Protect the Old – About 10% of Vaccination Effort Can Prevent 90% of the Deaths

We have to protect the old people first to prevent the most COVID-19 deaths. COVID-19 is most deadly to older people, so vaccinating the roughly 7-10% of people who are over 70 would prevent over 75% of COVID deaths.

This is the distribution of COVID-19 deaths by age in Israel.

The US has similar COVID-19 deaths by age. If the US vaccinate the roughly 40 million people over the age of 65 then 90% of COVID deaths could be prevented.

A little over 10% of the effort would provide 90% of the death prevention prevent.

SOURCES- David Wallave Wells, Ariek Kovler, Infoplease
Written By Brian Wang,

56 thoughts on “Protect the Old – About 10% of Vaccination Effort Can Prevent 90% of the Deaths”

  1. Yet your tourism related businesses and their workers will breathe a sigh of relief when the "losers" come back to Perth, spending their loser dollars.

  2. True, but your don't want half of your medical personel off sick at a time when they are needed most. So you have to make allowance for them and some other frontline workers as well.

  3. I expect there to be another bump upwards in the death rate in late Jan and Feb due to Christmas and New Year contacts. By the beginning of April we should start to see a decline in death rates due to vaccination of the elderly.

  4. I live in a city of two million people in a State that is seven times the area of Germany. We have had no covid-19 cases for 8 months outside of quarantine hotels that out-of-state visitors are required to stay in for 14 days for health monitoring. Life goes on as normal. The economy is doing well. Old people are not dying from covid and young people are not losing their jobs. Mass vaccinations will allow us to open our borders to folks from loser regions next year.

  5. We don't the profile of high spreaders. Other than people of high human contact exposure like Salon workers, cashiers, teachers, it may include unmarried young adults in their 20's and 30's. If we had, we could prioritize them too.

  6. The argument sheep dont like. But… but.. lives and old lives. you must close you know to save the others… you are so selfish ohh ohh conspiracy theories oh omg I wont talk to you any mooore. F off. Open your eyes. we can protect people and still carry on this is just insane.
    Here's the argument no one talks about. Whats better an old person dying and losing the 1 or 2 years he had left in him or a young person losing the rest of his life by losing his job, not paying his shlt and not having a family…

  7. are you having a laugh?? nobody wants to protect the old, not even their families, quite the opposite, everybody wants to get rid of the old, the sooner the better…

  8. It doesn't have to be 100%, 90% might be enough. Just get the death rate down to that of the flu and we could be open for business.

  9. Obviously, the most vulnerable. You are trying to provide some relief for the overburden healthcare system.

  10. I agree, but if we used good science the CDC would not be able suggest race based equality distribution. Equality comes first, damn the consequences of more total deaths.

  11. If everyone wanted better outcomes, they should have made better choices.
    Love of the inept has its consequences.

    COVID-19 deaths per million as of December 16, 2020
    Belgium 1,582.89
    Peru 1,130.53
    Italy 1,092.2
    Bosnia and Herz 1,047.26
    North Macedonia 1,041.06
    Slovenia 1,029.24
    Spain 1,028.13
    Moldova 987.72
    United Kingdom 969.71
    USA 921.31
    France 870.77
    Sweden 745.42
    Netherlands 581.67
    Canada 364.07
    Germany 283.21

    Norway 73.86
    Finland 84.42
    Japan 20.44
    Malaysia 13.21
    Singapore 5.08
    New Zealand 5.08
    China 3.4
    New Guinea 0.91
    Thailand 0.86
    Vietnam 0.36

    Top 10 total deaths
    USA 302,411
    Brazil 182,799
    India 144,096
    Mexico 115,099
    Italy 65,857
    UK 64,810
    France¹ 58,394
    Iran 52,670
    Spain 48,401
    Russia 47,410

  12. That's where I'm going: Any list that has more than "age" as a sorting parameter is going to have too many people arguing that it is wrong and discriminatory and is forcing the wrong people to have/not have vaccines that they want/don't want and …..

    If we've learned one thing this year (and we should have known it already) it's that the perfect is the enemy of the good, and in health care politics the perfect, and the good, and the OK are the enemy of the barely acceptable but at least it's feasible.

    Or as Carl von Clausewitz put it:

    Everything is very simple in warbut the simplest thing is difficult.


    War is politics by other means


    Everything is very simple in politics, but the simplest thing is difficult.

    Not because the very simple options are the best, but because you haven't got a chance of doing anything that isn't simple.

  13. The big problem I think, Dr Pat is that every sorting algorithm ends up having not just 'risk' as a factor, but ethical questions which are really hard to balance (though we do it every day, every year). For instance, [old] is the obvious easy-to-prove factor.  

    How about [old and has cancer].  Worth the outlay?

    How about [old, has cancer, smokes 3 packs a day]? Ah, erm…

    H A [not so old, smokes, drinks, unemployed, destitute]? Hmmm…

    What about [destitute, druggie, pervert, in prison]. Ahm… 

    See the point: of course you do. It is obvious. We tend to moralize, to put 'right behavior' on the balance pan of the QuickSort that'd order the list of all peoples (say just in America!)…

    Old, not-a-citizen, BUT sole provider for a family of 13?

    Undocumented alien, mother w/o husband of 4, grandmother w/o son-in-laws of 14?  

    One could extend this list almost endlessly.  

    What about trans folk?  
    … Old fâhgs with AIDS?  
    … … IV drug users on SF streets?  
    … … … Melbourne hookers?  
    … … … … Coal miners in Newcastle? 

    What about the paymasters for firefighters?  
    … or their admin assistants?
    … … or ornery husbands of 911 call takers

    What about pharmacy pill counters?
    … or the repairmen for the pill-counting machines
    … … or the mail clerks receiving the drugs…
    … … … or the window washers and virus mitigators wiping doors and windows

    ⋅-⋅-⋅ Just saying, ⋅-⋅-⋅
    ⋅-=≡ GoatGuy ✓ ≡=-⋅

  14. I'm reminded of the rules about airport security. Simple, simplistic even, rules that end up leaving almost everyone shaking their head about how even a little bit of thought would give you something so much better.
    But it seems that only a set of rules that simplistic can be implemented, nationwide, over hundreds of millions of people, by an organisation that doesn't have a lot of time to do it, and do so without leaving edge cases that can result in political screams of discrimination or accusations of corruption.

    And I'm not sure that pure age is THAT bad a choice. How many people over 80 don't have other health problems that should bump them up the list anyway? OK, by the time you get down to 60 years olds, there are people who are doing triathlons and people who need mobility scooters. But by that point the crisis is mostly past anyway and you'll be able to start applying more thought to the process.

  15. Most anyone under 70 with enough co-morbidities to qualify for early vaccination is going to have at least used an emergency room or free clinic, so there would generally be documentation of their conditions.

    Such people would probably have to request early vaccination, unlike those whose doctor might suggest they get it.

  16. To be clear, I meant that to select vaccination targets beyond "covid exposed worker" and "over 70", Doctors would know which of their patients have co-morbidities and so are in a position to decide if some of them should be given precedence.

    It wouldn't be perfect, any more than just giving the shot to everyone over 70 is. But longer term, it's a lot better than giving all of every single person's health information to a single big bureaucracy to evaluate.

    Yeah, insurance companies already have much of that data, but legally I think they'd have to get a request from their customer (or some emergency legislation) in order to evaluate that data to select vaccine recipients.

    Also a lot of the people under 70 who would be most at risk don't have health insurance.

  17. Your link refers to just minnesota. I'm referring to the whole US – see my link replying to Brett Bellmore. Pretty much every state is following a slightly different trend, though most are showing the current 'wave' in some form.

  18. Yes, going strictly by age has less drama, but it is such a poor choice, that, that rule will breakdown. And healthy young nurses have already been given the vaccine. When politics comes in, it becomes who "deserves" this vaccine or who do we value. So, everyone given good press: nurses, firefighters, teachers, volunteers who give out food…are moved to the head of the line. Then there are all the people who view themselves as victims of society. They will think they should go before big bad old Whitey.
    The poor can afford regular checkups…that is what Obama care does. Doesn't do anything else well. But most people get some kind of checkup now. Maybe if all Americans had blood work and scans, a lot more issues could be detected, but we have what we have. And there are a lot of cowards and just people who don't plan to follow any advise that does not appeal to them, so they don't bother to find out about their health.

  19. Wow when became saving lives a goal on itself? Wanna save, I have some tips, to gain 100x lives

    Stop serving food over-sugered
    Limit car to 20m/h
    No abortions
    No wars
    No guns
    No skooters
    No ..

  20. "Let the doctors decide" is a rich man's game. Anyone with money will know which doctors to go to. Doctors like Michal Jackson's, and Prince's. There are doctors who give their patients anything they want, for a fat fee.

    There is a huge amount of people over 70, almost certainly more than we have doses for.

    Quick and dirty could count each comorbidity as a point and each decade over 40 as a point. Until, more complete information is processed.

    Slightly less crummy would be assigning a risk value to each comorbidity at 3 levels of severity for each comorbidity, and adding the increase in risk due to age. As long as these numbers are known, anyone can add theirs up, or put it in an app that totals it.

  21. The more people get infected by something either virus, bacteria or metazoa the bigger the population of the infective agent gets and the higher is the probability for the pathogen to acquire an advantageous mutation. That is the reason why vaccines work as carpet bombing and not as aimed strikes. If the vast majority of the population is left not vaccinated pathogens will have high probability to win the evolutionary lottery

  22. Exactly. In theory, if you would do it perfectly, you could determine the 1% that dies from COVID, and vaccinate them.
    Determining the people that are hospitalized shouldn't be a difficulty as well. That would be another 1-2%.

    Maybe have an error factor in determination of 4x, and you could have a reduction of 100% of the deaths and hospitalizations with just 10% vaccination.

    Then measures can be lifted much faster.

  23. The strategy can be a little better, by including other information.
    About 4% get seriously ill – In the Netherlands, about 1% was admitted in the hospital, and about 1% has died.

    So, if we have the perfect strategy, with 2-4% vaccinated, one could elimate all serious COVID cases.

    If you know exactly which people would get seriously sick, you can very quickly reduce the risk of Covid and thus reduce the measures.

  24. Not according to the New York Times… They just recently argued that old people should just die, because they're white.

  25. The graph I was looking at today shows that the autumn surge in cases seems to have peaked about two weeks before Thanksgiving and is quickly declining, albeit not as rapidly as it increased. The secondary spike on November 27th seems to be caused by the state not reporting any results on Thanksgiving Day itself and adding both days cases together.
    The trend does not appear to correlate to either imposition of restaurant shutdowns (November 19th) or other government interventions (as the decline predates them and looks like a fairly uniform trend), nor to the previous two weeks weather which were quite mild compared to the two weeks before that. Source Accuweather for Minneapolis.

  26. Red, my little town 's hospital had to close off everything to make room for covid patients. >80 . I was with you, I had thought there were infections but it wasn't an issue. Here we do have a lot of retirees.

  27. Agree with most of your statement except "Innocent others are probably the corpses in their wake. " These people are just going about what people do. No malicious intent. Your statement is a symptom of a broader disease taking hold.

    Fear leads to the dark side …

  28. Worth mentioning that the US appears to be seeing the top of a peak in cases – though with Xmas coming up, we may see yet another bump before a real decline.

    Cases were peaking just around Thanksgiving, then went back up to the current (apparent) peak after. And it's sounding like a lot of people are saying "screw it, I'm heading home for the holidays", so another bump up seems likely. Lots of flying going on for example.

  29. No – getting the number of hospitalizations and deaths attributable to Covid down should take precedence over reducing the spread, even if many of the potential victims would die within a year anyhow.

    First because it's heartless to let people die who MAYBE have only a year left – cutting off half or more of their remaining life.

    But even from a cold-blooded standpoint, it's the death count that is keeping the world focused on Covid and creating economically harmful restrictions to prevent the spread. If there were few deaths, people would mostly ignore it, and things would go back toward normal.

    Also, preventing lots of Covid deaths via vaccination is going to be a lot easier than reducing spread (case counts) for a given number of doses.

  30. If that data and the sorted list of (millions of) targets was ready now, maybe we could try.

    But this is going to be a massive vaccination program – such finesse and precision is probably not practical and trying for it would be slower and likely less effective than just targeting broad and easily identified groups as quickly as possible.

    "Works around covid patients" and "over 70" are good enough metrics to start with.

    That said, another good mechanism is "let doctors decide if a patient of theirs is a special case who should get the vaccine sooner".

  31. I can see your approach having political problems despite being more logical.

    Line up from oldest to youngest and that's the order? Very few people are going to think they are being deliberately targeted.

    (Obviously SOME people will, there are people who feel deliberately targeted if you breathe, but at some point they are just a crazy nutcase and everyone else knows it.)

    But every time you add a complication to the criteria, a higher and higher % of the population will either not understand it, or will deliberately pretend not to understand it, and claim victimization.

    To just make up a "scandal" on the spot: If you are using the criteria of pre-existing conditions, then that means that people who can't afford regular checkups and medical care won't have records of such conditions and DISCRIMINATION!!!!1111eleven111!!!

    Having the vaccination order determined by some opaque (at least to many) algorithm from the hated health insurance companies? Not going to fly with many people.

  32. The best review I have found is from "Yanni Gu; The Johns Hopkins News-Letter, Nov. 22, 2020"- "A Closer Look at US Deaths Due to Covid-19."
    There is so much political involvement that it is useful to step back and look at the actuarial expectations.
    Our "long term care" (nursing home) residents have an average survival of about 18 months. The annual Influenza season overloads the hospitals, and increases the monthly death rate in LTC.
    The vaccine, when prioritised to LTC residents will allow the other comorbidities to progress at their usual rates- the people in their last year will still die. Protecting the LTC staff should be the major focus, and acute hospital staff, then grocery store staff. The older we are, the more likely we are to die of any medical cause.
    In Brian's table from Israel, above, he shows that 90% of the deaths are of people over 60- my suspicion is that a large number of the deaths were not in "healthy" people, and that a "90% decrease in the actual mortality rate" in the cohorts at risk would not be achievable.

  33. Focusing on the most vulnerable if they get infected is one approach to allocating the vaccine. Another would be to focus on those who would spread it to the most vulnerable. I wonder which group is larger.

    I suppose that focusing on the most vulnerable would be more reliable, since I imagine we can more easily identify them. The consequences of overlooking a subset of those who would spread it to the most vulnerable could be pretty large, and it probably is harder to identify those who would spread it to the most vulnerable, making it likely that some would be overlooked. Still, I would like to know whether anyone has looked at allocating the vaccine to those who would spread it to the most vulnerable, and if so, what the conclusions were.

  34. It sounds like rewarding those who are the most irresponsible, however, the very sick are probably not the ones spreading it all over. The spreaders will probably be just fine. Innocent others are probably the corpses in their wake.
    So, I have to concur. Outbreaks should be a factor as well.

    The thing is, every city will be given doses. Are you just going to squander those doses quickly or choose the most vulnerable? Also, there may be physical limits on how many you can treat a day. Having a big stockpile even while you are using it is taking away from its use somewhere else.

    These things are not cut and dry.

  35. No only would it save lives, it would significantly reduce the burden on our overburdened healthcare system. We should also add comorbidity to the equation.

  36. Better to simply assign every person a priority number with a formula that accepts age as a major factor but also includes conditions like diabetes, obesity, heart disease that are vulnerabilities as well as job status as essential or medical worker, living arrangements etc. There are multiple factors to priority, it’s not rocket science to just assign everyone a number that takes them all into account.

  37. I was going to go this direction, and then I thought, "Hey wait, Mindbreaker is typing, I'd better wait haha!"

    You said what I was thinking, only with more finesse and more knowledge than I would have. xD

    It might not necessarily be popular to group people by characteristics, but it could be incredibly efficient and useful, especially depending on availability of doses. This might be a situation in which people with pre-existing conditions get a better place in line, too.

  38. To go strictly by age is to ignore the knowledge we have gained about the breadth of features that makes people likely to be hospitalized or die. This kind of data insurance companies work with regularly to decide who is a greater risk for them. It would be a simple mater to run a computer program on the data and get a risk score based on all the relevant health conditions, results of physicals, age, gender and ethnicity. Then that can be adjusted based on likelihood of exposure. Those in nursing homes obviously have the greatest risk of exposure. Those elderly who live in their homes but need people to come in the house and care for them daily are probably also at high risk. Independent, elderly in their homes with larger properties, can probably wait a bit longer.
    The insurance providers can run the numbers and give their policy holders a place in line in accordance with those numbers.

    My solution may not have the same drama. But that can be a good thing too. Better if the order is not by groups, or the groups will be competing politically to get theirs first.

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