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> San Francisco has had less than 1/3 as many deaths per capita as the US national average... What do you believe this comparison means? I'm not sure its sayi

> San Francisco has had less than 1/3 as many deaths per capita as the US national average... What do you believe this comparison means? I'm not sure its saying much of anything. Perhaps you could come up with another similar sized city, with same socioeconomic/population-type makeup, with same latitude and seasonality profile to compare against? I'm not familiar with SF data sources on this, but I'm curious if you can provide a source for current IFR? My state here in southeast US's IFR is .012. That includes people who died in car accidents, of poisonings, of falls and other injurious actions while having tested positive for COV in last 28 days. My county is comprised of mostly older folks (median age 44), small at 186K people, and we haven't had a COV death registered in the last 11 months. >We can compare e.g. Sweden to other Nordic countries to see what an abysmal failure the Swedish “herd immunity” strategy turned out to be. Can you show some data sources for this? Everything I'm seeing is pointing to Sweden's last 2 flu seasons (encompassing COVID years) showing the same or lower all cause mortality than their previous 15-20 years. With 2018 being the major outlier not just in Sweden but all around the world, for which we still have no explanation.

jacobolus 5y ago
San Francisco has done significantly better than any other city in the continental USA, despite being one of the most internationally connected, transit dependent, and densely populated. Honolulu is the only similarly successful large US city. > IFR is .012 Do you mean CFR (case fatality rate)? IFR (infection fatality rate) is always only speculative, because we don’t ever have complete knowledge of the number of infections. In total throughout the pandemic SF has had ~670 Covid deaths and ~54,000 confirmed Covid cases for a population of ~880,000. For the same population, the USA average would be ~2090 deaths and ~110,000 confirmed cases. Except those are both dramatic underestimates of the relative numbers because SF has consistently had a much lower percentage of positive tests, and hasn’t had anywhere near the US gap between confirmed Covid deaths and total excess deaths.
- native_samples 5y ago
  0.012 would be too low to be a CFR. That roughly the right number for COVID IFR (maybe a bit too low), which can be calculated in ways that make it less speculative e.g. sero-surveys. Even so CFR is also speculative because so many cases aren't reported: that's the reason IFR exists as a separate concept. In science you're really meant to use all the data because the problem with this sort of cherry-picking is that it can go both ways. Florida removed all its restrictions and was predicted to become a bloodbath just like they predicted that for Sweden. It didn't happen, results appear to have been unaffected by the changes. Studies that look at all the data find no correlations between lockdowns and COVID mortality (but lots of correlations with other bad problems).
  - daddylongstroke 5y ago
    This is the correct take. At this point, since we've already vaccinated the only control groups we had in the trials, we no longer can draw valuable conclusions. The only statistic that we should now rely on, in order to account for all positives and negatives from government's COVID response (vaccinations, lockdowns, hysterics and tantrums) is year-over-year (preferably flu season) all cause mortality, in a specific location, for a specific population.
  - jacobolus 5y ago
    > 0.012 would be too low to be a CFR. 0.012 is the San Francisco CFR. 0.016 is the USA CFR, if we go by confirmed cases/deaths as reported by the New York Times. The IFR should be substantially lower than either of these; many deaths go uncounted, but a far larger proportion of infections never get a confirmed positive test. I would guess IFR to be in the 0.004–0.008 range. (Which is still scary high!) I’m sure if you do a search of the academic literature you can find more careful analysis and better informed estimates. It obviously varies from place to place and is substantially dependent on demographics and availability of medical care. * * * Florida was a bloodbath! It has had among the worst outcomes anywhere in the USA since mid 2021. Tens of thousands of avoidable deaths after the universal free availability of extremely effective vaccines and better understanding of viral transmission. The state government not only stopped any state-level public health action, it actively prevented state/local public health departments and local governments from acting. It is hard to imagine a more complete failure of state leadership. Florida has had something like 4x more Covid deaths than San Francisco, per capita. And if we only look at deaths after widespread vaccine availability, Florida has had >10x more. Of course, the virus eventually burned through a large majority of the unvaccinated population, and without enough remaining hosts to infect, flamed out. Fingers crossed that future virus variants don’t have enough immune escape to burn back through the state again.
- daddylongstroke 5y ago
  I do mean IFR. I hope you understand that the CFR numbers you're quoting, are also speculative estimates. :-) Almost certainly the number of infections is vastly undercounted as recognized by CDC's footnotes on their Data Tracker. As of middle of last year, the CDC estimates that 45-55% of all Americans had been infected with COVID.
  - deleted 5y ago
    [deleted]
  - jacobolus 5y ago
    > CDC estimates that 45-55% of all Americans had been infected with COVID. If we take 330 million people as an estimated US population, an IFR of 0.012 and 0.44 of everyone infected (CDC estimate from 1 October), that would be 1.74 million deaths. But the number of Covid deaths in the USA is probably only around 1 million (CDC estimate is 920 thousand as of 1 October), putting the US IFR at ~0.006. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burden.html https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd... I’d estimate a US IFR somewhere in the 0.004–0.008 range. We missed counting a significant number of Covid deaths, but we didn’t miss 60% of them. (In US counties with the highest proportion of elderly people, the IFR might locally be closer to 0.012.) But that is still a very high IFR! Covid is a scary, scary disease. Deadly, highly contagious even before symptoms, and indistinguishable from common respiratory diseases during the part of the infection when most spread happens. Fortunately we have extremely effective vaccines (if only we can convince everyone to take them), and spread takes place almost always between unmasked people indoors making it relatively inexpensive to dramatically reduce the reproductive rate of the virus by avoiding indoor spaces and wearing masks when they are inevitable.
    - daddylongstroke 5y ago
      > In US counties with the highest proportion of elderly people, the IFR might locally be closer to 0.012.) Yes, I do live in one of these older counties and specifically in my region of the county. Obviously words such as 'scary' are useless and subjective. Anti-biotic-resistant strep nearly killed me 3 years back, so to me, that was a scary disease. The COVID I had was milder than my yearly flu, and this is effect on the overwhelming majority of the population even considering the obesity rate in the US. Scary is not the word I would use. > But that is still a very high IFR! I mean, perspective is everything. What are you comparing this IFR to? I consider this a very low IFR, especially when you realize what we in the US classify a "COVID death". We do not count deaths of any other diseases using the same methodology as we have with COVID as far as I'm aware, and I believe this is the primary reason for our inflated mortality vs. most of the rest of the world.

jacobolus 5y ago

San Francisco has done significantly better than any other city in the continental USA, despite being one of the most internationally connected, transit dependent, and densely populated. Honolulu is the only similarly successful large US city. > IFR is .012 Do you mean CFR (case fatality rate)? IFR (infection fatality rate) is always only speculative, because we don’t ever have complete knowledge of the number of infections. In total throughout the pandemic SF has had ~670 Covid deaths and ~54,000 confirmed Covid cases for a population of ~880,000. For the same population, the USA average would be ~2090 deaths and ~110,000 confirmed cases. Except those are both dramatic underestimates of the relative numbers because SF has consistently had a much lower percentage of positive tests, and hasn’t had anywhere near the US gap between confirmed Covid deaths and total excess deaths.

native_samples 5y ago
0.012 would be too low to be a CFR. That roughly the right number for COVID IFR (maybe a bit too low), which can be calculated in ways that make it less speculative e.g. sero-surveys. Even so CFR is also speculative because so many cases aren't reported: that's the reason IFR exists as a separate concept. In science you're really meant to use all the data because the problem with this sort of cherry-picking is that it can go both ways. Florida removed all its restrictions and was predicted to become a bloodbath just like they predicted that for Sweden. It didn't happen, results appear to have been unaffected by the changes. Studies that look at all the data find no correlations between lockdowns and COVID mortality (but lots of correlations with other bad problems).
- daddylongstroke 5y ago
  This is the correct take. At this point, since we've already vaccinated the only control groups we had in the trials, we no longer can draw valuable conclusions. The only statistic that we should now rely on, in order to account for all positives and negatives from government's COVID response (vaccinations, lockdowns, hysterics and tantrums) is year-over-year (preferably flu season) all cause mortality, in a specific location, for a specific population.
- jacobolus 5y ago
  > 0.012 would be too low to be a CFR. 0.012 is the San Francisco CFR. 0.016 is the USA CFR, if we go by confirmed cases/deaths as reported by the New York Times. The IFR should be substantially lower than either of these; many deaths go uncounted, but a far larger proportion of infections never get a confirmed positive test. I would guess IFR to be in the 0.004–0.008 range. (Which is still scary high!) I’m sure if you do a search of the academic literature you can find more careful analysis and better informed estimates. It obviously varies from place to place and is substantially dependent on demographics and availability of medical care. * * * Florida was a bloodbath! It has had among the worst outcomes anywhere in the USA since mid 2021. Tens of thousands of avoidable deaths after the universal free availability of extremely effective vaccines and better understanding of viral transmission. The state government not only stopped any state-level public health action, it actively prevented state/local public health departments and local governments from acting. It is hard to imagine a more complete failure of state leadership. Florida has had something like 4x more Covid deaths than San Francisco, per capita. And if we only look at deaths after widespread vaccine availability, Florida has had >10x more. Of course, the virus eventually burned through a large majority of the unvaccinated population, and without enough remaining hosts to infect, flamed out. Fingers crossed that future virus variants don’t have enough immune escape to burn back through the state again.
daddylongstroke 5y ago
I do mean IFR. I hope you understand that the CFR numbers you're quoting, are also speculative estimates. :-) Almost certainly the number of infections is vastly undercounted as recognized by CDC's footnotes on their Data Tracker. As of middle of last year, the CDC estimates that 45-55% of all Americans had been infected with COVID.
- deleted 5y ago
  [deleted]
- jacobolus 5y ago
  > CDC estimates that 45-55% of all Americans had been infected with COVID. If we take 330 million people as an estimated US population, an IFR of 0.012 and 0.44 of everyone infected (CDC estimate from 1 October), that would be 1.74 million deaths. But the number of Covid deaths in the USA is probably only around 1 million (CDC estimate is 920 thousand as of 1 October), putting the US IFR at ~0.006. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burden.html https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd... I’d estimate a US IFR somewhere in the 0.004–0.008 range. We missed counting a significant number of Covid deaths, but we didn’t miss 60% of them. (In US counties with the highest proportion of elderly people, the IFR might locally be closer to 0.012.) But that is still a very high IFR! Covid is a scary, scary disease. Deadly, highly contagious even before symptoms, and indistinguishable from common respiratory diseases during the part of the infection when most spread happens. Fortunately we have extremely effective vaccines (if only we can convince everyone to take them), and spread takes place almost always between unmasked people indoors making it relatively inexpensive to dramatically reduce the reproductive rate of the virus by avoiding indoor spaces and wearing masks when they are inevitable.
  - daddylongstroke 5y ago
    > In US counties with the highest proportion of elderly people, the IFR might locally be closer to 0.012.) Yes, I do live in one of these older counties and specifically in my region of the county. Obviously words such as 'scary' are useless and subjective. Anti-biotic-resistant strep nearly killed me 3 years back, so to me, that was a scary disease. The COVID I had was milder than my yearly flu, and this is effect on the overwhelming majority of the population even considering the obesity rate in the US. Scary is not the word I would use. > But that is still a very high IFR! I mean, perspective is everything. What are you comparing this IFR to? I consider this a very low IFR, especially when you realize what we in the US classify a "COVID death". We do not count deaths of any other diseases using the same methodology as we have with COVID as far as I'm aware, and I believe this is the primary reason for our inflated mortality vs. most of the rest of the world.