6 ms·

Around 500,000 people died of malaria in 2018. COVID-19 deaths are currently at 250,000 (according to worldometers.info), but deaths are only just starting to s

by jml7c5 6y ago

Around 500,000 people died of malaria in 2018. COVID-19 deaths are currently at 250,000 (according to worldometers.info), but deaths are only just starting to slow down, and it's unclear how many deaths are going unreported. (There has been suggestion that in some places, actual deaths may be twice as high; apparently even after one adds reported COVID-19 deaths to an area's expected "regular" deaths, there is a shortfall vs actual deaths.) It's worth noting that in terms of person-years lost, an average malaria death is significantly worse as it predominantly kills children under the age of 5.

SamBam 6y ago
> in terms of person-years lost "Potential" person years lost, I guess. If you used "person years" the same way you use "Our firm has a combined 125 years of experience" then it's the other way round. (Grim discussion, I guess, but I'm just not certain I agree with the unspoken assumption that seems to be in that statement, that the younger the death, the more tragic/more effect on society.)
- xiphias2 6y ago
  It's a horrible assumption. I know that my parents probably have only 5-15 years of their life left, so I make sure to have contact with them as much as possible, and keep up longevity research, though I know that they don't like to experiment as much as I would in their place.
  - SamBam 6y ago
    > I know that they don't like to experiment as much as I would in their place. Hard to know. Do you think there's zero chance that, when you're their age, you might be the one telling your adult kid that you've had a happy, long life, and don't feel the need to experiment with longevity?
- jml7c5 6y ago
  Yes, "potential person years" or a similar phrasing would have been clearer. >(Grim discussion, I guess, but I'm just not certain I agree with the unspoken assumption that seems to be in that statement, that the younger the death, the more tragic/more effect on society.) It is a matter of morality and personal ethics. I chose to mention it only because the discrepancy in this case is so large, and it felt almost misleading to not relate the information. That said, I regret framing it in such a coldly utilitarian way.
  - vikramkr 6y ago
    These cold terms are how these discussions are had in industry. It's the core behind value based pricing - quality adjusted life years or QALYs are what many health systems use to determine what they will or wont pay for. As long as money is scarce, these are how conversations are had. A drug that saves a child's life is worth more, and people are willing to pay more, than a drug that saves an older person's life. There are cutoffs and thresholds. In the UK, with a few exceptions, a drug cant cost much more than 30 thousand pounds for each extra quality adjusted year of life (e.g. an extra year bedridden might only count as 30% of a year, while an extra year closer to functional might count as 95%) for NICE to approve paying for it. In the developing world, the value of a human life is set at about 2x GDP per capita per QALY. In the US, for a drug to be cost effective, it should be less than 150,000 dollars per QALY (but many drugs aren't).
- thaumasiotes 6y ago
  The usual metric is QALY, "quality-adjusted life years". (The idea of quality adjustment being that three years of being 82-84 isn't as good as three years of being 22-24.)
roywiggins 6y ago
Someone has actually crunched the numbers on this! The person-years lost for COVID is currently about 10 years on average. https://www.wsj.com/articles/coronavirus-kills-people-an-average-of-a-decade-before-their-time-11588424401 https://www.wsj.com/articles/coronavirus-kills-people-an-ave...
- kurthr 6y ago
  Alternately, the person years of those children haven’t started, and can easily be replaced... Maybe we shouldn’t just be ranking people by age, if we want to come to moral outcomes?
  - gajomi 6y ago
    > we shouldn’t just be ranking people by age, if we want to come to moral outcomes? Agreed. But I think quantifications can still be useful. Person-years probably aren't the right sort of quantification though, in that they blend together too many kinds of human experience. But I imagine most people would agree that statements like "X% of grandparents, lost 10 years earlier than expected" or "Y% of children under 10" allow for comparing the relative impact on families. Quantifying losses doesn't mean that we consider the quantified as fungible.
    - wizzwizz4 6y ago
      > Quantifying losses doesn't mean that we consider the quantified as fungible. Unless you're a hospital director on a budget, or something. (I don't know how such people cope; there's no winning decision there.)
  - lotsofpulp 6y ago
    I don’t understand what you mean when you write person years of those children haven’t started yet? They were born, so how have their person years not started? And in context of opportunity cost, in a situation where limited medical resources need to be allocated, it’s not a controversial opinion that a 90 year old can be let go in favor of saving a 10 year old.
koheripbal 6y ago
The 2018 number is 405K according to the WHO - and it's dropping every year, significantly, despite exploding populations. source: https://www.who.int/news-room/feature-stories/detail/world-malaria-report-2019 https://www.who.int/news-room/feature-stories/detail/world-m... Tremendous progress is being made against Malaria. Of course, it's not enough until will destroy this scourge.
- jml7c5 6y ago
  I'm not sure how I ended up with "around 500,000" instead of the (readily available) actual number. Thank you for the correction.
HarryHirsch 6y ago
average malaria death is significantly worse as it predominantly kills children under the age of 5 It's not only deaths, it's also lost opportunity, as malaria is a chronic disease. Children miss out on schooling, adults miss out on work, and malarious areas miss out on investment.
jimmaswell 6y ago
> unclear how many deaths are going unreported I'd been hearing the numbers might be inflated from diagnoses on dead people without tests. Hard to know what's really going on with anything with all the conflicting information.
- joshuahedlund 6y ago
  > Hard to know what's really going on with anything with all the conflicting information. Yes, but you don't have to give up. If you use critical thinking and assess the competing claims and the strength of the evidence for them, it becomes clear that the evidence for inflated counts is extremely weak, bordering on hearsay, and inconsistent with the overall data, while the evidence for extra uncounted deaths is much broader and stronger and consistent with the overall data, so while there is uncertainty about the true numbers, on net it's reasonable to assume more deaths are being missed than overcounted.
  - amenod 6y ago
    Does that really seem reasonable to you? Should we assume that social isolation, lack of physical activity, change of habits, being laid off a job and worse health care (preventive for example) have no impact on the number of deaths? That's quite a big assumption.
- jml7c5 6y ago
  Take a look at: https://fullfact.org/health/covid-deaths/ https://fullfact.org/health/covid-deaths/ There are certainly some deaths being incorrectly attributed to COVID-19, but I think the data conclusively rejects the hypothesis that there is rampant COVID-19 over-reporting.
- SamBam 6y ago
  Almost certainly the other way around. The most useful measure is "excess deaths" -- those are simply the statistical "excess" of deaths we are currently experiencing compared with the average at this time in years past, and are uninfluenced by diagnoses, coroners, politicians, etc. Here are some good state-by state graphs [1], and here's a country-wide graph [2] By any measure, our "excess deaths" since February have spiked enormously, and significantly more than the current official Covid death count. Some may be due to hospitals overflowing preventing other care. But it's pretty clearly all Corona-related. 1. https://www.nytimes.com/interactive/2020/04/28/us/coronavirus-death-toll-total.html https://www.nytimes.com/interactive/2020/04/28/us/coronaviru... 2. https://www.washingtonpost.com/investigations/2020/05/02/excess-deaths-during-covid-19/ https://www.washingtonpost.com/investigations/2020/05/02/exc...

by jml7c5 6y ago

SamBam 6y ago

> in terms of person-years lost "Potential" person years lost, I guess. If you used "person years" the same way you use "Our firm has a combined 125 years of experience" then it's the other way round. (Grim discussion, I guess, but I'm just not certain I agree with the unspoken assumption that seems to be in that statement, that the younger the death, the more tragic/more effect on society.)

xiphias2 6y ago
It's a horrible assumption. I know that my parents probably have only 5-15 years of their life left, so I make sure to have contact with them as much as possible, and keep up longevity research, though I know that they don't like to experiment as much as I would in their place.
- SamBam 6y ago
  > I know that they don't like to experiment as much as I would in their place. Hard to know. Do you think there's zero chance that, when you're their age, you might be the one telling your adult kid that you've had a happy, long life, and don't feel the need to experiment with longevity?
jml7c5 6y ago
Yes, "potential person years" or a similar phrasing would have been clearer. >(Grim discussion, I guess, but I'm just not certain I agree with the unspoken assumption that seems to be in that statement, that the younger the death, the more tragic/more effect on society.) It is a matter of morality and personal ethics. I chose to mention it only because the discrepancy in this case is so large, and it felt almost misleading to not relate the information. That said, I regret framing it in such a coldly utilitarian way.
- vikramkr 6y ago
  These cold terms are how these discussions are had in industry. It's the core behind value based pricing - quality adjusted life years or QALYs are what many health systems use to determine what they will or wont pay for. As long as money is scarce, these are how conversations are had. A drug that saves a child's life is worth more, and people are willing to pay more, than a drug that saves an older person's life. There are cutoffs and thresholds. In the UK, with a few exceptions, a drug cant cost much more than 30 thousand pounds for each extra quality adjusted year of life (e.g. an extra year bedridden might only count as 30% of a year, while an extra year closer to functional might count as 95%) for NICE to approve paying for it. In the developing world, the value of a human life is set at about 2x GDP per capita per QALY. In the US, for a drug to be cost effective, it should be less than 150,000 dollars per QALY (but many drugs aren't).
thaumasiotes 6y ago
The usual metric is QALY, "quality-adjusted life years". (The idea of quality adjustment being that three years of being 82-84 isn't as good as three years of being 22-24.)

roywiggins 6y ago

Someone has actually crunched the numbers on this! The person-years lost for COVID is currently about 10 years on average. https://www.wsj.com/articles/coronavirus-kills-people-an-average-of-a-decade-before-their-time-11588424401 https://www.wsj.com/articles/coronavirus-kills-people-an-ave...

kurthr 6y ago
Alternately, the person years of those children haven’t started, and can easily be replaced... Maybe we shouldn’t just be ranking people by age, if we want to come to moral outcomes?
- gajomi 6y ago
  > we shouldn’t just be ranking people by age, if we want to come to moral outcomes? Agreed. But I think quantifications can still be useful. Person-years probably aren't the right sort of quantification though, in that they blend together too many kinds of human experience. But I imagine most people would agree that statements like "X% of grandparents, lost 10 years earlier than expected" or "Y% of children under 10" allow for comparing the relative impact on families. Quantifying losses doesn't mean that we consider the quantified as fungible.
  - wizzwizz4 6y ago
    > Quantifying losses doesn't mean that we consider the quantified as fungible. Unless you're a hospital director on a budget, or something. (I don't know how such people cope; there's no winning decision there.)
- lotsofpulp 6y ago
  I don’t understand what you mean when you write person years of those children haven’t started yet? They were born, so how have their person years not started? And in context of opportunity cost, in a situation where limited medical resources need to be allocated, it’s not a controversial opinion that a 90 year old can be let go in favor of saving a 10 year old.

koheripbal 6y ago

The 2018 number is 405K according to the WHO - and it's dropping every year, significantly, despite exploding populations. source: https://www.who.int/news-room/feature-stories/detail/world-malaria-report-2019 https://www.who.int/news-room/feature-stories/detail/world-m... Tremendous progress is being made against Malaria. Of course, it's not enough until will destroy this scourge.

jml7c5 6y ago
I'm not sure how I ended up with "around 500,000" instead of the (readily available) actual number. Thank you for the correction.

HarryHirsch 6y ago

average malaria death is significantly worse as it predominantly kills children under the age of 5 It's not only deaths, it's also lost opportunity, as malaria is a chronic disease. Children miss out on schooling, adults miss out on work, and malarious areas miss out on investment.

jimmaswell 6y ago

> unclear how many deaths are going unreported I'd been hearing the numbers might be inflated from diagnoses on dead people without tests. Hard to know what's really going on with anything with all the conflicting information.

joshuahedlund 6y ago
> Hard to know what's really going on with anything with all the conflicting information. Yes, but you don't have to give up. If you use critical thinking and assess the competing claims and the strength of the evidence for them, it becomes clear that the evidence for inflated counts is extremely weak, bordering on hearsay, and inconsistent with the overall data, while the evidence for extra uncounted deaths is much broader and stronger and consistent with the overall data, so while there is uncertainty about the true numbers, on net it's reasonable to assume more deaths are being missed than overcounted.
- amenod 6y ago
  Does that really seem reasonable to you? Should we assume that social isolation, lack of physical activity, change of habits, being laid off a job and worse health care (preventive for example) have no impact on the number of deaths? That's quite a big assumption.
jml7c5 6y ago
Take a look at: https://fullfact.org/health/covid-deaths/ https://fullfact.org/health/covid-deaths/ There are certainly some deaths being incorrectly attributed to COVID-19, but I think the data conclusively rejects the hypothesis that there is rampant COVID-19 over-reporting.
SamBam 6y ago
Almost certainly the other way around. The most useful measure is "excess deaths" -- those are simply the statistical "excess" of deaths we are currently experiencing compared with the average at this time in years past, and are uninfluenced by diagnoses, coroners, politicians, etc. Here are some good state-by state graphs [1], and here's a country-wide graph [2] By any measure, our "excess deaths" since February have spiked enormously, and significantly more than the current official Covid death count. Some may be due to hospitals overflowing preventing other care. But it's pretty clearly all Corona-related. 1. https://www.nytimes.com/interactive/2020/04/28/us/coronavirus-death-toll-total.html https://www.nytimes.com/interactive/2020/04/28/us/coronaviru... 2. https://www.washingtonpost.com/investigations/2020/05/02/excess-deaths-during-covid-19/ https://www.washingtonpost.com/investigations/2020/05/02/exc...