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A clickbait title behind which there is a yet another article about COVID.
The title is still accurate, no?

And the reason for the decrease in life expectancy is still a reflection of the state of the US public health system.

The title subliminally suggests that we've lost 26 years of life expectancy. Many will perceive it this way. This very reasonably can be considered a form of clickbait.
The article definitely discusses COVID because it is a big driver behind this drop in life expectancy but it also talks about other causes of death that have increased in frequency that contributed to this change, and other causes of death that have actually decreased in frequency (but not enough to offset). Overall I found this to be a good article. I don't see how the title can be clickbait if it it contains an interesting data point that is expanded upon well in the article.
Living longer is generally bad for the economy. Why do we care so much life expectancy. Other than a measurement a countries success?
Because human life is more valuable than the economy?
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Other than us as individuals wanting to live long and see our family grow or to explore the wonders of the world. Why does one person living long have more value over someone having a good quality life?
I don't see how these are mutually exclusive.
People living longer is generally a proxy for people being healthier. A healthier society is more prosperous since people can work more and produce better output.
Sure but you end up with wealth hoarding as older people live into retirement and by the time they pass on their kids are entering retirement.
Then tax them or otherwise increase the distribution of wealth. "Kill them since it's easier" is such an odd way to look at things to me.
Not sure where I said I said kill them or implied killing them.
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Society exists for the betterment of its constituents. Life expectancy is considered an important success metric because people generally like living long. While you're right that old people are less productive, the health of the economy is not the goal of a society. The economy is a tool we use to better our lives. We should never be beholden to the tool itself. The moment the economy stops making our lives better, it's time to make some changes.
Living longer generally has a negative affect on the economy so the quality of life in some ways is worse for the younger generations. So it seems it’s only useful as a metric of short term success of a country.
All those laborers working, enabling greater return to capital, are doing so based on a social contract. One that doesn't send them to the glue factory the second they no longer are capable laborers.
That can't be true, the free market is efficient and if killing off your parents increases that efficiency then it obviously should be done because nothing else matters.

/S

Besides what others have said, it's important not to confuse life expectancy and longevity. Because life expectancy averages lifespans, life expectancy declines very rapidly when a lot of young people are dying. Note that the article mentions drug overdose as a major driver - which probably affects the young more than the old.
Life expectancy and longevity goes hand in hand. Resolving issues hindering life expectancy only serves to extend longevity.
Getting infant mortality down would have a big impact on the life expectancy in the US but has nothing to do with longevity.
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> Living longer is generally bad for the economy.

How?

We can save the economy if we all just die earlier and stop having kids. It's us that's the problem. Do this and the stock market will go back up!
I feel compelled to echo that life is worth living without a booming economy.

You’re here because that’s true and your ancestors agreed.

How does reducing the size of the consumer pool help the economy? More consumers helps the economy.
Retired generation tend to hoard their wealth to live off, not spend it, by the time they pass their kids are retiring, the wealth never goes back into the economy as investments or purchases. Or of course you end up with an aged population that depends on taxes to survive.
Do they use average for these numbers? I suspect they do. I wish they would give median, mode, and standard deviation also.
It is super rare to see information on the data’s distribution. You are lucky if they even specify if the average is mean or median.
There is a surprising meta story buried in this data. While covid killed many, and (unintentional) overdoses were in second place, heart disease was in third place. On first glance this might not seem extraordinary, but it is. Heart disease isn't something that presents over a matter of months or even years. It takes decades of obesity/smoking/high blood pressure/diabetes for atherosclerosis to form, before one might suffer a heart attack. A sudden lifestyle change during covid shouldn't have resulted in any change to present day heart attack rates. But it did.

There is data pointing at two possible causes here. The first is neat and politically palatable. Covid increases the risk of heart attack. (https://www.nature.com/articles/d41586-022-00403-0#:~:text=M...).

The second, much more contentious fact is that mRNA vaccines elevate the risk of heart attack. (https://www.bmj.com/content/378/bmj.o1554) In fact, Danish research currently indicates that those who have taken the mRNA vaccines are at greater risk of all-cause mortality. (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4072489). Note that this paper is currently in peer review. It is receiving more scrutiny than perhaps any other paper in history. There are literally trillions of dollars on the line. Using public, global data, the Danish researcher finds that one is more likely to die after taking the mRNA vaccines, even after accounting for the protective effects against covid. Interview here for those interested (https://unherd.com/thepost/study-into-mrna/).

I think it likely that the increase in heart attacks is a combination of both of these factors.

Disclaimer: I have taken three mRNA vaccines.

Hasn’t heart disease been the top cause of death for years?
Yes, heart disease and stroke have been way up there for decades. Type 2 diabetes, also diet-driven, is a close follower. Cancer may have been behind these two but it as well has many diet-driven types, but I’m not sure how much those comprise overall rates of cancer.
Since the 1920's it's been way up there on the list.

But just ignore that. This is about Covid, it must be. /s

It's almost like there can't be only one factor in anything to do with a list containing as many variables as one full of people who died from heart disease.

Yes, but the study is exploring the sudden change.
The paper you linked is investigating whether the mRNA vaccine influenced 46 deaths among 122,164 recipients of the vaccine. That is not relevant to the change in life expectancy observed in the submitted article.
You know thats how study analysis in life science studies work don't you?

Check out hazard ratio - https://en.wikipedia.org/wiki/Hazard_ratio - it covers the increase in likelyhood above base case. You seem to be implying it doesnt matter because the absolute number is low. Thats not how life science studies work. If this causes a 10k% increase in your hair turning orange, even if it affects a low number of people, its still a drastic increase in hazard ratio.

The things you said are correct. However, it is also true, to parent’s point, that the error bars grow relatively larger the smaller the absolute sample size, and the smaller the measured effect is, right? This is also how life sciences work; noise in the data is more problematic the smaller the sample, and certainty is only achieved when the signal is far greater than the noise. (These researchers aren’t claiming certainty, they’re using this data to say more study is needed.)

The abstract says “For overall mortality, with 74,193 participants and 61 deaths (mRNA:31; placebo:30), the relative risk (RR) for the two mRNA vaccines compared with placebo was 1.03 (95% CI=0.63-1.71).”

A single person change in the death rate for either group here can change the summary outcome that people use as their talking point. Meanwhile, out of any other sample of seventy thousand people, it’s pretty likely that both numbers will change, probably by a larger delta than 1.

The real problem here is drawing too hard of a conclusion like the GP did: “Danish researcher finds that one is more likely to die after taking the mRNA vaccines, even after accounting for the protective effects against covid.” Framing things this way is premature and misleading when you’re talking about 31 people out of 75k. The researchers did not come to that conclusion, they did not necessarily find that everyone is more likely to die with the vaccine than without, they found a small sample that perhaps suggests it might be possible, and they’re saying we should collect a larger sample to find out if it’s true.

It potentially is relevant. If the mortality rate is ~8/1000 and all 46 of those individuals die at half their expected duration it appears to move the life expectancy down by over a year when extrapolated to the general population.
Is there a proposed mechanism for the increased mortality? I would be more curious if there were. Why would receiving a segment of a genome in a vaccine be more dangerous than receiving all of it by getting COVID?
He didn't suggest that it was more dangerous than covid (there are studies that tackle this question though, with answers that vary by age cohort, leading to health authorities like Denmark and Sweden prohibiting the jab for young people)

The proposed mechanism is clear, it's not the genome it's the spike protein. The jabs were suggested to keep this protein in the local muscle tissue, and clinical evidence suggests that this does not happen. It makes its way to the heart where it causes issues

Wasn't this suggested in the original comment's italicized phrase, "even after accounting for the protective effects of COVID"? It argues that we have the relative risk backwards.

This might have been suggested by some, but systemic effects have been acknowledged since the beginning. Both of the original papers on the safety of the Moderna and Pfizer vaccines report systemic effects being more common in the jab group than the placebo.

> Danish research currently indicates that those who have taken the mRNA vaccines are at greater risk of all-cause mortality.

Is the same true for people who take the flu shot? Maybe people who get vaccinated are just less healthy in general.

No and no I think. Flu shots are not based on mRNA. Being vaccinated is also directly correlated with being healthy.
Being vaccinated COULD be correlated with being less healthy just in that old people might be more likely to be vaccinated and young people more likely to "take their chances", and there are few things less healthy than being old.
My perception was that most infants all over the world now receive shots like MMR, TDaP and IPV. The herd immunity gained through this exercise automatically makes us less susceptible to certain diseases which were widespread even 50-60 years ago, and in turn, more healthy, even at old age.
> Being vaccinated is also directly correlated with being healthy.

Source?

I've shared my perspective in response to the other comment.
Another obvious cause for the increase in heart disease related deaths which you ignored is that level of treatment and detection of heart disease was reduced due to people less regularly seeking medical care during the pandemic.
How did it look in US during height of covid? I would definitely agree in say most of Europe where people including doctors got properly shit scared, and medical care was... lacking to be polite. Very bad time to be in situation to require medical help.

But I had the impression that US (maybe apart from NY) was trying to keep business as usual as much as possible.

>But I had the impression that US (maybe apart from NY) was trying to keep business as usual as much as possible.

More or less a lot of companies took some handouts from the government while half the country insisted it was a demonrat hoax and the others stayed home to try and stop having out hospitals blown the fuck out.

There was a strong effect on medical services and the willingness or ability to use them for non-covid illnesses during the height of the pandemic. Many people who took Covid seriously locked down and may have put off getting routine examinations or even going to the doctor when they should have because of fear of exposure (my parents for example, who while in a Republican area where most people were not very concerned about covid were this way and many other people especially in major blue cities would do the same) and on the other side, people in areas that may have been skeptical of covid may have been turned off because of reduced or near zero service while local hospitals dealt with the effects of covid on the local community.
Routine checkups and other non-urgent care was frequently postponed or canceled, especially during the bigger waves when hospitals and ICUs were at risk of being overwhelmed.
It wasnt exactly lacking but immediately after COVID really started all non-critical office visits were cancelled. Lots of elective and non-critical outpatient procedures were canceled and impossible to reschedule for months. Even now it can take months to schedule a regular checkup. Staffing issues and long waits at the emergency room are still common. If you’re about to die there’s not going to be a wait.

A lot of people, including myself, waited a long time for our yearly (or bi yearly if you’re older) visit. I’m sure a lot of older people could have done some preventative stuff to prevent a heart attack. Like getting a stint put in if they had an irregular heart beat, had this happened to a family member in their late 80s.

Short of having some acute emergency, it was for all intents and purposes IMPOSSIBLE to get a doctor's appointment of any sort through the height of the pandemic. At least that was my family's experience in Los Angeles.
I wonder if the mechanism is the same for both covid and the vaccines - perhaps the immune response/inflammation by the body to the common proteins in the vaccine/virus are the cause in both?

On a side note I wonder if Low Dose Naltrexone would help, as LDN is generally considered helpful for "correcting" an overactive immune response.

Yes, in early 2020 it was reported pretty often that the unique-for-a-coronavirus spike protein was the part of the virus causing most of the damage. Seems like no one thought twice about injecting us with mass amounts of it for the vaccines...
Well, less mass amounts of it then catching actual covid...
If its an inflammatory response you're worried about, maybe just eat more fish?
Certainly - I'm not very concerned about covid/vaccine inflammation for myself as I (unfortunately) have other health conditions that already cause a lot of inflammation. Though, aren't there mercury risks from consuming fish in large quantities?
> Though, aren't there mercury risks from consuming fish in large quantities?

The mercury exposure can vary by a factor of 100 depending on what species you're eating, and sourced from where

In general, to decrease mercury exposure, stick with small fish that are short-lived and lower on the food chain, as well as shellfish.

Mercury reference for a high level idea (some of this is out of date or not specific enough by species/fishery and also doesn't cover many local fish): https://www.fda.gov/food/metals-and-your-food/mercury-levels...

edit: a good reference site is https://seafood.edf.org/ which breaks down by fishery and multiple contaminants. For example, if I searched "striped bass" I can see that the wildcaught ones are higher risk than farmed ones due to water contamination of both mercury and PCB on the east coast of the united states.

Maybe its also the exposure to any form of covid dna. There is no end to variance of long covid symptoms, and most of them are simply not reported. Ie my wife is a doctor, and after 3rd covid (which should have been some variant of omicron) she noticed her hair falls out more.

Could be coincidence, but her sister who lives 1000km away got similar (or same due to visits) covid at roughly same time, and has same symptoms. Nobody reports stuff like this unless some researchers go out and actually start asking for this specifically en masse or do some hard statistics like this on whole populations.

But then again, I realize I know next to nothing about this virus in detail, and people like to speculate.

Is there reason to believe "long covid" is even a thing? Is covid so significantly different from many diseases that it has about 50 various "long" symptoms that run the gamut from brain fog to change in taste to a rash and now to hair loss?

I do notice that there's significant baggage associated with covid, and a large number of people terrified of it, along with most of these symptoms being neurological (and the rest self-diagnosed). It's also politically convenient to push "sure the disease itself is like a bad cold, but you'll be permanently damaged in various unforeseeable ways!".

I'm 3x vaxxed myself, I've also had covid to be clear. All the evidence I've seen about long covid is anecdotes. Is there any hard data to substantiate?

I've suspected the whole time that a bunch of viruses trigger "long [whatever]" symptoms of some kind for some people who get them, and Covid's just where all the attention is. People get a normal cold or the flu and are still a little foggy a year later, maybe they don't connect it to the virus, you know?
I think your skepticism here is good and smart. I had the same. Anyone who relies only on self-reported issues has the ability to have general axienty increases cause 'covid associated' behaviors.

That said, neurological covers more than just self-reported concerns like this. Take a look at this paper: https://www.nature.com/articles/s41591-022-02001-z

You can ignore a lot of these (and I do) as they are self reported, but some are not. Consider Cerebrovascular disorders or some of the others.

There appears to be an association that is non-subjected non-self-reported between people who got covid and people who did not. The study makes NO statement that can be attributed to people who got covid with/without the vax because the study was started/concluded prior to the vax being in general circulation amongst a high number of the population.

So yes, I think "long covid" has a large amount of general anxiety - but not this much. I think its likely we will find this is 1/2 our brains just making up symptoms and 1/2 actual legit f'ing scary problems. I hope I'm wrong. This study implies I'm not.

Cheers.

A lot of people went really sedentary during the pandemic. This is reflected in other data as well and could likely explain the uptick in heart disease: it isn’t the development of the disease that needed to go from 0 to 1, but the transition to symptomatic expression across a population that essentially moved a big clump of already-diseased but asymptomatic people forward at once.
Two additional factors:

- Much higher stress from making ends meet, world events, national decline, etc.

- Supply chain issues leading to lower quality chemical byproducts in your food and household items. Though we don’t know how much of a problem this is and we may not for a long time, if ever.

Good points.
I wonder about your sedentary comment. You said during the pandemic, when we were encouraged to stay home, but what about after? At first it feels true because a lot of people WFH now. But before Covid, most people drove to work, which isn't really any better than WFH and it's arguably worse due to the stress of driving.

Covid also strongly encouraged outdoor activities over indoor ones. In my area, many indoor events were converted to outdoor events and we found that even with the relaxation of precautions, people prefer we keep them outdoors as it was more enjoyable.

I suppose my experience doesn't match up with people who live in more disagreeable climates, like the South or Southwest.

Yeah it’s a complex shift but all the indicators I’ve seen at a population level show upticks in markers associated with increased sedentary behaviors.

Some people definitely went the other way and took up more healthful activities but the dominant shift seems to have been toward less physical activity.

I personally wonder if the “long covid cognitive effects” aren’t down to things like less exercise, more social isolation and too much screen time, especially as people keep looking for explanations for effects on children.

It’s not like it all went away when the pandemic officially ended either. People can be slow to change.

I remember reading years ago that the average American adult puts on 3 lbs during the holiday season and then never recovers by dropping that excess weight, so it just accumulates every year. For the people whose fitness routines and health were negatively impacted by COVID (e.g. people who had young children at home, in my experience, and people who got really sick), I think we might be seeing a similar effect. You can't get back lost time even after life "returns to normal."
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It's easy to go from non-sedentary to sedentary. It's harder to go back. So some didn't go back - they remained sedentary after Covid concern faded.

I don't know what fraction of the population went sedentary, and what fraction of those remained sedentary. It could be enough to matter statistically.

As far as I know, while a sedentary lifestyle leads to or exacerbates the physical deterioration which leads to death by heart disease, I do not think slowing down brings it on, at least within a couple of years. For people at high risk, unaccustomed exercise is recognized as a trigger of acute disease (with snow-shoveling being a well-known example.)
> Danish research currently indicates that those who have taken the mRNA vaccines are at greater risk of all-cause mortality

My first suspicion is that those who have more contact with medicine tend to have greater all-cause mortality because they probably have a reason to have contact with medicine - there's tons of correlation and it's hard to tease out causation.

Vaccines certainly have tradeoffs and in the US at least there are mechanisms in place to try and offset those https://en.wikipedia.org/wiki/National_Childhood_Vaccine_Inj...

What's new is the politicization of vaccines, and particularly in one American political party, but I suspect the math (including the new mRNA vaccines) is as it ever was; vaccines are a huge net win for public health.

Generally one thing I've noticed about medicine could probably be summed up as - it's really complicated, there are trade-offs to nearly every decision, and you eventually die anyway.

This is misinformation. COVID-19 vaccines aren't covered by the National Vaccine Injury Compensation Program [0], but the Countermeasures Injury Compensation Program (CICP) [1]

But wait, there's more!

> Will the Countermeasures Injury Compensation Program provide compensation to individuals injured by COVID-19 vaccines? [2]

> ...For a category of vaccines to be covered by the VICP, the category of vaccines must be recommended for routine administration to children or pregnant women by the Centers for Disease Control and Prevention, subject to an excise tax by federal law, and added to the VICP by the Secretary of Health and Human Services. No COVID-19 vaccines currently meet this criteria.

So, no, there is not a mechanism in place to offset those.

[0] https://www.hrsa.gov/vaccine-compensation [1] https://www.hrsa.gov/cicp [2] https://www.hrsa.gov/cicp/faq

Fair enough, I did not mean to imply that it would be covered; I don't know those details. All I'm saying is that it has been recognized for sometime that there are vaccine injuries, but the net benefits of them to public health have been large.
Agreed, it's a valuable program. Just not (currently) relevant to the discussion of mRNA COVID-19 vaccines.
I find that study unconvincing, it is based on very limited data. They essentially looked only at the initial RCTs for the vaccines, and the total number of deaths is very low there. This ignores all the information gathered after the vaccines were approved, which of course doesn't have randomly assigned placebo groups, but does have far greater numbers. If the mRNA vaccines were indeed killing as many people as they saved we would have seen that in other sources of data as well.
> The second, much more contentious fact is that mRNA vaccines elevate the risk of heart attack.

The bulk of the covid excess deaths (unsurprisingly) happened before vaccination. This is going to be somewhat difficult to tease out of the numbers. Frankly it's probably not true.

> the Danish researcher finds that one is more likely to die after taking the mRNA vaccines, even after accounting for the protective effects against covid

That is absolutely not what that paper says! Go read it again.

I've been persuaded that we are plagued by hyperinsulinemia due to the sugar in the American diet. There's plenty of studies on this but as an additional point of anecdata, I reached for a can of Campbell's butternut squash soup yesterday, packaged with their new "healthy" brand "Well Yes!" https://www.campbellsoupcompany.com/newsroom/news/campbell-s...

NINETEEN GRAMS of sugar. In a small can of squash soup.

> Danish researcher finds that one is more likely to die after taking the mRNA vaccines, even after accounting for the protective effects against covid.

Please be careful talking about it like this, it has the potential to be misleading. This is too strong of a statement, and the researchers did not make a claim this strong. They have a small sample for which the number of people who died with placebo was 1 person less than the number of people who died (not necessarily of COVID) after taking an mRNA vaccine. With 31 people in the sample who died after taking the vaccine out of 74,000, the potential for noise is high, and they are simply suggesting that we should ask the question again with a larger sample, they are not claiming to have conclusively found that the odds of actually dying with the vaccine are higher than without.

another factor - lockdown decreasing social ties, which in turns increases mortality. Loneliness kills.
With so many excess deaths due to COVID, should we expect a deficit of deaths in coming years?
In that the people who are already dead won't die again? Since they will no longer be counted I would expect numbers to simply return to average among those left living. I doubt the survivors are extra healthy or less susceptible to the normal causes of death.
No, as in those that were going to die in the future, will no longer die in the future. Returning to the average doesn't make sense. There's a fixed amount of deaths that have to be spread across the timeline somehow and logic would tell us that lots of early deaths (concentrated very heavily in the elderly range of the age distribution) will necessarily subtract from the future. Of course there's a ton of other variables at play that could hide this reality.
That's not how the math works though. The people who are dead brought the average down because they died at a younger age. The only way to compensate for that would be if those left alive live longer than average. There is no reason to expect that to happen.
It seems to me like I'm arguing the instantaneous rate of death will be lower afterwards, since there's a swath of elderly people missing from the population, but you're arguing about the average reverting over time (and specifically that it won't revert from the impact of the pandemic). I don't think the premature death impact of covid will be that large compared to, say, obesity or diabetes. So the impact on the average won't be severe & could be easily offset if our public health leaders produced actual positive results. Instead we've got an unhealthy population and no one accepts the blame.
>people who are already dead won't die again?

Oh look, another chronic-death denier

COIVD killed and kills mostly the aged, infirm, obese, or otherwise health compromised people. So the survivors are more healthy than average and less susceptible to normal causes of death.
That makes sense and should have a smallish effect. But to compensate for such a large and sudden drop in life expectancy wouldn't the survivors need to be exceptionally more healthy than average and live significantly longer? That's surely not going to happen in two years either. So what I would expect is a very slow reversion back to average, with maybe a slight bump above average in ten years or more.
As we keep learning more about long Covid, I expect that even if we stopped transmission of the virus today we’d still be seeing excess death and shorter lifespans for a long time. There are a lot of people walking around unaware of the organ damage they are living with due to minor bouts of Covid. Since the effects with subsequent infections seem to be cumulative, and more and more people getting repeated infections the next couple of decades are going to be a massacre with deaths from several different causes going up as people start to succumb to the effects of long Covid.
Completely uneducated opinion, but probably not. By participating on Reddit's Herman Cain Award subreddit, one of the themes is that survivors from advanced infections don't die outright, but are left with lifetime illnesses. I can't help but think that these long haulers, who weren't in the best health to begin with, are going to survive over the next 5 years.
These excess deaths occurred over a period of two or three years. The subsequent deficit will be spread over perhaps 30 years so it would be around 1/10th as much.
I wonder how much of this has to do with COVID and how much has to do with fentanyl.

I am shocked that no one is even talking about the excess fentanyl deaths. Also how much of this is attributed to our fading health system?

Everyone is talking about fentanyl. The problem is that overdoses aren't "excess deaths", those show up in hospitals as real data. And they aren't enough to explain the kind of numbers we saw with covid. Surely fentanyl overdoses are a problem, and they get a bunch of coverage. But they absolutely aren't "the real story" behind the covid excess death numbers; that's just your priors arguing in your head.
Fentanyl overdoses and suicides are excess deaths in that they contribute to excess death numbers when they are higher than expected. They just don't account for the full number of excess deaths over the last few years - the lion's share is almost certainly from the virus.
This article about life expectancy specifically lists overdose deaths as a major contributor to decreased life expectancy
The comment I was responding to was positing that the covid "excess deaths" statistics (not the same thing as life expectancy measurements) were confounded by fentanyl overdoses. They are not.
Fentanyl and suicide tend to kill young people, while COVID tends to kill people who are very old (at one point, the average age of a COVID death was greater than the life expectancy number).

It's the increasing mortality of young people that really drops life expectancy.

While true, the obesity issue was always going to force this down eventually anyways. Boomers are probably the oldest generation that will die younger than their parent due to it (statistically speaking). And probably just get worse from there for a good while. Innovative breakthroughs in health science can not keep pace with the wave of obesity related health issues.
But did the lockdown cause more overdose deaths?
The number I could find for all cause drug overdose death (including everything in addition to fentanyl) for the last twelve months was 110k.

Cardiovascular disease 870k.

Cancer 610k.

Usual caveats apply to cause of death reporting, but fentanyl alone is not terribly relevant to this topic.

If a typical fentanyl overdose is destroying 30-40 years of life expectancy and a typical covid death is destroying 5, then 40k fentanyl overdoses would be similar to 280k covid deaths in terms of life expectancy.

I don't know if my numbers are right, but your numbers don't lead me to dismiss fentanyl from the current conversation.

Yeah, I don’t think excess COVID deaths are driving life expectancy either. It’s the two things I listed in my comment, both of which are getting worse with time and are affecting people earlier and earlier.

Although I’ve heard anecdotal evidence that COVID infection does damage cardiovascular health.

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No one is talking about fentanyl? The opioid epidemic is a constant and ongoing topic of conversation and debate. It's one of the defining political issues of our time with Gavin Newsom just weeks ago vetoed a supervised administration bill which took up a news cycle. The opiod epidemic is one of the most talked about things out there. Pharma companies and others are being sued to hell and back for their role in the epidemic. Just this February there was a 26 billion dollar settlement[1]. Honestly, I'm not sure how you'd manage to avoid hearing news about one of the defining public health issues of the past two decades.

[1] https://www.npr.org/2022/02/25/1082901958/opioid-settlement-...

Fentanyl has had a ton of coverage so I’m not sure why you think nobody is talking about it but I suspect that our limited response mostly has to do with the degree to which drug problems are often symptoms of social problems we’ve chosen not to do with.

The article specifically details the different factors in the overall decline in expected longevity. COVID is the largest but definitely not the only one:

https://static.scientificamerican.com/sciam/assets/Image/202...

Is life expectancy measured from 5 years old onwards, or from 1 second old?

It's frustrating to see numbers thrown around about how much life expectancy rose over the years in the past, only to discover that the average was so low because so many kids never made it past 5 years old. Why would including those deaths be in any way informative for people alive? That average tells me almost nothing about my life expectancy! :(

The article never mentions it, but the graph says "at birth" is the starting point.

Maybe the article was updated since you read it? It goes into their methodology:

"Arias and her colleagues calculated life expectancy using a technique called a period life table. This involved the researchers imagining a group of 100,000 hypothetical infants and applying the death rates observed for the real population in 2021 for each year of those infants’ lives. The result is not the life expectancy for a cohort of actual babies born in 2021 but rather a snapshot of how life expectancy rates would apply to various age groups at a specific point in time, Arias says."

"Life expectancy" is short hand for life expectancy at birth, but other life expectancies such as life expectancy at age 65 are also measured. For instance, https://data.oecd.org/healthstat/life-expectancy-at-65.htm
The conditional distribution of time-to-death is how I interpret it after conversation with my actuary fellow friend. "Conditional on being in this well-defined population, how long until I die in expectation?"
Well that is a problem with all stats reporting. Infant Mortality is another one "journalists" love to beat the US health system over, never highlighting how the different stats are reported by different nations, or other factors that make the US infant Mortality rate naturally higher due to our reporting standards, and standard procedures.

Life Expectancy is not really a good guide for anything, it is just a number various political groups can use to influence public policy to their agenda

I mean, there is still a large portion of the US who simply don't get any form of preventative cure, doctors becoming extremely overworked and stressed from the impossible amount of diagnostic and billing paperwork, and rural hospitals regularly closing. I've found there are few defenders of the US healthcare status quo who aren't insurance reps or ideologs who have never had a lapse in coverage
You are correct that there is not much debate over the short comings of the US system, the debate is over what is the cause of those short coming, and what is the resolution.

I, and many others, believe government regulations is the cause including everything from the tax code that irrevocably links insurance to employment, to regulations that transform "insurance" to prepaid health plans, to medicare massively under paying providers, and about 10000 other things...

The "other side" believes government is the holy grail and will magically fix everything if we just make everything single payer medicaid for all...

The main argument I've heard is that healthcare is simply something in which an individual carriers no bargainning power. Death versus payment is a system which is ideal for capitalism to thrive because you can basically charge as much as an individual can bare. In such a system, any non-guaranteed solution will be flawed because the desires of the market (low cost/high profits) will never align with the desires of patients (affordable care/access to large amount of care).

The only way to break that paradigm is to guarantee access to care through some non revokable mechanism, which typically needs an entity like a state to provide (but could be run through a sufficiently large enough non-profit)

>>Death versus payment is a system which is ideal for capitalism to thrive

Which is a false dilemma, red herring and a strawman all in one.

The vast majority of health services / decisions are not life or death, far far from it. We can see that in area's where insurance is does not normally cover or is very limited. Dental Services, Vision, Cosmetic Surgery, etc etc

Even in "traditional" health care, the "urgent care" market is pretty competitive with providers having standardized price lists I can look up online and see which provider I want to go to.

For example about a year ago I had a trip and fall, my shoulder was in pain and I have a High Deductible insurance so everything would be out of pocket. I looked at the various providers near me, got their standard prices and went to one that provided the best value to me.

Market forces absolutely can be applied to 90% of medical care. For true Life and Death emergencies, a huge part of those will be covered under other insurances anyway like Home Owners, Car, etc. for the remainder will maybe that is a place for government regulations but that does not justify a full take over by the government

I'm pretty sure this was what Obama attempted (basically universal coverage for life threatening scenarios) and it was pretty much killed on the vine.

There are many individuals who are pretty healthy and for whom high deductible plans are sufficient, but that does not apply to those with chronic health issues (and ironically, those with chronic health issues often have trouble maintaining employment, which is honestly pretty funny in a macabre way of maximizing suffering). I think the issue is that the clarity of what is minor and what is life and death is unknown until diagnosis has occurred. Additionally we still have a situation where if you have a pain in your arm and are uncovered you're in a pretty rough spot. I guess faking a car accident to get your care on someone's car insurance is a solution... but I'm not really sure that scales to an entire nation

>Additionally we still have a situation where if you have a pain in your arm and are uncovered you're in a pretty rough spot.

Correct, and I believe that market forces will reduce the costs there by making health choices economical. Walmart tried to get into the market of providing basic health care clinic at their stores. They dropped the program because the regulation were so over bearing even they could not make it profitable. The root of the high costs is government...

However at the heart of this is the underlying debate of if healthcare is a right. People that believe it is reject the idea of profiting off healthcare so anything that would allow for profits is viewed as wrong. Ironically many of these same people have no problems with mandating everyone get a COVID Vaccine that is making Pfizer, Moderna, and other billions in profit

I only support the concept of negative rights, so you in that context you should have the right to seek healthcare from the provider of your choice free from government regulations, but I do not believe the government or anyone has the duty to provide you with care. Under that system of rights the best method to provide healthcare for the most people and the lowest possible price and highest quality is a market.

>I only support the concept of negative rights, so you in that context you should have the right to seek healthcare from the provider of your choice free from government regulations, but I do not believe the government or anyone has the duty to provide you with care.

That makes sense with your positions, and I don't view long debates on fundamental positions to be productive on the Internet, ask not what your country can do for you and all that. I do hope life is always good to you and you'll never be in a position where you'd be left without access to care for an extended period; that gnawing fear of going bankrupt from your own body does terrible things to people.

It might be harder to compare against countries or consider as some sort of predictor - but as a measure presuming we the methods are similar over time - the trend should be valuable. Regardless of starting point, if the measure in the US, for life-expectancy or infant mortality change, and it wasn't a measurment change, then there is something worth understanding going on in the complex system of lifestyle and healthcare in the country.
I personally don’t see the average as useful anyway. It’s a stat meant for headlines and a surface level benchmark as it’s easy to consume. More interesting would be to see the mix perhaps by decade of age at death. It also needs to normalize for number of people alive in each cohort.
Life expectancy is a weird one, not going to lie.

All the numbers are wrong from some perspective.

You mention a good one. The fact that life expectancy was so low in the past was due to infant mortality. If you lived to like 15 (IIRC), your life expectancy got much longer. Like 60s to 70s (once again, IIRC).

And that even holds today. The longer you live, the longer you can expect to live. If you're 70, you have a life expectancy of 14 (male) to 17 (female) years. If you're 80, you have a life expectancy of 7 (m) to 9 (f) years. If you're 90, you have a life expectancy of about 4 years.

And all of that seems kind of weird on the face. If I'm 70, I can expect to live 14 years on average. Which takes me to 84, which is greater than 80. But if I'm 80, I can expect to live to 87, which is greater than 84.

But it's the nature of averages. When I'm 70, I'm being average with other 70 year olds. Some of them die at 71, some at 93. Every year, more and more people drop off. If you make it to 80, all those who didn't make are no longer relevant.

Or measure it from conception, and it’s been falling like a rock for awhile now.
Depending on what you mean by "for a while now". It appears that abortions in the US peaked over thirty years ago and have been falling since.
Interesting. I was just shooting from the hip, but it looks like you’re right. (And still right even if we look at the abortion rate or abortion ratio, instead of just the absolute number.)
The people who write these papers and their reviewers don't take such elementary facts into account.

The actual answer is that US infant mortality has stayed almost constant during those 26 years, and was so low to start with that even reducing it to zero wouldn't have made much change in overall mortality.

https://www.statista.com/statistics/1041693/united-states-al...

The linked article also goes into more details.

"Addressing these gaps in life expectancy would require the U.S. to overhaul its health care system and make it work for everyone, many experts say."

Are they even listening to what they, themselves, are saying?

Yes, healthcare reforms can help. The economic gaps they previously mentioned are still going to be a problem. It doesn't matter if you have totally free healthcare if you lack any hope for your economic situation. That's where the substance abuse (liver disease, OD, etc), suicide, and other self destructive behaviors are still a problem. Ostensibly, the Healthcare reforms would have the least impact on the overall issue since Medicaid and Medicare are available to Native Americans already, and covid mortality is skewed to the older populations who are eligible for these programs already (although sign-up and other administrative issues may exists).

When I poke deeper into these type of life expectancy headline claims, I usually find life expectancy is continuing to improve for the typical North American adult who does not:

* Abuse drugs or alcohol.

* Become obese.

* Commit suicide.

While the overall statistical decline is unfortunate, the underlying causes result from things already known to shorten lifespan. If you add eating healthy, reasonable exercise and maintaining routine healthcare the numbers improve even more.

This is bogus.

"Life expectancy" is the number you obtain after you run a statistical model. More precisely the Lee-Carter model [1]. The Lee-Carter model is based on the idea that over more than one hundred years the average annual mortality rate (or rather its logarithm) decreases linearly for all ages and other buckets (sex or race for example). So, you fit a one factor linear model using SVD.

Now, after Covid-19, we've had an outlier event. Any linear regression would be thrown out of wack after such an event. Or, to be more technical, any L2 linear regression.

What is the predictive power of the Covid event for the future mortality? One can claim that people affected by long Covid will show increased mortality rates in the years and decades to come. Maybe. In any case, the Covid event holds zero predictive power to newborns. And life expectancy is by definition the life expectancy of newborns.

Bottom line: this is just a statistical artifact. Life expectancy now is not lower than before Covid. If anything, Covid accelerated some advances in medicine, so life expectancy is higher than the projected increase over 2 years.

[1] https://en.wikipedia.org/wiki/Lee%E2%80%93Carter_model

"the Covid event holds zero predictive power to newborns"

If their parents, siblings, or grandparents died or suffered long-term health consequences then newborns could be affected in all sorts of ways, up to and including shortening their lifespan.

The economic impact of COVID-19 will also affect people's mortality, as fewer opportunities, less earning potential, and economic recession will affect people's health by resulting in poorer health care, unhealthier living conditions and food, and quite possibly depression -- all of which are known to affect lifespan.

So I wouldn't be so quick as to rule out any affect on newborns. It's just more complicated than merely saying that X number of newborns died directly due to COVID-19.

You are right, but all those things can't be predicted by running the Lee-Carter model, which looks at the realized mortality in the past.

So, one might say, "There's a possibility future mortality could potentially be higher", this is not the statement made by Scientific American. The statement is "Our evidence tells us the mortality will be higher; it will be about as high as if we turned back time by 26 years". That is absolutely not the case. It's misinterpreting the results of a model that is applied mechanically to data that should not be applied to.