Covid-19 may have killed nearly 3M in India, far more than official counts show | Hacker News Reader

Covid-19 may have killed nearly 3M in India, far more than official counts show

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393 pointspseudolus398 comments

Not very surprised.

An Indian expat living in NL, with parents living back home in India. My (retired, old) parents are afraid to get tested for COVID because they hear way too many incidents from their neighbourhood about “hospitals faking COVID test results just so that they can admit them for 4 days, administer expensive drugs, charge them some hefty bill, and send home”. As stupid as it sounds, I could not force my parents to go and wait in the line to get COVID test, after he says “I believe I don’t have COVID now. But if I go to the testing center that is so badly managed and understaffed where only people with obvious high level of COVID are brought to get official result, I will get COVID there!”.

Say what you will, but if the basic trust in doctors and healthcare is lost, how would people get tested, and how can you trust any statistics from there?!

I’m ashamed, stupefied and angry at the same time.

> hospitals faking COVID test results just so that they can admit them for 4 days, administer expensive drugs, charge them some hefty bill, and send home

Why would hospitals admit someone who isn't actually in need of care? If you need hospital care for Covid, it's (almost exclusively) because you need supplemental oxygen, and that's something that's pretty hard to fake.

Edit: the question is: how are these hospitalizations actually done practically. Are doctors faking diagnoses (e.g. hypoxia), convincing patients they need care, which they are persuaded to accept? Or are patients forcibly admitted without being asked?

> Why would hospitals admit someone who isn't actually in need of care?

In places without socialized medical coverage and low levels of ethical integrity (unfortunately, too many places in the world - especially impoverished states), the answer is "money".

Yes perhaps the question was unclearly posed, I mean - how do people allow themselves to be admitted to expensive care without being in need of it?

Are doctors "persuading" patients that they need care, and the problem is lack of information about what rights you have to actually refuse, or information about what the symptoms would be etc?

Yep that's usually what happens. Not everyone has the same access to basic medical information and rely solely on the doctor's word. That is how many people fall into cult-like or religious "medicine" or end up spending way too much on otherwise farsical treatment.

Why would socialized medicine exclude this behavior? Medicare fraud in the US is in the billions.

The US does not have socialised medicine.

I believe parent referred to Medicare as a subset in American health care that is socialized, to some degree.

I guess I am mostly alone in thinking that for a system to be socialised, it has to apply to everyone or almost everyone in a country equally. From the comments and the voting, I understand that having it apply to "almost" half the population is already socialised to this time slot :)

So by your definition much of Europe (which has a robust private healthcare system) isn’t socialized?

Europe isn't a country and doesn't have uniform policies in this way. It also doesn't have things as an entity (except for a selection of laws that it's members implement differently in most cases).

Because of those facts, I have trouble even formulating a response to your question - it doesn't make sense to me.

Much of Europe has a mix of public and private healthcare, hence by your argument, none of those countries have socialized medicine.

We do, just for certain groups, such as elderly and the poor. Hell like 40% of births here are paid for by medicaid. But we have system here where only up to upper middle class (~$142k) of income is paid to social security tax, so middle class pays for both poor and themselves, while poor pays for no one and rich disproportionately only pay for themselves.

There is no income limit on Medicare payroll taxes, just social security.

Agreed, although that doesn't negate the presence of socialized health care.

Yes, but at least there is more equity between poor and rich in this regard.

More like equity between middle class and rich. The poor are getting free stuff at expense of both.

The rich have more because they have more money, giving poor people free stuff actually increases equity, it doesn’t decrease it. SS isn’t very equitable because of the income limits, payroll taxes in general are less equitable because they aren’t (very) progressive.

One person being handed health care on a silver platter while I work the better part of a week to pay for it for my family doesn't sound equitable to me.

You are assuming the poor in America aren't working hard and are having health care handed to them on a silver platter, neither of which is true in general. But sure, many poor people (who don't qualify for Medicaid) are looking forward to the day they turn 65 and can get healthcare benefits...hoping that they live that long enough to see any of that.

Of all the developed countries, only America treats its non-rich citizens so harshly. Your implied advice that poor people should "just work harder and make more money!" isn't very useful.

Resorting to a bunch of straw-man attacks making lying and vicious, calculated claims to make me look like I've attacked the poor as "not working hard" is a really bad look for you. It's the look of someone who failed at making a cogent argument so they resort to a sob story about me attacking the poor.

All I'm saying is it isn't equitable for one person (who could have not worked a day in their life) to be handed health care on a silver platter while I work the better part of a week to pay for it for my family. Do you not understand many on public health care don't have to work for the better part of a week to receive benefits, and never have? I'm not talking about old people who spent 40 years paying into the system.

The person you replied to was being generous to your argument, and nothing but polite. The fact is that plenty of the "poor" work as much as you do, but you think they're somehow enslaving you because you get paid more.

If you continued working the same job you have now, but at $7.50/hr, would it be fair to characterize your receiving the same health care you receive now as being handed to you on a silver platter?

>The person you replied to was being generous to your argument, and nothing but polite.

And nothing says generous and polite by making the lying, vicious claim that I've assumed ' the poor in America aren't working hard' and that I implied 'that poor people should just work harder and make more money!' It's purely fiction designed to paint me as the evil denigrator of the poor.

>The fact is that plenty of the "poor" work as much as you do, but you think they're somehow enslaving you because you get paid more.

'The fact' that both of you have to put words in my mouth (or alleged thoughts) to make your argument speaks volumes here.

>If you continued working the same job you have now, but at $7.50/hr, would it be fair to characterize your receiving the same health care you receive now as being handed to you on a silver platter?

By handed on a silver platter I was referring to someone capable of working, but who requests (and is handed) health care for free without performing any labor at all at the expense of someone working and paying an involuntary tax. I never said that was all or even most poor. I'm not referring to the poor person making 7.50 buying their own private health insurance. There's probably an argument from some perspective that 'equitable' could mean everyone works the same amount of labor (20 hours or whatever) per month to pay for healthcare, although I'm not sure even that would precisely be equitable. One able bodied person of equal insurance risk pool to another working BOTH more hours AND paying more for same insurance would certainly sound inequitable.

You said:

> One person being handed health care on a silver platter while I work the better part of a week to pay for it for my family doesn't sound equitable to me. reply

This exactly implies that if only those poor people worked a "better part of a week to pay for it" like you did, they wouldn't be getting their health care served on a silver platter. Not a straw man.

The straw man is that I've assumed ' the poor in America aren't working hard' and that I implied 'that poor people should just work harder and make more money!'

Of course if you compensate providers for health care through the fruit of your labor and investments, you've earned it and it hasn't been provided to you on a silver platter; I don't think anyone is disputing that.

>This exactly implies that if only those poor people worked a "better part of a week to pay for it" like you did, they wouldn't be getting their health care served on a silver platter.

See my response below:

A large subset of the US does have socialized medicine. Medicare (65 million people), Medicaid (75 million people), and the military health system (10 million people).

That’s nearly half the US population.

That insurance isn't socialized medicine. In Europe for example, the hospital is owned by the government/state/etc, the doctors are hired directly by the hospital, the medicine costs are directly set by the state and so on.

No private parties at all.

> In Europe for example, the hospital is owned by the government/state/etc,

Europe is a big place with many different types of systems. What you're describing sounds like the UK. But places like NL[1] or DE[2] are more like Medicare/aid for all (basic coverage) + Obamacare (mandatory private insurance, sometimes supplementary). The providers may be private practitioners.

NB: I'm not an expert in these systems so I may have gotten some details wrong. My main point is that "European healthcare" isn't a monolith and it's not all state-owned.

https://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands

https://en.wikipedia.org/wiki/Healthcare_in_Germany

The key word is fraud: getting something for nothing. Medicare itself bills at a lower rate than private insurance. For many doctors and hospitals, Medicare can be a margin-reducing annoyance. The private insurance patients are where the moneys at.

Fraud being changed for unneeded services?

Not sure what your point is.

That kind of fraud can occur because you have a socialized system interfacing with a non-socialized one. The government is paying the costs, but they don’t actually have much control over or oversight of the care. It is not like Australia where the government is all in by funding the hospitals and doctors directly.

https://www.counterfraud.gov.au/case-studies/clinic-owner-co...

”A medical clinic owner defrauded the Commonwealth of more than $3.3 million by claiming rebates for services not given to over 5,870 different patients.”

He got caught very quickly, I’m not sure what this proves (that idiots exist in every country?).

You claimed it doesn’t happen in Australia and I proved it does.

Why are you moving goal posts?

This is like a Trump supporter claiming that the Democrats stole the election because a bunch of Trump voters got caught voting illegally, very easily because...the system actually works. Here, yes, you can still commit fraud in Australia, but your chances of getting caught quickly are almost 100%.

You provided no source to back that up. You’re saying a doctor who orders an extra unnecessary test will get caught 100% of the time?

Clearly fantasy.

Blunt answer : Money, greed, short term thinking and lack of ethics.

How? Doctors turn into actors and cheat the public. Anecdotally, my relatives say they were never treated for COVID, but told that they needed admission because they have high risks(diabetes, respiratory troubles, high blood pressure) and need to be monitored in order to make sure COVID is treated early. After 4 days of a battery of tests(non COVID related), they are sent home saying they escaped the wrath of COVID because they were lucky. I don’t know what to say.

This is why I'd never want to visit any doctor whose paycheck is affected by the treatment he gives (or doesn't).

A doctor who has even a small kickback on prescriptions from a pharmaceutical company is completely out of the question in my book at least.

As an Indian living in India, I've heard some of these stories:

a. They are asked to get admitted "for observation because they are at high risk". If they ask to leave, the doctors ask them to sign a very scary sounding wavier disclaiming the hospital of responsibility for their death.

b. There apparently this one lab that will return a positive covid test if the docs ask them to and they get a cut of what the patient pays.

It needs to be said that I don't know if any of these are true.

> Say what you will, but if the basic trust in doctors and healthcare is lost, how would people get tested, and how can you trust any statistics from there?!

To me this is a huge problem: some doctors are gaming the system and providing fake covid certificates or vaccination stamps. What else could doctors be hiding from me in other situations ? My mom said it was a war crime to deliver fake covid vaccination stamps (I can see how a doctor doing that would see himself as a resistant so good luck having a healthy debate about that). It breaks something fundamental. In a way I hope most of them did it for the money rather than out of anti-vax/anti-system.

On a related note I was stuck for three days in a house during this summer's flood (floor level flooded, second okay, I stayed at the third) . I had food, water and was okay. At some point I could have left the house to be relocated in a roofed sport centre or a school with other people but I decided against it in fear of getting covid in a crowded space. It was before omicron. Maybe I overreacted but I didn't want to take any risks.

A war crime? For which ongoing war?

I believe they meant to express the idea that such a scenario is beyond morally reprehensible, so as to liken it morally to a war crime.

In her head it's more like "these people are fighting the state and are enemy of the state and its citizens".

The one on Covid. See Macron last year's speech https://www.bbc.com/news/av/51917380

Of course my mom is not asking for a war tribunal to prosecute people. She's talking about the gravity of the facts.

This is stupid and insulting for people who experienced a true war. Does she know what wartime is like? Because I do and Ican tell you this has nothing to do with what we have right now.

> This is stupid and insulting for people who experienced a true war. Does she know what wartime is like? Because I do and Ican tell you this has nothing to do with what we have right now.

What's stupid is your insistence on trying to imply that a remark she made about the gravity of some acts is the same as her saying it's wartime.

And for what it's worth, yes she actually does know what wartime is.

I wasn't aware it was a requirement to be allowed to express one's concerns about the behavior of some people though and to relate it to despicable behaviors she saw first hand.

This holier-thanthou attitude is very well misplaced. It's also significant you choose to single her out on this and say nothing of Macron who made a war time speech. And Macron has way more influence than my mom.

Words mean things. War crimes are only committed during a war, by definition. Just call it criminal if you want, but "war crime" is inappropriate.

As for macron he is just like most politicians, he uses this idiotic and misplaced war rethoric to fool people and make it easier to suspend rights and liberties.

> Words mean things. War crimes are only committed during a war, by definition. Just call it criminal if you want, but "war crime" is inappropriate.

Yes, words mean things.

But people use words with variations on their meanings to put emphasis or for comical effects or for anything else every day and that's fine. That's what language is for. My mom thinks it's worse than a criminal act and speaks the words "war crimes" ? Good, that captures and convey her feelings better.

You may not like it but people do that all the time and they also make analogies that aren't 100% logical 1-1 mappings to what they are trying to explain.

Better get used to it and keep this word definition rhetoric tactics for people who wants to argue on this level.

All this hate for the medical profession. You have people who work long hours, bear huge responsibility and are treated like shit for a pathetic salary.

I honestly don't even know why they keep doing it. You get less crazies as a prison guard and they have better security.

What hate ? Most people who hate on the medical profession are antivax. There has been violent actions taken against the medical workers in vaccination and testing centers in Belgium and France.

Lack of trust because of misdeeds does not mean one hates all Doctor and nurses who work their ass off to literally save people’s lives. It is not binary.

There is a difference between - will I go to the hospital if I get hurt or have a medical need versus do I trust the hospital to not fleece for some care I may not need. The fact that this question needs to be asked is a result of the lack of trust. If there is any profession where there should have been zero tolerance for malpractice, it is this noble medical profession.

In the US it is the accumulation of years of frustration with our for-profit system. Insurance at a minimum feels like a parasite, and then on top of that it is the personification of byzantine bureaucratic mazes and arbitrary rulings.

Insurance is also fragile, where an employee that needs their healthcare for something like cancer is then exposed to be laid off and lose coverage.

When you need it most, you are subjected to exploitation and fraud: surprise billing, lack of coverage, and doctors that feign ignorance about costs and complexities.

Meanwhile anyone that knows how billing professionals knows: #1 rule is bill when you can, the #2 rule is to bill as much as possible.

The end result is a lack of faith in our system, where it is just a system of profiteering and exploitation.

They work long hours because they will eventually make a lot of money (my friend is a cardiologist, not even a surgeon, and makes 800k per year in the US) and get huge amounts of prestige. Doctors are the only nerd profession that is cool and sexy. And the number of hours is actually less than it used to be back in the day.

Of course, you don't get as many perks from the drug/device company reps anymore, or have they figured out how to give doctors steak dinners and golf junkets again?

In my apartment complex in India, we have ~300 apartments and ~1000 residents. There have been over 70 cases of Covid here since the beginning of last year (including 15 as I type this) and only one of them was hospitalized - a 3 year old boy. All the others were quarantined and recovered at home. I don't know where your parents live, but what I've seen in Delhi, Bangalore and Chennai (I don't have first/second-hand knowledge of other places) is that hospitals refuse to admit you unless you absolutely need to be admitted.

Edit - just to add, the kid mentioned above also recovered, but he was hospitalized for a couple of days with very high fever.

Depends on where you are and how connected you are. In my locality (Bangalore) a bunch of people who tested positive got admitted to hospitals on 'precaution' even though they were all mild and advised to isolate at home.

OPs point was that it doesn't matter what the hospitals are actually doing, if people don't trust them.

True, but what I'm saying is there's no reason to mistrust the hospitals as I've not seen the alleged behaviour at all. Add to that the fact that you don't even need to go to a hospital to get yourself tested in the first place - in most cities you can get it done by a professional at home (though it's possible OP's parents live in a rural area where this facility is not available).

> True, but what I'm saying is there's no reason to mistrust the hospital

That doesn't matter _if people don't trust the hospitals_. Whether or not there's a reason for it is insignificant.

> as I've not seen the alleged behaviour at all

As an aside, one anecdote doesn't mean that there's no reason to mistrust the hospital. I have elderly relatives in care homes, and I've not seen them abused. That doesn't mean there's not a problem with abuse in care homes here in the UK

Exactly right!. Some people take their own example from a privileged position and claim that everyone can get same treatment/service.

Well, it's not one anecdote - it's 70+ in my apartment complex and probably 100+ overall, but I get your point.

it is one anecdote. Too many indians of privilege do not appreciate the fact that the majority of the country does not have that same privilege. Seventy people around you are all in the same social strata as you.

Are you saying not being admitted to a hospital is a privilege? I would think that if a hospital did want to fleece someone, gainfully employed and insured people would be the best candidates rather than poor people who may not be able to afford the treatment.

Trusting hospitals is the privilege being referred to.

The situation is far worse in smaller towns and cities in places like Bihar and UP. I remember hearing stories during the second wave (some of which I was able to confirm) about doctors not telling family members that their loved ones had passed away so as to be able to keep charging the family for continued hospital care. The loss of trust in the medical profession is very real.

I’m not from India and for the longest time it was tempting to think of India as one homogeneous place; but that is not what it’s like at all. Isn’t India enormous, with many quite different states and different levels of development? And bottom line, what percent of the population has access to good quality health services vs what the GP described?

This is exactly right. The disparity in the level of healthcare that you would get in an Indian state like Bihar vs that in a state like Kerala is similar to the difference you'd expect between Sub-Saharan Africa and a second world Eastern European country.

Can confirm. Have personally seen this in Patna, Bihar.

> doctors not telling family members that their loved ones had passed away so as to be able to keep charging the family for continued hospital care.

While I've heard anecdotally that this happens, I find it hard to believe that this happened during the second wave when hospitals were, in general, being overrun with patients and running out of beds and oxygen cylinders. Why would you want to risk getting caught doing this when you anyway have a long queue of prospective patients waiting for a bed?

Even in the US, there's a segment of the population who are getting themselves killed by not getting vaccinated and then refusing to accept proper medical care at the hospital because they believe that COVID is a conspiracy and that medical practitioners are in on the scheme. They roll in 5 days after they start showing symptoms with low oxygen levels hoping to find a doctor who will prescribe ivermectin and vitamins to become self-fulfilling prophecies when doctors refuse to treat them with things that aren't approved or helpful.

Also in Europe. Death by ozonotherapy is real.

Cumulative Deaths: Selected Countries and States (per 100K)

https://ig.ft.com/coronavirus-chart/?areas=eur&areas=usa&are...

Your parents are smart. Hospitals are a prime spreading location and testing centers are often crowded. Also, an overworked nurse may make mistakes in testing centers and slip up on hygiene rules.

The situation is similar in Europe, actually. Including loss of trust.

Everyone talks so much shit on USA car culture but our testing centers are typically a drive thru where patients are isolated in their cars thereby protecting everyone. Patients swab themselves and then hand the sample over through a few inch opening in the window.

So many downsides to that.. how do you get tested if you dont have a car? How do you drive a car when you are very sick? How do you make sure properly do the test on themselves?

Sorry, but I dont find this a good argument in favor of a car-culture at all.

It's not a theoretical harm, either.

https://www.latimes.com/opinion/story/2020-07-07/op-ed-drive...

> For each walk-up site, we looked at how many people live within a mile radius and could conceivably walk to the site. You don’t need to look at a map to know that too many people and places are left behind. If you don’t have a car but live in South Los Angeles, chances are you can find a nearby walk-up test site. But if you’re carless in East L.A., there is not a single walk-up option in your community. The entire San Fernando Valley — with a population of almost 2 million — received its first and only walk-up site, in Arleta, in late June.

https://www.businessinsider.com/new-yorkers-without-a-car-ar...

> After trekking nearly two hours on public transit to get to the testing site in Flatbush, a neighborhood in New York's Brooklyn borough, the 30-year-old taproom manager was surprised to discover a line of cars snaking around the address instead of a line of people. McGrath, who does not own a car, approached a state trooper at the testing site to confirm his suspicions that a vehicle was required to be tested.

> "I walk up to one of the state troopers and he says, 'You can't walk in, you have to have a car,'" McGrath told Business Insider, adding that it appeared as though he was not the first New Yorker to arrive at the testing site on foot.

I have gotten so many covid tests in the past two years. Some of them are drive thru only but most don't care either way. In DTLA proper the testing centers are mostly for pedestrians.

Consider the possibility that your experiences aren't universal.

I cited specific examples of people having trouble getting tested without a car.

And here I was thinking that Germany was car-centric... anecdotal evidence, but in my small town there is a testing site in a pharmacy a few hundred meters from my home, and I couldn't imagine that you would have trouble finding a testing site accessible by foot or public transport in larger cities.

You walk. That’s what they did in SF. One lane for cars, one for pedestrians.

Having a car is not a requirement to get tested. It has made it really easy to get tested though. For what it’s worth, this isn’t our idea as a nation. Korea was doing it before us.

The drive through testing really does offload a lot of stress that would otherwise be placed on physicians and pharmacies. The logistics are a huge win. Locally we’ve had unoccupied parking structures used to house the tests. Even without that you basically just need a parking lot, a couple tents, and a restroom.

If you’re so sick you can’t drive you can have DoorDash or any other delivery service send you an at home test. If you’re too sick for that, you probably should call for medical services and not an antigen test.

I’m in Georgia, which has not offered any support for people during the pandemic beyond what the Federal government provided, and it’s pretty easy to get a test due to the efforts of private companies. If you don’t have a car you can often walk up provided there is a sidewalk. We also have testing available in every chain pharmacy and in dedicated facilities that have sprung up in unoccupied mall space or buildings used by bank branches and fast food establishments that are vacant.

I rode my scooter through the CVS drive through for a test this weekend to get tested. It's really not an issue.

"drunk driving may kill a lot of people, but it also helps a lot of people get to work on time, so, it;s impossible to say if its bad or not,"

You’re equating cars with drunk driving?

In India - at least in the cities - you don't even need to step out for a Covid test. You can request a technician to come and collect your sample from the comfort of your home, and you'll get the result in a few hours or the next day at most. I'm not sure where the commenter's parents live, but if they live even in a moderate-sized city, they're being unnecessarily paranoid.

Thanks for bringing this up. I will check whether such a facility exists in the village where my parents live. If you’re curious, they live in Srirangam, Trichy, TamilNadu.

> If you’re curious, they live in Srirangam, Trichy, TamilNadu

Wonderful place, except for the heat :-). I've visited there (for the temples) on a few occasions.

A lot of testing centers / labs such as Lister or Thyrocare can do in person sample collections, such as this one below are available.

Its quite easy to get a test done at home. (Mentioned of lister metropolis because they had come home for some other sample collection and mentioned of this) . You can check aggregator apps as well that provide this list.

https://www.metropolisindia.com/parameter/trichy/covid-19-rt...

Here in Thailand I can walk into 7-11 and buy a rapid antigen test for $3 and go take it at home

Same in Germany.

The testing centers are free for the most part.

Driving to a testing center and sitting in your car could easily use $3 in gas and more of your time. 7-11 is absolutely everywhere here, you don't understand the level of convenience.

I'm in my condo right now, I could go to a 7-11, come back and have my result all within 10 minutes for $3. But yeah car culture in America is great

This isn't the typical scenario in the Bay Area where testing centers are walk-in vs. drive through. To ensure testing consistency, swabbing is done by a healthcare worker (e.g., nurse) not by the person being tested. This is my experience across 4-counties here, San Francisco city included.

Net-net, COVID-testing privacy isn't a laudable consequence of the US's car culture, at least not everywhere in the US.

I know of at least 1 drive-through testing center, at the San Jose Fairgrounds. There may be more, but not sure.

Though there the testers/nurse puts the swab in the nose.

Does their city have at home testing where someone comes home to collect samples and results are emailed to the patient?

this question will appear insulting but do you think there is a cultural reason why there is so much scamming in India or by Indians? I've read many hackernews posts on Indian swe candidate lying on the take home test or CV. 100% of the phone scammers I encountered here in Australia have a South Asian accent.

I am from a developing country myself and do understand that this kind of thing happens when a big part of a country is low on the Maslow's hierarchy, but India seems to get it worse somehow?

India is by far the largest poor country by population, it's reasonably advanced technically, and English is widely spoken.

It's no coincidence that the other country we often associate with scams, Nigeria, is also large and has many English speakers.

There are plenty of scams in (say) China as well, they just target Chinese speakers.

I get a ton of Chinese language scam robocalls in the US, they're just not specifically memorable because I don't speak Chinese.

> this question will appear insulting but do you think there is a cultural reason why there is so much scamming in India or by Indians? I've read many hackernews posts on Indian swe candidate lying on the take home test or CV. 100% of the phone scammers I encountered here in Australia have a South Asian accent.

It's not "cultural", e.g. here in Germany we have a huge problem with phone fraud originating in Turkey [1]. The reason why scams are so common for "foreign" countries is relatively simple: fraudsters need people speaking the language pretty well, but do not want attention from domestic law enforcement... meaning you need a remote country with a shoddy/easily bribable law enforcement, speaking the same language as the "target" country, a huge supply of desperate, poor people willing to turn to crime for money and easy ways to transfer money from the target country to the source country and back to wherever the ringleaders are. For English-speaking countries, the biggest country where these conditions meet is India and the Philippines (and historically, Nigeria), for German-speaking countries it's Turkey (with historically close migration links from the post-WW2 "Gastarbeiter" era).

[1]: https://www.bka.de/DE/UnsereAufgaben/Deliktsbereiche/Betrueg...

I know few companies in India who for some amount would write essay, thesis for students. A large number of them are from US. These companies make very good money from them. Yeah everybody cheats, maybe westerns are very good at hiding it.

Another anecdote: In my home town, a doctor took the government funding to open a covid centre. She then only admitted patients that were mild cases and had chances of survival, for those who had little chance of surviving she would not admit them and send them home. One might think that maybe she was being smart in triaging the patients, but I know her personally and her only motive was money.... Because relatives are less likely to pay for a dead patient than they are for someone who came home alive.

Extremely shameful but not surprising.

Can you please share the name of that Centre? I would love to investigate.

Thanks.

I am a physician and my contribution to this conversation might not be appreciated, but here it goes. I work at a medical university with two medical colleges and a wide healthcare system and we were involved in the clinical trials for Covaxin (India's indigenous vaccine) as we as Covid care and immunisation. As a foot soldier, I am tired of fighting stories such as yours that raise doubt on statistics with anecdotes. The statistics maybe flawed, but we need some scientific rigour in decrying them. Not 'my parents said' stories.

The anecdote about faking covid test results is plainly wrong. There is a mechanism for registering every PCR-RT test that is done along with the Aadhaar Unique Identity Number. The results need to be validated at different levels. These have been digitised. You can access your parents records online and verify and validate them too. All this is available on your mobile apps. The digitisation and workflow management make faking the results very difficult if not impossible.

Hospitals are specially licensed to treat Covid. Not all hospitals can admit covid patients. It is not like every small clinic or hospital at the corner can simply admit patients. The total bill for ANY COVID RELATED ADMISSIONS are capped. The test fees are capped. There simply is not much incentive to fake results when the fees cannot be charged on whim.

Of course, common people like your parents are fed misinformation by the social media (anti-vaxxers movement in the US) and a lot of fear about corporate profiting, big pharma, etc are the usual trope.

Big pharma sure profits, but they profit most off such staple as baby powder and insulin. Their profits, data of efficiency on vaccines etc are under glare of scientific scrutiny, while their pain killers and opioids are where they don't get any investigation.

The death rates on the other hand in India are under reported and there is a huge backlog that is being cleared right now.

You may not believe it, but India's response to the pandemic has been nothing less than fantastic, given the sorry affairs of its health infrastructure. The mechanisms at every level worked satisfactorily. Were they miraculous? no.

Efficient given the resources? Yep. It could have been worse. Far far worse.

Edit. Oh I forgot to add... our hospitals lost a lot of money and our entire budget. We had to borrow to keep things running and are in the red for the next few years.

So all this 'profiteering'... try running a hospital.

Edit 2: The local administration commandeered our hospitals to set up Covid wards. Admissions were made electronically for hospital based observational wards. Food and medicines were made free for all the admitted patients. Also, Oxygen. Did I tell about the overtime payments to doctors, nurses and paramedical staff? All from the hospital funds. Patients paid nothing. Thats right. Nothing. Not a cent.

The way the comment you are responding to was written and explicitly quoted, and yet said the commenter was still trying to get their parents to go despite the multiple objections, made it to me sound like they were not claiming the things you are defending against but merely restarting them as something the parents said.

Well, I for once, appreciate your contribution :)

Hey. A lot to unpack here. But, first, THANKS!! for everything you do and the care you have for doing things right. Please don't take criticisms such as mine to mean that "everything is wrong and everyone is wrong" instead of its actuality where there is something wrong amidst several right.

With that out of the way, I did try to explicitly say that my experience is not first hand and that it is of that from my parents and my frustration that they cannot get tested as often as I can in the NL, and trust the local healthcare setup as I do here.

I for one am a lot relieved to hear from you that the digital systems are put to good use in verifying COVID tests, administration of vaccines, treatment, bills etc. Unfortunately, my parents concerns were still not addressed by these re-assurances. One may still test positive for COVID, but not really need the excessive medical procedures that the private hospitals/doctors do with monetary aims. Even worse, a doctor could simply admit someone for a couple of days and run all the tests only to come up and say after 2 days and a bill of several thousand rupees, - "your covid test was negative", please be careful about your other problems we took care of.

Secondly, if the regional testing centers or doctor's offices are as badly managed and under-staffed as my dad claims in his region, it is hard to trust the rest of the system to work, and not be scared of contracting covid just by visiting the test centre. I realise that India is big, diverse and unequal so it may not be the case where you are.

One of the reasons, I am stupefied, angry and scared is also from your list...

> our hospitals lost a lot of money and our entire budget.

> Did I tell about the overtime payments to doctors, nurses and paramedical staff? All from the hospital funds. Patients paid nothing

At least from a sample size of two (in a country with a couple billion people), it is not true. My uncle and aunt were hospitalised. for "mild" covid late last year, and came back home after 4 days with a fat bill, lot of frustration from defending against what they perceived as needless tests, and of course COVID. A private hospital could still keep the COVID cost to whatever regulatory maximum is, and still do absurd tests to milk the patient's insurance policies :-(

The only way for this system to gain trust is transparency. For patients to take hospitals to court with trustworthy judicial system. However, here we are where India reports a few lakh people died, and researchers claim it is wrong by several orders of magnitude :-(

I trust the sincere work of yours. But, we have a long way before that can be applied to the majority.

Your reply is disingenuous.

You state that you do not have "first hand" experience and yet are pushing questionable narratives from your Parents/Aunts/Uncles (who frankly seem to belong to the irrational "don't get the vaccine" crowd) as fact. Having lived through it all in India, i can categorically state that your narratives are very much false.

You seem to have no idea of the statistical nature of Covid tests; they are not binary. A Doctor has to make a judgement call on the result of the test (eg. RT-PCR) vs. the results of other tests (eg. Chest Scan) which is not easy. Given our limited resources in everything (i.e. Education/Hospitals/Doctors/Nurses as a percentage of the Total Population) it can become rather difficult to convince people of the costs (tests, time and money) involved. While of course there are many problems/inefficiencies with the system and we did drop the ball in preparing for the 2nd wave (as did the rest of the World) overall i would say we have done a stellar job of managing the crisis with the limited resources we have at our disposal.

Thanks for the comment. Are you able to elaborate on the big pharma profits most on baby powder, insulin and pain killers? In the world I live in, they pushed those markets to the brink in the form of baby powder lawsuits, an epidemic of obesity and the opioid crisis. Also, have you looked into Pfizer's profits for 2021?

https://www.cnn.com/2021/11/02/business/pfizer-earnings/inde...

Edit: Baby Powder Lawsuit - https://www.nytimes.com/2020/06/23/health/baby-powder-cancer...

Obesity Worldwide - https://www.who.int/news-room/fact-sheets/detail/obesity-and...

Opioid deaths began with increased prescription - https://www.cdc.gov/opioids/basics/epidemic.html

I also appreciate your contribution. Unlike a lot of the so called NRIs, at least you chose to stay and do your part to make India better.

FYI for those wondering - NRI stands for Non-Resident Indian/Not Really Indian depending on how pejorative you want to be.

Nicely explained.

India should be an example of underdeveloped nation managing their covid situation. I'd like these policies to be documented and shared with UN med and shared with the world.

> You may not believe it, but India's response to the pandemic has been nothing less than fantastic

Come on, India was probably the only country in the world where there were dead bodies floating in rivers. https://www.bbc.com/news/world-asia-india-57154564

During the second wave in April-May 2021, which India had ample time to prepare for, hospitals just didn’t have oxygen.

https://www.tribuneindia.com/news/haryana/ex-envoy-dies-wait...

https://www.washingtonpost.com/world/2021/04/21/india-hospit...

States purposely undercounted their death tolls by vast amounts.

https://twitter.com/deepakpatel_91/status/139341986118379930...

That said some states like Kerala and Maharashtra managed the pandemic much better than others like UP and Bihar, so your experience could be based on one of the better performing states.

To be fair, there is no country in the world operating with as little resources for as many people as India. The scale of administrating a pandemic response in India is mind-boggling.

The dead body floating thing happened in 1 or 2 states. My understanding is that dumping the body in Ganges is a cultural thing in some towns in those states. Someone from there told me that the older generation wants their body to be thrown in Ganges or buried on the shore so that they can get 'moksha'.

> The dead body floating thing happened in 1 or 2 states.

Those were the worst hit states - UP and Bihar. What was observed during the second wave was not normal, something like that last happened in 1918 after the Spanish flu:

https://www.bbc.com/news/world-asia-india-57068503 "This is not the first time bodies have floated up in rivers in India during a pandemic.

"The River Ganga was swollen with dead bodies", the famous Hindi language writer and poet, Suryakant Tripathi, better known as Nirala, wrote about the 1918 outbreak of Spanish flu in his village in a province which is now India's Uttar Pradesh state."

While I agree that we shouldn't be seeing bodies in rivers, I am not entirely convinced if Covid and Spanish flu in India are comparable.

The below links say bodies were found in many rivers, not just Ganga.

"A report released by the sanitary commissioner in 1918 later documented that it was not just Ganga that was clogged up with bodies, but all rivers across India."

https://economictimes.indiatimes.com/news/politics-and-natio...

https://en.wikipedia.org/wiki/1918_flu_pandemic_in_India

I don't think if scenarios such as below are happening in India, the leftist Indian media would stay silent.

“India perhaps never saw such hard times before. There is wailing on all sides. … There is neither village nor town throughout the length and breadth of the country which has not paid a heavy toll.

Elsewhere, the Sanitary Commissioner of the Punjab noted, “the streets and lanes of cities were littered with dead and dying people … nearly every household was lamenting a death, and everywhere terror and confusion reigned.”

https://theconversation.com/1918-flu-pandemic-killed-12-mill...

Just found out that there was a similar incident back in 2015 where they found more than 100 dead bodies in Ganges in the same region. It was also reported by BBC. Now I am wondering if BBC conveniently forgot that and went far back to 1918, just so that they can compare India's current situation to Spanish flu?

https://www.bbc.com/news/world-asia-india-30808745

https://en.wikipedia.org/wiki/Unnao_dead_bodies_row

It is NOT a cultural practice in either of these states to simply "dump the body" in the Ganges. The tradition is to scatter the ashes in the river. Wood burnig open air cremations along the river bank is the norm, which takes several hours to reduce a body to ashes & bone fragments. Under usual conditions, a family member would remain with the pyre till the end, and would collect the bone fragments, mostly the next day. A lot of the leftover material is wood ash, which would be deposited in the river directly by the crematorium workers. Historically when resources have been tight & crematoriums overwhelmed by epidemics in the past, a family member would not be present, and unscrupulous crematorium workers would overturn partly cremated bodies in the river to ensure fast turnover, which is what seems to have happened in 2020. Desperate families might also inter the bodies directly in the river.

Unless I misunderstood, someone I know from one of these 2 states recently told me their grandparent wanted to be disposed of like that. They said their generation or their parents don't believe in such practices.

According to the below article, some communities do practice dumping body in Ganges.

"He further informed that the practise of dead body being disposed in the rivers is prevalent in two particular stretches in central/eastern U.P. and the epicentre of which is in Kanpur Unnao region in central U.P and Banaras-Ghazipur area in eastern U.P"

https://indianexpress.com/article/india/practice-of-bodies-b...

There was also another incident in 2015 from the same Unnao region where they found more than 100 bodies in Ganges.

https://en.wikipedia.org/wiki/Unnao_dead_bodies_row

From the link that you pointed to

    Police officials of Unnao have offered an explanation that the bodies were
    of "people who were dumped in the river or buried on the banks after their 
    families could not afford a proper cremation."

You are trying hard to give the story a spin that dead bodies in the river in such numbers is nothing notable.

Government contractors pressed into removing commemorative burial markers less they be counted by drones

https://www.youtube.com/watch?v=ZiLzIuMsnW0

Let me find something in English to give context on these shallow graves

https://www.youtube.com/watch?v=6Q6hYu3EsC0 (will give viewers an idea of the mindboggling scale of the phenomenon)

The following videos are not in English but you should be able to get a sense of the numbers by looking at them

https://www.youtube.com/watch?v=ALO0VjfxXDA (pardon the annoying and unnecessary dramatization music)

https://www.youtube.com/watch?v=8DWWeOt4jWM

I am not disputing that people were interring the bodies because they cannot afford cremation. But is that proof that all of them died of covid? In the last video you linked (Burka Dutt one), the pandit gives 2 reasons for more bodies on the river bed: 1. fear of covid 2. cremation charges went up due to covid, which in turn caused people to inter the bodies of non-covid deaths as well.

My point of replying to the original comment which used dead bodies in India's river as a sign of under counting was to question the idea of comparing the current situation to Spanish flu (which killed upto 17-18 million in India). What happened in UP/Bihar (news says up to 2000 bodies were found) is an isolated incident, specific to those states. Can that be used as an indication that the remaining 26 states are hiding, since these 2 are one of the most poorest states in India? I should be hearing news about discarded bodies from other states also right?

> Government contractors pressed into removing commemorative burial markers less they be counted by drones

Since you posted local YouTube channels, do you know how they handled the new dead bodies after the news about this incident broke out?

> But is that proof that all of them died of covid?

All was never even the hypotheses, that is a strawman argument. The hypotheses is that this incident, of thousands of bodies floating down the river and buried on the sand bars, is a striking, once in a century phenomena given the numbers. If this was normal we would have seen such numbers prior to covid.

The major reason, as you had noted as well, is the breakdown of the infrastructure for dealing with deaths by a state that is not competent enough to prevent them. Some state did far better than others. You had mentioned two, Tamil Nadu and Kerala.

Note that the population of UP + Bihar is the same order of magnitude as a middle sized European countries. One does not need other states to contribute if these two are badly hit.

Like I mentioned at the end of the initial comment, some families do indeed inter the bodies directly in the river, unable to afford the cost of cremation - this is also mentioned at the end of the wiki article you linked. This isn't new or surprising information. If there are communities that do this as a matter of routine, it's certainly not a significant source considering the 100s of millions who live along the river, where these community's dead mostly disappear without record into the river. For what its worth, it's certainly not a standard practice for the region. If bodies were present at significantly larger numbers in 2020, it suggests that either communities that do not traditionally practice interring in the river were doing it out of desperation, or that the traditional communities suffered significantly more deaths in the Delta wave, both of which are troubling concepts. The other possibility is that these were unclaimed bodies unceremoniously discarded by the civic administration, and the angle perhaps most appealing to those opposed to the current political dispensation.

EDIT: regarding the anecdote about a grandparent asking for this, there's a lot of context we don't know. Rather than a traditional practice, it might simply be a comment based out of frustration about the expense & bother to the family for a "standard" funeral. I also have family from the region and I've never heard of this as a standard routine widespread practice. For the most disadvantaged communities, I can understand it.

Regarding the grandparent comment, they are definitely not poor. They have a lot of money.

One of the comments below linked to a couple of videos, one of which is this: https://www.youtube.com/watch?v=8DWWeOt4jWM

In this, Burka Dutt is interviewing a local pandit. He says he is not sure if these are all covid deaths. He gives 2 reasons for the increase in number of bodies:

1. fear of covid

2. increase in cremation costs due to increase in covid deaths.

So, those bodies are not necessarily all due to covid deaths.

The video shows a lot of bodies cremated on the river bank. Once the water level rises during rain, the pandit says they will all float into the river.

Also learned that some inter the bodies of infants and unmarried women directly into the river. This may explain the 2015 incident where they found more than 100 bodies, mostly of unmarried girls and children.

> He says he is not sure if these are all covid deaths

Yes, though he's speculating, as are we all. The reality is that bodies turned up in the river at an unprecedented rate just as the rest of the country was struggling with Delta. Bodies floating into the rising river is not something that only happened in 2020. Indeed, if rains are a known issue why cremate so close to the rising river? Pyres were so close to the river because there an unusually high number of them. Nobody would suggest that 100% of them were COVID deaths, but it seems likely a very high proportion of them probably were. Indeed, as the top level headline notes that excess deaths, regardless of the official cause of death is what we need to watch out for as a signal.

> Also learned that some inter the bodies of infants and unmarried women directly into the river

This is actually in line with the standard practice in other parts of the country, ie, burial, rather than cremation, for children and maidens.

> Regarding the grandparent comment, they are definitely not poor. They have a lot of money.

The point is that there is context to the comment we're not privy to. The elderly say many things out of frustration and as a commentary on their own families sometimes. For example, I had a relative remark several times that when he died he wanted to be 'thrown to the dogs', or in the trash. Does it imply that this was a traditional practice in the family? No, but it was a comment on the perceived indifference of his family. Are there communities that practice interring in the river as a traditional practice, and not simply as a cost saving measure, and your friend is from one such group? Perhaps, but if there are they are a vanishingly small group, otherwise the river would be choked with bodies on a regular basis. A body showing up once in a while would not be noteworthy. That so many did in a very short window in the summer of 2020 says that the traditional practitioners probably aren't the source.

I have seen dozens (probably hundreds in my overall life) of dead bodies in the Ganges long before Covid. It's disgusting but try telling the people to change their traditions and you will cause a riot.

> Big pharma sure profits, but they profit most off such staple as baby powder and insulin. Their profits, data of efficiency on vaccines etc are under glare of scientific scrutiny, while their pain killers and opioids are where they don't get any investigation.

Pfizer reported that earnings and sales more than doubled in the past quarter, and it raised its outlook for results the full year, thanks greatly to its Covid-19 vaccine.

The vaccine business alone was responsible for more than 60% of the company's sales, as vaccine revenue rose to $14.6 billion from only $1.7 billion a year earlier. The company said its Covid vaccine sales accounted for $13 billion of that revenue. Revenue outside of its Covid vaccine business was up a far more modest 7%.

https://www.cnn.com/2021/11/02/business/pfizer-earnings/inde...

It's the largest part of the business now, and they are protected from downside: Under the PREP Act, companies like Pfizer and Moderna have total immunity from liability if something unintentionally goes wrong with their vaccines.

https://www.cnbc.com/2020/12/16/covid-vaccine-side-effects-c...

large parts of this comment are an appeal to authority. India’s response to the pandemic was an absolute disaster to the poor who incidentally make up the majority of the country and whose voices are rarely heard. This comment reeks of privilege and a lack of information about just how bad the indian medical situation is.

As just one example, india STILL does not have a good handle on WHAT is killing people. Up until 2018, there were annual death surveys to determine the cause of death. Think about that - people go door to door and record verbal responses about how people died. That is how poor data in india is.

These are not anecdotes and you should - respectfully - stop taking anything the indian government says at face value.

I agree with almost everything you say. Hospitals saved my MIL when she caught Covid in 2020 and had lungs affected. She was treated by a Doctor via video and only a nurse (hired a month ago, new to her job) doing the actual physical work.

My only gripe is the shame that is attached to testing positive. The system kicks into extraordinary paranoia when someone tests positive. That is the reason why people refuse to be tested. My MIL did not test for weeks after she started coughing. Thankfully, my SIL traveled from the US forced her to test and admitted her.

I understand the reasons and the struggle of the hospitals, but there is a bit of heavy handedness (nowhere near China, I must admit) that is scaring people away.

I am thankful to the Doctors and nurses of India. They have saved at least two lives in my immediate family.

Finally, A Voice of Sanity.

A very sincere Thanks to You/Fellow Doctors/Nurses for doing such a fantastic job during the most trying of circumstances.

As a caring child of old parents, you should get your parents to NL where you can provide the best possible care for them, instead of letting them die in a place where they can't even get a COVID test done.

If OP’s parents are anything like my dad, they have zero interest in trading their warm homeland with its familiar language and culture for cold northern Europe. My dad would rather die in Texas than live in Germany, much as he enjoyed spending a week here this summer meeting his grandson.

Older people have attachments other than their grown-up children.

This. My parents have zero interest in spending their older years in a region that doesn’t speak the language they know, colder, and has simply a different way of life than theirs not to mention their social circle.

I wholeheartedly agree with their choice, and will do my best to help them where they are.

When millions are dying around them helplessly for want of good care, it seems cruel to let them fend for themselves in their old age, where they are scared to consult a doctor. If they are not willing to come to you, shouldn't you visit, and take care of them in these difficult times?

I have been also wondering about this. My impression is that Tamil Nadu is much better in terms of health care compared to many Indian states. So, its strange that the parents are refusing to get tested. I am thinking that the parents are afraid to take public transport, and they don't want to burden their NRI son/daughter, so are making up excuses.

Tamil Nadu, Kerala are significantly ahead in many key social and public health metrics. Were they not been compensated for by BIMARU (roughly, Bihar, MP, Rajasthan, Uttar Pradesh) states India would be competitive with first world standards. Unfortunately, the BIMARU states are the most populous and consequently controls the political fate of the rest of the country.

The issue needs more context. It's not that they are fending for themselves in their old age. They are retiring in a village with a social circle they are comfortable with, and near a temple that they consider as pilgrimage, and have my sister who can reach them in couple of hours should there be a dire need.

I'd visit if it would be of any help.

> instead of letting them die in a place where they can't even get a COVID test done.

I find it hard to believe that they are unable to get tests. During the peaks, it may have been true. Outside of that, there was no shortage. And we don't even need to go to hospitals for covid tests, there are plenty of independent labs. So, if their parents don't trust hospitals, they can go to those testing centers instead. Many in my family did that, that too 2-3 times (since they have to show negative RT PCR result for travel).

> I find it hard to believe that they are unable to get tests.

Yes, he is probably just dissing his country to earn some "brownie points".

The anglophile Indian elite is surprisingly ignorant of what is going on in their own country. The anglophile Indian elite also controls many aspects of the country.

This out-of-touch anglophile elite is the reason India is so dysfunctional, even more than other poor developing countries.

That's interesting because for a long time there's been this right-wing narrative about how "India benefited from British colonization."

I suppose the British did introduce some technology and civic systems, but they also probably fractured the society and created a new kind of caste system.

How much of today's seeming culture of corruption in India is a legacy of colonialism vs. how much was there already? I'm asking because I'm only looking from a distance.

Also makes me wonder if the Chinese cultural revolution, while a disastrous failure on very many levels, might have erased a lot of the legacy of past colonialism... for the same reason that a gigantic natural disaster might lead to shiny new infrastructure after everything gets rebuilt.

This is an empirically accurate assessment. The priorities of the Anglophone elite (which dominate the IAS and other parts of the admin) are divorced from the priorities of the rest of the country. This manifests in issues akin to what they call “structural racism “ in the US.

Ie: budgeting priorities; India over budgets IITs and other elite institutions over other colleges and primary education. This results in a system with excellent top universities, but a steep drop in educational quality in tier 2 institutions (and very low educational outcomes in public primary and secondary schools).

The government also focuses on agricultural price stability over farm income (ie banning agricultural exports during high prices).

One can argue that the popularity of Modi and the other regional satraps (with language based sub nationalism) is a result of this institutional bias. Imagine how you would vote if you couldn’t participate in the economy of your hometown because all the street signs/store names were in a language you couldn’t read.

>The government also focuses on agricultural price stability over farm income (ie banning agricultural exports during high prices).

Given the farm law protests I don't know if you can pin that one on the anglophone elite.

It's not as bad but it's not too different from other countries. Trust has evaporated in France, it didn't devolve into full on medical scam like what you describe, but the feeling is the same. People don't trust doctors or nurses and can't go willingly there (hence the limited vaccination rate).

> hence the limited vaccination rate).

Of checks notes 73% of all eligible ( 5 years or older, all doses required ( booster included), and it was 12 years or older until yesterday, so there's a huge drop since then). Many were forced by restrictions on everyday life, but still, that's certainly not "limited".

If they are worried about hospitals, please request them to go to any of the independent labs that does covid tests. These labs are not connected to hospitals, they get paid only for the test, so doesn't matter to them whether the patient is positive or not. Many in my family did that.

Also, when one of my family members got positive during the first peak, they went to a local government hospital (small town). They got really great care (including 4-5 doses of some injection worth ~10000 Rs per dose if I remember correctly, free food etc), and paid absolutely nothing.

India compromises of 28 states. And all most all of them have a population bigger than New Zeland and some of them even have populations bigger than Brazil. Stop over generalizing your experiences with one state in India with entire India. What one experiences in Bihar or UP would be completely different from what one experience in Kerala or Goa for example. Be specific when talking about your experience in India.

*is comprised of

e: Muphry’s Law got me. Comprises or is composed of is fine.

The point of language is to communicate. As long as you understand what the person is saying it's good enough. Once you start cherry picking on the syntax itself you are missing the actual point of why the language was invented in the first place.

Not when what you write (compromises) literally mean something radically different. That’s not syntax.

You still understand the context right. What's the point of cherry-picking then?

I don't think you understand what cherry-picking means. Also syntax, grammar and pronunciation are important. Understanding the context is not enough.

I am guessing 'blocked_again' is from India, which means English is not their native language. Having to translate ones thoughts to a foreign language itself is hard, so I am with 'blocked_again' on this.

I am from India too. People can learn.

My mother is Pakistani if that makes people feel better.

Why though? In India, we somehow have this obsession about English. Some Indians think speaking English make them a better person than a regular Indian. Indian speaking in a western accent is considered by some as superior than an Indian accent one. Indians make fun of each other for their accents, their lack of English knowledge etc. Why it has to be that way? Its just a language, that too a foreign one.

Reluctance in gaining even a basic level of mastery in language skills goes to show you don't respect / value other people's time. You want your readers to put in the extra effort required to make sense out of your half-baked messages.

Asking people to use coherent English on an English language forum is a reasonable expectation. I wasn't making a value judgement on the thread OP. I hope this is clear (this is why reading comprehension is important too).

Obviously I have more than a basic understanding of English. The whole issue with this thread is that I accidentally miswrote a sentence and even after understanding the context someone found it the necessary to point that I made a mistake. The whole point of language is to communicate your ideas. If you understand what I am saying then the point of writing the sentence is accomplished. Instead deciding to focus on the syntax or grammar or whatever is just missing the whole picture.

I also didn't understand how they jumped to 'you lack basic understanding of English' just because you used a word differently. The only possibility I can guess for them picking on you like this is because you tried to question the hateful misinformation being posted here. They couldn't counter you on your actual content, so instead tried to pick on any other fault they could. Or they are trying to discourage people like you from questioning their narrative, and want to make sure that you have a negative experience on way or the other.

This is what the thread OP posted... > India compromises of 28 states.

So compromise is now the same as comprise? I don't think you have a leg to stand on here.

Replying via edit:

>The point is that everyone is capable of figuring out that it's a typo and I actually meant comprises of.

Like I said elsewhere this is not what I objected to. I was responding to the assertion "...As long as you understand what the person is saying it's good enough...".

It is not good enough. The proper thing for you to do here would have been acknowledging your mistake and correcting it instead of promoting mediocrity.

People have the capacity of making heads or tails out of sloppy writing but why should they put in the effort to do so? It is your responsibility to put your thoughts coherently in the first place. This is the least you can do.

The point is that everyone is capable of figuring out that it's a typo and I actually meant comprises of. There is almost no one who reads that sentence and is confused what I actually meant. The brain of an average person is perfectly capable of doing that. Focusing on that typo even after totally understanding what I wrote is completely missing the point of language in the first place. Which is to communicate ideas.

I’ve read enough newspaper articles and government press releases from subcontinent that while I believe you, I don’t believe that holds for everyone. I am sure there are people who might go on to confuse the two words.

>The point is that everyone is capable of figuring out that it's a typo and I actually meant comprises of.

Like I said elsewhere this is not what I objected to. I was responding to the assertion "...As long as you understand what the person is saying it's good enough...".

It is not good enough. The proper thing for you to do here would have been acknowledging your mistake and correcting it instead of promoting mediocrity.

Well I agree that I should have been a bit more careful while writing the sentence.

At the same time, it's completely pointless to correct someone instead of focusing on the discussion when you totally understand what the other person said.

> Reluctance in gaining even a basic level of mastery in language skills goes to show you don't respect / value other people's time.

I am not sure how using 'comprises' instead of 'is comprised of' can be considered as reluctance in gaining a basic level of English.

> You want your readers to put in the extra effort required to make sense out of your half-baked messages.

How is the message half-baked just because one word in that whole paragraph was wrong?

> Asking people to use coherent English on an English language forum is a reasonable expectation. I wasn't making a value judgement on the thread OP. I hope this is clear (this is why reading comprehension is important too).

I perfectly understood what 'blocked_again' said despite English not being my first language. I am pretty sure normal humans can process these sentences without any problems. Now if we are talking about 'reading comprehension' for machines, it may be a different issue.

I ran your comment in Word's grammar checker. It suggested a couple of changes.

1. Change 'required' to 'needed' in "required to make sense".

Reason: Clarity. A simpler word would be clearer for your reader.

2. Change 'master' to 'proficiency' in "mastery in language skills".

Reason: Inclusiveness. A gender-neutral term here would be more inclusive.

3. Change 'wasn't' to 'was not' in "I wasn't making a".

Reason: Formality. In formal writing, try spelling out the word.

1. Disagree, required and needed are equally clear. 2. Mastery is gender neutral. Perhaps your grammar checker is confusing this with master? 3. Rules of what is and isn't formal have changed. Contractions such as wasn't, isn't are perfectly fine.

These are just nits. Not at the same level as using compromised instead of comprised. Edit: Actually this is a non-issue, I responded to the assertion "...As long as you understand what the person is saying it's good enough...".

Your reading comprehension skills need serious work.

Comprises is actually correct, if you read my edit you would see that I admitted that and learned something in the bargain myself.

Master(y) in acquisition of skills context is gender neutral. The reason is to avoid master/mistress - slave connotation.

The word you are looking for is nit-picking.

The [US]CDC director just said over 75% of “covid deaths” occurred in people with at least four comorbidities. Since the US administration can’t shut down covid, suddenly all this data is getting shared publicly.

The whole point of studying excess deaths is to figure out covid's contribution over and above the usual number of deaths due to these pretty common conditions (like high blood pressure.)

my in laws ordered a covid test, paid via paytm, the person came and took the sample, took the money and never returned results.

Did you order a Thyrocare test by any chance?

no, it was not a thyrocare, might have been a local contractor working for apollo. However, my mom went recently and for the return booked an at home travel test collection through https://www.metropolisindia.com/covid-19-test and was able to get an rt-pcr result in less than 24 hrs.

If your parents don't have symptoms, or have manageable symptoms and are self-isolating, why bother testing? As long as they're fully vaccinated they've done their absolute best in this situation.

I think the self-isolation part is key. If they're doing that as if they have Covid then I agree with you. And honestly, I think the commenters parents have a fair point about being in line with other likely Covid infected people.

There are additional outpatient therapies that can be medically indicated depending on symptoms, risk factors, and locally approved care protocols. Most physicians will only prescribe those therapies based on a positive PCR test. Some of those therapies include monoclonal antibodies (less effective now with the Omicron variant) or a brief course of fluvoxamine.

But for vaccinated patients with mild symptoms and no major risk factors, staying home and avoiding public testing sites is a reasonable approach.

Another anecdote from the US (New York).

A friend of mine works as a cop. One day someone got shot and he had to help get the victim to a hospital. The victim was bleeding blood and eventually died in that hospital. A few hours later, the hospital provided the cause of death as COVID, because they found out that the victim had the virus ¯\_(ツ)_/¯

So much for the self-righteous angst. As an Indian 'expat', what did you do to help? What is it about it that is so surprising. It's obvious that being a low income country, the health care is not the best, but compared to the rest of the world they are doing alright.

I hope you feel better that you called out on the righteousness of someone who highlights a problem. How dare someone speak of a problem when you can happily live in an ignorant world where everybody always speaks of how good things are.

In the interest of a civil discourse. I will say that I did mean that I am not surprised by the fact that the stats are not correct because I am aware of the ground reality from my anecdotal sources that point in the same direction. Not that my country does or doesn’t do anything.

The first step to solving a problem is recognising that it exists, and not wish washing it away.

As an Indian, I’m sad that you’re not angry.

> being a low income country, the health care is not the best

The Indian state of Kerala would like to differ.

States and leadership that are more keen on disrupting the social fabric, polarize it to gain votes, sure that would divert resources into such harmful instruments. The consequences were well observed as dead bodies by the thousands buried on river sand bars or floating down the water, with government officials working to conceal the evidence by removing religious commemorative markings left on the sand graves.

> The Indian state of Kerala would like to differ.

Kerala chief minister who is a communist is coming to US for health care next week.

https://www.indiatoday.in/india/story/kerala-chief-minister-...

Most Hospitals in India are a really big scam.

Many of my colleagues got sick in Hyderabad and from what I hear the hospitals directly sell drugs in black.

Three of them got admitted to yashodahospitals (https://www.yashodahospitals.com/) and all three of them had to pay 5x the price for Remdesivir. The worst part is this was sold to them by the hospital management.

Also, in India, when a doctor refers you to a diagnostic center for a lab test, the diagnostic center pays the doctor money in the form of a kickback.

It’s pathetic.

I live in the US and the healthcare situation is bad but not as bad as in India. You would never want to get sick in India and visit a hospital there.

> As stupid as it sounds, I could not force my parents to go and wait in the line to get COVID test, after he says “I believe I don’t have COVID now. But if I go to the testing center that is so badly managed and understaffed where only people with obvious high level of COVID are brought to get official result, I will get COVID there!”.

May I ask why you wanted them to? Honestly his response sounds rational to me.

It does sound rational, but incomplete. The missing piece is the one where he searches for (and hopefully finds) an alternative where he can get tested without increasing risk of infection. For example, tracking down an at-home test (he could have used one of the 1M+ tests that Florida recently allowed to expire).

My parents visited my sister for 2 days. They traveled by a private car, but must have stopped for food along the way. After they have been back, both of them experienced fatigue and cold symptoms. As much as it is normal for them to experience after a trip, I wanted them to rule out COVID early. I have heard that early diagnosis and treatment for COVID at their age can be a life saving difference.

If I experienced the same symptoms here in NL, I’d have also taken a test myself just to be sure that I am not spreading it around.

His decision is rational after he explained the reason to me. However, I wish that reason doesn’t exist and that people can get tested without such concerns.

As an Indian, I can tell you that every single family I know has lost someone to COVID. But this part of India wasn't as torn apart as the cities like Delhi or Bangalore. Or like rural India, whose death toll we never counted.

Both sides of the ideological split here were arguing over the stats until the Ganges swelled up with bodies. But even then, the right continues to deny the extent of death.

Are home/self tests an option?

I mean if it's just about knowing it yourself so that you can get yourself PCR tested when you known you likely have it (and as such might soon need medical support).

That seems like a valid option for me, though only if available and hospitalized reasonable priced.

For be the difference between self-tests rapid tests and test station rapid tests seem to mainly be:

- if you have self-test

- if you can afford it (test station rapid tests are up to some limit payed by health care, in my case)

- if you need the digital certificate that you did a tests (some places require vaccination + test)

- self-test produce more wast through additional packaging, non-reusable plastic tubes etc.

I’m from India, and have plenty of family and friends there in close contact, and I have literally never heard of anything as ridiculous as this yet. No idea why this is a top voted comment.

Why is this upvoted? This is just "fearmongering" BS. The parent is generalizing from his Parents response who it seems belong to the irrational "don't get the vaccine" crowd. They are reflecting their own prejudices onto the Doctors/Nurses/Health Service Infrastructure who have done a fantastic job amidst trying circumstances.

I think many users from Reddit's /r/india are here. I recognized one user name. After turning /r/india to pretty much anti India, they are doing the same here. And that means I need to leave HN too to stay away from the negativity, just like I had to do with /r/India.

Excess deaths will need to become the standard statistic used to compare nations. Otherwise, we'll be debating "deaths FROM vs. deaths WITH COVID" and the differing statistical definitions from nation to nation. Moreover, is a death from lack of access to medical care due to the collapse of a medical system a COVID death? Is a death of despair from isolation and unemployment a COVID death?

My sense is, when the pandemic is analyzed historically, "excess deaths" will be the only salient statistic in the literature.

Unfortunately, it's still not a great comparison. Countries with lockdowns had less deaths from things like other illnesses, traffic accidents, et cetera.

It's still a better metric than some guy on science.com effectively saying "I feel this number should be much higher"

The point is to capture all those effects together. People who died in car crashes after 9/11 grounded all the planes have in some sense died from the terrorist attack, even though nothing at the scene suggests it.

Same with covid, if someone dies from undiagnosed cancer due to lockdowns, they have been affected by covid in one way or another. That's what the "with or from" comment is about, we get past it by looking at the total effect.

> Same with covid, if someone dies from undiagnosed cancer due to lockdowns, they have been affected by covid in one way or another.

If a death would have been prevented by just not having lockdowns, then tallies that it's included in being high shouldn't be used to justify having lockdowns.

> Excess deaths

Excess deaths are not just due to COVID.

But the vast majority would be.

That remains to be proven, since authorities have a large incentive to play the COVID-fear card.

What incentive would that be?

> Excess deaths are not just due to COVID.

Can you clarify what you mean by this?

What kinds of things might excess deaths be attributable to, and to what rate / ratio would you expect?

Not OP. But it's becoming increasingly clear (to me, at least) that data about reality has been lost. And no amount of "statistics", "modelling" and accounting for confounding variables will get that data back. This applies to masks, lockdowns, vaccine effectiveness and treatment effectiveness.

Even if we do get a reasonable set of that data back via statistical means, I personally wouldn't trust it. Too many things weren't tracked, people had incentives to fudge numbers, data-integrity and duplication issues, etc. As much as I know there are lots of incredibly smart and educated people working on this, I see most of this as people running around throwing spaghetti at a wall to see what sticks, some hoping to get paid for it, others hoping to save lives.

Likewise for your question. We simply don't have data or knowledge about what people did or how they behaved differently that might have caused a non-covid death to be reasonably attributed to covid. Suicide rates, anti-social behavior of children not seeing people's faces, people hiding pro-active tests, dentists visits, hiding from leaving the house and getting depression, the list is huge and specifically unconstrained.

> Not OP. But it's becoming increasingly clear (to me, at least) that data about reality has been lost.

Are you claiming that death counts are incorrect and data about deaths have been lost?

Not death-counts, but definitely data about the deaths yes. So detailed reasons for the death, specifics about the death that may be pertinent, their covid history prior to the death, how covid did or didn't affect their behavior that may have caused the death, etc.

Example: Are we keeping track of all the people that skipped a routine test because of covid lockdowns? And then, is there a subsequent record of that fact linked to every covid case of death? Or are we stuck modelling the correlation/overlap of those two data points because we track those statistics across populations separately?

Eh, I think we have enough variation in local responses that we'll be able to tease a lot of the data out with a reasonable degree of confidence.

We're living in a world full of counterfactuals, with some places mandating -- and enforcing -- mandates on various public health measures rigorously, and other places not.

The pandemic also has a time dimension. To the extent that excess deaths are from deferred treatment and missed testing, we expect them to get worse over time -- people missing a cancer screening in March 2020 shouldn't have resulted in excess deaths in April 2020, in the extreme. "Real" COVID deaths meanwhile we'd expect to follow the peaks and valleys of the infections.

It will be a lot of work, but that's what grad students are for.

> It will be a lot of work, but that's what grad students are for.

I really get the impression that a lot of these conspiracy theories are really rooted in an inability to understand how statistics work; and just how much can be legitimately derived from the data.

You can complain about everything in the world, but not about masks. Masks work, we've known they work since at least 1919. When worn correctly by large groups of people in risky environments (indoors, poor airflow), they greatly reduce transmission rates.

Everything else, you can say stuff about, vaccines have side effects, we don't know if and how much they reduce transmission, treatments are in flux, but masks are a simple and obvious solution with almost 0 side effects.

Masks with a decent seal work and studies with mannequins show this. But in real life, an airborne disease, massive gaps by the side of your nose, wet cloth, rules such as wear it to your restaurant table then take off to eat, it's a pathetic exercise at best.

Gee, I wonder if anyone thought of testing conditions similar to real life. Nah, nobody did, because everyone is stupid.

https://www.mpg.de/17916867/coronavirus-masks-risk-protectio...

https://www.nature.com/articles/d41586-020-02801-8

Even bad masks poorly worn are better than no masks, and the effect is statistically significant.

Also reducing the areas in which there is unmitigated exposure is a good thing, not a bad thing.

> Gee, I wonder if anyone thought of testing conditions similar to real life. Nah, nobody did, because everyone is stupid.

No need for that, at all.

From [1]:

> A recent British Medical Journal review looked at six, fairly porcine, studies concerning mask-wearing and estimated an impressive 53% reduction in risk. But the single randomised controlled trial estimated the smallest effect: a reduction of about 18% (-23% to 46%) in Sars-CoV-2 infections. The “heaviest” studies, an analysis of US states and a survey of about 8,000 Chinese adults in early 2020, observed rather than experimented and its editorial highlights the risks of confounding variables influencing both wearing masks and infections and the impossibility of disentangling the effects of measures fluctuating simultaneously. Indeed, this review found an identical 53% reduction from handwashing.

There is an introduction of Spiegelhalther and Masters given here[2]. It's well worth reading that BMJ article, btw.

[1] https://www.theguardian.com/theobserver/2021/nov/28/ivermect...

[2] https://statsandstories.net/media1/covid-by-the-numbers

These are all muted by omicron that has an R7-R10.

Sure, wearing a Helmut is safer but if you hit something at 90 km/hr does it matter?

So that you may be identifiable? But you're right, so many of the arguments for masks don't hold up to the context they're used in, whether that's for high Rº or untrained non-medical professionals, type of mask, public use, (probably) aerosolised virus… the list goes on.

That study proves exactly what I said.

It describes an ideal situation where people are wearing well fitting medical grade or better masks with a virus as transmissible as Delta.

From the only randomised controlled study of masks... https://bmjopen.bmj.com/content/5/4/e006577.long

"The rates of all infection outcomes were highest in the cloth mask arm, with the rate of ILI statistically significantly higher in the cloth mask arm (relative risk (RR)=13.00, 95% CI 1.69 to 100.07) compared with the medical mask arm. Cloth masks also had significantly higher rates of ILI compared with the control arm. An analysis by mask use showed ILI (RR=6.64, 95% CI 1.45 to 28.65) and laboratory-confirmed virus (RR=1.72, 95% CI 1.01 to 2.94) were significantly higher in the cloth masks group compared with the medical masks group. Penetration of cloth masks by particles was almost 97% and medical masks 44%."

Things vary wildly across the world but in most of Europe people aren't allowed to use cloth masks anymore, and haven't been for at least half a year.

They have to wear either surgical masks or FFP2.

> When worn correctly by large groups of people in risky environments (indoors, poor airflow), they greatly reduce transmission rates.

Not if the time in said environment is long. Also masks have good protection against droplets, not much against aerosols.

> We simply don't have data or knowledge about what people did or how they behaved differently that might have caused a non-covid death to be reasonably attributed to covid.

Which is somewhat tangential to my question.

Disregard any formal attribution to COVID 19 as a cause of death - direct or indirect.

Parent was suggesting all excess deaths are not just due to COVID (directly or indirectly).

Sensibly allocating excess deaths to different categories is really the question here, and I'm wondering what caveats we should be careful about.

From a terribly abstract perspective, total excess deaths within a population, year on year, prior and then during a global pandemic, should give us some useful baselines.

People are now skipping routine cancer screenings, check ups, and altogether avoiding any health care out of fear of catching covid. Its not hard to find stories of people with heart attacks not going to the hospital! Kids are missing routine vaccinations, etc. Drug overdoses are up - more deaths in SF are from ODs than Covid last time I looked. Dementia patients and those in nursing homes truly took a nose dive by completely separating them from human contact (they deteriorate rapidly with no stimulation). I imagine lots of people stopped exercising and put on loads of weight.

Sure. It doesn't matter at a national population level.

---

Excess deaths is an epidemiological measure and should be used for epidemiological purposes - targeting a public health response.

It seems like quite a few people have confused epidemiology, clinical care, and virology. Each of these fields can suggest data for the others, but can't speak definitively until the studies are actually done.

For example, some have said that omicron is more mild than other variants; but it would be more correct to say that the average experience of omicron in the population is more mild AT THIS TIME.

At this time, many people have been vaccinated or recovered from a previous infection, so without some very particular data, you cannot say that omicron is more mild.

Edit:

> you cannot say that omicron is more mild than another variant to any particular person in a clinical context.

The theory of the matter is that you take what's working and you apply it and discard what's not working. The practice of the matter is that if excess deaths goes up due to drug use increasing during lockdowns, the public health reaction is to increase lockdowns.

Excess deaths - and maybe a QALY-loss estimate - are the only way to "score" the pandemic and different countries' response to it, but I suspect there will be a lot of writing on "actual COVID deaths" versus "deaths from hospitals deferring treatment due to COVID surges" versus knock-on deaths attributable to the pandemic, lockdowns, unemployment.

We're getting so much interesting data out of this pandemic, both biological and sociological. Which public health measures were effective? Which ones were acceptable to different populations, and why? How does misinformation flow? How well can governments control the narrative?

There are going to be PhD theses built on this for the next ten, twenty years.

Deaths from hospitals differing treatment are also a great assessment of COVID impact on society. If COVID hardly hit a region, then they didn't need to delay surgeries. If COVID ravaged through the country, likely the hospitals were impacted and had to delay surgeries. All excess death is relevant.

Right, but it's important to distinguish excess deaths caused by covid and covid hostpital impacts vs excess deaths caused by lockdown behavioral changes.

Lockdowns and mandates are something a region can instrument independently, and we now have lots of data to assess the benefits/impact of different degrees and types of lockdowns and mandates in jurisdictions that were impacted by the same number of new covid cases.

And then if it turns out that lockdowns actually cause deaths due to youth suicides, they’ll be swept under the rug and be used to excuse more lockdowns.

An inconvenient truth.

https://www.nbcnews.com/news/us-news/youth-suicide-attempts-...

The Economist's excess death tracker is online here: https://www.economist.com/graphic-detail/coronavirus-excess-...

The article was last updated in October 2021, but the data in the charts is current insofar as it's available.

Their methodology is posted on Github here: https://github.com/TheEconomist/covid-19-excess-deaths-track...

They get their data from the World Mortality Dataset (https://github.com/akarlinsky/world_mortality). They claim their modeled baselines fit a linear trend for year, to account for long-term increases or decreases in mortality, and a fixed effect for each week or month up to February 2020.

I haven't dug into the details of the methodology but it appears very sensible. Of course it's very dependent on overall mortality rates having been accurately reported to begin with.

If the Economist keeps this this chart going long enough, we should expect that in countries worst affected by covid, future mortality rates will fall below the expected baseline. The simple (if somewhat morbid) logic being that in those places the most vulnerable people will have already died.

You are in luck, they just updated it today.

It doesn't sound like anyone really knows how many people exist or are born or die in India, so it's not clear that the Economist's attractive presentation of the data could have any real basis in India, without a primary data source.

Evidently the underlying dataset doesn't include China.

I do not see any data about India

It's not in the table but there is a mention in the text below:

> In India, for example, our estimates suggest that perhaps 2.3m people had died from covid-19 by the start of May 2021, compared with about 200,000 official deaths.

I find it strange China isn't in this list.

I've taken to calling them "Pandemic Deaths", ie deaths caused by the pandemic, regardless of specific source. Makes it a little harder to split hairs.

Then that should include suicides from lockdown inflicted mental distress

You mean it should include a negative adjustment for the fact that suicides fell in 2020 in the U.S.?

https://www.cdc.gov/nchs/data/vsrr/VSRR016.pdf

>Rates for persons aged 10–34 were higher in 2020 than in 2019, whereas rates for persons aged 35 and over were lower.

I highlighted the important part.

> only the 5% increase for those aged 25–34 (from 17.5 to 18.3) was significant.

Hope that helps.

It's super weird that people try to focus on this when the larger failure of policy is that car crash deaths were up more than 18%, resulting in far more absolute deaths. You are talking about a change of 320 deaths while the car crash increment was 3140 additional deaths.

Australia had a severe nationwide lockdown and suffered negative excess mortality in 2020

It does

Excess deaths per capita, please.

> Is a death of despair from isolation and unemployment a COVID death?

Since that's driven by the response to COVID, I certainly don't think it should be, because the response is a choice which differs meaningful from a death by COVID infection or comorbidity. Teasing apart the deaths directly caused by COVID from those that indirectly led from our response to COVID is important for making these decisions in the future.

India desperately needs a public institution like the NHS of the UK!

Few years ago my father died of ILD(Interstitial Lung Disease), as per the doctors. I had my doubts about the diagnosis, but I had no where to go to for second opinion. There is a private hospital syndicate in every city of India; no hospital goes against other hospitals in the same city; they will cover each others back because most of the hospitals have the same "consulting doctors". They just loot the patient's relatives by prescribing same drug but from different manufacturer. And if they realise that the patient is going to die, then the family members are pressured to take the patient home or elsewhere, this is to avoid "death count" on their register. I was literally asked to take my father home the day he died suggesting that "take him home, we will provide the ambulance and he will die on the way home so it won't be on anyone of us!"

The medicine profession in India is not just joke, it is inhumane and lacks any value for humanity.

India should have looked at some of the European countries when setting up it's healthcare, education and news media policy. Unfortunately the country has copied verbatim everything in this regard from the US!

The value of life is negative in India, unfortunately.

Clickbaity and really questionable science. The author did 0.1% sample survey of adults and asked about covid deaths in the family. I am sure a common man is no expert to tell if someone died of covid, or with covid or during covid - unless there is a medical report. I would not trust any conclusions of phone survey of such small size of general population. The paper would have more credibility if the looked at health records. I am just saying, this is hard problem and the authors of the paper did a very lousy job and with questionable standards.

Any surveys of India are going to amount to a small sample size across the entire population - India is massive.

Also, they're almost certainly undercounting the extremely poor, a very sizable group that is going to fall through the cracks no matter what standards you're trying to abide by.

There's a reason the title says "may" - there's an acknowledgement of room for error here.

The point is, India, in spite of their lack of adequate healthcare, are showing mortality rates well below other countries. I applaud the attempt to discern what the toll may truly be, flawed as it may be.

I'm sure if it was as simple as looking at public health data then they wouldn't have spent the money calling people in a survey.

I'm fine with people calling out error margins for research, but do you really have to say this is lousy clickbaity work?

Did you read the attached paper? Where did you find the 0.1% number and what do you mean by it? Do you mean that the sample size was 0.1% of Indian population? And, do you know what the minimum sample size should be for such study?

Here is the attached paper: https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

This really should not be a surprise. There are many countries that have extremely low covid case counts and deaths compared to their population and development status. And even some of the developed countries get it terribly wrong, for instance, NL, where I live has a 50% gap between the official COVID deaths and the excess deaths taken over the same period (about 21000 officially, and about 40000 when looking at excess deaths). The government publications, debates and various websites all use the first number, only the CBS, the bureau for statistics uses the second.

Let's hope somehow all kind of numbers were recorded anyway (instead of only one kind reported in mass media) and we can get a better picture of what happened in coming years and start comparing impacts, costs, benefits, disadvantages of different covid policies.

They are recorded, as part of regular, normal statistics (cause of death, etc).

Now that there are good updated numbers on excess deaths, that should be observed before saying, for example, that South Africa is not suffering much from omicron.

There are some plausible reasons to think omicron is not as dangerous as Delta, but it remains very dangerous. The gap between official numbers and excess deaths means that, unfortunately, South Africa's numbers are not a reliable indicator.

The Economist has a web page that tracks excess deaths. I'm sure there are others.

> The Economist has a web page that tracks excess deaths. I'm sure there are others.

EuroMOMO[0] is one everyone should take a look at.

The "pooled number of deaths by age group" graphs I found thought-provoking, particularly the 0-14 years and 15-44 years graphs.

[0] https://www.euromomo.eu/graphs-and-maps

Yes, https://www.economist.com/graphic-detail/coronavirus-excess-...

And for India, The Economist estimates 1.1 to 7.6 m excess deaths, implying 27 to 184 (!) infections per 100 people so far.

There is a great paper on excess mortality during the COVID-19 pandemic that also corroborates this for almost every country that tracks death count.

https://elifesciences.org/articles/69336

Interesting. Those figures actually do not agree with the amount that the Dutch CBS reports, the CBS figures are much worse than the 12% undercount reported in this paper. But the paper is from a while ago already so maybe that explains the discrepancy.

We have a post like this every month.

What incentive does the country have to under report COVID deaths? Get some glorious trophy from the west on its stellar COVID management?

Save face with people and continue winning elections? The people don't blame the government for covid.

Not to mention, the numbers are reported independently by the states, ruled by very different political parties.

> We have a post like this every month.

I'm not sure that's true. And if it were to be true, I'm not sure how it speaks against the claims made in this article?

> What incentive does the country have to under report COVID deaths? Get some glorious trophy from the west on its stellar COVID management?

I don't think TFA is trying to establish what incentives an administration may have to try to demonstrate their administration was more effective than it actually was. (Though, having written that out loud ...)

> Save face with people and continue winning elections? The people don't blame the government for covid.

I admire your optimism regarding the passive objectivity of 'the people'.

Generally, I'd expect a population (within any ersatz democracy) to evaluate the quality of its administrators based on their performance during a pandemic, and subsequently vote accordingly.

> Not to mention, the numbers are reported independently by the states, ruled by very different political parties.

How would you expect this to play out if every incumbent politician / political party in each state, was incentivised to downplay mortality rates from COVID19?

> And if it were to be true, I'm not sure how it speaks against the claims made in this article?

I'm not sure how this somehow, every month, is "hacker" "news"

> What incentive does the country have to under report COVID deaths? Get some glorious trophy from the west on its stellar COVID management?

It's about incentives and costs at every level. If the person filling out the death paperwork writes covid, does that require more work than not writing covid (paperwork, cleaning, testing, etc)? Does it bring shame to their work, their colleagues or facility or community?

What about the incentives of the "scientists" doing this study?

Why don't you elaborate on that rather than posting a leading question. I don't understand what a supposedly bias scientist living in Canada has to gain from his analysis about India?

The post above me was asking us to think about the incentives at every level of the government/state machinery.

I was merely pointing out that the we should also take the incentives of these "scientists" under consideration.

> what a supposedly bias scientist living in Canada has to gain

Just speculating: the same thing any bs vendor stands to gain. Relevance and funding..

Again, what they say could actually be true. This simply isn't rigorous enough and it boils down to "I think the number is higher"

The incentive is obvious. And by looking at partisan media outlets you can see that the political machines take it seriously.

When Trump was in power CNN had a covid death count being displayed 24/7. America's ranking in deaths was constantly mentioned.

When he lost the election it was removed.

2021 saw more covid deaths in the US than 2020. Despite vaccines being available. This received almost no coverage.

And now, in the US the cases and deatha in individual states is used for political gain by both sides. Especially when the states governor is seen as a possible political candidate.

> When Trump was in power CNN had a covid death count being displayed 24/7. America's ranking in deaths was constantly mentioned.

CNN might be partisan but I don't know that this is a good example. In 2020 COVID was new, and people were all clamoring to see new updates about it. Trump being in office was (I think) somewhat incidental.

In 2021, I think people are tired of hearing about COVID as much and as a result it didn't get the total 24/7 coverage as often. I remember a similar thing happening shortly after 9/11.

> What incentive does the country have to under report COVID deaths? Get some glorious trophy from the west on its stellar COVID management?

Local politicians may have other motives - there have been close links of COVID prevalence among the extreme poor / in slums [1], for example. Concealing COVID deaths may be an attempt to hide the fact that the government has failed to serve that community.

Additionally, there may be fiscal impacts based on COVID classification - not sure what India in specific is doing, but for example, the US covers funeral costs for COVID deaths. Three million COVID funerals are a lot of money.

> Save face with people and continue winning elections? The people don't blame the government for covid.

Oh yes they do. A large part of why Germany's Conservative-led coalition was shot down in last year's election was the handling of the coronavirus pandemic - incompetence on all levels of government as well as some conservative backbenchers taking nearly 50 million euros in sketchy mask deals [2].

In contrast, factually good management politics can earn historic landslide wins [3].

[1]: https://arxiv.org/abs/2010.06958

[2]: https://www.sueddeutsche.de/bayern/bayern-lobbyregister-poli...

[3]: https://www.bbc.com/news/world-asia-54519628

> Oh yes they do

I should have been clearer. Indians don't blame the government for COVID as evidenced by election results everywhere in the country irrespective of the political spectrum. Even places where the incumbents lost, COVID was a non issue.

This pandemic literally started with local politicians and bureaucrats, in Wuhan, lying to their central government and to the media about its effects, and grossly under-reporting deaths. This accelerated the spread, or may even mean they missed a window of opportunity to stop the spread.

It's obvious that officials have many incentives to downplay the impact, and dodge and shift blame. When local officials lie, their national government will probably repeat the lies, perhaps unknowingly

For >70% seroprevalence, with IFR 0.5 (best estimates pre-vaccination), and a population of 1.4 billion would still give around 5 million deaths. I would expect India’s IFR baseline to be lower than average western (younger population, low obesity), but surges would lead to healthcare collapse raising it.

India: 3,000,000 / 1,300,000,000 = 0.002307692307692308

Of course a lot and too much.

Germany: 120000 / 83000000 = 0.0014457831325301205

But why arguing with absolute non-comparable numbers without context? Click rate?

The point of the article is how India cases are very under-reported. If it was just about officially reported death rate of the country normalized by population, as you did in your math, there wouldn't be an article at all.

Yes, I understand, my point is, why putting this absolute number into the article title?

Because it's a pretty high number. It shows that if an epidemic breaks out in an where it cannot be controlled, the toll is high. If Andorra would have denied the existence of COVID and refused to take measures, the numbers would be a bit lower.

Germany has reported 114K deaths. India has only reported 484K deaths.

There are other aspects to the underreporting of deaths - https://www.science.org/doi/10.1126/science.abm5154

> The analyses find that India’s cumulative COVID deaths by September 2021 were 6-7 times higher than reported officially.

From back in June - https://www.npr.org/sections/goatsandsoda/2021/07/20/1018438...

> The analysis, from the Center for Global Development, a think tank in Washington, D.C., looks at the number of "excess deaths" that occurred in India between January 2020 and June 2021 — in other words, how many more people died during that period than during a similar period of time in 2019 or other recent years.

> Drawing death data from civil registries and other sources, the report came up with three estimates for undercounts. The conclusion is that between 3.4 and 4.7 million more people died in that pandemic period than would have been predicted. That's up to 10 times higher than the Indian government's official death toll of 414,482.

The story isn't about the number of deaths itself but rather the underreporting of deaths. Another possible title would be "Covid-19 believed to be underreported by 6-10x in India" - though that fails to capture the sheer toll of the death and isn't as eye catching.

There is nothing to compare it with in Germany (for example) because the number of unreported covid-19 deaths is likely very small in comparison to the totals.

I think the question is fair on "why isn't the headline that actual deaths are over 6 times reported deaths?"

That is, the absolute number is big, but it is not that that is the story. The story is how that big number relates to another number.

Because people died and it's data.

I would argue this is neither a lot nor too much. That's my personal opinion. But I would use this statistic as an argument to relax a little and allow for controlled spread of Omicron and have the pandemic become endemic finally.

"He also focused on the large cities, where death rates may have been lower than in the countryside"

Didn't the WHO estimate 120 million people would die in developing countries of hunger brought on by economic conditions of the pandemic.

This seems to meet the criteria. They also said delta was much more deadly than alpha, 2021 being more deadly than 2020, ie hunger, malnutrition, my guess is 2022 will be more deadly than 2021. Due to the same reasons, mainly in the country side, poorer communities.

The average age of registered people in India is 26, you should expect a low IFR in such a population living in a warm climate, with limited air conditioning - where you see summer spikes in Texas for example.

Unfortunately it's too easy to believe this. During the height of the delta wave, my old classmates from India were frantically sharing tips on our alumnae Whatsapp group on how to source ventilators for family members. Everybody had a parent, aunt, or uncle in the ICU. Many didn't make it. One classmate reported that in the space of a 2-week period, 10 members of his extended family had died. This is all anecdotal, but seems indicative of a situation that goes far far FAR beyond the official statistics.

Of course the daily stats aren't accurate. Not nearly so, I believe. Some nations have better capability for testing. Some nations have people wealthy enough to get tested or provide free testing, whereas others do not. In some places, knowledge of COVID-19 does not exist.

Does / did anyone really believe that the USA is the leading the death count, when countries with more questionable infrastructure and huge populations like China and India exist?

China has pretty good testing infrastructure that they use aggressively when any cases are found. Surely the residents of Xi’an are being swabbed every week now.

But China is much more developed than India.

Does China have a motivation to be honest about their figures? Did they a year ago, or two years ago? Even if they're honest now, no doubt they were first hesitant once the cat (COVID-19 in this case) got out of the bag?

China isn’t North Korea, there are plenty of information paths between China and the rest of the world that doesn’t go through the party. The party has motivation to be honest in so much that if they weren’t honest, it would be obvious very quickly that they weren’t tame they’d lose face.

Back when COVID first came out, local officials on the ground were hesitant to bring attention to what they thought was a minor problem at the time. Even when the deaths began piling up, they were still trying to hide from the central government, and even then, plenty of information was leaking to the outside, everyone knew something was up even if they weren’t sure what it was. However, once the central government got involved, well, any chance of deception at the local level was off the table. The central government doesn’t really have a boss to hide things from, so in that case, things work out for transparency (but, ya, if they thought they could hide something, they would be tempted to for face reasons).

China has pretty propaganda-heavy testing infrastructure - they do heavily publicised one-off mass testing of entire cities which the state media points to as proof of their superiority over other countries which aren't doing that, but outside of that testing appears to be extremely questionable. They've had pretty astounding incidents like not testing people hospitalized with Covid symptoms in the one province which had known, uncontrolled community spread at the time at a point when Western countries (or at least the UK) were systematically testing anyone who went near a hospital. And of course testing entire cities is going to miss recently infected people and doesn't help find cases outside the city boundary, which is likely more common than they let on...

It’s not just propaganda though. Anyone who has family or friends in China has heard gripes about how much testing they are being subject to. You can’t really dismiss them as being brainwashed with the party line or something. China has a zero COVID policy, and they are extremely aggressive about that. I guess you are arguing that these policies are just applied to the cities and not the villages?

I would never trust the Chinese government to publish accurate numbers. But their society definitely kept pre-Omicron covid cases really low. Their infrastructure to identify and quarantine cases is much better than the US's or Europe's since they are an authoritarian state.

In Egypt the minimum wage for public sector workers is EGP 2,400 per month. A rapid test costs about EGP 700. Are the case numbers accurate when even a rapid test costs as much as a third of one's monthly salary?

High-risk Covid gene more common in South Asians

They say around 60% of people from South Asian backgrounds and 15% of people of European ancestry carry the high-risk version of the gene.

They estimate the risky version of the gene is present in about 2% of people from African-Caribbean backgrounds and 1.8% of people of East Asian descent.

https://www.bbc.com/news/health-59165157

I'm surprised how little press this study got. What is the explanation for the lack of coverage I'm missing?

And? What should an average person do with this knowledge -- "may have killed"? Get petrified once again and, of course, rush to get jabbed, or get a new booster?

And then, of course, keep waiting for other scary news, and yet new solutions dictated by the governments and corrupted doctors, which will always involve jabs and boosters, and QR codes.

What's the point in this kind of knowledge? Does it impove or harm your life?

Compare the mortality rates of bubonic plague and covid, and see whether the latter is really dangerous for an average person.

Same thing you do with knowledge of more people having died in anything, say "damn, that sucks" and continue living your life, unless you're in a position to do more than that.

As for the mortality rates of bubonic plague and covid, it is quite a bit more sensible to be concerned about covid right now and want to avoid catching it.

Or... its being over reported in the west. US counts people who died with covid in the total number, maybe India is a bit more sensible in that regard.

This is so easily disproved, just look at total deaths for the period. Where do you think they are coming from?

DUIs are up, suicides are up, overdoses are up, and we keep putting off both routine and urgent medical procedures. There are people with cancer whose procedures are getting bumped because hospitals are full.

There's a meaningful difference between "died from COVID", "died with COVID", and "died due to circumstances surrounding COVID". Our excess deaths are the sum of those 3 categories.

I can tell you for a fact that "died from COVID" is not 100% of those excess deaths, because suicides and overdoses are up. I can't tell you what percentage are in each category, but this "all excess deaths are from COVID" idea is obviously untrue.

The CDC data doesn't even agree with equating excess deaths to COVID deaths. [1] Note that they call out accidents and diabetes deaths increasing 15%.

1. https://www.cdc.gov/nchs/pressroom/podcasts/2022/20220107/20...

> suicides and overdoses are up

Do you have reliable statistics on that? Quick ducking showed that suicide rates in the US rose during the 2010's, but it's hard to find more recent numbers. This article claims that suicide rates fell in 2020.

https://edition.cnn.com/2021/11/03/health/suicide-rate-2020-...

See this article. Theres an updated one with even more striking statistics.

https://www.nytimes.com/2021/11/17/health/drug-overdoses-fen...

You're responding to a question about suicide with a completely different article about opioid deaths, and the article itself attributes those deaths to the still-increasing substitution of fentanyl, which has nothing to do with lockdowns. Yet you're talking about "striking statistics" when suicides did decline.

So... a new 22k deaths by overdose, plus 2.5k new vehicular deaths, minus 1.7k suicides, vs 522k excess deaths. There were a total of 45,855 recorded deaths by suicide. ALL suicides, ALL drug overdoses, and ALL traffic fatalities TOGETHER do not add up to half of the excess deaths. You're spewing complete bullshit.

https://jamanetwork.com/journals/jama/fullarticle/2778361

Somebody else posted the overdoses, I think I stand corrected on the suicides. They're down overall, but up among adolescents and I think my brain extrapolated that out to a general increase. My apologies on the bad data!

I'm slightly suspicious of the claim that they fell, because it flies in the face of common sense and historical trends, but weirder things have happened. It just seems strange that amidst a period where people are self-reporting increases in mental health issues that the suicide rate would drop.

Suicide hotline calls were way up in 2020 [1] (Crisis Text Line was up 40%, SAMHSA hotline was up circa 500%). Major depressive disorder was up 28% in 2020, and anxiety disorders were up 26%. [2]

Perhaps there's a confounding factor here like telehealth increasing the availability of and participation in mental health treatment. Or maybe the abundance of death made people cherish life more.

The cynic in me wonders if the data was massaged to maintain support for lockdowns, but I don't have anything to substantiate that, so it's not a declaration of fact.

1. https://www.npr.org/sections/health-shots/2020/05/04/8478417...

2. https://www.statnews.com/2021/10/08/mental-health-covid19-pa...

> It just seems strange that amidst a period where people are self-reporting increases in mental health issues that the suicide rate would drop.

Maybe the lockdowns brought people closer together with roommates and family. Long commutes are awful for mental and physical health - widespread WFH cut down on that significantly. Home cooking went slightly up[1] which improves physical and mental health because of healthier eating. People had to do more outdoor recreational activities instead of going to malls and bars, and maybe that made them healthier and less likely to commit suicide.

There are so many confounding factors that it's impossible to tease them apart.

1. https://www.fooddive.com/news/survey-7-in-10-consumers-say-t...

We're way into conjecture territory at this point, so I don't mean any of this as fact.

What confuses me about theories like that is that self-reported mental health issues were up in 2020 [1]. I would have thought if it was increased closeness to roommates/family or home cooking or recreational activities then people would report higher life satisfaction and lower rates of mental health issues.

That CDC report even indicates a 4.4% rate of suicidal ideation, which is higher than normal.

It might be something we never know, but it does make me curious and skeptical. If the data really is correct, there might be advances in mental health treatment hidden here somewhere, which would be great.

1. https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm

There's a lag with suicide data. For example, in the UK, the data comes from date of registration not the date of death, and death registrations are delayed because of the huge numbers of people dying by covid.

And then there's probably a lag in deaths too - anyone working in suicide is being very cautious about the early data showing decreases or no rises, because we don't know what's coming.

Nearly everything you said is incorrect:

https://jamanetwork.com/journals/jama/fullarticle/2778234

In 2020, suicides down, cancer deaths down (because covid tends to kill cancer pages much earlier than they would've died, if at all). Some deaths are up, but no where near the numbers to outweigh covid deaths.

Interestingly, the sudden, unexplained spike in a bunch of categories for 2020 is very suspect.

Many of them are probably due to the fact that people were less likely to go to the hospital due to fear or hospitals being clogged. Patient care took a big hit, basically.

You're right on the suicides, I misremembered, my apologies.

I don't know why you're going after a straw-man here. Your own link even shows that COVID isn't anywhere near 100% of the excess deaths, it's ~70% of them. That's my only point. Excess death is not a suitable proxy for COVID deaths, because COVID deaths are only a portion of the excess deaths, sizeable though it may be.

We have excess death, a big portion of those is from COVID, but there are numerous elevated causes of death that also form a substantial portion of those excess deaths. You can't just declare that we have 500k excess deaths, and COVID is around, so COVID killed 500k people.

If someone dies because they cannot get treatment in a hospital (because it is full of covid patients) do you not consider that death a byproduct of the covid epidemic?

Fwiw a friend mine had a stage 4 breast cancer diagnosis that went undetected for months because of COVID. They have a 92% chance of dying in the next five years.

My uncle is got final approval for a heart transplant in December. We are currently unsure if there will hospital room if he gets called this week.

COVID is killing people just fine with or without the disease and the unvaccinated by choice need to stop taking up hospitals beds.

Looks at the CDC numbers. Accidental deaths are up several fold.

Can't be flu can it, because that's miraculously disappeared!

If you call all the measures against covid miraculously, sure.

And why would the flu deaths suddenly be up so much compared to earlier years? And how would it do that while we're looking for it and don't find it?

What's miraculous about flu disappearing? Most Covid countermeasures (masking, distancing) work on flu, we already had a flu vaccine, and flu is far less contagious.

I'd also imagine that if you were susceptible to the flu, you'd also be susceptible to COVID. So some of those who got COVID got that instead of the flu.

> This is so easily disproved

Oh, you were checking every dying patient?

> just look at total deaths for the period. Where do you think they are coming from?

People clearly died. Now, the question is, they died directly from covid, or died from effects of the lockdown?

It is well documented they straight up covered up covid deaths in republican states.

If you make comments like this, why not provide some link as a 'reason to believe'. For all I know you're absolutely spot on but I won't get far quoting "hogrider on HN" as a source, will I? And if your observation thus goes no further, what's the point of it?

I see many comments dissing corrupt doctors and hospitals.

I think this is really unfair and demoralizing to the many in the medical profession who have been working in the middle of this crisis often at the cost of great personal sacrifices, showing up for yet another grueling long day of work, day after day, holding consultation sessions on youtube (https://www.youtube.com/c/drkkaggarwal) by finding slivers of time, even when they themselves are infected (more than once) and would eventually succumb, braving lynching and the attitude of the government that does little apart from vapid token gestures of flower showers and setting the brutality of the police force on medical students should they complain about their lot. https://www.youtube.com/watch?v=yIrOLwQtwYo

Disclaimer: I am not in the medical profession

In rural places in India most deaths are not registered at all. There are no funeral and memorial services. Family members and neighbors get together and perform the last rituals without notifying the authorities in any way. The death is counted only when family approaches govt for death certificate which is needed for bank accounts, transferring real-estate or any other govt formalities that needs to be closed. It is hard to get the exact count of deaths with such an unorganized system. I don't deny govt conspiracy to lower the numbers but I think majority of deaths didn't even reach govt books.

Yeah, but is it surprising? Government would like to put only confirmed cases in covid death and non-confirmed ones in 'other' category. Media would like to put unconfirmed cause of death in covid category and hence the higher number.

Somehow there is this assumption that higher number would lead to outrage and cause changes for the better healthcare infrastructure. I for one can't not agree that with current per capita income level and tax revenues an order of magnitude improvement in healthcare infra is possible.

I live in the Bay Area. I just visited my parents who caught Covid in November. Nobody wants to get tested in India. If you test positive, the local Government gets notified of it and they harass you. My father had GI issues so he was in the hospital for a week (and hated it), my Mom had mild symptoms. She had to get a doctor's note to stay home. Even then, multiple people harassed her at home ("we have to sanitize the home" - take money and throw random chemicals).

I spent Christmas to Jan 7th in India. I carried a bunch of antigen tests and delayed my RT PCR tests till the last day. Did not leave home, just spent time with parents.

In general, nobody cares about Covid in India anymore. Every family has lost one or more family members (my family lost 7) during Delta in April - July 2021, so there is a general resignation. The general Hindu / Indian resignation to karma kicks in and they have largely moved on.

My parents felt comfortable doing antigen tests with me and not a RT PCR - and I don't blame them.

I struggled quite a bit. Relied heavily on Gerson Duckbill N95 masks. Not surprised by these numbers at all.

We (US) are at 850k. No way India is doing better than us per capita.

The Omicron new cases reported surge on worldometers is up to 800,000 new cases PER DAY, this is more than 300% higher than at any point in COVID ever.

The death curves trail the new cases by a bit, so we'll see. But holy cow is something up. I really really hope Omicron has substantially less mortality.

"I think all governments want to downplay the degree of deaths”

That is really unsupported. There is also the opposite desire, e.g. to justify unpopular covid control measures.

Hospitals definitely have a financial incentive to classify any death "with covid" as a death "from covid."

I remember when I saw the first reports about Covid in India in 2020 locals on social media were suggesting that despite the reported mass deaths the unofficial numbers would likely be significantly higher because only people who actually made it to hospitals were counted and many people dying in rural/poorer areas (where tests or even medical care weren't widely available) were cremated without a diagnosis.

I'm not at all surprised to see that this may still be the case now a year an a half later.

We seem not surprised that India could undercount millions of deaths, but my impression is that China's near-perfect suppression of all variants of the virus in their population of 1.4 billion is taken at face value. Is it not possible that China is also covering up their real death toll?

Of course not, there's no incentive for China to lie. None at all, they first established the virus existence, where it came from and took appropriate action.

What else do you expect? /s

The Chinese state has the ability and means to do what few other countries can - lock down millions of people and mean a lockdown where people are confined to their homes.

There are also millions of Chinese citizens outside china. If China were hiding millions of deaths, we would have heard about it.

I've heard anecdotally by a Chinese immigrant that many people back home had family members that mysteriously didn't make it.

Just the usual "Nothing to see here, move along" that's common to authoritarian regimes who would rather sweep things under the rug than admit failure.

I can accept their extreme methods could potentially suppress outbreaks. But could anything really work this well? And shouldn't it have a breaking point - at some point you run into something like omicron that spreads so quickly it has to overwhelm your ability to track and trace and you can't make testing supplies fast enough or hire people to police it fast enough.

And if you're not being given good information, how does an overseas Chinese individual spot anything amiss? Their parent or grandparent dies in China. Well, that's not unusual in itself. It's only unusual if it is happening more frequently than it should, and if that information isn't being made available, how could they know?

COVID is rampant in the United States, yet it doesn't seem like my friends parents and grandparents are dying at any particularly worrying rate - and yet overall, they absolutely are. If the data weren't there, it would be hard to notice anything were happening at all. You could lie to me and make me think supply chain issues were caused by something else, that my occasionally crowded local hospital was seeing a bad flu season, etc.

People have extended social circles in PRC that span hundreds to thousands depending on connections. Family & friends, their acquaintances, coworkers etc. No one I know in PRC has or knows of anyone that's tested positive. Reports are similar from other PRC diaspora as well. Including business owners with thousands of employees.

Whereas every Chinese diaspora knows of someone getting covid abroad. Every Indian / Pakistani I know have lost people during delta wave back home. Everyone I know in west knows someone whose tested positive during omicron. And this is with noticeable lockdowns, congested hospitals, burning dead bodies on the streets. Versus PRC that has been open since mid 2020 except for targeted lockdowns.

There's also other indicators like import case statistics that many countries maintained into 2020. The TLDR is while flights from North America / EU and other regions were transporting massive amounts covid positives in repatriation flights early in the pandemic, PRC exported very little in the months after Hubei lockdown and then as far as I know, none.

Probably not, people would "notice the bodies piling up in the corner" and change their behavior if friends and relatives start dying and you'd see that in terms of how full restaurants are, etc. It's not like the Hunanese government was all that good at keeping the scale of the original outbreak secret.

I was seeing the image of the funeral pyres, and was thinking that this is the easiest way to make a body disappear.

As 70-85% of Indians are Hindus and they burn their deceased, if someone wanted to count total number of deaths by dead bodies, they would not be able to.

All bodies are gone.

Births and deaths are registered with the government.

can't burn in the burning grounds unless a death certificate is produced

Well, there were stories of unburned bodies found floating in the rivers, there are many who couldn't afford the cremation. There's the official rule (registration needed) and the reality on the ground: insufficient government service coverage leading to undocumented births and deaths.

Even China has a lot of undocumented births, because of the 1-child-policy: https://thediplomat.com/2015/03/chinas-hidden-children/ (IMO the accepted "legend" that there were a lot of abortions just demonized the Chinese, whether nefariously or on purpose)

You can't just cremate a corpse by throwing it on some wood and pouring gasoline on it. Even proper cremation still leaves behind some "scrap" (of course medical devices and prosthetics, but also some bones can be very difficult to fully turn to ashes).

After the Spanish Flu and now COVID-19, I think it's time we admit that deaths in a pandemic are fully susceptible to Goodhart's Law. It may be best if each country's number of deaths is kept under wraps until everything is over.

Wow Look at China! 1000 people died on April 15th, 2020 and then not a single death.

Imagine such an advanced country, we should all move there or adopt their form of government!

https://news.ycombinator.com/item?id=29873938

Yeah, communism for the win, we want more Tienanmen square stuff and concentration camps for certain minority groups.

I think you missed the sarcasm.

Enough information leaks out of China that we can be fairly confident they at least don't have massive waves of deaths and overwhelmed hospitals.

Totalitarian governments can do better in this sort of scenario, for a while. It's not a great trade-off 99.9% of the time, but there's a reason wars, disaster recovery, etc. tend to be fought by executive fiat rather than democratic decision making.

The only source of their stats is the party. It's part of their politics to downplay the bad and show off the good. They have nothing to gain by showing to their population that they are weak in front of this pandemic.

The only source of statistics is the party, but that's not the only source of information. If the healthcare system was collapsing in China due to COVID megadeaths, we'd know.

Whether the healthcare system "collapses" has to do with how hard it actually tries. We did get reports early on that the crematoriums were working far more than usual.

> We did get reports early on that the crematoriums were working far more than usual.

That's precisely what I'm talking about, right? That information got out; the world was able to see information indicating a higher death toll that official numbers implied, despite attempts to keep it quiet.

There are only 22 countries that do not have diplomatic missions to China.

The remaining countries have embassies, counsel general offices, and similar throughout China. Beijing has 172 embassies plus missions from the EU, African Union, Arab League, and the UN.

24 other cities throughout China have counsel general offices [1].

All of these have extensive contact with the local populations, and all of them have secure means of communication back to the home governments.

There are a large number of foreigners from a wide variety of countries living in China for business reasons, or visiting China for business reasons, who have extensive contact with the local populations.

The party might be able to control the domestic flow of information sufficiently to keep their own people in the dark, but for events with wide impact such as epidemics and pandemics they can't stop other governments from finding out through reports from all those foreigners.

Conclusion: either China's death rates are actually quite low from COVID, or they are not and the other governments (including the US, all of the EU, Japan, Australia, Korea) know this but are keeping it secret themselves as are the numerous non-government workers who regular are in China.

[1] https://en.wikipedia.org/wiki/List_of_diplomatic_missions_in...

> The analyses find that India’s cumulative COVID deaths by September 2021 were 6-7 times higher than reported officially.

The officially reported number of Covid deaths are ~483k. So according to this analysis, the real number of deaths should be closer to 3.3 million.

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