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Singapore has had a death rate of 0.06%, with ~42k cases. The main difference between them and the rest of the world has been how much they test. New York has m

Singapore has had a death rate of 0.06%, with ~42k cases. The main difference between them and the rest of the world has been how much they test. New York has more hospital beds per 1,000 than Singapore does for instance. There’s no other factor that could possibly explain the death rates being off by more than 3 orders of magnitude between those two places.

scarmig 6y ago
That doesn't explain it, though: the number of NYC deaths so far is 0.2% of its population. Assuming 100% of NYC is infected, that's a floor of 0.2% IFR. No amount of under testing can explain that. Which isn't to say that Singapore's death rate is an undercount, but that higher testing rates can't explain it.
- zaroth 6y ago
  I think the mistake that many people keep making is trying to nail down a single IFR. There isn’t one. The fatality rate depends heavily on the demographics of the infected population. IFR of a entirely young demographic would be below 0.01%. IFR of a nursing home would be 3 orders of magnitude higher. If someone shows me a low IFR I can safely bet that they surely aren’t finding 50% of their cases in their nursing homes. Conversely, if 50%+ of your cases are in nursing homes, your population IFR is going to look a lot worse than if you had kept that relatively small population safe.
- crooked-v 6y ago
  The difference with Singapore probably has more to do with how (a) face mask wearing was and still is compulsory for everyone at all times outside of their homes (the fine for not doing so is the equivalent of $210 USD), and (b) every single government-run community center in the city had free reusable face masks available for months for anyone who didn't already have one.
- AmericanChopper 6y ago
  Singapore’s actual death rate is also a much more reliable number than New York’s. The NY criteria for recording a Covid death has been pretty much anybody who could have potentially been infected at their time of death. There are some other confounding factors too, like SG infections being primarily among young people, and NY state discharging Covid patients to nursing homes. But none of that explains the monumental difference in death rates between SG and pretty much the entire rest of the world. The virus is certainly far less deadly than most reported statistics would have you believe.
  - crooked-v 6y ago
    The criteria don't really matter, because we can look at the total number of excess deaths to reliably see that an absurdly excess number of people died in NYC compared to previous years.
  - scarmig 6y ago
    > The NY criteria for recording a Covid death has been pretty much anybody who could have potentially been infected at their time of death. This is false. Even if it were true, you could look to NYC's excess deaths and see a huge surge in them that would correspond to a similar IFR.
  - chimprich 6y ago
    > The NY criteria for recording a Covid death has been pretty much anybody who could have potentially been infected at their time of death. This is a common "fact" asserted in these discussions, and it's never backed up with any evidence.
    - AmericanChopper 6y ago
      https://www.theguardian.com/us-news/2020/apr/15/new-york-city-coronavirus-death-toll-jumps-revised-count https://www.theguardian.com/us-news/2020/apr/15/new-york-cit... > The soaring death toll has been fueled by the adding of 3,778 people who were not tested for Covid-19 but are presumed to have died from it. Singapore’s organised approach is clearly going to produce much more reliable statistics than NYs presumption based approach.
- yomly 6y ago
  You can't just data this stuff. There's so much nuance and context in the data that it's very hard to compare countries. Singapore is militant on testing everyone. This presumably gives a high fidelity on the "true" spread of the virus. What is also true is that Singapore has been extremely militant on isolating and controlling the virus. Their staff have ample PPE and their hospitals have very successfully isolated covid positive patients. For instance, anyone positive here is quarantined in a govt run facility and cannot return home until testing negative two days in a row. This may have recently relaxed but was true throughout circuit breaker/lockdown. I believe they are also trying to partition covid patients from non covid patients at the hospital level. (eg NCID) Both anecdotally from frontline doctors, and from reading various news reports, a big problem about the first wave of covid was how the problems can snowball. Hospitals were very easily filled up with sick patients, but worse any existing patients could very easily catch covid. For example cancer patients who are immunocompromised. So the lethality of the disease is actually a function of its local penetration as more people die if hospitals effectively experience cascading failure. My understanding is that tipping point is quite fine, this is especially true back in March when everyone was still hoping it wouldn't reach their shores, and hospitals had very limited space for isolating covid patients and for treating patients that required ICU. While hospitals have been empty I also know that hospitals have become extremely aggressive at not accepting patients. For example, my friend's mother was bedridden for a month but was never seen by a doctor. Meanwhile you have people dying at home and in care homes, so I think "hospitals are empty" doesn't tell the whole picture.
zzzzzzzza 6y ago
"There's no other factor" Yes there is. In singapore the death rate was much higher until covid moved into foreign worker dorms, where everyone is younger on average than the general population... You need to look at mortality rate by age group. South Korea also has relatively complete testing/tracing, you can find that data on the wikipedia page on covid19 in s. korea.

scarmig 6y ago

That doesn't explain it, though: the number of NYC deaths so far is 0.2% of its population. Assuming 100% of NYC is infected, that's a floor of 0.2% IFR. No amount of under testing can explain that. Which isn't to say that Singapore's death rate is an undercount, but that higher testing rates can't explain it.

zaroth 6y ago
I think the mistake that many people keep making is trying to nail down a single IFR. There isn’t one. The fatality rate depends heavily on the demographics of the infected population. IFR of a entirely young demographic would be below 0.01%. IFR of a nursing home would be 3 orders of magnitude higher. If someone shows me a low IFR I can safely bet that they surely aren’t finding 50% of their cases in their nursing homes. Conversely, if 50%+ of your cases are in nursing homes, your population IFR is going to look a lot worse than if you had kept that relatively small population safe.
crooked-v 6y ago
The difference with Singapore probably has more to do with how (a) face mask wearing was and still is compulsory for everyone at all times outside of their homes (the fine for not doing so is the equivalent of $210 USD), and (b) every single government-run community center in the city had free reusable face masks available for months for anyone who didn't already have one.
AmericanChopper 6y ago
Singapore’s actual death rate is also a much more reliable number than New York’s. The NY criteria for recording a Covid death has been pretty much anybody who could have potentially been infected at their time of death. There are some other confounding factors too, like SG infections being primarily among young people, and NY state discharging Covid patients to nursing homes. But none of that explains the monumental difference in death rates between SG and pretty much the entire rest of the world. The virus is certainly far less deadly than most reported statistics would have you believe.
- crooked-v 6y ago
  The criteria don't really matter, because we can look at the total number of excess deaths to reliably see that an absurdly excess number of people died in NYC compared to previous years.
- scarmig 6y ago
  > The NY criteria for recording a Covid death has been pretty much anybody who could have potentially been infected at their time of death. This is false. Even if it were true, you could look to NYC's excess deaths and see a huge surge in them that would correspond to a similar IFR.
- chimprich 6y ago
  > The NY criteria for recording a Covid death has been pretty much anybody who could have potentially been infected at their time of death. This is a common "fact" asserted in these discussions, and it's never backed up with any evidence.
  - AmericanChopper 6y ago
    https://www.theguardian.com/us-news/2020/apr/15/new-york-city-coronavirus-death-toll-jumps-revised-count https://www.theguardian.com/us-news/2020/apr/15/new-york-cit... > The soaring death toll has been fueled by the adding of 3,778 people who were not tested for Covid-19 but are presumed to have died from it. Singapore’s organised approach is clearly going to produce much more reliable statistics than NYs presumption based approach.
yomly 6y ago
You can't just data this stuff. There's so much nuance and context in the data that it's very hard to compare countries. Singapore is militant on testing everyone. This presumably gives a high fidelity on the "true" spread of the virus. What is also true is that Singapore has been extremely militant on isolating and controlling the virus. Their staff have ample PPE and their hospitals have very successfully isolated covid positive patients. For instance, anyone positive here is quarantined in a govt run facility and cannot return home until testing negative two days in a row. This may have recently relaxed but was true throughout circuit breaker/lockdown. I believe they are also trying to partition covid patients from non covid patients at the hospital level. (eg NCID) Both anecdotally from frontline doctors, and from reading various news reports, a big problem about the first wave of covid was how the problems can snowball. Hospitals were very easily filled up with sick patients, but worse any existing patients could very easily catch covid. For example cancer patients who are immunocompromised. So the lethality of the disease is actually a function of its local penetration as more people die if hospitals effectively experience cascading failure. My understanding is that tipping point is quite fine, this is especially true back in March when everyone was still hoping it wouldn't reach their shores, and hospitals had very limited space for isolating covid patients and for treating patients that required ICU. While hospitals have been empty I also know that hospitals have become extremely aggressive at not accepting patients. For example, my friend's mother was bedridden for a month but was never seen by a doctor. Meanwhile you have people dying at home and in care homes, so I think "hospitals are empty" doesn't tell the whole picture.

zzzzzzzza 6y ago

"There's no other factor" Yes there is. In singapore the death rate was much higher until covid moved into foreign worker dorms, where everyone is younger on average than the general population... You need to look at mortality rate by age group. South Korea also has relatively complete testing/tracing, you can find that data on the wikipedia page on covid19 in s. korea.