Preprint Did “long COVID” increase road deaths in the U.S.?, 2023, Robertson

LarsSG

LarsSG

Senior Member (Voting Rights)
Abstract

Objective To examine data on COVID-19 disease associated with a 10 percent increase in U.S. road deaths from 2020 to 2021 that raises the question of the potential effect of pandemic stress and neurological damage from COVID-19 disease.

Methods Poisson regression was used to estimate the association of recent COVID-19 cases, accumulated cases, maximum temperatures, truck registrations, and gasoline prices with road deaths monthly among U.S. states in 2021. Using the regression coefficients, changes in each risk factor from 2020 to 2021 were used to calculate expected deaths in 2021 if each factor had remained the same as in 2020.

Results Corrected for the other risk factors, road deaths were associated with accumulated COVID-19 cases but not cases in the previous month. More than 20,700 road deaths were associated with the changes in accumulated COVID-19 cases but were substantially offset by about 19,100 less-than-expected deaths associated with increased gasoline prices.

Conclusions While more research is needed, the data are sufficient to warn people with “long COVID” to minimize road use.

What is already known about this topic Previous short-term fluctuations in road deaths are related to changes in temperature, fuel prices, and truck registrations.

What this study adds Corrected for other risk factors, the monthly changes in road deaths from 2020 to 2021 in U.S. states were associated with cumulative COVID-19 cases.

How this study might affect research, practice, or policy Studies are needed to distinguish the potential relative effects of neurological damage as well as the stress of coping with the pandemic on driving, walking, and bicyclist behavior. Warning people with “long covid” about road risk is warranted.

https://www.medrxiv.org/content/10.1101/2023.10.11.23296868v1
 
How many extra deaths were caused by a specific headbanger track? How many by a specific cute kitty youtube that were forwarded to people who were driving (and just had to check their phone)? How many due to stress over a rise in inflation? Why not spend billions of dollars in studying all possible extra risk factors so that you can publish warnings that most people will ignore?
 
The study is certainly drawing a long bow. In theory, reduced reaction times as part of Long Covid might be playing a part, but the investigators report a real time association between road deaths and Covid-19 cases. So, it's more likely to be people who are sick with acute Covid-19, maybe coughing causing inattention, than Long Covid issues.

And actually, I think it's a lot more likely that, in this 2020-2021 period, when there were lockdowns and people avoiding travel at certain times and working from home, that periods of increased social interaction increased both Covid-19 cases and road traffic (and therefore deaths on the road).
 
This is a legitimate concern, many people with cognitive problems from either Long Covid or other causes give up driving because it's either dangerous for themselves or other people, but this is not the right way to study this. I don't know why medicine insists on using invalid tools and methods to study things, but they really should be spending more time improving the tools they use to study instead of misusing them and publishing so many useless studies that are, at best, uninterpretable.

What they are doing far too often is trying to perfect a questionnaire that will allow people to properly rate the temperature of a substance from touch. There is no such thing. Science needs precise measurements with all other things being equal, this statistical scattershot approach is mostly useless. This is actually a serious issue that needs to be understood, but it will not be understood using those primitive methods.
 
Hutan said:
The study is certainly drawing a long bow. In theory, reduced reaction times as part of Long Covid might be playing a part, but the investigators report a real time association between road deaths and Covid-19 cases. So, it's more likely to be people who are sick with acute Covid-19, maybe coughing causing inattention, than Long Covid issues.

And actually, I think it's a lot more likely that, in this 2020-2021 period, when there were lockdowns and people avoiding travel at certain times and working from home, that periods of increased social interaction increased both Covid-19 cases and road traffic (and therefore deaths on the road).
Click to expand...

The paper reports a correlation between cumulative covid cases and road deaths (and no significant correlation with past month covid cases and road deaths), which doesn't suggest that it was acute covid.

I don't know that I find the paper that convincing, but alongside the other papers we've seen showing slower reaction times in LC, I does seem somewhat plausible.
 
abstract said:
More than 20,700 road deaths were associated with the changes in accumulated COVID-19 cases
Click to expand...
I didn't read the whole paper. I took 'changes in accumulated COVID-19 cases' to mean current month cases - but I guess that doesn't really make sense - they could have just said 'current month cases' if that is what they meant. Perhaps 'cases in the previous month' means the most recent monthly figures available? (whereas as I had assumed they were for the month preceding the current month, assuming the data was close to real time, as it was where I live).

abstract said:
Corrected for the other risk factors, road deaths were associated with accumulated COVID-19 cases but not cases in the previous month.
Click to expand...
Even with those different assumptions, I still think the idea I suggested makes sense. It is likely that the biggest driver of road deaths was the number of vehicles on the road, with road traffic increasing over the 2020-2021 period as lockdowns were eased and people returned to socialising (including drinking alcohol) and working outside the home. Therefore, cumulative COVID-19 cases, road traffic and road deaths would all be expected to increase over time.

It seems very odd indeed that the abstract does not mention those factors as something to be tested.

Long Covid typically causes people to socialise less and travel less, so surely any increase in road deaths caused by inattentive Long Covid drivers would be balanced by people with Long Covid spending less time on the road.
 
Hutan said:
Even with those different assumptions, I still think the idea I suggested makes sense. It is likely that the biggest driver of road deaths was the number of vehicles on the road, with road traffic increasing over the 2020-2021 period as lockdowns were eased and people returned to socialising (including drinking alcohol) and working outside the home. Therefore, cumulative COVID-19 cases, road traffic and road deaths would all be expected to increase over time.
Click to expand...

In the US, traffic deaths were significant higher in 2020 than in previous years (and then higher again in 2021). So it wasn't a dip in 2020 with a rebound in 2021. I don't think it is well understood why (though part of it is that with less traffic some people tend to drive like complete idiots).

I agree that it is very hard to tease out anything conclusive from this data, but that there is a state-level correlation between cumulative Covid cases and road deaths is interesting.
 
Now published as —

Did ‘long COVID’ increase road deaths in the USA?
Leon Robertson

OBJECTIVES
To examine data on COVID-19 disease associated with a 10% increase in US road deaths from 2020 to 2021 that raises the question of the potential effect of pandemic stress and neurological damage from COVID-19 disease.

METHODS
Poisson regression was used to estimate the association of recent COVID-19 cases, accumulated cases, maximum temperatures, truck registrations and gasoline prices with road deaths monthly among US states in 2021. Using the regression coefficients, changes in each risk factor from 2020 to 2021 were used to calculate expected deaths in 2021 if each factor had remained the same as in 2020.

RESULTS
Corrected for the other risk factors, road deaths were associated with accumulated COVID-19 cases but not concurrent cases. More than 20 700 road deaths were associated with the changes in accumulated COVID-19 cases but were substantially offset by about 19 100 less-than-expected deaths associated with increased gasoline prices.

CONCLUSIONS
The lingering effects of COVID-19 on neurological function may be a risk factor for behaviour leading to road deaths.

Link | PDF (Injury Prevention)
 
I had COVID while I was on the road in 2022. I recovered in a week, but I suffered another week of PEM like dazed state. I got up in a Walmart parking lot in wee hours one morning and then proceeded to get hit by a truck while pulling out of the lot. With it, my record of no at-fault accident in 40 years went out the door.

But that's just an anecdote. The accidents and deaths could've gone up because more people hit the road during the COVID lockdown. The demand for campers and bikes that went through the roof came back down to earth last year, so the stat for 2023 might counter the hypothesis. In fact, LC may reduce road deaths by taking people off the road. I hadn't been able to drive for a long time since I got ME/CFS because I couldn't hold up the steering wheel for long.
 
Just to add a comparison - which might suggest there's a far bigger problem than driving while LC. US has close to exactly 5 times the UK population. US road deaths 2022 = 46,270, UK = 1,695

US road death per annum have been above 30k since 1946 increasing up to 50k in the 1970s but hit sub 34k each year between 2009 and 2015, only to climb steadily year on year back to 1990 levels thereafter. I don't see how it's possible to identify an LC effect against a background trend of otherwise unexplained increase.

Motor vehicle fatality rate in U.S. by year

2023 preliminary figures show slight reduction on 2022: 44,250: https://injuryfacts.nsc.org/motor-vehicle/overview/preliminary-estimates/
 
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