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Comment by mirimir | Hacker News Reader

Maybe Italy is a worst case, both because it didn't quarantine early enough, and because greater population inversion.

> It's now a well-established fact that older people and those with underlying health issues are more susceptible to succumbing to Covid-19. With 23 percent Italians aged 65 or above and a median age of 47.3, the Italian population is the oldest in Europe. This is chiefly responsible for the high fatality rate in Italy.[0]

Also these articles.[1,2] And similar to the age effect in China.

0) https://www.ibtimes.sg/fatality-rate-7-16-why-coronavirus-de...

1) https://nypost.com/2020/03/12/heres-why-the-coronavirus-deat...

2) https://www.theguardian.com/world/2020/mar/03/italy-elderly-...

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Italy isn't the worst case, they're just 2 weeks' ahead of most other countries.

Looking at the latest SitRep from WHO, my home country (Sweden) has small no. infected (775), but grew 25% vs the previous day. If that rate keeps up, number of infected will keep on doubling every 4-5 days and in 14 days' time will be at what Italy is today (17k infected). And then another week later it'll break 100k. Exponential growth is a bastard in that sense.

True.

But still, maybe Italy is a worst case.

Trying to be optimistic here, being >70 and all ;)

Iran is likely the worst case, but it’s hard to know the full situation there.

I had the same worries for Greece when in just two days recorded cases doubled from 100 to 200, but since the government imposed partial lockdown measures the rate of infections slowed down significantly. My guess is the same will happen everywhere. It's just that it's easier to see the growth slowing when you have an order of magnitude less incidents than Italy. We have to trust the process.

> but since the government imposed partial lockdown measures the rate of infections slowed down significantly.

They shouldn't have; what you're seeing is noise. There's a lag of roughly two weeks between when a person is infected and when they'll get caught by a test, so any benefits of the current lockdown will only be visible close to end of March.

In Sweden we've avoided testing people who haven't been in high risk areas, and moved from that to only testing 'risk groups' (elderly and with preexisting conditions), so the numbers shouldn't be seen as reflective of the total number of infected.

Isn't Sweden itself a risk area? Looking at cases per 1M population [1], Sweden is at no 10, and its neighbors Norway and Denmark are at 2 and 6.

How come there are so many cases per capita? All the neighboring regions like Poland, Russia and even the North of Germany, have fewer cases.

[1] https://www.worldometers.info/coronavirus/#countries

Sweden, like the UK and possibly the Netherlands has chosen to let the disease spread among the population to achieve what they call "herd immunity" [1 - Swedish]. There might be some truth to the herd immunity thought, the problem is they don't have any control over the speed at which the infection will spread through society. Eventually everyone who can be infected will get infected no matter what is done so that herd immunity will also occur in a situation where the spread is limited by isolation as is done in most other countries. In other words, herd immunity is a given outcome of all approaches and as such does not need to be stated as a goal. The goal should be to limit the load on the health care system so as to limit the number of people who will die in the wake of reverse triage in an overloaded system.

In short, the stated goal will always be achieved so it is a variable which can be struck from the equation. Having this as a goal is the equivalent of not having any goal at all.

[1] https://www.expressen.se/nyheter/strategin-lat-manga-smittas...

This isn't exactly the stated goal of the UK, so much as something our government has concluded is the inevitable outcome no matter what they do. The goal is the one you suggest - to limit the load on the healthcare system and the number of people who die as a result.

Note that it's only the opinion of someone that Sweden is following the "herd immunity" strategy, and it's denied by several officials.

Sweden hasn't closed down schools etc like other countries have done so it's fair to argue that it's being done in practice, but it doesn't seem to be a conscious decision.

Statsepidemiolog Anders Tegnell säger att resonemanget om flockimmunitet ”delvis” stämmer, men att det inte är myndighetens strategi. – Vårt huvudsyfte nu är att få smittspridningen att gå så långsamt som möjligt.

...which translates to...

State epidemiologist Anders Tegnell says the reasoning around herd immunity is partly correct but that it is not the organisation's strategy - our main goal now is to get the infection to spread as slow as possible

...but the Swedish government is not actually doing much to limit the spread of the disease other than telling people who show symptoms to stay at home. By now it has mostly been proven that infected people spread the infection for a few days before they show symptoms and the fact that children can be and often seem to be asymptomatic carriers the spread will be rapid and result in a large number of people in need of medical care. The Swedish health care system was already overloaded before the pandemic so it will not be able to handle a large number of patients in need of critical care. The same scenario is now playing out in Italy so this should not come as a surprise.

Likely because we travel more and have more tourists in the Nordic.

For Denmark we actually seeded our Corona spread by bringing home hundreds of infected (it turned out) from ski vacation in Italy and Austria (265 from Austria alone) and not putting them in quarantine.

> but grew 25% vs the previous day. If that rate keeps up, number of infected will keep on doubling every 4-5 days

1.25^3 ≈ 2 so the doubling period for 25% growth would be closer to 3 days.

Italy may be a worst case, but we haven't seen the worst from it yet.

what's the source for italy being the oldest country? As of 2018 Germany was the oldest in the EU and their crude mortality ratio is among the lowest so far.

https://worldpopulationreview.com/countries/median-age/

That figure may be “% of population >= 85 years old”, where Italy does lead the EU. See p21 in this report [1] from Eurostat for a breakdown by country. About 3.45% of Italy is at least 85, compared to about 2.75 for Germany. That’s about 40% higher.

So Italy is older in the sense of “more people who are very old”. But you are right that the mortality difference so far is not explained entirely by this gap.

It may be informative to watch how this evolves in Greece, and to a greater extent (due to more infection before a lockdown) France and Spain. Those are the next oldest countries in the EU by this measure, and all are well above 3%.

[1] https://ec.europa.eu/eurostat/documents/3217494/10166544/KS-...

and it doesn't help that italians have a tradition of kissing each other on the cheek, twice, when they meet

On the other hand, Italy has very good food hygiene standards, as anyone who has been told off for touching the fruit and veg in the grocers can tell you. You never have a shop assistant handle money and then touch food, which you see all the time in the UK/US

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