# Why is US mortality so bad in the "fourth wave"? **URL:** \ **Category:** The Quarantine Zone\ **Tags:** covid-quarantine\ **Created:** [August 9, 2021, 4:26pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315 "2021-08-09T16:26:22Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![griffin1977](https://avatars.discourse-cdn.com/v4/letter/g/977dab/32.png) [@griffin1977](https://boards.straightdope.com/u/griffin1977)\ **Post date:** [August 9, 2021, 8:49pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/21 "2021-08-09T20:49:10Z")
But that would only explain this if other countries were testing more than us. Which could be the case but isn’t definitely (at least not to the degree that would explain this difference). ---
**Author:** ![Gorsnak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gorsnak/32/7587_2.png) [@Gorsnak](https://boards.straightdope.com/u/Gorsnak)\ **Post date:** [August 9, 2021, 9:05pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/22 "2021-08-09T21:05:06Z")
I looked a bit for age group breakdowns of vaccination rates in lagging States, but only found demographic breakdowns by race & ethnicity. Anyone know where to find vaccination data by age for places like Louisiana? ---
**Author:** ![Tfletch1](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tfletch1/32/5340_2.png) [@Tfletch1](https://boards.straightdope.com/u/Tfletch1)\ **Post date:** [August 9, 2021, 9:20pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/23 "2021-08-09T21:20:47Z")
> [@griffin1977](#): > > But that would only explain this if other countries were testing more than us. Which could be the case but isn’t definitely (at least not to the degree that would explain this difference). European countries and Israel have much, lower positivity rates than many regions in the US. ---
**Author:** ![China\_Guy](https://avatars.discourse-cdn.com/v4/letter/c/779978/32.png) [@China\_Guy](https://boards.straightdope.com/u/China_Guy)\ **Post date:** [August 10, 2021, 3:40am UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/24 "2021-08-10T03:40:32Z")
I give two thumbs up to naming this the DeSantis variant instead of Delta. Both start with a D ---
**Author:** ![Monty](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/monty/32/47_2.png) [@Monty](https://boards.straightdope.com/u/Monty)\ **Post date:** [August 10, 2021, 4:36am UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/25 "2021-08-10T04:36:45Z")
On top of that, both D and Delta are the fourth letters in their respective alphabets! ---
**Author:** ![asahi](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asahi/32/8693_2.png) [@asahi](https://boards.straightdope.com/u/asahi)\ **Post date:** [August 10, 2021, 10:49am UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/26 "2021-08-10T10:49:24Z")
A lot of valid points have already been brought up, particularly vaccine rates. But there’s another factor we might need to consider as well and that’s the health of those who are getting sick and their underlying factors (obesity and related problems being a big one in the U.S.). ---
**Author:** ![griffin1977](https://avatars.discourse-cdn.com/v4/letter/g/977dab/32.png) [@griffin1977](https://boards.straightdope.com/u/griffin1977)\ **Post date:** [August 10, 2021, 3:16pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/27 "2021-08-10T15:16:22Z")
> [@Tfletch1](#): > > European countries and Israel have much, lower positivity rates than many regions in the US. But that was also true during previous waves, and the overall mortality rate was very similar between the US and and those countries. That’s why this is so perplexing, whatever the cause (or causes) it is something that was the same between the US and elsewhere during the first waves, but different between the US and elsewhere in the fourth waves. ---
**Author:** ![Great\_Antibob](https://avatars.discourse-cdn.com/v4/letter/g/e47c2d/32.png) [@Great\_Antibob](https://boards.straightdope.com/u/Great_Antibob)\ **Post date:** [August 10, 2021, 4:09pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/28 "2021-08-10T16:09:24Z")
Well, yes, the difference this time is that the major surge is striking areas that are less vaccinated. In previous waves, it did hit different parts of the country but everybody had the same immunity going into it, i.e. not much at all. Now, deaths are more concentrated in areas that are less vaxxed, and hospitals in those areas are also being overwhelmed, meaning higher death rates than we would otherwise had. If we had more uniform vaccination rates and a more uniform case load, we wouldn’t see as many deaths because those patients would be more uniformly divided across the country. Instead, there are open hospital beds in Massachusetts while Arkansas is trying to find hospitals beds hundreds of miles away while patients are waiting hours or days for a free bed or room, often in hallways. ---
**Author:** ![Great\_Antibob](https://avatars.discourse-cdn.com/v4/letter/g/e47c2d/32.png) [@Great\_Antibob](https://boards.straightdope.com/u/Great_Antibob)\ **Post date:** [August 10, 2021, 4:32pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/29 "2021-08-10T16:32:53Z")
So, to expand on this, we have some stats [from the CDC](https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days): Looking at Massachusetts, over the last 7 days, they’ve performed 3075.5 tests per 100k people, had 75.6 cases per 100k, and 0.2 deaths per 100k people. By contrast, Arkansas over the last 7 days has performed 1873.02 tests per 100k people, had 524.9 case per 100k, and 4.8 deaths per 100k people. So, two different states and two wildly different results. Performing only 60% of the tests per capita but having nearly 7 times as many cases per capita and 24 times (!) the number of deaths per capita in the last week. Pandemic mitigation measures (including vaccination) are a pretty clear difference. I know that’s not a palatable answer, but the cause in the difference is really clear in the data. We’re NOT seeing a difference in between the entire US and elsewhere in the world. We ARE seeing a difference in particular regions within the US and elsewhere. Those regions are getting overwhelmed. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [August 10, 2021, 4:45pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/30 "2021-08-10T16:45:44Z")
Could be that Americans are just unhealthier in general. Obesity, for instance, was/is a major contributing factor in Covid mortality. Maybe Americans are significantly fatter than Europeans and Israelis. And aside from fat, perhaps other unhealthy habits as well. ---
**Author:** ![Great\_Antibob](https://avatars.discourse-cdn.com/v4/letter/g/e47c2d/32.png) [@Great\_Antibob](https://boards.straightdope.com/u/Great_Antibob)\ **Post date:** [August 10, 2021, 4:56pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/31 "2021-08-10T16:56:50Z")
Sounds like a “just so” story. Parts of the US look a lot like Europe or Israel, case and death wise. Other parts, not so much. And while obesity is greater in the South than elsewhere (I thinK?), it’s not 20 times greater. Again, treating the US as a single bloc for COVID does not make sense. Trying to get national level answers for a national level statistic when regional differences are so great doesn’t make sense. ---
**Author:** ![Horatius](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/horatius/32/3572_2.png) [@Horatius](https://boards.straightdope.com/u/Horatius)\ **Post date:** [August 10, 2021, 5:14pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/32 "2021-08-10T17:14:24Z")
> [@Velocity](#): > > Could be that Americans are just unhealthier in general. Obesity, for instance, was/is a major contributing factor in Covid mortality. Maybe Americans are significantly fatter than Europeans and Israelis. And aside from fat, perhaps other unhealthy habits as well. But then, why isn’t Canada kind of in the middle of those two? We’re not as fat, on average, as Americans, but we are fatter than Europeans. If this were a major factor, you’d think Canada would show some effect of this, but I don’t think this is the case. > [@Great\_Antibob](#): > > Pandemic mitigation measures (including vaccination) are a pretty clear difference. I know that’s not a palatable answer, but the cause in the difference is really clear in the data. Screw “palatable”. The facts are the facts, and we need to stop coddling those who would ignore them for some stupid political reason. Start calling them out, loudly and rudely. People are dying, even more unnecessarily than last year, and it’s past time we got mad about it. ---
**Author:** ![Tfletch1](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tfletch1/32/5340_2.png) [@Tfletch1](https://boards.straightdope.com/u/Tfletch1)\ **Post date:** [August 10, 2021, 6:46pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/33 "2021-08-10T18:46:18Z")
> [@griffin1977](#): > > But that was also true during previous waves, and the overall mortality rate was very similar between the US and and those countries. > > That’s why this is so perplexing, whatever the cause (or causes) it is something that was the same between the US and elsewhere during the first waves, but different between the US and elsewhere in the fourth waves. Hmmm. Maybe the vaccination rate for 65+ people is lower in the US than the rest of the industrialized countries. That would definitely alter the death rate in the recent wave. The first wave hit many European countries hard before it really hit the US (with exceptions like NY). So their death rate was understandably high. Plus a lot of European countries have a high average age. The big winter death rate was shortened by vaccination of the elderly in the US. Now that Europe is more vaccinated than the US (especially the elderly), I really think that’s the difference in death rate now. ---
**Author:** ![Gorsnak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gorsnak/32/7587_2.png) [@Gorsnak](https://boards.straightdope.com/u/Gorsnak)\ **Post date:** [August 10, 2021, 7:59pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/34 "2021-08-10T19:59:31Z")
I don’t know why you continue to insist that it’s perplexing. It’s pretty clearly the result of some regions in the US having lower vaccination rates in the vulnerable demographic, i.e. old people. And that, in turn, is the result of the much greater politicization of covid in the US than elsewhere. Really, this is just not at all mysterious. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [August 13, 2021, 3:34am UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/35 "2021-08-13T03:34:31Z")
> [@griffin1977](#): > > > [@Gorsnak](#): > > > > This lack of testing point I find really confusing. It’s true that highly vaccinated countries are performing fewer tests, and may be undercounting 4th wave covid cases due to higher numbers of asymptomatic or weakly symptomatic cases. But what does that have to do with mortality rates? I find it very hard to believe that people dying of covid in the UK or wherever aren’t being tested. So how is decreased testing elsewhere supposed to explain how the US has a higher covid mortality rate in this wave? > > Obviously the 1 person out of 100 (or whatever it is) who dies is going to be tested, along with the 5 or whatever that get hospitalized (to choose some numbers at random). But whether the other 94 people do or not is going to directly effect the mortality rate. > > If 90 of the remaining people get tested (then it looks like you have 96 people with covid). They you have an apparent mortality rate of 1%. If only 45 get tested then the it looks like you have 51 people with Covid and the mortality rate looks like 2%. > > Post vaccination when people are getting more colds anyway (in my experience at least) its particularly likely that someone who has mild covid because they are vaccinated may not bother getting tested (and the fact no one wants nasty medical bill in the US, means it will be more like in the US) [https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burden.html](https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burden.html) According to the CDC 1 in 4.2 infections (due to covid) get reported. 1 in 3.8 symptomatic infections get reported 1 in 1.8 hospitalizations are reported. 1 in 1.3 deaths are reported. However these numbers are pre-delta variant. The delta variant is mostly a disease of people who chose not to get vaccinated for one reason or another. I wouldn’t be surprised if a lot of people who are sick are either in denial thats it covid, or they don’t want to admit they were wrong and their own stubbornness caused this to happen. I know I"ve heard stories of people in hospitals being verbally abusive to nurses because even as they were barely able to breathe they still said that covid was a hoax. Maybe the covid death rate vs diagnosed infection rate is about the same as it was pre-delta (1 in 1.3 deaths due to covid is reported), but the rate diagnosed and reported for symptomatic and asymptomatic infections is far lower. Which is scary in its own right, because aren’t we back at 200k officially diagnosed cases a day, or somewhere near that? Maybe the ratio is (as a guess) 1 in 6 now, which would mean a million or more people are actually catching covid daily. On the plus side I guess it means delta would burn itself out fairly quickly if a million or more people are catching it each day. ---
**Author:** ![bordelond](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bordelond/32/150_2.png) [@bordelond](https://boards.straightdope.com/u/bordelond)\ **Post date:** [August 13, 2021, 9:02pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/36 "2021-08-13T21:02:30Z")
> [@Wesley\_Clark](#): > > Which is scary in its own right, because aren’t we back at 200k officially diagnosed cases a day, or somewhere near that? Over 140,000 cases in the U.S. over each of the past two days. Current 7-day average is about 125,000, and one week ago it was 106,000. Single day peak for the U.S. was about 308,000 cases on January 8, 2021. Highest 7-day average was about 255,000 on January 11, 2021. > **[United States COVID - Coronavirus Statistics - Worldometer](https://www.worldometers.info/coronavirus/country/us/)** > > United States Coronavirus update with statistics and graphs: total and new cases, deaths per day, mortality and recovery rates, current active cases, recoveries, trends and timeline. ---
**Author:** ![naita](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/naita/32/5862_2.png) [@naita](https://boards.straightdope.com/u/naita)\ **Post date:** [August 13, 2021, 10:33pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/37 "2021-08-13T22:33:33Z")
In Western Countries other than the US the vaccination rates for the first groups offered the vaccination is way higher than in the US. In the UK for instance around 90% of those 60+ are vaccinated and even the age group 40-49 is over 75% vaccinated. For the US only 75% of those over 75 are vaccinated. The CDC dashboard annoyingly reports the percentage of the total vaccinated in each age group, and I’m not going to do any other groups by hand. I think the disparity in vaccination rates for the oldest groups is a good indication that the US has a much lower vaccination rate even in the most vulnerable groups, and with the addition of regional and other demographical heterogenity in vaccination rates it is no surprise that the US has higher mortality. > **[Covid vaccine: How many people are vaccinated in the UK?](https://www.bbc.com/news/health-55274833)** > > A look at progress made in vaccinating the country, as more than 52 million people have received at least one dose and 38 million have had a booster or third dose. > **[COVID Data Tracker](https://covid.cdc.gov/covid-data-tracker/#vaccination-demographic)** > > CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website. ---
**Author:** ![Tfletch1](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tfletch1/32/5340_2.png) [@Tfletch1](https://boards.straightdope.com/u/Tfletch1)\ **Post date:** [August 13, 2021, 10:49pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/38 "2021-08-13T22:49:46Z")
> [@naita](#): > > In Western Countries other than the US the vaccination rates for the first groups offered the vaccination is way higher than in the US. In the UK for instance around 90% of those 60+ are vaccinated and even the age group 40-49 is over 75% vaccinated. For the US only 75% of those over 75 are vaccinated. The CDC dashboard annoyingly reports the percentage of the total vaccinated in each age group, and I’m not going to do any other groups by hand. > > I think the disparity in vaccination rates for the oldest groups is a good indication that the US has a much lower vaccination rate even in the most vulnerable groups, and with the addition of regional and other demographical heterogenity in vaccination rates it is no surprise that the US has higher mortality. Yep. That’s it right there. ---
**Author:** ![pdhenry](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pdhenry/32/5561_2.png) [@pdhenry](https://boards.straightdope.com/u/pdhenry)\ **Post date:** [August 14, 2021, 3:52pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/39 "2021-08-14T15:52:48Z")
> [@Tfletch1](#): > > Hmmm. Maybe the vaccination rate for 65+ people is lower in the US than the rest of the industrialized countries. That would definitely alter the death rate in the recent wave. Vaccination data for 65+ is readily available both nationally and per state. Overall the US has fully vaccinated 81% of 65+ with 91% receiving at least one shot. (source, NY Times [COVID vax pages](https://www.nytimes.com/interactive/2020/us/covid-19-vaccine-doses.html)) Seems unlikely that we’re that far behind other nations in the 65+ demographic, aside from local variation - some counties in Alabama, Arkansas and Missouri have under 50% full vaccination even for 65+ - and the correlation to higher case rates in those counties is clear. ---
**Author:** ![naita](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/naita/32/5862_2.png) [@naita](https://boards.straightdope.com/u/naita)\ **Post date:** [August 14, 2021, 9:38pm UTC](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315/40 "2021-08-14T21:38:17Z")
> [@naita](#): > > For the US only 75% of those over 75 are vaccinated. The CDC dashboard annoyingly reports the percentage of the total vaccinated in each age group, and I’m not going to do any other groups by hand. I calculated these numbers by using the numbers on the CDC’s page on the demographics of vaccinations, which said that as of yesterday just over 16 million 75 plus were vaccinated, and that they were 7 percent of the population, and then I forgot the actual results, which were less than 70%. Apparently the demographic data doesn’t include Texas, but subtracting Texas from the denominator doesn’t get us anywhere near the 80% that CDC’s other summary, quoted by @pdhenry, states. I assume the CDC, who starts with the raw data, has the right calculation though. So the status for older American’s is not as dire as I though. [Previous page](https://boards.straightdope.com/t/why-is-us-mortality-so-bad-in-the-fourth-wave/948315.md?page=1)