Comment by tzs | Hacker News Reader

Comment by tzs | Hacker News Reader

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> Of course, some countries have seen far more deaths than others, but the statistics make it pretty clear this is because their populations are older and have more comorbidities

The statistics you cited make clear they are correlated. You can't infer causation without first considering why those countries have fewer comorbidities. E.g.,

> > The report found that every country where less than 40% of the population was overweight had a low Covid-19 death rate of no more than 10 people per 100,000.

It could be that the reason they have less overweight people is that they are more prone to follow health and nutrition advice in general, and this same propensity led them to also follow advice on avoiding COVID.

Looking at a US obesity rate map, there is reasonable correlation between high obesity rate states and states for which COVID has had high second and third wave death rates.

But there is also a good correlation between high death rate states and states where people are lax in taking preventative measures. That seems to be better than the obesity rate correlation. Florida, for example, is noticeably lower on obesity than the rest of the South, being more in line with most of the Northeast and the Northwest but is a leader in not taking COVID preventative measures, and has had terrible second and third waves compared to states with comparable obesity rates.

> But there is also a good correlation between high death rate states and states where people are lax in taking preventative measures. That seems to be better than the obesity rate correlation. Florida, for example, is noticeably lower on obesity than the rest of the South, being more in line with most of the Northeast and the Northwest but is a leader in not taking COVID preventative measures, and has had terrible second and third waves compared to states with comparable obesity rates.

A better correlation according to who?

According to one report, the two greatest risk factors for COVID are age and weight[1]. Over 20% of the population in Florida is 65+, the second highest percentage in the nation, and Florida also happens to be the third most populous.

Florida isn't an outlier if you look at the age distribution of deaths: over 77% of deaths are in those 65+.

[1] https://www.worldobesityday.org/assets/downloads/COVID-19-an...

[2] https://theconversation.com/severe-covid-in-young-people-can...

Maine has the same 65+ percent as Florida, a higher obesity rate, yet their delta wave peak was about 1/3 of Florida's by cases per capita, and around 1/4 of Florida's by deaths per capita. Maine's overall COVID profile looks a lot like Washington's, which is around 40th in 65+ percentage and has obesity rates about the same as Florida.

Age and obesity are certainly significant risk factors, but it sure looks like how well those risk factors translate into cases and deaths depends greatly on what protective measures against COVID are taken.

Perhaps it might be better to compare Maine to other rural states like Idaho or Montana rather than, you know, Florida.

Montana is 18% 65+, compared to 20% Maine (and Florida). Its obesity rates are about the same as Florida (25-30%) behind Maine's 30-35%.

Montana's delta peak in cases per capita was about 2x Maine's. Montana's delta peak per capita death rate was a little more than 2x Maine's.

Idaho is 15% 65+, which puts then around 30th in rank. Obesity rates in the 30-35% range like Maine.

Idaho's per capita delta peak was a little under twice Maine's for cases, but over 3x Maine's for deaths (almost as high as Florida's).

Serious people measure death rates, not "cases". Cases is pretty arbitrary.

If you want, you can do serological studies to estimate the proportion of a population that was infected, but please don't think there is any value to "cases", and serological studies are generally done after a disease is over, because diseases hit different areas in different times. They spread over time, going from place to place, so one area with a low infection rate may simply not have been hit yet. A great example of this is Singapore, which everyone thought had licked the disease, when in reality it was just hit later. Similarly everyone was blaming New York, but even though New York made some mistakes with nursing homes, it's biggest crime was to be one of the places hit first. Similarly, after the disease burned through New York and started growing in Arizona, that didn't mean that suddenly New York had better policies than Arizona. That's why you wait until everything is over and then you do serological studies before jumping to conclusions.

FYI lowest death rates (as of 3 days ago) are Vermont, Maine, Alaska, Hawaii. Hawaii is a bit of an outlier as it is an island that for a while had strict protocols limiting visitors. I suspect Hawaii merely delayed its day of reckoning, similar to Australia or New Zealand, but I could be wrong. Time will tell.

Highest death rates are Mississippi, New Jersey, New York, Louisiana, Alabama.

Massachusetts has a higher death rate than Florida. Does that mean it has worse policies? No you can't conclude that, it just means there are a lot of confounding variables and you can't conclude efficacy of policies like that. California has a higher death rate than Utah, does that mean it has worse policies? No, you can't conclude that either. That's not how you do science.

https://www.statista.com/statistics/1109011/coronavirus-covi...

We'll need to wait until it's all over to get the final tally. Then we can also do serological studies to determine extent of infection.

You are looking at death rates over the entire course of the pandemic so far. To see how measures against COVID affect deaths you need to look how rates change during the pandemic because measures taken changed over time.

Massachusetts, New Jersey, and New York all had a huge spike in deaths in the first couple of months of the pandemic. After that, their months were roughly in the middle of the pack compared to other states until vaccines.

In the post vaccine months they have been bottom 20%, while Florida has been in the top 20%.

> To see how measures against COVID affect deaths you need to look how rates change during the pandemic because measures taken changed over time.

The problem with this is that you're assuming the rates changed primarily or exclusively because measures changed (if they even did).

There are bigger factors you're not considering. Take, for example, New York. It was one of the first epicenters of the pandemic in the US. Large numbers of people got infected early on, and decisions were made that actually contributed to the spread of the virus in some of the highest risk groups. As a result, lots of people got natural immunity or died in New York in the first waves, so there were fewer people to infect in the later waves.

Anyway, the data has clearly established that in terms of the risk of any individual anywhere dying from COVID if they become infected, age, weight and metabolic comorbidities (namely diabetes) are the primary factors.

You've been arguing that if you live somewhere where your risk of being infected in the first place is reduced by restrictions/preventative measures, that's a bigger factor. That's totally irrelevant to the discussion of individual risk when infected.

But they are higher in elderly, an even higher correlation.

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