Analysis of the number of deaths: Do the elderly really only die from Covid-19?

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Lockdown came too late: Analysis of the number of deaths: Do the elderly really only die from Covid-19?

The number of deaths related to Covid-19 is rising rapidly. 698 people have died in the past 24 hours alone. A look at the statistics shows who the lockdown measures came too late for.

A 78-year-old man from Heinsberg and an 89-year-old woman from Essen are among the first people in Germany to die in connection with Covid-19. That was in March 2020. Several months later, it is still mainly people from this age group who are dying as a result of being infected with the novel coronavirus.

On December 15, 2020, the Robert Koch Institute (RKI) reported in its management report: Of a total of 22,435 deaths since the start of the pandemic, 19,663 people were 70 years or older. That’s 87.5 percent.

An analysis from the USA also shows that the probability of dying from Covid-19 increases rapidly with age. While less than one percent of those infected die in the 50-year-old age group, it is already one in seven of the 80-year-olds and one in four of the 90-year-olds (as of September 24, 2020).

Deadly lockdown: Pandemic measures cost additional lives

The RKI counted 23,427 deaths on December 16. The pandemic is likely to cause significantly more deaths. On the one hand, there is a certain number of unreported cases, as not all deceased have been tested for Sars-CoV-2. On the other hand, every lockdown also harbors a fatal danger: This is what doctors from the Hochrhein Clinic in Waldshut-Tiengen discovered. They examined the death rate in their district from February 24 to May 31, 2020 – shortly before, during and after the first lockdown in Germany.

According to this, 227 people died in Waldshut in Baden-Württemberg in April – 37 percent more than in the same month in previous years. There was an average of 165 deaths in April of 2016, 2017, 2018 and 2019. Thus there were now 62 more deaths. Of these, however, only 34 had been proven to be infected with Sars-Cov-2. So 28 people died not directly related to the virus.

A significantly high number that cannot be explained by chance alone, emphasized Stefan Kortüm to FOCUS Online. The specialist in anesthesiology and intensive care medicine at the Hochrhein Clinic was the head of the study.

Kortüm sees the origin of the increased deaths in April primarily in emergency medicine. Shortly before the lockdown began, fewer people went to the emergency room. “From February 25, the numbers fell slightly,” reports Kortüm. “This coincides with the first statements from politicians that one should protect the hospitals, shouldn’t go to the emergency room with every cold, considering the expected rush of corona patients.”

However, the study suggests that not only people with a cold have refrained from going to the emergency room, but also actual emergencies who have thus foregone vital treatment.

An extreme drop in the number of patients was then recorded from calendar week 12 – with the start of the lockdown. Comparable studies for all of Germany have not yet been published. However, in April there were actually declining numbers in the emergency rooms in Germany and even worldwide, confirms Kortüm. This suggests that people elsewhere have waived important treatment due to the lockdown – and may have died as a result of it.

The study from Waldshut does not provide concrete information on the age of the deceased. However, Kortüm believes it is very likely that older people in particular were affected.

Gloomy look into the future: Rising new infections announce further Covid-19 deaths

Not only are the deaths particularly alarming in the older age groups, but also the number of new infections. We will therefore have to reckon with a further increase in deaths over the next few weeks.

After a sharp increase in the meantime, new infections in the lower and middle age groups have leveled off at a high level, but they are still increasing in people over 80 – in 90-year-olds they even skyrocket.

  • x-axis: calendar weeks
  • y-axis: 7-day incidences

Lockdown came too late – especially for the elders

The graphic shows: The lockdown light at the beginning of November apparently came too late, especially for the elderly, and should have included tougher measures. Ralf Reintjes, epidemiologist at the University of Applied Sciences in Hamburg, was skeptical from the start: “The approach of the November lockdown was too optimistic,” he said in an interview with FOCUS Online. “Just closing the restaurants, cultural and sports facilities is simply not enough to significantly reduce the incidence of infection.”

A look abroad shows: Where a hard lockdown was decided to act against exponentially rising infection curves, the curve then fell steeply. Examples are Israel, France and Belgium.

The soft lockdown in Germany should have been followed by a hard lockdown much more quickly, says Reintjes: “Politicians would have had to readjust the November lockdown after two or three weeks when it became clear that the infection numbers would not move down with the previous restrictions . ”

Now precious time will have to pass before the stricter measures that were decided in mid-December had an impact on the figures. “It takes a few weeks before the kink in the curve can be measured,” predicts Reintjes.

Death rates by federal state: Saxony with the oldest population at the top

The state of Saxony has the most deaths in relation to the number of inhabitants. Here there are 41.8 people per 100,000 inhabitants (as of December 14). This could be explained by the age structure, among other things: Saxony has a particularly large number of old people. In no other federal state are there so many people over 80 years of age in relation to the total number of inhabitants.

An evaluation by the Federal Statistical Office, which examined the age development in Germany from 2004 to 2014, named the city of Görlitz in Saxony an “age stronghold”. At 7.9 percent, there is no other urban or rural district where the proportion of people over 80 is as high as there. The district of Görlitz currently reports 248 deaths in connection with Covid-19 (as of December 14). For comparison: Berlin has so far recorded 846 deaths. That is only 3.4 times more than in Görlitz, although 14 times as many people live in Berlin.

The death rate cannot be explained solely on the basis of the old age of the residents. There are also other factors, such as the anti-corona measures taken by the respective state government, the supply situation in intensive care units and the population density. The latter can help to ensure that fewer people become infected in the first step, and thus fewer people die from the virus. The state with the lowest population density in Germany, Mecklenburg-Western Pomerania, also has the lowest number of deaths associated with Covid-19.

Hardly any deaths among very young people from Covid-19

Young, healthy people cope with an infection with Sars-CoV-2 much better. The RKI records particularly few deaths among the under-20s. Up to December 15, 2020, only eleven cases had been submitted, not all of which have yet been validated.

  • In the age group 20 to 29 there are 27 deaths.
  • There are 50 deaths in the 30 to 39 age group.
  • There are 174 deaths in the 40 to 49 age group.

The number in the 50 to 59-year-old category is worrying: there are already 667 deaths. The very first German citizen who died in connection with Covid-19 also falls into this age group: A 59-year-old man traveled to Egypt at the beginning of March and tested positive for Corona there, according to the Ministry of Health in Cairo. He had been treated in an intensive care unit, but his condition had progressively deteriorated and he had eventually died in the clinic.

Pre-existing conditions contribute to a severe course of Covid-19

Why do older people in particular die after being infected with Sars-CoV-2? The risk of a particularly severe course, which in the worst case can be fatal, increases with age. On the one hand, this is due to the fact that the immune system becomes weaker over the years. On the other hand, other diseases increase with age. If the body is already burdened with diabetes, cardiovascular diseases, cancer or a lung disease, the fight against Sars-CoV-2 is more difficult.

According to District Administrator Stephan Pusch, the 78-year-old corona death from Heinsberg “had a variety of previous illnesses”, including diabetes and heart problems. He eventually died of heart failure.

Klaus Püschel, Director of the Institute for Forensic Medicine at the University Medical Center Hamburg-Eppendorf, performed autopsies on the first corona deaths. From March 22nd to April 11th, he examined 65 deceased. More than half had a previous disease of the lungs, in 28 dead other organs were affected or they lived with transplanted organs.

None of the 65 deaths were exclusively sick with Covid-19. They also suffered from cancer, diabetes, obesity, cardiovascular problems, high blood pressure and arteriosclerosis.

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