5 ms·

It's important to remember that this is what the mortality looks like after all the measures that were put in place to protect against covid. I.e. after repeate

by gpm 5y ago

It's important to remember that this is what the mortality looks like after all the measures that were put in place to protect against covid. I.e. after repeated reasonably strict lock-downs, masks, travel restrictions, and so on and so forth. The increase in alcohol and drug deaths shouldn't be compared to the number of covid deaths that did occur to judge those measures, but to the number of covid deaths that didn't.

bsaul 5y ago
Unfortunately, I don’t think we have any definitive answer as to what those measures really did to prevent covid deaths, nor do i think will we ever (eg: the recent debate on sweden handling of covid)
- lettergram 5y ago
  I don’t think you can ever get anything definitive. But if you compare Norway, Denmark, Sweden and Finland. All in the same region, with very similar cultures, similar diets, similar language, etc etc You can see the difference clear enough to make inferences. There were a lot of people in the scientific community, Perhaps the majority, suggested Sweden’s method was superior to what many other countries were doing. The fact is, people are effectively believing what they want. There wouldn’t be a need for censorship if the truth was clear.
  - angelzen 5y ago
    The clarity presupposes that 'cumulative covid deaths / million' is the ultimate measure of a society's worth and achievement. We are incredibly focused on this one metric, to the expense of literally everything else.
  - benjaminwootton 5y ago
    You could compare the relative performance of US states for an even better comparator, eg Florida and Texas. I know they are in the news now, but they’ve been open all year and performed better than many more restricted states. Sweden is apparently much more dense in the cities, has larger cities, bigger migrant population etc so apparently making comparisons across Scandinavia isn’t as helpful as you would expect.
- gpm 5y ago
  I definitely don't think we have a definitive answer yet. I think one day you might be able to get a good definitiveish answer. For instance, you can assume that everyone gets covid in the "no measures" case, and extrapolate death rates using serosurveillance to get the portion of the population infected in reality. Once Covid is "over" you can see the number of people who died in reality. There will always be all sorts of errors in such an estimate. From bad data, to things like death rate depending on your assumptions about variants, vaccines, and the make up of the population. But once we get the "how we did in the end numbers" it's plausible that we can make some sort of comparison to "how we could have done".
- benjaminwootton 5y ago
  Indeed. Restrictions and deaths seem very loosely correlated. For the most part they delayed things, but there is surprisingly little evidence that the cure is better than the disease.
ummonk 5y ago
On the other hand the accurate comparison should be QALYs not deaths. Even leaving aside quality impacts, a 40 year old dying from lockdown-induced alcohol overdose loses far more life years than a 70 year old dying from no-lockdown COVID.
- betwixthewires 5y ago
  It is a good metric, but it comes off a bit callously, and if you're going to get into the weeds there you might need to consider that one persons years are not used as well as others by many metrics, so how do you calculate that? Income per year on average? Children reared? Discretionary spending as a judge to how well someone enjoyed their life? I'd say stopping at number of deaths is a better metric.
  - wyager 5y ago
    QALY isn’t perfect (or even especially good), but it’s clearly better than number of deaths.
    - betwixthewires 5y ago
      If it's so clear why don't you draw a picture as to why.
      - wyager 5y ago
        Because saving someone who’s 95 years old and about to keel over isn’t, on expectation, as valuable as saving someone who’s 5 years old and has a whole life ahead of them.
  - ummonk 5y ago
    If you think a 70 year old dying is anywhere near as bad as a 10 year old dying, I don't know what to say to you.
angelzen 5y ago
Very true. But at some point the public discourse and public health policy must consider tradeoffs. A. Lockdowns have costs. Deficits that will take decades to pay off. Lives lost to alcohol and depression. Economic hardship. A lost education year. Etc. B. The pandemic has vastly different risk profiles for different age groups. At an extreme, under 20s have 1/1000 fatality risk compared to over 70s. It is fundamentally faulty to design a blanket one size fits all policy under such circumstances.
- tehwebguy 5y ago
  What are some of the options?
  - hn8788 5y ago
    Instead of having blanket lockdowns for everyone, reserve certain hours or days for at-risk people. A few of the stores near me, like Target and Wal-Mart, were closed from 7-9 am every day unless you were a senior citizen. That seems like a better solution than restaurants and non-essential stores being forced to close down 24/7. I went to a local mall a few days ago, and the amount of stores that went out of business because of the lockdowns is rediculous. I wouldn't be suprised if the whole mall has to close down soon, there's no way it's profitable to keep it running with 2-3 snack vendors and a couple of barber shops / nail salons being the major businesses left.
    - tehwebguy 5y ago
      Seems like this would just make it so there would be no hospital beds available for non-covid things no? Unless maybe Canada has a few times more hospitals / beds per capita than the US?
      - BadInformatics 5y ago
        It does not, and any discussion of whether certain public health measures should've been implemented should take that into consideration. Toronto-area hospitals were literally sending ICU patients to smaller cities because their own wards were overflowing. Moreover, attrition rates among clinicians (nurses especially) has been atrocious over the past year or so. People are only willing to put up with so much shit for so long, and most provincial systems have zero slack at the moment. That said, measures like GP described were/are in play in many cities. Seniors time was a fixture in the first few months of the pandemic, especially in smaller areas that did not experience a large caseload. That's another point too: I think a lot of HN commenters are unaware of just how fragmented and regional the Canadian healthcare system is. No two provinces implemented the same restrictions or policies at the same time, and only a couple put in strict stay-at-home style lockdowns. Note how the article mentions large increases in both Ontario (lax policies, then sudden strict lockdowns) with Alberta (very few restrictions). Even in Ontario, walking outside the biggest few cities would result in an immediate drop of most of the strict measures present in, say, the GTA. I know it's hard to capture this nuance discussing with strangers on some random online forum, but it's essential if we are to properly discuss cause and effect.
betwixthewires 5y ago
That's exactly what I was thinking, one way to get a estimate of this number would be to compare per capita infections and deaths with a country with somewhat similar demographics that had no real lockdown measures to see roughly how many lives were saved. The Netherlands comes to mind. Another way to do it would he to compare only the under 65 per capita infection rate in a similar country (could also be Netherlands) that had no lockdown and use the mortality rate for that demographic in the first country (which would be Canada in this case) and determine roughly how many lives were saved.
refurb 5y ago
Exactly. We created the TSA, Patriot Act and spent billions on wars in Iraq and Afghanistan. We can’t compare the costs to the deaths we’ve had from terrorism since (zero) we need to compare it to all the terrorism deaths that were prevented. See why that’s a bad argument?
logicchains 5y ago
It's also important to remember that scientifically it's unclear whether lockdowns even reduce covid mortality. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30208-X/fulltext#fig0002 https://www.thelancet.com/journals/eclinm/article/PIIS2589-5... found "full lockdowns and wide-spread COVID-19 testing were not associated with reductions in the number of critical cases or overall mortality."
dukeofdoom 5y ago
Since viruses tend to become less deadly overtime to the host. You have no idea if it was better to let COVID run, and people develop natural immunity. The delta variant in India is much more infectious, but also much less deadly to the population there. Exactly the change you expect a virus to make overtime, since killing the host tends to end the viruses ability to spread. Its turning into cold, or mild flue. This virus was only ever a real threat to the elderly, who still control most of the wealth, and vote in large numbers. What you're seeing is politics of self preservation of the eldest generation on the way out, at the expense the younger generations. Much like hoarding resources, they continue to quench to life. At some point younger people will rebel if this continues. The real threat is return to authoritarianism. It has killed tens of millions in the last century.

by gpm 5y ago

bsaul 5y ago

Unfortunately, I don’t think we have any definitive answer as to what those measures really did to prevent covid deaths, nor do i think will we ever (eg: the recent debate on sweden handling of covid)

lettergram 5y ago
I don’t think you can ever get anything definitive. But if you compare Norway, Denmark, Sweden and Finland. All in the same region, with very similar cultures, similar diets, similar language, etc etc You can see the difference clear enough to make inferences. There were a lot of people in the scientific community, Perhaps the majority, suggested Sweden’s method was superior to what many other countries were doing. The fact is, people are effectively believing what they want. There wouldn’t be a need for censorship if the truth was clear.
- angelzen 5y ago
  The clarity presupposes that 'cumulative covid deaths / million' is the ultimate measure of a society's worth and achievement. We are incredibly focused on this one metric, to the expense of literally everything else.
- benjaminwootton 5y ago
  You could compare the relative performance of US states for an even better comparator, eg Florida and Texas. I know they are in the news now, but they’ve been open all year and performed better than many more restricted states. Sweden is apparently much more dense in the cities, has larger cities, bigger migrant population etc so apparently making comparisons across Scandinavia isn’t as helpful as you would expect.
gpm 5y ago
I definitely don't think we have a definitive answer yet. I think one day you might be able to get a good definitiveish answer. For instance, you can assume that everyone gets covid in the "no measures" case, and extrapolate death rates using serosurveillance to get the portion of the population infected in reality. Once Covid is "over" you can see the number of people who died in reality. There will always be all sorts of errors in such an estimate. From bad data, to things like death rate depending on your assumptions about variants, vaccines, and the make up of the population. But once we get the "how we did in the end numbers" it's plausible that we can make some sort of comparison to "how we could have done".
benjaminwootton 5y ago
Indeed. Restrictions and deaths seem very loosely correlated. For the most part they delayed things, but there is surprisingly little evidence that the cure is better than the disease.

ummonk 5y ago

On the other hand the accurate comparison should be QALYs not deaths. Even leaving aside quality impacts, a 40 year old dying from lockdown-induced alcohol overdose loses far more life years than a 70 year old dying from no-lockdown COVID.

betwixthewires 5y ago
It is a good metric, but it comes off a bit callously, and if you're going to get into the weeds there you might need to consider that one persons years are not used as well as others by many metrics, so how do you calculate that? Income per year on average? Children reared? Discretionary spending as a judge to how well someone enjoyed their life? I'd say stopping at number of deaths is a better metric.
- wyager 5y ago
  QALY isn’t perfect (or even especially good), but it’s clearly better than number of deaths.
  - betwixthewires 5y ago
    If it's so clear why don't you draw a picture as to why.
    - wyager 5y ago
      Because saving someone who’s 95 years old and about to keel over isn’t, on expectation, as valuable as saving someone who’s 5 years old and has a whole life ahead of them.
- ummonk 5y ago
  If you think a 70 year old dying is anywhere near as bad as a 10 year old dying, I don't know what to say to you.

angelzen 5y ago

Very true. But at some point the public discourse and public health policy must consider tradeoffs. A. Lockdowns have costs. Deficits that will take decades to pay off. Lives lost to alcohol and depression. Economic hardship. A lost education year. Etc. B. The pandemic has vastly different risk profiles for different age groups. At an extreme, under 20s have 1/1000 fatality risk compared to over 70s. It is fundamentally faulty to design a blanket one size fits all policy under such circumstances.

tehwebguy 5y ago
What are some of the options?
- hn8788 5y ago
  Instead of having blanket lockdowns for everyone, reserve certain hours or days for at-risk people. A few of the stores near me, like Target and Wal-Mart, were closed from 7-9 am every day unless you were a senior citizen. That seems like a better solution than restaurants and non-essential stores being forced to close down 24/7. I went to a local mall a few days ago, and the amount of stores that went out of business because of the lockdowns is rediculous. I wouldn't be suprised if the whole mall has to close down soon, there's no way it's profitable to keep it running with 2-3 snack vendors and a couple of barber shops / nail salons being the major businesses left.
  - tehwebguy 5y ago
    Seems like this would just make it so there would be no hospital beds available for non-covid things no? Unless maybe Canada has a few times more hospitals / beds per capita than the US?
    - BadInformatics 5y ago
      It does not, and any discussion of whether certain public health measures should've been implemented should take that into consideration. Toronto-area hospitals were literally sending ICU patients to smaller cities because their own wards were overflowing. Moreover, attrition rates among clinicians (nurses especially) has been atrocious over the past year or so. People are only willing to put up with so much shit for so long, and most provincial systems have zero slack at the moment. That said, measures like GP described were/are in play in many cities. Seniors time was a fixture in the first few months of the pandemic, especially in smaller areas that did not experience a large caseload. That's another point too: I think a lot of HN commenters are unaware of just how fragmented and regional the Canadian healthcare system is. No two provinces implemented the same restrictions or policies at the same time, and only a couple put in strict stay-at-home style lockdowns. Note how the article mentions large increases in both Ontario (lax policies, then sudden strict lockdowns) with Alberta (very few restrictions). Even in Ontario, walking outside the biggest few cities would result in an immediate drop of most of the strict measures present in, say, the GTA. I know it's hard to capture this nuance discussing with strangers on some random online forum, but it's essential if we are to properly discuss cause and effect.

betwixthewires 5y ago

That's exactly what I was thinking, one way to get a estimate of this number would be to compare per capita infections and deaths with a country with somewhat similar demographics that had no real lockdown measures to see roughly how many lives were saved. The Netherlands comes to mind. Another way to do it would he to compare only the under 65 per capita infection rate in a similar country (could also be Netherlands) that had no lockdown and use the mortality rate for that demographic in the first country (which would be Canada in this case) and determine roughly how many lives were saved.

refurb 5y ago

Exactly. We created the TSA, Patriot Act and spent billions on wars in Iraq and Afghanistan. We can’t compare the costs to the deaths we’ve had from terrorism since (zero) we need to compare it to all the terrorism deaths that were prevented. See why that’s a bad argument?

logicchains 5y ago

It's also important to remember that scientifically it's unclear whether lockdowns even reduce covid mortality. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30208-X/fulltext#fig0002 https://www.thelancet.com/journals/eclinm/article/PIIS2589-5... found "full lockdowns and wide-spread COVID-19 testing were not associated with reductions in the number of critical cases or overall mortality."

dukeofdoom 5y ago

Since viruses tend to become less deadly overtime to the host. You have no idea if it was better to let COVID run, and people develop natural immunity. The delta variant in India is much more infectious, but also much less deadly to the population there. Exactly the change you expect a virus to make overtime, since killing the host tends to end the viruses ability to spread. Its turning into cold, or mild flue. This virus was only ever a real threat to the elderly, who still control most of the wealth, and vote in large numbers. What you're seeing is politics of self preservation of the eldest generation on the way out, at the expense the younger generations. Much like hoarding resources, they continue to quench to life. At some point younger people will rebel if this continues. The real threat is return to authoritarianism. It has killed tens of millions in the last century.