Ask HN: Will we ever know what is the actual death rate of Covid-19? | Hacker News Reader

Ask HN: Will we ever know what is the actual death rate of Covid-19?

4 pointskkcorps10 comments

Figures vary drastically by country with very high variance.

Most developed countries have systems in place to capture statistics like deaths so I'm sure they are being counted.

For less developed countries that task is much harder.

However, with the high level of death it is almost certain many Covid-19 fatalities are being missed, which means the official numbers are probably on the low side.

But as the numbers are so high and will undoubtedly continue to rise into the future, does that really matter?

This is the worst pandemic to hit the world since the Spanish Flu of 1918.

> Figures vary drastically by country with very high variance.

Different countries:

1. Took different measures to tackle the problem (i.e. with better/worse outcomes).

2. Are at a different point on the curve (i.e. for some countries the worse is yet to come).

3. Are actively trying to hide the true numbers.

I would guess the numbers are overstated due to cases being "clinically" diagnosed without an actual test (i.e. doctor looks at symptoms and says you probably have Covid)

We also have no idea of test accuracy across the myriad of tests being administered. Look to the Spanish Flu post analysis to see how wide the StdDev will likely be.

Counterpoint. Countries are reporting higher death rates in even if you take out the deaths attributed to COVID-19. One possible explanation for this difference is people are dying from COVID-19 and not being counted as victims of the pandemic.

Financial Times has some reporting on this.

Case in point, we will never really know and we should feel lucky that this wasn't catastrophic and we got away with our lack of preparedness.

I think the count of the number of countries that have got away this outbreak is much smaller than the number of countries still dealing with the outbreak.

I would also say many of these countries are just at the start of this process.

The are only a few ways a country can get over the virus:

1. Find a vaccine (which is still months/years away).

2. Impose very strict isolation rules (i.e. New Zealand)

3. Develop heard immunity (i.e. reach a point where 70+% of the population have been infected).

Everyone got off easy because the CFR is single digits, likely less than 1%.

I'm talking about a real epidemic, where one in 3-5 died, than things would be real bad.

Probably not to a high degree of accuracy. Many will die without having been tested and diagnosed. Some will die indirectly of complications. The testing itself is not perfect. Seriological screening will only give us an approximation for how widespread total infections have been, since we know some infections will pass unseen. For instance spain just released a study indicating that 5% of their population of has been exposed and 1/3 of those had no symptoms. That means that exposure is ten times the tested rate.

Like most questions, the answer will get more complex the closer you look. But we're doing the "science" thing: collecting more data, and narrowing the error bars. Past a point, you know enough that more accuracy won't change your action choices. That's a good enough answer for me.

Here are some recent analyses:

https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v...

https://arxiv.org/abs/2005.00495

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3590771

We'll likely be able to figure out a more accurate rate by reading between the lines. IMHO some inaccuracies are inevitable because of straight up lying by certain State interests.

Working out death rate for anything is surprisingly complex.

Countries count deaths using very different methods (someone who tested positive and died in hospital; someone who tested positive and died anywhere; someone presumed positive with covid mentioned as cause on death certificate; all cause mortality etc etc). Some of these figures are affected by amount of testing available.

Eventually we will get a number for the death rate of covid-19, but that will have lots of caveats around age and comorbidities.

At the moment the UK is severely undercounting deaths directly caused by covid-19, and isn't counting deaths indirectly caused by covid-19.

The Kings Fund has an excellent explainer here: https://www.kingsfund.org.uk/publications/deaths-covid-19

NHS England+Improvement have some notes on their data here: https://www.england.nhs.uk/statistics/statistical-work-areas...

The Office for National Statistics have a nice (but out of date) page here: https://blog.ons.gov.uk/2020/03/31/counting-deaths-involving...

Chris Hatton has a great thread about the mortality statistics for people with learning disability and or autism: https://twitter.com/chrishattoncedr/status/12609675671555153...

And Nick Stripe has a twitter thread here: https://twitter.com/NickStripe_ONS/status/126124441541637734...

Another paper on UK care homes: https://ltccovid.org/wp-content/uploads/2020/05/England-mort...

This is for France, and it's pretty good: https://science.sciencemag.org/content/early/2020/05/12/scie...

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