Older People are Less Pessimistic about the Health Risks of Covid-19
nber.org/papers/w27494.pdfPosted Jul 10, 2020, 8:24 AM UTC
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This is really fascinating and I hope in the future they ask more questions about exposure to news and information about COVID-19, because it could reveal the best channels for reaching out to the public about health risks.
This is already showing that there's a lot of misinformation out there, which confirms what a lot of us have noticed on social media and in person. How many of us who post here have posted about the Lombardy symptom/severity probability study elsewhere and been downvoted for it?
But the objective age gradient is very far from beliefs. The 18-34 group in our data reports a median believed conditional fatality rate of 2%. However, available epidemiological estimates for the US or other developed countries using different samples and methods indicate a conditional death rate for this age group of at most about 0.2%(Ferguson et al.2020, Covid CDC Response Team 2020, Modi et al.2020, Russell et al.2020). The young appear to assess their mortality risk to be more than 10 times the available data. In contrast, the respondents in the 70 years or older group report a median conditional death rate of about 1%. The same epidemiological estimates indicate for this group a conditional death rate between 5% and 10%. The elderly assess their mortality risk to be between 5 and 10 times lower than current best estimates.
And from their conclusion
One way to rationalize this preliminary evidence is to think of Covid-19as a “disease and death” shock that was particularly surprising and hence salient for the young. In this view, such a shock led the young to inflate Covid-19as well as non-Covid-19health related risks. We plan to explore this as well as other hypotheses using the future waves of the survey. If confirmed, these findings may have important lessons for the way in which we respond to large shocks, not just during pandemics. First, shocks may have a greater impact if they are more surprising or occur against a lower background risk. Second, increased risk in certain domains may spill over into heightened sensitivity to risk in similar domains.
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But that's not what this study is about. You're talking about actual risk and modifying your behavior based on that. This study is about perceived risk.
You accurately said that there's a 1 in 500 risk of dying for the entire cohort, but this study is showing that 18-34 year olds believe that they have a 1 in 50 chance of dying. That order of magnitude is going to cause a very different reaction in people that isn't without harm.
Edit: And for comparison, the 2018 odds of an American dying in a pedestrian accident was 1 in 541.
Edit 2: To explain, we can't accurately judge the overall harm/benefit of an intervention unless we have an actual understanding of the risk. At a 1 in 50 chance we may be able to justify increases in anxiety, substance abuse, self harm and relationship violence because the chance of dying from those things may still only be 1 in 100 or 1 in 75. But if the risk of dying from COVID-19 is 1 in 500 and the intervention raises the chance of death from other causes to 1 in 400 or 1 in 100 then we would need to reconsider those interventions.
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The paper makes note of generational political differences, but I wonder if lived experience in the era before widespread vaccination for childhood diseases also affects attitudes. The oldest age group would have been witness to polio outbreaks that were seemingly random, with survivorship bias perhaps making them downplay a disease with a much lower CFR and risk of lifelong injury than polio.
Again without diving too much into speculation and anecdotes it's always intrigued me just how attitudes about pandemics have changed over the last century. The cultural memory of the 1918 influenza pandemic is vanishingly thin in the western world. News censorship during the war played a large role, but even personal journals, works of literature, etc. don't talk much about it.
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I hope they do more of these, because social media exposure could play a large part as well. Social media, by its very nature, tends to leave out a lot of details so it could lead to overestimating the risks presented.
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Also the social media "everyone's talking about..." amplification effect, where the number of times a story is shared or commented on tends to affect people's perception of how common the issue is.
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Older people don’t participate nearly as much in social media. Younger people may see many more personal stories of Covid infections among their large group of social media friends when compared to what older people hear about among their smaller tighter groups of physical friends. This could result in both groups having personal perceptions which are at odds with the mathematical reality.
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Abstract:
A central question for understanding behaviour during the Covid-19 pandemic, at both the individual and collective levels, is how people perceive the health and economic risks they face. We conducted a survey of over 1,500 Americans from May 6 – 13, 2020, to understand these risk perceptions. Here we report some preliminary results. Our most striking finding is that perceived personal health risks associated with Covid-19 fall sharply with age.
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Reminder this is a science sub. Cite your sources. No politics/economics/anecdotal discussion
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The age-adjusted risk of a Covid-19 infection is very close to the background risk of living ~1 year. For old people already used to facing a 10% risk of death in any given year, doubling this to 20% might sound as scary as doubling from 0.1% to 0.2% for a younger person.
Add to this that the "risk of the unknown", e.g. long term complications, chronic infections or deadly second waves have a much higher possible impact on young people than old people.
In total it actually makes sense. Old people are used to disease and death, several of their friends die every year. Young people barely ever experience it.
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Posting this here because it seems like the kind of thing that may be important when it comes to vaccine deployment and understanding compliance with non-pharmaceutical interventions (perhaps in particular the unexpectedly high level of compliance in general). This appears to contradict the narrative that young people are reckless and disproportionately contributing to transmission through voluntary behaviour.
Maybe they feel like they have a finite amount of time to live anyway, so it’s not worth wasting years just to hide from a virus? Not saying that’s the correct opinion, but that’s kind of the vibe I’ve gotten from some older people I know.
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