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Comment by stormdennis | Hacker News Reader

In the UK non white ethnic groups and especially Bangladeshis have had the highest mortality rate from Covid 19 and yet the countries they come from are faring better than the UK is against the disease. The explanation for this when it's found will be interesting, one factor might be climate and possible vitamin D deficiency among these groups in Britain.

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No one in Bangladesh believes Bangladesh's low death number. I live here. Freedom of the press is non-existent (al-most all press/media is owned by government party). There are actual laws that say that you can't say anything against the government online (many have been prosecuted for this).

There is literally only 1 party - all other parties are destroyed, their members arrested or banned, jailed on real or fake cases.

Bangladesh's health care has been horrible even before the pandemic. Air pollution is extremely high. We don't have the infrastructure to handle so many patients - private hospitals are having a hard time handling patients. Public hospitals are even worse. Central oxygen is almost non-existent, lack of proper PPE, masks or proper testing. They only recently started ramping up tests - but the numbers are still very low.

Even with all the hiding and misinformation by the government, the official number is still climbing at an alarming rate.

I fear that we in the west will simply not even know that this catastrophy is occuring all over the third world. Maybe in a few years we will find out just how terrible this pandemic was.

I genuinely wonder if there is any data that backs the hypothesis what countries where the current health and healthcare conditions are already very poor are showing low numbers of symptomatic covid-19 cases because most people who are susceptible to disease have already succumbed to other diseases over the years.

Also, testing. Testing is hard to get in the US. We are obviously fucking up in many ways ATM, but if you can't get testing here when you want it, imagine getting it in a poor country with inadequate healthcare.

In my anecdotal experience I haven't seen it hard. Lots of counties in California are offering free testing for anyone. Not to mention commercial testing has been open for anyone for months now.

I'm not sure what you are comparing it to.

The US has had more testing per capita than New Zealand, Norway, Switzerland, or Canada.

Compared to countries like India and Bangladesh, the US has had well over an order of magnitude more testing.

I'm looking at the main chart, second to last column, at https://www.worldometers.info/coronavirus/

Lower life expectancies and lack of elder group homes might also explain it. For the first one, those with pre-existing conditions that the virus usually has more of an effect on are mostly already dead. For the latter, a lot of the cases in the west have been in nursing homes that simply don’t exist in poorer countries.

Or they might just not have the resources to get accurate statistics and ascertain cause of death due to the virus.

Is there a difference in obesity rates between the two populations?

More sun in India, Bangladesh. Less in UK. Might be simple answer is that the darker skin = less vitamin D. So higher the latitude, dark skinned people might be in more trouble.

Yes I've been interested in this theory as well. Also see the number of deaths in carehomes - where a lot of people spend all days indoors.

Let's just say I've been taking my Vit-Ds for the last 3 months!

Care homes house at risk people that are susceptible to getting sick from anything. They live in close quarters and are touched by lots of workers throughout the day. I doubt Vitamin D and indoors has anything to do with it.

It certainly doesn’t help.

In the UK, April 2020 was the sunniest April on record (224 hours of bright sunshine), and May 2020 was the sunniest month on record (626 hours).

Now, how much time UK citizens spent in the sun compared to those in other countries is a different question, but "less sun" doesn't appear to be the answer at face value.

[1] https://www.metoffice.gov.uk/about-us/press-office/news/weat... [2] https://www.metoffice.gov.uk/about-us/press-office/news/weat...

You also need the sun at a higher angle to get enough UV exposure (vitamin D creation is triggered by UV B exposure).

More sunshine isn't enough.

The UV responsible for vitamin D production effectively does not penetrate glass so it depends how much time people actually go outside.

As a dark-skinned developer, I used to feel terrible when I was in Germany/US for over 2 months - to the point of being suicidal. It was like my body and mind was breaking down. Colds, migraines, illness, body aches, joint pain. Only later was I diagnosed with acute vitamin-D deficiency.

Vitamin-D supplements turned around my life like a miracle. Nowadays I pop myself with every single vitamin-<anything> tablet in the market.

I tried Sunlight, but Sunlight in northern latitudes is a joke.

If you have darker skin yes. But I always thought that white skin is an evolutionary adaptation to the reduced levels of sunlight available at Northern latitudes.

It's more about the colour of skin * place of residence interaction than anything else.

> I tried Sunlight, but Sunlight in northern latitudes is a joke.

hahaha, brilliant!

The vitamin d connection might partially also explain why Sweden has a higher mortality rate than its neighboring countries, because Sweden has accepted more immigrants

Vitamin D supplements and fortifications in food are commonplace here though, so that would have to be compared to actual vitamin D levels to know for sure

Or it could be because Sweden has reacted far less than us...

There are plenty of dark skinned Norwegians, Finns and Danes these days.

I guess everyone finds the explanation that suits his beliefs best.

It is quite obvious that the reasons Sweden has > 3000 deaths and Norway has less than 300 is because of much less severe restrictions. Sweden has twice the population, but quite similar demographics.

Sweden has much more of an immigrant / foreign-born parent population. About 25%-30% vs. 13-15%.

As of 2017, Statistics Sweden reported that around 2,439,007 or 24.1% of the inhabitants of Sweden were from a foreign background: that is, each such person either had been born abroad or had been born in Sweden to two parents who themselves had both been born abroad.[22] Also taking into account people with only one parent born abroad, this number increases to almost a third in 2017.

https://en.wikipedia.org/wiki/Demographics_of_Sweden#Migrati...

Immigrants constituted 13% of the population at the start of 2015, and an additional 2.6% were born in Norway by immigrant parents[12] (up from 8,3% and 1,5% in 2006[13]). The same year, 19% of births in Norway were to immigrant parents.

https://en.wikipedia.org/wiki/Demographics_of_Norway#Ethnici...

GP isn't denying they have more immigrants, they are saying it makes more sense to point to their reaction to the pandemic than to point at their number of immigrants. This explanation is both more simple and it doesn't have strange racist undertones.

I was just replying to the idea that the demographics are the same.

Pointing out an observation in relation biology and vitamin d production, even if totally incorrect, does not mean it's racist. If anything, if someone with darker skin living in Sweden would get their vitamin d levels checked and correct it because the comment above, it would help them.

> Sweden has much more of an immigrant / foreign-born parent population.

This was said in response to the statement that Sweden has 10x more deaths than Norway.

For the same year, 2017, it's 24.1% for Sweden and 16.8% for Norway: https://en.wikipedia.org/wiki/Immigration_to_Norway

And in both countries almost half of the immigrants come from Europe or similar latitudes.

This doesn't explain the factor 10 difference in outcome.

Most cases in Sweden are in the age groups >70 since the elder care homes and elder care workers.

The situation would probably be very different if they have the equipment and training to deal with it. Many were even threatened to be fired if they put on face masks.

Not sure it's that simple. Massachusetts has a population of 6.7M and 7152 deaths (average age 82) with a lockdown.

Sweden has a pop. of 10M with 3K deaths.

Florida has a pop. of 20M with 2566 deaths and not much of a lockdown.

It seems to me that the death rate is a function of how well protected the elderly are and in particular if C19 has gotten into long term care homes as it has in MA (62% of MA C19 deaths in long term care homes) and I think Sweden, but Florida locked down its LTC homes at the beginning of March.

https://www.forbes.com/sites/theapothecary/2020/05/26/nursin...

It is not as clear cut as this. Massachusetts has a population of 6.7M and 7152 deaths. Sweden has a pop. of 10M with 3K deaths.

Massachusetts is approximately 20,306 sq km, while Sweden is approximately 450,295 sq km, making Sweden 2,118% larger than Massachusetts.

So the 10M residents of Sweden are much more spread than in MA. Also MA was late in how they have dealt with Covid and the number of cases was progressing much faster.

It's not that simple. Population density numbers don't tell us anything useful at the national level. Most Swedes are clustered into a few urban areas.

ok then look at the stats in Stockholm

> the 10M residents of Sweden are much more spread than in MA.

Probably not. Swedes are a fairly urban people, many living in blocks of flats in cities.

Here is what Wikipedia has to say about Stockholm:

    Population (31 December 2019)[3][4][5]
     • Capital city 975,904
     • Density 5,200/km2 (13,000/sq mi)
     • Urban[6] 1,605,030
     • Urban density 4,200/km2 (11,000/sq mi)
     • Metro 2,377,081
     • Metro density 360/km2 (940/sq mi)

And here is Boston:

    Population (2019)[2][3][4][5][6]
     • City 692,600
     • Density 14,344/sq mi (5,538/km2)
     • Urban 4,180,000 (US: 10th)
     • Metro 4,628,910 (US: 10th)[1]

So Sweden might be twenty times the size but the urban population density is not so wildly different.

Texas is an even more dramatic example.

29 million people with only 1,734 deaths, and 4 of the 11 largest US cities.

If you scale Norway to Texas on population, you would get 1,000 deaths.

If you scale Finland to Texas, you would get 1,700 deaths.

Texas did as well as Finland with five times the population, with barely any lockdown.

It's the climate. The same reason Greece did so well. The same reason Rome didn't get hit like Milan (when it should have been hit far worse).

It's why all of San Diego County only has 283 deaths with a population of 3.3 million.

And it's why formerly hard hit locations are starting to open up: their temperatures have climbed enough to slow the virus. NYC will be fully open this Summer and yet the virus won't be ravaging the city like it previously did, and this is why.

The Italian doctor - Alberto Zangrillo - that recently made headlines by saying the virus was fading in potency? That's the higher temperatures reducing the potential of the virus to transmit, it's reducing the viral loads they're seeing. We already knew to expect this, that's why numerous experts were predicting the virus would fade as the seasons changed and temps climbed.

How do you explain Mexico and Brazil in that case?

The much lower viral loads in Italy could be a result of other things such as widespread mask usage.

I think you could well be on to something. But there are still too many questions to be certain that heat is slowing transmission.

Right, and that's why LA with its 30+ degrees Celsius, right next to San Diego, is stil growing in the amount of cases per day.

There are clearly other variables related to the _spread_ of C19 (for example public transport -- Texas and California don't have much, whereas it's widely used in Boston, NYC and many European cities).

I'm not sure I buy into the climate aspect (Brazil?) ... as for the "fading potency" theory? Maybe. But could it be that as it spreads asymptomatically through the healthy, younger population we're seeing the beginnings of some sort of herd immunity? "They" say we need 60-80% which we're not seeing yet, but clearly it's not going to be a "binary" thing where the spread suddenly stops when we get to 80%.

I think if you separate the spread of SARS-Cov2 from the severe/fatal cases of the C19 disease, what's emerging is that it's the elderly and "infirm" that are dying, but not the remainder of the population (aside from those with health issues). Perhaps the death rate correlates to 1) how much SARS-Cov2 has spread asymptomatically within the healthy population and 2) how much of that asymptomatic but healthy population have _interacted_ with elderly people / long term care homes (thus introducing SARS-Cov2 which is devastating to them).

Texas and California are now at the top with way more new cases than NY.

Internationally, Brazil is outstripping the US in new cases, and India, Russia, Pakistan, and many others are ahead of the western European countries people are still discussing.

The character of the epidemic has changed rapidly and people don't seem to be paying attention.

You really shouldn't be using Texas as an example, because Texas is a prime example of how the bulk of the new cases are shifting to states and countries that didn't originally rank at the top.

People are having discussions and making pronouncements as though the epidemic is over, or at least no longer rapidly evolving and can be judged in retrospect.

States that had more new cases the other day than NY or NJ:

California, Texas, North Carolina, Illinois, Arizona...

There are about fifty countries with more new cases recently than Italy. Do you think those countries are all really cold or something?

Norway has similar ratios for immigration and lower mortality.

It's not that.

Sweden tested a lax social distancing approach and it backfired.

You and OP mention Vitamin D as a possible rationale for the differences. But, what about countries like Mexico? No shortage of sun there.

Also the definition of a covid 19 death in the UK is extremely, err, innacurate

a lot of dirt poor countries have closed EVERYTHING, and given jack to the people. Complain to the hand. Obviously low deaths--on Covid, and so far. Not something to be proud of and definitely not long term. Virus is still around, waiting for the opportunity.

I think that in some of these countries the virus doesn't exist anymore, for example in Montenegro: https://www.worldometers.info/coronavirus/country/montenegro...

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