12 ms·

Italy has an older population, hence more susceptible to deaths and spreading of the virus: - Average age of death due to Coronavirus in Italy is 82 [1] - In

Italy has an older population, hence more susceptible to deaths and spreading of the virus: - Average age of death due to Coronavirus in Italy is 82 [1] - In Italy, 3.65% of the population is 80 or older [2]. - In Korea, 1.75% of the population is 80 or older [3] [1] https://www.epicentro.iss.it/coronavirus/bollettino/covid-19-infografica_eng.pdf https://www.epicentro.iss.it/coronavirus/bollettino/covid-19... [2] https://www.populationpyramid.net/italy/2019/ https://www.populationpyramid.net/italy/2019/ [3] https://www.populationpyramid.net/republic-of-korea/2019/ https://www.populationpyramid.net/republic-of-korea/2019/

T-A 7y ago
3.65% / 1.75% ~ 2.09, so the difference in age profile might explain a factor 2 in the mortality ratio of Italy vs South Korea. The actual ratio is currently 7.9: 827 out of 12462 cases in Italy (6.6%), 66 out of 7869 cases in South Korea (0.84%).
- rwcarlsen 7y ago
  Maybe co-morbidities or general health per age is better in S. Korea.
  - UncleOxidant 7y ago
    It's all the kimchi.
    - Ghjklov 7y ago
      How long can the virus survive in a container of kimchi? I truly would like to know.
- skmurphy 7y ago
  If you factor in collapse of medical services -- Italy ran out of ventilators / ICU beds--the gap becomes clearer. You have to look at over 60 as more likely to be hospitalized, putting strain on medical system.
  - zaroth 7y ago
    This doesn’t account for it because South Korea didn’t even have the number of serious cases that Italy has. The real answer is simply that the number of tests is not equal to the number of cases. The number of positive tests is a factor of the number of tests done, and how selective the testing was allowed to be. It is only loosely related to the number of infected people (technically it is the lower bound).
    - fnord123 7y ago
      >The real answer is simply that the number of tests is not equal to the number of cases. Ye olde "3.6 roentgens. Not great but not terrible" factor. https://m.youtube.com/watch?v=Mg5HOnq7zD0 https://m.youtube.com/watch?v=Mg5HOnq7zD0
    - skmurphy 7y ago
      My comment was directed at age structure of population accounting for difference in mortality, complicated by effective collapse of medical care in certain regions of Italy that meant severe cases that could have been managed because critical and then fatal without ventilation support.
    - RobertoG 7y ago
      >>"The real answer is simply that the number of tests is not equal to the number of cases." I think you are right, but, assuming all the deaths are reported, the obvious implication is that the mortality rate is a lot lower than 3% If fact, looking to Germany, I would say that it's around 0.2, 0.3 % That would be the good news, the bad news is that it's extremely contagious, probably because nobody is immune to this thing. Of course, I'm only a random guy in the Internet, so take it with a grain of salt.
      - gpderetta 7y ago
        I think the current most credible estimate is 0.8%-1%. That's what the UK government has been planning for, for example.
- Retric 7y ago
  A large number of South Korea infections are even younger due to how it spread. Italy: Above 80: 1,532 (18.4)% vs age 20-29: 296 (0.0)% South Korea: Above 80: 243 (3.1)% age 20-29: 2,261 (28.7)% https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_South_Korea https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_S... https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Italy https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I... Of note, neither country has had anyone under 30 die. Deaths in the 80+ age range are 8.23% in South Korea and 13.2% in Italy. PS: South Korea saw 2 deaths under age 50 where Italy has seen 1. So this age is by far the largest factor.
  - nostromo 7y ago
    I'm not sure how the media should report on deaths over 80, or even over 90. It's not that old people aren't worthy of protection, but when you're 85 in the US you have a 10% chance of dying in the next year for any and all reasons. So saying this disease kills 15% (for example) of 80+ year olds without context sounds horrific, but contextualized in the actual risks of just being very old to begin with, sounds much less scary. If Italy, for example, were to report on the number of fatal infections in people younger than the natural life expectancy, the fatality rate would drop in half.
    - black_puppydog 7y ago
      you could also say that for people 80 and above, this epidemic will more than double their already significant chances of dying this year...
      - toolz 7y ago
        That's a really hard thing to say this early. For all we know many 80+ people are asymptomatic and most older people aren't negatively affected at all by covid 19. It seems really dangerous to conflate actual mortality rate with mortality rate among the confirmed cases. Those numbers will be drastically different with diseases that have many asymptomatic carriers.
- ghostbrainalpha 7y ago
  Except if the increased rate of death is from the medical system being over capacity.... this still wouldn't be a good test of quality of their responses, but more just revealing the capacity of their medical system.
- krzyk 7y ago
  The infection in Italy started in hospital or in retirement home (I don't remember which), so the first infected were people > 70. In South Korea it started in a cult, where most people were young < 40, and moslty women (which have less CFR than man for COVID-19). And the rest was South Korean lack of regard for privacy (they have a map for each case where you can trace where and when a given infected person was - so you can check if you were near him/her) and technological superiority.
  - T-A 7y ago
    > The infection in Italy started in hospital or in retirement home (I don't remember which), so the first infected were people > 70. Italy's patient #1 is 38 (see the article). Patient #0 has not been identified. > In South Korea it started in a cult, where most people were young < 40 That would be the Shincheonji Church of Jesus: https://en.wikipedia.org/wiki/Shincheonji_Church_of_Jesus#Association_to_the_coronavirus_outbreak https://en.wikipedia.org/wiki/Shincheonji_Church_of_Jesus#As... I don't know what their age profile is, but the outbreak began with a 61-year old ("Patient 31"), and several people mentioned here are above 50 (the founder is 88): https://www.nytimes.com/2020/03/10/world/asia/south-korea-coronavirus-shincheonji.html https://www.nytimes.com/2020/03/10/world/asia/south-korea-co...
    - kijin 7y ago
      About 80% of South Korean cases were less than 60 years old, with a peak in the 20s [1]. It is widely rumored that Shincheonji prefers to recruit young people who are easier to exploit. [1] https://coronaboard.kr/#age-card https://coronaboard.kr/#age-card
  - deleted 7y ago
    [deleted]
- elorant 7y ago
  My guess is that there are a lot of unreported cases in Italy while in Korea authorities seem to ran more vigorously tests. So the latter might have much more accurate numbers than the former.
  - tomcooks 7y ago
    More rigorous tests than Italy, seriously?
    - Benmcdonald__ 7y ago
      Yes and yes
    - pbourke 7y ago
      > More rigorous tests than Italy, seriously? SK leads the world. 3,692 / 1MM pop vs Italy 826 / 1MM pop. Source: https://www.vox.com/science-and-health/2020/3/12/21175034/coronavirus-covid-19-testing-usa https://www.vox.com/science-and-health/2020/3/12/21175034/co...
    - hcknwscommenter 7y ago
      You say "rigorous tests" OP said "vigorously tests". Very different meaning. The test in both countries is essentially the same, and thus the same rigor (in terms of sensitivity and specificity). The vigor by which the testing was performed (in terms of #people tested as a % of total pop) is WAY WAY higher in S. Korea.
    - bane 7y ago
      South Korea used to be at about the same development index as Italy maybe...20 years ago? Today it's tied with Israel (as of 2018) and above Spain, France, and Italy. The PPP is also about 10% higher than Italy and has about half the unemployment rate. Most importantly it has one of the most advanced healthcare systems in the world. https://en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare https://en.wikipedia.org/wiki/List_of_countries_by_quality_o...
      - 7y ago
- _-___________-_ 7y ago
  Please don't conflate case fatality rate with actual fatality rate. South Korea has almost certainly just had more time and "medical bandwidth" to find more of the minor and asymptomatic infections that make up potentially 80%+ of the total, and turn them into cases by diagnosing them.
  - superpermutat0r 7y ago
    I thought that actual fatality rate is always higher than measured in case of exponentially growing pandemics. Just imagine the case where it takes 20 days for people to die. Your calculations of fatality rate this early in the disease would be conservative.
    - _-___________-_ 7y ago
      A far bigger factor in a disease like this, where 80%+ of people have mild illness, is all the people that were never recorded as cases because their symptoms were too mild or were non-existent. People want to use CFR as a measure of how worried they should be, or as some kind of comparison between countries, and it's totally inappropriate for either purpose.
      - superpermutat0r 7y ago
        If they are never recorded does that not mean they infect more people and that results in sicker population creating more burden to the health system - resulting in more deaths? The statistics always seem to go up no matter what kind of interpretation.
        _-___________-_ 7y ago
        The point is that deaths - the numerator of the case fatality rate - are basically always recorded, whereas cases - the denominator of the case fatality rate - represent only a subset of the people that are infected. When the health system is severely overburdened, that subset because a smaller and smaller proportion, as scarce resources are used for testing of people presenting at hospitals rather than population-based testing. People who are asymptomatic or have minor symptoms don't present at a hospital, so they don't get tested, so they never get recorded as a case (which, by definition, requires a test and a diagnosis). The real population fatality rates are guaranteed to be lower than the CFR unless you believe that every person who is infected is being tested and diagnosed, and it's my opinion that they'll be much lower.
- petre 7y ago
  It's also easier to leave Italy and spread the disease because it doesn't have a DMZ in the North and lots of migrant workers and other EU nationals, free to leave at any time. Some have fled the lockdown using ferries through Croatia or Greece and then on to their home countries. When the North was quarantined, many Italians irresponsibly fled to the South, prompting the authorities to issue a country wide lockdown. Good luck trying to escape by ferry from Korea to Japan, Russia or China in the middle of a pandemic. North Korea is out of the question. Also Koreans are likely to obey the rules imposed during a healty emergency crisis (they also has a MERS epidemic in 2015), while Italians are more likely dismiss them as nonsense.
tunesmith 7y ago
More susceptible to deaths I understand, but is an older population more susceptible to spreading of the virus? Is probability of "infection given exposure" (as opposed to being a carrier) also greater with age? (I know that's true for kids, but hadn't heard if that trend continues across all age ranges.)
Leary 7y ago
It's not just the deaths now, but the trajectory. Korea has this under control, Italy won't for another 1-2 weeks.
taeric 7y ago
The part of Italy hit also has air quality, per aqi searches, that is comparable to the region in China that was hit hard. Have people looked that it is not age, but baseline damage to your lungs that is the main factor in serious cases? Older people will have more exposure to local air pollution, just from having lived longer. That existing damage can be what contributes to complications, right?
- neuronic 7y ago
  I wonder if and how long-term smokers are skewing the stats.
  - taeric 7y ago
    That hinges a lot on if I'm right. Which is still unlikely, as much as I'm find of my own opinions. :)
- Camillo 7y ago
  Source? Right now air in Wuhan [0] seems to be significantly worse than Milan [1]. Both cities are under some level of quarantine, but it has been stricter and going on for much longer in Wuhan. Chinese sources say that the air in Wuhan is much better than it was before the quarantine. We can assume that the difference between the two cities would be even larger during normal activity. Edit: Milan is much closer to Seoul [2] than to Wuhan. [0]: https://www.airvisual.com/china/hubei/wuhan https://www.airvisual.com/china/hubei/wuhan [1]: https://www.airvisual.com/italy/lombardy/milano https://www.airvisual.com/italy/lombardy/milano [2]: https://www.airvisual.com/south-korea/seoul https://www.airvisual.com/south-korea/seoul
  - taeric 7y ago
    I used those sites and looked at daily historical. I grant that China was strictly worse. But Milan is strictly worse than everywhere else getting hit. Edit: and the air being better after the quarantine would support my hypothesis. It wasn't that that helped, but the better air. (Which is still very bad)
humaniania 7y ago
https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp... SK has 12 hospital beds per 1,000 people vs 3 in Italy.
codeulike 7y ago
A big part of the answer is in the article: SK have tested 5 times more people so picked up more mild cases in their stats
- 3JPLW 7y ago
  Yeah, but they've also been able to significantly slow the spread, growing at what looks to be closer to 10% day-over-day (doubling every week). Most everywhere else is seeing 25-35% (doubling every 2-3 days).
  - xorfish 7y ago
    New cases in SK are on a downward trend for around 10 days now. They achieved a reproduction value that is quite a bit below for at least the last 3 weeks.
  - kaitai 7y ago
    These go hand in hand. In the US we cannot slow the spread because we refuse to test anyone who doesn't need acute care or who doesn't have documented contact with travelers or foreign nationals. The research from Helen Chu's lab at University of Washington shows that this means we missed the start of community transmission entirely in Washington. Here, there are health care workers who can't get a test! They deal with people with significant health problems every day and could be spreading it all over -- but because they didn't travel, they can't get a test.
    - mjevans 7y ago
      The massive shortage of tests doesn't help either. There's plenty of blame, but I'd assign most of it to US politics.
lmilcin 7y ago
I can understand how it is more susceptible to death but I don't see the connection with spreading. Old people tend to move about much less and none of the references support that older people are in any way more responsible for spreading the virus. I think much better explanation would be that Italy has a lot of tourism, it is basically a tourism hub for northern and eastern Europe. Tourism == a lot of people moving about, very frequently, then leaving the country. Almost all initial cases here in Poland seem to be connected with somebody coming back from vacation in Italy.
ivanhoe 7y ago
There are also cultural differences, Italians like to hang out in groups, outside, personal space is much smaller, people hug and kiss and touch all the time. Also they're not really the most disciplined nation, lots of them simply ignored the safety rules, continued to go out, there were even some cases where infected people run away from quarantine. And additionally the spread of virus is not uniform as it depends on social circles, so it's very hard to compare the situations using just general population stats. In South Korea one of the early patients infected more than a thousand other people, while some patients infected no one else or only a few. It's totally random event, and a few patients like that can create a huge differences in the spread of the disease. In Italy they've had the bad luck that early on virus got into hospitals and retirement homes, so the most sensitive population was massively affected.
- m_mueller 7y ago
  I think there is another factor as well: have a look at train stations during rush hour on East Asia currently vs. Europe. 1) the density is significantly higher but 2) nearly everyone is wearing surgical masks now. I think that mask wearing is an effective measure to slow down the spread, acting at the sender side rather than the receiver (which Western people tend to focus on). You can see a similarly lower exponential spread in other Asian nations compared to Europe and I think that masks plus a lesser degree of body contact can explain this largely.
  - mantap 7y ago
    Part of the problem is that pretty much everybody in East Asia already owned at least one mask. In Europe pretty much nobody owned a mask prior to COVID-19. And masks have been sold out for weeks. If masks were easily available you'd see people wearing them I'm sure.
    - WildGreenLeave 7y ago
      At least in The Netherlands there are still plenty of masks to be found. You won't find the surgical masks anymore but masks for construction work is still plenty available. I think most europeans look down on wearing masks as something stupid, most europeans also think hand sanitizer is stupid. (This just applies to my dutch family and friends over there, I am currently in Thailand and always wearing a mask and hand sanitizer)
bad_user 7y ago
No, the far more likely explanation is that the total number of cases reported for Italy don't reflect reality. Because they are overwhelmed Italian hospitals basically send people home if they have a fever or other symptoms with no test administered, instructed to come back in case the symptoms worsen, only people having trouble breathing being admitted in the ICU. Italy could easily have in reality 10 times the number of reported total cases or more.
- leoedin 7y ago
  Just look at how many people from other other countries got infected in northern Italy a few weeks ago. Italy had diagnosed a few hundred cases, yet suddenly hundreds and hundreds of people who were in the area and have returned home now have it in other countries. It's clearly far more highly prevalent than testing suggests.
- lou1306 7y ago
  > Because they are overwhelmed Italian hospitals basically send people home if they have a fever or other symptoms with no test administered, Sources, please. > only people having trouble breathing being admitted in the ICU. Well, why would you put someone without respiratory failure in an ICU to egin with? Also, Italy performs 1 test per 1000 people [1]. Surely there are more cases than the reported ones, but 10 times? I am no statistician, but wouldn't it require extreme bad luck to miss so many cases with such extensive testing? [1] https://www.worldometers.info/coronavirus/covid-19-testing/ https://www.worldometers.info/coronavirus/covid-19-testing/
  - imtringued 7y ago
    Did they test random people or only people with symptoms? If the latter then your distribution is heavily biased and a 10x difference is not an outlier, it's the expected outcome.
    - makomk 7y ago
      According to those stats 14% of people tested were positive and of those, about half had to be admitted to hospital. It's clearly very far from a random sample.
virtualritz 7y ago
Something that is not much talked about is the fact that many people apparently die from a sepsis (bacterial) that is caused by the primary infection. In Italy, it is almost customary to pop medication that contains antibiotics whenever you feel a bit under the weather. I lived in Italy, I experienced this first hand even from my more educated friends. Because of this Italians have an antibiotics resistance of 26.8% [1]. I do not have data for South Korea but in Germany, where I live, antibiotics are not available over the counter. You always need to see a professional and then they are much more expensive that e.g. in Italy. The resistance rate here in Germany is 0.4% [1]. That's 67 times (!) lower than in Italy. [1] https://atlas.ecdc.europa.eu/public/index.aspx?Dataset=27&HealthTopic=4 https://atlas.ecdc.europa.eu/public/index.aspx?Dataset=27&He...
- J-dawg 7y ago
  This is fascinating, I didn't know that data about antibiotic resistance was available like this, and definitely had no idea there was such huge variation between countries. Surely this should be considered a major public health emergency in itself? Are the countries with high percentages taking steps to limit antibiotic use? Coming from the UK the idea of letting people buy antibiotics as easily as painkillers seems crazy. And what the hell is going on in Greece!?
  - tw202003131459 7y ago
    > Surely this should be considered a major public health emergency in itself? Indeed. There's an episode of Sam Harris's podcast with Matt MCarthy from last summer. The episode title is The Plague Years, and they go into quite a bit of detail on this sort of thing and ruminate about how low on the radar it is for most people (if it even registers at all), despite the seriousness of the situation.
- mightypirate 7y ago
  antibiotics are not available over the counter in Italy

T-A 7y ago

3.65% / 1.75% ~ 2.09, so the difference in age profile might explain a factor 2 in the mortality ratio of Italy vs South Korea. The actual ratio is currently 7.9: 827 out of 12462 cases in Italy (6.6%), 66 out of 7869 cases in South Korea (0.84%).

rwcarlsen 7y ago
Maybe co-morbidities or general health per age is better in S. Korea.
- UncleOxidant 7y ago
  It's all the kimchi.
  - Ghjklov 7y ago
    How long can the virus survive in a container of kimchi? I truly would like to know.
skmurphy 7y ago
If you factor in collapse of medical services -- Italy ran out of ventilators / ICU beds--the gap becomes clearer. You have to look at over 60 as more likely to be hospitalized, putting strain on medical system.
- zaroth 7y ago
  This doesn’t account for it because South Korea didn’t even have the number of serious cases that Italy has. The real answer is simply that the number of tests is not equal to the number of cases. The number of positive tests is a factor of the number of tests done, and how selective the testing was allowed to be. It is only loosely related to the number of infected people (technically it is the lower bound).
  - fnord123 7y ago
    >The real answer is simply that the number of tests is not equal to the number of cases. Ye olde "3.6 roentgens. Not great but not terrible" factor. https://m.youtube.com/watch?v=Mg5HOnq7zD0 https://m.youtube.com/watch?v=Mg5HOnq7zD0
  - skmurphy 7y ago
    My comment was directed at age structure of population accounting for difference in mortality, complicated by effective collapse of medical care in certain regions of Italy that meant severe cases that could have been managed because critical and then fatal without ventilation support.
  - RobertoG 7y ago
    >>"The real answer is simply that the number of tests is not equal to the number of cases." I think you are right, but, assuming all the deaths are reported, the obvious implication is that the mortality rate is a lot lower than 3% If fact, looking to Germany, I would say that it's around 0.2, 0.3 % That would be the good news, the bad news is that it's extremely contagious, probably because nobody is immune to this thing. Of course, I'm only a random guy in the Internet, so take it with a grain of salt.
    - gpderetta 7y ago
      I think the current most credible estimate is 0.8%-1%. That's what the UK government has been planning for, for example.
Retric 7y ago
A large number of South Korea infections are even younger due to how it spread. Italy: Above 80: 1,532 (18.4)% vs age 20-29: 296 (0.0)% South Korea: Above 80: 243 (3.1)% age 20-29: 2,261 (28.7)% https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_South_Korea https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_S... https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Italy https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I... Of note, neither country has had anyone under 30 die. Deaths in the 80+ age range are 8.23% in South Korea and 13.2% in Italy. PS: South Korea saw 2 deaths under age 50 where Italy has seen 1. So this age is by far the largest factor.
- nostromo 7y ago
  I'm not sure how the media should report on deaths over 80, or even over 90. It's not that old people aren't worthy of protection, but when you're 85 in the US you have a 10% chance of dying in the next year for any and all reasons. So saying this disease kills 15% (for example) of 80+ year olds without context sounds horrific, but contextualized in the actual risks of just being very old to begin with, sounds much less scary. If Italy, for example, were to report on the number of fatal infections in people younger than the natural life expectancy, the fatality rate would drop in half.
  - black_puppydog 7y ago
    you could also say that for people 80 and above, this epidemic will more than double their already significant chances of dying this year...
    - toolz 7y ago
      That's a really hard thing to say this early. For all we know many 80+ people are asymptomatic and most older people aren't negatively affected at all by covid 19. It seems really dangerous to conflate actual mortality rate with mortality rate among the confirmed cases. Those numbers will be drastically different with diseases that have many asymptomatic carriers.
ghostbrainalpha 7y ago
Except if the increased rate of death is from the medical system being over capacity.... this still wouldn't be a good test of quality of their responses, but more just revealing the capacity of their medical system.
krzyk 7y ago
The infection in Italy started in hospital or in retirement home (I don't remember which), so the first infected were people > 70. In South Korea it started in a cult, where most people were young < 40, and moslty women (which have less CFR than man for COVID-19). And the rest was South Korean lack of regard for privacy (they have a map for each case where you can trace where and when a given infected person was - so you can check if you were near him/her) and technological superiority.
- T-A 7y ago
  > The infection in Italy started in hospital or in retirement home (I don't remember which), so the first infected were people > 70. Italy's patient #1 is 38 (see the article). Patient #0 has not been identified. > In South Korea it started in a cult, where most people were young < 40 That would be the Shincheonji Church of Jesus: https://en.wikipedia.org/wiki/Shincheonji_Church_of_Jesus#Association_to_the_coronavirus_outbreak https://en.wikipedia.org/wiki/Shincheonji_Church_of_Jesus#As... I don't know what their age profile is, but the outbreak began with a 61-year old ("Patient 31"), and several people mentioned here are above 50 (the founder is 88): https://www.nytimes.com/2020/03/10/world/asia/south-korea-coronavirus-shincheonji.html https://www.nytimes.com/2020/03/10/world/asia/south-korea-co...
  - kijin 7y ago
    About 80% of South Korean cases were less than 60 years old, with a peak in the 20s [1]. It is widely rumored that Shincheonji prefers to recruit young people who are easier to exploit. [1] https://coronaboard.kr/#age-card https://coronaboard.kr/#age-card
- deleted 7y ago
  [deleted]
elorant 7y ago
My guess is that there are a lot of unreported cases in Italy while in Korea authorities seem to ran more vigorously tests. So the latter might have much more accurate numbers than the former.
- tomcooks 7y ago
  More rigorous tests than Italy, seriously?
  - Benmcdonald__ 7y ago
    Yes and yes
  - pbourke 7y ago
    > More rigorous tests than Italy, seriously? SK leads the world. 3,692 / 1MM pop vs Italy 826 / 1MM pop. Source: https://www.vox.com/science-and-health/2020/3/12/21175034/coronavirus-covid-19-testing-usa https://www.vox.com/science-and-health/2020/3/12/21175034/co...
  - hcknwscommenter 7y ago
    You say "rigorous tests" OP said "vigorously tests". Very different meaning. The test in both countries is essentially the same, and thus the same rigor (in terms of sensitivity and specificity). The vigor by which the testing was performed (in terms of #people tested as a % of total pop) is WAY WAY higher in S. Korea.
  - bane 7y ago
    South Korea used to be at about the same development index as Italy maybe...20 years ago? Today it's tied with Israel (as of 2018) and above Spain, France, and Italy. The PPP is also about 10% higher than Italy and has about half the unemployment rate. Most importantly it has one of the most advanced healthcare systems in the world. https://en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare https://en.wikipedia.org/wiki/List_of_countries_by_quality_o...
    - 7y ago
_-___________-_ 7y ago
Please don't conflate case fatality rate with actual fatality rate. South Korea has almost certainly just had more time and "medical bandwidth" to find more of the minor and asymptomatic infections that make up potentially 80%+ of the total, and turn them into cases by diagnosing them.
- superpermutat0r 7y ago
  I thought that actual fatality rate is always higher than measured in case of exponentially growing pandemics. Just imagine the case where it takes 20 days for people to die. Your calculations of fatality rate this early in the disease would be conservative.
  - _-___________-_ 7y ago
    A far bigger factor in a disease like this, where 80%+ of people have mild illness, is all the people that were never recorded as cases because their symptoms were too mild or were non-existent. People want to use CFR as a measure of how worried they should be, or as some kind of comparison between countries, and it's totally inappropriate for either purpose.
    - superpermutat0r 7y ago
      If they are never recorded does that not mean they infect more people and that results in sicker population creating more burden to the health system - resulting in more deaths? The statistics always seem to go up no matter what kind of interpretation.
      - _-___________-_ 7y ago
        The point is that deaths - the numerator of the case fatality rate - are basically always recorded, whereas cases - the denominator of the case fatality rate - represent only a subset of the people that are infected. When the health system is severely overburdened, that subset because a smaller and smaller proportion, as scarce resources are used for testing of people presenting at hospitals rather than population-based testing. People who are asymptomatic or have minor symptoms don't present at a hospital, so they don't get tested, so they never get recorded as a case (which, by definition, requires a test and a diagnosis). The real population fatality rates are guaranteed to be lower than the CFR unless you believe that every person who is infected is being tested and diagnosed, and it's my opinion that they'll be much lower.
petre 7y ago
It's also easier to leave Italy and spread the disease because it doesn't have a DMZ in the North and lots of migrant workers and other EU nationals, free to leave at any time. Some have fled the lockdown using ferries through Croatia or Greece and then on to their home countries. When the North was quarantined, many Italians irresponsibly fled to the South, prompting the authorities to issue a country wide lockdown. Good luck trying to escape by ferry from Korea to Japan, Russia or China in the middle of a pandemic. North Korea is out of the question. Also Koreans are likely to obey the rules imposed during a healty emergency crisis (they also has a MERS epidemic in 2015), while Italians are more likely dismiss them as nonsense.

tunesmith 7y ago

More susceptible to deaths I understand, but is an older population more susceptible to spreading of the virus? Is probability of "infection given exposure" (as opposed to being a carrier) also greater with age? (I know that's true for kids, but hadn't heard if that trend continues across all age ranges.)

Leary 7y ago

It's not just the deaths now, but the trajectory. Korea has this under control, Italy won't for another 1-2 weeks.

taeric 7y ago

The part of Italy hit also has air quality, per aqi searches, that is comparable to the region in China that was hit hard. Have people looked that it is not age, but baseline damage to your lungs that is the main factor in serious cases? Older people will have more exposure to local air pollution, just from having lived longer. That existing damage can be what contributes to complications, right?

neuronic 7y ago
I wonder if and how long-term smokers are skewing the stats.
- taeric 7y ago
  That hinges a lot on if I'm right. Which is still unlikely, as much as I'm find of my own opinions. :)
Camillo 7y ago
Source? Right now air in Wuhan [0] seems to be significantly worse than Milan [1]. Both cities are under some level of quarantine, but it has been stricter and going on for much longer in Wuhan. Chinese sources say that the air in Wuhan is much better than it was before the quarantine. We can assume that the difference between the two cities would be even larger during normal activity. Edit: Milan is much closer to Seoul [2] than to Wuhan. [0]: https://www.airvisual.com/china/hubei/wuhan https://www.airvisual.com/china/hubei/wuhan [1]: https://www.airvisual.com/italy/lombardy/milano https://www.airvisual.com/italy/lombardy/milano [2]: https://www.airvisual.com/south-korea/seoul https://www.airvisual.com/south-korea/seoul
- taeric 7y ago
  I used those sites and looked at daily historical. I grant that China was strictly worse. But Milan is strictly worse than everywhere else getting hit. Edit: and the air being better after the quarantine would support my hypothesis. It wasn't that that helped, but the better air. (Which is still very bad)

humaniania 7y ago

https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp... SK has 12 hospital beds per 1,000 people vs 3 in Italy.

codeulike 7y ago

A big part of the answer is in the article: SK have tested 5 times more people so picked up more mild cases in their stats

3JPLW 7y ago
Yeah, but they've also been able to significantly slow the spread, growing at what looks to be closer to 10% day-over-day (doubling every week). Most everywhere else is seeing 25-35% (doubling every 2-3 days).
- xorfish 7y ago
  New cases in SK are on a downward trend for around 10 days now. They achieved a reproduction value that is quite a bit below for at least the last 3 weeks.
- kaitai 7y ago
  These go hand in hand. In the US we cannot slow the spread because we refuse to test anyone who doesn't need acute care or who doesn't have documented contact with travelers or foreign nationals. The research from Helen Chu's lab at University of Washington shows that this means we missed the start of community transmission entirely in Washington. Here, there are health care workers who can't get a test! They deal with people with significant health problems every day and could be spreading it all over -- but because they didn't travel, they can't get a test.
  - mjevans 7y ago
    The massive shortage of tests doesn't help either. There's plenty of blame, but I'd assign most of it to US politics.

lmilcin 7y ago

I can understand how it is more susceptible to death but I don't see the connection with spreading. Old people tend to move about much less and none of the references support that older people are in any way more responsible for spreading the virus. I think much better explanation would be that Italy has a lot of tourism, it is basically a tourism hub for northern and eastern Europe. Tourism == a lot of people moving about, very frequently, then leaving the country. Almost all initial cases here in Poland seem to be connected with somebody coming back from vacation in Italy.

ivanhoe 7y ago

There are also cultural differences, Italians like to hang out in groups, outside, personal space is much smaller, people hug and kiss and touch all the time. Also they're not really the most disciplined nation, lots of them simply ignored the safety rules, continued to go out, there were even some cases where infected people run away from quarantine. And additionally the spread of virus is not uniform as it depends on social circles, so it's very hard to compare the situations using just general population stats. In South Korea one of the early patients infected more than a thousand other people, while some patients infected no one else or only a few. It's totally random event, and a few patients like that can create a huge differences in the spread of the disease. In Italy they've had the bad luck that early on virus got into hospitals and retirement homes, so the most sensitive population was massively affected.

m_mueller 7y ago
I think there is another factor as well: have a look at train stations during rush hour on East Asia currently vs. Europe. 1) the density is significantly higher but 2) nearly everyone is wearing surgical masks now. I think that mask wearing is an effective measure to slow down the spread, acting at the sender side rather than the receiver (which Western people tend to focus on). You can see a similarly lower exponential spread in other Asian nations compared to Europe and I think that masks plus a lesser degree of body contact can explain this largely.
- mantap 7y ago
  Part of the problem is that pretty much everybody in East Asia already owned at least one mask. In Europe pretty much nobody owned a mask prior to COVID-19. And masks have been sold out for weeks. If masks were easily available you'd see people wearing them I'm sure.
  - WildGreenLeave 7y ago
    At least in The Netherlands there are still plenty of masks to be found. You won't find the surgical masks anymore but masks for construction work is still plenty available. I think most europeans look down on wearing masks as something stupid, most europeans also think hand sanitizer is stupid. (This just applies to my dutch family and friends over there, I am currently in Thailand and always wearing a mask and hand sanitizer)

bad_user 7y ago

No, the far more likely explanation is that the total number of cases reported for Italy don't reflect reality. Because they are overwhelmed Italian hospitals basically send people home if they have a fever or other symptoms with no test administered, instructed to come back in case the symptoms worsen, only people having trouble breathing being admitted in the ICU. Italy could easily have in reality 10 times the number of reported total cases or more.

leoedin 7y ago
Just look at how many people from other other countries got infected in northern Italy a few weeks ago. Italy had diagnosed a few hundred cases, yet suddenly hundreds and hundreds of people who were in the area and have returned home now have it in other countries. It's clearly far more highly prevalent than testing suggests.
lou1306 7y ago
> Because they are overwhelmed Italian hospitals basically send people home if they have a fever or other symptoms with no test administered, Sources, please. > only people having trouble breathing being admitted in the ICU. Well, why would you put someone without respiratory failure in an ICU to egin with? Also, Italy performs 1 test per 1000 people [1]. Surely there are more cases than the reported ones, but 10 times? I am no statistician, but wouldn't it require extreme bad luck to miss so many cases with such extensive testing? [1] https://www.worldometers.info/coronavirus/covid-19-testing/ https://www.worldometers.info/coronavirus/covid-19-testing/
- imtringued 7y ago
  Did they test random people or only people with symptoms? If the latter then your distribution is heavily biased and a 10x difference is not an outlier, it's the expected outcome.
  - makomk 7y ago
    According to those stats 14% of people tested were positive and of those, about half had to be admitted to hospital. It's clearly very far from a random sample.

virtualritz 7y ago

Something that is not much talked about is the fact that many people apparently die from a sepsis (bacterial) that is caused by the primary infection. In Italy, it is almost customary to pop medication that contains antibiotics whenever you feel a bit under the weather. I lived in Italy, I experienced this first hand even from my more educated friends. Because of this Italians have an antibiotics resistance of 26.8% [1]. I do not have data for South Korea but in Germany, where I live, antibiotics are not available over the counter. You always need to see a professional and then they are much more expensive that e.g. in Italy. The resistance rate here in Germany is 0.4% [1]. That's 67 times (!) lower than in Italy. [1] https://atlas.ecdc.europa.eu/public/index.aspx?Dataset=27&HealthTopic=4 https://atlas.ecdc.europa.eu/public/index.aspx?Dataset=27&He...

J-dawg 7y ago
This is fascinating, I didn't know that data about antibiotic resistance was available like this, and definitely had no idea there was such huge variation between countries. Surely this should be considered a major public health emergency in itself? Are the countries with high percentages taking steps to limit antibiotic use? Coming from the UK the idea of letting people buy antibiotics as easily as painkillers seems crazy. And what the hell is going on in Greece!?
- tw202003131459 7y ago
  > Surely this should be considered a major public health emergency in itself? Indeed. There's an episode of Sam Harris's podcast with Matt MCarthy from last summer. The episode title is The Plague Years, and they go into quite a bit of detail on this sort of thing and ruminate about how low on the radar it is for most people (if it even registers at all), despite the seriousness of the situation.
mightypirate 7y ago
antibiotics are not available over the counter in Italy