Excess All-Cause Mortality in the US and 18 Comparison Countries
jamanetwork.com
jamanetwork.com
The very first graph shows that it's not "just another flu". Abnormally many deaths, even with the strict measures. Mainly for those aged 45 and older (but also not just "old people" dying, lots in the group 45-64).
Further down "Z-scores by country" also shows a pretty normal curve for Norway and Denmark but many excessive deaths for Sweden, meaning the notion of "sweden just reports covid deaths differently" that was common a few months back isn't an explanation.
There you go. Data from official government agency. "Preliminary" and not full year since we're only in October 2020 now.
https://scb.se/hitta-statistik/statistik-efter-amne/befolkni...
What am I looking at? What are you trying to show? Just posting a random graph is not really helpful.
Total (and monthly) deaths per 100k inhabitants, per Jan-Sep period each year. The bar-chart shows the "Total" row from the Excel. Both illustrations have descriptions in English
Do you need help interpreting the data and graph given previous conversation? The height of the bars represent the number of deaths over different years and the bars are basically same height. I.e. considering all deaths, covid and actions taken (no lockdown but more distancing), no more than usual have died. Especially considering last year was a bit lower and therefore likely some old people who didnt die last year unfortunately did so this year.
I will post what I just posted below: "Do you need help interpreting the data and graph given previous conversation? The height of the bars represent the number of deaths over different years and the bars are basically same height. I.e. considering all deaths, covid and actions taken (no lockdown but more distancing), no more than usual have died. Especially considering last year was a bit lower and therefore likely some old people who didnt die last year unfortunately did so this year."
If you only look at one month then yes there is absolutely an increase. If you want to stare blindly at that month then go ahead. Scream if you want to also. But I think some might be interested in hearing that no more than usual have died in Sweden this year. I have seen similar stats for other countries.
The mortality this April was 13% higher than the next highest value in the table. 29% higher than the next highest April value in the table. If you really have a problem with "very high", we can agree on "high". But we do agree that (a) this is not just an accident but caused by a real-world cause, (b) that real-world cause is Covid-19, and (c) the spike could have been avoided or at least flattened. Yes?
> good, you are part of the group I wanted to reach.
If you really want to reach us, a good way would be to tell us what you really want to tell us. If what you want to tell us is that Sweden did everything right at all times, you'll have to argue a bit more explicitly.
> no more than usual have died in Sweden this year
Yes. Looks like after its disastrous April Sweden managed a good turnaround.
Though I also wonder what early pandemic policies related to nursing homes had on these excess fatalities.
"But until this outbreak is over it won't be possible to know for sure which countries have dealt with the virus better.
'That's when we can really learn the lessons for next time,' says Prof Oke."
EDIT: My point is that the epidemic is not over yet and countries with a low immunity could be hit harder later on. It's just too early to compare mortality numbers.
Yes. Once the epidemic is over. It's not over yet.
Having low numbers now could mean that the following outbreaks are more severe. Having lockdowns now could mean that there is no more money for a second, third or fourth lockdown to keep the following outbreaks under control. It could be but it does not have to be. We have to wait until the pandemic is finally under control to really count numbers.
Though, I'm not sure that was the GP's intention.
I should point out this is all predicated on a statement I believe to be false. (I suspect policy does meaningfully affect infection rates.)
E.g if obesity is > 30 BMI, Australia might have similar percentage to the US, but US might still have much mor people > 35 BMI than Australia which could have mostly 30-35 BMI people.
Is it over? I don't think so. Cases are rising quickly in Europe now that winter is coming. We should refrain from issuing judgement on the matter and comparing strategies of different countries until at least next spring when cases go down again in all countries. There may be some surprises coming in winter.
Because after the summer vacations were over, everyone went back to normal. People returned to offices, children to school. At schools, measures were in place for the first two weeks. Since then, business as usual to a large extent. I have the impression that we got complacent, this thing isn't over yet unfortunately.
I am afraid that we traded our summer vacation against new lockdowns, so. Schools where I live already switch certain events to virtual, most likely cancel certain classes. And they are approaching the point where they are forced to close again. And we are only a couple of months into the new school year. Doesn't bode well.
I'm not sure why the factor this in at all. Why not compare each country to its OWN baseline mortality -- as opposed to confusingly compare between high and low mortality countries?
Is that a subtle joke about mean body mass in the US, or a grammatical error? http://ddg.gg/?q=count+vs+mass+noun
No, I wasn't trying to do a subtle joke about obese americans. But now that you inspire me, I will consider it in the future.
My prediction is that unless a miracle happens and an amazing vaccine (or a therapeutic) is developed, Swedish strategy will "win" this one. The curves aren't looking good at all for other European countries heading into winter, and their economies are decimated, so they can't tolerate full shutdown anymore.
It's a virus. It's endemic. _Everyone_ will get it eventually, if not now, then a month or two from now. There's really no way around this simple fact.
So it follows that stretching your infections over a longer time is beneficial.
Sweden's GDP in Q2 was down 8%. Germany's was down 10%.
Correct. Mortality doesn't say very much now. The true IFR would be a better indicator but since testing availability is very inconsistent it is hard to compare the number of infected across countries or time. The mortality numbers are also inconsistent in many places (which is why we looked at all-cause mortality in the first place).
> It's a virus. It's endemic. _Everyone_ will get it eventually, if not now, then a month or two from now. There's really no way around this simple fact.
This is plainly wrong. Vaccines have decreased the severity of many viral diseases and in some cases even eradicated the virus completely. Even without a vaccine, some countries have driven down the infection numbers almost to zero. Even the countries that could not eradicate it will only see 10-80% of the population infected in the long run.
> Swedish strategy will "win" this one.
For one, it is too early to declare a winner. We have to wait.
The Swedish strategy may work very well in Sweden. But that doesn't mean that it would have worked in countries with a different social structure, population density or climate.
At a minimum, this is not "plainly" wrong: there's no vaccine against any other coronavirus, and vaccine against the flu (next most fatal thing on the table) is not great.
Also, a vaccine does not prevent _infection_. It merely gives your body antibodies to deal with it when you get it. Sometimes those antibodies work, sometimes they do not. The initial estimates for C19 vaccines seem to put it at 50% effectiveness. People seem to be expecting a silver bullet. It's not going to happen, especially not this quickly. But irrespective of whether we have a vaccine, yes, everyone will get it eventually.
> For one, it is too early to declare a winner. We have to wait.
My point exactly. That's why I'm not declaring them the winner. They are experiencing an uptick in cases, too, though nowhere near as dramatic as e.g. France, Spain, Italy or the UK.
Even at 50% effectiveness, a vaccine would drive R(t) well below 1.0 and end the pandemic fairly quickly.
It'll be fun when the dust settles to going back to look at alternative approaches to estimate how effective the lockdowns were.
[0] https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm - "Weekly number of deaths (from all causes)"
https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...
The article notes that, through July 25, there were 235,610 excess U.S. deaths. The link you gave shows that excess deaths started March 28th, for a period of ~119 days.
Wikipedia says that the U.S. had 291,557 combat deaths during WWII, which was over a ~1366 day period of U.S. combat involvement if we count the period from Pearl Harbor until the end of the war. The U.S. is about 2.46 more populous now, so adjusting for that, the ratio of the rate of excess death over the period studied vs. U.S. combat deaths in WWII is (235610 / (119 * 2.46)) / (291557 / 1366) = 3.77.
Since you're calling 3.77x the population-adjusted rate of WWII combat deaths "mostly normal", I would be curious to know what rate of death you would consider abnormal.
On a non-population-adjusted basis, which is arguably the correct measure if we want to think about waging a war that's the equivalent of WWII, the death rate over the period studied would've been equivalent to the U.S. combat deaths from waging 9.28 simultaneous WWIIs. Personally, I wouldn't consider simultaneously engaging in nine wars the size of WWII to be business as usual.
I'd be particularily interested in comparing the above ratio for Vietnam, or to German or Russian (combat & non-) WW2 deaths.
I think most college-educated Americans are aware that the Soviets lost nearly endless waves of soldiers against the Nazis. I also think most Americans are largely indifferent to the numbers of German rank-and-file soldiers killed, as if sympathy for the enemy dead would somehow diminish admiration for the heroes who defeated the Nazis.
On a side note, I have a Scottish friend who still swears up and down that Americans weren't involved in D-Day. I tried pointing him at Wikipedia entries for Utah and Omaha beaches, but I get the impression he believes it's just American propaganda that the US had much involvement in WWII before the Nazis were on the retreat.
Well, clearly this is an abnormal number of deaths. Pretty much every week is statistically Very Unlikely.
But it is 20% higher than the background rate. Quitting a job as a day labourer and going into roofing is something like a 400% death rate. People voluntarily subject themselves to some pretty outsized risks.
> Wikipedia says that the U.S. had 291,557 combat deaths during WWII...
That is about a decade worth of car accidents. So on the one hand, horrific. On other other hand, the raw number of deaths is not the biggest issue at play. It didn't stop Americans marching over to the other side of the world to fight people.
This is an example of how statistics can mislead. Why not select the worst 119 days of ww2 and compare it to 119 days of covid? After all, most of 1366 days of ww2 didn't involve actual fighting. Also, are we including definitive covid deaths or "covid related deaths". Because if we included "ww2 related deaths and not just combat deaths", then I suspect that ratio would plummet towards 0.
> I would be curious to know what rate of death you would consider abnormal.
I guess it depends, but spike in deaths every now and then is normal even if it looks abnormal. It may sound counterintuitive but that's just life.
Your statistical analysis is intentionally dishonest. You cherrypicked the time frame and example to fit your agenda. How about try another set of data - the US combat deaths on D-Day ( 2500 deaths ) and extrapolate that to 119 days and population adjust and enjoy. Funny how that makes covid look like a walk in the park huh? But if I did that, it would be just as intellectually dishonest as your example.
Also, almost all of the combat deaths in ww2 was young healthy men whereas covid seems to afflict predominantly older people - almost all of them 45 and over. So not quite apples to apples right?
Not only is it not actually business as usual, as other commenters remark, but this rate of death is despite the severe measures taken.
Without such measures, deaths would have been 10-20 times higher.
Is that based on anything? I’m skeptical - many places that took more severe measures did worse than places that took less severe measures (both within the US and internationally), and nowhere ended up with death rates per capita an order of magnitude larger than what we’re seeing in the US.
I really disagree with your observations based on living in NL and visiting Sweden several times over the last few months. These are two very poor examples of countries where mask-wearing is prioritized and accepted.
The Dutch government only a week or two ago "urgently advised" wearing masks indoors, and even with that advice in my own experience a majority of people are not wearing one. Before that, hardly anyone wore a mask indoors. I've traveled to Antwerp a few times for work in the past few months, and the prevalence of masks there compared to NL is striking.
And Sweden generally has been quite averse to wearing masks in public...it's not ever been mandated anywhere, not even on transit like in NL.
https://www.thelocal.se/20200831/sweden-remains-an-outlier-d...
[0] COVID-19 herd immunity in the Brazilian Amazon: https://www.medrxiv.org/content/10.1101/2020.09.16.20194787v...
And, I wouldn’t necessarily extrapolate what happened in one city to what would happen across an entire country.
So yeah, more deaths, no doubt. But 10-20x more? Seems unsupported.
Why would you start both the article and the abstract by saying that the US has experienced more death than any other country when the US also has (by far) the largest population of all countries surveyed?
Reporting the per capita figure would be enough to make the point that the US did not handle the pandemic well. This way it just sounds like unwarranted self-flagellation.
You would be incorrect. Perhaps the reason this death rate was mentioned is because the US is an outlier in both absolute numbers as well as per capita deaths.
Maybe I should have added reliable to data.
I'm highly skeptical of the ~4000 deaths figure reported as the death count for China and I have the sense that the authors of the study were too or they would have included it in their study.
As for India, when you factor in rural areas, I don't think the reporting and data would be as reliable as for the US. [1]
To go back to my original point, I'm not arguing that the US successfully handled COVID. Nor am I trying to demonize China or India. I'm just saying that the author's decision of foregrounding absolute death toll over per capita is poor and misleading given the sample they used. It could be seen as bad faith on the part of the authors when the per capita number can support their argument just as well.
[1] https://www.sbs.com.au/news/india-s-coronavirus-cases-pass-7...
> The US has experienced more deaths from coronavirus disease 2019 (COVID-19) than any other country and has one of the highest cumulative per capita death rates.
Why is that misleading or bad faith?
It’s not hard to see they have lots of blame and that has nothing to do with the US administration.
China has not been completely forthright about the early stages of the covid's spread and they engaged in tactics similar to, but not quite as bad, as what the current US administration and some states have done to try to hide the scope of the disease within their jurisdiction. It seems like a lot of countries have done poorly at communicating with their citizens and with each other regarding covid.
China didn't shut down travel fast enough, but by the time things has started to appear and become concerning covid had already left China and was en route to Italy and the west coast of the US. Once the nature of the disease and particularly the asymptomatic transmission stage became clear everyone needed to adjust. To claim this is some fault of the Chinese government is pure BS.
As for pushing 'malign' interest, you are entitled to your own opinions but that seems to be another unfounded value judgement that is just as easily dismissed as right-wing propaganda.
One. Single. Event.
Where are the other shipments in to other cities? Where is the supply chain evidence that this was an across-the-board jump in urn orders and not a single entrepreneur aiming to pre-order big and then have inventory he could resell at a markup if things went bad? Where is the rest of the evidence?
And this statement captures all the info one needs, in my opinion. But abstracts are partly about selling the importance of the paper, so there's some leeway in how facts are presented.
[1] https://www.bloomberg.com/news/articles/2020-04-01/china-con...
I also vehemently disagree "the evidence would be clearly visible". History is littered with genocides on a massive scale that were successfully covered up. We still don't know exactly how many people died in the Holocaust or Holodomor, for example (estimates vary by millions). So this claim that you cannot cover up deaths is clearly false.
It's also very likely the US is over-reporting numbers.
For example, studies have shown US death certificates have "major errors" the majority of the time [3], and several US states have counted unrelated deaths as "COVID" deaths, including Washington State (later partially corrected) [4].
I also disagree with your claim that evidence of China's data manipulation does not count because it's 'six months old', you can't wave away evidence like that.
[1] https://nationalpost.com/news/world/lines-of-urns-in-wuhan-p...
[2] https://www.developingtelecoms.com/telecom-business/operator...
[3] https://www.usatoday.com/story/news/investigations/2020/04/2...
[4] https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/...
It looks like you are still grasping at straws and lacking evidence for the claims being made.
The evidence 'backed by US intelligence'? WTF are you talking about? Did you not even read the articles you provided as your 'evidence'? None of them reference US intelligence sources. One is a trade rag describing a single data point without context and the other is a mid-level conservative paper that used random twitter pull quotes to tart up a minor story being passed around the wire services.
Truly weak sauce.
The GP was arguing that per-capita deaths should replace total deaths. In context, your argument is "Total deaths are a useful metric and should be included, because the US is not the most populous country." Maybe it's true, but the argument is non-sequitur. As we all know, the real reason total deaths is a useful metric is that pancakes are delicious.
Also, the GP was explicitly arguing that the US is the largest of the 18 surveyed countries, which gives an implicit nod to the US not being the largest country in the world.
Edit: changed OP to GP.
[1] https://www.bloomberg.com/news/articles/2020-04-01/china-con...
The paper is entirely about per-capita death rates.