8 ms·

One question I have is how many of these excess deaths is due to coronavirus and how many are due to our response to coronavirus since people are not getting th

One question I have is how many of these excess deaths is due to coronavirus and how many are due to our response to coronavirus since people are not getting their regular health care. For example, my dad has congestive heart failure and sees his doctor once a month and gets an EKG every time. I've been in appointments and the majority of the discussion centers around changes in his EKGs from the previous months. Right now, he's not getting these regular checkups and appointments. He could have a change in prognosis go undetected and end up with a preventable heart attack. Is coronavirus the black swan event or is our reaction to coronavirus the black swan event. It's hard to say. Looking at all cause mortality excess deaths between Sweden and lockdown countries, it's hard to say: https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html https://www.nytimes.com/interactive/2020/04/21/world/coronav... One question I'm also curious about is if in the years following the coronavirus, will we see negative excess deaths relative to previous seasonal averages because of the excess deaths right now.

zests 6y ago
Yeah, its quite amazing how poor our data is. Combine that with how politicized the issue is and I don't think we will ever have reliable numbers.
ceejayoz 6y ago
> One question I have is how many of these excess deaths is due to coronavirus and how many are due to our response to coronavirus since people are not getting their regular health care. I wouldn't personally know where to start on getting the data, but you can likely tease this out by evaluating populations with already limited access to healthcare - uninsured, low-income folks with $13k deductibles, etc. Have you considered getting your dad an Apple Watch, so he can do his EKGs at home and send to a doc? Not as effective as a twelve-lead, but maybe it'd help at least somewhat?
- malandrew 6y ago
  I've been looking at the KardiaMobile but the reviews on Amazon look pretty bad. How well does the Apple Watch perform since it's just on a wrist?
  - ceejayoz 6y ago
    I honestly don't have the information to answer that. I do know the single-lead EKG has some limitations, but they may not be relevant to your dad's particular scenario. Worth a conversation with the doctor, I suspect.
    - malandrew 6y ago
      Yeah the real tricky thing is how well they do. We originally thought he had bradycardia because his heart rate as measured by his heart pressure cuff showed it in the high 30s. However once he got an EKG, it became clear that his heart rate was normal but he was afib and all the irregularity wasn't being picked up properly by the BP cuff monitor. I'm guessing that something like the apple watch is accurate enough to inform someone previously healthy that something is now wrong, but wouldn't be accurate enough to tell someone who is unhealthy if their condition is worsening.
      - ceejayoz 6y ago
        The Apple Watch's EKG is definitely good enough for diagnosing bradycardia - you can see very clear QRS complexes showing up on it. (I would not necessarily trust the 24/7 LED-based rate monitoring.)
        malandrew 6y ago
        Yeah, but brachycardia wasn't the problem and that's easy to diagnose. What I want to know is if it is good enough to know that it wasn't actually brachycardia but was instead afibrillation with weak parts of the cardiac cycle.
thu2111 6y ago
In the UK about half the excess deaths don't mention COVID at all on the death certificate. Of those that do, a very high proportion are extremely old, i.e. they died with the disease rather than of it. If you take that into account the lockdown kills far more healthy people than COVID.
- gpderetta 6y ago
  Germany is in lockdown and seeing no excess deaths (covid or otherwise). The whole of Italy is in lockdown, but areas badly affected by covid are seeing much more more unexplained excess death than other less affected areas. It seems to me that lock-down is very unlikely to be the thing that is killing people.
  - thu2111 6y ago
    Germans haven't been told repeatedly they have a patriotic duty to avoid hospitals to save their national treasure. The British numbers are public and speak for themselves. ER attendance halved. Cardiac patients halved. People stopped going to hospitals when they needed to - luckily Germany avoided socialised healthcare and hospitals are just seen as normal companies. As for Italy, there have been similar problems there with elderly homes in particular and hospitals struggling with staffing sure to lockdowns and isolation. Ultimately this is the same virus everywhere. It doesn't look like it though. So differences in national performances are telling us a lot of important things about how governments have reacted.
- DanBC 6y ago
  Where are you getting your UK stats from please?
giardini 6y ago
People are huddling inside in fear of Covid-19. How many of these excess deaths are caused by fright and the stress thereof? "Can You Die from Fear? The Baskerville Effect" https://www.drmirkin.com/histories-and-mysteries/the-baskerville-effect.html https://www.drmirkin.com/histories-and-mysteries/the-baskerv...
- cy_hauser 6y ago
  And there's an opposite effect. Way fewer people are dying or being hurt by car crashes. Normally one of the leading causes of death in the "prime of life" age range. And even more weird, deaths and injuries for young people are way down as impulsive risk taking and peacocking are reigned in. So weird all the indirect effects.

zests 6y ago

Yeah, its quite amazing how poor our data is. Combine that with how politicized the issue is and I don't think we will ever have reliable numbers.

ceejayoz 6y ago

> One question I have is how many of these excess deaths is due to coronavirus and how many are due to our response to coronavirus since people are not getting their regular health care. I wouldn't personally know where to start on getting the data, but you can likely tease this out by evaluating populations with already limited access to healthcare - uninsured, low-income folks with $13k deductibles, etc. Have you considered getting your dad an Apple Watch, so he can do his EKGs at home and send to a doc? Not as effective as a twelve-lead, but maybe it'd help at least somewhat?

malandrew 6y ago
I've been looking at the KardiaMobile but the reviews on Amazon look pretty bad. How well does the Apple Watch perform since it's just on a wrist?
- ceejayoz 6y ago
  I honestly don't have the information to answer that. I do know the single-lead EKG has some limitations, but they may not be relevant to your dad's particular scenario. Worth a conversation with the doctor, I suspect.
  - malandrew 6y ago
    Yeah the real tricky thing is how well they do. We originally thought he had bradycardia because his heart rate as measured by his heart pressure cuff showed it in the high 30s. However once he got an EKG, it became clear that his heart rate was normal but he was afib and all the irregularity wasn't being picked up properly by the BP cuff monitor. I'm guessing that something like the apple watch is accurate enough to inform someone previously healthy that something is now wrong, but wouldn't be accurate enough to tell someone who is unhealthy if their condition is worsening.
    - ceejayoz 6y ago
      The Apple Watch's EKG is definitely good enough for diagnosing bradycardia - you can see very clear QRS complexes showing up on it. (I would not necessarily trust the 24/7 LED-based rate monitoring.)
      - malandrew 6y ago
        Yeah, but brachycardia wasn't the problem and that's easy to diagnose. What I want to know is if it is good enough to know that it wasn't actually brachycardia but was instead afibrillation with weak parts of the cardiac cycle.

thu2111 6y ago

In the UK about half the excess deaths don't mention COVID at all on the death certificate. Of those that do, a very high proportion are extremely old, i.e. they died with the disease rather than of it. If you take that into account the lockdown kills far more healthy people than COVID.

gpderetta 6y ago
Germany is in lockdown and seeing no excess deaths (covid or otherwise). The whole of Italy is in lockdown, but areas badly affected by covid are seeing much more more unexplained excess death than other less affected areas. It seems to me that lock-down is very unlikely to be the thing that is killing people.
- thu2111 6y ago
  Germans haven't been told repeatedly they have a patriotic duty to avoid hospitals to save their national treasure. The British numbers are public and speak for themselves. ER attendance halved. Cardiac patients halved. People stopped going to hospitals when they needed to - luckily Germany avoided socialised healthcare and hospitals are just seen as normal companies. As for Italy, there have been similar problems there with elderly homes in particular and hospitals struggling with staffing sure to lockdowns and isolation. Ultimately this is the same virus everywhere. It doesn't look like it though. So differences in national performances are telling us a lot of important things about how governments have reacted.
DanBC 6y ago
Where are you getting your UK stats from please?

giardini 6y ago

People are huddling inside in fear of Covid-19. How many of these excess deaths are caused by fright and the stress thereof? "Can You Die from Fear? The Baskerville Effect" https://www.drmirkin.com/histories-and-mysteries/the-baskerville-effect.html https://www.drmirkin.com/histories-and-mysteries/the-baskerv...

cy_hauser 6y ago
And there's an opposite effect. Way fewer people are dying or being hurt by car crashes. Normally one of the leading causes of death in the "prime of life" age range. And even more weird, deaths and injuries for young people are way down as impulsive risk taking and peacocking are reigned in. So weird all the indirect effects.