Hacker News new | ask | show | jobs
by bad_alloc 916 days ago
> With the worst of COVID behind us, annual deaths for all causes should be back to pre-pandemic levels — or even lower because of the loss of so many sick and infirm Americans.

Since we now know that Covid can lead to long-term suppression of the immune system and that a significant part of infected people have other lingering issues, this is obviously false.

1 comments

If Covid immunosuppression is the problem, then why are young people (per the article) a disproportionate share of the excess deaths?

> Unlike in the pandemic’s early phase, these deaths are not primarily among the old. For people 65 and over, deaths in the second quarter of 2023 were 6 percent below the pre-pandemic norm, according to a new report from the Society of Actuaries. Mortality was 26 percent higher among insured 35-to-44-year-olds, and 19 percent higher for 25-to-34-year-olds, continuing a death spike that peaked in the third quarter of 2021 at a staggering 101 percent and 79 percent above normal, respectively.

Indeed, that suggests they are correct - unless you have a better explanation of why older people are doing better than pre-pandemic.

Because young people have robust immune systems and old people don’t. This makes young people have dramatically worse outcomes to anything suppressing their immune systems. Old people’s immune systems are already compromised. Hence, the results of immunosuppression will be much worse for younger adults.
Because old folk’s immune systems are already differentiated/less effective
That doesn't mean they can't become less effective from Covid. The article mentions that deaths among the elderly are below pre-pandemic levels, which suggests that any such immune weakening is not the reason for excess deaths.
Proportionally. If you used up your naive T-Cells on your way to 60/70s there aren’t many left to lose. Whereas if you dumped them all on a few Covid infections in your 20s and 30s you’d see a proportional uptick in younger deaths alongside the life expectancy drops that we’re also seeing. As for the below pandemic death rate, folks can’t die twice and the aged were dry tinder for SARs
IS there some reason to believe you wouldn't have the exact same problem in a pre-Covid world where people are being regularly exposed to colds, flus, RSV, and every other respiratory virus on a constant basis in their 20s and 30s? Why would losing naive T-cells to Covid adaptions be a bigger issue than losing naive T-cells to the zillions of other infections?
There are a few viruses with this behavior. The ones you mentioned are not.

It's likely just a matter of being unlucky this time that a well spreading virus stumbled upon this way of avoiding immune system which breaks it.

A bad case of Ebstein-Barr virus (a herpesvirus, causing mononucleosis) can set you down for life, for example. Certain bacteria like ones causing Lyme disease can do it too. You don't hear it talked about because they do not spread as readily.

How much higher are drug overdoses in 2023 compared to 2019?
The article mentions overdoses. They don't explain the difference.

> To some extent, we know what is killing the young, with an actuarial analysis of government data showing mortality increases in liver, kidney and cardiovascular diseases, and diabetes. Drug overdoses also soared nationwide, but not primarily in the young working class.

The article claims that but I can't tell what evidence they have for that claim. One of their linked pdfs[0] is long but as far as I can tell involves working class insured folks, and the chart on p31 shows Drug Overdoses as the largest excess category by far for the 0-44 age group.. Also page 27 says "Note that recent period deaths may continue to shift from non-COVID to COVID as COD coding becomes more complete".

Edit: and the table on p43 seems to directly contradict their claim that the excess deaths are concentrated among the young "working" as opposed to non-working: Age 15-44 have almost the same percentages (18.9% vs 19.2%) for excess Q2 deaths; the insured cohort is the slightly lower one. "It's probably mostly drug overdoses and COVID" still seems like a reasonable null hypothesis to me.

[0] https://www.soa.org/4ac0fd/globalassets/assets/files/resourc...