Tag: Old age

COVID-19 hospitalization by age in Maryland

Since mid-July 2020 in Maryland, we understood that the 20-59 yr age group was problematic, especially the 20-29 yr age group that is racing to overtake all age groups in terms of number of COVID-19 cases (relative to their population, see top chart below).

In terms of COVID-19 hospitalizations, we also saw a small rebound (see chart below; it seems that it subsides since beginning of August).

But what we didn’t know (for this small peak as well as since the beginning) was what is the age of these hospitalized populations. Did these hospitalizations impacted more the older adults? The younger ones? Or the children? The Maryland Department of Health COVID-19 dashboard doesn’t report that information (nor in the API).

Despite the recent issue about switching hospitalization reporting from CDC to HHS, it seems that CDC is still reporting hospitalization data at COVID-NET (Coronavirus Disease 2019-Associated Hospitalization Surveillance Network), at least until the end of July. There, it is interesting to note that Maryland is the only state which reporting represents 100% of the population (24 counties) – that’s good!

Screenshot of COVID-NET method description showing that 100% of the Maryland population is represented

Now, the CDC also has an interactive graph where you can see and filter the data by yourself. Here is the situation up to August 9, 2020, for Maryland:

The peak of April-May is well represented, with the 85+ population reaching a peak at nearly 100 weekly hospitalizations per 100,000 pop. All the other age groups increased during that time, the older the higher (unfortunately).

Now, since July, we see some of these age groups increase again. At the end of July:

Age group	Weekly hospitalization rate
65-74 yr	16.0
75-84 yr	21.6
85+ yr	17.6

Weekly hospitalization rates for the week of July 27, 2020 in Maryland, MD, USA

This, in my opinion, reinforce the view that, cases might be increasing in the younger population (also thanks to testing being more available) and children and young adults might be less impacted when infected. But the older population is the first impacted by any increase in cases. It was true in April-May. It is again the case with this small peak. If we should take preventative measures to contain COVID-19, it is for us – but especially for the older population, our parents.

To be continued …

As usual, you’ll find other graphs on my page about COVID-19 in Maryland (and figures above are updated with new data as they appear) and the data, code and figures are on Github (including these ones).

Age of COVID-19 deaths in Maryland

After my previous post on the age of COVID-19 cases in Maryland, it was logical that I write about the age of COVID-19 deaths in Maryland. So far, media and State Departments of Health all agreed that the older someone is, the more risk this person has to die from coronavirus.

So far, this is unfortunately also true in Maryland. In the graph below, we clearly see that people 50-59 years old have more than 250 deaths, people 60-69 have more than 500 deaths, people 70-79 have more than 750 deaths and people 80+ have nearly … 1,5000 deaths! The graph at the bottom also clearly shows that people in age categories 60 and above provide most of the new daily deaths due to COVID-19 (even if we came back down from a peak at about 40 deaths in 80+ at the end of April).

The simpler section at the latest date for which death data by age is available (i.e. today, July 9th, 2020) also shows this curve highly skewed towards older age groups (at the bottom, compare that to cumulative cases, on top):

The two graphs below confirm that people in old age are at much higher risk of death due to COVID-19. On top, if we report the deaths in each age group by the population they actually are in Maryland, we also see that deaths in 80+ disproportionaly affect this age group, reaching a COVID-19-specific mortality rate of 629 per 100,000 pop.!!! The table under the graph gives all the data points.

And when we look at it to see the relative importance of each age groups compared to the total number of cases, we see again that people aged 80+ have 46% of all deaths, followed by people 70-79 (25%) and people 60-69 (16%).

Age group (years old)	COVID-19-specific mortality rate (per 100,000 pop.)
0-9	0
10-19	0.1
20-29	2.2
30-39	4.9
40-49	13.1
50-59	28.8
60-69	70.8
70-79	180.1
80+	629.8

COVID-19-specific mortality rate, by age group, in Maryland, on July 9th, 2020

As opposed to cases by age, we don’t see here any shift in most affected age group: the older some is, the more risk of dying from COVID-19 exists (and part of the problem is the close living conditions in nursing homes). There aren’t 1,000 solutions to protect them: wear a mask and practice physical distancing, especially when there is a risk to meet elderly people and transmit the disease to them!

To be continued …

Projection of the American ageing population

Yesterday, GOOD issued an infographic of America’s Aging Workforce (reproduced below). One of the key learning I take from it is that many Americans are unprepared for retirement. Indeed, the average American worker has saved $25,000 for retirement but it is estimated she/he will need $350,000 if she/he wishes to retire at 65 (i.e. 14 times more money!).

I was also wondering: after China and Belgium, how will the population age in the USA?

The US Census Bureau maintains national projections of the population and its latest data is from 2009. Among other things, it takes into account the resident population and demographic components of change (births, deaths, and net international migration). For international migration (in and out of the USA), there are four alternative assumptions (described in the method statement):

in the High Net International Migration scenario, they increase the previously projected net international migration by a fixed ratio ;
in the Low Net International Migration scenario, they decrease the same previously projected net international migration by the same fixed ratio ;
the Constant Net International Migration scenario illustrates the effect a level trend in international migration would have if maintained over the projection period ;
finally, in the Zero Net International Migration, the number of immigrants and emigrants is held constant at a value of zero for the entire projection period, thus assuming a closed population and no movement of individuals into or out of the United States.

By proceeding in this way, the overall number of migrants projected to enter or leave the population is (optionally) modified while maintaining the assumptions about the distributions of demographic characteristics.

Now, as expected, the American population is indeed aging. From approximately 12% in 2000 the population above 64 years old will increase to more than 21% in 2050 (in the constant scenario, see below). We also see an acceleration of the increasing number of elderly in the USA between 2010 and 2030. This US estimation is a bit lower than the estimations for China (>23%) and Belgium (>25%).

In the graph above, I took the Constant Net International Migration scenario as I consider it as the most conservative. When one plots all the scenarii, we can see the difference is not so big: the US population above 64 years old in 2050 will be between 19% (High scenario) and 23% (Zero scenario) of the total US population (see below).

The main issue remains to maintain older people as much as possible the same levels of health and independence as they enjoyed during their active lives. As highlighted by GOOD, America’s workforce will need to work well past age 65 to save enough money for retirement.

Yesterday was International Day of Older Persons

On 14 December 1990, the United Nations General Assembly designated 1st of October the International Day of Older Persons. 1990 … it is already more than 20 years ago! People who signed the resolution at that time are now more than 20 years older. Some (most) of them probably are now considered as “old persons”. Do they still have the same view on elderly? Maybe the highlighted principles at that time (independence, participation, care, self-fulfilment, dignity, …) are too broad, too short, just enough?

So, already a century ago 😉 people were concerned by the dramatic changes in the composition of the world population. Thanks to progresses and greater availability of preventive measures and treatments more people are living longer and healthier. Even in countries where fertility rate is high, there will be less and less working-age adults per older adult. When you look at China, the percentage of people above 65 years old is projected to rise up to one fourth of the total population in only 40 years.

Actual and projected percentage of people above 65 in China (partial data from Leeder et al., Columbia University, 2005)

Imitating other countries like the USA, UK, the Netherlands, etc., Belgium recently launched its Open Data Initiative. Well, don’t expect fancy graphs nor any “web 2.0” widgets, it’s only a repository of data made available elsewhere. Most (if not all) data is provided “as it is”, in proprietary formats and not easily combined nor even visualized. So I welcome this initiative but just wish it will be at least maintained and updated or, better, grown into something better, just like other government open data websites. A dream will be to have at least direct data manipulation online, downloads in open formats, a clearly open license and why not an open API?

So, what about the elderly in Belgium? There is a section about population forecast by age (which comes from the economy ministry in Excel format).

Projected aging of population in Belgium (data from http://data.gov.be)

The Belgian population will continue to increase. The older population in Belgium will increase faster than the younger population. But seen like this, the growth will not be very dramatic.

Actual and projected percentage of people above 65 in Belgium (data from http://data.gov.be)

If we look at the projected percentage of people above 65 years old, we see that Belgium in 2010 is already at the same status as China in 2040. If experts say China will have an alarming percentage of old people in the future, the future is already here in Belgium! But it’s also true that Belgium took many decades to achieve this allowing some adaptations to take place. China will achieve it in only a few decades and will have to cope with these changes very quickly.

UN highlighted some challenges and ways to overcome them at a country / government level. The main issues will be to maintain older people as much as possible the same levels of health and independence as they enjoyed during their active lives.

N.B. For other sources of data in Belgium, one may be interested in visiting the Bureau fédéral du Plan, Statistics Belgium and the Statistics section of the National Bank of Belgium.