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Comment by nnq | Hacker News Reader

A better question from everyone outside the US: what the flying f is with the huuuuuge (accounting for estimated no. of infected and other factors) number of deaths in the USA??!!?!

I mean, the US is (a) a developed country with modern health-care, (b) there is no common 'old parents living in same home with some of the adult children' situation you have in Italy + Eastern Europe, (c) there are no norms of common physical contact like 'kissing on meeting' (see France, Italy, northern Romania etc.), (d) the population is generally very dispersed (compare US density with areas of Western Europe or China) and (e) there is prevalent use of personal cars instead of public transport (as opposed to Western Europe and China, again), which should further diminish transmission.

US stats look worrying for everyone on Earth, it almost looks like a wild difference in viral strains or some other important but unknown factor.

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Whilst I agree the USA has a lower population density than most of the world it is not exactly true. This figure assumes everyone is equally spread out. However many inhabitants of the USA live in cities therefore population density is much higher. The same thing happens in Spain which goes from one of the least dense countries in Europe to one of the most dense looking at it in these different ways.

The USA has a large population and I assume this is why you think the numbers are huge. Deaths per thousand are around a half of the UK and less than a third of Italy and Spain.

In not very worried by US stats they seem fairly similar to elsewhere in the world. What I'm worried about is that it seems like American politicians, media, people think they are much further along infection than they are.

Edit - typo

Not only is the population large, a lot of people are large as well. Obesity, diabetes, and cardiovascular health are huge factors in covid-19 mortality.

> A better question from everyone outside the US: what the flying f is with the huuuuuge (accounting for estimated no. of infected and other factors) number of deaths in the USA??!!?

That's only true if you don't know what "per capita" means.

So far the US has 172 death per 1M population. That's better than other countries with supposedly better healthcare including:

- Belgium

- France

- Spain

- Italy

- UK

- Netherlands

- Sweden

- Ireland

- Switzerland

And many more.

> US stats look worrying for everyone on Earth

I'm more worried about people's inability to understand the difference between stats and absolute numbers specially on this site where we're supposed to know better.

NYC is currently at 1462 deaths per million.

The whole country of Spain is at 510 deaths per million. How high do you think their biggest hot spot is?

I think the point is that treating the USA as some sort of unified region for statistical purposes is in itself problematic.

The thing that worries me about NYC statistics is that they're awful, and we now have serum tests that indicate that -- at best -- we're about 1/3 of the way through. (Current serum tests indicate 20-25% of NYC has caught it, current R0 estimates indicate that 70-85% would need to catch it for it to burn itself out without any additional measures.)

This puts reasonable estimates of "how bad can it get?" at north of 5000 deaths per million, if we don't properly contain it. This, really, is the new information we're getting out of US numbers.

Community of Madrid looks to be at 1228, based on official statistics.

There are other place also doing poorly, some as badly as NYC, maybe a little better, maybe a little worse, but right now, until someone screws up worse, NYC is currently in the running for "worst COVID-19 death rate in a major city".

I think it would be more honest if US statistics would be split per state or social/economic region otherwise you I would complain that you also are in the same catherogy with the ones you accuse.

Since the very beginning, everyone expected the US to have a very high percentage of death (remember discussing that my friends even before the US had a single casuality).

Hypertension and diabetes were listed as have a lot of impact of the mortality rates, and the general extremely bad health of the american population, coupled with the lack of a quality public health system made it the perfect target. That, plus more political issues, such as not being able to enforce curfew easily, a general mistrust in representatives, and a president that remained convinced it wasn't such a big deal for a very long time.

All in all, i think the number remain quite low compared to the worst case scenario.

Or we had a wildly incompetent response from the federal government.

https://www.nytimes.com/2020/04/28/opinion/coronavirus-trump...

Because societal norms in the US dictate that individualism takes priority over communalism no matter what.

Source: am American

The US has a low rate of testing, was late to impose lockdowns (mostly; a few states were fairly proactive), and is bad at enforcing them (again, mostly). Having a leader who spent the first few weeks of the crisis on TV denying there was a problem, _while people were already dying in the US_, probably didn't help; most countries don't have that.

> some other important but unknown factor

The important factor is probably just very poor crisis management. US death rates aren't _that_ high, anyway; on paper they're low to medium vs Europe, though given that the rate of testing is lower than almost anywhere in Western Europe that's probably understated.

What I always think of if I hear this is the tallness paradox between Europe and USA. When controlling for ethnicity, the modern white person from the US is on average about 1.5 inches (4 cm) shorter than the average person from the EU. As far as I know its uncertain why exactly this is (american used to be taller until mid of the last century) but the usual suspect is class inequality the lets to poorer sanitation for poorer people which in turn are also more likely to infect richer people which leads to less growth in adolescents. But ultimately, the cause of this phenomenon in not known.

Obesity?

Compare the US to the EU as a whole and you’ll see that the two are doing pretty similarly.

Well US has an obesity problem and this is considered to worsen Covid effects.

There are differences in vaccine regimen too, which lead to be a statistically significant factor. (edit) The first point is in reference to the BCG hypothesis, search at MedRHiv for similar entries such as: Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19"

In addition to early travel exposure, common travelling, social factors-vs-car culture, obesity and diabetes, etc.

Within Europe, the BCG hypothesis seems a differentiating factor, though further studies are necessary. The reason for the effect of the vaccine are not currently known.

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