3 ms·

>The most obvious confounding factor is of course that as covid rates rise, people are more likely to wear a mask. Another confounding factor is that the West

>The most obvious confounding factor is of course that as covid rates rise, people are more likely to wear a mask. Another confounding factor is that the West has many densely populated cities AND good record-keeping regarding mortality. As you get into poorer and poorer countries, you must also take into account the likelihood of error in their mortality statistics. You must also consider that those who are less likely to wear a mask (even with a mandate) may also be otherwise more likely to contract and spread covid in the first place, and as long as there is a sufficiently large network of those people for the virus to operate in, mask mandates may make no overall difference in the mortality even if it were 100% effective in preventing death. Ie, if the virus was always primarily circulating among people unlikely to wear a mask, a mask mandate would make little difference. Mask mandates affect public behavior, but it may very well be that what people do in private is much more significant for transmission.

VancouverMan 4y ago
We shouldn't rush to trust the numbers from Western nations. Consider the counting approach used in Toronto, which is Canada's most populous city, and the fourth most populous city in North America. According to Toronto Public Health: "Individuals who have died with COVID-19, but not as a result of COVID-19 are included in the case counts for COVID-19 deaths in Toronto." https://twitter.com/TOPublicHealth/status/1275888390060285967 https://twitter.com/TOPublicHealth/status/127588839006028596... That seems like a fundamentally flawed counting approach to me. Suppose a person is infected, but he's showing no symptoms, and doesn't even realize he's infected. He feels just fine, and goes for a long-distance bike ride. Near the end of it, he's hit by a transport truck that runs a red light, and he suffers severe head injuries. He's taken to the hospital, where he is tested as a precaution, and his test returns a positive result. Due to the severity of his head injuries, he dies a few hours later. If that happened in Toronto, then he'd apparently be counted as a "COVID-19 death", despite the infection having absolutely nothing to do with his death. Of course, that's just one of many ways that somebody infected could die in a way that has absolutely nothing to do with an infection. Any count that includes things completely unrelated to that which are meant to be counted is a count that shouldn't be trusted.
- panarky 4y ago
  > Suppose a person is infected, but he's showing no symptoms, and doesn't even realize he's infected ... hit by a transport truck It's easy to invent a scenario that wouldn't get counted correctly. Here's one that wouldn't get counted correctly with your method: "Suppose a person is hospitalized for diabetes and would have a 95% chance of surviving, except that she also has covid which reduces her survival probability to 40%." There are two or three orders of magnitude more hospitalizations for [diabetes + covid] than [massive head trauma when hit by a truck + covid]. So maybe we should use the counting method that is least inaccurate overall, and not try to optimize for rare events?
- vannevar 4y ago
  In this case, a systematic error wouldn't change the conclusion as long as the same method was used for all countries. As for the broader argument about people dying with COVID vs people dying of COVID, the excess mortality rates are consistent with the assumption that the reported death rate from COVID in Western nations is pretty accurate, and may even undercount the true figure (see e.g. https://www.nature.com/articles/d41586-022-00104-8 https://www.nature.com/articles/d41586-022-00104-8).
- lamontcg 4y ago
  Suppose a person is your average overweight middle aged sedentary American and they die of a stroke and happen to test positive for the virus. There's a pretty good chance they died of COVID-19-associated immune thrombocytopenia, even though they may not have been symptomatic when they died. A lot of those cardiac events are going to go uncounted if a country isn't testing for the virus, or isn't attributing CVAs to the virus when the person didn't really have any respiratory complications / pneumonia.

VancouverMan 4y ago

We shouldn't rush to trust the numbers from Western nations. Consider the counting approach used in Toronto, which is Canada's most populous city, and the fourth most populous city in North America. According to Toronto Public Health: "Individuals who have died with COVID-19, but not as a result of COVID-19 are included in the case counts for COVID-19 deaths in Toronto." https://twitter.com/TOPublicHealth/status/1275888390060285967 https://twitter.com/TOPublicHealth/status/127588839006028596... That seems like a fundamentally flawed counting approach to me. Suppose a person is infected, but he's showing no symptoms, and doesn't even realize he's infected. He feels just fine, and goes for a long-distance bike ride. Near the end of it, he's hit by a transport truck that runs a red light, and he suffers severe head injuries. He's taken to the hospital, where he is tested as a precaution, and his test returns a positive result. Due to the severity of his head injuries, he dies a few hours later. If that happened in Toronto, then he'd apparently be counted as a "COVID-19 death", despite the infection having absolutely nothing to do with his death. Of course, that's just one of many ways that somebody infected could die in a way that has absolutely nothing to do with an infection. Any count that includes things completely unrelated to that which are meant to be counted is a count that shouldn't be trusted.

panarky 4y ago
> Suppose a person is infected, but he's showing no symptoms, and doesn't even realize he's infected ... hit by a transport truck It's easy to invent a scenario that wouldn't get counted correctly. Here's one that wouldn't get counted correctly with your method: "Suppose a person is hospitalized for diabetes and would have a 95% chance of surviving, except that she also has covid which reduces her survival probability to 40%." There are two or three orders of magnitude more hospitalizations for [diabetes + covid] than [massive head trauma when hit by a truck + covid]. So maybe we should use the counting method that is least inaccurate overall, and not try to optimize for rare events?
vannevar 4y ago
In this case, a systematic error wouldn't change the conclusion as long as the same method was used for all countries. As for the broader argument about people dying with COVID vs people dying of COVID, the excess mortality rates are consistent with the assumption that the reported death rate from COVID in Western nations is pretty accurate, and may even undercount the true figure (see e.g. https://www.nature.com/articles/d41586-022-00104-8 https://www.nature.com/articles/d41586-022-00104-8).
lamontcg 4y ago
Suppose a person is your average overweight middle aged sedentary American and they die of a stroke and happen to test positive for the virus. There's a pretty good chance they died of COVID-19-associated immune thrombocytopenia, even though they may not have been symptomatic when they died. A lot of those cardiac events are going to go uncounted if a country isn't testing for the virus, or isn't attributing CVAs to the virus when the person didn't really have any respiratory complications / pneumonia.