Looking at number of total deaths, it's possible a lot of countries are undercounting coronavirus deaths.
It is not just Iran.
For example, I believe that Belgium has a very inclusive count (proven or suspected) and other countries count only if proven.
This also means that some countries undercount when they have insufficient testing capacity.
Also, with co-morbidities there is a choice whether to assign the cause of death to these factors or to COVID-19. If someone was dying from lung cancer and also contracted Covid-19 at the end what was the cause of death?
So the rule of thumb is: don’t try to compare numbers between countries.
And also note that in some cases you cannot event compare data locally: for example, in the UK, England and Scotland have different definitions.
But to put that in a realistic perspective, it is a little bit like if you corporate Enterprise Architecture function published new guidelines for how to ensure data consistency across business units. Publishing a document does not make it so overnight.
A few countries are close enough to be considered accurate. Some are off by over 100%.
It will be interesting, when it's all over and all numbers are in, to look at the statistics of this.
Anybody claiming to know specifically what to expect from something that has never happened before should be treated with a healthy dose of skepticism. Especially if their only way of taking measurements is so imprecise and inconsistently applied.
The deaths may not be directly attributable to the infectious agent and disease mechanism of SARS-COV-2 or COVID-19, that is, the virus or disease. But they are, in the absence of another plausible causal mechanism, part of the overall impact on public health.
Gross mortality anomoly is the truest measure of impact.
(Deeper discussions of causality and epistemology omitted.)
I’m not sure this is accurate. From what I’ve read, many people simply aren’t tested. They are old, got pneumonia, and died. The cause of the pneumonia may have been any number of things, but some large proportion of them are expected to be flu during flu season.
More starkly, visits to the ER for strokes and heart attacks plummeted during lockdown. But there weren’t actually fewer strokes and heart attacks. Many of those people just died at home.
In short, no one can say how many of excess deaths were COVID vs lockdown deaths, but it certainly isn’t the case that the “lockdown”‘category is actually a net negative.
If I saw this trend only in a handful of countries I'd say they are undercounting (FWIW I still think they are) but because we can see this in US, EU and Asia, it'd say virus is getting less deadly/treatment is getting significantly better.
That, and the age structure of the infected changed: the older people are doing what they can to avoid the infection, if they are able to do that.
Also, across the world, different measures are still in place, changing the dynamics of the spread, compared to the start of the pandemic when the spread was practically unconstrained. The dynamics of the spreading is also different in different settings.
There's no any scientific reason to believe that "the virus" changed in any way biologically. It's the world that does its best to adapt. Also, the schools and the universities are not opened for students at the moment in many countries, also slowing down the spreading.
Edit: answer to: "Viruses don’t mutate?"
The coronaviruses have additional mechanisms to correct the copying, slowing down the mutations, compared to e.g. flu viruses.
Edit2: answering: "The main reason for why Coronaviruses don't mutate much is because they don't have to": I wouldn't call that "the main reason", but it's a part of their success. Coronaviruses have longer genome than many other viruses, and having uncontrolled mutations in that longer genome would make them degrade too fast, so there is that molecular mechanism they have, correcting the copying errors. Additionally, they have other mechanisms to recombine their genetic material, something like "sex between (corona)viruses" where even more than two parents could be possible. But that's different from mutations and happens under different conditions. Knowing all that, and all that what est31 mentions, it is indeed true, the coronaviruses really simply don't need to "mutate fast."
Edit3: "There different strains" is not true. They are different isolates, where the completely minor differences exist, but for all it is known, until somebody proves otherwise, and nobody has, there is still just a single "strain" of SARS-CoV-2.
Edit4: Thanks to Gibbon1, yes, comparing with influenza is tricky, but maybe it's good to give readers the idea once again that this is surely not flu and that the viruses aren't the same and don't behave the same.
Viruses don’t mutate?
The main reason for why Coronaviruses don't mutate much is because they don't have to. While influenza constantly comes up with mutations so that it can come back seasonally, it seems that Coronaviruses take a different approach by evading adaptive immunity instead. E.g. feline Coronaviruses can infect cats over and over again, without large increases in ability for cats to fight it. That's also the case a bit for SARS-Cov-2, there are reports of humans getting infected a second time, but they are rather rare reports, we'd have far more of them if humans had no good adaptive immunity.
There different strains, but apparently the virulence is pretty similar [0].
[0] https://coronavirusexplained.ukri.org/en/article/cad0013/
Single stranded viruses are a lot more stable.
More testing does not explain falling CFR in South Korea for one thing.
A month or so ago, there was a research paper (admittedly an unreviewed preprint) that suggested there are different strains circulating in the US - the part I remember is that the New York City and Chicago strains did indeed act slightly but measurably differently. I think there was a third as well.
As Dr. Fauci would say, it doesn't matter, even if it were a peer reviewed it can still be bad. (1)
There are a lot of bad studies, especially on the "preprint servers" that in more quiet times would not appear at all, or which nobody would take a bit serious. Now there is a lot of wishful thinking or bias involved even in their perception.
The scientific process doesn't protect anybody from some studies simply being bad, the process is there that eventually the bad ones are going to not be reconfirmed, and the really good ones are those that have many confirmations and have even the power to make new predictions, that remain true.
There are known issues with these studies claiming different "strains" too easily.
1) https://www.rev.com/blog/transcripts/dr-fauci-hydroxychloroq...
Note that the trend is worldwide. Even in countries with very high testing in the beginning. South Korea for one!
I also think it's unlikely to have the virus pathology synchronized across the world with current travel restrictions.
Last time I checked the virus actually seem to feature some "dual gene pool" mechanics, which should make it more robust and adaptable to "fading out".
https://www.reuters.com/article/us-health-coronavirus-italy-...
57% in Bergamo province with antibodies.
Italian lockdowns didn't stop COVID - human immune systems did.
This also means for every 1 detected case, there were 46 actual COVID instances in Bergamo.
Should actually read
57% of a "random" sample of 9965 people who were tested in Bergamo province have antibodies.
That might be true for Bergamo, but certainly not for the rest of Italy, especially outside of Lombardy which had much lower infection numbers and death numbers.
Having as many dead as in Bergamo everywhere (0.58% of the whole population according to a short google search) would be unacceptable.
If all of the world reached Bergamo stage, there would be no way to test 57% of the world population.
That doesn't mean there are 46 * 18 million cases world wide -- the deaths would be catastrophic world-wide, just like they were in Bergamo.
However, that is the stuff of the future and the ivory tower. In the course and flow of this public health crisis it is necessary for reasonable speculation and extrapolation to be used to drive our responses.
There is no evidence that I have heard that the most susceptible have been culled from the population yet, and there is no logical reason to believe that this has happened. In fact the contrary seems to be true when the pattern of the outbreak is observed in the USA. Potentially there remain a huge well of victims left in the population.
To claim that this abet contingent knowledge is illegitimate in the face of the human catastrophe that could result from rejecting it strikes me as an rejection of all of the principles of the enlightenment. Our rationality is our sword and shield for fighting the shadows on the wall of the cave. I for one will not be putting these tools down. It is wrong to cower in the dark when our brains can light a light and let us see a path to safety.