.

3. Analysis of American Indian/Alaskan Native Males and White Males

I added age as an analysis factor for these two groups. The figure below shows the results of that analysis.

American Indian/Alaskan Native male lines have downward pointing triangles. White males have circles. 

Something to note: American Indians/Alaskan Natives have jagged lines. The reason is that the underlying numbers are relatively small so a relatively small change can seem to show large swings in the crude rate. That being the case one needs to focus not on the swings but on the overall trends that unfortunately point strongly upward.

I selected most productive years in 10 year age ranges that consist of the 10 year age ranges of:

• 25-34
• 35-44
• 45-54
• 55-64

For both American Indian/Alaskan Native males and White males the most deadly years range from 45 to 64. For American Indian/Alaska Natives males those years have proven particularly deadly, especially in recent years. And it is clear, that for American Indians/Alaskan Native males, deaths from despair begin relatively early in life and become more strongly pronounced as they grow older.

Something that interested me was the American Indian/Alaskan Native and Whites show similar patterns in the 25 to 34 age range. 

Two more figures separately show American Indians/Alaskan Native and White males.

These two groups are clearly at the most risk for death from despair and the numbers are staggeringly high.

This series of articles will continue. 

Death from Despair Part 4: Analysis by Age Groups

This data was collected from CDC's Wonder database for all the years available: 1999 to 2018. They're broken down into 10 year age groups from 15 to 85 (plus) years old. I removed from the figures the age groups for everyone under 15 years old and all those where the age the person was not reported. The under 15 years old age group data showed crude rates of less than 1 death per 100,000, too low to be included in the figures.

Deaths from Despair by Age Group

The figure below shows the crude rates of death from despair by age group. The dashed line curve is the overall total for all age groups to provide a baseline of comparison and a dividing line for those over, under and on the line. 

As seen in other studies two age groups, 45-54 and 55-64, show the highest growth rate  as well as the highest number of deaths from despair. Those in the 65-74 age group closely follow the Total line.   

I inserted the figure above to call attention to something that I found particularly disturbing. The age groups I have boxed are those ages that could only be considered "the prime of life." One would consider these to be the best years of anyone's life. (I know I do.) Yet in recent years, the rate of death from despair are 1) above the Total baseline and 2) the highest of all the age groups. Furthermore, the growth rates for the 25-34 and 35-44 age groups has noticeably jumped over the last 5 years.

The two age groups with little or no growth are the 75-84 and 85+ groups. Furthermore, they're below the baseline. 

The 15-24 age group has the lowest crude rate, but it's a crude rate has nearly doubled during this 20 year period and that is concerning.

Finally, to point out that during 1999, the data points for most of the age groups were in a much closer range (from 13.9 to 43.0) than in later years where the spread has become much wider from a crude rate of 25.8 to 82.1. 

COVID-19 Spread: Updates from the Washington Post - Updated

When a novel virus spreads, it's important to have access to trusted sources of information. Here's an article from the Washington Post regarding the spread of the COVID-19 virus around the world. This article will be updated from time to time.

Here's the link: https://www.washingtonpost.com/world/2020/01/22/mapping-spread-new-coronavirus/?arc404=true

One more thing ... if you take a look at the end of the article, there's a table of history of various diseases. One of the things that I did, was from the data provided to determine the death rate of COVID-19. Using the reported numbers, the death rate is 3.46%. (86013 inflected and 2977 deaths.) That could be high because not all COVID-19 cases are likely to have been detected. 

I updated the parameters in my quick model to 1) number of persons that an infected person would infect = 2 and 2) death rate = .0346. Number for multiple generational points = 75. 

This is what the model produced:

Generation	0	1	2	3	4	5	6	7	8	9	10	11
Number infected in Generation	1	2	4	8	16	32	64	128	256	512	1,024	2,048
Running total infected	1	3	7	15	31	63	127	255	511	1,023	2,047	4,095
Total deaths	0	0	0	1	1	2	4	9	18	35	71	142
Multiple Origination Points Infected	75	150	300	600	1,200	2,400	4,800	9,600	19,200	38,400	76,800	153,600
Running total infected	75	225	525	1,125	2,325	4,725	9,525	19,125	38,325	76,725	153,525	307,125
Total deaths	3	8	18	39	80	163	330	662	1,326	2,655	5,312	10,627

UPDATE: Of note, I reported the COVID-19 death rate as 3.46% based on the numbers supplied by the Washington Post in the article shown above. I reported that value as a death rate with caveats. However, about a week after I stated the above COVID-19 death rate, the World Health Organization (WHO) reported a death rate of 3.4%. I was about to alter my death rate to 1% based on recent reporting. But for now I'm not going to update what my model has predicted with respect to the number of deaths until I receive an updated number from WHO or the CDC.

Changing the number for multiple generational points to 42, here's what you get:

Generation	0	1	2	3	4	5	6	7	8	9	10	11
Number infected in Generation	1	2	4	8	16	32	64	128	256	512	1,024	2,048
Running total infected	1	3	7	15	31	63	127	255	511	1,023	2,047	4,095
Total deaths	0	0	0	1	1	2	4	9	18	35	71	142
Multiple Origination Points Infected	42	84	168	336	672	1,344	2,688	5,376	10,752	21,504	43,008	86,016
Running total infected	42	126	294	630	1,302	2,646	5,334	10,710	21,462	42,966	85,974	171,990
Total deaths	1	4	10	22	45	92	185	371	743	1,487	2,975	5,951

So based on the assumptions embedded in the model (and these are speculative assumptions ... please note that fact) the current state of spread of and the number of deaths from the COVID-19 virus has 42 points of origination, spread over 10 generations where the person-to-person infection rate is 2.0 and the death rate is .0346. 

This also suggests that the spread to the next generation could result in a substantial jump in the number of cases (5 figures to 6 figures) as well as well as in the number deaths. But as with all things monitoring the data and updating the model with the new data is essential.

Update

From NBC News, I received a new person-to-person infection rate and the seemingly minor change makes a pretty significant change in the numbers. Here are the parameters: 1) person-to-person infection rate = 2.2, 2) death rate remains at .0346 and the number of origination points = 39 (to match up with current data). Here's the table:

Generation	0	1	2	3	4	5	6	7	8	9	10	11
Number infected in Generation	1	2	5	11	23	52	113	249	549	1,207	2,656	5,843
Running total infected	1	3	8	19	42	94	207	456	1,005	2,212	4,868	10,712
Total deaths	0	0	0	1	1	3	7	16	35	77	168	371
Multiple Origination Points Infected	39	86	189	415	914	2,010	4,422	9,728	21,402	47,083	103,584	227,884
Running total infected	39	125	314	729	1,642	3,652	8,074	17,802	39,204	86,287	189,871	417,755
Total deaths	1	4	11	25	57	126	279	616	1,356	2,986	6,570	14,454

To reach the current number of reported infected people with 39 originating people is the 9th generation as opposed to the 10th generation. Also the jump in numbers to the next generation suggest that approximately 18,000 more people will be infected than in the previous table. 

The point I want to make is that even a slight uptick in the infection rate can have significant consequences.  This is why testing is so important. Keeping the infection rate down makes the epidemic more manageable. This is why informing the public regarding what they should be doing to not become or lower the chances of being infected is so important. This is why having competent people managing this public health emergency is so important. 

The Trump Administration

However, it seems that at the level of the Trump Administration, we have people who have no idea of what to do. Who have been denial for weeks about the likely spread of the virus outside of China and into the US. Trump's recent decision to restrict travel to and from Iran, Italy and South Korea in addition to China is not only short sighted, but utterly inane. The virus is in the US, it is spreading in the US. It's too late for travel restrictions to have any real effect. And besides, travel restrictions only buy you time to prepare, something the Trump Administration neglected to do in it's state of denial about how the virus could spread to the US. 

Quick Model of the Predicted Spread of the Corona Virus

To satisfy my own curiosity, I created a simple model of the multigenerational spread of the CoronaVirus. I'm not an expert on public health so I'm not certain of the assumptions and process of a spreading virus but I know the mathematics is correct. 

Anyway, here's a snapshot of a table based on the following assumptions:

• Generational disease spread originating from one person over 11 generations. (I have no idea if 11 generations is reasonable, but I wanted to provide some sense of how widely the disease could spread.) 
• Each infected person spreads the disease to 3.8 other people. 
• Mortality rate is .02 (2% or crude rate of 2000 per 100,000)
• I guessed that it would take 36 hours for each person to spread the disease to the 3.8 other people. I don't take my timescale all that seriously but it provides some sense of how fast a disease could spread.

The table below shows the spread from single origination point and from 50 origination points. The number of days that it would take to generate these numbers based on my timescale assumption is about 17 days. (These tables have been updated. The death rate in my original tables was .03 not .02. These tables have a death rate of .02.)

Generation	0	1	2	3	4	5	6	7	8	9	10	11
Number infected in Generation	1	4	14	55	209	792	3,011	11,442	43,478	165,216	627,821	2,385,721
Running total infected	1	5	19	74	283	1,075	4,086	15,527	59,005	224,221	852,043	3,237,763
Total deaths	0	0	0	1	6	21	82	311	1,180	4,484	17,041	64,755
Multiple Origination Points Infected	50	190	722	2,744	10,426	39,618	150,547	572,078	2,173,896	8,260,805	31,391,059	119,286,025
Running total infected	50	240	962	3,706	14,131	53,749	204,296	776,374	2,950,270	11,211,075	42,602,134	161,888,159
Total deaths	1	5	19	74	283	1,075	4,086	15,527	59,005	224,221	852,043	3,237,763

I have to admit, I gasped when I saw these numbers and thought, I hope this isn't the case. But if the government takes action to stem the infection rate from 3.8 to 2, here's what you get:

Generation	0	1	2	3	4	5	6	7	8	9	10	11
Number infected in Generation	1	2	4	8	16	32	64	128	256	512	1,024	2,048
Running total infected	1	3	7	15	31	63	127	255	511	1,023	2,047	4,095
Total deaths	0	0	0	0	1	1	3	5	10	20	41	82
Multiple Origination Points Infected	50	100	200	400	800	1,600	3,200	6,400	12,800	25,600	51,200	102,400
Running total infected	50	150	350	750	1,550	3,150	6,350	12,750	25,550	51,150	102,350	204,750
Total deaths	1	3	7	15	31	63	127	255	511	1,023	2,047	4,095

The situation becomes far, far more manageable. In addition, the actions the government should take should reduce the number of generations the virus is allowed to spread to others. 

Having seen these numbers, it makes sense to me why South Korea is doing mass testing. The faster you can get infected people out of the environment where they can infect other people, the more manageable the epidemic becomes. In addition, this suggests that barriers and changes in people's behavior to slow the spread of the virus would significantly assist in stemming epidemic.

What Should You Do to Protect Yourself, Your Loved Ones and Your Fellow Citizens?

I prefer not to provide anyone with advice regarding what you should do. However, I'll happy to provide you with expert resources. So ...

Here's the CDC website for the CoronaVirus: https://www.cdc.gov/coronavirus/2019-ncov/index.html

Here's the website for the National Institute of Health: https://www.nih.gov/health-information/coronavirus 

My Comments Regarding the Trump Administration

Now, let's see if in the US, the Trump Administration is able to get it's act together. That news conference on 26 Feb 2020 was not all that reassuring. It was clear that Trump himself is completely clueless about the situation he and his administration are facing and what to do about it. Putting Pence at the head of the effort wasn't reassuring at all. As Governor of Indiana, Pence's policies lead to an outbreak of HIV in southern Indiana. And it took Pence far too long to respond and take actions that addressed the epidemic.(https://www.washingtonpost.com/politics/2020/02/27/mike-pence-hiv-indiana/) 

Let us all continue to monitor the situation going forward.

I'll admit that I have an intense dislike of Trump and the growing group of servile sycophants that surround him. This Administration is corrupt and incompetent, and headed by someone who requires obsequiousness, but careless nothing about competence and truth. 

My opinion has only been reinforced by the Trump Administration's statement that all information, interviews and and statements regarding the CoronaVirus must be cleared through Pence and thus filtered through the administration. In other words, the Administration just muzzled Dr. Anthony Fauci and others. This should scare everyone. Public health should never be politicized, but it appears that it now has. 

I can admit to you that I didn't like the Bush Administration either for a whole host of reasons beginning with lying to get the US into a war with Iraq. But, I can say when it came to concerns about public health, both nationally and internationally, they were not all that bad. 

I feel that I give Administrations credit where credit is due and criticize them when their actions and policies do damage. And from what I have seen, Trump and his Administration has done little to make things better and done lots of damage. And things are only getting worse.


Here's an article from the Washington Post regarding a newly filed whistle blower complaint: https://www.washingtonpost.com/health/2020/02/27/us-workers-without-protective-gear-assisted-coronavirus-evacuees-hhs-whistleblower-says/