6 ms·

And lockdowns can cause mortality too. In England, the waiting list for operations (these are procedures that a doctor has determined are required medically, so

And lockdowns can cause mortality too. In England, the waiting list for operations (these are procedures that a doctor has determined are required medically, some are elective but England doesn't do many electives because of cost) is expected to hit 12m in a few years...the total adult population in England is 56m. Ignoring the economic turmoil that they cause, ignoring the social turmoil. There are no very good choices. But the high cost of lockdowns should dictate that they only be used when the alternative is extremely large numbers of people dying (at least in the UK, this was probably met at some point last year but hasn't been met for the majority of the Covid period).

Pyramus 5y ago
How many people is "extremely large" in your opinion? And who? Or to put it another way: Would you be okay to go, while we keep everything open? How about your parent, or grand-parent?
- jseban 5y ago
  Isn't this exactly what measuring excess mortality is for? But it's not reported anymore since there is none, and media has instead shifted to infection rate. If you were old and had little time left, and had a compromised immune system that made any slight infection possibly lethal, and you had the choice to close down society to lower your risk of infection, would you do it?
  - _djo_ 5y ago
    What? There has been significant excess mortality, as summarised here: https://www.economist.com/graphic-detail/coronavirus-excess-deaths-tracker https://www.economist.com/graphic-detail/coronavirus-excess-... My own country alone has seen nearly 300 000 excess deaths compared to the annual average, with the waves of excess deaths neatly tracking those of known COVID infection waves.
    - jseban 5y ago
      This is exactly the problem, you're using an absolute number without reference "look big number = scary" and you are simply comparing to an average, which doesn't say anything about whether or not this is an unusual or especially different situation. "The temperature outside is 2 degrees higher than average". Ok what conclusions can you draw from that? Very little. Just because you make a big scary number without reference, doesn't allow you to jump to a conclusion out of fear, it's just manipulative misleading misinterpretation to make it look as scary as possible, to disable people's critical thinking and support a point that actually doesn't have any basis.
      - _djo_ 5y ago
        No, I'm providing what you asked for: A measurement of excess deaths. That is, not just the number of people who died, but the number calculated to have died over and above the normal seasonal average. If those excess death calculations are perfectly acceptable to calculate the effect of bad flu seasons and other mortality-affecting events, why are they suddenly not okay now?
        jseban 5y ago
        Yeah like every other article they use a formula to calculate what is "excessive" which is not explained at all, and is used as the whole basis of the article. I took a peak in the github repo and I can't really read R well enough to make anything of it, but from a quick look and reading the article "take the number of people who die from any cause in a given region and period, and then compare it with a historical baseline from recent years" it could be a well defined prediction, or it could just be an average. It's unclear as the method section here is completely unknown, and I'm sceptical how you could ever calculate a fixed number prediction without obscuring the standard deviation. Why not just show standard deviation, median, average, percentile. Show the standard deviation in the graph.
        _djo_ 5y ago
        You know that's just an article providing an overview, right? It's not the official source of excess mortality statistics. For that, each country maintains an official group that has access to death certificates and other records when preparing statistics. The figure I quoted, for instance, is from the South African Medical Research Council, who publish their methodology. There's also EuroMOMO and many others. Did you really think that statisticians and scientists have just magically forgotten about how to do basic statistics, for decades, when preparing these reports?
  - dragonwriter 5y ago
    > Isn't this exactly what measuring excess mortality is for? But it's not reported anymore since there is none It isn't reported because it takes more explanation than the media likes to give, and direct COVID-19 death counts are less complicated, not because “there is none” which is just false: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.destatis.de/EN/Press/2021/10/PE21_481_12.html https://www.destatis.de/EN/Press/2021/10/PE21_481_12.html
    - jseban 5y ago
      Direct covid-19 deaths are irrelevant in relation to deciding about lockdowns, that's deliberately making an issue more complex than it is, in order to obscure it. If covid deaths are simply a proportion of expected death, which are not higher than usual, then there is no need for any measures at all.
      - dragonwriter 5y ago
        > expected death, which are not higher than usual Again, as stated in GP (with supporting data) in neither Germany (the context of the article) nor the US (the context and source of much of the political debate in the thread) is it true that actual deaths are not higher than expected from pre-pandemic experience.
- sdenton4 5y ago
  Replying to sibling: There's PLENTY of excess mortality: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm Summer of this year was close to normal again, though it is of course easy to imagine it wouldn't have been in a zero-restrictions scenario.
  - jseban 5y ago
    That doesn't say anything, it only counts death during one single year: 2020. And concludes that the death rate is excessive during the flu season, compared to not in the flu season. It expects death rate to be constant over the year, which is wrong. You need to take the total number of deaths per capita, for 2020, and compare that to the same number for 2019, 2018, 2017 etc. And look at the standard deviation.
    - sdenton4 5y ago
      What on earth are you looking at? The default view is US weekly excess deaths for 2018 through October 2021, and uses historical estimates from 2013 to present to estimate per-week thresholds: it's most certainly NOT using a single threshold per year. Go read the methodology section, please! You can clearly see bumps due to flu season in previous years, but because flu season happens every year since before 2013, this becomes a regular seasonal effect and don't show up as 'excess' except in late 2018. We also happen to know that flu was greatly suppressed by anti-Covid measures these last two years.
      - jseban 5y ago
        You are correct, I looked at it again, it's actually using historical data. But I'm still not sure what I'm looking at, overlaying a single year over an average is always going to look "excessive". I want to see previous years as well, why not just extend the graph? That's the one single most important number that you never get so see. Here they have buried it in a complex algorithm which looks honestly suspicious at first glance, upper bound for excessive death is basically the same as average. Is standard deviation really that low? EDIT: I just want to see how many people died per capita in 2020, 2019, 2018, 2017 and so forth, why is that not shown anywhere?
- hogFeast 5y ago
  I don't think you need to outline a number in advance (if you are familiar with the UK's response, one very big problem has been that forecasts of deaths has consistently undershot estimates even when England wasn't in lockdown and had no mask mandate). We had excess mortality around 10k/week in April, that probably did require a lockdown (to be clear though, if the govt had handled the care home situation better than maybe not necessary) but the bump in December last year was very minor. I am not sure what you mean by who...whoever gets Covid. Yes, no issues at all. I support lockdowns and have had relatives who became very ill because of lockdowns (delayed/ineffective hospital treatment, I am actually not well myself either for the same reason). I think trying to argue that someone should only support/oppose something because they have something to gain personally is the reason why politics in some countries is totally fucked (the UK is probably the worst for this, somewhere around 2017/18 most of the media became tabloids and every politics story contained some hyperbolic bullshit from some random person claiming their life would be destroyed by X minor policy change...it is just a waste of time and energy for all involved).
howinteresting 5y ago
I agree that the NHS is fucked, but that's because of: * COVID itself * its funding and delivery model making it vulnerable to politicians acting in bad faith far more than restrictions on gatherings. By the way, an "elective" surgery is one that can be scheduled in advance. Most elective surgeries are not optional. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/types-of-surgery https://www.hopkinsmedicine.org/health/treatment-tests-and-t...
- hogFeast 5y ago
  Right, and how do you explain what has happened in Scotland then? The SNP gave ample rope to the NHS, and they promptly hung themselves with it. I agree there are structural issues but those aren't separable from the funding issues. A few months ago, the Tories said the NHS was getting £20bn in extra funding, and journalists were being briefed by NHS lobbyists/BMA that weekend that it wasn't enough...at some point, the public has to recognise that the resources problem isn't separable from the structural problems. My comment about electives was for the US audience. The US does a huge amount of quality-of-life, elective surgeries that don't happen in the UK (i.e. giving an 85-year old a knee replacement). So when you write something like: the waiting list is long, people from the US might not understand that the mix of surgeries in the UK is very different from there, and it largely represents people who need prompt care (for example, I have a relative who is a high bowel cancer risk and needs a regular screen, in the US this would likely happen annually but hasn't happened for about three years now because they were overdue in early 2020 and then everything stopped).

Pyramus 5y ago

How many people is "extremely large" in your opinion? And who? Or to put it another way: Would you be okay to go, while we keep everything open? How about your parent, or grand-parent?

jseban 5y ago
Isn't this exactly what measuring excess mortality is for? But it's not reported anymore since there is none, and media has instead shifted to infection rate. If you were old and had little time left, and had a compromised immune system that made any slight infection possibly lethal, and you had the choice to close down society to lower your risk of infection, would you do it?
- _djo_ 5y ago
  What? There has been significant excess mortality, as summarised here: https://www.economist.com/graphic-detail/coronavirus-excess-deaths-tracker https://www.economist.com/graphic-detail/coronavirus-excess-... My own country alone has seen nearly 300 000 excess deaths compared to the annual average, with the waves of excess deaths neatly tracking those of known COVID infection waves.
  - jseban 5y ago
    This is exactly the problem, you're using an absolute number without reference "look big number = scary" and you are simply comparing to an average, which doesn't say anything about whether or not this is an unusual or especially different situation. "The temperature outside is 2 degrees higher than average". Ok what conclusions can you draw from that? Very little. Just because you make a big scary number without reference, doesn't allow you to jump to a conclusion out of fear, it's just manipulative misleading misinterpretation to make it look as scary as possible, to disable people's critical thinking and support a point that actually doesn't have any basis.
    - _djo_ 5y ago
      No, I'm providing what you asked for: A measurement of excess deaths. That is, not just the number of people who died, but the number calculated to have died over and above the normal seasonal average. If those excess death calculations are perfectly acceptable to calculate the effect of bad flu seasons and other mortality-affecting events, why are they suddenly not okay now?
      - jseban 5y ago
        Yeah like every other article they use a formula to calculate what is "excessive" which is not explained at all, and is used as the whole basis of the article. I took a peak in the github repo and I can't really read R well enough to make anything of it, but from a quick look and reading the article "take the number of people who die from any cause in a given region and period, and then compare it with a historical baseline from recent years" it could be a well defined prediction, or it could just be an average. It's unclear as the method section here is completely unknown, and I'm sceptical how you could ever calculate a fixed number prediction without obscuring the standard deviation. Why not just show standard deviation, median, average, percentile. Show the standard deviation in the graph.
        _djo_ 5y ago
        You know that's just an article providing an overview, right? It's not the official source of excess mortality statistics. For that, each country maintains an official group that has access to death certificates and other records when preparing statistics. The figure I quoted, for instance, is from the South African Medical Research Council, who publish their methodology. There's also EuroMOMO and many others. Did you really think that statisticians and scientists have just magically forgotten about how to do basic statistics, for decades, when preparing these reports?
- dragonwriter 5y ago
  > Isn't this exactly what measuring excess mortality is for? But it's not reported anymore since there is none It isn't reported because it takes more explanation than the media likes to give, and direct COVID-19 death counts are less complicated, not because “there is none” which is just false: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.destatis.de/EN/Press/2021/10/PE21_481_12.html https://www.destatis.de/EN/Press/2021/10/PE21_481_12.html
  - jseban 5y ago
    Direct covid-19 deaths are irrelevant in relation to deciding about lockdowns, that's deliberately making an issue more complex than it is, in order to obscure it. If covid deaths are simply a proportion of expected death, which are not higher than usual, then there is no need for any measures at all.
    - dragonwriter 5y ago
      > expected death, which are not higher than usual Again, as stated in GP (with supporting data) in neither Germany (the context of the article) nor the US (the context and source of much of the political debate in the thread) is it true that actual deaths are not higher than expected from pre-pandemic experience.
sdenton4 5y ago
Replying to sibling: There's PLENTY of excess mortality: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm Summer of this year was close to normal again, though it is of course easy to imagine it wouldn't have been in a zero-restrictions scenario.
- jseban 5y ago
  That doesn't say anything, it only counts death during one single year: 2020. And concludes that the death rate is excessive during the flu season, compared to not in the flu season. It expects death rate to be constant over the year, which is wrong. You need to take the total number of deaths per capita, for 2020, and compare that to the same number for 2019, 2018, 2017 etc. And look at the standard deviation.
  - sdenton4 5y ago
    What on earth are you looking at? The default view is US weekly excess deaths for 2018 through October 2021, and uses historical estimates from 2013 to present to estimate per-week thresholds: it's most certainly NOT using a single threshold per year. Go read the methodology section, please! You can clearly see bumps due to flu season in previous years, but because flu season happens every year since before 2013, this becomes a regular seasonal effect and don't show up as 'excess' except in late 2018. We also happen to know that flu was greatly suppressed by anti-Covid measures these last two years.
    - jseban 5y ago
      You are correct, I looked at it again, it's actually using historical data. But I'm still not sure what I'm looking at, overlaying a single year over an average is always going to look "excessive". I want to see previous years as well, why not just extend the graph? That's the one single most important number that you never get so see. Here they have buried it in a complex algorithm which looks honestly suspicious at first glance, upper bound for excessive death is basically the same as average. Is standard deviation really that low? EDIT: I just want to see how many people died per capita in 2020, 2019, 2018, 2017 and so forth, why is that not shown anywhere?
hogFeast 5y ago
I don't think you need to outline a number in advance (if you are familiar with the UK's response, one very big problem has been that forecasts of deaths has consistently undershot estimates even when England wasn't in lockdown and had no mask mandate). We had excess mortality around 10k/week in April, that probably did require a lockdown (to be clear though, if the govt had handled the care home situation better than maybe not necessary) but the bump in December last year was very minor. I am not sure what you mean by who...whoever gets Covid. Yes, no issues at all. I support lockdowns and have had relatives who became very ill because of lockdowns (delayed/ineffective hospital treatment, I am actually not well myself either for the same reason). I think trying to argue that someone should only support/oppose something because they have something to gain personally is the reason why politics in some countries is totally fucked (the UK is probably the worst for this, somewhere around 2017/18 most of the media became tabloids and every politics story contained some hyperbolic bullshit from some random person claiming their life would be destroyed by X minor policy change...it is just a waste of time and energy for all involved).

howinteresting 5y ago

I agree that the NHS is fucked, but that's because of: * COVID itself * its funding and delivery model making it vulnerable to politicians acting in bad faith far more than restrictions on gatherings. By the way, an "elective" surgery is one that can be scheduled in advance. Most elective surgeries are not optional. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/types-of-surgery https://www.hopkinsmedicine.org/health/treatment-tests-and-t...

hogFeast 5y ago
Right, and how do you explain what has happened in Scotland then? The SNP gave ample rope to the NHS, and they promptly hung themselves with it. I agree there are structural issues but those aren't separable from the funding issues. A few months ago, the Tories said the NHS was getting £20bn in extra funding, and journalists were being briefed by NHS lobbyists/BMA that weekend that it wasn't enough...at some point, the public has to recognise that the resources problem isn't separable from the structural problems. My comment about electives was for the US audience. The US does a huge amount of quality-of-life, elective surgeries that don't happen in the UK (i.e. giving an 85-year old a knee replacement). So when you write something like: the waiting list is long, people from the US might not understand that the mix of surgeries in the UK is very different from there, and it largely represents people who need prompt care (for example, I have a relative who is a high bowel cancer risk and needs a regular screen, in the US this would likely happen annually but hasn't happened for about three years now because they were overdue in early 2020 and then everything stopped).