Coronavirus: Dose Matters in the Demographics of Death
by
New York Gov. Andrew Cuomo (YouTube screenshot)

It will surprise no one that the most recent demographic data released by New York City’s Department of Health reveals that the City’s elderly — those over 65 years old — make up 70 percent of all deaths from coronavirus in NYC facilities. As of Friday, April 3, there were 1,584 coronavirus deaths in New York City. Males continue to dominate the demographics of death with 985 deaths for males vs. 597 deaths for females.

Queens continues to lead the death rates in the five boroughs with 499 deaths out of the total of 1,584 coming from Queens. But the Bronx is a close second with 438 deaths. Brooklyn reports 388 deaths with Manhattan reporting 179 deaths, and Staten Island with 79. Overwhelmingly, the deaths are occurring among those with underlying medical conditions including diabetes, lung disease, cancer, immunodeficiency, heart disease, hypertension, asthma, kidney disease and GI/liver disease.

This is the real story of coronavirus. Those without underlying conditions—including elderly people without underlying conditions—are highly unlikely to die. As the April 3 data demonstrates, only one NYC person without underlying conditions age 65 to 74 died of the virus, and only 3 individuals age 75 and over died of coronavirus. That’s a total of 4 deaths of elderly people without underlying conditions out of 1,584 deaths from coronavirus.

Ironically, it is more likely for younger people without underlying conditions to die of the virus than elderly. While no one without underlying conditions has died under age 17, eight individuals from age 18 to 44 have died, and 14 individuals without underlying medical conditions age 45 to 64 have died. This finding can possibly be explained by the new research that reveals that viral dose matters—the level of the amount of virus a person is exposed to matters.

According to a report in the New York Times by Joshua Rabinowitz, a professor of chemistry and genomics, and Caroline Bartman, a genomic researcher, the importance of viral dose is being overlooked in discussions of the coronavirus: “As with any other poison, viruses are usually more dangerous in larger amounts. Small initial exposures tend to lead to mild or asymptomatic infections while larger doses can be lethal.”

This has policy implications. Working in an office building that once had someone with the coronavirus in it is not as dangerous as dancing with a coronavirus infected person in the streets of New Orleans for Mardi Gras or on the beaches during Spring Break. And neither are as dangerous as spending time around severely ill Coronavirus patients in an ICU ward. This helps us understand why young healthcare workers — without underlying conditions — are falling ill with the virus. Many of them are dying.

In China, more than 3,300 health care workers were infected including Dr. Li Wenliang who died after being the first to alert the world to the pandemic. More than 4,800 health care workers have been infected in Italy and as New York City’s hospitals become ever more impacted, several ER physicians and other healthcare workers are reported to be in critical condition — some health care workers have died. We have to protect healthcare workers with whatever they need and it seems that we are finally doing that.

But for the rest of us, it is time to think about the policy implications of the fact that dose matters. It is possible to return to work at the end of our 30 day confinement — but with proper precautions including masks, hand-washing, and appropriate social distancing. Medical personnel will always face extreme risk and need to be protected. But, for the rest of us, risk-reduction measures should suffice — including mandatory mask-wearing in congested cities like New York City. Considering the fact that “dose matters” can make all the difference.

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