Latest EURO MOMO data shows excess all-cause mortality in some countries | Hacker News Reader

Latest EURO MOMO data shows excess all-cause mortality in some countries

euromomo.eu

One interesting thing that I can see there is that the current excess for many countries seem to be no worse so far from a larger excess in the early weeks of 2017.

Another very surprising thing is to see no excess mortality in Sweden, a country criticized for a laxer strategy against COVID-19.

I was not expecting to see that.

I leaned towards Doomer, especially early on, but must admit that looked at on the scale of years, it's possible that this will turn out to be a blip followed by a new normal of (say) a three-percent higher rate.

One caveat is that over the long run, everyone dies exactly once. A more interesting stat will be life-expectancy (i.e., presumed years lost). But then again, most people dying aren't losing that many years of their life expectancy. (Apologies for being grim.)

Yes, but this is with everything locked down. The trick is going to be figuring out how to unlock without the doomer scenario occurring.

I meant that this is what I think might happen if/as lockdown is slowly released. There will be some trick in figuring out how slow is slow enough, and perhaps we'll go back and forth a bit, but this looks like what will happen.

If we keep things locked down too long, immense numbers of people will die from that. We need to minimize all deaths, not just deaths from the virus.

> We need to minimize all deaths, not just deaths from the virus

The recent events lead me to believe that it is not what countries are doing. Even WHO posted a figure in 2019 of 8 millions of deaths per year from Tabacco. The covid19 will not reach that level anytime soon, yet every country in the world accepted a major economy self-sacrifice to "save" people from covid19. How to explain that?

People choose to smoke. Nobody chooses Covid-19. (Yes, I know, people are in different cultures, and some of those cultures promote smoking while others discourage it. Still, smoking isn't an infection. You don't catch it from people around you, other than second-hand smoke.)

More: People smoked. The people who die from smoking this year are for the most part not dying from this year's smoke. They're dying from smoke from 20 or 30 years ago (or perhaps from 20 or 30 years of cumulative smoke).

Even more: They're already trying pretty hard to get people to stop smoking.

And yet one more: There are 8 billion people in the world. If we don't stop Covid-19, maybe 30% of the world's population is going to get it this year, or maybe next. Of those, maybe 1% to 3% are going to die. That's 24 to 72 million people.

That's why Covid-19 gets a bigger push than tobacco.

I don't understand what you are saying. If deaths from covid continued at the current rate without increasing, then there would be about 2 million by the end of the year, about 1/4th of your number for tobacco.

But if people didn't take drastic action, do you think it would not double at least twice more? That's only two weeks of 10% growth per day. And where would it stop?

My theory is : no matter the lockdown, the virus will always be there (it will come back) and people who would die from it will die from it anyway, but due to the lockdown they just won't die all at same time. If they won't die from covid19, they will die from another flu or another complication.

The lockdown only buys them time so a vaccine can be developed specifically for covid19

How much economy (including lives that depend on the economy) are we willing to sacrifice to save 0.001% of the world population.... ?

I'm sorry but all of this doesn't make sense in regards to the "effort" made to save elderlies in the past.

Sweden is on the same track as Switzerland, but about a week behind. They will probably show up on the map in either 1 or 2 weeks.

http://91-divoc.com/pages/covid-visualization/

and deaths are up to 5 weeks behind cases.

My 'week behind' is from comparing per-capita cumulative deaths.

The number of confirmed cases doesn't track as well between countries, probably due to different testing strategies. Norway, Denmark, and Sweden all have similar per-capita cases, but Denmark has half the death rate as Sweden and Norway has half the death rate of Denmark.

JFYI: Sweden is now in the "Very High" bucket for week 14. There's a disclaimer above the map:

> As always, the number of deaths in the recent weeks should be interpreted with caution as adjustments for delayed registrations may be imprecise.

Yep, so far this is on the order of a bad flu year in terms of excess mortality. Given that Sweden seems no worse yet than other countries it suggests that the lockdown may not be as effective as claimed.

Too early to tell there.

https://abcnews.go.com/Health/wireStory/virus-deaths-rise-sw...

> For weeks, the numbers of COVID-19 cases and fatalities were proportionally similar between Sweden and Denmark, but while the economic results of the strict isolation are being felt in Denmark, Sweden’s mortality rate has reached more than 88 dead per million, compared with around 47 dead per million in Denmark.

Keep in mind that the various lockdown are also greatly decreasing road accidents, or ski, or climbing, or whatever other dangerous activities, so the absence of a bump is not so straight forward.

Note that Euromomo reporting is seriously delayed for probably most countries. Here are Dutch numbers that include better estimates for week 14

https://twitter.com/DToshkov/status/1249693421201129480

https://twitter.com/statistiekcbs/status/1248552559637389312

It's worth noting that previous major flu seasons were around January. So it's pointless to compare current death numbers with another March weeks. You need to compare it to previous flu seasons.

So Germany, which is right next door to the Netherlands/France/Italy, is experiencing no excess mortality. What did they do right and how can we have some of that.

We don‘t talk to our grandparents anymore.

Listen to experts, have highly competent leadership, run a coordinated response.

Incompetency kills.

I don’t think that explains the whole situation, or at least I don’t believe that all but Germany have incompetent leaders, have bad experts, and lack coördination.

Yep, that's the story the media here tells. Of course. "We are so exceptional, we Germans."

In reality, we had just four times more ventilators available than any of the larger countries around us, so we never hit the "no treatment possible" situation.

No, that can't be it. Ventilators is a last resort kind of measure, most people under ventilators die either way, so they can't affect numbers much. I suspect Germany is just testing more and earlier than others.

No idea where you got that information.

Testing in Germany started very late, but was then increased rapidly.

As of today, Germany has done 1,317,887 tests. The US: 3,029,979 tests, Italy: 1,073,689 tests. (Source: https://www.worldometers.info/coronavirus/) So not exceptionally more than others.

Testing wouldn't really affect the sort of excess mortality numbers this site reports.

The response wasn't very coordinated in the beginning, but we were lucky enough to start a lockdown in a timely fashion. So far we also managed to keep the disease mostly away from the most vulnerable groups.

We were mostly lucky to have about four times as many ventilators as France or Italy.

The numbers I read in two different sources: Germany has about 20,000 ventilator places, while France, Italy, Spain, and UK have about 5,000 each.

So in Germany, we didn't hit the "no more ventilators" situation and people didn't die.

Edit: Here a recent article confirming it: "Germany still has 10,000 free ICU beds" (in German: https://www.tagesspiegel.de/politik/coronavirus-in-deutschla...)

Edit 2: Pretty sick, considering that in Italy and France thousands are dying because there are no ICU beds, and here in Germany they are just empty and unused.

It's a funny kind of luck that requires planning and investment over many years.

Not really. Its just a number in the books. Whoever made that decision decades ago, got it right, luckily. But that's about it.

Had this virus affected the kidneys instead of the lungs, the outcome would have been way different.

Also, over the last week, mortality has been increasing here as well. So better "den Tag nicht vor dem Abend loben".

> Had this virus affected the kidneys instead of the lungs, the outcome would have been way different.

And if my aunt had wheels and pedals, she'd be a bicycle.

They didn't stock up on ventilators by throwing darts at a dartboard to choose what type of medical equipment to buy. They stocked up on ventilators because a pandemic centering on a respiratory illness was statistically much more likely to occur than one centering on the kidneys.

> And if my aunt had wheels and pedals, she'd be a bicycle.

But that would not make your aunt a deadly virus, would it?

> statistically much more likely

Maybe. Just like the US did. Or maybe it was some other reason. I believe you don't have any source?

> Had this virus affected the kidneys instead of the lungs, the outcome would have been way different.

Kidney infections don't tend to spread easily.

Luck favors the prepared mind, so could it be just an indicator of something deeper?

Maybe Germany has 4x as much ventilators as France, but also k times as much of many other things that matter?

I wonder if countries like France will realize they have to improve and become more like Germany instead of doubling down on their downwards spiral.

> Luck favors the prepared mind,

Then the US should be much better off, because they have about ten times more ventilators than Germany has. But only four times the population.

But, the US was unlucky to have 50% of cases in only one city. So they ran out of ventilators in that one place, while having a surplus elsewhere.

They reacted quickly and correctly by sending hospital ships (much quicker than trying to put ICU beds on trucks).

Of course, compared to the EU, the US is still handling the situation way better.

Unfortunately the hospital ships are equipped to deal with wartime problems, i.e. trauma victims. They don't help too much in a pandemic.

They are not there to treat COVID-19, but to lower the "day to day load" of hospitals, so the hospitals have more capacity for COVID-19 patients. At least that's what they said on PBS Newshour.

That changed about a week ago.

https://newyork.cbslocal.com/2020/04/06/coronavirus-update-u...

I'm not sure about Germany, but at least in Italy ICUs were at 80% capacity when the outbreak hit.

In the this week in virology podcast from Friday they talk with a clinician in NYC who mentions they are trying to avoid respirators and use masks and nose oxygen. He mentioned the illness looks more like altitude sickness and respiratory distress and that ventilators could be doing more damage than good at that stage.

Dr. Seheult touched on this as well in his update a few days ago. Really worth watching as well:

https://www.youtube.com/watch?v=o8aG63yigjA

Doubt it, people in need of ventilators would clearly fall under Covid19 mortality, not all cause mortality. Also it seems that people who are put on ventilators are pretty much goners anyway.

Please correct me if I'm wrong but most of Germany is highlighted as "No data", at least in this map.

What score do you see? Germany is marked as "No data" for me.

Is there anything in this data indicating that there is something going on more severe than the flu? I don't see anything.

"It's not worse than the flu when we lockdown the entire global economy" is not a comforting fact, even if true.

We don't know how it would have been without lockdown. We just see this data and it looks totally normal.

> We don't know how it would have been without lockdown.

Sure we do. It's not hard to see the curves flattening once mitigation efforts go into place, and slow-to-react countries having a harder time of it. https://91-divoc.com/pages/covid-visualization/

It also stands to reason that a respiratory virus would be affected by a country going on lockdown, given the mechanism.

In data that are 2 days to 5 weeks old we see that it kills as many as a bad flue year despite massive efforts to contain it.

As far as I know, Sweden didn't do much lockdown and is in normal range too. (At least so far). If it stays this way: If it would have been really that massive without measure, shouldn't Sweden be a huge outlier?

They've taken some mitigation steps - closing high schools and universities, banning large gatherings, encouraging work from home, social distancing, etc. It's also unclear if it's working:

https://abcnews.go.com/Health/wireStory/virus-deaths-rise-sw...

> After a sharp spike in deaths in Sweden, Prime Minister Stefan Lofven proposed an emergency law allowing the quick closure of public venues and transportation if needed. Lofven also warned citizens to prepare for possibly up to thousands of deaths.

Being selfish and looking at the numbers for the UK.

One thing that is striking is the peaks in age. The total figures look like the peak has yet to arrive, but thats because the mortality in the 65+ range is climbing (Given that 13% and rising have cases, this isn't suprising)

but the 18-65 looks like it has peaked. This shows a similar pattern to spain, if a bit earlier on the slope.

However this is just a shallow observation.

Maybe the over 65s in the UK can't isolate themselves as easily as younger age groups. Knowing percentages of older people in nursing homes for different countries could be useful.

It’s gotten into the old folks homes just as in Spain.

The Office for National Statistics is gathering lots of data for the England and Wales (but not NI or Scotland). (There's some lag in the ONS data).

"The provisional number of deaths registered in England and Wales in the week ending 3 April 2020 (Week 14) was 16,387; this represents an increase of 5,246 deaths registered compared with the previous week (Week 13) and 6,082 more than the five-year average." https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

"The @ONS said the 16,387 deaths registered in England and Wales in the week to 3 April, was the highest weekly total since they started recording weekly deaths in 2005" https://twitter.com/ShaunLintern/status/1249990956302073856?...

If we look at the weekly death for 2020, compared to the weekly death averaged for the past 5 years we see large spikes in excess mortality. We'd expect some increase because the UK has an ageing population, but not this much. https://twitter.com/ActuaryByDay/status/1249983121254203395?...

Or we can look at max / min mortality for each week since 2010, and overlay covid-19 excess mortality https://twitter.com/EdConwaySky/status/1250007002165755905?s...

We can include flu and pneumonia https://twitter.com/philjvtaylor/status/1250094624707928065?...

"Of the deaths registered, 3,475 mentioned coronavirus, which is 21 per cent of all deaths, compared to 539 deaths and 4.8 per cent of all deaths in the previous week." https://nhsproviders.org/topics/covid-19/coronavirus-member-...

(I upvoted you. I don't understand why you got downvotes.)

It's good to see how healthy people in Luxembourg became with all this pandemic!

This isn't exactly a good rebuttal to "it's just the flu". But it's still important datapoint in itself.

It's really just another data point. Using absolute numbers of deaths, it is hard to differentiate between an epidemic where R0 is moderate (say, 2.5) and the IFR is fairly high, or another where the R0 is higher (e.g. 6) and the IFR is lower. Both get you a lot of hospital load and an increased number of deaths.

Some interesting studies coming out now supporting the iceberg theory. Depending on your perspective, that could be good news.

Thanks, but we already know there is a pandemic going on causing excess mortality. In fact depending on where we are in the world we are at the tail end of a solid 3 week block where this pandemic and its effect on the local society was the only thing being reported on.

Or in other words: these excess mortality numbers include Covid-19 deaths, it's not the sexy excess mortality that excludes the pandemic some media have reported on.

A lot of my dutch friends have been saying: "look! look! no excess mortality in the numbers"

so this is pretty important.

Let them have a look at [1]

It shows a graph of the death rates for the past 3 years. This year is not a good year (to put it mildly)

If they're Dutch, then they know what the RIVM stands for. For others reading this, you can probably compare it best to the Dutch version of the CDC.

[1] https://www.rivm.nl/monitoring-sterftecijfers-nederland

We didn’t know that it’s causing excess mortality, at least not from any data I’ve seen. It’s all been COVID related deaths which is pretty meaningless in its own.

This is the important data that shows how bad it really is - albeit not normalised for the reduction in other deaths such as car crashes etc.

So have you read the stories about how hospitals rent cooling containers and some cities use ice rinks to get additional storage capacity for dead bodies and go "I wonder if there is any excess deaths going on"?

Those hot spots of mortality could like be offset by reduction of other causes of death in less affected areas.

Just as a counter-point to excess mortality being obvious.

Uh, you have to provide a casual link between excess and suppression buddy, otherwise it's not a counterargument.

My counter-point was only that it isn't _obvious_, as you stated.

Have you read this thread where there are people still saying "covid-19 isn't that bad, it's about the same as a rough flu year"?

Data helps persuade those people that this is worse than most flu years in recent history.

But would a 10% worse flu worth a global recession due to global lockdown ?

Yes, I have. The counter argument to that is that all the people who were going to die this year just died in the same week. This would of course temporarily overwhelm mortuaries etc but would result in no excess mortality for the year.

The infection rate numbers are essentially meaningless since governments are testing differently. Others don’t even have any tests at all.

The death numbers are also meaningless unless you know they are truly extra deaths that wouldn’t have occurred otherwise. Some countries are under-counting by only counting hospital deaths. Some countries are over-counting by counting any death with COVID as a COVID death. A death count in itself is meaningless without an expected death count which we almost never see.

Now do I believe we have a real problem? Yes. Can I quantify it? No. Not without excess mortality data like this on an ongoing basis.

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