10 ms·

Due to massive population and relatively sparse testing centers available, IMV, numbers might have been off even the first time. Even this time, I think the num

Due to massive population and relatively sparse testing centers available, IMV, numbers might have been off even the first time. Even this time, I think the numbers are far off. In my home, during the first wave, all family members caught fever. All of us took an antiviral medicine. We were already isolated, in the peak of lockdown. Took all precautions and avoided contact with anyone else. The doctor who we consulted, our regular family doctor, did not recommend for testing and in any case, testing was not easily accessible. I suspect a lot of such instances are there and the real infection numbers might be around 3 times the reported figures. If that is true, what is remarkable is the low death rate.

__blockcipher__ 6y ago
> If that is true, what is remarkable is the low death rate. Not sure what the implied IFR of your scenario is, but FWIW John Ioannidis has the global IFR at .15%. Furthermore SARS-2 is so incredibly age stratified wrt risk (something we conveniently ignore in public health mandates) that non-1st-world countries can have incredibly low death rates since fewer people survive to old age (and there is relatively less prevalence of diseases of modernity). Whereas the data I’ve seen for the increases in global poverty, child starvation, missed medical appointments and missed [non-COVID] vaccinations is staggering. Yet another cost of a one-size-fits-all approach taken across the globe. Take a look through a dataset of COVID deaths and you’ll notice something that gets lip service but isn’t talked about nearly enough: https://datacatalog.cookcountyil.gov/widgets/3trz-enys https://datacatalog.cookcountyil.gov/widgets/3trz-enys Diseases of modernity.
- Gibbon1 6y ago
  > John Ioannidis Not a credible source.
  - __blockcipher__ 6y ago
    Literally wrote one of the most famous evidence-based papers in the world about why most interventions don’t work. But Gibbon1 said he’s not a credible source because he doesn’t like his conclusions even though he works with the WHO to publish global SARS/2 IFR research. Got it, I’ll perform a bayesian update with this new info. ...Hmm, weird, my posteriors didn’t change at all.
    - Gibbon1 6y ago
      His paper early in 2020 showing high levels of infection in Santa Clara County was hot garbage. The man is a total and complete embarrassment. https://sciencebasedmedicine.org/what-the-heck-happened-to-john-ioannidis/ https://sciencebasedmedicine.org/what-the-heck-happened-to-j...
    - cameldrv 6y ago
      Ioannidis has made claims of very low IFRs throughout the pandemic. If you go look at hard hit areas though, the population fatality rate is higher than his infection fatality rate. Just as one example, New Jersey has close to a 0.3% population fatality rate. If Ioannidis were correct, that would imply that every person in New Jersey had been infected twice. Ioannidis may have had some very interesting ideas, but his data analysis on COVID has simply been shown to be incorrect.
      - __blockcipher__ 6y ago
        You’re comparing global IFR to a specific region. Not the same claim. US mortality is worse because of our extensive diseases of modernity and decent proportion of elderly. Furthermore you are assuming that the excess deaths are solely attributable to COVID-19. The truth is not even close.
        cameldrv 6y ago
        No, I'm talking about confirmed COVID deaths. Ioandis' original study was in Santa Clara County, CA, where they estimated 0.17%. I don't see how New Jersey, for example, materially differs in a relevant way in terms of population statistics from Santa Clara. I would also note that New Jersey STILL has a high COVID case rate, even with 47% of the population vaccinated. They did not achieve herd immunity with their 0.3% death rate, because far less than 100% of the population has gotten COVID, so the IFR is very obviously significantly higher than 0.3%. They made a prediction, the prediction was wrong. It's clearly motivated reasoning, because the authors on these studies have had policy prescriptions since the very beginning that depend on COVID not being very dangerous. Unfortunately reality is not required to adhere to a particular set of political views, and arguing with a virus is not effective.
  - xxxxxxx12 6y ago
    Ah ok! The esteemed internet silhouette Gibbon1 informs us that the credentialed expert John Ioannidis is not credible.
sn41 6y ago
Your suspicion may be right, the actual maybe off by a large factor. Sero survey whose results were available early February statistically indicated about 270 million exposures (as indicated by presence of antibodies) till February [1] (assuming a population of 1300 million). [1] https://www.businesstoday.in/latest/trends/over-21-indians-already-exposed-to-covid-19-shows-sero-survey/story/430318.html https://www.businesstoday.in/latest/trends/over-21-indians-a...
daliusd 6y ago
India is relatively young country - that might explain the low death rate. It would be interesting to see statistics by age groups compared to countries like Italy.
- kumarvvr 6y ago
  True. I also suspect that, in general, Indian people are exposed to more pathogens on a daily basis compared to developed countries. It might be due to factors such as lax regulation in food and restaurant sectors (street food is highly popular among the young and old, and its generally not too hygienic). There might be more faster and stronger immunological responses due to this increased exposure.
  - vijaybritto 6y ago
    Please stop saying this "we may be more immune because we are exposed to more viruses". Doctors have repeatedly clarified that this is not true and this immunity does not help in COVID's case. This is an argument used by antivaxxers all across the country. This also pushes people to false medicines like Ayurveda/Homeotherapy
    - hesarenu 6y ago
      I don't think there are many antivaxxers in india. The group who are in Ayurveda are more likely to take the vaccine and continue using Ayurveda thats from my experience.
      - bongoman37 6y ago
        Unfortunately, there are plenty of antivaxxers in India, especially in the upper middle classes who copy talking points from crunchy western folks. Its not as high as that in, say, California but it is a non negligible fraction.
      - boruto 6y ago
        While this is true about people who follow Ayurveda, Many people thought covid was not a big deal from because how easy the first wave went through. The vaccine slots were mostly free till a month back when the crunch started.
isolli 6y ago
I also wonder if the virus could be spreading fast through India's extremely dense urban areas, and would naturally slow down in rural areas. Since 2/3 of Indians live in rural areas, that would be another reason to hope for a low death rate for the country overall.
ramraj07 6y ago
What do you mean by “took antiviral” during the first surge? What antiviral was available in india back then? Tamiflu?
- sanmon3186 6y ago
  I think OP meant antibiotics, not antivirals.
- kumarvvr 6y ago
  Sorry, I mean antibiotics. Specifically Azithromycin.
deven88 6y ago
> If that is true, what is remarkable is the low death rate. Death count is also very much under reported.[1] I am not able to find the reference but only testing count is reliable, positive case and death counts are highly under reported. [1] 4th plot. https://www.ft.com/content/683914a3-134f-40b6-989b-21e0ba1dc403 https://www.ft.com/content/683914a3-134f-40b6-989b-21e0ba1dc...
CaptArmchair 6y ago
> massive population I think population size is incredibly underappreciated. It's hard to comprehend large numbers. More to the point, 1.3 billion people. On par with China. Those are the two most populous nations in the world. Third place is the United States. With 334 million people, which is 1/4th in size compared to India or China. To put that in perspective: the world population today is 7.7 billion. Those 3 countries together constitute about 37% of the global population. https://www.cia.gov/the-world-factbook/countries/world/#people-and-society https://www.cia.gov/the-world-factbook/countries/world/#peop... 273.000 cases on april 18th, that's 0.021% of India's population. To be clear: I do not intend to diminish the amount of suffering. 273k a day is an insane number of people who require specialized healthcare. India is also a microcosmos unto itself. It's an incredibly complex and diverse society due to it's sheer size. That's also something which is underappreciated if you live across the world. Even in this day and age, it's worth being aware of the fact that news from India tends to be condensed in a few terse paragraphs published on, predominantly western, ephemeral online outlets. In the process, the complexity of India is easily lost. Why is that important? Because many readers of the news will tend to compare that to their own frame of reference. When people argue about the accuracy of numbers from PCR testing, hospital admissions, deaths,... it's easy to forget that this pertains to a 1.3 billion people across a diverse continent, having conditions which aren't at all equal regardless of where you travel. My point here is this: the vastness and the complexity of the continent compared with a rapidly unfolding event make it hard to observe and comprehend what is going on. This isn't a new issue. It was, and to an extent still is, an issue when one tries to assess the exact impact of the Spanish Flu in India: The number of deaths caused by Spanish Flu in India is an estimate as well ranging from 12 million to 17-18 million on Wikipedia. And that's during a time when the population was vastly lower then it is today: the 1921 census states recorded a population of 318 million. What historians do have asserted is the social and political impact of the pandemic on the Indian sentiment regarding the then colonial rule, and, in the long run, triggered a long rally towards independence. Even though exact data are hard to come by. https://en.wikipedia.org/wiki/1918_flu_pandemic_in_India https://en.wikipedia.org/wiki/1918_flu_pandemic_in_India https://www.censusindia.gov.in/Census_And_You/old_report/census_1921.aspx https://www.censusindia.gov.in/Census_And_You/old_report/cen... Even in this day and age, the fact that everyone - scientists, data experts, policy makers - are puzzled and wildly speculating about what's going on in India is also a reflection of the limited capabilities of modern technology as well. Even in an era of digitization it's still extremely hard to gather data from a complex, rapidly involving context and being able to ask relevant questions which will yield to a more accurate explanation. Rather then enless speculating about the exactness of data, the big question for Indian policy makers on all administrative and governmental levels would be: how to respond? how to save lives? how to protect the country's infrastructure? And how to do all that in a flexible, transparent, effective manner which can capture / cater to the complexity of the Indian nation.
dominotw 6y ago
https://news.ycombinator.com/item?id=23004361 https://news.ycombinator.com/item?id=23004361 Top comment here suggests that india did really good with lockdowns first time around. They just got too confident?

__blockcipher__ 6y ago

> If that is true, what is remarkable is the low death rate. Not sure what the implied IFR of your scenario is, but FWIW John Ioannidis has the global IFR at .15%. Furthermore SARS-2 is so incredibly age stratified wrt risk (something we conveniently ignore in public health mandates) that non-1st-world countries can have incredibly low death rates since fewer people survive to old age (and there is relatively less prevalence of diseases of modernity). Whereas the data I’ve seen for the increases in global poverty, child starvation, missed medical appointments and missed [non-COVID] vaccinations is staggering. Yet another cost of a one-size-fits-all approach taken across the globe. Take a look through a dataset of COVID deaths and you’ll notice something that gets lip service but isn’t talked about nearly enough: https://datacatalog.cookcountyil.gov/widgets/3trz-enys https://datacatalog.cookcountyil.gov/widgets/3trz-enys Diseases of modernity.

Gibbon1 6y ago
> John Ioannidis Not a credible source.
- __blockcipher__ 6y ago
  Literally wrote one of the most famous evidence-based papers in the world about why most interventions don’t work. But Gibbon1 said he’s not a credible source because he doesn’t like his conclusions even though he works with the WHO to publish global SARS/2 IFR research. Got it, I’ll perform a bayesian update with this new info. ...Hmm, weird, my posteriors didn’t change at all.
  - Gibbon1 6y ago
    His paper early in 2020 showing high levels of infection in Santa Clara County was hot garbage. The man is a total and complete embarrassment. https://sciencebasedmedicine.org/what-the-heck-happened-to-john-ioannidis/ https://sciencebasedmedicine.org/what-the-heck-happened-to-j...
  - cameldrv 6y ago
    Ioannidis has made claims of very low IFRs throughout the pandemic. If you go look at hard hit areas though, the population fatality rate is higher than his infection fatality rate. Just as one example, New Jersey has close to a 0.3% population fatality rate. If Ioannidis were correct, that would imply that every person in New Jersey had been infected twice. Ioannidis may have had some very interesting ideas, but his data analysis on COVID has simply been shown to be incorrect.
    - __blockcipher__ 6y ago
      You’re comparing global IFR to a specific region. Not the same claim. US mortality is worse because of our extensive diseases of modernity and decent proportion of elderly. Furthermore you are assuming that the excess deaths are solely attributable to COVID-19. The truth is not even close.
      - cameldrv 6y ago
        No, I'm talking about confirmed COVID deaths. Ioandis' original study was in Santa Clara County, CA, where they estimated 0.17%. I don't see how New Jersey, for example, materially differs in a relevant way in terms of population statistics from Santa Clara. I would also note that New Jersey STILL has a high COVID case rate, even with 47% of the population vaccinated. They did not achieve herd immunity with their 0.3% death rate, because far less than 100% of the population has gotten COVID, so the IFR is very obviously significantly higher than 0.3%. They made a prediction, the prediction was wrong. It's clearly motivated reasoning, because the authors on these studies have had policy prescriptions since the very beginning that depend on COVID not being very dangerous. Unfortunately reality is not required to adhere to a particular set of political views, and arguing with a virus is not effective.
- xxxxxxx12 6y ago
  Ah ok! The esteemed internet silhouette Gibbon1 informs us that the credentialed expert John Ioannidis is not credible.

sn41 6y ago

Your suspicion may be right, the actual maybe off by a large factor. Sero survey whose results were available early February statistically indicated about 270 million exposures (as indicated by presence of antibodies) till February [1] (assuming a population of 1300 million). [1] https://www.businesstoday.in/latest/trends/over-21-indians-already-exposed-to-covid-19-shows-sero-survey/story/430318.html https://www.businesstoday.in/latest/trends/over-21-indians-a...

daliusd 6y ago

India is relatively young country - that might explain the low death rate. It would be interesting to see statistics by age groups compared to countries like Italy.

kumarvvr 6y ago
True. I also suspect that, in general, Indian people are exposed to more pathogens on a daily basis compared to developed countries. It might be due to factors such as lax regulation in food and restaurant sectors (street food is highly popular among the young and old, and its generally not too hygienic). There might be more faster and stronger immunological responses due to this increased exposure.
- vijaybritto 6y ago
  Please stop saying this "we may be more immune because we are exposed to more viruses". Doctors have repeatedly clarified that this is not true and this immunity does not help in COVID's case. This is an argument used by antivaxxers all across the country. This also pushes people to false medicines like Ayurveda/Homeotherapy
  - hesarenu 6y ago
    I don't think there are many antivaxxers in india. The group who are in Ayurveda are more likely to take the vaccine and continue using Ayurveda thats from my experience.
    - bongoman37 6y ago
      Unfortunately, there are plenty of antivaxxers in India, especially in the upper middle classes who copy talking points from crunchy western folks. Its not as high as that in, say, California but it is a non negligible fraction.
    - boruto 6y ago
      While this is true about people who follow Ayurveda, Many people thought covid was not a big deal from because how easy the first wave went through. The vaccine slots were mostly free till a month back when the crunch started.

isolli 6y ago

I also wonder if the virus could be spreading fast through India's extremely dense urban areas, and would naturally slow down in rural areas. Since 2/3 of Indians live in rural areas, that would be another reason to hope for a low death rate for the country overall.

ramraj07 6y ago

What do you mean by “took antiviral” during the first surge? What antiviral was available in india back then? Tamiflu?

sanmon3186 6y ago
I think OP meant antibiotics, not antivirals.
kumarvvr 6y ago
Sorry, I mean antibiotics. Specifically Azithromycin.

deven88 6y ago

> If that is true, what is remarkable is the low death rate. Death count is also very much under reported.[1] I am not able to find the reference but only testing count is reliable, positive case and death counts are highly under reported. [1] 4th plot. https://www.ft.com/content/683914a3-134f-40b6-989b-21e0ba1dc403 https://www.ft.com/content/683914a3-134f-40b6-989b-21e0ba1dc...

CaptArmchair 6y ago

> massive population I think population size is incredibly underappreciated. It's hard to comprehend large numbers. More to the point, 1.3 billion people. On par with China. Those are the two most populous nations in the world. Third place is the United States. With 334 million people, which is 1/4th in size compared to India or China. To put that in perspective: the world population today is 7.7 billion. Those 3 countries together constitute about 37% of the global population. https://www.cia.gov/the-world-factbook/countries/world/#people-and-society https://www.cia.gov/the-world-factbook/countries/world/#peop... 273.000 cases on april 18th, that's 0.021% of India's population. To be clear: I do not intend to diminish the amount of suffering. 273k a day is an insane number of people who require specialized healthcare. India is also a microcosmos unto itself. It's an incredibly complex and diverse society due to it's sheer size. That's also something which is underappreciated if you live across the world. Even in this day and age, it's worth being aware of the fact that news from India tends to be condensed in a few terse paragraphs published on, predominantly western, ephemeral online outlets. In the process, the complexity of India is easily lost. Why is that important? Because many readers of the news will tend to compare that to their own frame of reference. When people argue about the accuracy of numbers from PCR testing, hospital admissions, deaths,... it's easy to forget that this pertains to a 1.3 billion people across a diverse continent, having conditions which aren't at all equal regardless of where you travel. My point here is this: the vastness and the complexity of the continent compared with a rapidly unfolding event make it hard to observe and comprehend what is going on. This isn't a new issue. It was, and to an extent still is, an issue when one tries to assess the exact impact of the Spanish Flu in India: The number of deaths caused by Spanish Flu in India is an estimate as well ranging from 12 million to 17-18 million on Wikipedia. And that's during a time when the population was vastly lower then it is today: the 1921 census states recorded a population of 318 million. What historians do have asserted is the social and political impact of the pandemic on the Indian sentiment regarding the then colonial rule, and, in the long run, triggered a long rally towards independence. Even though exact data are hard to come by. https://en.wikipedia.org/wiki/1918_flu_pandemic_in_India https://en.wikipedia.org/wiki/1918_flu_pandemic_in_India https://www.censusindia.gov.in/Census_And_You/old_report/census_1921.aspx https://www.censusindia.gov.in/Census_And_You/old_report/cen... Even in this day and age, the fact that everyone - scientists, data experts, policy makers - are puzzled and wildly speculating about what's going on in India is also a reflection of the limited capabilities of modern technology as well. Even in an era of digitization it's still extremely hard to gather data from a complex, rapidly involving context and being able to ask relevant questions which will yield to a more accurate explanation. Rather then enless speculating about the exactness of data, the big question for Indian policy makers on all administrative and governmental levels would be: how to respond? how to save lives? how to protect the country's infrastructure? And how to do all that in a flexible, transparent, effective manner which can capture / cater to the complexity of the Indian nation.

dominotw 6y ago

https://news.ycombinator.com/item?id=23004361 https://news.ycombinator.com/item?id=23004361 Top comment here suggests that india did really good with lockdowns first time around. They just got too confident?