Analysis: Who Is Still Dying From Covid? The CDC Can’t Answer That

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Analysis: Who Is Still Dying From Covid? The CDC Can’t Answer That

To truly understand where we are in the Covid pandemic, we need to be able to answer an essential question: Who are the 400-500 people who are still dying from this disease each day and what could be done to prevent these deaths? It’s a surprisingly difficult question to answer.

Eric Topol, director of the Scripps Research Translational Institute in La Jolla, California, asked people not to be “numb” to these numbers on his popular Twitter feed, and people responded by asking the same questions I’ve been posing to experts for weeks. Who is dying in late 2022? Is it nursing home residents? Anti-vaxxers? Essential workers? How many of them have had the vaccine? Boosters? Did we fail them, or did they fail to take care of themselves?

When I asked the CDC for relevant statistics, they sent me a widely circulated graph which showed the rates of death were much lower for vaccinated people. But without raw numbers on these deaths, it’s still hard to know why the death toll has plateaued at such a high level.

In the same interview in which Biden remarked that the pandemic was over, the president also said that people seemed to be “in pretty good shape.” That’s a common perception, because most people who get Covid do recover and go on with life.

Michael Osterholm, who is director of the Center for Infectious Disease Research and Policy at the University of Minnesota, acknowledged as much on a recent episode of his podcast. Most people are not at high risk of death from Covid, he said, “and yet people are dying … What is it that makes people vulnerable to serious illness? Who is it that’s ending up in our ICUs? We don’t know. Our public health information systems are not providing us that kind of data.”

There is at least some data suggesting that more boosters among the elderly would help. There’s strong evidence that a first booster makes a big difference, and that the risk of death is much higher for those over 65. And yet, Osterholm said, only 70% of Americans over 65 have had their first booster. (Only 26% have had a second booster.) 

Topol has also shared concerns about our lack of information. Not only do we lack detailed information on how many (if any) vaccine shots they’ve had, we also lack data on what treatments they received. “Did they get Paxlovid? Did they get bebtelovimab?” he  asked in the Los Angeles Times. (Bebtelovimab is a monoclonal antibody treatment.)

Even if vaccines vastly reduce risk, it doesn’t follow that anti-vaxxers are the root of the problem. It’s easily possible for vaccines to be very protective but still see the majority of deaths among the fully vaccinated, simply because younger unvaccinated people face less risk than fully vaccinated seniors.

One reason clear data aren’t available is that the US doesn’t collect that information in a uniform way, said Stephen Kissler, an infectious disease researcher at the Harvard School of Public Health.  “A lot of public health happens at city level or lower so, because of that, it’s really hard to combine data across states to assess who is ending up in the hospital or dying of Covid-19,” he said. “The mix is hard to standardize.”

Another challenge has to do with the complex immunological landscape, he said. It’s not just a matter of how many boosters people have that determines their level of protection, but when they’ve gotten them. Add to that the fact that the most vulnerable people are more likely to get vaccinated.

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