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My main concern with this study is that it uses reported Covid-19 deaths to infer the fatality rate. According to the paper, the fatality rates in the US are f

My main concern with this study is that it uses reported Covid-19 deaths to infer the fatality rate. According to the paper, the fatality rates in the US are far higher than the rates in China and India. While the inferred fatality rate in the US is as high as ~1.3% (Louisiana), in many other places like China outside Wuhan and in India, the inferred death rate is close to 0.0%. I highly doubt that's actually the case. It seems much more likely that Covid-19 deaths have been under-reported in China and India. Anecdotally, my Pakistani friend called Covid-19 a "rich-person" disease because only rich people in Pakistan can afford a Covid-19 test. That may account for the lower number of reported Covid-19 deaths in poorer places.

Mountain_Skies 6y ago
Speaking of Pakistan, a friend who is a pediatrician there said that childhood vaccinations have declined by 50% since the start of the pandemic, possibly because parents are too scared to go to a medical facility to have it done out of concern of being infected by covid19. The secondary impacts from the pandemic and our response are going to start becoming more apparent.
- dimitrios1 6y ago
  Suicides, hunger + starvation due, cancers and other diseases or illnesses not caught early, domestic abuse incidents, civil unrest (people get antsy when they have nothing to do). I'd say they are already pretty apparent, people are just fine to have their heads in the sand.
  - mrb 6y ago
    The only data I've seen (Peru) suggests that lockdowns significantly 𝗱𝗲𝗰𝗿𝗲𝗮𝘀𝗲𝗱 homicides, suicides, traffic accidents, and other accidental deaths. I wonder if the same effect exists in other countries: https://mobile.twitter.com/zorinaq/status/1314844027846500354 https://mobile.twitter.com/zorinaq/status/131484402784650035...
    - dimitrios1 6y ago
      I didn't mention homicides. Traffic accidents being down makes complete sense -- nobody is going anywhere. The CDC says there is an increase in suicide ideation https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm The PAHO says the pandemic exacerbates suicide risk factors https://www.paho.org/en/news/10-9-2020-covid-19-pandemic-exacerbates-suicide-risk-factors https://www.paho.org/en/news/10-9-2020-covid-19-pandemic-exa... There are some other studies that I don't necessarily know what to make of that already say they are increasing.
      - mrb 6y ago
        I copy pasted the text. Anyway, suicides are decreasing in Peru. That's the important point.
  - chillwaves 6y ago
    Sounds like we need to restructure our social safety nets in America to prevent hunger + starvation and make sure people get the health care they need regardless of their ability to pay.
    - dimitrios1 6y ago
      That's what you got from this? An opportunity to inject a political talking point? People are afraid to go into a hospital. From March until September (for some states), people were being turned away because their routine screenings and exams were not seen as essential. Screenings and exams that can catch lumps, polyps, etc. Routine medical care is down across the board. Dental health is suffering. For food, global supply chains have been interrupted and brought to a halt. These have months-long reverberations that have yet to be fully recovered. The people who suffer the most from supply chain interruptions are the most vulnerable, and those that live in food deserts. Again, money hasn't been mentioned yet. But yes, you do have a mass loss of ability to provide, and businesses going under at record pace. There isn't a social safety net in the world you could construct to suddenly handle millions going out of work because of lockdowns.
      - chillwaves 6y ago
        COVID isn't the only barrier to access to health care. > There isn't a social safety net in the world you could construct to suddenly handle millions going out of work because of lockdowns. I disagree. Seems easily doable, given the wealth and capacity of the country. Just a matter of political will. Why have other countries managed to take care of their workers? Maybe we can ask Canada for pointers?
      - R0b0t1 6y ago
        Are there accessible data on this? From where I'm standing now in the US, coverage about the pandemic has basically halted.
        R0b0t1 6y ago
        I mean, there are superficial articles referencing the pandemic all of the time despite with some inappropriate decline in mainstream news. There is nothing (besides HN?) that seems to be tracking the research closely.
mrb 6y ago
Indeed. The Economist recently analyzed excess deaths data and concluded the true number of COVID-19 deaths is likely about twice higher as of September, or about 2M: https://mobile.twitter.com/JamesFransham/status/1309560070322237442 https://mobile.twitter.com/JamesFransham/status/130956007032... In any case we know India and Brazil (2nd and 3rd country with highest death toll) are underreporting deaths: https://www.bmj.com/content/370/bmj.m2859 https://www.bmj.com/content/370/bmj.m2859 and https://mobile.twitter.com/muradbanaji/status/1284481215563575296 https://mobile.twitter.com/muradbanaji/status/12844812155635...
nradov 6y ago
Researchers in India conducted an antibody seroprevalence study of poor people in Mumbai and calculated a fatality rate under 0.1%. The tests were free, subjects didn't have to pay anything. https://mumbaimirror.indiatimes.com/coronavirus/news/sero-survey-finds-antibodies-in-57-of-those-tested-in-slums/articleshow/77231626.cms https://mumbaimirror.indiatimes.com/coronavirus/news/sero-su...
- mkolodny 6y ago
  Do people in Mumbai get Covid-19 positivity tests for free? If not, then I'd be surprised if all of the 18 million people in Mumbai have been able to afford them.
  - nradov 6y ago
    Did you read the article? They gave free tests to a random sample of Mumbai residents.
    - mkolodny 6y ago
      Antibody tests check whether someone has had Covid-19 in the past. Those tests are different from tests which check to see whether someone currently has Covid-19. If someone dies without having already tested positive for Covid-19, in many places they won't be counted as having died from Covid-19. So it's likely that many Covid-19 deaths haven't been counted - especially in places where most people can't afford the tests that check whether they currently have Covid-19.
Barrin92 6y ago
> in many other places like China outside Wuhan and in India, the inferred death rate is close to 0.0% it's very plausible that it's < 0.1%. Singapore and large parts of Africa or the ME have seen few deaths. Young populations, low rates of obesity, diabetes and other diseases that probably plague regions like Louisiana will change the outcomes quite drastically. Singapore in particular is probably a high fidelity case. It has one of the highest testing rates on the globe, likely clean data and they've registered 28 deaths on >50k cases.
- nopzor 6y ago
  singapore has a special factor that you didnt mention. the very large majority of their cases were in foreign worker dorms. almost none of these workers are over 40, and are generally in good health. so the demographics are very different.
  - Barrin92 6y ago
    >so the demographics are very different. yeah sure but that's the point. the demographics in much of the world are more favourable. The median age in Nigeria is 18 years, on the African continent 20. Much of Asia is relatively young as well. It's the Western places who are the outlier.
    - nopzor 6y ago
      you’re missing my point. singapore has a more elderly population than the usa. the covid outbreak was largely in foreign worker forms which have a much lower average age than the rest of singapore. singapore is not nigeria. it’s quite an elderly society.
r00fus 6y ago
Would data about excess death vs COVID death prove the matter?
spfzero 6y ago
If you look at China, but omit Wuhan, then wouldn’t the better comparison be to the U.S., omitting Louisiana? Why take the highest region in the U.S., and compare to another country while specifically omitting the highest region there?
- mkolodny 6y ago
  From the paper: "Locations are defined at the level of countries, except for the USA where they are defined at the level of states and China is separated into Wuhan and non-Wuhan areas."

Mountain_Skies 6y ago

Speaking of Pakistan, a friend who is a pediatrician there said that childhood vaccinations have declined by 50% since the start of the pandemic, possibly because parents are too scared to go to a medical facility to have it done out of concern of being infected by covid19. The secondary impacts from the pandemic and our response are going to start becoming more apparent.

dimitrios1 6y ago
Suicides, hunger + starvation due, cancers and other diseases or illnesses not caught early, domestic abuse incidents, civil unrest (people get antsy when they have nothing to do). I'd say they are already pretty apparent, people are just fine to have their heads in the sand.
- mrb 6y ago
  The only data I've seen (Peru) suggests that lockdowns significantly 𝗱𝗲𝗰𝗿𝗲𝗮𝘀𝗲𝗱 homicides, suicides, traffic accidents, and other accidental deaths. I wonder if the same effect exists in other countries: https://mobile.twitter.com/zorinaq/status/1314844027846500354 https://mobile.twitter.com/zorinaq/status/131484402784650035...
  - dimitrios1 6y ago
    I didn't mention homicides. Traffic accidents being down makes complete sense -- nobody is going anywhere. The CDC says there is an increase in suicide ideation https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm The PAHO says the pandemic exacerbates suicide risk factors https://www.paho.org/en/news/10-9-2020-covid-19-pandemic-exacerbates-suicide-risk-factors https://www.paho.org/en/news/10-9-2020-covid-19-pandemic-exa... There are some other studies that I don't necessarily know what to make of that already say they are increasing.
    - mrb 6y ago
      I copy pasted the text. Anyway, suicides are decreasing in Peru. That's the important point.
- chillwaves 6y ago
  Sounds like we need to restructure our social safety nets in America to prevent hunger + starvation and make sure people get the health care they need regardless of their ability to pay.
  - dimitrios1 6y ago
    That's what you got from this? An opportunity to inject a political talking point? People are afraid to go into a hospital. From March until September (for some states), people were being turned away because their routine screenings and exams were not seen as essential. Screenings and exams that can catch lumps, polyps, etc. Routine medical care is down across the board. Dental health is suffering. For food, global supply chains have been interrupted and brought to a halt. These have months-long reverberations that have yet to be fully recovered. The people who suffer the most from supply chain interruptions are the most vulnerable, and those that live in food deserts. Again, money hasn't been mentioned yet. But yes, you do have a mass loss of ability to provide, and businesses going under at record pace. There isn't a social safety net in the world you could construct to suddenly handle millions going out of work because of lockdowns.
    - chillwaves 6y ago
      COVID isn't the only barrier to access to health care. > There isn't a social safety net in the world you could construct to suddenly handle millions going out of work because of lockdowns. I disagree. Seems easily doable, given the wealth and capacity of the country. Just a matter of political will. Why have other countries managed to take care of their workers? Maybe we can ask Canada for pointers?
    - R0b0t1 6y ago
      Are there accessible data on this? From where I'm standing now in the US, coverage about the pandemic has basically halted.
      - R0b0t1 6y ago
        I mean, there are superficial articles referencing the pandemic all of the time despite with some inappropriate decline in mainstream news. There is nothing (besides HN?) that seems to be tracking the research closely.

mrb 6y ago

Indeed. The Economist recently analyzed excess deaths data and concluded the true number of COVID-19 deaths is likely about twice higher as of September, or about 2M: https://mobile.twitter.com/JamesFransham/status/1309560070322237442 https://mobile.twitter.com/JamesFransham/status/130956007032... In any case we know India and Brazil (2nd and 3rd country with highest death toll) are underreporting deaths: https://www.bmj.com/content/370/bmj.m2859 https://www.bmj.com/content/370/bmj.m2859 and https://mobile.twitter.com/muradbanaji/status/1284481215563575296 https://mobile.twitter.com/muradbanaji/status/12844812155635...

nradov 6y ago

Researchers in India conducted an antibody seroprevalence study of poor people in Mumbai and calculated a fatality rate under 0.1%. The tests were free, subjects didn't have to pay anything. https://mumbaimirror.indiatimes.com/coronavirus/news/sero-survey-finds-antibodies-in-57-of-those-tested-in-slums/articleshow/77231626.cms https://mumbaimirror.indiatimes.com/coronavirus/news/sero-su...

mkolodny 6y ago
Do people in Mumbai get Covid-19 positivity tests for free? If not, then I'd be surprised if all of the 18 million people in Mumbai have been able to afford them.
- nradov 6y ago
  Did you read the article? They gave free tests to a random sample of Mumbai residents.
  - mkolodny 6y ago
    Antibody tests check whether someone has had Covid-19 in the past. Those tests are different from tests which check to see whether someone currently has Covid-19. If someone dies without having already tested positive for Covid-19, in many places they won't be counted as having died from Covid-19. So it's likely that many Covid-19 deaths haven't been counted - especially in places where most people can't afford the tests that check whether they currently have Covid-19.

Barrin92 6y ago

> in many other places like China outside Wuhan and in India, the inferred death rate is close to 0.0% it's very plausible that it's < 0.1%. Singapore and large parts of Africa or the ME have seen few deaths. Young populations, low rates of obesity, diabetes and other diseases that probably plague regions like Louisiana will change the outcomes quite drastically. Singapore in particular is probably a high fidelity case. It has one of the highest testing rates on the globe, likely clean data and they've registered 28 deaths on >50k cases.

nopzor 6y ago
singapore has a special factor that you didnt mention. the very large majority of their cases were in foreign worker dorms. almost none of these workers are over 40, and are generally in good health. so the demographics are very different.
- Barrin92 6y ago
  >so the demographics are very different. yeah sure but that's the point. the demographics in much of the world are more favourable. The median age in Nigeria is 18 years, on the African continent 20. Much of Asia is relatively young as well. It's the Western places who are the outlier.
  - nopzor 6y ago
    you’re missing my point. singapore has a more elderly population than the usa. the covid outbreak was largely in foreign worker forms which have a much lower average age than the rest of singapore. singapore is not nigeria. it’s quite an elderly society.

r00fus 6y ago

Would data about excess death vs COVID death prove the matter?

spfzero 6y ago

If you look at China, but omit Wuhan, then wouldn’t the better comparison be to the U.S., omitting Louisiana? Why take the highest region in the U.S., and compare to another country while specifically omitting the highest region there?

mkolodny 6y ago
From the paper: "Locations are defined at the level of countries, except for the USA where they are defined at the level of states and China is separated into Wuhan and non-Wuhan areas."