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I'm not sure what you intend by those test counts? Japan has 874 dead. Assuming IFR of 1%, that implies about 87k infected. But they report 17k confirmed cases,

I'm not sure what you intend by those test counts? Japan has 874 dead. Assuming IFR of 1%, that implies about 87k infected. But they report 17k confirmed cases, so they're missing ~80% of the cases. I mentioned this to head off any suggestion that Japan's trace and test operation was responsible for their success, since at best it's decreasing R by that ~20%. Perhaps Japan is failing to catch some deaths too; but they're an open society with freedom of speech, so I don't expect their numbers to be grossly wrong. So what could South Dakota and Wyoming's public health system be doing that's worse than Japan? I don't know the answer, but it's not clear to me at all that the difference is in their government responses vs. some aspect of their initial situations. I gave deaths per capita because that's the probability that someone in that state will have died of coronavirus, which is what most people care about directly. Your (deaths/people)/(people/area) has no corresponding direct significance. To then call that "the relevant number" overstates the importance of population density, and also models population density badly when it's non-uniform (as you note for NYC). I agree that population density is an important factor, just not as determinative as your post would seem to imply. Oh, and looks like you quoted my post before I edited it, sorry. But I believe false confidence is polarizing and would like to see less of it, as uncomfortable as the true uncertainty may be.

akiselev 6y ago
> I'm not sure what you intend by those test counts? Japan has 874 dead. I'm saying I believe their numbers are inaccurate because they're undertesting and stats I could use to validate them (overall number of deaths to calculate seasonal excess mortality) are also currently inaccurate for unrelated reasons. I agree that the number of deaths will be impossible to hide in an open society like Japan but for bureaucratic reasons it will take a while to compile and validate those stats before normalizing them enough to compare between years let alone nations. Until then, I'm not convinced and any argument based on Japan as an example is also suspect. > To then call that "the relevant number" overstates the importance of population density, and also models population density badly when it's non-uniform (as you note for NYC). Uhm, what? Deaths per million lumps Wyoming in with New York City, making it even less accurate to what people care about. Manhattan will not be reopening on the same schedule as some town on the outskirts of Fargo. Someone in the middle of a dense city does not face the same risk as someone whose closest neighbor is 2 miles away. Also, it's a virus. There's almost a century of medicine and public health expertise that shows that all things being equal, density is the dominant factor. I thought ending quarantine is what people cared about. Your false confidence about Japan's comparability to the US is not helping. Population density is why NYC and Wyoming aren't comparable yet you're trying to compare another country.
- tripletao 6y ago
  So what do you think explains the difference between Japan and NY? It's not population density. Even if Japan's death count is understated, there is zero chance that all of Japan's medical staff and press have somehow failed to notice and report NYC-level mortality. And I'm not sure what you think is my "false confidence about Japan's comparability to the US"? I certainly don't believe Japan's response would work equally well in NY, considering that NY applied stricter measures and ended up with 200x the death rate. I believe the susceptibility of individual regions to the coronavirus varies greatly with factors we don't yet understand, including population density, cultural and behavioral factors, weather, maybe air pollution, maybe genetics. I'd guess these factors explain much more of the variation in mortality by region than variation in the governments' responses, though I'm not sure. And you're missing my point about deaths per capita. That's an intrinsically meaningful number, because people care about the probability that they die (or get seriously sick, etc.). Other numbers are valuable only to the extent they predict something people intrinsically care about. Population density is one such input to the prediction, but it's clearly not the only factor, and your simplistic focus on that isn't useful.
  - akiselev 6y ago
    > So what do you think explains the difference between Japan and NY? There are a thousand factors but my bet is that Japan experienced SARS firsthand and just like South Korea or Vietnam, they learned their lesson. It became the epidemic case study for public health officials and doctors in the entire region (and Canada). Regulators went out of their way to make reporting easy and doctors were all trained to look for and treat viral respiratory diseases early. Wearing masks went from being an oddity to wide spread cultural acceptance. For those reasons, you can't compare the effectiveness of measures in California to those in Wyoming using Japan as a measuring stick. There are far more differences between Japan and California than there are between California and Wyoming. The latter share their language, the majority of their healthcare regulations, political differences, the CDC, and so on. Right now, traveling from Japan to Wyoming is practically impossible but traveling from California to Wyoming is a medium length road trip or one hop in a a tiny plane with zero enforceable travel restrictions. > Even if Japan's death count is understated, there is zero chance that all of Japan's medical staff and press have somehow failed to notice and report NYC-level mortality. I'm not an expert on Japanese culture but I've got enough first hand experience to know that is a failure of imagination and the definition of false confidence. Read about Tepco, the Japanese nuclear regulators, and the series of unfortunate events that led to Fukushima containment failures. It was a systemic failure that shares many parallels to Japans's coronavirus response. > And I'm not sure what you think is my "false confidence about Japan's comparability to the US"? I certainly don't believe Japan's response would work equally well in NY, considering that NY applied stricter measures and ended up with 200x the death rate. You (imo) falsely believe that Japan's death rate is accurate (let's wait a few months for accurate general morality). You also falsely believe that their death rate can be used to draw conclusions about the effectiveness of measures in the United States. I'm not sure about the former but certain about the latter. New York had "stricter" measures based on cultural expectations that were practically cultural norms in Japan. There is simply no baseline or control group possible between the two demographics. > I'd guess these factors explain much more of the variation in mortality by region than variation in the governments' responses, though I'm not sure. There is less variation within nations than there is between them. That's why they became nations instead of going to war amongst themselves (modulo some geopolitics that apply to the Middle East and the Balkans, not Japan). > And you're missing my point about deaths per capita. That's an intrinsically meaningful number, because people care about the probability that they die (or get seriously sick, etc.). Other numbers are valuable only to the extent they predict that. Population density is one input, but it's clearly not the only factor, and your simplistic focus on that isn't useful. People care about ending the quarantine. The quarantine will end based on public health policy. Public health decision makers aren't basing their decision on deaths per capita, they're basing them on localized deaths per capita, which depends on the density in each city, metropolis, and states. I honestly don't even know what point you're trying to make. Are we trying to end the quarantine or are you trying to make some ideological point?

akiselev 6y ago

> I'm not sure what you intend by those test counts? Japan has 874 dead. I'm saying I believe their numbers are inaccurate because they're undertesting and stats I could use to validate them (overall number of deaths to calculate seasonal excess mortality) are also currently inaccurate for unrelated reasons. I agree that the number of deaths will be impossible to hide in an open society like Japan but for bureaucratic reasons it will take a while to compile and validate those stats before normalizing them enough to compare between years let alone nations. Until then, I'm not convinced and any argument based on Japan as an example is also suspect. > To then call that "the relevant number" overstates the importance of population density, and also models population density badly when it's non-uniform (as you note for NYC). Uhm, what? Deaths per million lumps Wyoming in with New York City, making it even less accurate to what people care about. Manhattan will not be reopening on the same schedule as some town on the outskirts of Fargo. Someone in the middle of a dense city does not face the same risk as someone whose closest neighbor is 2 miles away. Also, it's a virus. There's almost a century of medicine and public health expertise that shows that all things being equal, density is the dominant factor. I thought ending quarantine is what people cared about. Your false confidence about Japan's comparability to the US is not helping. Population density is why NYC and Wyoming aren't comparable yet you're trying to compare another country.

tripletao 6y ago
So what do you think explains the difference between Japan and NY? It's not population density. Even if Japan's death count is understated, there is zero chance that all of Japan's medical staff and press have somehow failed to notice and report NYC-level mortality. And I'm not sure what you think is my "false confidence about Japan's comparability to the US"? I certainly don't believe Japan's response would work equally well in NY, considering that NY applied stricter measures and ended up with 200x the death rate. I believe the susceptibility of individual regions to the coronavirus varies greatly with factors we don't yet understand, including population density, cultural and behavioral factors, weather, maybe air pollution, maybe genetics. I'd guess these factors explain much more of the variation in mortality by region than variation in the governments' responses, though I'm not sure. And you're missing my point about deaths per capita. That's an intrinsically meaningful number, because people care about the probability that they die (or get seriously sick, etc.). Other numbers are valuable only to the extent they predict something people intrinsically care about. Population density is one such input to the prediction, but it's clearly not the only factor, and your simplistic focus on that isn't useful.
- akiselev 6y ago
  > So what do you think explains the difference between Japan and NY? There are a thousand factors but my bet is that Japan experienced SARS firsthand and just like South Korea or Vietnam, they learned their lesson. It became the epidemic case study for public health officials and doctors in the entire region (and Canada). Regulators went out of their way to make reporting easy and doctors were all trained to look for and treat viral respiratory diseases early. Wearing masks went from being an oddity to wide spread cultural acceptance. For those reasons, you can't compare the effectiveness of measures in California to those in Wyoming using Japan as a measuring stick. There are far more differences between Japan and California than there are between California and Wyoming. The latter share their language, the majority of their healthcare regulations, political differences, the CDC, and so on. Right now, traveling from Japan to Wyoming is practically impossible but traveling from California to Wyoming is a medium length road trip or one hop in a a tiny plane with zero enforceable travel restrictions. > Even if Japan's death count is understated, there is zero chance that all of Japan's medical staff and press have somehow failed to notice and report NYC-level mortality. I'm not an expert on Japanese culture but I've got enough first hand experience to know that is a failure of imagination and the definition of false confidence. Read about Tepco, the Japanese nuclear regulators, and the series of unfortunate events that led to Fukushima containment failures. It was a systemic failure that shares many parallels to Japans's coronavirus response. > And I'm not sure what you think is my "false confidence about Japan's comparability to the US"? I certainly don't believe Japan's response would work equally well in NY, considering that NY applied stricter measures and ended up with 200x the death rate. You (imo) falsely believe that Japan's death rate is accurate (let's wait a few months for accurate general morality). You also falsely believe that their death rate can be used to draw conclusions about the effectiveness of measures in the United States. I'm not sure about the former but certain about the latter. New York had "stricter" measures based on cultural expectations that were practically cultural norms in Japan. There is simply no baseline or control group possible between the two demographics. > I'd guess these factors explain much more of the variation in mortality by region than variation in the governments' responses, though I'm not sure. There is less variation within nations than there is between them. That's why they became nations instead of going to war amongst themselves (modulo some geopolitics that apply to the Middle East and the Balkans, not Japan). > And you're missing my point about deaths per capita. That's an intrinsically meaningful number, because people care about the probability that they die (or get seriously sick, etc.). Other numbers are valuable only to the extent they predict that. Population density is one input, but it's clearly not the only factor, and your simplistic focus on that isn't useful. People care about ending the quarantine. The quarantine will end based on public health policy. Public health decision makers aren't basing their decision on deaths per capita, they're basing them on localized deaths per capita, which depends on the density in each city, metropolis, and states. I honestly don't even know what point you're trying to make. Are we trying to end the quarantine or are you trying to make some ideological point?