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Comment by Recurecur | Hacker News Reader

The obvious interpretation of this is that in some places like Italy, the older population received much more exposure than it did in the US. In Italy, this was due to so many extended families living in the same home.

In fact, things would have skewed even younger in the US except for the nursing home debacle in NY and NJ.

It's worth pointing out that there's quite a disconnect between the US media coverage of the mortality rate here, versus the higher mortality rate in Britain, France, and other EU countries. There is also a good chance that COVID mortality in the US is being significantly overcounted.

Regardless, there's little choice at this point - we need to keep the economy open as we wrestle with minimizing hospital visits and fatalities. Let's hope improved treatments are developed at a high rate!

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>There is also a good chance that COVID mortality in the US is being significantly overcounted.

It seems experts (CDC among other) suggest the mortality is quite a bit undercounted, since there are many deaths for which the person is not tested, since we lacked the testing capabilities.

One interesting place to see it is expected death rates versus actual death rates while COVID is here, and note there is no other known thing that spiked at the same time to account for the excess deaths.

What science groups or medical groups are claiming it's overcounted?

For example,

https://www.scientificamerican.com/article/how-covid-19-deat...

https://www.npr.org/sections/goatsandsoda/2020/05/13/8548736...

Is this really true though? Most states report separate numbers for cases and confirmed cases as well as deaths and confirmed deaths. In Texas there is something like a 3 order of magnitude difference between the number of reported cases and the number of confirmed cases and you can see wild discontinuities in the reporting data as they periodically change their methodology and or criteria. New York, for instance, was reporting deaths were Covid-19 might have contributed rather than confirmed deaths.

My biggest problem is that while it is trivial to find mountains of Covid visualizations, raw data with clear explanations of it's criteria and methodology is very hard to come by. I think it's quiet likely that some locations are over reporting and others are under reporting.

>Is this really true though?

According to the research papers and professional groups I've looked as this is true. If you want to discount experts that are well aware of the problems, methodologies, etc., then I don't know how you'll reach any conclusion. Non-experts are rarely more accurate than experts on complex issues.

As to methodology, CDC lists and recommends methodologies for all diseases, and COVID deaths are counted by them using the same methodology that all deaths are, whether cancer, heart attack, car wreck, etc. So there is nothing special about how COVID deaths are counted from their recommendations.

Many states seems to have political pressure to downplay COVID, but I've not seen credible complaints (or any complaints) by whistleblowers claiming they're pressured to increase death counts.

And overall death counts versus expected death counts gives a picture of likely COVID caused deaths that makes them far undercounted.

I expect scientists to arrive at pretty good counts eventually, then political and nonsense spreaders to ignore anything that doesn't suit their narratives.

Here's [1] some CDC covid methodology info - if you google CDC COVID methodology or CDC disease methodology you'll find plenty of methodology on data collection.

[1] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidvi...

I'm not trying to pick fights with experts or claim there there is some hidden agenda to inflate death counts, I just want frank discussion of the data. Now, from the CDC methodology you linked,

"For COVIDView, the percentage of total deaths occurring in a given week that had pneumonia, influenza and/or COVID-19 (PIC) listed as a cause of death is calculated. PIC deaths are identified based on ICD-10 multiple cause of death codes J09-J18.9 or U07.1. PIC is being monitored in order to provide a more accurate representation of COVID-19 related mortality than would monitoring COVID-19 alone. Deaths due to COVID-19 may be classified as pneumonia deaths or influenza deaths (deaths due to “flu” or “flu-like illness”) in the absence of positive SARS-CoV-2 test results. The combined PIC categorization also prevents double counting of deaths"

The death rate from Covid-19 includes deaths from other causes that have similar symptoms. The reasons for this are good, it's very difficult to identify between these diseases and lumping them together probably gives a more accurate result than relying on confirmed cases. There's no malice here, it's just a very difficult problem to work on, but it's also a methodology that should be likely to give a high side estimate. Then from there, they calculate excess deaths [1], which I was able to find through your link (thank you). Outside of New York/New Jersey and Massachusetts, I don't find a high disparity in the excess death ratio that supports the idea that there is significant under reporting of deaths.

You can find cause of death vs year on their charts at [2] and most of the excess deaths are from cardiac arrest or dementia. Now, that could be caused by Covid, except if we go to New York where Covid has been by far the worst in the US, you see a huge jump in respiratory deaths directly lining up with the peaks in the reported Covid cases. So are more people having heart attacks? Is Covid causing heart attacks? Are people unwilling to get treated at hospitals for heart attacks because they are afraid of Covid? These are unanswered questions and it could go any which way from what I understand. The data appears to be out, and I think it will be out for a while which is why I don't feel comfortable pushing the idea that we are under-reporting deaths or over-reporting deaths because I think that we don't actually know.

[1] https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm [2] https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm...

>but it's also a methodology that should be likely to give a high side estimate

It's the same methodology they use for all diseases. If it's too high an estimate, they'd pretty quickly find it since it would overcount enough reasons fro death that totals would not match measured death totals.

In my original post I linked evidence and the expert reasons why counting is likely low.

>Outside of New York/New Jersey and Massachusetts, I don't find a high disparity in the excess death ratio that supports the idea that there is significant under reporting of deaths.

The CDC link had many states with many thousands of excess deaths. And remember CDC death count lags actual death counts by a few weeks, so the 118k-154k (95%-ile) they list is to be compared to COVID as of a few weeks ago, which was under 110K two weeks ago. So taking the median gives around 136K actual deaths (prob not all COVID, but majority so) vs 110K reported - approx 20% undercounted.

>So are more people having heart attacks? Is Covid causing heart attacks?

Both of those are likely true [1]. Research since then is looking like COVID is killing asymptomatic people via attacking the heart.

>I don't feel comfortable pushing the idea that we are under-reporting deaths or over-reporting deaths because I think that we don't actually know

I've found significant decent groups and projects claiming undercounting, many with decent empirical evidence. I've not found the opposite, despite looking. I posted a few to get you started - discount as you wish.

[1] https://www.sciencedaily.com/releases/2020/03/200327113743.h...

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