Risk and Young People- Weighing the Costs of Covid Restrictions
Some data comparing deaths of young people from Covid versus the spikes in suicides, traffic fatalities, homicides and drug overdoses stemming from the trauma of the last two years.
The worst part of the partisan disinformation injected into our politics by Trump, Fox and associated right-wing forces is that it has infected normal discussions on steps forward from Covid. Most parents, teachers, local elected officials, and voters have struggled in good faith on how to reduce the deaths from the pandemic. Weighing the risks and harms from opening or closing indoor dining, returning to workplaces, and opening schools is inherently hard.
While as I will argue, I think the balance of harms at this point support making schools as open as possible, including moving to drop masks in schools, there are good faith reasons to assess those risks and harms differently. That is what makes these decisions hard.
Making those decisions even harder is that the pandemic and associated measures to stop it have been accompanied by massive spikes in other death-dealing forces in 2020, including:
· a 7.2% spike in traffic fatalities (a 23% jump in fatality rates accounting for reduced driving), and
· a 31% jump in drug overdoses.
(Suicide did not have a similar overall jump, a question I will return to below.) You can see the bad faith injected into our politics by those trying to explain that jump in crime on anything other than the complete societal disruption that has driven these other measures of social alienation.
At the best of times, our political debate is skewed in what risks we focus on. As this chart reflects, adding in estimates for annual deaths from other sources of preventable deaths such as pollution, workplace injuries and unsafe consumer products, it is obvious how bizarrely skewed our discussions on “safety” are with their focus on the threat of crime compared to the far large death counts from traffic fatalities, suicides, drug overdoses and, pre-Covid, the largest source of preventable death, pollution.
Nowhere is that bad faith more reflected than police demanding rollbacks of criminal justice reforms in the name of protecting the lives of police officers, even as many police refused to wear masks nationwide and were some of the most vaccine-resistance groups in 2021. Even as 301 police officers died of Covid in 2021, police organizations instead played up the far smaller number killed in firearm deaths (62), notably only slightly higher than officers dying in traffic-related deaths (58).
Aside from the bad faith, what also complicates the debate is that Covid is an unusually age-skewed pandemic, with deaths concentrated among older people. During 2020, that mattered little as we shut down most social interaction, including in schools, to stop the spread of the disease. But as most people have become vaccinated, what is true is that this is largely not a “pandemic of the unvaccinated” but a “pandemic of the stubborn and old unvaccinated.” With the remaining unvaccinated far less likely to wear masks in their own lives or reduce social interaction, reducing spread in schools will not have much impact on the unvaccinated adult population.
In thinking about school policies, for example, that leaves us evaluating the danger and harms of Covid to children themselves versus the losses from reducing their social interaction. What’s true is, looking at 2020 CDC data (see table below), deaths from traffic, murder, suicide, and drug overdoses were far, far larger than Covid deaths for young people aged 0-14 and ten times the Covid deaths for the overall 0-24 age group. Just the increase in deaths from those markers of social alienation (see graph below) was also more deaths than from Covid in 2020. (Note: the CDC categorizes drug and alcohol overdoses as “poisonings.”)
Obviously, lockdowns and social distancing were not the only cause of these spikes in alienated behavior. Mass death all around, including among kids’ relatives, is enough to induce all sorts of anti-social and self-destructive behavior. On the other hand, as a sociologist, the kinds of disruptions in social relationships and identity we saw in the last two years is exactly what research from Emile Durkheim in his book Suicide and successor studies would predict leading to this kind of increase in alienated deaths.
Why suicide itself did not increase that much has been broadly debated and, of course, drug overdoses are often just an alternative version of that. Multiple studies (see here, here and here as well) showed a rise in depression as measured by traditional questions asked by psychologists. Yet completed suicides were flat or even fell slightly. Psychiatrist Scott Alexander had an extensive blog post exploring the issue and admits there is no satisfying answer, but there is an argument that the nature of Covid lockdowns created more family closeness to both monitor loved ones and put an extra brake on people committing suicide - but there is no simple explanation.
One important point is that overall suicide rates had been decreasing before Covid, but that was largely a drop among white Americans, while suicide rates for Black, Latino and Asian Americans had been rising – and continued to rise more under Covid. Black kids younger than 13 commit suicide at rates twice that of white peers. When you compare young white and black people, as the table and graph below show, all four areas of traffic accidents, suicide, drug overdoses and homicide increased more dramatically for black kids and young adults, ages 0-24. Drug overdoses increased 77% for young Blacks in 2020- compared to 41% for young whites, while the absolute number of additional Black murder victims was far more than young white victims, despite the former being a far smaller percentage of the population. If we are talking about an equitable response to Covid, taking steps to reverse this should be a top priority.
As Omicron still rages across the country, looking to return to any kind of normal still seems a stretch, but even with the explosion of cases due to Omicron, only about one child under 18 has died on any day nationwide from Covid in the last month—still far, far less than the spike in self-harm and alienated violence that has engulfed young people in the last two years.
Whether a return to a degree of normalcy will fully reverse those trends is an open question, but it is a reasonable hope and reason to try. What is also true is that those who talk about the value of normalcy for our kids should be first in line demanding adults get vaccinated to make that easier.
But at some point, the stubbornness of the unvaccinated should stop being the focus of public policy, and instead, the focus should shift to addressing the suicides, gun violence, traffic fatalities, and drug overdoses reflecting the trauma our kids have suffered.
There are reasonable debates on the best way and pace to do that, but it needs to start happening sooner rather than later.
Fascinating statistics and argumentation. Thank you.
On the statistics: Is there any way to know how many of the poisoning/drugs category are from drugs and how many from other types of poisoning? I assume the younger kids suffer relatively less drug-related deaths and older kids relatively fewer, but the exact proportion affects your argument that we should interpret drug and poisoning deaths as suicides and thus should discount the lack of measured increase in (other types of) suicide.
On the argument: What would you say to the argument that it is too early to reduce mitigation any more than it already has been reduced because community spread is so high and there is great value in reducing community spread, including reducing the numbers of Covid infections that lead to long Covid and reducing overall rate of infection and thus slowing the emergence of new variants? By this reasoning, the most urgent unaddressed need may be increasing access to vaccination around the world.