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Comment by entee | Hacker News Reader

Nearly 100,000 people have died of COVID19 and there’s good evidence that this is a substantial undercount. All this in a context where we shut down transmission vectors (being indoors, with lots of people). Most estimates I’ve seen suggest we’ll hit 150k-200k deaths by end of year. 2017-2018 flu season killed about 80,000 with no mitigation efforts. Just on the face of it, this virus is far more than 2x deadlier than the flu.

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Sure, but 2x deadlier than the flu just means 2 flu seasons. It's not great, but we don't do half-lockdowns fur 1 flu season. Why do a full lockdown for the equivalent of two flu seasons?

What would the numbers look like without mitigations? There are certainly some flu seasons that are 2x worse than average. I imagine that the cutoff between no action and hard mitigation would be a 10x flu event. It seems plausible to me that this would have been 10x the flu with business as usual.

That still doesn’t do accounting for the negative effects of mitigation. The truth is that this is an open-ended ethical question and it’s not fun to participate in.

> What would the numbers look like without mitigations?

Look at Sweden, you'll find that their very light measures are not worse than the very late but much stronger measures of harder hit areas.

If you compare Sweden to the other Scandinavian countries (which is the most suitable comparison considering population distribution and habits) the light measures actually seem to have resulted in a much higher prevalence.

https://www.bloomberg.com/news/articles/2020-05-14/sweden-co...

Yes, but not catastrophic prevalence. The question was whether not locking down things like schools would result in much higher deaths than we currently see in for example England or New York. The answer is no, not necessarily.

In Sweden a lot of people were self-isolating and being cautious without the need of a formal lockdown. They still have the most deaths per capita in Europe.

Schools were open. A million kids went to crowded classrooms every day for the past two months and death rate is still not even close to England, Belgium, Italy or New York.

The number of deaths per capita is higher than England, Belgium, and Italy however the total number is lower (they have a smaller population). They also have a low population density, a lot of single households, and as a population have less issues with diabetes, obesity, and chronic heart conditions compared to other countries.

It is not black and white :)

Targeted lockdown was a good idea in the context (not that much different clusters).

Sweden was since the beginning at the place where France will be next week, but Sweden did not have the Mulhouse cluster that crippled multiple hospitals in eastern France.

Many thanks to Switzerland and Germany for helping us saving a dozen patients by the way.

If you compare Sweden to other countries with full and absolute total lockdowns like Belgium the UK and Spain and Italy....they actually have lower incidences of infections fatalities and higher incidences of recoveries.

Sweden is the control group in all of this for how effective lockdowns are and it's showing that they're potentially not as effective as we think they are.

You can't compare Sweden to those countries. Not the same density, not the same hubs, not hit at the same time, not the same social comportments.

Even compared to France they have advantages and they have pretty close numbers (+30% excess death vs + 33%).

Sweden has a higher density of day to day human interactions than any country with full quarantine lock down.

How do the other data points apply to a country that's been on quarantine for months and another that has never been on quarantine?

The exponential explosion of coronavirus cases hasn't happened in Sweden and it's not happening so far when people reopen their economies. there's not even a second wave in economies that have been reopened since early May like Florida.

The model was flawed.

Time to face facts quarantine was ineffective response.

The major flaw in your argument is focusing on an official quarantine order. In practice it seems many of the places you mention have an informal quarantine in place. In Florida Miami-Dade county did have a lockdown though the broader state didn’t. It’s also the densest, so most at risk. Nursing homes also took steps way beyond the government order and well before the order. There’s also tons of evidence that people did not adopt initially and are not returning to normal behavior. For example even in Sweden restaurant attendance was down massively even in the absence of an official ban.

You may be right that a more localized or targeted response has almost the same effect as a full lockdown. (Though things are still decidedly not great in Sweden concerning the death rate). But people are taking massive measures even in non-locked down areas, it’s improper to compare that to the status quo ante.

If there wasn't a lock down in Florida like you say and no hospitals were overwhelmed and no exponential explosion of cases happened.... Then that's all the evidence you need to know that flattening the curve was a myth and quarantine was an ineffective solution.

(the same effect happened in Sweden by the way)

I bet you based on these data points that every region that opens it's economy will have the same result. Steady state of cases, no second wave.

Quarantine was pointless. A lot of lives were ruined by the flat curve proponents...for nothing.

That’s actually not what I said. I’m saying there were lockdowns in the most important regions (Miami-Dade for example), that people behaved as though there were lockdowns in at risk areas (nursing homes), and that people are still behaving with lockdown-style precautions. All of these things produced a flatter curve, and have also to a certain extent done so in Sweden where people followed many (not all) lockdown precautions without official government decree.

Just because the government didn’t say things were locked down doesn’t mean they weren’t in practice. Look at Sweden’s GDP losses, restaurant attendance, movie attendance, you’ll find they haven’t avoided massive economic damage. In exchange they also have a pretty high death rate.

These things are complicated, but it’s pretty clear lockdown behavior cuts infection spread. It’s also pretty clear people are terrified of getting sick, so they’ll adopt the behavior to a certain degree regardless of decree. This means issuing a decree or not doesn’t make you avoid economic pain, but a decree might make it easier to guide the right actions and give pretext to minimize economic pain via external support.

"it’s pretty clear lockdown behavior cuts infection spread."

It's not clear at all...as basic social distancing is appearing to have the exact same effect as lockdown.

People are finding it impossible to discuss this rationally. If you try to disagree with the seriousness of this and even insinuate that the response is incorrect you are demonized even if you back it up with data.

The data from Sweden and regions opening up their economies are starting to show that there are is no exponential explosion of coronavirus cases like predicted, no hospitals are being overwhelmed.

The data is starting to show and will continue to show as time marches... that quarantine was potentially ineffective, the fatality rate was extremely inflated, and flattening the curve was potentially a mistaken theory.

> there’s good evidence that this is a substantial undercount.

I don’t know about the US, but most European countries count anyone who died with corona as a covid death. No matter how clearly you died to something else.

The overall flu mortality estimation counts people we guess might have flu, but never seeked doctor. As deaths, they estimate how may other deaths are fly and add them (like % of pneumonia). There is also fuzziness about who counts as death from flu too. For covid, there is no added estimation afaik, if you die without test you dont count.

It is not like one number was super clean and other dirty. Both are dirty and estimations.

While that may be true, most European countries still undercount the true death rates since there are large discrepancies between each country's official covid deaths and excess deaths.

Playing devil's advocate, how are we sure excess deaths are due to covid and not the lockdowns instead? (Suicides, cancelled surgeries, etc.)

Ok, playing systems-engineer here: we'd call those secondary COVID-19 deaths caused by the either de facto or de jure lock-downs.

Why, oh why, are some people so obsessed with lowering the number of COVID-19 related deaths at every possible opportunity? Its weird.

> Why, oh why, are some people so obsessed with lowering the number of COVID-19 related deaths at every possible opportunity? Its weird.

Maybe they want to minimize the amount of secondary COVID-19 deaths?

Fair enough, but WHY?

Here is a less contentious example:

1. consider a severe, long drought

2. this will damage the livelihoods of many in the hinterland - farmers and those in the small town that service them

3. many may be driven to suicide.

Would you not agree that such excess suicides are 'caused by the drought'?

Yes, but it's not quite the same, because the suicides etc for COVID-19 are not directly caused by the virus, but by our reaction to it, and some believe it's an over-reaction.

I'm not an expert on the actual, real dangers, e.g. how many and who will die, so that's not what I'm concerned with. If they're terribly high, doing what ever is necessary to stop it is right, I consider that obvious. "Flattening the curve" makes generally sense to me, in a "let's make sure our hospital system doesn't collapse" kind of way.

I live in a county of a bit over 300.000 people in Germany. We have 10 known active cases in the county. We're still in a very constrained soft-lock-down, i.e. schools not running normally, half the offices not open, mandatory masks, public services on emergency-only-level etc. We're still taking damage economically, obviously. Lots of people are scared to death in a very real way, and are still afraid to leave their houses.

Is it still the right call to remain in this state today? Will it be when we have 0 active cases, but there are counties nearby that still have more than 0? By saying "well, everything that happens happens because of COVID-19", we're removing our agency from the equation.

Not all countries have lockdowns to the same degree, yet they all have discrepancies between excess deaths and official covid deaths.

Clearly, not all excess deaths are covid deaths though, a minority of them are certainly related but not directly caused by it.

If only people with symptoms are being tested, and 80% of people are asymptomatic, how are we not drastically overestimating fatality rate?

Where do you see the data that 80% of people are asymptomatic? You complain elsewhere in this thread of being dismissed even when you have data, yet provide none.

We understand that you think that the lockdowns are bunk and that this is a big non-issue cooked up by the world to ruin our lives; sure, maybe, but where is the data?

Here is a medical journal sufficient?

This is more study than was given to full lockdowns.

This was posted to Hacker News a few weeks ago as well.

https://thorax.bmj.com/content/early/2020/05/27/thoraxjnl-20...

"We understand that you think that the lockdowns are bunk "

Correction...lockdowns ARE bunk.

WHERES THE SECOND WAVE?

Why hasn't Sweden followed the model of exponential explosion that was used to justify the lockdowns.

The flat curver movement was unscientific and wrong and you would do well to fight unscientific attacks on your civil freedoms with all of your vigour going forward because this isn't the last time this will be attempted.

Thank you for posting the data. These are both brand new from yesterday, however, so I’m not sure why the tone here is so belligerent. Either way, this is incredibly interesting, and something we should continue to look into going forward. It sure would be nice to ease up on the lockdowns if they are not the correct path going forward.

If you do some research and start questioning the narrative the amount of demonization and arrogant dismissiveness you get for it will make you belligerent. lol

People are scared and when you disagree with the experts even if you're right you get treated poorly.

Additionally, the only closed system study we've had of this, is a cruise ship. And this was replicated there. 80% asymptomatics.

https://www.cnbc.com/2020/05/27/over-80percent-of-coronaviru...

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