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Comment by pachico | Hacker News Reader

I read an interesting article describing how cultural factors are affecting virus spreading. Among many things, the family configuration is radically different in Germany than in Italy or Spain and this is one of the key factors (besides Germany being able to buy and execute tests to confine who needed to be confined in time). It looks like many Italians (also many Spaniards but not so many) live with their parents even when they are 30-40 years old. In addition, many grandparents take care of children in daily or regular basis. This means that very socially active slices of society are in constant contact with the the population which is most at risk.

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So far the median age of German cases is 47. It is 63 for Italy. Also, Germany isn’t doing postmortem testing on people that are dying from preexisting conditions that could be suspicious. Italy has tested corpses that weren’t initially tested.

Global numbers are so tough to compare with different countries testing differently, reporting differently, and of course demographic differences.

Very true. Each country is following also different policies. I personally know a few people that are infected in Spain but have not been officially tested so they don't make part of any statistic.

If they have not been officially tested, how do you know they are infected? It's not enough to have symptoms; I myself had several symptoms about a month ago, but they didn't test me because they were not enough symptoms and I didn't have a travel history to mainland China, so then I still don't know if I was actually infected or it was just a flu.

It is what the doctors told them. Also considering they have been in direct contact with officially tested infected people. Young people with very hard breathing difficulties (for the first time in their life), fever, muscular and bone pain, etc. Btw, the doctors call them at least once a day but they are confined at home.

The differentiating question might be did you have a running nose? If yes, it's not the coronavirus.

WHO says "very few" people will get a running nose, but that is not equivalent to saying you do not have the virus if you have a running nose. I'd be careful saying blanket statements like this

Why do they test people who are dead already? Given the shortage of tests, wouldn't it more sense to test people who are alive?

1. You can still do contact tracing of a dead person, and follow-up on who they interacted with.

2. Bigger death numbers allow medical professionals to go to their government, and demand for more stringent quarantine measures.

To trace contacts of the deceased person. For an elder person, it's likely he/she has interacted with other elders, and it's good to check.

Compared with testing a healthy young person who is asymptomatic, it's better to test the dead one.

Edit: but healthy people with some suspect symptoms should of course remain isolated.

One person in a nursing home of now 20 dies of respiratory complications matching pre-existing conditions.

You can:

- assume it was coronavirus, test the remaining 20 people - cost: 20 tests

- or, test the dead person, then only test the remaining 20 people if that test comes back positive - cost: 1 test or 21 tests, expected cost 1 + 20 * % chance the person was infected tests.

Unless you believe there's a 95% chance they were infected, the tests are better spent elsewhere.

(This assumes you are also going to isolate them until the results are in regardless, which has further cost and dangers especially in high-risk groups. And that you are either already testing or not testing anyone outside the living group possibly exposed. Public health is a wicked problem.)

Dying patients are still in contact with tons of people: doctors, nurses, relatives, etc; and these people go on infecting, unless they are traced and isolated. One case in Southern Italy resulted in death, but the body was incorrectly released for the funeral like a regular case. Result: dozens of infections at the funeral.

Different places in the world have different levels of test shortage.

To put those case figures in context; the median age of the population as a whole in Germany is 47, and for Italy it's 45. [1]

[1] https://worldpopulationreview.com/countries/median-age/

Italy doesn't test people that die outside of the hospitals either.

https://www.reuters.com/article/us-health-coronavirus-italy-...

The OP is not talking about people dying outside hospitals, it saying that people with dying with preexisting conditions are not tested

There was an additional interesting cultural correlation I heard: there are more cases in the south and south-west of Germany plus a slightly outlier in Hamburg layer. This matches apparently when there are winter holidays in schools (different in each state in Germany) and the fact the generally skiing is more popular in the south, were many people would travel to the Alps, including northern Italy, for vacation. This could possibly mean that more people from these regions brought the virus back home.

There are more explanations. Karneval/Fasching/Fasnacht celebrations are hugely popular in the South and West and virtually inexistent in the North and East. The east is generally poorer (so easterners travel less) and has less popular tourist destinations - except Berlin, which has been hit badly enough.

Also, if you compare the map of corona cases with population density maps of Germany you will see a strong correlation.

That’s essentially saying where there is more people there is more virus; which is close to a tautology.

Not a tautology but yes, that is essentially what I am saying.

I just found it weird that people seem to be focusing on all sorts of factors like family structure, median income, winter holidays, Fasching/Karneval celebrations etc (which of course also play a role) while completely ignoring that higher population density facilitates the spread of a novel virus.

Can confirm for Hamburg being an exception in the north, the holidays there are often called skiing holidays because people will travel to Austria, Switzerland and Italy for skiing. I live in the greater metropolitan region and still have family in the city, and they've mentioned that everybody that they know in quarantine is so because they've returned from Austria or Italy.

Indeed i worry that these measures on the south don't work because of this: https://i.imgur.com/AuTw89a.png

Physical distance is a major determinant, as people naturally in times of crisis tend to stick together or even visit their parents more often.

Ah, so one could draw a link to the single currency. The single currency is basically European countries tethering theirs to the Deutschmark, which is great for Germany, but disastrous for the others. So, economic boom for Germany, kids can afford to live away from their parents. Economic hardship for others (remember "PIIGS"?) mean kids have been living with their parents more...

Before people downvote me for being kooky conspiracy theory, read:

https://www.csmonitor.com/World/Europe/2012/0924/Euro-crisis...

and:

https://www.forbes.com/sites/timworstall/2016/09/11/the-euro...

The conspiracy part of it is that you're fundamentally misunderstanding German society. Exporting to European countries (and the world) is great for shareholders and they've made a lot of money. It's not so much so for the average worker, and they aren't earning a lot more in real money. The jobs are in the cities, the rents are rising very quickly, the taxes are high and there's very little individual wealth for the middle class. There's no "economic boom" that would enable large parts of the German society to live comfortably, and it may come as a surprise, but trickle-down isn't working in Germany either.

Very interesting. In Germany, many deaths occurred in retirement homes...

most live together with multiple generations in china too.

That would be an interesting factor, do you still have the link to the article?

https://elpais.com/sociedad/2020/03/20/actualidad/1584729408...

I also found this related to the same: https://www.google.com/amp/s/www.lanacion.com.ar/el-mundo/lo...

The Spanish and Italians also kiss each other on greeting.

Bavarians do that too.

Except they don't?

And in many Asian countries they bow. Maybe that's one reason countries like South Korea, Taiwan, and Singapore were able to slow down the spread so quickly.

Interesting point. But maybe there is also difference in air travel/contact between Germany/Italy/Spain and China.

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