Home / General / Newsflash: The COVID pandemic has been the worst public health catastrophe in American history, and it’s not close

Newsflash: The COVID pandemic has been the worst public health catastrophe in American history, and it’s not close


Ross Douthat engages in a very special kind of counterfactual speculation here, wondering what would have happened if the COVID-19 pandemic had been really bad:

And as terrible as it is that one in 500 Americans have died of Covid, it’s still much easier to have gone through the pandemic without having a close friend or family member die of it — as I have not, for instance — than it would be were the toll one in 50.

Before the pandemic I once built a column around the psychiatrist-blogger Scott Alexander’s concept of “the scissor,” which describes a controversy or idea or event perfectly calibrated to divide people while making them think that the other side is bonkers. Arguably Covid’s death rate makes it a perfect scissor: It’s high enough to make the alarmed feel vindicated, but still low enough that many skeptics feel vindicated as well.

Whereas if the fatality figures were 10 times lower I suspect there would be much more internal liberal debate over the wisdom of the sweeping early response. And if they were 10 times higher I think there might have been more red-state support for public-health restrictions of all kinds.

On the one hand, some overly optimistic conservatives like Richard Epstein — who Douthat cites on this point — thought COVID was only going to kill 500 Americans, total (I don’t buy Epstein’s ex post bullshit that this was a typo and he “really” meant 5000 total deaths during the course of the epidemic, but when you’re off by a zillion percent either way who cares really).

On the other hand, Douthat points out, some alarmist liberals claimed the death toll could eventually reach seven figures when in fact . . . wait a moment please, let me adjust my earpiece, as I’m getting an update from my producer:

Excess deaths from all causes since February of 2020 per the CDC: 830,400. Current seven-day moving average of COVID deaths: 1,520. Days left in the year: 103.


M’kay, but according to Math it could have been six million (where have I heard that number before?) so, um, both sides somehow or the other.

Douthat is as close to a “good” prominent conservative commenter as there is out there, but he too is here trying to downplay how bad COVID has actually been, although he’s much more subtle about it than the usual “it’s all old people and fat people so just stay in shape and old people die all the time anyway” Aktion T4 reasoning among our right wing friends.

After 20 months and endless statistics it’s easy to get desensitized to how bad the COVID pandemic in America (not to mention the rest of the world) has been and still is. Here’s one way of getting a handle on that.

Last year, the age-adjusted all-cause mortality rate in the USA rose by 15.9%. This is by far the biggest one-year rise in that rate in the 120 years that the official public health records go back in regard to this most basic measure of overall public health. The only other one-year rise that’s even slightly comparable was during the first year of the Spanish flu pandemic, when all-cause mortality rose by 11.7%. (The next-worst single-year increase since the 1920s, prior to COVID, was a 4% increase during the worst year of World War II for US combat deaths).

But here’s the thing: the following year all-cause mortality fell by 19%, falling below what had been the baseline rate in the years immediately before the Spanish flu pandemic. (An unexplained epidemiological mystery is why the age-adjusted mortality rate during the Spanish flu epidemic in the USA barely changed on net, as it fell even more drastically in 1919 than it rose the previous year). By contrast, it seems probable that age-adjusted all-cause mortality in the USA will be even worse in 2021 than it was in 2020, given that we are heading for as many or more COVID deaths this year as last. And, crucially, those deaths are going to collectively have a bigger effect on life expectancy, given that, because of the high level of vaccination in the elderly population, the people who have died and will die from COVID this year will end up being on average quite a bit younger than those who died from the pandemic last year.

Over the past century, America has dealt with many purported public health crises, some real (AIDS, opioid addiction, skyrocketing homicide rates in the 1970s and 1980s) and some fake (“obesity,” foreign terrorists, reefer madness, Satanic ritual abusers). But no public health crisis in the nation’s history has had anywhere close to as catastrophic an effect on public health as the COVID pandemic.

This would be true even if somehow magically the pandemic ended in the USA tomorrow, which of course it would if the quarter of the adult population that refuses to get a vaccine that would end the epidemic would do so.

But thanks to the right wing media complex, of which Ross Douthat is the most “respectable” representative, that’s not going to happen.

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