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> for now we assume that total COVID-19 deaths equal excess mortality. This seems reasonable, although I'd suggest it's an underestimate of COVID-19 deaths. E

> for now we assume that total COVID-19 deaths equal excess mortality. This seems reasonable, although I'd suggest it's an underestimate of COVID-19 deaths. Excess deaths counts have been consistently showing negative in countries during periods of time where they have coronavirus under control. Other significant causes of death (including suicide, influenza, road traffic accidents) appear to be down. As such, I'd assume that COVID-19 deaths are likely somewhat higher than excess mortality figures. I'm prepared to accept the assumption that they're approximately the same. [Edited to note: the linked article discusses this with further detail and evidence]

pbreit 5y ago
Excess deaths could easily be attributed to non-covid factors like Alzheimer’s. Suggesting the US had 900k covid deaths is ridiculous. Only 1 of the 6 considered factors lists covid as a direct cause.
- joshuamorton 5y ago
  > Excess deaths could easily be attributed to non-covid factors like Alzheimer’s. Why would there suddenly be an 100% YoY increase in the number of Alzheimers deaths?
  - craftinator 5y ago
    Because we like to ignore facts that counter our worldviews.
  - pbreit 5y ago
    Hospitals and doctors were basically not handling any non-covid patients.
    - joshuamorton 5y ago
      Alzeimer's currently doesn't have any effective treatments, so I'd repeat the question: how would the fatality rate from Alzheimer's double year over year?
      - pbreit 5y ago
        Alzheimers patients are among the worst off in a restricted healthcare scenario. https://www.wsj.com/articles/coronavirus-pandemic-led-to-surge-in-alzheimers-deaths-11593345601 https://www.wsj.com/articles/coronavirus-pandemic-led-to-sur...
deleted 5y ago
[deleted]
galangalalgol 5y ago
I just don't understand where they got such high excess death numbers in the first place. Fitting a sinusoid with a 52 week perios and adding a slope for population growth you can get a very good (R=99.xx) fit up until the pandemic. Using that ramped sinusoid the excess death number comes out about 50k over the reported covid totals. Edit: data source is cdc total mortality page. Going back to 2014
timr 5y ago
> [Edited to note: the linked article discusses this with further detail and evidence] Here's the sum total of evidence provided: > An analysis by the Netherlands statistical agency suggested that all excess deaths in the Netherlands were directly due to COVID-19 So they use a single study out of Europe to extrapolate here. > The second driver of excess mortality is reduced health care utilization for many causes;3 however, the impact of reduced health care use on health outcomes is harder to prove. Many mechanisms have been proposed, including reduced vaccination rates and reduced births in hospital.4 Demonstrated increases in cause-specific mortality related to these causes, however, have not yet been verified. The impact of changes in health care utilization on excess mortality may be observed in later years, rather than in 2020 or the first quarter of 2021. So they dismiss this. > Third, convincing evidence has been found that rates of anxiety and depression have increased, which might in turn lead to increases in deaths from suicide.5 To date, the evidence on increased suicide is very limited.6 Opioid deaths, on the other hand, have clearly increased7 in the United States. Compared to past trends, opioid deaths increased by around 15,000 since March 2020. Evidence on whether this has also occurred in other countries awaits further study. So again, they dismiss this. > Fourth, we reviewed the evidence on decreases in injuries as a result of reductions in mobility. We analyzed data from 12 countries that provide cause of death data by week or month, which allows us to test whether some causes decreased significantly during 2020 and whether that decrease was related to the decreases in mobility that have been reported. This analysis suggests that globally, injury mortality decreased by 5% in 2020 due to reductions in mobility. At the global level, this translates into a reduction of approximately 215,000 deaths. Conveniently, when then assumption works out in their favor, they include it in the model. > Fifth, some infectious causes of death may have declined during the pandemic due to the behavioral changes associated with control of the pandemic, including mask use and reduced contact with others. Causes that have clearly declined are influenza,8,9 respiratory syncytial virus,10 measles,11 and possibly other respiratory viruses and viral diarrheas. For example, influenza cases in the United States declined 99.3% from the winter season of 2019–2020 to the winter season of 2020–2021. Combining the reductions reported in different countries in influenza, respiratory syncytial virus, and measles, the global reduction in mortality from these causes may be larger than 400,000 deaths. Again, when the assumption works in their favor, they include it. > Sixth, deaths from some chronic conditions such as ischemic heart disease or chronic respiratory disease declined in some months of 2020, most notably in May and June in Europe. These declines were most likely due to the fact that frail individuals who died from COVID-19 earlier in the year would otherwise likely have died from these chronic conditions. The strongest evidence for this effect is that excess mortality was negative in some countries in Europe in June when the reported COVID-19 death rate was very low. In aggregate, this effect likely reduced mortality by only 2% based on our analysis. This is so egregious as to be laughable...they find evidence for something, and then "based on their analysis", limit the effects. > The main potential increases in excess mortality due to deferred care and increases in drug overdose and depression are hard to quantify at this point or are of a much smaller magnitude. Given that there is insufficient evidence to estimate these contributions to excess mortality, for now we assume that total COVID-19 deaths equal excess mortality. So they didn't even try. Again...I don't know what the right answer is here, but this is, at best, a biased reading of the available data. All you can do is throw up your hands and go back to first principles: without prospective validation, statistical models are fiction.
antibuddy 5y ago
I noticed (late summer last year) that especially age group 25-44 is/was affected in the US with a +25% (excess) mortality YoY. It is not entirely unusual that diseases affect different countries differently; However I found it peculiar.
- teachingassist 5y ago
  I suspect this is the same in other countries. 25-44 year olds don't usually die (typical mortality is approx 0.1%), so +25% represents a relatively small number in absolute terms.
  - antibuddy 5y ago
    At least in Germany[0] and Sweden I found nothing like that. [0]: https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Bevoelkerung/Sterbefaelle-Lebenserwartung/Tabellen/sonderauswertung-sterbefaelle.xlsx?__blob=publicationFile https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Bevoel... edit: I found no English version unfortunately, but at least the Excel file which is easier to work with.
  - username90 5y ago
    USA is an outlier on this. You can compare with Italy for example: https://www.statista.com/statistics/1191568/reported-deaths-from-covid-by-age-us/ https://www.statista.com/statistics/1191568/reported-deaths-... https://www.statista.com/statistics/1105061/coronavirus-deaths-by-region-in-italy/ https://www.statista.com/statistics/1105061/coronavirus-deat... USA has 30 times the deaths among 30-39 year olds but only 5.5 times the population. It isn't just Italy, almost every other country has a distribution similar to Italy.
    - gremlinsinc 5y ago
      Italy has a huge older population and a lot more lax on cigarettes... older smokers = raised chances of death... USA on the other hand has excess obesity across all metrics (I'm one), so if it hit younger ages harder here it's probably due to obesity epidemic raising death chances.
mschuster91 5y ago
> Excess deaths counts have been consistently showing negative in countries during periods of time where they have coronavirus under control. > Other significant causes of death (including suicide, influenza, road traffic accidents) appear to be down. That's most probably a direct factor of the containment measures. Influenza has been on sometimes historic lows (https://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ https://www.who.int/influenza/surveillance_monitoring/update...), and as many people have stayed home streets have been free and people don't drive home from bars totally drunk, both drastically reducing road accidents. Suicides however? These are going up by some indications (https://www.nature.com/articles/s41562-020-01042-z https://www.nature.com/articles/s41562-020-01042-z), as is domestic violence (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195322/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195322/).
- yyyk 5y ago
  Suicides rates are the same or down in most of the world[0], and were apparently reduced in the US during the pandemic[1]. [0] https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00091-2/fulltext https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0... [1] https://www.medrxiv.org/content/10.1101/2021.02.13.21251682v1 https://www.medrxiv.org/content/10.1101/2021.02.13.21251682v...
rajin444 5y ago
> Other significant causes of death (including suicide, influenza, road traffic accidents) appear to be down. Can you source your other claims? At least one seems to be wrong. Traffic deaths seem to be up: https://www.usatoday.com/story/money/cars/2021/03/05/pandemic-travel-traffic-deaths-up-8-2020-despite-driving-less/4590942001/ https://www.usatoday.com/story/money/cars/2021/03/05/pandemi...
- teachingassist 5y ago
  Other countries are reporting otherwise, typically in the tens of percents down. Singapore, Greece, India, Germany, UK, Zambia, Malta, Philippines: https://www.todayonline.com/singapore/fall-traffic-accidents-deaths-2020-anomaly-quieter-roads-during-covid-19-pandemic-police https://www.todayonline.com/singapore/fall-traffic-accidents... https://www.marketscreener.com/news/latest/Road-Traffic-Accidents-July-2020--31383155/ https://www.marketscreener.com/news/latest/Road-Traffic-Acci... https://www.hindustantimes.com/cities/delhi-news/road-accident-fatalities-hit-30-year-low-in-2020-101613770584900.html https://www.hindustantimes.com/cities/delhi-news/road-accide... https://www.destatis.de/EN/Themes/Society-Environment/Traffic-Accidents/_node.html https://www.destatis.de/EN/Themes/Society-Environment/Traffi... https://www.gov.uk/government/statistics/reported-road-casualties-in-great-britain-provisional-estimates-year-ending-june-2020 https://www.gov.uk/government/statistics/reported-road-casua... https://zambiareports.com/2020/07/22/332-die-road-accidents-second-quarter-2020/ https://zambiareports.com/2020/07/22/332-die-road-accidents-... https://newsbook.com.mt/en/2021-sees-decline-in-road-traffic-accidents-and-deaths/ https://newsbook.com.mt/en/2021-sees-decline-in-road-traffic... https://www.topgear.com.ph/news/motoring-news/mmda-edsa-road-crash-data-2020-a962-20200909 https://www.topgear.com.ph/news/motoring-news/mmda-edsa-road... These are mostly unchecked secondary sources, of course. But, your secondary source, the "National Safety Council", appears to over-report deaths compared to the Department of Transportation's later figures. In 2019, they over-reported by... 8%.

pbreit 5y ago

Excess deaths could easily be attributed to non-covid factors like Alzheimer’s. Suggesting the US had 900k covid deaths is ridiculous. Only 1 of the 6 considered factors lists covid as a direct cause.

joshuamorton 5y ago
> Excess deaths could easily be attributed to non-covid factors like Alzheimer’s. Why would there suddenly be an 100% YoY increase in the number of Alzheimers deaths?
- craftinator 5y ago
  Because we like to ignore facts that counter our worldviews.
- pbreit 5y ago
  Hospitals and doctors were basically not handling any non-covid patients.
  - joshuamorton 5y ago
    Alzeimer's currently doesn't have any effective treatments, so I'd repeat the question: how would the fatality rate from Alzheimer's double year over year?
    - pbreit 5y ago
      Alzheimers patients are among the worst off in a restricted healthcare scenario. https://www.wsj.com/articles/coronavirus-pandemic-led-to-surge-in-alzheimers-deaths-11593345601 https://www.wsj.com/articles/coronavirus-pandemic-led-to-sur...

deleted 5y ago

[deleted]

galangalalgol 5y ago

I just don't understand where they got such high excess death numbers in the first place. Fitting a sinusoid with a 52 week perios and adding a slope for population growth you can get a very good (R=99.xx) fit up until the pandemic. Using that ramped sinusoid the excess death number comes out about 50k over the reported covid totals. Edit: data source is cdc total mortality page. Going back to 2014

timr 5y ago

> [Edited to note: the linked article discusses this with further detail and evidence] Here's the sum total of evidence provided: > An analysis by the Netherlands statistical agency suggested that all excess deaths in the Netherlands were directly due to COVID-19 So they use a single study out of Europe to extrapolate here. > The second driver of excess mortality is reduced health care utilization for many causes;3 however, the impact of reduced health care use on health outcomes is harder to prove. Many mechanisms have been proposed, including reduced vaccination rates and reduced births in hospital.4 Demonstrated increases in cause-specific mortality related to these causes, however, have not yet been verified. The impact of changes in health care utilization on excess mortality may be observed in later years, rather than in 2020 or the first quarter of 2021. So they dismiss this. > Third, convincing evidence has been found that rates of anxiety and depression have increased, which might in turn lead to increases in deaths from suicide.5 To date, the evidence on increased suicide is very limited.6 Opioid deaths, on the other hand, have clearly increased7 in the United States. Compared to past trends, opioid deaths increased by around 15,000 since March 2020. Evidence on whether this has also occurred in other countries awaits further study. So again, they dismiss this. > Fourth, we reviewed the evidence on decreases in injuries as a result of reductions in mobility. We analyzed data from 12 countries that provide cause of death data by week or month, which allows us to test whether some causes decreased significantly during 2020 and whether that decrease was related to the decreases in mobility that have been reported. This analysis suggests that globally, injury mortality decreased by 5% in 2020 due to reductions in mobility. At the global level, this translates into a reduction of approximately 215,000 deaths. Conveniently, when then assumption works out in their favor, they include it in the model. > Fifth, some infectious causes of death may have declined during the pandemic due to the behavioral changes associated with control of the pandemic, including mask use and reduced contact with others. Causes that have clearly declined are influenza,8,9 respiratory syncytial virus,10 measles,11 and possibly other respiratory viruses and viral diarrheas. For example, influenza cases in the United States declined 99.3% from the winter season of 2019–2020 to the winter season of 2020–2021. Combining the reductions reported in different countries in influenza, respiratory syncytial virus, and measles, the global reduction in mortality from these causes may be larger than 400,000 deaths. Again, when the assumption works in their favor, they include it. > Sixth, deaths from some chronic conditions such as ischemic heart disease or chronic respiratory disease declined in some months of 2020, most notably in May and June in Europe. These declines were most likely due to the fact that frail individuals who died from COVID-19 earlier in the year would otherwise likely have died from these chronic conditions. The strongest evidence for this effect is that excess mortality was negative in some countries in Europe in June when the reported COVID-19 death rate was very low. In aggregate, this effect likely reduced mortality by only 2% based on our analysis. This is so egregious as to be laughable...they find evidence for something, and then "based on their analysis", limit the effects. > The main potential increases in excess mortality due to deferred care and increases in drug overdose and depression are hard to quantify at this point or are of a much smaller magnitude. Given that there is insufficient evidence to estimate these contributions to excess mortality, for now we assume that total COVID-19 deaths equal excess mortality. So they didn't even try. Again...I don't know what the right answer is here, but this is, at best, a biased reading of the available data. All you can do is throw up your hands and go back to first principles: without prospective validation, statistical models are fiction.

antibuddy 5y ago

I noticed (late summer last year) that especially age group 25-44 is/was affected in the US with a +25% (excess) mortality YoY. It is not entirely unusual that diseases affect different countries differently; However I found it peculiar.

teachingassist 5y ago
I suspect this is the same in other countries. 25-44 year olds don't usually die (typical mortality is approx 0.1%), so +25% represents a relatively small number in absolute terms.
- antibuddy 5y ago
  At least in Germany[0] and Sweden I found nothing like that. [0]: https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Bevoelkerung/Sterbefaelle-Lebenserwartung/Tabellen/sonderauswertung-sterbefaelle.xlsx?__blob=publicationFile https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Bevoel... edit: I found no English version unfortunately, but at least the Excel file which is easier to work with.
- username90 5y ago
  USA is an outlier on this. You can compare with Italy for example: https://www.statista.com/statistics/1191568/reported-deaths-from-covid-by-age-us/ https://www.statista.com/statistics/1191568/reported-deaths-... https://www.statista.com/statistics/1105061/coronavirus-deaths-by-region-in-italy/ https://www.statista.com/statistics/1105061/coronavirus-deat... USA has 30 times the deaths among 30-39 year olds but only 5.5 times the population. It isn't just Italy, almost every other country has a distribution similar to Italy.
  - gremlinsinc 5y ago
    Italy has a huge older population and a lot more lax on cigarettes... older smokers = raised chances of death... USA on the other hand has excess obesity across all metrics (I'm one), so if it hit younger ages harder here it's probably due to obesity epidemic raising death chances.

mschuster91 5y ago

> Excess deaths counts have been consistently showing negative in countries during periods of time where they have coronavirus under control. > Other significant causes of death (including suicide, influenza, road traffic accidents) appear to be down. That's most probably a direct factor of the containment measures. Influenza has been on sometimes historic lows (https://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/ https://www.who.int/influenza/surveillance_monitoring/update...), and as many people have stayed home streets have been free and people don't drive home from bars totally drunk, both drastically reducing road accidents. Suicides however? These are going up by some indications (https://www.nature.com/articles/s41562-020-01042-z https://www.nature.com/articles/s41562-020-01042-z), as is domestic violence (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195322/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195322/).

yyyk 5y ago
Suicides rates are the same or down in most of the world[0], and were apparently reduced in the US during the pandemic[1]. [0] https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00091-2/fulltext https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0... [1] https://www.medrxiv.org/content/10.1101/2021.02.13.21251682v1 https://www.medrxiv.org/content/10.1101/2021.02.13.21251682v...

rajin444 5y ago

> Other significant causes of death (including suicide, influenza, road traffic accidents) appear to be down. Can you source your other claims? At least one seems to be wrong. Traffic deaths seem to be up: https://www.usatoday.com/story/money/cars/2021/03/05/pandemic-travel-traffic-deaths-up-8-2020-despite-driving-less/4590942001/ https://www.usatoday.com/story/money/cars/2021/03/05/pandemi...

teachingassist 5y ago
Other countries are reporting otherwise, typically in the tens of percents down. Singapore, Greece, India, Germany, UK, Zambia, Malta, Philippines: https://www.todayonline.com/singapore/fall-traffic-accidents-deaths-2020-anomaly-quieter-roads-during-covid-19-pandemic-police https://www.todayonline.com/singapore/fall-traffic-accidents... https://www.marketscreener.com/news/latest/Road-Traffic-Accidents-July-2020--31383155/ https://www.marketscreener.com/news/latest/Road-Traffic-Acci... https://www.hindustantimes.com/cities/delhi-news/road-accident-fatalities-hit-30-year-low-in-2020-101613770584900.html https://www.hindustantimes.com/cities/delhi-news/road-accide... https://www.destatis.de/EN/Themes/Society-Environment/Traffic-Accidents/_node.html https://www.destatis.de/EN/Themes/Society-Environment/Traffi... https://www.gov.uk/government/statistics/reported-road-casualties-in-great-britain-provisional-estimates-year-ending-june-2020 https://www.gov.uk/government/statistics/reported-road-casua... https://zambiareports.com/2020/07/22/332-die-road-accidents-second-quarter-2020/ https://zambiareports.com/2020/07/22/332-die-road-accidents-... https://newsbook.com.mt/en/2021-sees-decline-in-road-traffic-accidents-and-deaths/ https://newsbook.com.mt/en/2021-sees-decline-in-road-traffic... https://www.topgear.com.ph/news/motoring-news/mmda-edsa-road-crash-data-2020-a962-20200909 https://www.topgear.com.ph/news/motoring-news/mmda-edsa-road... These are mostly unchecked secondary sources, of course. But, your secondary source, the "National Safety Council", appears to over-report deaths compared to the Department of Transportation's later figures. In 2019, they over-reported by... 8%.