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Comment by fxj | Hacker News Reader

"But there are other factors that may have contributed to Italy’s fatality rates, experts say. This includes a high rate of smoking and pollution - the majority of deaths have been in the northern region Lombardy region, which is notorious for poor air quality."

This was also the case in china, but the age structure is different:

"A study in JAMA this week found that almost 40 per cent of infections and 87 per cent of deaths in the country have been in patients over 70 years old."

"An older population skew within the infected population explains most of the disparity in fatality rates between high and low countries. According to a study of the fatalities of COVID-19 cases in Italy, 99% of all deaths had an underlying pathology. Only 0.8% had no underlying condition."

Seems like a perfect storm for the elderly in italy who smoke a lot and most of them having an underlying condition like cardiovascular disease or diabetes II.

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Lots of people over 40 have at last some mild health issues, over 60 almost everyone. Even younger people often enough have conditions they're not even aware of. So just wanted to say, don't get overly relaxed by these stats.

> Even younger people often enough have conditions they're not even aware of.

True and more complicated than that sounds. I was diagnosed with asthma at 28. A year and a half ago, at age 39, a pulmonary specialist rated my lung capacity at 115% compared to other males of my age and height likely due to exercising through unmedicated asthma. Undiagnosed underlying conditions shouldn’t prevent intentional efforts to be continuously healthy.

When we talk about underlying conditions, note that a pretty significant percentage of the population qualifies.

Elevated blood pressure, childhood asthma, obesity, diabetes

High blood pressure alone captures 1/3rd of the public, and it qualifies as a underlying condition. 1/2 of the public has "cardiovascular disease". It goes on and on.

It just seems like at this point people are just trying to comfort themselves. A 51 year old gentleman near me passed very quickly from COVID-19 and the report claimed he had a pre-existing condition. Later the wife was interviewed and she described him as completely healthy...but he had bronchitis when he was a child.

That’s a good point. I imagine many populations have large numbers of people with these ‘underlying conditions’, minor or not. Many folks are at high risk of severe reactions.

I still think it’s important for people to understand that the other conditions do appear the be strongly correlated to severe cases. I don’t think it’s just a false comfort. There is so much misunderstanding out there. Many friends and family I talk to seem to have a distorted view of the realty of what the disease actually is.

https://www.bloomberg.com/news/articles/2020-03-18/99-of-tho...

There is no doubt that the other conditions make people more vulnerable to this disease, and others. That correlation is incredibly real.

What is the false comfort is people's belief that noting this ensures their own safety. My comment was that underlying conditions afflict the vast majority of us, yet people are taking the news as if it means these people all had stage 4 cancer or something and were already on death's door.

Yeah that makes sense.

It does drive me crazy though, when I hear friends that have let themselves be consumed by fear or misunderstanding. It can unnecessarily affect their live in very negative ways.

For example, my co-worker had a falling accident a couple days ago and severely hurt his shoulder. He is afraid he tore his rotator cuff. He is early 30s, a very smart person, but has been consumed with panic about the disease. He refuses to go see a doctor in fear of catching covid-19. It’s like he thinks it’s some sort of death sentence. He lives in a relatively rural county in SC, where according to the state health department there is 1 confirmed case.

Couldn't worse air and more smoking in Wuhan lead to the same numbers? Worse conditions in Wuhan: more people needing hospitalization (young and old) the young recover, and get counted as recovered. Meanwhile in Italy, better air means only the very weak show severe symptoms, are tested, counted as infected, and their prospects are worse.

Age is an independent risk factor, and richer countries' populations skew older. More old people means more deaths. Assuming similar environmental conditions and infection rates, Italy will see more critical cases purely as a function of population age.

Also lots of people in Italy living together with children and grandchildren might have aggravated the problem.

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