Ireland is facing a public health crisis which will claim the lives of at least 5,000 people over the next 12 months, destroying the lungs of many thousands more, leaving them – literally – gasping for breath. It is smoking.
While smoking-related deaths have outpaced Covid-19 deaths by a factor of more than two to one since the beginning of the pandemic, and will continue to claim thousands of lives each year for the foreseeable future, the curse of the cigarette attracts few headlines and little public interest.
Death by smoking is simply seen as a fact of life. It is not headline news, as the damage it does has been with us for more than a century, but the new health menace, Covid-19, has been attracting almost all the attention across all age groups, with many younger people in particular vastly overstating its impact, according to the Perils of Perception Irish Times/Ipsos MRBI poll.
It also suggests that more than one in five people believe Ireland is being hit harder than other countries in the EU, when the reality is the country is mid-table at worst.
The announcement of the mounting toll of sickness and death from the illness which has been coming from the health authorities shortly before or shortly after 6pm every day for almost six months has had a positive effect on our levels of awareness. People are acutely aware of the impact of the disease, and most of those who took part in the survey were able to accurately assess how many lives have been lost to Covid-19.
All told, 53 per cent put the death toll at between 1,500 and 2,000, while the median – the midpoint of all the answers provided – was 1,750. On August 4th, in the middle of the polling period, the actual total number of deaths stood at 1,763.
There are information gaps, however, and there appears to be a misperception about the risk to older people.
Some 80 per cent of all the deaths recorded so far have been among those aged over 75. Yet, when asked, the majority of people guessed the percentage of deaths among the older cohort at 50 per cent or less, with fewer than 20 per cent of respondents guessing the correct percentage of deaths among the over-75s.
While there is a perception that younger people are largely ignoring the illness – perhaps fuelled by talk of house parties and videos circulating widely on social media of people having too-lively brunches – the reality is somewhat different.
People under the age of 35 are more likely than older people to overestimate the number of deaths due to Covid-19, and almost one in five of that cohort told researchers that there had been at least 5,000 coronavirus deaths so far this year in Ireland.
There is also confusion as to how hard young people are being hit by the illness. When asked what percentage of Covid-19 related deaths were among under-35s, younger people suggested that the number was 13 per cent.
Across the entire polling group, when given a menu of bad things that might happen to them in the months ahead, Covid-19 finished in the top spot with a commanding lead.
When asked if a heart attack, Covid-19 or a car accident over the next 12 months was of greatest concern, coronavirus finished on 64 per cent, with people more than five times more concerned about contracting Covid-19 than they are about having a heart attack, which stood a long way back on 12 per cent.
A further 20 per cent of people said they were worried about being in a car accident. Across the board people were more than three times more concerned about contracting Covid-19 than they were about being in a car accident.
Spread across the entire population, such a number may make sense, but when focused on a younger cohort it raises question marks. More young people will die in car accidents this year than will die of Covid-19, but those under 35 are twice as concerned about contracting Covid-19 than they are about being in a car crash.
The poll also reveals a disconnect between how Ireland is faring when compared with other countries in the EU. The country with the unenviable record of the highest death toll per head of population in the bloc is currently Belgium. When asked, 38 per cent guessed Germany had the highest level, 25 per cent said Sweden, 23 per cent said Belgium and 12 per cent said Ireland.
Covid-19 has distorted our perception
Analysis: We know our coronavirus stats, but overestimate its risk, writes Kieran O'Leary
As part of The Irish Times/Ipsos MRBI Perils of Perception series, specific attention was given to Covid-19 and how our new-found obsession with Covid-19 statistics has shaped our understanding of the virus.
Importantly, it also explores how our knowledge of Covid-19 affects our perceptions of personal risk – a key factor determining the actions we take on a daily basis.
Research for this survey took place between July 30th and August 10th, at a time when the number of new cases each day was rising and local restrictions were imposed on three counties.
A nationally representative sample of 1,000 people aged 15 and older were asked about their awareness and attitudes towards Covid-19 and other diseases. The results show high levels of awareness of the number of Covid-19 deaths, matched with significant concerns relating to catching the disease.
When asked to identify the number of deaths in Ireland attributed to Covid-19 most respondents were remarkably accurate in their estimation. A majority (53 per cent) gave an answer between 1,500 and 2,000, with a median – the midpoint of all the answers provided – of 1,750 deaths.
Halfway through the fieldwork period, on August 4th, the total number of deaths to date was 1,763.
We should not be surprised by this high degree of accuracy. Many of us await the daily update by the National Public Health Emergency Team; the new case and death statistics have been daily headlines for almost six months.
We also asked the public to estimate the fatalities in Ireland from two other major causes of death: smoking and alcohol. While both receive less coverage than Covid-19 it is likely that more people will die this year as a result of smoking and alcohol than will die as a result of Covid-19.
Encouragingly, people are generally accurate in their estimations of deaths from smoking and alcohol. The median answer for deaths so far this year due to smoking-related diseases is 3,000, which is broadly in line with the Health Service Executive estimates of almost 6,000 deaths annually.
The median answer for alcohol-related deaths is 2,000, again not much different from the reality of about 2,800 deaths annually according to the Global Burden of Disease Study.
The impact of Covid-19 is borne more heavily among older people and those with underlying health conditions. However, with younger people accounting for a high proportion of recent cases, we might have expected the data to show that young people are less familiar with Covid-19 statistics and consequently underestimate the risk.
The data tells a different story. Rather than underestimating the scale of the problem, those aged under 35 are more likely than older age groups to overstate the number of deaths due to Covid-19. Roughly one in five (19 per cent) of under-35s reckon that there have been 5,000 deaths or more due to Covid-19.
Furthermore, when asked to estimate the percentage of Covid-19-related deaths that were aged under 35, respondents in the under-35 age group were significantly wide of the mark.
Their estimate that 13 per cent of Covid-19 related deaths have been among the under-35s is very much at odds with the reality that less than 1 per cent of those who died so far due to Covid-19 were aged under 35.
This Covid-19 Perils of Perception study also looked at perceptions of risk. Covid-19 is something that we have become fearful of, and rightly so. However, our perception of risk is not always calibrated with the actual level of risk.
To explore perceptions of risk further, we asked respondents what was of greater concern to them personally over the next 12 months: catching Covid-19, being in a car accident or having a heart attack.
Unsurprisingly most people identify that catching Covid-19 is a greater concern with 64 per cent fearing the virus the most, compared with 20 per cent who say that they are most concerned about being in a car accident and 12 per cent most concerned about having a heart attack.
Do these perceptions of risk make statistical sense?
In general, people are more than five times more concerned about catching Covid-19 than they are about having a heart attack. According to vital statistics data published by the Central Statistics Office, over 1,700 deaths in Ireland during 2019 were caused by a heart attack – broadly similar to the number of deaths that have been attributed to Covid-19 so far this year.
Similarly, levels of concern about catching Covid-19 are more than three times higher than being in a car accident. At the total population level this makes sense: the number of deaths from car accidents is only a fraction of the Covid-19 deaths so far in 2020.
However, more young people will likely die in car accidents this year than from Covid-19. In spite of this, those aged under 35 are more than twice as concerned about getting Covid-19 as they are about being in a car accident.
We have been overwhelmed by Covid-19 statistics, and not surprisingly the numbers have stuck for most of us.
The virus may also have distorted our perceptions for risk, with other serious illness taking somewhat of a back seat.
Such risk-perception gaps at times like this are probably unavoidable, -but it is nonetheless important to be mindful that they exist and do not widen in time.
Kieran O’Leary is a director of Ipsos MRBI