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Comment by fabian2k | Hacker News Reader

I think it is important to keep in mind that Covid-19 is still contained to some extent due to various measures. The influenza numbers are for the most part without any behaviour changes or rules (the influenza season ended roughly when Covid started to spread). The Covid-19 deaths would be higher if it were able to spread unhindered through the entire population.

And even in this somewhat unfair comparison Covid caused three times as many deaths.

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Influenza is contained because there is some form of herd immunity already. Remember COVID-19 is a novel coronavirus, which is why it's spread so much so fast, no one is immune at first. But to suggest that the covid death numbers will be this high year after year after year is unlikely in my opinion, as is shown by the fact that many places with big first waves (north italy, sweden, london) don't have a second wave (especially in death numbers).

Influenza is also new every year. There have been other Coronaviruses before.

Not exactly new. Partial immunity to many strains of flu is common and widespread. Not so much to SARS family coronaviruses. (Which are very different from other coronaviruses, much more than flu strains between each other.)

Nevertheless, isn't the latest finding that many people already seem to be partially immune - perhaps because there are some similarities to other Corona viruses that the immune system can latch on to?

London was under lockdown until June, everyone is already acting like it will be locked down again in the next week or so, and has had strict mask and hygiene and social distancing rules for six months, had a government direction for everyone "who can" work from home to do so for ~4.5 of the last six months (it was briefly rescinded then reinstated), crash built hospitals in convention centres to try to handle overload from hospitals and still is currently at the same new case rate as April[0]. Fortunately death rates are still fairly low. I don't know if a vaccine/other interventions will prevent it being a yearly disaster but it certainly currently is.

[0]: https://data.london.gov.uk/dataset/coronavirus--covid-19--ca...

My friends in London tell me mask wearing is not widely respected or enforced, which is contributing towards the next lockdown.

It's, also, important to keep in mind that Influenza has a vaccination, which is very cheap and many elderly people take it. Yet, many die from it (and it doesn't make any headlines).

We are at the end just comparing apples to oranges. It would be really interesting to make such comparisons if we hadn't any vaccination for Influenza.

Also Influenza is not a novel virus, so if 40k people die of Influenza this year, doesn't mean that it couldn't have killed more people, because in fact, there was another 40k who died the year before and therefore don't die again, and another 40k who died 2 years ago, etc.

Basically Influenza is endemic and the deaths are evenly distributed over long periods of time, whereas a novel virus will obviously have a huge initial death count in year 1, but subsequent years will see equally many less deaths logically.

You can approximate the effect of a new Influenza without vaccines if you look at the numbers for the year 1918. That definitely made headlines (In this special case that is an interesting story by itself). But the effect influenza had in 1918 is not comparable to the normal flu.

So if people insist that Covid-19 is just like the flu, agree with them and remind them of a new flu without vaccines, just like the Spanish Flu.

It’s also contained because unleashing it would totally overwhelm almost any nation’s hospitals, cause a cascading death toll because no treatment could be given.

>It’s also contained because unleashing it would totally overwhelm almost any nation’s hospitals, cause a cascading death toll because no treatment could be given.

This is clearly not true because it didn't overwhelm Sweden's hospitals, or Japan's, or South Dakota's, even though they didn't have lockdowns, just voluntary social distancing.

I intentionally mentioned behaviour changes first in my comment, we can't fully separate rules and lockdowns from voluntary behavioural changes. In the end all that matters is the changed behaviour, not whether it was enforced or not.

Full lockdowns are also not the best way to handle increasing numbers now, they were necessary earlier this year because we didn't know much about the virus and which situations are the most dangerous. With the knowledge we have today we can use more specific interventions to contain the virus.

Japan has a culture of wearing masks when conditions prevail (normally pollution related but also disease). They also tend to be not into physical contact in social settings, and are more likely to be in compliance to societal laws.

Not as clear as you make it sound: Swedes did change their behaviour/travel patterns in response to Covid-19, the Japanese instituted mask etiquette a century ago, and no one lives in South Dakota.

No, it's pretty clear. Relatively minor changes in behaviour (Swedes were famously out chatting in cafes and shopping at a time when many other places were under universal curfews and business closures) cannot explain the huge deviation from what the models predicted, at least not without making the models entirely unfalsifiable. Meanwhile masks are useless. Look at the graphs of almost any country that has a mask mandate and when that mandate was introduced - no inflection point is visible. Nowhere! If masks worked, at least some places would show a clear change in growth rate $incubation_period days after the mask mandate was enforced, but it never happens.

As for "nobody lives in South Dakota", well, tell the people who live there that.

And don't forget Belarus. The usual excuse for that is "you can't trust anything out of Belarus", although of course many people live there and no overflowing hospitals were reported by any foreigners there either.

There's a very clear and visible pattern here, which is a really deep desire to believe that epidemiology as a field knows what it's doing, that the models work, that lockdowns weren't useless. But the data is as clear as day. No correlation between lockdowns and health outcomes. No lockdowns yet no ICU exhaustion in Sweden despite Sweden having one of the lowest ICU capacities in Europe - the exact opposite of what we were told to expect. Mask mandates have no visible impact on the spread of 'infection' (PCR positives, not quite the same thing).

Well it probably depends on the amount of IC beds / ventilators / trained personnel available per location. I know that here in The Netherlands they narrowly avoided a triage situation where your condition decided if were going to get treated.

A second order effect that might not be obvious is that during the first wave a lot of non-emergency procedures were postponed, a lot of these non-emergency procedures can still be quite urgent and can have negative consequences for the people who had to wait.

Att the start of the pandemic Sweden had the next-lowest number of ICU places per capita in Europe (Portugal had the lowest). The capacity was doubled, field hospitals were built... and not used since the hospitals could handle the inflow. This was partly due to some very controversial and in my opinion unethical guidelines which mandated morphing instead of oxygen for certain groups of elderly (i.e. involuntary euthanasia) but it is unknown if those policies had much effect on the park ICU occupation.

Apart from some bad mistakes in the beginning where the infection was allowed to spread in care facilities Sweden has weathered the epidemic (as in the local version of the pandemic) no worse than surrounding countries and certainly no worse than e.g. New York.

no worse than surrounding countries

Deaths per 1k population:

                total       last month
    Sweden      0.59        0.0058
    Denmark     0.11        0.0053
    Finland     0.063       0.0016
    Norway      0.051       0.0020

I’m tired of seeing scoreboard style comparisons everywhere as some sort of gotcha. Any scientific analysis worth its salt will look into the values to start explaining the numbers and put it all into context.

For instance, can we explain where Sweden’s deaths occurred? Large care homes (100+ residents) that were ill prepared? Are they expected to have a large amount or average amount of excess deaths at the end of 2020? Why is it tracking average and why are some lockdown heavy countries tracking much higher (because lack of health care due to shutdowns?) What even represents a covid death or case?

> For instance, can we explain where Sweden’s deaths occurred? Large care homes (100+ residents) that were ill prepared?

A large problem in Sweden is that many of the staff in care homes do not speak Swedish or don't speak/read it well. This has led to the instructions on how and when to use PPE not being followed or not being followed well which led to a large number of infections in care homes [1]. Since people in care homes tend to be part of high-risk groups for severe COVID-19 this had led to a large number of deaths which could have been prevented. I stated this in the original message ('Apart from some bad mistakes in the beginning where the infection was allowed to spread in care facilities').

[1] https://www.sydsvenskan.se/2020-07-10/svag-svenska-kan-ha-pa...

What makes presenting a list of numbers a “gotcha”? It’s a better starting point for discussion than a random unsupported assertion. I would interpret a complaint about introducing numbers and measurement as evidence that the complainant has a weak position that can’t stand objective scrutiny. Numbers aren’t everything, but they’re definitely a something...

> This was partly due to some very controversial and in my opinion unethical guidelines which mandated morphing instead of oxygen for certain groups of elderly (i.e. involuntary euthanasia)

This is an extremely serious accusation. I live in Sweden and have not seen any reference to this practice mentioned in media.

I saw something related to it in two outlets, the BBC and YLE (finnish news).

https://www.bbc.com/news/world-europe-52704836

https://www.wsj.com/articles/coronavirus-is-taking-a-high-to...

https://yle.fi/uutiset/3-11433976

The intent was to give palliative care, not literally murder people . Although this source does sound the alarm that the line is thin.

In essence, palliative care for cancer does not translate into the same effect with COVID-19.

https://www.dagensmedicin.se/artiklar/2020/06/15/palliativ-v...

Seriously?

http://www.aftonbladet.se/nyheter/kolumnister/a/dO3ddB/en-pa...

http://www.aftonbladet.se/nyheter/a/GGk664/de-nast-intill-av...

http://www.aftonbladet.se/nyheter/a/4q9V1g/kritiken-mot-aldr...

https://www.dagensmedicin.se/artiklar/2020/06/15/palliativ-v...

https://www.expressen.se/debatt/min-pappas-dod-i-covid-19-bl...

https://www.aftonbladet.se/ledare/a/Ln0r9Q/morfin-istallet-f...

https://www.exakt24.se/lakare-upprord-efter-lackt-journalant...

https://www.exakt24.se/lakare-forskrackt-dodshjalp-istallet-...

https://lakartidningen.se/aktuellt/nyheter/2020/05/geriatrik...

https://www.varldenidag.se/nyheter/lakare-kraver-syrgas-till...

https://www.riksdagen.se/sv/dokument-lagar/dokument/skriftli...

If you have not heard of this it is because you're following the wrong media, clear and simple. Even Aftonbladet published on this, there was an open letter in Läkartidningen (doctor's journal), Dagens Medicin wrote on it, the 'alternative' media were all over this, questions were asked in Riksdagen.

Why did you not know? Also, why did you not simply search around a bit to verify the statement before posting your reply?

Applying palliative care on the recommendation of Socialstyrelsen is not euthanasia.

Maybe in Netherlands non-emergency treatments were postponed, but in Hungary even some emergency treatments were deprioritized by the government. I tell my parents every times I speak to them to be very careful to not get sick, as they can’t expect the same level of treatment that they had a year ago.

That's an additional factor if you get to the limits of your healthcare system. At that point Covid gets more lethal because many people don't get adequate care, and every other critical illness also get more lethal because the hospitals are overflowing.

Sweden showed that not to be the case. It's the only real control I know of for the hypothesis that you present as fact.

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